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HomeMy WebLinkAboutC13-139 Well and Wise • GENERAL GRANT TERMS, CONDITIONS AND UNDERSTANDINGS Title of Project: Well and Wise: Chronic Disease Self - Management and Physical Activity for Older Adults in Eagle, Garfield, and Pitkin Counties Grant ID #: 5250 Purpose of Project: Implement the Well and Wise Project, a project that aims to improve health outcomes for seniors in the Rural Resort Region of Colorado. The Project consists of evidence -based Chronic Disease Self - Management Programs (CDSMP) and physical activity classes included in Falls Prevention such as N'Balance and Tai Chi. It will be implemented at a variety of community-based locations. Grantee Organization: Checks to be Made Payable to: Eagle County Public Health Department Eagle County Government 551 Broadway 551 Broadway Eagle, CO 81631 Eagle, CO 81631 Tax Identification Number: 846000762 Amount of Grant Awarded: Period for Which Support is Granted: $222,666 over a 24 -month period From 3/15/2013 Through 3/14/2015 Contingencies: Intended Measurable Results to be Reported on: Healthy Living - increase number of Coloradans who are educated on chronic disease management. Expected Intermediate Milestones: Over the course of the two -year grant, the Eagle County Public Health Department will do the following: Year One: - Recruit and train six new instructors in chronic disease self- management and fall prevention classes - Secure new community sites to offer classes - Serve a minimum of 77 participants in Garfield, Pitkin and Eagle County - Continue to form relationships with health care centers to help build participant referrals - Report on pre- and -post survey responses Year Two: - Train new instructors (if needed) - Expand to an additional site and add classes where needed - Build referral system, working especially with Federally qualified Health Care /Community Health Centers and Patient Centered Medical Homes - Work with the State Unit on Aging to establish a reimbursement voucher program - Serve a minimum of 144 participants in Garfield, Pitkin and Eagle County - Report on pre- and -post survey responses Payment and Requirements Schedule: Requirement Due Date Requirement Payment Amount Approximate Payment Schedule 5/9/2013 Signed Grant Agreement $114,333 5/23/2013 3/15/2014 Progress Report $108,333 5/1/2014 4/15/2015 Final Report Payments are contingent upon receipt and approval of the associated requirements. The Foundation requests that you provide your reports using the format found at www.coloradohealth.org. Grant ID #5250 - 1 - N151 *Project Director * *Grantee Organization Primary Contact (please correct the info - mation below if necessary) (please correct the information below if necessary) Ms. Karen N Koenemann Ms. Jennifer Ludwig Healthy Communities Manager Public Health Director Eagle County Public Health Department Eagle County Public Health Department 551 Broadway 551 Broadway Eagle, CO 81631 Eagle, CO 81631 * The project director is the individual directly responsible for developing the proposed activity, its implementation, and day -to -day direct supervision of the p - oject. * *The organization primary contact is the CEO /Executive Director of the grantee organization. Grant ID #5250 - 2 - The Colorado Health Foundation is awarding this Grant to the above named organization ( "Grantee ") and Grantee agrees to, the following: 1. Tax Exempt Status, Grantee represents that: a. To provide current and appropriate documentation if organization is a government supported agency, such as school, museum, .library or government agency or department. b. To provide The Colorado Health Foundation with immediate written notification of any changes in the organization's tax - exempt status. 2. Expenditure of Funds This Agreement (together with any income earned upon investment of Grant funds) is made for the purpose outlined herein and may not be expended for any other purpose without the Colorado Health Foundation's prior written approval. Expenditures of Grant funds must adhere to the specific line items in the attached Grant Budget. If the grant is greater than $50,000, changes to individual line items (increases and decreases) that are greater. than 25% of that line item and greater than $1,000 must be requested in writing to the Colorado Health Foundation Grants Director and approved in writing by Foundation staff. Requests should be submitted using the form and instructions found at www.ColoradoHealth.org in the "For Grantees" section. If the Grant is intended to support a specific project or for a specific period, any portion of the Grant unexpended at the completion of the project or the end of the period specified above on Page 1 (the "Grant Period ") shall be returned immediately to the Colorado Health Foundation. With prior written approval from the Colorado Health Foundation the Grant Period may be extended in order to reach the anticipated outcomes. Requests should be submitted using the form and instructions found at www.ColoradoHealth.org in the "For Grantees" section. 3. Prohibited Use of Funds Grantee will not permit any Grant funds or income derived from such funds to be used for "political expenditures" as defined in Section 4955 of the Code , including but not limited to participation or intervention in a political campaign for a public office. So that Grantor may monitor its election under Section 501(h) of the Code, Grantee will not permit any Grant funds or income derived from such funds to be used for any "lobbying expenditures" as defined in Section 4911 of the Code without the Colorado Health Foundation's specific written consent. Section 4911 of the Code describes "lobbying" as a variety of activities including attempting to influence legislation at any level of government. Influencing legislation is further described as attempts to influence public opinion on a legislative subject or direct communications with those who formulate legislation. This restriction does not preclude the Grantee from expending funds for nonpartisan analysis, study, and research. Grant ID #5250 - 3 - Gr2 ntee represents that it is knowledgeable about Executive Order 13224 and the USA Patriot Act of 2001 and Grantee will not permit any Grant funds or income derived from such funds to be expended or re- granted so as to benefit any person or organization with ties to terrorists. 4. No Assignment or Delegation Grantee may not assign or otherwise transfer its rights or delegate any of its obligations under this Agreement without the prior written approval of the Colorado Health Foundation. 5. Records and Reports Grantee must keep a record of all receipts and expenditures relating to this Agreement and to provide the Colorado Health Foundation with a written report summarizing the project promptly following the nd of the Grant Period. The Colorado Health Foundation may also require interim reports. Grantee reports should describe progress achieving the Grant Purposes (including progress toward measurable results and intermediate milestones outlined above on Page 1) and include a detailed accounting of the uses or expenditure of all Grant funds. Grantee also agrees to provide any other info mation reasonably requested by the Colorado Health Foundation. If Grantee obtains any audited fm cial statements covering any part of the period of this Agreement, copies of such statements shal be provided to the Colorado Health Foundation promptly after receipt. Grantee must keep the fins cial records with respect to the Grant and this Agreement, along with copies of any reports sub fitted to the Colorado Health Foundation, for at least four years following the year in which all Gra t funds are fully expended. 6. Required Notification Gr tee must provide the Colorado Health Foundation with immediate written notification of: (1) its ina lity to expend the Grant funds for the Grant Purposes; or (2) any expenditure of Grant funds for any urpose other than the Grant Purposes; and, (3) any other breach by Grantee of this Agreement. 7. Rea onable Access for Evaluation and Oversight Gra tee will permit the Colorado Health Foundation and its representatives, at its request, to have reas nable access during regular business hours to its files, records, accounts, personnel and clients, or o ler beneficiaries for the purpose of making such fmancial audits, verifications, or program eval ations as the Colorado Health Foundation deems necessary or appropriate concerning the Grant and o discuss Grantee's programs, procedures and operations with Grantee's personnel. 8. Res:arch Involvin: Human Sub'ects: If th - Grant is to be used in whole or in part for research involving human subjects, Grantee hereby certi ies that Grantee, applying the ethical standards and the criteria for approval of grants set forth in its I temal Review Boards and professional oaths, has determined that the human subjects involved in th s Grant will not experience risk over and above that involved in the normal process of care and are 1 kely to benefit from the proposed research program. Grant ID #5250 _4 - 9. Publicity: The Colorado Health Foundation encourages Grantee to publicize information concerning the Grant in the Grantee's newsletters, annual reports, press releases, Web -site and other relevant media. Grantee will obtain the prior written approval of the Colorado Health Foundation prior to releasing or publicizing such information. The Colorado Health Foundation welcomes any photographs relevant to the Grant for the Colorado Health Foundation's use. Photos must have prior client releases (if applicable) for publication purposes. Without further notice to or consent from Grantee, the Colorado Health Foundation may include information regarding this Agreement and/or Grant, the amount and purpose of the Grant and photographs, logo or trademark, and other published/printed information or materials (provided by Grantee) and its activities, in the Colorado Health Foundation's periodic public reports, newsletters, Web -site and news releases. 10. Colorado Charitable Solicitations Act Grantee represents that it is aware of and in compliance with the Colorado Charitable Solicitations Act governing fundraising in Colorado. 11. Right to Modify or Revoke The Colorado Health Foundation reserves the right to discontinue, modify or withhold any payments to be made under this Agreement or to require a total or partial refund of any Grant funds if, in the Colorado Health Foundation's sole judgment , such action is necessary or prudent: (1) because the Grantee has not fully complied with the terms and conditions of this Agreement; (2) to protect the purpose and objectives of this Agreement or any other charitable interest of the Colorado Health Foundation; or (3) to comply with the requirements of any law or regulation applicable to Grantee, the Colorado Health Foundation, or this Grant. 12. Termination The Colorado Health Foundation's obligations under this Agreement shall automatically terminate in the event of the insolvency, receivership, bankruptcy filing, or dissolution of Grantee. In addition to its right of revocation under Paragraph 11 above, the Colorado Health Foundation may terminate this Agreement at any time by giving Grantee at least 30 days of written notice. Upon termination of this agreement for any reason, all payments by the Colorado Health Foundation to Grantee shall cease at such time as may be determined by the Colorado Health Foundation. Termination or revocation of this Agreement by the Colorado Health Foundation will not terminate Grantee's obligations under this Agreement with respect to Grant funds expended or otherwise not Grant ID #5250 - 5 - returned to the Colorado Health Foundation. Grantee's obligations under Paragraphs 5, 7, 9 and 16 shall also survive termination of this Agreement. 13. See ial Conditions and Re. ortin Gr. tee will submit reports to the Colorado Health Foundation according to the reporting schedule set orth on page one of this Agreement. 14. Amendment Thi Agreement may be amended, supplemented or extended only by written communication signed by e Colorado Health Foundation. 15. No ' artnershi. A . enc or Third Part Beneficiaries Not ing contained in this Agreement shall create or be deemed to create a partnership or agency bet een the Colorado Health Foundation and Grantee and nothing contained in this Agreement shall be . - emed to give rise to any rights or benefits to third parties not a party to this Agreement. 16. Irate lectual Pro. ert (a) rantee represents and warrants that it owns or has the right to use all intellectual property that will be employed by Grantee or its agents in the performance of this Agreement, including without limitation, Grantee's obligations under subsection (c) below. (b) All works and matters created or discovered through the performance of this Agreement, including but not limited to, implementation methodologies, best practices guides and training cumcula (the "Work "), are owned by the Grantee provided, however, that the Work may be used by Grantee only to fulfill its charitable mission (i.e., activities recognized by the IRS as charitable and not resulting in "unrelated business taxable income" as defined in Section 512 of the Code), unless otherwise agreed in writing by The Colorado Health Foundation. (c) rantee hereby grants to The Colorado Health Foundation a nonexclusive, irrevocable, perpetual, wor wide, fully transferable, royalty -free license to (i) the Work, to make, use, sell, license to othe s, reproduce, create derivative works of, publish, republish, distribute, perform and display the Wo in any current or future form and for any purpose in furtherance of its charitable mission, and (ii) y other intellectual property incorporated into or used in connection with the Work to the exte t reasonably necessary to enable The Colorado Health Foundation to use and practice the lice sed Work. The license herein granted to The Colorado Health Foundation shall vest without any fort er action on the part of Grantee. Without the prior written consent of The Colorado Health Fou dation, Grantee will not enter into any agreement with a third party that would restrict Grantee's ability to perform its obligations under this subsection (c). 17. Disc .aimer Notting contained herein, including the required reporting and review procedures, shall be construed as a warranty, representation, or approval by the Colorado Health Foundation that the services Grant ID #5250 - 6 - • rendered by Grantee are adequately or properly rendered on either an individual or program -wide basis. Grantee shall have sole responsibility for all damages, costs, fines, attorneys' fees, or liabilities of any kind or nature arising from any claims, demands or suits resulting from the Grantee's performance or failure to perform under this Agreement to the extent permitted by law. Nothing herein shall be deemed a waiver of Grantee's rights under the Colorado Governmental Immunity Act. 18. Controlling Document The terms and conditions of this Agreement shall be the controlling document between the Colorado Health Foundation and Grantee. All verbal communication, notes, minutes or other documentation of the Colorado Health Foundation shall be deemed merged into this Agreement. In making this Grant, the Colorado Health Foundation has relied on the information and representations submitted to the Colorado Health Foundation by Grantee and Grantee represents that all such information and representations are true and complete. 19. Future Funding Grantee acknowledges that, except as expressly provided in this Agreement, the Colorado Health Foundation has no obligation to Grantee with respect to any additional or future funding. Kelly Dunkin Date Vice President, Philanthropy The Colorado Health Foundation The undersigned certify that they are duly authorized officers of Grantee and, as such, are authorized to accept this contract on behalf of Grantee, to obligate the Grantee to observe all of the terms and conditions placed on this Agreement, and in,connection with this Agreement to make, execute, and deliver on behalf of the Grantee all agreements, representations, receipts, reports, and other instruments of every kind. ACCEPTED AND AGRE D TO: Ilk h _ ` L ► I C 9 a . 131 - - - • . . • • _ - -. • • - - - _ • ... -a •.•., 6 9. / /# s T :� ' �, r ou - Y►-1 � a eh , --/-1 s I t a PQ.le_ I P 61(-1,(2 C :'= : " D • - - - Date • j e 0 X} d Oe 7` 6— t 1171. Rid Grant ID #5250 - 7 - Organization Name: Eagle County Public Health Department ' Project Title: Well and Wise: Chronic Disease Self- Management and Physical Activity for Older Adults in Eagle, Garfield, and Pitkin Counties Request ID: 5250 Proposal Expenses Approved Budget Year 1 Year 2 Year 3 Total General Operating $ - Program/Project $ - Personnel $ 74,543.00 $ 74,543.00 $ 149,086.00 Programming /Project Costs $ 24,790.00 $ 18,790.00 $ 43,580.00 Administrative costs related to program $ - Capital $ - Total Direct Costs $ 99,333.00 $ 93,333.00 $ - $ 192,666.00 Consultants $ 15,000.00 $ 15,000.00 $ 30,000.00 Other $ - Fiscal Sponsor's Fee Of applicable) $ - Indirect Costs (Max 10 %) $ - Total Other Costs $ 15,000.00 $ 15,000.00 $ - $ 30,000.00 GRAND TOTAL $ 114,333.00 $ 108,333.00 $ - $ 222,666.00