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HomeMy WebLinkAboutC13-114 CO Department of Public Health and Environment • EAGLE COUNTY HEALTH AND HUMAN SERVICES i Statement of Work TB Program Contracts and Purchase Orders Scope of Work for Eagle County Public Health Agency July 1, 2013 through June 30 2017 These provisions are to be read and interpreted in conjunction with the provision of the Task Order Contract specified above. I. Project Description: Funds provided under the Task Order are to assist in supporting tuberculosis (TB) prevention and control activities as stated in Colorado Revised Statues (CRS) 25 -4 -501 -Part 5 Tuberculosis (et seq) and Rules and Regulations Pertaining to Epidemic and Communicable Disease Control (6 -CCR- 1009 -1, Regulation 4). Contractor will provide or coordinate the following services for all individuals within its service area according to the statutes and regulations listed above and according to Colorado Department of Public Health and Environment (CDPHE) Tuberculosis Manual, but in no event less than those duties required by statute and rules (listed above). Use of funds will be prioritized as follows: priority 1) finding all patients with active TB and ensuring completion of appropriate therapy, priority 2) finding and evaluating contacts of TB patients and ensuring completion of appropriate therapy, 3) evaluation of newly arrived immigrants and refugees with Class B TB designation, and priority 4) targeted testing of high -risk persons and ensuring completion of therapy for latent TB infection (LTBI). If available, use patient's medical insurance as primary payment source. CDPHE will reimburse for diagnostic and clinical services at current Medicaid rate unless prior approval has been given by the CDPHE TB Program. II. Performance Requirements/Deliverables 1. Suspected or confirmed active TB a. The Contractor will provide, or arrange for, chest x -rays and interpretations. b. The Contractor will collect, or arrange for the collection of, specimens for mycobacteriology testing on all persons suspected of having TB. Assure appropriate testing is performed, e.g., smears for acid - fast bacilli, (using concentrated fluorescent method), isolation of mycobacteria (using rapid methods), identification of Mycobacterium tuberculosis complex (MTB) (using rapid methods), and susceptibility testing (isoniazid, rifampin, ethambutol, and pyrazinamide) on isolates of MTB. Contractor should use the CDPHE Laboratory for testing. The CDPHE Laboratory will, at no charge to the Contractor, supply specimen containers and perform the above testing for the Contractor. The Contractor will arrange for the transportation of the specimens to the CDPHE Laboratory for testing. c. The Contractor will provide, or arrange for, the placement of patients who require isolation. The Contractor will contact CDPHE TB Program for assistance, if needed, and to request reimbursement from CDPHE for those costs incurred by the Contractor in isolating a patient. d. The Contractor will provide, or arrange for, all other necessary laboratory testing and medical evaluation services. 551 Broadway P.O. Box 660 1 Eagle, CO 81631 1 970.328 8840 A "//x2 ?3 //U//?, �:3 ;a 3'.'•di3••a• ..., < x «2[ „a,k4 'a - - - -: ASS S 3t L 1'X f4 -0 i„ O/�410i0 4 - , ,M , :.. . ow E.$ 5` mianzazoiA ..�: ,: � -; BEY l y � � i � 3 � j � �* �� 3 r e. The Contractor will order TB medications through the CDPHE TB Program. f. The Contractor will provide CDPHE with the medical insurance information for those patients who have medical insurance. g. The Contractor will provide, or arrange for, the treatment of patients with suspected or confirmed active TB, including directly observed therapy (DOT), and ensure adherence to treatment. h. The Contractor will provide, or arrange for, a HIV antibody test for all persons diagnosed with TB disease, regardless of their age or the apparent absence of risk factors for HIV infection. In accordance with section 25 -4 -1401, et seq., C.R.S., as amended, the Contractor will report all known HIV antibody test results to the CDPHE. The Contractor will inform those individuals whom refuse testing of the risks associated with HIV /TB co- infection. i. At least monthly, the Contractor will monitor and evaluate those persons with suspected or confirmed active TB. j. The Contractor will monitor and evaluate those persons with LTBI at least monthly. k. The Contractor will increase the proportion of persons that complete LTBI treatment to meet the state objective of 80% by 2015 and maintain or improve on that rate thereafter. 1. The Contractor will provide culturally appropriate patient education and information pertaining to TB treatment and /or follow -up plan. The Contractor will provide services in patient's language using medical interpretation resources such as AT &T language line as needed. m. All reports of suspected or confirmed active TB disease will include: reason for initiating, patient name, date of birth, country of birth, date arrived in U.S., demographic information, locating information, provider information, TB risk factors, results of diagnostic testing, results of mycobacteriology including susceptibility results, dates of infectious period, treatment information, changes in patients' status, diagnosis, or any other information as appropriate. The Contractor will report to CDPHE when a TB patient completes treatment, moves, or transfers out of the Contractor's service area. Information may be reported via web -based TB case /contact management system (TBdb) or via "Tuberculosis Surveillance and Case Management Report" (TB 17), which is incorporated herein by this reference, made a part hereof, and attached hereto as "Attachment B -1 ". Confirmed cases of TB will include all data elements identified in the "Report of Verified Case of Tuberculosis (RVCT) ", which is incorporated herein by this reference, made a part hereof, and attached hereto as "Attachment B -2 ". The CDPHE shall provide the format and instructions for any additional information requests. Report forms are subject to revision and Contractor agrees to use most recent version. 2. Contacts to newly identified infectious TB (smear and /or culture positive pulmonary or laryngeal) a. The Contractor will ensure that all contacts to newly identified infectious TB cases are identified, investigated, and receive appropriate evaluation. Contact investigation and any follow -up needed as a result of an occupational exposure shall be conducted by the local Health Department. p y epartment. b. When indicated, the Contractor will provide, or arrange for, chest x -rays and interpretations for all such contacts. c. When indicated, the Contractor will provide, or arrange for, other laboratory testing, and other necessary medical evaluation services for all such contacts. d. The Contractor will provide, or arrange for, the treatment of patient (including directly observed preventive therapy (DOT) when appropriate), and ensure the completion of therapy for infected contacts. e. The Contractor will order TB medications through the CDPHE TB Program for all such contacts. f. The Contractor will provide CDPHE with the medical insurance information for those patients that have medical insurance. g. The Contractor will provide, or arrange for, an HIV antibody test to all persons with LTBI with HIV risk factors or from an HIV endemic area. In accordance with section 25 -4 -1401, et seq., C.R.S., as amended, the Contractor will report all known HIV antibody test results to the State. The Contractor will inform all individuals whom refuse testing of the risks associated with HIV /TB co- infection. h. At least monthly, the Contractor will monitor and evaluate persons with LTBI during treatment for all such contacts. i. The Contractor will provide culturally appropriate patient education and information pertaining to LTBI treatment and /or follow -up plan. The Contractor will provide services in patient's language using medical interpretation resources such as AT &T language line as needed. j. The Contractor will submit a preliminary Tuberculosis Contact Investigation Record, (which is incorporated herein by this reference, made a part hereof, and attached hereto as "Attachment B -3" to the CDPHE TB Program after initiation of each contact investigation. The Contractor will submit a final report to CDPHE when a contact investigation is completed. Report forms are subject to revision and Contractor agrees to use most recent version. k. For those persons identified, as part of a contact investigation, with latent TB infection, or those with suspected latent TB infection requiring treatment recommendations from CDPHE, the Contractor will report reason for initiating, patient name, date of birth, country of birth, date arrived in U.S., demographic information, locating information, provider information, TB risk factors, results of diagnostic testing, treatment information, or any other information as appropriate. The Contractor will report to CDPHE when a patient completes treatment, moves, or transfers out of the Contractor's service area. Information may be reported via web -based TB case /contact management system (TBdb) or via "Tuberculosis Surveillance and Case Management Report" (TB 17). CDPHE shall provide format and instructions for any additional information requests. Report forms are subject to revision and contractor agrees to use the most recent version. 3. Newly arrived immigrants and refugees with Class B TB designation a. The CDPHE TB Program will notify the Contractor of all newly arrived Class B TB immigrants /refugees via a CDC 75.17 form which is incorporated herein by this reference, made a part hereof, attached hereto as "Attachment B -4" or Follow -up worksheet which is incorporated herein by this reference, made a part hereof, attached hereto as "Attachment B -5 ". Report forms are subject to revision and contractor agrees to use most recent version. b. Within thirty (30) calendar days of the Contractor's receipt of written notification from the State of the arrival of a Class B immigrant /refugee, the Contractor will contact that immigrant and conduct, or arrange for, a TB screening that includes medical evaluation, tuberculin skin test or whole blood interferon y assay, chest radiograph, and three spontaneous sputum specimens for AFB smear and culture collected on consecutive days. c. Upon completion of testing and examination, the Contractor will fill out, sign, and date the CDC 75.17 form or Follow -up worksheet, and return it within 90 days to: Colorado Department of Public Health and Environment Tuberculosis Program Attn: Class B Coordinator 4300 Cherry Creek Drive South Denver, CO 80246 d. The Contractor will, when indicated, provide, or arrange for, treatment and ensure completion of therapy. e. The Contractor will order TB medications through the CDPHE TB Program. f. The Contractor will provide CDPHE with the medical insurance information for those patients that have medical insurance. g. The Contractor will provide culturally appropriate patient education and information pertaining to LTBI treatment and/or follow -up plan. The Contractor will provide services in patient's language using medical interpretation resources such as AT &T language line as needed. h. For those persons identified with LTBI or active TB, the Contractor will report patient name, date of birth, country of birth, date arrived in U.S., demographic information, locating information, provider information, TB risk factors, results of diagnostic testing, treatment information, or any other information as appropriate. Contractor will report when a patient completes treatment, moves, or transfers out of the jurisdiction. Information may be reported via web -based TB case /contact management system (TBdb) or via "Tuberculosis Surveillance and Case Management Report" (TB 17). CDPHE shall provide format and instructions for any additional information requests. Report forms are subject to revision and Contractor agrees to use most recent version. 4. Other high -risk persons with LTBI a. When indicated, the Contractor will provide, or arrange for, chest x -rays and interpretations. b. When indicated, the Contractor will provide, or arrange for, all other necessary laboratory testing and medical evaluation services. c. The Contractor will provide, or arrange for, the treatment of patient and ensure the completion of therapy. d. The Contractor will order TB medications through the CDPHE TB Program. e. The Contractor will provide the CDPHE with the medical insurance information for those patients that have medical insurance. f. The Contractor will provide, or arrange for, a HIV antibody test to all persons with LTBI with HIV risk factors or from an HIV endemic area. In accordance with section 25 -4 -1401, et seq., C.R.S., as amended, the Contractor will report all known HIV antibody test results to the CDPHE. The Contractor will inform those individuals whom refuse testing of the risks associated with HIV /TB co- infection. g. At least monthly, the Contractor will monitor and evaluate persons with LTBI during treatment. h. The Contractor will provide culturally appropriate patient education and information pertaining to LTBI treatment and /or follow -up plan. The Contractor will provide services in patient's language using medical interpretation resources such as AT &T language line as needed. i. For persons with LTBI, the Contractor will report reason for initiating, patient name, date of birth, country of birth, date arrived in U.S., demographic information, locating information, provider information, TB risk factors, results of diagnostic testing, treatment information, or any other information as appropriate. Contractor will report when a LTBI patient completes treatment, moves, or transfers out of the jurisdiction. Information may be reported via web -based TB case /contact management system (TBdb) or via "Tuberculosis Surveillance and Case Management Report" (TB 17). The CDPHE shall provide format and instructions for any additional information requests. Report forms are subject to revision and Contractor agrees to use most recent version. j. Tuberculin skin testing, chest radiographs, chest radiograph interpretations, other diagnostic testing, and medical evaluations are not eligible for reimbursement under this Task Order for the following: i. Correctional facility inmates; ii. Persons, other than Class B TB immigrants /refugees, undergoing immigration medical examinations; iii. Paid or volunteer employees of health care facilities, long -term care facilities, drug treatment centers, correctional facilities, shelters, schools, or child care facilities that undergo skin testing as part of a routine employment skin testing program. 5. TB education and consultation As needed, the Contractor will provide consultation services to providers in its service area regarding TB reporting, screening, treatment, and follow -up. 6. Reports for contract monitoring The Contractor will provide CDPHE with a Tuberculosis Semi - Annual Progress Report on TB activities in its service area. This applies to Contracts, not Purchase Orders. A sample of the Tuberculosis Semi - Annual Progress Report is incorporated herein by this reference, made part hereof, and attached hereto as "Attachment B -6 ". Report forms are subject to revision and contractor agrees to use most recent version or submit a similar type of report. The Contractor will submit report within two months after funding period ends. 7. Confidentiality The Contractor will maintain internal medical and administrative records in a manner which ensures the confidentiality and security of those records in accordance with all applicable statutes including, but not limited to, 25 -1 -107, C.R.S., as amended. I. Invoicing To receive compensation under this Contract or Purchase Order, the Contractor will submit a signed CDPHE Reimbursement Invoice Form. This form is accessible from the CDPHE internet website http: / /www.cdphe. state. co. us /StandardizedInvoice /index.html CDPHE shall provide technical assistance in accessing and completing the form. The CDPHE Reimbursement Invoice Form must be submitted within sixty (60) calendar days of the end of the billing period for which services were rendered. Expenditures will be in accordance with the Statement of Work and attached Budget. Tuberculin skin testing, chest x -rays, and chest x -ray interpretations are not eligible for reimbursement under this Contact or Purchase Order for the following: i. correctional facility inmates; ii. Persons other than Class A or B TB immigrants undergoing medical examinations; iii. Paid or volunteer employees of health care facilities, long -term care facilities, drug treatment centers, correctional facilities, shelters, schools, or child care facilities that undergo skin testing as part of a routine employment skin testing program. Submit completed CDPHE Reimbursement Invoice Form: Mail: Pete Dupree, Assistant TB Program Manager Colorado Department of Public Health and Environment DCEED-A3 -TB 4300 Cherry Creek Drive South Denver, Colorado 80246 -or- Fax: (303) 759 - 5538 - Attention: Pete Dupree -or- Email: peter.dupree @state.co.us To be considered for payment, billings for payments pursuant to this Contract or Purchase Order must be received within a reasonable time after the period for which payment is requested, but in no event no later than sixty (60) calendar days after the relevant performance period has passed. Final billings under this Contract or Purchase Order must be received by the State within a reasonable time after the expiration or termination of this Contract or Purchase Order; but in no event no later than sixty (60) calendar days from the effective expiration or termination date of this Purchase Order. Unless otherwise provided for in this Contract or Purchase Order, "Local Match ", if any, will be included on all invoices as required by funding source. The Contractor will not use federal funds to satisfy federal cost sharing and matching requirements unless approved in writing by the appropriate federal agency. II. Monitoring CDPHE's monitoring of this Contract or Purchase Order for compliance with performance requirements will be conducted throughout the contract period by the TB Program's Assistant Manager. Methods used will include review of documentation reflective of performance including progress reports, site visits, and review of electronic data. The performance of Contracts (not Purchase Orders) shall be evaluated at quarterly intervals and communicated to the Contractor. A Final Contractor Performance Evaluation will be conducted at the end of the life of the contract. III. Remedies for issues of non - compliance The contractor shall be notified by email within 14 calendar days of discovery of a compliance issue. Within thirty (30) calendar days of discovery, the Contractor and CDPHE will collaborate, when appropriate, to determine the action(s) necessary to rectify the compliance issue and determine when the action(s) must be completed. The action(s) and time line for completion will be documented by email and agreed to by both parties. If extenuating circumstances arise that requires an extension to the time line, the Contractor must email a request to the Assistant TB Program Manager and receive approval for a new due date. CDPHE will oversee the completion/implementation of the action(s) to ensure time lines are met and the issue(s) resolved. If the Contractor demonstrates inaction or disregard for the agreed upon compliance resolution plan, CDPHE may exercise its rights under the Remedies section of this contract. Eagle County, Colorado Keith Montag, County Manager of C6ritractor Signature ate