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HomeMy WebLinkAboutC17-173 Colorado Department of Public Health and EnvironmentDEPARTMENT OR I r,{r FHLA-CCPD ffE,LkXkT1T1 71k FAAA TASK ORDER AMENDMENT ROUTING NUMBER 18 FHLA 96047 To Original Task Order Routing Number 16 FHLA 76514 TASK ORDER AMENDMENT #2 This Task Order Amendment is made this 3rd day of May, 2017, by and between the State of Colorado, acting by and through the DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT, whose address or principal place of business is 4300 Cherry Creek Drive South, Denver, Colorado 80246, hereinafter referred to as the "State"; and, BOARD OF COUNTY COMMISSIONERS OF EAGLE COUNTY, (a political subdivision of the state of Colorado), whose address or principal place of business is 500 Broadway, Eagle, CO 81631-0850, for the use and benefit of the Eagle County Public Health Agency, whose address or principal place of business is 551 Broadway, Eagle, CO 81631, hereinafter referred to as the "Contractor". FACTUAL RECITALS The parties entered into a Master Contract dated January 17, 2012, with contract routing number 13 FAA 00016. Pursuant to the terms and conditions of the Master Contract the parties entered into a Task Order Contract dated April 30, 2015, with encumbrance number CT FAAA FHLA 20160000000000000062, and task order contract routing number 16 FHLA 76514, hereafter referred to as the "Original Task Order Contract", whereby the Contractor was to provide to the State the following: This project serves to increase the number of workplaces in Eagle, Grand, Jackson, Pitkin, and Summit Counties offering comprehensive worksite wellness programs that include healthy eating, physical activity and other healthy lifestyle behaviors. Changes were required to extend for an additional term and to reflect changes to the Additional Provisions. The State promises to pay the Contractor the sum of Two Hundred Fifty Five Thousand Dollars, ($255,000.00) for the renewal term of 1 year, ending on June 30, 2018, in exchange for the promise of the Contractor to perform the specifications to the work described herein. NOW THEREFORE, in consideration of their mutual promises to each other, stated below, the parties hereto agree as follows: Consideration for this Contract Amendment to the Original Task Order Contract consists of the payments and services that shall be made pursuant to this Contract Amendment, and promises and agreements herein set forth. 2. It is expressly agreed to by the parties that this Contract Amendment is supplemental to the Original Task Order Contract, contract routing number 16 FHLA 76514, as amended by Amendment #1, contract routing number 17 FHLA 87000, collectively referred to herein as the Original Task Order Contract, which is by this reference incorporated herein. All terms, conditions, and provisions thereof, unless specifically modified herein, are to apply to this Contract Amendment as though they were expressly rewritten, incorporated, and included herein. Page 1 of 4 18 FHLA 96047 AMD #2 .docx ver 03.5.17 It is expressly agreed to by the parties that the Original Task Order Contract is and shall be modified, altered, and changed in the following respects only: A. This Contract Amendment is issued pursuant to paragraph 5 of the Original Task Order Contract. The revised Additional Provisions of the Original Contract, are incorporated herein by this reference and identified as Exhibit F. Modified Provisions: 1. The following provisions are hereby added: a. Provision of Lawful Presence in Section 13, Page 2, of the Additional Provisions. b. Provision for Media Disclaimer in Section 14, Page 2, of the Additional Provisions. B. The period of performance of the current term is hereby extended by Twelve (12) months, changing the current ending date from June 30 2017 to June 30 2018. The revised period of performance is July 1, 2015 through and including June 30, 2018. 1. This Contract Amendment is for the renewal term of July 1, 2017, through and including June 30, 2018. The maximum amount payable by the State for the work to be performed by the Contractor during this renewal term is Two Hundred Fifty Five Thousand Dollars, ($255,000.00) for an amended total contract financial obligation of the State of Seven Hundred Thirty Eight Thousand Dollars, ($738,000.00). a. For this renewal term the maximum amount payable attributable to a State of Colorado funding source is Two Hundred Fifty Five Thousand Dollars, ($255,000.00), and the amended total contract financial obligation attributable to a State of Colorado funding source is Seven Hundred Thirty Eight Thousand Dollars, ($738,000.00). The modified specifications to the original Statement of Work and Budget are incorporated herein by this reference and identified as "Exhibit G", Exhibit H". The Original Task Order Contract is modified accordingly. All other terms and conditions of the Original Task Order Contract are reaffirmed. 4. The Effective Date of this Contract Amendment is July 1, 2017, or upon approval of the State Controller, or an authorized delegate thereof, whichever is later. 5. Except for the General Provisions and Special Provisions of the Original Task Order Contract, in the event of any conflict, inconsistency, variance, or contradiction between the terms and provisions of this Contract Amendment and any of the terms and provisions of the Original Task Order Contract, the terms and provisions of this Contract Amendment shall in all respects supersede, govern, and control. The Special Provisions shall always control over other provisions of the Original Task Order Contract or any subsequent amendments thereto. The representations in the Special Provisions to the Original Task Order Contract concerning the absence of personal interest of state of Colorado employees are presently reaffirmed. 6. FINANCIAL OBLIGATIONS OF THE STATE PAYABLE AFTER THE CURRENT FISCAL YEAR ARE CONTINGENT UPON FUNDS FOR THAT PURPOSE BEING APPROPRIATED, BUDGETED, AND OTHERWISE MADE AVAILABLE. Page 2 of 4 18 FHLA 96047 AMD #2 .docx ver 03.5.17 SIGNATURE PAGE Contract Routing Number: 18 FHLA 96047 THE PARTIES HERETO HAVE EXECUTED THIS TASK ORDER AMENDMENT Each person signing this Task Order Amendment represents and warrants that he or she is duly authorized to execute this Task Order Amendment and to bind the party authorizing his or her signature. CONTRACTOR STATE OF COLORADO Board of County Commissioners of Eagle County for John W. Hickenlooper, Governor the use and benefit of the Eagle County Public Health Agency Colorado Department of Public Health and (a political subdivision of the state of Colorado) Jillian H. Ryan Print Name of Authorized Individual Chair ri T' le f Au d rvidual nature o Authorized ividual Environment Larry Wolk, MD, MSPH, Executive Director and Chief Medical Officer By: �- Lisa McGovern Purchasing and Contracting Section Director, CDPHE It -D Date PROGRAM APPROVAL LEGAL REVIEW Colorado Department of Public Health and Environment Cynthia H. Coffman, Attorney General By: By: !` Signature of Authorized CDPM Program Approver Signature — Senior Assistant Attorney General i�ai171 ate Date In accordance with §24-30-202 C.R.S., this Task Order Amendment is not valid until signed and dated below by the State Controller or an authorized delegate. STATE CONTROLLER BSA', JD By: CDPHE Agency Delegate Effective Date: `C /?-0// Page 3 of 4 18 FHLA 96047 AMD #2 .docx This page left intentionally blank. Page 4 of 4 18 FHLA 96047 AMD #2 .docx EXHIBIT F ADDITIONAL PROVISIONS To Original Contract Routing Number 16 FHLA 76514 Contract Amendment #2 Routing Number 18 FHLA 96047 These provisions are to be read and interpreted in conjunction with the provisions of the Contract specified above. 1. This Task Order Contract contains state funds. 2. To receive compensation under the Task Order Contract, the Contractor shall submit a signed Monthly CDPHE Reimbursement Invoice Form. This form is accessible from the CDPHE internet website htt ://www.colorado.gov/cs/Satellite/CDPHE-Main/CBON/1251622941228 and is incorporated and made part of this Task Order 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 45 calendar days after the end of the billing period for which services were rendered. Expenditures shall be in accordance with this Statement of Work and Budget. Scan the completed and signed CDPHE Reimbursement Invoice Form into an electronic document. Email the scanned invoice with the Excel workbook containing the Expenditure Details page to the assigned CCPD Program Contract Coordinator. Final billings under the Task Order Contract must be received by the State within a reasonable time after the expiration or termination of the Task Order Contract; but in any event no later than 45 calendar days from the effective expiration or termination date of the Task Order Contract. Unless otherwise provided for in the Task Order Contract, "Local Match", if any, shall he included on all invoices as required by funding source. The Contractor shall not use federal funds to satisfy federal cost sharing and matching requirements unless approved in writing by the appropriate federal agency. 3. Time Limit For Acceptance Of Deliverables. a. Evaluation Period. The State shall have 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 of the failure or deficiencies, in writing, within 30 calendar days of. 1) the date the deliverable is delivered to the State by the Contractor if the State is aware of the failure or deficiency at the time of delivery; or 2) the date the State becomes aware of the failure or deficiency. 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 of time, not to exceed 30 calendar days, to correct the noted deficiencies. 4. Health Insurance Portability and Accountability Act (HIPAA) Business Associate Determination. The State has determined that this Task Order Contract does not constitute a Business Associate relationship under HIPAA. This award does not include funds for Research and Development. Page 1 of 2 Contract Exhibit A AdditionalProvisions 2017-04-24 1ON40111.11d 1 6. If Contractor indicates full expenditure of funds under this Task Order Contract by February 28 of each grant year and the full expenditure does not occur, CDPHE has the option to reduce current or upcoming Task Order Contract by said amount or a percent deemed reasonable by CDPHE. CDPHE will notify the Contractor of the potential need to decrease the current or upcoming budget. If the Contractor indicates at a later date than February 28 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 February 28, CDPHE will reallocate unspent funds without any penalties to the Contractor. Contractor shall request prior approval in writing from CDPHE for all modifications to the Statement of Work or for a cumulative modification to the direct costs in excess of twenty-five percent (25%) of the total budget for direct costs, between budget categories. Budget revisions are also required to incur expenses against a budget category with zero funds budgeted. To open a new budget category line, the Contractor must seek approval from CDPHE prior to incurring expenditures against the new budget line. Any request for modifications to the Budget in excess of 25% percent of the total budget for direct costs or $250,000.00, whichever is less, shall be submitted to CDPHE at least 90 days prior to the end of the contract period and may require an amendment in accordance with General Provisions, Section 5 of this Task Order Contract. Contractor affirms that it maintains no affiliations or contractual relationships, direct or indirect, with tobacco companies, owners, affiliate, subsidiaries, holding companies, or companies involved in any way in the production, processing, distribution, promotion, sales, or use of tobacco. The State of Colorado, specifically the Colorado Department of Public Health and Environment, shall be the owner of all equipment as defined by the Federal Accounting Standards Advisory Board (FASAB) Generally Accepted Accounting Principles (GAAP) purchased under this Task Order Contract. At the end of the term of this Contract, the State shall approve the disposition of all equipment. 10. Contractor shall not use funds provided under this Task Order Contract for the purpose of lobbying as defined in Colorado Revised Statutes (C.R.S.) 24-6-301(3.5)(a). 11. CDPHE may increase or decrease funds available under this Task Order Contract using a Grant Funding Change Letter substantially equivalent to Attachment F -I. The Grant Funding Change Letter is not valid until it has been approved by the State Controller or designee. 12. CDPHE may require continued performance for a period of up to two (2) years at the same rates and same terms specified in the Task Order Contract. If CDPHE exercises this option, it will provide written notice to Contractor at least 30 days prior to the end of the current Task Order Contract term in a form substantially equivalent to Attachment F-2. If exercised, the provisions of the Option Letter shall become part of and be incorporated into the original Contract. The total duration of this Task Order Contract, including the exercise of any options under this clause, shall not exceed three (3) years. 13. Contractors that provide direct services of benefit to individuals 18 years of age or older shall ensure they only provide services to individuals lawfully present in Colorado. Contractor shall maintain documentation demonstrating the individual's establishment of lawful presence, which shall include documentation of an appropriate identification document and an affidavit as required by section 24-76.5-103, C.R.S. 14. Publications, presentations, or public events resulting from Amendment 35 CCPD Grants Program funding must include the following acknowledgment of grant support and a disclaimer. Funding for this event/project/program was provided (in part) by Amendment 35 Cancer, Cardiovascular, and Pulmonary Disease Program (CCPD) funding. The views expressed do not necessarily reflect the official policies of, nor does the mention of imply endorsement by, the Colorado Department of Public Health and Environment. Page 2 of 2 Contract Exhibit -A AdditionalProvisions 2017-04-24 GRANT FUNDING CHANGE LETTER Attachment F-1 Date: State Fiscal Year: Grant Funding Change CMS Routing # Letter (GFCL) # CORE Encumbrance # TO: <Insert Grantee's name> In accordance with Section of the Original Contract routing number , [insert the following language here if previous amendment(s), renewal(s) have been processed] as amended by [include all previous amendment(s), renewal(s) and their routing numbers], [insert the following words here if previous amendment(s), renewal(s) have been processed] between the State of Colorado, Department of Public Health and Environment and <insert contractor name> beginning <insert start date of original contract> and ending on <insert ending date of current contract amendment, the undersigned commits the following funds to the Grant: The amount of (federal, state, other) grant funds available and specified in Section of <insert previous contract modification number and routing number> is ❑ increased or ❑ decreased by $ amount of change to new total funds for the period <date to date> of $ <insert new period cumulative total> for the following reason: Section is hereby modified accordingly. The revised Budget is incorporated herein by this reference and identified as Revised Exhibit *. (if budget attached; delete sentence if no budget included.) Complete the table below; insert/delete rows as needed. The table below reflects the original budget and all modifications to the total since the effective date of the Original Contract. SUMMARY OF CHANGES CMS Routing Document Type # Funding Source (federal, state, other) Period Dollar Amount Period Total Original Contract $ $ $ $ Contract Cumulative Grand Total $ This Grant Funding Change Letter does not constitute an order for services under this Grant. The effective date of hereof is upon approval of the State Controller or <insert projected effective date>, whichever is later. IM STATE OF COLORADO John W. Hickenlooper, Governor Department of Public Health and Environment PROGRAM APPROVAL Colorado Department of Public Health and Environment Lisa McGovern INSERT -Name of Authorized Individual Purchasing and Contracting Section Director, CDPHE INSERT -Official Title of Authorized Individual Date Date In accordance with §24-30-202 C.R.S., this Contract is not valid until signed and dated below by the State Controller or an authorized delegate. STATE CONTROLLER Robert Jaros, CPA, MBA, JD By: Name of Agency Delegate -Please delete if contract will be routed to OSC for approval. Effective Date: Contract Grant Funding Change Letter.docx ver 27.4.17 Page 1 of 1 Attachment F-2 OPTION LETTER Date: State Fiscal Year: Option Letter No. =CMS Routing # CORE Encumbrance # 1) OPTIONS: Choose all applicable options listed in §1 and in §2 and delete the rest. a. Option to renew only (for an additional term) b. Change in the amount of goods within current term c. Change in amount of goods in conjunction with renewal for 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 2) 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 cost/price specified in Section , AND/OR an increase/decrease in the amount of goods/services at the same rate(s) as specified in Identify the Section, Schedule, Attachment, Exhibit etc. b. For use with Option 1(f), please use the following: 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 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 cost/price 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. STATE OF COLORADO PROGRAM APPROVAL John W. Hickenlooper, Governor Colorado Department of Public Health and Environment Department of Public Health and Environment By: By: Lisa McGovern INSERT -Name of Authorized Individual Purchasing and Contracting Section Director, CDPHE INSERT -Official Title of Authorized Individual Date Date In accordance with §24-30-202 C.R.S., this Contract is not valid until signed and dated below by the State Controller or an authorized delegate. STATE CONTROLLER Robert Jaros, CPA, MBA, JD By: Name of Agency Delegate -Please delete if contract will be routed to OSC for approval. Effective Date: Contract Option Letter.docx ver 27.4.17 Page 1 of 1 STATEMENT OF WORK To Original Contract Routing Number 16 FHLA 76514 Contract Amendment #2 Routing Number 18 FHLA 96047 These provisions are to be read and interpreted in conjunction with the Provisions of the contract specified above. L Entity Name: Eagle County Public Health and Environment Term: July 1, 2017—June 30, 2018 IL Project Description: This project serves to increase the number of workplaces in Eagle, Grand, Jackson, Pitkin, and Summit Counties offering comprehensive worksite wellness programs that include healthy eating, physical activity and other healthy lifestyle behaviors, in order to reach at -risk populations to reduce risk factors for chronic diseases such as cancer and cardiovascular disease. Workplaces will be assisted in strengthening existing or creating new evidence. -based wellness programs through Health Links. III. Definitions: 1. CCPD — Cancer, Cardiovascular and Pulmonary Disease Grants Program 2. CDPHE — Colorado Department of Public Health and Environment 3. Health Links Advisors — Helps employers develop, or enhance an existing, worksite wellness program 4. Health Links Colorado -Health LinksTM is a nonprofit initiative spearheaded by health and safety experts at the Center for Health, Work & Environment within the Colorado School of Public Health 5. HEAL — Healthy Eating and Active Living 6. Quarters: Q1 — Quarter 1: July 1 -September 30 Q2 — Quarter 2: October 1 -December 31 Q3 — Quarter 3: January 1 -March 31 Q4 — Quarter 4: April 1 -June 30 7. Region 12 —Northwest Colorado Council of Governments (NWCCOG) Economic Development Region 12, which is comprised of Eagle, Grand, Jackson, Pitkin, and Summit Counties. 8. WorkWell Collaborative Advisory Committee — worksite wellness "coalition", formerly the Regional Health and Wellness Sector Partnership (RHWSP). 9. WWC — WorkWell Collaborative, which is comprised of Eagle County Public Health and Environment, Health Links Colorado and the Northwest Colorado Council of Governments. IV. Work Plan: Goal #1: Transform communities to support health and make healthy behaviors easier and more convenient for Coloradans. Objective #1: No later than the expiration date of this contract, increase from 75 to a minimum of 100 workplaces in Region 12 offering comprehensive worksite wellness programs that include healthy eating, active living and other healthy lifestyle behaviors and maintain a minimum retention rate of 50% among employers who are already offering worksite wellness, in order to reach at -risk populations to reduce risk factors for chronic diseases such as cancer and cardiovascular disease. Primary Activity #1 The Contractor shall ensure that the WorkWell Collaborative receives oversight and guidance from a group representing primary sectors across Region 12. 1. The Contractor shall ensure that the WorkWell Collaborative meets regularly (a minimum of every other month) to plan and coordinate worksite wellness activities across the Region. 2. The Contractor shall ensure that the WorkWell Collaborative is a standing agenda item on the Workforce Development Board Quarterly meetings. 3. The Contractor shall ensure that a WorkWell Collaborative representative is in attendance at Sub -Activities #1 all quarterly Workforce Development Board meetings to provide updates about the project and to elicit feedback and guidance. 4. The Contractor shall report WorkWell Collaborative updates back to local public health agencies, local chambers, and other relevant stakeholders in each County on a quarterly basis. 5. The Contractor shall work with the WWC to develop a WWC sustainability plan to continue the WWC beyond the current CCPD grant cycle. Primary Activity #2 The Contractor shall maintain a corps of Health Links Advisors for Region 12. Page I of 4 EXHIBIT G Page 2 of 4 L The Contractor shall provide technical assistance to Health Links Advisors assigned to each of the five (5) Counties in Region 12. 2. The Contractor shall ensure Health Links Advisors receive HEAL focused continuing Sub -Activities #2 education so they can support the employers they are working with. 3. The Contractor shall provide worksite wellness trainings to employers across Region 12 that focus on HEAL and health equity topics, including Center for Disease Control and Prevention Healthy Food Service Guidelines orequivalent. The Contractor shall ensure that Health Links Advisors identify and follow-up on leads of Primary Activity #3 employers and business groups from employer -based events on a monthly basis. 1. The Contractor shall ensure that Health Links Advisors contact a minimum of ten (10) new employers and/or business groups (e.g., Chambers of Commerce) per county (and combined for Grand and Jackson Counties) to promote worksite wellness. 2. The Contractor shall ensure Health Links Advisors work with the employers to identify their needs and provide technical assistance related to HEAL or other areas identified. 3. The Contractor shall develop an updated communications plan for the current contract period and implement the communications plan. The communications plan will be targeted Sub -Activities #3 to employers and will include the importance of worksite wellness and share information about program assistance tools. 4. The Contractor shall ensure that Health Links Advisors are able to refer employers to local and statewide resources for HEAL focused worksite wellness activities, built environment changes and policies. 5. The Contractor shall ensure that a minimum of five (5) employers across Region 12 make built environment or policy changes that support healthy eating and active living for employees. Primary Activity #4 The Contractor shall ensure Health Links Advisors develop strategic collaborations that will help reach and engage employers related to worksite wellness. 1. The Contractor shall initiate and/or maintain existing collaborations with employer -based stakeholders, (e.g., Chambers of Commerce, sector -based associations) for worksite wellness and HEAL. Sub -Activities #4 2. The Contractor shall ensure a minimum of two (2) of the five (5) Counties in Region 12 have one (1) or more local programs that recognize worksite wellness (e.g., local Chamber awards events that include worksite wellness). Objective 42: No later than the expiration date of this contract, support a minimum of two (2) public sector organizations to become prominent leaders of healthy eating and active living in the community through worksite wellness and community planning with a HEAL focus. The Contractor shall select a minimum of two (2) public sector organizations to introduce and Primary Activity #1 pilot the concept of "place -based worksite wellness" which includes introducing policy, systems and/or environmental changes that support HEAL that will benefit both employees and the broader community. 1. The Contractor shall build and/or strengthen relationships with public sector organizations to support them in health -based initiatives, including but not limited to worksite wellness. 2. The Contractor shall introduce initiatives that support HEAL for staff and constitutents to organizations (e.g., HEAL Cities and Towns Campaign, Healthy School Champions) and Sub -Activities #1 provide technical assistance in the application process so they can be seen as leaders in the community for wellness. 3. The Contractor shall provide technical assistance to the identified organizations for developing policy, systems and/or environment changes that support both the health of employees and community members. 1. 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 Standards and during the contract term. The contractor shall monitor documents and website content for Requirements updates and comply with all updates. 2. The Contractor shall submit data as required by Kaiser Permanente Institute for Health Research, the CCPD evaluation contractor, to include: semi-annual reports; annual evaluation reports; and other evaluation monitoring and data submissions as determined by Page 2 of 4 EXHIBIT G Page 3 of 4 the evaluation contractor and CCPD in alignment with the CDPHE-approved evaluation plan that follows the CCPD Strategy Requirements and Reporting Metrics document. These documents are incorporated and made part of this contract by reference and available on the following website: a. Two (2) year grantees shall use: https://www.colorado.gov/pacific/sites/default/files/PW A35 CCPD-Attachment-F- FY17-18-CCPD-Strategy-Specifications-and-Metrics.pdf. b. Three (3) year grantees shall use: https://www.colorado.lzov/pacific/sites/default/files/DC A3 5 -CCPD_ StrateQy- Specifications-and-Metrics.pdf. 3. The Contractor shall plan and budget for appropriate representatives to attend a minimum of one (1) in-person CCPD Grantee Meeting, date(s) and location to be determined. 4. The Contractor shall participate in conference calls with CDPHE staff as needed, including a minimum of one (1) per quarter. 5. The Contractor shall provide CDPHE, upon request, written procedures related to gift card purchase 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 distributing 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. 6. The Contractor shall ensure that all model healthy food and beverages policies for vending and concessions developed and adopted per this contract meet or exceed minimum standards as described in the Center for Disease Control and Prevention Healthy Food Service Guidelines. This document is incorporated and made part of this contract by reference and available on the following website: https://www.cdc.gov/obesity/downloads/guidelines for federal concessions and vending operations.pdf 7. The Contractor shall ensure participation by the grantee and/or subcontractor in a minimum of six (6) CDPHE Worksite Wellness Grantee Coordination calls. 8. The Contractor shall complete the final progress re ort as a non -reimbursable deliverable. Increase the number of workplaces in Region 12 by offering comprehensive worksite wellness Expected Results of programs that include healthy eating, physical activity and other healthy lifestyle behaviors, Activity(s) from 75 to a minimum of 100, in order to reach at -risk populations to reduce chronic disease risk factors. Measurement of Expected Data and measurements collected by Kaiser Permanente Institute of Health Research per the Results CDPHE-approved evaluation plan. .........................__-,.._-....-.....-..,-....,-_._........mxs....7. ..?"..-..:�'".,_..a.-.:,,,,,,,,�,�,�����r„a;r ...._....................._...........,.........,,......_.........,-.........._..::.....a..,.-, }„ .... 3��;;��,�::,�-�,ti��--,��;��:x����"�:�M�-3o�s,::�»,�;;,�;,:�;, ri�ib'"�c:;c�e;�,��;�z5uca; 3,... ,,,.. w, ,T _ ,. .,.,, .,F .....,..,...............-.._,.....,,,,.._,._._-._.._..-..............-...,_..........-._..._.............-...........-.,,.............._...._,..,,-.,,,-. ,�,;;;;;;,�;:;:;;; Com lehon Date Deliverables 1. The Contractor shall submit electronically to the CCPD Program No later than 15 days Contract Coordinator: a CDPHE approved Progress Report to following the end of include quarterly reports and an annual report. Q1, Q2, Q3, Q4. 2. The Contractor shall submit electronically to the CCPD Program No later than 15 days Contract Coordinator: a summary of monthly WorkWell following the end of Collaborative meetings. Ql, Q2, Q3. Final report due no later than June 30, 2018. 3. The Contractor shall submit electronically to the CCPD Program No later than 15 days Contract Coordinator: a summary of quarterly updates provided to following the end of the oversight group (the Workforce Development Board). Q1, Q2, Q3. Final report due no later than June 30, 2018. 4. The Contractor shall submit electronically to the CCPD Program No later than 15 days Contract Coordinator: a summary report of employers following the end of participating in wellness programs including number of Q2, Q3. Final report employers achieving certification, and practices and policies due no later than June including HEAL. 1 30, 2018. Page 3 of 4 104:111.1V !i V. Monitoring: CDPHE's monitoring of this contract for compliance with performance requirements will be conducted throughout the contract period by the CCPD Program Contract Coordinator. Methods used will include a review of documentation determined by CDPHE to be reflective of performance to include 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 of the contract. VI. Resolution of Non -Compliance: The Contractor will be notified in writing within 15 calendar days of discovery of a compliance issue. Within 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 contract monitor 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 of this contract. Page 4 of 4 5. The Contractor shall submit electronically to the CCPD Program No later than 15 days Contract Coordinator: copies of advertisements for public following the end of awareness campaign. Q2, Q3. Final report due no later than June 30, 2018. 6. The Contractor shall submit electronically to the CCPD Program No later than 15 days Contract Coordinator: a report detailing events held to increase following the end of awareness of worksite wellness in Region 12. Q1, Q2, Q3. Final report due no later than June 30, 2018. 7. The Contractor shall submit electronically to the CCPD Program No later than 15 days Contract Coordinator: a copy of the communications plan used to following the end of educate employers regarding worksite wellness. Q2. 8. The Contractor shall submit electronically to the CCPD Program No later than June 30, Contract Coordinator: a summary of local recognition awards 2018. and/or local agency programs that recognize worksite wellness. 9. The Contractor shall submit electronically to the CCPD Program No later than June 30, Contract Coordinator: a summary policy, systems, and/or 2018. environmental change projectsin the context of HEAL and worksite wellness. 10. The Contractor shall submit electronically to the CCPD Program No later than June 30, Contract Coordinator: a summary of public sector relationships 2018. and efforts to connect HEAL initaitives. 11. The Contractor shall submit electronically to the CCPD Program No later than June 30, Contract Coordinator: a copy of the WWC sustainability plan. 2018. 12. The Contractor shall submit electronically to the CCPD Program No later than June 30, Contract Coordinator: a list of Health Links Advisor and 2018. employer training topics, training schedule, materials and a list of attendees. 13. The Contractor shall submit electronically to the CCPD Program No later than June 30, Contract Coordinator: a summary of stakeholder groups contacted 2018. during outreach activities with event details. 14. The Contractor shall submit electronically to the CCPD Contracts No later than June 30, Coordinator: a final evaluation report. 2018. V. Monitoring: CDPHE's monitoring of this contract for compliance with performance requirements will be conducted throughout the contract period by the CCPD Program Contract Coordinator. Methods used will include a review of documentation determined by CDPHE to be reflective of performance to include 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 of the contract. VI. Resolution of Non -Compliance: The Contractor will be notified in writing within 15 calendar days of discovery of a compliance issue. Within 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 contract monitor 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 of this contract. Page 4 of 4 • !COLORADO 0 Department of Public Health & Environment Exhibit H Budget PREVENTION SERVICES DIVISION- BUDGET WITH JUSTIFICATION FORM Contract Routing # 18 FHLA 96047 Contractor Name Eagle County Public Health and Environment Budget Period July 1, 2017 -June 30, 2018 Project Name WorkWell Collaborative Program Contact Name, Katie Haas, Healthy Communities Title, Phone and Email Supervisor, 970-328-8855, katie.haast@eaeIecourtv.us Fiscal Contact Name, Title, Marie Hermosillo, Program Support, 970 Phone and Email 328-8849, marie.hermosillo@eaglecounty.us CT FAAA FHLA 20160000000000000062 Expenditure Categories Personal Services Salaried Employees Budget Item Gross or Percent of Total Amount Supports SOW Annual Time on Requested from Position Title Description of Work (Yes/No) Salary Fringe Project CDPHE Healthy Communities The Healthy Communities Supervisor will provide Yes $64,602.49 $37,976.00 50% $51,289.25 Supervisor oversight of staff, programming and ensure fiscal responsibility of budgeting and coordinating subcontractor, as well as being the primary lead on SOW activities. The Supervisor will also work CDPHE's Evaluator to provide data and evaluation support as needed Health Promotion The Health Promotion Coordinator will support Yes $53,431.46 $36,488.00 10% $8,991.95 Coordinator programming elements from the scope of work, including developing partnerships with public sector organizations and supporting the subcontractors hired. Total Health Alliance The Total Health Alliance Coordinator will support Yes $46,800.00 $14,196.00 10% $6,099.60 Coordinator programming elements from the scope of work, including planning trainings for employers and assuring communication across WWC partners and other community stakeholders. Total Personal Services (including fringe benefits) $66,380.79 Supplies & Operating Expenses Budget Item Supports Total Amount SOW Requested from Item Description of Item (Yes/No) Rate Quantity CDPHE Office Equipment and General office supplies such as pens, flip charts, markers, etc. Yes $500.00 1 $500.00 Supplies Conferences and Training Understanding Small Enterprises Conference in Denver - 2 staff Yes $300.00 6 $1,800.00 Opportunities members to present about the WWC and attend sessions ($400x2=$800), Colorado Culture of Health Conference - 2 staff and/or WWC members to attend ($200 x 2 = $400), Colorado Health Symposium - 2 staff to attend ($300 x 2 = $600) Registration for Employer Registration fees for Health Links Advisors, ECPHE and NWCCOG key Yes $100.00 30 $1,000.00 Recognition Events staff to participate in recognition, promotion and learning events for Health Links and worksite wellness (e.g. Vail Valley Partnership Success Awards, Healthy Mountain Business Symposium, Colorado Culture of Health Conference) Page 1 of 3 V. 1 Jan 2013 Exhibit H Budget PREVENTION SERVICES DIVISION- BUDGET WITH JUSTIFICATION FORM Contract Routing # 18 FHLA 96047 Contractor Name Eagle County Public Health and Environment Budget Period July 1, 2017 - June 30, 2018 Project Name WorkWell Collaborative Program Contact Name, Katie Haas, Healthy Communities Title, Phone and Email Supervisor, 970-328-8855, katie.haas ea lecount .us Fiscal Contact Name, Title, Marie Hermosillo, Program Support, 970 supplies 328-8849, Phone and Email marie.hermosillo ea lecount .us CTFAAA FHLA 20160000000000000062 Meeting and event Supplies to support meetings and local events to engage employers in Yes $350.00 4 $1,400.00 supplies Health Links with key stakeholders across the region (Approximately 4 events anticipated per year; estimated costs include: $100 for food, $50 for posters/other event supplies, $200 for booth space) Total Supplies & Operating Expenses $4,700.00 Travel Budget Item Supports Total Amount SOW Requested from Item Description of Item (Yes/No) Rate Quantity CDPHE Mileage- in state Trips required for meetings and coordination among community Yes $0.54 2291.46 $1,237.39 stakeholders, trainings, etc., reimbursed at $0.54 per mile. Lodging Lodging for required CCPD meeting for two staff members ($200 x 2 = Yes $200.00 10 $2,000.00 $300); Lodging for up to eight W WC partners/staff members for training and employer recognition events outside of the Region ($200 x 8 = $1,600) Meals ECPHE staff will attend one mandatory meeting in Denver. Meal Yes $50.00 10 $500.00 estimate is based on current government per diem rate for Denver: $49.50. One day per diem per staff member for the meeting (2 x $49.50 = $99). In addition, meals for staff attending training events outside of the Region will need to be covered (one day per diem $49.50 x 8 =$396) Total Travel $3,737.39 Contractual Budget Item Supports Total Amount sow Requested from Subcontractor Name Description of Item (Yes/No) Rate Quantity CDPHE Northwest Colorado $2,000 - annual membership fees for local Chambers, $4,000 -fee for Yes $6,000.00 1 $6,000.00 Council of Governments leading participation/representing worksite wellness on the Rural (NWCCOG) Resort Region Workforce Development Board and championing worksite wellness to Region 12 employers Health Links $48,000-4 Health Links Advisors (1 per Region 12 County - Pitkin, Yes $112,500.00 1 $112,500.00 Eagle, Summit, Grand, Jackson); $1000 per month x 12 months x 4 advisors), $14,000 - 7 training events across Region 12 at $2,000 each, $15,000 Program and Advisor Support, $3,000 - Reporting, $16,000 - Accelerator Program, $16,500 - public awareness campaign about worksite wellness and Health Links (100 newspaper ads across 5 newspapers x $100 per ad =10,000, 4 radio campaigns x $1,500 each = $6,000) Subcontractor for trainings Three trainings for employers in Region 12, estimated at $2,000 per Yes $2,000.00 3 $6,000.00 for Region 12 Employers training, on topics that include, but are not limited to, HEAL and health equity. Subcontractor to support Subcontractor knowledgeable in worksite wellness and place -based Yes $42,000.00 1 $42,000.00 "place -based worksite health to support local municipalities in becoming leaders in the wellness" community for wellness and provide technical assistance for policy, systems and environmental changes that will benefit the health of both employees and the community. Total Contractual $166,500.00 Page 2 of 3 V. 1 Jan 2013 Exhibit H Budget PREVENTION SERVICES DIVISION- BUDGET WITH JUSTIFICATION FORM Contract Routing # 18 FHLA 96047 Contractor Name Eagle County Public Health and Environment Budget Period July 1, 2017 -June 30, 2018 Project Name WorkWell Collaborative Program Contact Name, Katie Haas, Healthy Communities Title, Phone and Email Supervisor, 970-328-8855, katie.haas ea lecount .0 Fiscal Contact Name, Title, Marie Hermosi lo, Program Support, 970 Phone and Email 328-8849, rie.hermosillo ea lecount .os CT FAAA FHLA 20160000000000000062 Page 3 of 3 V. 1 Jan 2013 SUB -TOTAL BEFORE INDIRECT $241,318.18 Indirect Total Amount Requested from Item Description of Item CDPHE Federally -negotiated indirect cost rate CDPHE-approved indirect cost rate De minimis indirect cost Eagle County does not currently have a negotiated Federal or CDPHE indirect rate agreement. Eagle County will $13,681.82 rate use the 10% DeMinimis rate for MTDC. Total Indirect $13,681.82 TOTAL $255,000.00 Page 3 of 3 V. 1 Jan 2013