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HomeMy WebLinkAboutC16-042 Colorado Department of Human Services - Nurse Family Partnership ProgramCONTRACT AMENDMENT
Amendment # 2 Original Contract CMS (CLIN) # Amendment CMS #
15 IHIA 68716 16 IHIA 87025
1) PARTIES
This Amendment to the above - referenced Original Contract (hereinafter called the Contract) is entered into by
and between Eagle County Government, dba Health and Human Services (hereinafter called "Contractor "),
and the STATE OF COLORADO (hereinafter called the "State ") acting by and through the Department of
Human Services, Office of Early Childhood, (hereinafter called the "CDHS ").
2) EFFECTIVE DATE AND ENFORCEABILITY
This Amendment shall not be effective or enforceable until it is approved and signed by the Colorado State
Controller or designee (hereinafter called the "Effective Date "). The State shall not be liable to pay or reimburse
Contractor for any performance hereunder including, but not limited to, costs or expenses incurred, or be bound
by any provision hereof prior to the Effective Date.
3) FACTUAL RECITALS
The Parties entered into the Contract for /to provide trained visiting nurses through the Nurse Home Visitor
Program (NHVP) to help educate mothers on the importance of nutrition and avoiding alcohol and drugs,
including nicotine, and to assist and educate mothers in providing general care for their children. This
amendment increases the funding by $4,379 for FYI 6.
4) CONSIDERATION- COLORADO SPECIAL PROVISIONS
The Parties acknowledge that the mutual promises and covenants contained herein and other good and valuable
consideration are sufficient and adequate to support this Amendment. The Parties agree to replacing the
Colorado Special Provisions with the most recent version (if such have been updated since the Contract and any
modification thereto were effective) as part consideration for this Amendment. If applicable, such Special
Provisions are attached hereto and incorporated by reference herein as Exhibit N /A.
5) LIMITS OF EFFECT
This Amendment is incorporated by reference into the Contract, and the Contract and all prior amendments
thereto, if any, remain in full force and effect except as specifically modified herein.
6) MODIFICATIONS.
The Contract and all prior amendments thereto, (Original Contract CMS 15IHIA68716; Option Letter #1 CMS
15IHIA77070; Option Letter #2 CMS 161HIA78997; Amendment #1 CMS 16IHIA79377), are modified as
follows:
a. Original Contract, Page 1
Increase budget by $4,379 from $380,407 to $384,786 for FY2016
The "CONTRACT PRICE NOT TO EXCEED" amount is increased by $4,379 to a new "CONTRACT
PRICE NOT TO EXCEED" amount of $758,609.
"MAXIMUM AMOUNTA VAILABLE PER FISCAL YEAR" has been amended to FY15: $373,823;
$FY16: $384,786.
b. Exhibit B —Amendment #1 is hereby replaced by Exhibit B -Amendment #2 — NHVP SFY2015 -16
Mid -Year Revised Budget and is attached and incorporated into this Amendment.
7) START DATE
This Amendment shall take effect on the later of its Effective Date or February 1, 2016.
8) ORDER OF PRECEDENCE
Except for the Special Provisions, in the event of any conflict, inconsistency, variance, or contradiction between
the provisions of this Amendment and any of the provisions of the Contract, the provisions of this Amendment
shall in all respects supersede, govern, and control. The most recent version of the Special Provisions
incorporated into the Contract or any amendment shall always control other provisions in the Contract or any
amendments.
9) AVAILABLE FUNDS
Financial obligations of the state payable after the current fiscal year are contingent upon funds for that purpose
being appropriated, budgeted, or otherwise made available.
APPR +JFEPAS TO FOP
Page 1 of 2 Fagl 1-Ilty Attorney's Office
ley :
cayie County Commissioners' Office
C16-042
CMS # 16 MIA 87025
THE PARTIES HERETO HAVE EXECUTED THIS AMENDMENT
Persons signing for Contractor hereby swear and affirm that they are authorized to act on Contractor's
behalf and acknowledge that the State Is relying on their representations to that effect.
CONTRACTOR
Eagle County Government,
dba Health and Human Services
J -ea h►,c M"Q4ti then
Chair, Board of County Commissioners
•i..rlC
*Sign
Date: 2, A /I(",
STATE Or COLORADO
John W. Hickenlooper, Governor
Colorado Department of Human Services
Reggie Bicha, Executive Director
By. Mary Ann nyder, Director, Office of Early Childhood
Date: o.) --//
ALL CONTRACTS REQUIRE APPROVAL BY THE STATE CONTROLLER
CRS §24-30-202 requires the State Controller to approve all State contracts. This Amendment is not valid
until signed and dated below by the State Controller or delegate. Contractor is not authorized to begin
performance until such time. if Contractor begins performing prior thereto, the State of Colorado is not
obligated to pay Contractor for such performance or for any goods and/or services provided hereunder.
STATE CONTROLLER
Robert Jaros, CPA, MBA, JD
By:
Clint WoodruffNal Gimple
Date: &h I'a'761,16
Page 2 of 2
Fxhlblt 9 - Amendment 02
Nurse Home Visiting Program SFY2015 -16 Mid -Year Revised Budget
FOR THE PERIOD: JWX 1, 2015 - June 30, 2016
APPLICANT: Eagle County Government, dba Health and Human Services
FUNDED CASELOAD: 63
COUNTIES SERVED: Eagle Count
Round dollar amounts: Le, 23.73 =24 21.45-23
ORIGINAL FV 15-16 BUDGET
Base
Salary
(Annual)
(or approved revised budget if your
REVISED FY 15 -16 BUDGET
agency has recleved an approved
BUDGET
budget revision since July 1, 20151
Jul} 11 2015 - June 30, I016
July 1, 2015 to June 30, 2016
811%
100%
100%
Wo%
100Y,
A. Other C. CpHS
A, Other C. CDHS
Sources of FUNDING
Sources or FUNDING
Funding ANIMPL.
Funding rNIMPI
PERSONNEL COSTS (Detail Expenses)
Personnel Services (Title and Name)
Nurw SupmWr- JaMe Wahror
Base
Salary
(Annual)
Fringe
Benefits
51i Effort
oa MIS
Funding
ONI V
Total
BUDGET
REVISED AUDGET
X%
$45,257; S13,304
$33,735 $23,437
S50,348 532,447
$63,336 534,049
_ $25.575 56,924
811%
100%
100%
Wo%
100Y,
$47,4991
_$57,172
$82,795
$97,385
�S32,A59
$14.789
542,538
597,937
$71,537
$71,537
S29.O55
50
5o
SO
SO
$-
$11.076
SO
5U
$O
547,499
S57,172
582,795
597.385
532,459
Huse Home VLsdor I- Joy Ariel reptaced Luz AWla
- -
-
Nuns HameMsitar 2. taVlru Beveridge
NuneHam *Hlsltor3- ArwwShPO*U -
Program Support Tedwidw - Kelly Mates
1. TOTAL PERSONNEL COSTS
--sol
$14,789
5312,604
$0
$11,974
$317,310
OPERATING (Detail Expenses)
BUDGET REVISED BUDGET
Oflicc Operating Expenses 0 a supplies Pens, etc) ^-
Client Support Materials
Printing & Publications _ _ _
Postal & Shipping Services
Communications (long distance. cellular and network service) _
Medical Supplies
Outside Services
Rc-mrcd model materials 0 c. Keys to Care Givinc. Beginning Rhvihm., etc)
$1.136
S2,O15
S1,100
S .
so.
so
so
so
Su
$
Stl
3
so
so
SO
So
SO
SO
50
SO
SO
SO
$O
50
SO
$1,136
$1.500
5444
$1
$2,700
$82
Si
$1
S I
S374
S 1
Sl
S-_)700
_
St
S1
_ Si
50
50
SO
Computers wl Software
Cellular Phones
Tablet laplupcornruters for hums visits J
2. TOTAL OPERATING
I
I SO SO S6,955 SO 50 S6,241
I BUDGET REVISED BUDGET
Trairthir and Technical Assistance e
Fee p
Total Cast
Nurse Initial Education Tuition (Joy Ariel) Per NIIV
{Per NIIV &-
Nuric Education Materials (New So ervisorlRN ONLY) Sup
"Per NEW &_
DANCE Education X 1 NHV ( Anne Shainholtz)_ Sup
P <r NIIV &
DANCE Liccmning X I NHV ( Anna: Shainhaltz) up
Program Support Fee PCr Sup _
Profcseional Development PcrNursc
Nurse Consultation ;Supervisor
$4,2`2': 1
- '1
$543 1
_ S595; 1
_ 555: 3
$7,396
_ 5600
$2,664„
_ $4.272
5543
5595
50 s0 SO $4,272
S0 S0 so S543
$595 $O 5595
_ S220 St _ SO 5165
_ $7,398 S -SO
$7,398
$2,400 SO- --so 52,400
E $2,664 Sri _ s0 $2,664
So $0 $13,277 So So $18,03
BC DG: =.1' REVISED BUDGET
5165
Sit
S0
sc
. TOTAL TRAINING and TECHNICAL ASSISTANCE
Equipment (Only list equipment where the price of one item exceeds $5,000, if the price Is less
than 55,0110, show the expense under o eratin�).
Computers w/ Software
Cellular Phones
Pableu 1 Mo computers for home visits
5 I
5 I S
51 SO
SO
$4
SO
Sol
S0;
$0,
. TOTAL EQUIPMENT
SO
SD
S3 $01
50
SO
-RAVEL (Detail Expenses)
BLIDG €T RI,VISE D BUDGET
Visit Outreach Mileage
NFP Trainor and Mectin� Travel (S isars, Nurses)
S. TRAVEL - - --
1
S:0.5251.
2,183
SD $0 $7.187
S SO $2.180
SO
$0
$12,708 so, S9 367
CONTRACTUAL (Include Contractual Services)
BUDGE "T REVISED BUDGET
ulia Kozusko - Mental Health Consultant
S3,F, SO
_
52,104
. CONTRACTUAL
SO $0 53.600 $0
So
$2,100
TOTAL DIRECT PROGRAM COSTS (Add bud et caf arses 1-6)
S111 SK7891 $349,1471 A
511.075
S353,055
Exhlblt B - Amendment 02
Nurse Home Visiting Program Sl~Y2015 -16 Mid -Year Revised Budget
FOR THE PERIOD: Juky 1, 2015 - June 30, 2016 _ J
APPLICANT. Eacle County Government. dba Health and Human Services
I: UNDER CASELOAD;:, 63 l
COUNTIES SERVED: Eagle Count, I
Round dollar amaunts: Le 21.74 -24 2-,4c 1,
n.j. ? 1.14
ORIGINAL I'V 15-16 BUDGET
(or approved revised budget iryour
REVISED FY 15 -16 BUDGET
agency has recieved an approved
JuI3 1, 2015 - June 30, 2016
budget revision since July 1, 2015)
July 1, 2015 to June 30, 2016
A. Otitrr: ENVIC. CDHS
A. Other C. CDIIS
Sources nt FUNDING
Sources of FUNDING
Funding
Funding, (NHVP)
ADMINSTRATIVE COSTS (Detail Adminizimth a Costs) r w Indirect (irapplicable)
BUDGET
REVISED BUDGET
Indirect Rate at 10% Salaries R Fring e .`
53 [.2601
SO SO 531,731
TOTAL AW11N11STRATIVE COSTS
Sol SO` S31,76O
So SO! 531,731
TAL PROGRAM COSTS (Direct Pro m +Administrative Casts)
5O Si4,789i $38O,407
SO 511,076 5384,78
n.j. ? 1.14
Exhibit B -Amendment #2
SFY 15 -16 NHVP Mid -Year Budget Revision Narrative
Fagic County Government, dba f icalth and Human Services
BUDGET NARRATIVE
FISCAL YEAR 2015 - 2016 (July 1, 2015 - June 30, 20I6)
PERSONNEL SERVICES CATEGORY
Jennie Wahrer, Nurse Supervisor, provides oversight. assistance and management for Home Visitors, and community outreach
Joy Aricl, LaVinn Beveridge, and Anne Shainholtz, Home Visitors conduct home visits and coordinate visiting schedules with families.
Kelly Matis, Program Support Technician provides data input and interpretation services
Fringe benefits are actual percentage rate of agency calculated against all salaries Includes nurkers' camp insurance, unemployment insurance, long -term disability,
FICA, retirement, wellness program, health, dental, and vision insurance. They arc calculated on a4.tual salaries and vary for each employee. Eagle County is
experiencing a 40 1to increase in health insurance costs for 2016.
'Joy ArieI, NHV replaced Lux Avila, NHV. Joy has been on FMLA since Oct 26, 2015 and is expected to return at end of January 2016, hence reduction in her
salary
Total Personnel Services Category. $317,310
OPERATING CATEGORY
Office Operating Expenses Costs are 51,136, includes pens, pencils, paper, markers, folders, toner for copier, photocopy paper, envelopes, stapling
materials, paper and binder clips, tape, name badges, labels, and batteries.
Client Support Materials Costs are S 1,500 to purchase client support materials for families and for the Nurse Home Visitors to assist in the work they
are doing with families beyond NHVP and PIPE handouts
Printing & Publications Costs are $444 for client printed materials (facilitators), staff supervision forms, home visit forms, reference publications,
Professional Journals, and brochures as deemed necessary by staff.
Postal & Shipping Services Costs at S l per year is reserved for postage and shipping costs,
Communications at $2,700 this amount covers the cost of cell phone services.
Medical Supplies at $82 per year, this covers supplies used for home visiting
Outside Services at S per year to cover cost of outside services,
Required model materials (i.e. Keys to Care Giving, Beginning Rhythms, etc.) at $1 are to cover NFP required model materials.
Cellular phones- 5374 used to purchase new upgraded cell phones for 2 NHV's.
Tablet/ laptop computers for home visits at $1 to cover equipment costs.
Total Costs Operating Category: $6,241
TRAININGand/or TEGHNICAL ASSISTANCE CATEGORY
Items in this category include training costs required to participate as a Nurse Family Partnership provider.
$543 for initial education materials.
52400 is for nurses each to participate in ongoing professional development training per individualized training plan,
One NHV will be trained in DANCE, and purchase 2 DANCE licenses, Mired a replacement nurse and the new nurse will require the Nurse Initial
Education Tuition (Joy Aricl). Nurse Education Materials (New Supervisor/RN ONLY) is requested for initial education materials. DANCE
Education for I NFIV ( Anne Shainholtz) will cover DANCE Education for one NHV. DANCE Licensing for 1 NI-IV (Anne Shamlioltz) will provide
the amount for required licensing by NFP.
Program Support Fee is a cost for continued program support for home visiting. Professional Development covers trainings for home visitors,
Nurse Consultation provides consultation fees for consultation support.
Total Costs Training and/or Technical Assistance Category: $18,037
EQUIPMENT CATEGORY
Amounts origninally requested in equipment were moved to the operating category.
Total Costs EQUIPMENT Category: $0
TRAVEL CATEGORY
Items in this category include mileage and travel costs for home visiting service delivery, meetings, conferences and trainings.
Visit Outreach Mileage costs are $7187 include: county and personal vehicles used when driving to and from home visits, to community meetings to
share information about NFP, and for recruitment. County vehicles costs includes replacement cost, fuel, and maintenance 2 county vehicles are used, l
is designated solely for NFP use, and I is shared with other HHS staff. Costs are based on past years experience.
NFP Training and Meeting Travel (Supervisors, Nurses) at 52180 includes: training conference expenses for one nurse and travel for quarterly
supervisor meetings, NFP (Nurse Family Partnership) training is a required training for Home Visitors when they begin with NHVP. This cost covers
transportation to training throughout CO, including necessary travel reimbursement and training costs. Quarterly supervisor meetings are meetings HV
staff hold with members of partnering agencies to ensure fidelity to the program and program quality. Travel for quarterly meetings includes coverage for
mileage to meeting locations.
11-TotalCosts Travel Category: $9,367
Page 3 of 4
Exhibit B - Amendment #2
SFY 15 -16 NHVP Mid -Year Budget Revision Narrative
Eagle County Government, dba I lealth and I luman Services
BUDGET NARRATIVE
FISCAL YEAR 2015 - 2016 (July 1, 2015 -June 30, 2016)
[CONTRACTUAL SERVICES CATEGORY
Julio Kozusko Mental Health Consultant at $2,100 is used to prouide mental health consultation for home visiting.
Total Costs Contractual Services Category: $2,100
ADMiNYSTRATIVE COSTS
[ndire.t Rate at 10:'� of total Salaries & Fringe.
Total Administrative Costs Category: $31,731
GRAND TOTAL COSTS TO BE BILLED TO CDHS: $384,786
Page 4 of 4