HomeMy WebLinkAboutC11-202 Environment Immunization Program Amendment 35 Immunization FundsSTATE OF C_JLORADO
John W. Hickenlooper, Governor
Christopher E. Urbina, MD, MPH
Executive Director and Chief Medical Officer
Dedicated to protecting and improving the health and environment of the people of Colorado
4300 Cherry Creek Dr. S.
Denver, Colorado 80246-1530
Phone (303) 692-2000
Located in Glendale, Colorado
http://www.cdphe.state.co.us
Laboratory Services Division
8100 Lowry Blvd.
Denver, Colorado 80230-6928
(303)692-3090
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Colorado Department
of Public Health
and Environment
Colorado Department of Public Health and Environment Immunization Program
Amendment 35 Immunization Funds for Local Public Health Agency
Statement of Work
Term: July 1, 2011 through June 30, 2012
1. The local public health agency (LPHA) shall collaborate with community leaders to work toward
formulating policies designed to solve local immunization access issues by:
A. Promoting, educating, and supporting providers regarding the value of active participation in reminder
and recall activities through:
1. community and provider trainings regarding implementation of clinic and practice based reminder
and recall systems.
2. collaboration with community providers to implement clinic and practice based reminder and recall
systems (i.e. Colorado Immunization Information System — CIIS).
3. implementation of LPHA clinic based reminder and recall systems.
2. The LPHA shall follow the Standards for Child and Adolescent Immunization Practices (CDC, 2006) to
assure all populations have access to appropriate immunization services and evaluate the effectiveness of
that service in their communities by:
A. Delivering optimal immunization clinical services including proper storage and documentation of
vaccinations including:
1. developing and following appropriate procedures for vaccine storage and handling with appropriate
clinic equipment and implementation of written policies and procedures for vaccine storage, vaccine
ordering, and emergency response.
2. utilizing up-to-date written vaccination protocols and having them readily accessible at all locations
where vaccines are administered.
3. persons who administer vaccines and staff who manage or support vaccine administration are
knowledgeable and receive ongoing education.
B. Conducting onsite clinical services with optimal access such as:
1. non-traditional clinic access at a minimum of one (1) of the LPHA's clinics to permit clients access
to necessary vaccinations during evening or weekend hours (e.g. expanded clinic hours).
2. providing "express lane" or drop-in appointments at the LPHA's clinic.
3. utilizing incentives to encourage completion of children's primary immunization schedule.
C. Providing support for immunization initiatives through the Colorado Supplemental Nutrition program —
Woman, Infants and Children (WIC) by:
1. providing vaccinations on site, or
2. assessing immunization histories and referring children appropriately, or
3. distributing educational materials regarding immunization and locally available services.
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3. The LPHA shall perform an o ment of the available immunization .ces within their jurisdiction and
.monitor the health of their comi..anities and children at risk for under-inimunization by:
A. Collaborating with one or more agencies to:
1. determine the availability of immunization services within their communities.
2. ensure immunization services are readily accessible at sites other than the LPHA's site.
3. provide community education regarding vaccines and immunizations through distribution of
educational materials, provision of educational workshops, and submission of press releases with
relevant news and updates.
4. provide technical advice and assistance for providers and other appropriate activities.
4. BUDGET: In consideration of those services satisfactorily and timely performed by the LPHA under this
Purchase Order, the State shall cause to be paid to the LPHA a sum not to exceed Thirty -Eight Thousand
Three Hundred Eight Dollars ($38,308.00). Of the total financial obligation of the State referenced above,
$0.00 are identified as attributable to a funding source of the United States government and, $38,308.00 are
identified as attributable to a funding source of the state of Colorado.
5. OFFICE VISIT FEE: Contractors receiving these 2011-12 Amendment 35 Immunization Funds for LPHA
agree to abstain from charging an office visit fee in addition to the allowable vaccine administration fee.
6. REIMBURSEMENT under this Purchase Order shall be made to the LPHA by the State on a quarterly
basis; accordingly, the LPHA shall be paid one fourth (1/4) of the State's financial obligation under this
Purchase Order each quarter. The LPHA shall be reimbursed Nine Thousand Five Hundred Seventy -
Seven Dollars$9( ,577.00) per quarter. The final payment for this Purchase Order is contingent upon the
State's timely receipt of an annual statement from LPHA in the form attached hereto as Attachment A,
which is incorporated herein by this reference.
7. REPORTS: The LPHA shall submit two (2) online progress reports to the State. These progress reports are
included in the progress reports required for the General Immunization Core Services contract. Each
progress report is due within fifteen (15) calendar days of the end of each reporting period. The progress
reports shall document the LPHA's progress towards completion of the activities described herein. The
LPHA's December and June payments shall not be reimbursed by the State until the requisite progress report
is submitted to the State by the LPHA. Reporting period and progress report due dates are as follows:
Progress Period Due Date
July 1 - December, 2011 January 15, 2012
January 1- June 30, 2012 July 15, 2012
Thank you for your cooperation and support. If you have any questions, please contact me, Teri Lindsey at
303-692-2732 (teri.lindseygstate.co.us), or Lynn McCracken at 303-692-2447 (lynn.mccracken@state.co.us).
Sincerely,
Beth Hoffinan
Fiscal Manager, Immunization Program
Phone: (303) 692-2314
Beth.hoffinankstate.co.us
Pa
AMENDMENT 35 FUNDS
EAGLE COUNTY PUBLIC HEALTH AGENCY total for FY 2012 = $38,308.00
LOCAL PUBLIC HEALTH PARTNER ACCEPTANCE OF Colorado Department of Public Health and
Environment Immunization Program Amendment 35 Immunization Funds for Local Public Health Agency
Statement of Work REQUIREMENTS:
on behalf of
hereby acknowledge the requirements for the above-named Immunization Service Purchase Order have been
reviewed, and are accepted and agreed to. I further acknowledge that I have the necessary authority to sign this
acceptance on behalf of the ,entity mentioned above.
Signatufe 1 Title Date
Attachment A
COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
IMMUNIZATION PROGRAM
2011-2012 CONTRACT REIMBURSEMENT CERTIFICATION FORM
PLEASE RETURN BY July 15,201
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All
.Ole.
tractor orut a ed Designee Date
CDPHE:
I hereby certify that contract requirements have been met and final payment of
$ for contract services for the period of July 1, 2011 through
June 30, 2012 is authorized.
SIGNATURE
Program Director or Authorized Designee
Date
