HomeMy WebLinkAboutC17-319 Colorado Department of Public Health and Environment4
DEPARTMENT OF PUBLIC HEALTH AND
ENVIRONMENT
CMS ROUTING NO. 18 FHLA 104025
APPROVED TASK ORDER CONTRACT — WAIVER #154
This task order contract is issued pursuant to master contract made on 11/23/2016, with routing number 18 FAA 00016.
STATE: CONTRACTOR:
State of Colorado for the use & benefit of the Board of County Commissioners of Eagle County
Department of Public Health and Environment 500 Broadway
Division of Prevention Services Eagle, Colorado 81631-0850
WIC Program for the use and benefit of the
4300 Cherry Creek Drive South Eagle County Public Health Agency
Denver, Colorado 80246 551 Broadway
Eagle, Colorado 81631
CONTRACTOR DUNS: 084024447
CONTRACT MADE DATE: 8/4/2017
CORE ENCUMBRANCE NUMBER:
201800001686
TERM:
This contract shall be effective upon approval by
the State Controller, or designee, or on 10/01/2017,
whichever is later. The contract shall end on 0913OP018.
PROCUREMENT METHOD
Exempt
BID/RFP/LIST PRICE AGREEMENT NUMBER
Not Applicable
LAW SPECIFIED VENDOR STATUTE.
Not Applicable
STATE REPRESENTATIVE:
Kathryn Gasowski
Department of Public Health and Environment
Division of Prevention Services
WIC Program
4300 Cherry Creek Drive South
Denver, Colorado 80246
CONTRACTOR ENTITY TYPE:
Political Subdivision
BILLING STATEMENTS RECEIVED -
Monthly
STATUTORY AUTHORITY. Not Applicable
CLASSIFICATION Subrecipient
CONTRACT PRICE NOT TO EXCEED• $217,974.00
FEDERAL FUNDING DOLLARS: $217,974.00
STATE FUNDING DOLLARS. $0.00
OTHER FUNDING DOLLARS: $0.00
Specify "Other":
MAXIMUM AMOUNT AVAILABLE PER FISCAL YEAR
FY18: $163,481.00
FY19: $54,493.00
PRICE STRUCTURE: Cost Reimbursement
CONTRACTOR REPRESENTATIVE:
Jennie Wahrer
Eagle County Public Health Agency
P.O. Box 660
Eagle, Colorado 81631
PROJECT DESCRIPTION
Conduct and administer a component of the Special Supplemental Nutrition Program for Women, Infants, and Children, hereinafter referred to
as the "WIC Program", within an approved service area. Service includes, but are not limited to, nutrition education and the provisions of
certain nutrition foods pregnant, lactating and postpartum women, infants, and children under five (5) years of age, whose income falls below
specified levels and have an identifiable nutrition risk factor, as described in 7 CRS, Part 246, and the State's WIC Program Manual
Contract Template Task Order LPHA ver 14.8.17
C17-319
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EXHIBITS:
The following exhibits are hereby incorporated:
Exhibit A - Additional Provisions (and any of its Attachments; e.g., A-1, A-2, etc.)
Exhibit B - Statement of Work (and any of its Attachments; e.g., B-1, B-2, etc.)
Exhibit C - Budget (and any of its Attachments; e.g., C-1, C-2, etc.)
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.
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(1), 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 specified
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.
3. 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 Contract and this Task Order Contract (including its exhibits 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 of priority: 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
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Contract Template Task Order LPHA ver 14.8.17
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 Contract; 6) other
exhibits/attachments 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".
5. The State, with the concurrence of the 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 modify 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.
6. 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.
7. STATEWIDE CONTRACT MANAGEMENT SYSTEM [This section shall apply when the Effective Date
is on or after July 1, 2009 and the maximunt amount payable to Contractor hereunder is $100, 000 or higher]
By entering into this Task Order Contract, Contractor agrees to be governed, and to abide, by the provisions of
CRS §24-102-205, §24-102-206, §24-103-601, §24-103.5-101 and §24-105-102 concerning 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
of Contractor's performance shall be part of the 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 of the end of the Task Order Contract term. Contractor shall be notified
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 and
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Contract Template Task Order LPHA ver 14.8.17
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.
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 of this 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 of 2006 (Public Law 109-282), as amended by §6062 of Public Law 110-252, including
without limitation all data reporting requirements required there under. This Act is also referred to as FFATA.
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Contract Template Task Order LPHA ver 14.8.17
SIGNATURE PAGE
Contract Routing Number. 18 FHLA 104025
THE PARTIES HERETO HAVE EXECUTED THIS CONTRACT
Each person signing this Contract represents and wan -ants that he or she is duly authorized to execute this Contract and to bind the party authorizing his or her
signature.
CONTRACTOR
Board of County Commissioners of Eagle County
(a political subdivision of the state of Colorado)
for the use and benefit of the
Eagle County Public Health cy
rint Name of Authorized Addividual
e 1"'A,2
Print Title of Authorized Individual
1,Lt_1/n' V. k�o..'l
Signature of Authorized Individual
�) 1(1 /1-1
ate
PROGRAM APPROVAL
Colorado Department of Public Health and Environment
Kathryn Gasowski
Fiscal Unit Supervisor — Nutrition Services
By:
Ripiature of Awfhorj7ed CDPHE Program Approver
_f ?1/ 7-
ate
STATE OF COLORADO
John W. Hickenlooper, Governor
Colorado Department of Public Health and
Environment
Larry Wolk, MD, MSPH, Executive Director and
Chief Medical Officer
By: ryvc
Lisa McGovern
Purchasing and Contracting Section Director, CDPHE
q - -2,1 - I I
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
ri
ros, ,MBA, JD
By:
Name of Agency Delega
te -Denise Burrows
Effective Date:
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Contract Template Task Order LPHA ver 14.8.17
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Contract Template Task Order LPHA ver 14.8.17
EXHIBIT A
ADDITIONAL PROVISIONS
To Contract Dated 08/04/2017 - CMS Contract Routing Number 18 FHLA 104025
These provisions are to be read and interpreted in conjunction with the provisions of the Contract specified above.
This Contract contains federal funds (see Catalog of Federal Domestic Assistance (CFDA) number 10.557).
The United States Department of Agriculture ("USDA"), through the Food and Nutrition Services ("FNS")
has awarded as of 10/01/2017 anticipated federal funds of $23,000,000.00 under Notice of Cooperative
Agreement Award, hereinafter "NCAA", number 3C0700701, to perform the following — to operate the
Special Supplemental Nutrition Program for Women, Infants, and Children, officially known as the "WIC
Program".
If the underlying Notice of Cooperative Agreement Award "NCAA" authorizes the State to pay all
allowable and allocable expenses of a Contractor as of the Effective Date of that NCAA, then the State
shall reimburse the Contractor for any allowable and allocable expenses of the Contractor that have been
incurred by the Contractor since the proposed Effective Date of this Contract. If the underlying NCAA does
not authorize the State to pay all allowable and allocable expenses of a Contractor as of the Effective Date
of that NCAA, then the State shall only reimburse the Contractor for those allowable and allocable
expenses of the Contractor that are incurred by the Contractor on or after the Effective Date of this
Contract, with such Effective Date being the later of the date specified in this Contract or the date the
Contract is signed by the State Controller or delegee.
To receive compensation under the Contract, the Contractor shall submit a signed Monthly CDPHE
Reimbursement Invoice Form. This form is accessible from the CDPHF. internet website
https://www.colorado.2ov/pacific/cdphe/standardized-invoice-form-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 of the billing period for which services were rendered.
Expenditures shall be in accordance with this Statement of Work and Budget. The Contractor shall submit
the invoice using one of the following three methods
Mail to:
Cyril Padilla, WIC Fiscal Administrator
Prevention Services Division — WIC Program
Colorado Department of Public Health and Environment
PSD -A4 -WIC
4300 Cherry Creek Drive South
Denver, Colorado 80246
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: Cyril Padilla,
WIC Fiscal Administrator, cyril.padilla@state.co.us
Fax the completed and signed CDPHE Reimbursement Invoice Form and Expenditure Details page to:
Attention: Cyril Padilla, WIC Fiscal Administrator, 303-756-9926
Final billings under the Contract must be received by the State within a reasonable time after the expiration
or termination of the 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.
Page 1 of 4
Contract Exhibit -A AdditionalProvisions 17.5.3
EXHIBIT A
The Contractor shall not use federal funds to satisfy 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 sixty (60) 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 thirty (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 thirty (30)
calendar days, to correct the noted deficiencies.
5. Health Insurance Portability and Accountability Act (HIPAA) Business Associate Determination.
The State has determined that this Contract does not constitute a Business Associate relationship under
HIPAA.
6. This award does not include funds for Research and Development.
7. The State, at its discretion, shall have the option to extend the term under this Contract beyond the Initial
Term for a period or for successive periods, of 1 year at the same rates and under the same terms specified
in the Contract. In order to exercise this option, the State shall provide written notice to Contractor in as
form substantially equivalent to Exhibit D. If exercised, the provisions of the Option Letter shall become
part of and be incorporated in the original contract. The total duration of this contract shall not exceed 5
years.
8. The State, at its discretion, may unilaterally increase or decrease the total funds available under this Grant,
the funds available under the Grant during any State fiscal Year or the funds available for any specific line
items described in this Grant. In order to exercise this right, the State shall provide written notice to
Grantee in a form substantially equivalent to Exhibit E. The exercise of this right shall not be valid until it
has been approved by the contractor.
9. The Contractor shall obtain the prior written approval of the State before, and as a condition of, purchasing
any equipment with WIC funds that costs Five Thousand Dollars ($5,000.00) or more. If such approval is
given by the State, and the Contractor purchases the equipment, then that equipment shall be the
property of the State's WIC Program
10. The Contractor shall insure that no claim is submitted to the State for the reimbursement of those services
which are already funded by other state or federal programs, or for costs which are not allowable as
defined in the WIC Program Manual, which is available at http://coloradowic.com/
11. The Contractor's claims for the reimbursement of all administrative costs shall be made in accordance with
all applicable requirements imposed by the USDA, including but not limited to 7 C.F.R., Part 246, as
Page 2 of 4
Contract Exhibit -A AdditionalProvisions 17.5.3
EXHIBIT A
amended, all applicable Office of Management and Budget (OMB) circulars, and t$e State's WIC policies,
as amended.
12. Continued State financial reimbursement under this Task Order Contract is contingent upon the continued
operation of the WIC program as described in this Task Order Contract, and the Contractor's timely
submission of all the reports, data, or other documentation required under this Task Order Contract.
13. Nondiscrimination: The Recipient will comply with following the nondiscrimination statutes and
regulations, other related regulations and any USDA nondiscrimination directives:
a. Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d- et seq.) and USDA regulations at 7 CFR
Part 15, Nondiscrimination, an Department of Justice regulations at 28 CFR Part 42,
Nondiscrimination; Equal Employment Opportunity: Policies And Procedures;
b. Title IX of the Education Amendments of 1972 (20 U.S.C. 1681 et seq.) and USDA regulations at 7
CFR Part 15a, Education Programs or Activities Receiving or Benefiting from Federal Financial
Assistance;
c. Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 1681 et seq.) and USDA regulations at 7 CFR
Part 15a, Education Programs or Activities Receiving or Benefiting or Benefiting from Federal
Financial Assistance, and Department of Justice regulations at 28 CFR Part 41, Implementation of
Executive Order 12250, Nondiscrimination On the Basis of Handicap In Federally Assisted Programs;
and
d. Age Discrimination Act of 1975 (42 U.S.C. 6101 et seq) The Grantee assures that it will immediately
take any measures necessary to effectuate the requirements in these laws, regulations and directives.
The Grantee gives this assurance in consideration of and for the purpose of obtaining the funds
provided under this agreement.
e. The Americans with Disabilities Act of 1990 (ADA) prohibits discrimination on the basis of disability
in employment (Title I), state and local government services (Title II), places of public accommodation
and commercial facilities (Title III). (42 U.S.C. 12101-12213).
The following nondiscrimination statement shall be included, in full, on all materials that are
produced by the grant recipient for public information, public education, or public distribution.
"In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights
regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating
in or administering USDA programs are prohibited from discriminating based on race, color, national
origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or
activity conducted or funded by USDA.
Persons with disabilities who require alternative means of communication for program information
(e.g. Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State
or local) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech
disabilities may contact USDA through the Federal Relay Service at (800) 877-8339. Additionally,
program information may be made available in languages other than English.
To file a program complaint of discrimination, complete the USDA Program Discrimination
Complaint Form, (AD -3027) found online at: http:Hwww.ascr.usda.gov/complaint filing cust.html,
and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the
information requested in the form. To request a copy of the complaint form, call (866) 632-9992.
Submit your completed form or letter to USDA by:
(1) mail: U.S. Department of Agriculture Office of the Assistant Secretary for Civil Rights 1400
Independence Avenue, SW Washington, D.C. 20250-9410;
Page 3 of 4
Contract Exhibit -A AdditionalProvisions 17.5.3
EXHIBIT A
(2) fax: (202) 690-7442; or
(3) email: program. intake-,usda.gov.
This institution is an equal opportunity provider.
14. The Contractor shall agree to support full use of federal funds provided from USDA/Food and Nutrition
Service to Colorado to administer the Special Supplemental Nutrition Program for Women, Infants, and
Children (WIC) as established in Section 12(b) of the Richard B. Russell National School Lunch Act, 42
U.S.C. 1760 (b), as amended by Section 361 of the Health, Hunger -Free Kids Act of 2010 (Public Law
111-296). This stipulates that funds provided for administration should be excluded from local agency
budget restrictions including at a minimum, hiring freezes, work furloughs, and travel restrictions affecting
the WIC program if there are enough WIC funds available to pay for those services during the contract
period
15. No State or other public funds payable under this Contract shall be used for the acquisition, operation or
maintenance of computer software in violation of United States copyright laws or applicable licensing
restrictions. The Contractor hereby certifies that, for the term of this Contract and any extensions, the
Contractor has in place appropriate systems and controls to prevent such improper use of public funds. If
the State determines that the Contractor is in violation of this paragraph, the State may exercise any remedy
available at law or equity or under this Contract, including, without limitation, immediate termination of
the Contract and any remedy consistent with United States copyright laws or applicable licensing
restrictions
Page 4 of 4
Contract Exhibit -A AdditionalProvisions 17.5.3
EXHIBIT B
STATEMENT OF WORK
To Contract Dated 8/4/2017 - Original Contract Routing Number 18 FHLA 104025
These provisions are to be read and interpreted in conjunction with the provisions of the contract specified above.
I. Entity Name: Eagle County Public Health Agency
Term: October 1, 2017 — September 30, 2018
II. Project Description:
The WIC Program is a federally funded program established through United States Department of Agriculture
(USDA) Food and Nutrition Services (FNS) to supply specified nutritious foods and nutrition education to low
income pregnant, lactating and postpartum women and children under five (5) years of age.
III. Work Plan:
Goal #1: The Women, Infants and Children (WIC) Program will improve the nutritional status of low income women and
children in Colorado.
Objective #1: The Contractor shall implement and operate the USDA — Food and Nutrition Services (FNS) Women, Infant
and Children program.
The Contractor shall provide nutrition education and referrals to all enrolled WIC participants
Activity #1
1. The Contractor shall conduct and document nutrition education services in the WIC
computer system, certifying participants for the WIC program and referring ,
participants identified as having a high nutritional/medical risk factor for high risk
nutrition counseling as necessary.
2. The Contractor shall create, implement, and evaluate an annual Local Agency
Nutrition Education Plan.
Sub -Activity
3. The Contractor shall monitor monthly participant caseload reports and develop
outreach strategies to increase program participation.
4. The Contractor shall create and maintain a current list of services and organizations
for referral purposes.
5. The Contractor shall contact the WIC State Program staff at the Colorado Department
of Public Health and Environment (CDPHE) with questions regarding regulation
interpretation.
Activity #2
The Contractor shall provide breastfeeding support to pregnant and postpartum women.
1. The Contractor shall endorse breastfeeding as the preferred and normal method of
infant feeding amongst WIC program participants.
2. The Contractor shall provide appropriate breastfeeding education to all pregnant
participants and throughout the postpartum period.
Sub -Activity
3. The Contractor shall establish clinic procedures to incorporate positive peer influence
prenatally and during the postpartum period (could include bulletin boards, classes,
support groups, and/or peer counselor contact) to encourage and support breastfeeding
amongst participants.
4. The Contractor shall ensure and document within the Compass system that all staff
complete the breastfeeding training module.
5. The Contractor shall collaborate with other programs/groups within its community
Page 1 of 6
Contract Statement of Work — Exhibit B
January 2015
EXHIBIT B
Page 2 of 6
Contract Statement of Work — Exhibit B
January 2015
that provide breastfeeding education and support.
6. The Contractor shall maintain a breast pump inventory and provide appropriate breast
pumps to participants, when necessary, and provide additional appropriate education
on pumping and breast milk storage.
The Contractor shall administer food benefits to all enrolled WIC participants.
Activity #3
1. The Contractor shall provide food benefits to all enrolled WIC participants based on
the individualized food prescription. Food benefits shall be issued via the Compass
computer system.
2. The Contractor shall provide training to WIC participants on use of WIC benefits.
Sub -Activity
3. The Contractor shall be responsible for the security and accountability of negotiable
food instruments (WIC Checks and EBT cards) and shall reimburse the State for any
WIC Program funds which are misused or otherwise diverted due to negligence, fraud,
theft, embezzlement, or any other loss caused by the Contractor, its employees or
agents.
The Contractor shall assign an employee to serve as a Local Agency Retail Coordinator
Activity #4
(LARC).
1. The LARC shall work in conjunction with the State WIC Program at CDPHE in
training, outreach and compliance activities for the WIC retail stores
Sub -Activity
2. The LARC shall respond to participant and retailer issues and notify state office of
unresolved or ongoing issues
The Contractor shall complete the necessary regulatory and administrative requirements of the
Activity #5
program.
1) The Contractor shall protect the confidentiality of a recipient's identity by limiting
access to the recipient's records to: the USDA, the General Accounting Office
(GAO), State WIC officials, local WIC employees, the recipient's health care provider
(with participant's permission), programs with a formal information sharing
agreement with the State WIC Program at CDPHE and listed on the Participant's
Rights and Obligations form, agencies with overlapping service areas, counties with
Commodity Supplemental Food Programs to prevent dual participation, and auditors
representing a federal, state or local government. Access to records by other third
parties must be accompanied by a release of information signed by the recipient.
2) The Contractor shall inform the WIC State Program at CDPHE of new employees and
Sub Activity
the security role to be assigned within the WIC computer system.
3) The Contractor shall complete a security access audit two times per year regarding the
current computer system users.
4) The Contractor shall require its employees to track time worked on the following WIC
activities: Nutrition Education, Breastfeeding Support, Clinic Services and
Administration. A time study report shall be generated by the Contractor based upon
this information for the WIC State Office.
5) The Contractor shall create an annual budget for operating the WIC program and
submit a copy of that budget to the WIC Fiscal Officer at CDPHE.
6) The Contractor shall provide the necessary Information Technology (IT) support, data
security, and internet access necessary to operate the WIC computer and peripheral
devices.
Page 2 of 6
Contract Statement of Work — Exhibit B
January 2015
EXHIBIT B
7) The Contractor shall be responsible for the security of all WIC equipment in its
control or possession and shall immediately report any loss or damage to that
equipment which is caused by the negligence, abuse, or misuse of the equipment by
the Contractor.
8) The Contractor shall maintain a computer equipment inventory for WIC Staff.
9) The Contractor shall respond to WIC State Program at CDPIIE, USDA and auditor
requests.
10) The Contractor shall submit an annual salary survey for WIC personnel expenses —
salary and benefits for use with the annual WIC funding formula.
Page 3 of 6
Contract Statement of Work — Exhibit B
January 2015
1.
The Contractor shall administer the WIC program to qualified participants according
to specifications outlined in the federal regulations 7 C.F.R. Part 246, available at
http://www.fiis.usda.gov/wic/wic-laws-and-regulations and through the Colorado WIC
program manual located at hups://Nvww.colorado.gov/cdphe/wic-manuals-and-guides
and any State WIC Program policy letters.
2.
The Contractor shall ensure that all participants to the program meet the following
eligibility requirements:
a. Are pregnant, lactating andlor post partum women OR are children under the age
of 5, who fall below the United States Department of Health and Human Services
(USDHHS) income poverty guidelines, found at
http://www.fns.usda.gov/wic/wic-laws-and-regulations AND
b. Who have an identifiable nutrition risk factor as described in the applicable
regulations and the State WIC Program Manual.
3.
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.
4.
The Contractor shall provide an environment for the participant/WIC staff visit that
is welcoming, breastfeeding friendly, and confidential.
5.
The Contractor shall accommodate cultural and language diversity of participants
through the use of translation services as needed.
Standards and
6.
The Nutrition Education Plan shall be submitted annually to the Nutrition Coordinator
Requirements
at the State WIC Program at CDPHE and shall include the following:
a. Objectives
b. Activities
c. Methods of evaluation
7.
The Contractor shall adhere to the following regarding staff:
a. Staffing shall be sufficient to service participant caseload and meet operating
standards as described in the WIC Program Manual.
b. Any newly hired staff shall complete the WIC Certification Program as described
in the WIC Program Manual, including new employee training
c. Staff shall attend regulatory scheduled workshops or State sponsored meetings on
administrative policies, procedures and nutrition.
d. Staff shall exhibit a positive attitude toward breastfeeding.
e. Staff shall consistently meet performance expectations.
f. Qualifications of personnel assigned by the Contractor to perform the services
outlined within this contract shall be available for review and approval by the
State WIC Program at CDPHE.
8.
IT support shall include:
a. Ordering equipment, as directed by the State WIC Program at CDPHE.
b. Setting up equipment and downloading the Compass system.
c. Setting up multi -function printers, card readers and PIN pad devices for EBT, and
signature pads with direction from the State WIC program.
d. Ensuring that no system changes or upgrades are done to the WIC computers
without first verifying that the upgrades are compatible with the WIC Compass
Page 3 of 6
Contract Statement of Work — Exhibit B
January 2015
EXHIBIT B
e. Computers and peripherals, such as printers, shall be disposed of at the direction
of the State WIC Program at CDPIIE.
9. The Contractor shall maintain a computer equipment inventory that includes:
a. Computer Model
b. Serial Number
c. Date purchased
d. Acquisition Cost
e. Warranty Expiration
f. Computer Location.
10. Specific guidance for the Contractor's Local Agency Retail Coordinator (LARC) is
provided in the WIC Program Manual and WIC Retailer Handbook located within the
Program Manual.
11. Time Study reports submitted to the State WIC Program at CDPIIE shall be:
a. For each of its employees to the WIC State Program for the time frame of one
week per month OR one month per quarter
b. Submitted to the WIC Fiscal Officer
12. The State WIC Program at CDPIIE shall provide an annual budget template.
13. The Security Access Form and Audit shall be submitted to the WIC Help Desk at the
State WIC Program at CDPHE. The forms are located in the WIC program Manual.
14. The State WIC Program at CDPHE shall:
a. Conduct program and fiscal monitoring visits in accordance with the WIC
Program Manual.
b. Provide monthly caseload reports to WIC Program Directors.
c. Provide nutrition education training and statewide meetings.
d. Provide access to on-line nutrition education for use with WIC participants.
e. Provide guidance on federal program regulations.
f. Provide funding for computers, equipment, specialty trainings and state meetings.
15. The Salary Survey template will be provided to WIC Program Directors annually by
the State WIC Program at CDPHE. It should be submitted for all staff members that
work on the WIC program. It must include monthly salary costs, monthly benefits
and monthly expected Full -Time Equivalent (FTE) hours to be worked on the WIC
grant for the calendar year. The salary survey shall be submitted to the WIC Fiscal
Officer at CDPHE.
16. The Contractor shall keep on file and have available for review, audit and evaluation:
a. A copy of this contract;
b. Information on the service area and financial eligibility standards used by the
Contractor;
c. Complete and accurate participant records documenting nutrition risk,
certification information of applicants, foods prescribed, nutrition care,
counseling and referrals provided under its WIC Program;
d. A complete, accurate, and current accounting which documents all funds received
and expended pursuant to this contract;
e. Detailed inventory records as described in Standards and Requirements, #5;
f. Complete and accurate retail records documenting training, monitoring and those
problems, if any with each retailer;
g. Racial/ethnic participation data;
h. Fair hearing information; and
i. Participant abuse records.
Expected Results ofI All eligible applicants are provided with WIC services within processing standards.
Activity(s)
Page 4 of 6
Contract Statement of Work — Exhibit B
January 2015
EXHIBIT B
IV. Monitoring:
CDPHE's monitoring of this contract for compliance with performance requirements will be conducted throughout
the contract period by the Fiscal Officer. Methods used will include a review of documentation determined by
CDPHE to be reflective of performance to include the Breastfeeding Peer Counseling Monitoring form 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 of the contract.
V. 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
Page 5 of 6
Contract Statement of Work — Exhibit B
January 2015
The State WIC Program at CDPHE will review monthly caseload reports and the annual
Measurement of Expected
Nutrition Education Plan evaluation to determine program scope and effectiveness.
Results
Completion Date
Deliverables
1. The Contractor shall submit an annual Nutrition Education
Due by September 1
Plan.
2. The Contractor shall submit an evaluation of the previous
Due by October 30
year's Nutrition Education Plan.
3. The Contractor shall submit an annual budget.
Due by November 1
4. The Contractor shall submit monthly or quarterly time
Monthly time
studies.
studies due within
30 days following
end of month.
Quarterly time
studies due within
30 days following
the end of the
quarter.
5. The Contractor shall submit Security Access Forms for all
Due when
employees.
requesting access
for a new employee
or when requesting
a change in access
to the Compass
Computer System.
6. The Contractor shall submit Security Access Audit Forms for
Due January 31e1
all WIC employees.
and Jul 31'x.
7. The Contractor shall submit an annual salary survey.—Due
by January 15
8. The Contractor shall provide computer equipment invento
Upon Request
IV. Monitoring:
CDPHE's monitoring of this contract for compliance with performance requirements will be conducted throughout
the contract period by the Fiscal Officer. Methods used will include a review of documentation determined by
CDPHE to be reflective of performance to include the Breastfeeding Peer Counseling Monitoring form 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 of the contract.
V. 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
Page 5 of 6
Contract Statement of Work — Exhibit B
January 2015
EXHIBIT B
request to the Fiscal Officer 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 6 of 6
Contract Statement of Work— Exhibit B
January 2015
EXHIBIT C
BUDGET
To Contract Dated 08/4/2017 - Contract Routing Number 18 FHLA 104025
Contract - FFY 2018 Budget October 1, 2017 — September 30, 2018 $217,974.00
TOTAL CONTRACT $217,974.00
Exhibit D
OPTION LETTER
Date:
State Fiscal Year: Option Letter No. I Original Contract CMS#
Option Letter CMS Routing # I CORE Encumbrance #
DELETE all BLUE text, CUSTOMIZE Red text and CHANGE Red text to Black after customization.
1) OPTIONS: Choose all applicable options listed below
a. Option to extend for a renewal or additional terns
b. Option to change amount of goods
c. Option to change amount of services
d. Option to change contract rates
e. Option to initiate next phase of contract
2) REQUIRED PROVISIONS. All Option Letters shall contain the appropriate provisions set forth below:
a. For use with Options a: In accordance with Section(s) enter section the Original Contract referenced above between
the State of Colorado, Colorado Department of Public Health and Environment, and enter Contractor's name the State
hereby exercises its option for an additional term beginning insert start date and ending on insert end date at the rates
stated in the Original Contract, as amended.
b. For use with Option b and c. In accordance with Section(s) enter section of the Original Contract routing number
referenced above, between the State of Colorado, Colorado Department of Public Health and Environment, and enter
Contractor's name the State hereby exercises its option to Increase/Decrease the quantity of Goods/Services or both at
the rates stated in the Original Contract, as amended.
c. For use with Option d. In accordance with Section(s) enter section of the Original Contract routing number
referenced above, the State hereby exercise its option to modify the Contract rates specified in Exhibit Section Number.
The Contract rates attached to this Option letter in Exhibit/Attachment Name replace the rates in the original Contract as
of the Option Effective Date of this Option Letter.
d. For use with Option e: In accordance with Section(s) enter section of the Original Contract routing number
referenced above, the State hereby exercise its option to initiate Phase indicate which Phase: 2, 3, 4 etc. which shall
begin on insert start date and ending on insert end date at the cost/price specified in Section enter section the Original
Contract referenced above.
e. For use with Options a, b, c that modifi, the contract value: The amount of the current Fiscal Year contract value
is increased/decreased by $ enter amount of change to a new contract value of insert new S amount as consideration for
services/goods ordered under the contract for the current fiscal year Indicate Fiscal Year. The Contract is hereby
modified accordingly. The amended total contract financial obligation including all previous amendments, option
letters, etc. is insert new $ amount.
3) Effective Date: The effective date of this Option Letter is upon approval of the State Controller if exact date is required
complete the following: enter date, and include the following: whichever is later.
STATE OF COLORADO
John W. Hickenlooper, GOVERNOR PROGRAM APPROVAL:
Department of Public Health and Environment
By: Lisa McGovern, Purchasing & Contracts Section Director I By:
Date:
Date:
ALL CONTRACTS REQUIRE APPROVAL BY THE STATE CONTROLLER
CRS §24-30-202 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
Contract_OptionLetter_ 17.7.17
By:
Contract_OptionLetter_ 17.7.17
Date:
Exhibit D
Exhibit E
GRANT FUNDING CHANGE LETTER
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 pre%ious
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 Funding Source
Document Type # (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.
By:
STATE OF COLORADO
John W. Hickenlooper, Governor
Department of Public Health and Environment
Lisa McGovern
Purchasing and Contracting Section Director, CDPHE
Date
By:
PROGRAM APPROVAL
Colorado Department of Public Health and
Environment
TNSERT-Name of Authorized Individual
INSERT -Official Title of Authorized Individual
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 Exhibit E ver 15.8.17 Page 1 of I.!
