No preview available
HomeMy WebLinkAboutC16-189 Colorado Department of Public Health Communities that Care - NOT FULLY EXECUTEDDEPARTIVIENT OF PUBLIC HEALTHAND ENVIRONT,IENT CMS ROUTING NO,17 FHLA 89319 APPROVED TASK ORDER CONTRACT - WAIVER #154 This task order contract is issued STATE: State ofColorado for the use & benefit ofthe Departmurt of Public Health and Environment Prevention Services Division Injury and Violence Prevention - Mental Health Promotion 4300 Cherry Creek Drive South Denver, Colorado 80246 coNrRAcr MADE DArE: 4110120L6 CORE ENCUMBRANCE NUMBER: CT FAJqAFHT A20 I 700000 135 TERM: This contract shall be effective upon approval by the State Controller, or designee, or on07/01/2016, whichever is later. The confact strall end on 06/30/2018. PROCUREMENT METHOD: Exempt BID/RFP/LIST PRICE AGREEMENT NTIMBER: Not Applicable I-A.W SPECIFIED \'ENDOR STATUTE: Not Applicable STATE REPRESENTATN/E: Ali Maffey, MSW Policy and Communication Unit Supervisor VIP - MHP Branch Prevention Services Division, A-4 4300 Cherry Creek Drive South Denver, Colorado 80246 pursuant to master contract made on 0l/ 17 / 12, with routing number 13 FAA 00016. CONTRACTOR: Board of County Commissioners of Eagle County (a political zubdivision ofthe state of Colorado) 500 Broadway, Eagle, Colorado 8 163 l-0850, for the use and benefit ofthe Eagle County Public Health Agency 551 Broadway, Eagle, Colorado 81631 coNrRAcroRDLrNS, 084024447 CONTRACTOR ENTITY TYPE: Political Subdivision Colorado BILLING STATEMENTS RECEIVED: Monthly srAruroRy AUTHoRITY: C.R.S. $ 25-3.5-1001 through 1007 et al. (October 15, 2009) cLASSIFIcATIoN: Sub-Recipient CONTRACT PRICE NOT TO EXCEED: $ I I 0,000.00 FEDERAL FUNDING DOLLARS: $Q.QQ STATE FUNDING DOLLARS: S I 10.000.00 OTHERFUNDINGDOLI.ARS: 50.00 Specify'Othef': MAXIMT]M AMOUNTAVAILABLE PER FISCAL YEAR: FYIT:$ I10,000.00 PRICESTRUCTURE. COStREiMbUTSCMENt CONTMCTOR REPRESENTATME: Jennifer Ludwig Public Health Director PO Box 660 Eagle, Colorado 81631 PROJECT DESCRIPTION: Implement the "Communities that Care" model to identify evidence-based or evidence-informed youth substance abuse prevention strategies and identify sustainable local or regional strategies for ongoing implementation ofyouth substance abuse prevention strategies. 17FHLA89319 TO.docx EaEle County Ccmmlssioners' OfFlceC16-189 DGIIBITS: The following exhibits are hereby incorporated: Exhibit A - Exhibit B - Exhibit C - Exhibit D - Exhibit E - Additional Provisions (and any of its Attachments; e.g., A-1, A-2, etc.) Staternent of Work (and any of its Attachments; e.g., B-1, B-2, etc.) Budget (and any of its Attachments; e.g., C-l,C-2, etc.) Grant Funding Change Letter Option Letter 2. GENERAL PROVISIONS The following clauses apply to this Task Order Contract. These general clauses may have been expanded upon or made more specific in some instances in exhibits to this Task Order Contract. To the extent that other provisions of this Task Order Contract provide more specificity than these general clauses, the more specific provision shall control. t.This Task Order Contract is being entered into pursuant to the terms and conditions of the Master Contract including, but not limited to, Exhibit One thereto. The total term of this Task Order Contract, including any renewals or extensions, may not exceed five (5) years. The parties intend and agree that all work shall be performed according to the standards, terms and conditions set forth in the Master Contract. In accordance with section 24-30-202(l), C.R.S., as amended, this Task Order Contract is not valid until it has been approved by the State Controller, or an authorized delegee thereof. The Contractor is not authorized to, and shall not; commence performance under this Task Order Contract until this Task Order Contract has been approved by the State Controller or delegee. The State shall have no financial obligation to the Contractor whatsoever for any work or services or, any costs or expenses, incurred by the Contractor prior to the effective date of this Task Order Contract. If the State Controller approves this Task Order Contract on or before its proposed effective date, then the Contractor shall commence performance under this Task Order Contract on the proposed effective date. If the State Controller approves this Task Order Contract after its proposed effective date, then the Contractor shall only commence performance under this Task Order Contract on that later date. The initial term of this Task Order Contract shall continue through and including the date specihed on page one of this Task Order Contract, unless sooner terminated by the parties pursuant to the terms and conditions of this Task Order Contract and/or the Master Contract. Contractor's commencement of performance under this Task Order Contract shall be deemed acceptance of the terms and conditions of this Task Order Contract. The Master Contract and its exhibits and/or attachments are incorporated herein by this reference and made a part hereof as if fully set forth herein. Unless otherwise stated, all exhibits and/or attachments to this Task Order Contract are incorporated herein and made a part of this Task Order Contract. Unless otherwise stated, the terms of this Task Order Contract shall control over any conflicting terms in any of its exhibits. In the event of conflicts or inconsistencies between the Master Confract and this Task Order Contact (including its exhibits 17FHLA893l9 TO.docx J. Page 2 of 6 ). and/or attachments), or between this Task Order Contract and its exhibits and/or attachments, such conflicts or inconsistencies shall be resolved by reference to the documents in the following order ofpriority: 1) the Special Provisions of the Master Contract; 2) the Master Contract (other than the Special Provisions) and its exhibits and attachments in the order specified in the Master Contract; 3) this Task Order Contract; 4) the Additional Provisions - Exhibit A, and its attachments if included, to this Task Order Contract; 5) the Scope/Statement of Work - Exhibit B, and its attachments if included, to this Task Order Conhact; 6) other exhibitVattachments to this Task Order Contract in their order of appearance. The Contractor, in accordance with the terms and conditions of the Master Contract and this Task Order Contract, shall perform and complete, in a timely and satisfactory manner, all work items described in the Statement of Work and Budget, which are incorporated herein by this reference, made a part hereof and attached hereto as "Exhibit B" and "Exhibit C". The State, with the concurrence ofthe Contractor, may, among other things, prospectively renew or extend the term of this Task Order Contract, subject to the limitations set forth in the Master Contract, increase or decrease the amount payable under this Task Order Contract, or add to, delete from, and/or modiff this Task Order Contract's Statement of Work through a contract amendment. To be effective, the amendment must be signed by the State and the Contractor, and be approved by the State Controller or an authorized delegate thereof. This contract is subject to such modifications as may be required by changes in Federal or State law, or their implementing regulations. Any such required modification shall automatically be incorporated into and be part of this Task Order Contract on the effective date of such change as if fully set forth herein. The conditions, provisions, and terms of any RFP attached hereto, if applicable, establish the minimum standards of performance that the Contractor must meet under this Task Order Contract. If the Contractor's Proposal, if attached hereto, or any attachments or exhibits thereto, or the Scope/Statement of Work - Exhibit B, establishes or creates standards of performance greater than those set forth in the RFP, then the Contractor shall also meet those standards of performance under this Task Order Contract. STATEWIDE CONTRACT MANAGEMENT SYSTEM [This section shall applywhen the Efective Date is on or after July I, 2009 and the maximum amount payable to Contractor hereunder is 5100,000 or higherJ By entering into this Task Order Contract, Contractor agrees to be govemed, and to abide, by the provisions ofCRS 524-102-205,924-102-206, $24-103-601, $24-103.5-101 and $24-105-102 conceming the monitoring of vendor performance on state contracts and inclusion of contract performance information in a statewide contract management system. Contractor's performance shall be evaluated in accordance with the terms and conditions of this Task Order Contract, State law, including CRS $24-103.5-101, and State Fiscal Rules, Policies and Guidance. Evaluation ofContractor's performance shall be part ofthe normal contract administration process and Contractor's performance will be systematically recorded in the statewide Contract Management System. Areas of review shall include, but shall not be limited to quality, cost and timeliness. Collection of information relevant to the performance of Contractor's obligations under this Task Order Contract shall be determined by the specific requirements of such obligations and shall include factors tailored to match the requirements of the Statement of Project of this Task Order Contract. Such performance information shall be entered into the statewide Contract Management System at intervals established in the Statement of Project and a final review and rating shall be rendered within 30 days ofthe end ofthe Task Order Contract term. Contractor shall be notifred following each performance and shall address or correct any identified problem in a timely manner and maintain work progress. Should the final performance evaluation determine that Contractor demonstrated a gross failure to meet the performance measures established under the Statement of Project, the Executive Director of the Colorado Department of Personnel and Administration (Executive Director), upon request by the Colorado Department of Public Health and Environment and showing of good cause, may debar Contractor anc 6. 17FHLA89319 TO. docx Page 3 of6 prohibit Contractor from bidding on future contracts. Contractor may contest the final evaluation and result by: (i) filing rebuttal statements, which may result in either removal or correction of the evaluation (CRS $24-105-102(6)), or (ii) under CRS $24-105-102(6), exercising the debarment protest and appeal rights provided in CRS $$24-109-106, 107,201 or 202, which may result in the reversal of the debarment and reinstatement of Contractor, by the Executive Director, upon showing of good cause. 8. If this Contract involves federal funds or compliance is otherwise federally mandated, the Contractor and its agent(s) shall at all times during the term ofthis contract strictly adhere to all applicable federal laws, state laws, Executive Orders and implementing regulations as they currently exist and may hereafter be amended. Without limitation, these federal laws and regulations include the Federal Funding Accountability and Transparency Act of2006 (Public Law 109-282), as amended by 96062 ofPublic Law ll0-252, including without limitation all data reporting requirements required there under. This Act is also referred to as FFATA. 17FHLA893l9_TO. docx Page 4 of6 THE PARTIES HERETO HAVE EXECUTED THIS CONTRACT * Persons signing for Contractor hereby swear and affirm that they are authorized to act on Contractor's behalfand acknowledge that the State is relying on their representations to that effect. ( uo, r,,'Koaro c r (o unt A,an, it, u,ur-,rt'\By: CONTRACTOR: BOARD OF COUNTY COMMISSIONERS OF EAGLE COUNTY for the use and benefit ofthe Eagle County Public Health Agency I7FHLA89319 TO.docx STATE OF COLORADO: JOHN W. HICKENLOOPER GOVERNOR ForExecutive Director Department of Public Health and Environment Department Program Approval: Print Title of Authorized Officer ALL CONTRACTS MUST BE APPROVED BY TIIE STATE CONTROLLER CRS S24-30-202 requires the State Controller to approve all State Contracts. This Contract 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, CPAe MBA, JD Date By: Legal Name of Contracting Entity Sigrature of Authorized S:/3t /tu, Date Page 5 of6 This page left intentionally blank. Page 6 of6 2. EXHIBIT A ADDITIONAL PROVISIONS To Task Order Contract Dated 0411012016 CMS Task Order Routing Number 17 FHLA 89319 These provisions are to be read and interpreted in conjunction with the provisions of the Task Order Contract specified above. I This Task Order Contract contains state funds. To receive compensation under the Contract, the Contractor shall submit a signed Monthly CDPHE Reimbursement Invoice Form. This form is accessible from the CDPHE internet website httos://www.colorado.sov/paci:lcicdphe/standardizecl-invoice-tbrm-and-links and is incorporated and made part of this Contract by reference. CDPHE will provide technical assistance in accessing and completing the form. The CDPHE Reimbursement Invoice Form and Expenditure Details page must be submitted no later than forty-five (45) calendar days after the end ofthe billing period for which services were rendered. Expenditures shall be in accordance with this Statement of Work and Budget. Scan the completed and sigrred CDPHE Reimbursement Invoice Form into an electronic document. Email the scanned invoice with the Excel workbook containing the Expenditure Details page to: Ali Maffey, MSW, Policy and Communication Unit Supervisor, ali.maffey@state.co.us Final billings under the Contract must be received by the State within a reasonable time after the expiration or termination ofthe Contract; but in any event no later than forty-five (45) calendar days from the effective expiration or termination date of the Contract. Unless otherwise provided for in the Contract, "Local Match", if any, shall be included on all invoices as required by funding source. The Contractor shall not use federal funds to satisff federal cost sharing and matching requirements unless approved in writing by the appropriate federal agency. Time Limit For Acceptance Of Deliverables. a. Evaluation Period. The State shall have thirty (30) calendar days from the date a deliverable is delivered to the State by the Contractor to evaluate that deliverable, except for those deliverables that have a different time negotiated by the State and the Contractor. b. Notice of Defect. If the State believes in good faith that a deliverable fails to meet the design specifications for that particular deliverable, or is otherwise deficient, then the State shall notify the Contractor ofthe failure or deficiencies, in writing, within thirty (30) calendar days of: l) the date the deliverable is delivered to the State by the Contractor ifthe State is aware ofthe failure or deficiency at the time of delivery; or 2) the date the State becomes aware of the failure or defrciency. The above time frame shall apply to all deliverables except for those deliverables that have a different time negotiated by the State and the Contractor in writing pursuant to the State's fiscal rules. c. Time to Correct Defect. Upon receipt of timely written notice of an objection to a completed deliverable, the Contractor shall have a reasonable period oftime, not to exceed thirty (30) calendar days, to correct the noted deficiencies. Ifthe Contractor fails to correct such deficiencies within thirty (30) calendar days, the Contractor shall be in default of its obligations under this Page 1 of3 Contract Exhibit-A AdditionalProvisions TaskOrder 040715 J. A EXHIBIT A Task Order Contract and the State, at its option, may elect to terminate this Task Order Contract or the Master Contract and all Task Order Contracts entered into pursuant to the Master Contract. Health Insurance Portability and Accountability Act (HIPAA) Business Associate Determination. The State has determined that this Contract does not constitute a Business Associate relationshio under HIPAA. This award does not include funds for Research and Development. If Contractor indicates full expenditwe of funds under this Contract by March 3 I of each gtant year and the full expenditure does not occur, CDPHE has the option to reduce current or upcoming Contract by said amount or a percent deemed reasonable by CDPHE. The State will notify the Contractor of the potential need to decrease the current or upcoming budget. If the Contractor indicates at a later date than March 3l of each grant year an expectation of surplus of funds or inability to fully expend said funds for unforeseen circumstances that Contractor had not anticipated by March 3 I, CDPHE will reallocate unspent funds without any penalties to the Contractor. Upon receipt of timely written notice of an objection by the State for inability to fully expend funds, the Contractor shall have a reasonable period oftime not to exceed ten (10) calendar days to respond to the action. If no dispute is received by the State within ten ( I 0) calendar days, the State has the option to reduce the current budget for the current year and any upcoming budget for future contractual agreements. Contractor shall request prior approval in writing from the State for all modifications to the Statement of Work/Work Plan or for any modification to the direct costs in excess of twenty-five percent (25%) of rhe total budget for direct costs. Any request for modifications to the Budget in excess of twenty-five percent (25%) of the total budget for direct costs shall be submitted to the State at least ninety (90) days prior to the end of the contract period and may require an amendment in accordance with General Provisions, Section 16, Contract ModiJications, of this Contract. The State of Colorado, specifically the Colorado Department of Public Health and Environment, shall be the owner of all equipment as defined by Federal Accounting Standards Advisory Board (FASAB) Generally Accepted Accounting Principles (GAAP) purchased under this Contract. At the end of the term of this Task Order Contract, the State shall approve the disposition of all equipment. Contractor shall not use State funds provided under this Task Order Contract for the purpose oflobbying as defined in Colorado Revised Statutes (C.R.S.) 2a-6-301(3.5)(a). The State may increase or decrease funds available under this Task Order Contract using a Grant Funding Letter substantially equivalent to Exhibit D. The Grant Funding Change Letter is not valid until it has been approved by the State Controller or designee. The State may require continued performance for a period ofup to three (3) years at the same rates and same terms specified in the Task Order Contract. If the State exercises the option, it will provide written notice to Contractor at least 30 days prior to the end ofthe current contract term in a form substantially equivalent to Exhibit E. If exercised, the provisions of the Option Letter shall become part of and be incorporated into the original Task Order Contract. The total duration of this Task Order Contract, including the exercise of any options under this clause, shall not exceed five (5) years. (Note: 5 years is the maximum allowable.) The State may increase or decrease the quantity of goods/services described in Exhibit B based upon the rates established in the Task Order Contract. Ifthe State exercises the option, it will provide written notice to Contractor as least I day prior to the end ofthe current contract term in a form substantially equivalent to Exhibit E. Delivery/performance of the goods/service shall continue at the same rates and terms. If 5. 6. 7. 8. 9. 10. ll. t2. Page 2 of 3 Contract-Exhibit-A-AdditimralProvisions-JaskOrdet-M07 1 5 EXHIBIT A exercised, the provisions of the Option Letter shall become part of and be incorporated into the original Task Order Contract. 13. The State may require the contractor to begin performance on the next contact phase as outlined in the Statement of Work in Exhibit B and at the same terms and same conditions stated in the Task Order Contract. Ifthe State exercises this option, it will provide written notice to the contractor at least I day prior to the end ofthe current phase in a form substantially equivalent to Exhibit E. Ifexercised, the provisions of the Option Letter shall become part of and be incorporated into the original Task Order Contract. Page 3 of3 Contract-Exhibit-A-AdditionalProvisions-JaskOrder-0407 1 5 EXHIBIT B STATEMENT OF WORK To Original Contract Routing Number 17 FHLA 89319 These provisions are to be read and interpreted in conjunction with the provisions of the contract specified above. Entity Name: Board of County Commissioners of Eagle County/Eagle County Public Health Agency Term: July l, 2016 through June 30, 2018 Project Description: This project serves to implement the Communities That Care mod,el, with fidelity, in order to identify evidence- based or evidence-informed youth substance abuse prevention strategies in cornmunities across Colorado. Additionally, this funding suppofts communities to identify sustainable local or regional strategies and funding for the ongoing implementation of youth substance abuse prevention strategies within each locality. III. Definitions: 1. Behavioral health: a continuum ofservices for individuals at risk of, or suffering from, mental, behavioral, or addictive disorders, and behavioral health, and as a discipline, refers to mental health, psychiatric, marriage and family counseling, and addictions treatment, and includes services provided by social workers, counselors, psychiatrists, psychologists, neurologists, and physicians, as well as nurse practitioners and physician assistants. 2. CDE: Colorado Department of Education 3. CDPHE: Colorado Department of Public Health and Environment 4. CTC or Communities That Care: an evidence-based community engagement model identified as a promising program by the Blueprints for Healthy Youth Development evidence-based registry. Communities that Care includes 5 Phases of implementation: a. Phase 1: Get Started b. Phase 2: Get Involved c. Phase 3: Develop Community Profile d. Phase 4: Create a Plan e. Phase 5: Implement and Evaluate 5. DCJ: Division of Criminal Justice, 6. LPHA: Local Public Health Agency 7. MCH: Maternal Child Health 8. OBH: Offrce of Behavioral Health at the Colorado Department of Human Services 9. Primary Prevention: As defined by the Centers for Disease Control's Principles of Prevention Guide, primary prevention takes place BEFORE substance abuse initially occurs. It involves programs and strategies designed to reduce the factors that put people at risk for substance abuse or exposure. Or, they encourage the factors that protect or buffer people from substances. 10. PYD: Positive Youth Development is an approach that guides communities and organizations in the way that they organize services, opportunities and supports. In practice, this approach incorporates the development of skills, opportunities and authentic relationships into programs, practices and policies, so that young people reach their full potential. 11. Socioecological model: CDC uses a four-level social-ecological model to better understand violence and the effect of potential prevention strategies. This model considers the complex interplay between individual, relationship, community, and societal factors. 12. State-funded prevention programs: Examples of state-funded prevention programs include the Tony Grampsas Youth Services projects, sexual violence prevention programs, communities funded by the Office of Suicide Prevention, LPHA Maternal Child Health, CDE grantees, collaborative management programs, community substance abuse treatment programs funded by OBH, Senate Bill 94 programs, and other Division of Criminal Justice programs. 13. Substance abuse: substance abuse among youth includes underage use ofmarijuana and alcohol and the misuse of prescription drugs/opioids. Additional substances may be included in the definition of substance abuse by a community if they have documented data of misuse or abuse among youth in their community, excluding tobacco. 14. TGYS: Tony Grampsas Youth Services grants for primary prevention programs in communities. II. venion: contract Statement ofwo* - Exhibit B December 201 5 17FHLA89319 ExB.docx Page I of8 EXHIBIT B Iv.Work Plan: Goal #L: Prevent substance abuse among youth within the community by addressing common risk factors and improving protective factors across the socioecological model within Colorado. Objective #l: No later than December 31,2016, the Contractor shall negotiate and receive formal agreement from key leaders and stakeholder groups within the community to implement the Communities That Care (CTC) model to identiS youth substance abuse prevention evidence-based strategies that address identified risk or protective factors within the community. Primary Activity #l The Contractor shall mobilize and build capacity among a coalition of stakeholders through steps of the Communities That Care model, using data and priorities tailored by each individual community. Sub-Activities #l L The Contractor shall provide a fuIl time Communities That Care Local Coorindator. 2. The Contractor shall recruit key leaders and potential community board members to participate in the CTC coalition, using guidance outlined in the CTC model. 3. The Contractor shall recruit leaders of state-funded prevention and treatment projects to participate in the community coalition, as available within the communities. 4. The Contactor shall recruit a minimum of one (1) youth advisor and one (l) family leader to participate on one of the workgroups within the community coalition. Family leaders may include graduates of CDPHE's Family Leadership Training Institute. 5. The Contractor shall use group facilitation skills and tools provided by CTC to help guide the coalition through the CTC process. 6. The Contractor shall prepare for and lead the CTC workshops for Phase I , in appropriate order and timing, for effective community progress. 7. The Contractor shall hold regular meetings of the coalition, a minimum of one (l) meeting of the coalition or a workgroup per month. 8. The Contractor shall complete the CTC Milestones & Benchmarks evaluation tool for Phase l, with the support of the coalition. 9. The Contractor shall ensure all community coalition meeting preparation and follow- up is completed. 10. The Contractor shall facilitate delegation of community prevention coalition tasks, including but not limited to collecting, organizing, and analyzing data; community outreach and public relations; and coalition meetings. I L The Contractor shall train community coalition members to expand community outreach. version: Contract Statement ofWork - Exhibit B December 2015 l7FHLA89319 ExB.docx Page 2 of8 EXHIBIT B Objective #2: No later than March 30, 2017, the Contractor shall complete an assessment and gap analysis of youth substance abuse prevention concerns within the community. Primary Activity #l The Contractor shall analyze local and regional data to identifu gaps in prevention for youth substance use or abuse. Sub-Activities l. The Contractor shall review data about substance abuse and mental health risk and protective factors in the community using a list provided by CDPHE of recommended indicators. This shall include school-, district-, or regional-level data from the Healthy Kids Colorado Survey. 2. The Contractor shall review and update information included in the existing local community health assessment required in the Public Health Act of 2008, regarding youth substance abuse and mental health with members of the coalition. 3. The Contractor shall prepare for and lead the CTC workshops for Phases 2-3 with appropriate timing for effective community progress, 4. The Contractor shall complete additional assessments/data analysis to develop a clear picture of gaps in youth substance abuse prevention within the community, specifically related to shared risk and protective factors that prevent substance use. 5. The Contractor shall request data from members of the coalition to further analyze gaps in local youth substance abuse prevention. 6. The Contractor shall request local or regional data from CDPHE released after the completion of the existing community health assessment to further identifr gaps or concerns related to youth substance use, abuse, and prevention. 7. The Contractor shall engage community members to assess risk and protective factors driving prioritized problems based on selected prevention priorities. 8. The Contractor shall map existing resources already in place within the community to address the gaps identified in the data. 9. The Contractor shall analyze and summarize these assessment results in an updated community health assessment report using a CDPHE-approved template for the substance abuse-related risk, protective and outcome data. 10. The Contractor shall present the results of the updated community health assessment report, a minimum of twice during the first twelve (12) months of this Contract, including members of the coalition and community. 1 l. The Contractor shall identify a shared mission and vision of coalition members, based on information from the updated needs assessment. 12. The Contractor shall complete the Phase 5 Trainings on Funding and Systems Change with the coalition. 13. The Contractor shall complete the CTC Milestones & Benchmarks evaluation tool for Phases 2-3 and related tasks in Phase 5, with the support ofthe coalition. vereion: Contract Statement of Work - Exhibit B December 201 5 l7FHLA893l9 Ex B.docx Page 3 of8 EXHIBIT B ., Objective #3: No later than June 30, 2017 , the Contractor shall develop a prevention action plan to implement primary prevention strategies to reduce risk and promote protective factors addressing gaps in youth substance abuse prevention identified in the assessment. Primary Activity #1 The Contractor shall develop a prevention action plan to address gaps in youth substance abuse prevention identified in the assessment, to be implemented in years two through five ofthis Contract, using evidence-based or informed strategies from a list approved by CDPHE. Sub-Activities 2. 3. +. 5. 6. Il. 8. The Contractor shall build capacity of community coalition members to address alcohol, prescription drug, and marijuana use/abuse among youth by providing a minimum of two (2) trainings designed for coalition members: substances and impacts oftheir use on young people and positive youth development principles and practices. The Contractor shall determine (in consultation with coalition) the geographic areas/community(ies) appropriate for intervention within the prevention action plan. The Contractor shall prepare for and lead the CTC workshops for Phases 4-5 with appropriate timing for effective community progress, with support from CDPHE. The Contractor shall develop a process for setting prevention priorities based on updated assessment data from that community. The Contractor shall identiff existing prevention programs that can be leveraged to address the strategies selected at each ofthe socioecological model levels, including programs funded by CDE, MCH, TGYS, OBH or DCJ. The Contractor shall identifu (in consultation with coalition) a minimum of one (1) prevention strategy from both the societal and community levels of the socioecological model to implement to improve social norms, life skills and resilience, and community connectedness. Strategies shall be selected from a menu of prevention strategies to be provided by CDPHE. The Contractor shall identifu (in consultation with coalition) action steps to improve implementation of evidence-based prevention strategies from the menu of prevention strategies at the individual and relationship levels ofthe socioecological model. The Contractor shall develop a logic model that illustrates and connects the problems the coalition will address, evidence-based strategies to address those problems, and anticipated outcomes. The Contractor shall work with community prevention coalition members, members of the larger community and CDPHE to develop a comprehensive community prevention action plan, using evidence-based or evidence-informed strategies from the menu of prevention strategies to be provided by CDPHE. The Contractor shall develop budgets for implementation of prevention strategies identified by the coalition. The Contractor shall identiff process and outcome evaluation measures for each action step and strategy implemented within the prevention action plan. The Contractor shall complete the relevant sections of the CTC Milestones & Benchmarks evaluation tool for Phases 4-5, with the support of the coalition. 9. t0 u t2 version: Contract Statement ofwork - Exhibit B December 2015 l7FHLA893lg_Ex B.docx Page 4 of8 EXHIBIT B ',i l. l .' Objective /14: No later than June 30, 2018, the Contractor shall begin to implement substance abuse prevention strategies within the community. Primary Activity #l The Contractor shall document the implementation of a minimum of twelve (12) months of completion of specific action steps and related evaluation measures from the prevention action plan, including successes and challenges the CTC coalition encountered while implementing substance abuse prevention strategies within the community. Sub-Activities #l 1. The Contractor shall be aware of and involved in the implementation of any substance abuse prevention strategies within both communities to avoid duplication. 2. The Contractor shall document successes or challenges encountered by community coalition members while implementing strategies. 3. The Contractor shall track progress toward implementation of the steps outlined in the community prevention action plan. 4. The Contractor shall discuss edits and updates to the community prevention action plan with the CDPHE contract monitor. 5. The Contractor shall complete the relevant sections of the CTC Milestones & Benchmarks evaluation tool for Phases 4 and 5, with the support of the coalition. Standards and Requirements l. The content of electronic documents located on CDPHE and non-CDPHE websites and information contained on CDPHE and non-CDPHE websites may be updated periodically during the contract term. The Contractor shall monitor documents and website content for updates and comply with all updates. 2. The Contractor shall participate in all required technical assistance meetings conducted by the CDPHE CTC team. 3. The Contractor shall facilitate and document the implementation of the five phases of the Communities That Care model with fidelity, providing justification for necessary adaptations. The five phases are described on the CTC website: http://www.communitiesthatcare.net/how-ctc-works/. incorporated and made part ofthis Contract by reference. 4. The Contractor shall ensure that the CTC Facilitator will demonstrate the skills identified in the CTC Facilitator job description provided by the University of Washington. 5. CDPHE will provide a list of recommended youth substance abuse and mental health risk and protective factor indicators for a community to review for inclusion in the updated community health assessment. 6. CDPHE will provide a menu of approved primary prevention strategies across the socioecological model for implementation by communities. These strategies will be based on the best available research and evidence for the prevention of substance abuse. 7. The Contractor shall select strategies for implementation in the community . prevention action plan from the menu of primary prevention strategies to be provided by CDPHE. The Conhactor shall employ a minimum of one (1) strategy at the community and one (l) strategy at the societal levels ofthe socioecological model. 8. The Contractor shall use the CDPHE-approved template for the community prevention action plan. 9. CDPHE will review the following submitted items within five (5) business days of receipt and provide feedback: a. updated chapter for the community health assessment with recent data on risk and protective factors related to youth substance use. b. community prevention action plan and related evaluation activities. 10. The Contractor shall receive CDPHE approval for the community prevention version: Contracl Statemeil ofWork - Exhibit B December 201 5 l7FHLA893l9_Ex B.docx Page 5 of8 EXHIBIT B I l. action plan prior to strategy implementation. The Contractor shall receive CDPHE approval for the community prevention action plan prior to implementing evaluation strategies. The Contractor shall submit any edits to the community prevention action plan to CDPHE for approval. The Contractor shall adhere to all eCTC license agreement requirements. The Contractor shall ensure all community facilitators using the eCTC system must successfully complete the Facilitator Training and content mastery assignment in advance of launching eCTC in their communities. a. To ensure high quality implementation of eCTC, this license assumes that community facilitators have successfully completed a Facilitator Training and content mastery assignment, and their communities are working with a certified CTC coach. The Contractor shall comply with the National Standards for Culturally and Linguistically Appropriate Services in Health Care (CLAS Standards) website http://wlvw.inteeration.samhsa.goviEnhancedCLASStandardsBluerrrint.pdf as they relate to health communications and is incorporated and made part of this Contract by reference. The Contractor shall utilize current substance abuse social marketing campaign materials provided by CDPHE. The Contractor shall use only marijuana research or statements on the health effects outlined by the Retail Marijuana Public Health Advisory Committee. These approved health statements and factsheets are incorporated and made part ofthis Contract by reference and are available on the following website www. colorado. gov/marij uana. The Contractor shall attend identified trainings, including grantee orientation, the Communities That Care model, effective facilitation strategies, positive youth development, accessing data resources, prevention-science, and others as identified. The Contractor shall use the CDPHE-approved progress and final report template, to be provided by CDPHE, which includes the following requirements: a. Updates to the Milestones and Benchmarks process tracking document, b. Number and description of community partners engaged in the coalition and workgroups, c. Evaluations of workshops, workgroups and coalition meetings, d. Updates, progress, and outcome reporting on any prevention action plan steps and related evaluation activities within the community prevention action plan, e. Opportunities and next steps for the program, and f. document a minimum of one (1) documented success story from the project The Contractor shall provide to CDPHE upon request written procedures related to gift card pwchase and handling. At a minimum, the procedures must include the following: a. How the gift card inventory is tracked and maintained b. Gift card storage and safeguards against theft c. The primary person responsible for securing and distribution gift cards, d. A gift card distribution log that records each gift card number, dollar amount, and the printed name and signature of each gift card recipient. The Contractor shall provide CDPHE with an updated staffroster of CTC Facilitators within two weeks of any staffing change. CDPHE will provide,Flealthy Kids Colorado Survey data at the regional level, where available. t2. 13. IAl+. 15. t6. t7. 18. 19. 20. 21. 22. Page 6 of8 version: contract Statement ofWork - Exhibit B December 2015 l7FHLA893l9_Ex B.docx EXHIBIT B www.chd.dphe.state.co.us/topics.aspx?q:Adolescent_Health_Data. This information is incorporated and made part of this Contract by reference. Expected Results of Activity(s) Reduce youth substance use and abuse through the implementation of the Communities That Care model and identified evidence-informed primary prevention strategies in communities across Colorado. Measurement ofExpected Results Final progress and outcome evaluation results, including: a. documented CTC Milestones & Benchmarks b. community health assessment with analyzed data on risk and protective factors related to youth substance use c. implementation of community prevention action plan, including evaluation activities Completion Date Deliverables 1. The Contractor shall provide a monthly update via phone to the CTC Coordinator at CDPHE on the progress of the activities and deliverables in the scope of work. The Contractor will include local CTC Coordinator staff on the monthly call for needed TA and coaching. No later than the first of each month 2. The Contractor shall provide completed "Milestones & Benchmarks" spreadsheet via email to CDPHE's CTC Coordinator documenting completed activities for Phase 1 of the CTC process. No later than December 31.2016. 3. The Contractor shall submit a mid-year progress report via email to the CDPHE CTC Coordinator following CDPHE guidance that provides an overview ofall activities imolemented in the first six months of fundine. No later than December 31,20t6. 4. The Contractor shall provide completed "Milestones & Benchmarks" spreadsheet via email to the CDPHE CTC Coordinator documenting completed activities for Phases 2- 3 ofthe CTC process. No later than March 31, 20t7 5. The Contractor shall provide an updated chapter ofthe community health assessment via email to the CDPHE CTC Coordinator with recent data on risk and protective factors related to youth substance use. No later than March 3l 20t7 6. The Contractor shall submit a community prevention action plan via email to the CDPHE CTC Coordinator for implementation in years two (2) through five (5) that addresses the identified gaps found in the community health assessment. No later than June 30, 20t7 7. The Contractor shall submit a first-year report via email to the CDPHE CTC Coordinator that provides an overview of all activities implemented in the first fiscal year. No later than June 30, 2017 8. The Contractor shall submit a quarterly report via email to the CDPHE CTC Coordinator that provides an overview of all activities implemented in the first quarter of the second fiscal year. No later than September 30,2017 vgrsion: Contract Statemeot of Work - Exhibit B December 2015 1 7FI{LA893 l9_Ex B.docx Page 7 of8 v. EXHIBIT B 9. The Contractor shall submit an eighteen-month (18) report via email to the CDPHE CTC Coordinator that provides an overview of all activities implemented in the first eighteen months of the contract. No later than December 3t,2017 10. The Contractor shall submit a quarterly report via email to the CDPHE CTC Coordinator that provides an overview of all activities implemented in the third quarter of the second fiscal year. No later than March 30, 2018 1l. The Contractor shall submit a final report via email to the CDPHE CTC Coordinator that provides an overview of all activities implemented in the second fiscal year. No later than July 31 2018 Monitoring: CDPHE's monitoring of this contract for compliance with performance requirements will be conducted throughout the contract period by the CDPHE CTC Coordinator. Methods used will include a review of documentation determined by CDPHE to be reflective of performance to include progress reports and other fiscal and programmatic documentation as applicable. The Contractor's performance will be evaluated at set intervals and communicated to the contractor. A Final Contractor Performance Evaluation will be conducted at the end of the life ofthe contract. Resolution of Non-Compliance: The Contractor will be notified in writing within fifteen (15) calendar days of discovery of a compliance issue. Within thirty (30) calendar days of discovery, the Contractor and the State 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 in writing 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 CDPHE CTC Coordinator and receive approval for a new due date. The State will oversee the completion/implementation of the action(s) to ensure time lines are met and the issue(s) is resolved. If the Contractor demonstrates inaction or disregard for the agreed upon compliance resolution plan, the State may exercise its rights under the provisions ofthis contract. VI. vemion: Conbact Statement ofwork - Exhibit B December 201 5 l7FHLA893l9 ExB.docx Page 8 of8 EXHIBIT C /\Iffi ICOLORADOAW ls::mrffiHlffiH- PREVENTION SERVICES DMSION. BUDGET WITH JUSTIFICATION FORM Contract Routing # 17 FHLA 89319 toitractor Name .':,:..:1,: - : ,, Eagle County Public Health and Environment Budget Period .f uly 1, 2016 - Jun e 30,2077 Project Name Communities That Care-Creating Healthy Youth in the Eagle River Valley Program Contact Nam€, Title, Phone and Email Sarah Kennedy, Total Health Alliance Coordinator, 970-328- Fiscal Contact Name. Title, Phone and Emait Denise Matthews, Program Support Services Manager, 970- Expenditurc Categories I tl it Position Title/Employee Name Description of Work Budget ltem Supports SOW lYes/Nol Gross or Annual Salani Frinqe Percent ot Time on Proie.t Total Amount Requested from CDPHE Project Administrator Project Administrator will provide oversight of contract, insure deliverables are met, act as main contact for CDPHE, provide required evaluation and reporting to CDPHE, establish regular check-in meetings with contractor (ERYC), attend CTC Coalition meetings and local trainings. Yes Ss7,ooo.o(s2,781.0(10.1 Ss,978.to 't:.ta:,::,.:u :: Position Title/Employee Name Descriotion of work Budget ltem Supports SOW lYes/Nol Hourlv Waoe Hourly Frinae Total # of Hours on Proiect Total Amount Requested from CDPHE I 50.00 ;"ffi;l;. .-'-it+r*t' I Supplies & Operating Etpenses I Item Descriotion of ltem Budget ltem Supports SOW lYes/Nol Rate OuantiW Total Amount Requested from CDPHE Sffice Supplies Seneral office supplies: flip chart paper, copy paper, toner Yes 587.00 1 S87.oo Printing lerinting of training materials, letters, handouts Yes Sroo.oo f Sloo.oo iqt Sli;*:;,":;. travel Item Description of ltem Budget ltem Supports 5()\ lYes/Nol Rate Ouantitv Total Amount Requested from CDPHE Vlileage .ocal travel to coalition meetings and other related activities: 2 neetings/month, 4 trainings, 42 miles per meeting Yes So.s4 lf /o 563s.04 Page 1 of2 EXHIBIT C PREvENrIoNsERvlcEs"lx.itljl;il:"-"t1ffi il:;lrttto"oNFoRM Contractor Name Eagle County Public Health and Environment Budget Period Jufy 1, 2016 - June 30,2077 Project Name Communities That Care-Creating Healthy Youth in the Eagle River Valley Program Contact Name, Tide. Phone and Email Sarah Kennedy, Total Health Alliance Coordinator, 970-328- Fiscal Contact Name, T'rde, Phone and Email Denise Matthews, Program Support Services Manager, 970- Page2 of2 EXHIBIT D Date:State Fiscal Year:Grant Funding Change Letter (GFCL) # CMS Routine # CORE Encumbrance # GRANT FUNDING CHAIIGE LETTER TO: ':lnsert Grant*s's namc." In accordance with Section of the Original Contract routing number , [inserr rhr 1allorvi:rg language here if prelious ar-lelrdment(s). rentrval(s) have been pri:cesssrll as amended by linclude allprevious arnendmenl(s), renewall.s) and their ror.iting n*mbersl, f ilsert the faiiorvirrg *,orils here rf previous amelrdrnenl{s), renerval{s) have been proccssed] between the State of Colorado, Department of Public Health and Environment and <irsed contractor name" beginning <inscrl srai:.late of original colllracl> and ending on ..insert ending date r:f current conlracl amendrnent>., the undersigned commits the following funds to the Grant: The amount of ({bderal, state, other) grant funds available and specified in Section of < insert previoi.rs contract nrr:dificatior numb*r and routing nunrber> is ! increased or ! decreased by $ anrour)i ofchange to new total funds for the period ":ijate to date'- of $ {ilscrl ntw period cumularive total" for the following reason: Section is hereby modified accordingly. The revised Budget is incorporated herein by this ref'erence and identifled as Revised Exhibit *. (if bud-set attached: delcte surrence if no budger included.) Complete the table beloiv; insert./eleletc roi,vs as needcd. The table below reflects the original budget and all modifications to the total since the effective date of the Original Contract. The effective date of hereof is upon approval of the State Controller or {insrrt p.ojccied effecrive dare.>, whichever is later. ALL GRANTS REOUIRE APPROVAL BY THE STATE CONTROLLER CRS 524-30-202 requires the State Controller to approve all State Grants. This Grant is not valid until signed and dated below by the State Controller or delegate. Grantee is not authorized to begin performance until such time. If Grantee begins performing prior thereto, the State of Colorado is not obligated to pay Grantee for such performance or for any goods and/or services provided hereunder. STATE CONTROLLER Robert Jaros, CPA, MBA, JD By: Date: SUMMARY OF CHANGES Document Type CMS Routing # Funding Source (federal, state. other)Period Dollar Amount Period Total Orieinal Contract $$ $$ $s $s $$ Contract Cumulative Grand Total $ ng not constltute an servlces STATE OF COLORADO John W. Hickenlooper, GOVERNOR Department of Public Health and Environment PROGRAM APPROVAL: By: By: Lisa McGovern, Purchasing & Contracts Section Director Date: EXHIBIT E 1) 2l Date:State Fiscal Year:Option Letter No.CMS Routinq # CORE Encumbrance # OPTIONS: Choose all applicable options listed in $1 and in $2 and delete the rest. a. Option to renew only (for an additionalterm) b. Change in the amount of goods within current term c. Change in amount of goods in conjunction with renewalfor additional term d. Level of service change within current term e. Level of service change in conjunction with renewal for additional term f. Option to initiate next phase of a contract REQUIRED PROVISIONS. All Option Letters shall contain the appropriate provisions set forth below: a. For use with Options 1(a-e): In accordance with Section(s)of the Original Contract routing number between the State of Colorado, Insert Name of Department or Higher Ed Institution , and Contractor's Name, the State hereby exercises its option for an additional term beginning Insert start date and ending on Insert ending date at a cosUprice specified in Section , AND/OR an increase/decrease in the amount of goods/services at the same rate(s) as specified in ldentify the Section, Schedule, Attachment, Exhibit etc. u. For use with Option l(fl. please use the followinq: In accordance with Section(s) of the Original Contract routing number between the State of Colorado, lnsert Name of Department or Higher Ed Institution , and Contractor's Name, the State hereby exercises its option to initiate Phase indicate which Phase: 2,3, 4, etc for the term beginning Insert start date and ending on Insert ending date at the cosUprice specified in Section c. For use with all Options 1(a-fl: The amount of the current Fiscal Year contract value is increased/decreased by $ amount of change to a new contract value of Insert New $ Amt to as consideration for services/goods ordered under the contract for the current fiscal year indicate Fiscal Year. The first sentence in Section is hereby modified accordingly. The total contract value including all previous amendments, option letters, etc. is Insert New $ Amt. 3) Effective Date. The effective date of this Option Letter is upon approval of the State Controller or , whichever is later. ALL CONTRACTS REOUIRE APPROVAL BY THE STATE CONTROLLER CRS S24-30-202 requires the State Controller to approve all State Contracts. This Contract 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 .Date: By: ATE OF COLORADO John W. Hickenlooper, GOVERNOR Department of Public Health and Environment PROGRAM APPROVAL: By: By: Lisa McGovern, Purchasing & Contracts Section Director Date: OPTION LETTER