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HomeMy WebLinkAboutC20-150 Colorado Department of Public Health and Environment Tuberculosis              C20-150 Page 1 of 3 Amendment Contract Number: 2020*3586 Amendment#2 Ver 27.01.20 ONTRACT AMENDMENT #2 SIGNATURE AND COVER PAGE(S) State Agency: Colorado Department Of Public Health and Environment 4300 Cherry Creek Drive South Denver, Colorado 80246 Original Contract Number: 19 FHHA 109259 Contractor: Board of County Commissioners of Eagle County 500 Broadway Eagle, Colorado 81631-0850 For the use and benefit of the Eagle County Public Health Agency 551 Broadway Eagle, Colorado 81631 Amendment Contract Number: 2020*3586 Amendment#2 Contract Performance Beginning Date: July 1, 2018 Current Contract Expiration Date: June 30, 2021 CONTRACT MAXIMUM AMOUNT TABLE Document Type Contract Number Federal Funding Amount State Funding Amount Other Funding Amount Term (dates) Total Original Contract 19 FHHA 109259 $0.00 $5,000.00 $0.00 07/01/2018- 06/30/2019 $5,000.00 Contract Amendment #1 2020*0130 Amendment #1 $0.00 $5,000.00 $0.00 07/01/2019- 06/30/2020 $5,000.00 Option Letter # 1 2020*0130 Option Letter #1 $1,000.00 $0.00 $0.00 09/01/2019- 12/31/2019 $1,000.00 Contract Amendment #2 2020*3586 Amendment #2 $0.00 $4,000.00 $0.00 07/01/2020- 06/30/2021 $4,000.00 Current Contract Maximum Cumulative Amount $15,000.00               Page 2 of 3 Amendment Contract Number: 2020*3586 Amendment#2 Ver 27.01.20 THE PARTIES HERETO HAVE EXECUTED THIS AMENDMENT Each person signing this Amendment represents and warrants that he or she is duly authorized to execute this Amendment and to bind the Party authorizing his or her signature. CONTRACTOR Eagle County Public Health Agency ______________________________________________ By: Signature ______________________________________________ Name of Person Signing for Contractor ______________________________________________ Title of Person Signing for Contractor Date: _________________________ STATE OF COLORADO Jared S. Polis, Governor Colorado Department of Public Health and Environment Jill Hunsaker Ryan, MPH, Executive Director ______________________________________________ By: Signature ______________________________________________ Name of Executive Director Delegate ______________________________________________ Title of Executive Director Delegate 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: Signature __________________________________________ Name of State Controller Delegate __________________________________________ Title of State Controller Delegate Contract Effective Date:_____________________ -- Signature and Cover Pages End --                   Page 2 of 3 Amendment Contract Number: 2020*3586 Amendment#2 Ver 27.01.20 THE PARTIES HERETO HAVE EXECUTED THIS AMENDMENT Each person signing this Amendment represents and warrants that he or she is duly authorized to execute this Amendment and to bind the Party authorizing his or her signature. CONTRACTOR Eagle County Public Health Agency ______________________________________________ By: Signature ______________________________________________ Name of Person Signing for Contractor ______________________________________________ Title of Person Signing for Contractor Date: _________________________ STATE OF COLORADO Jared S. Polis, Governor Colorado Department of Public Health and Environment Jill Hunsaker Ryan, MPH, Executive Director ______________________________________________ By: Signature ______________________________________________ Name of Executive Director Delegate ______________________________________________ Title of Executive Director Delegate 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: Signature __________________________________________ Name of State Controller Delegate __________________________________________ Title of State Controller Delegate Contract Effective Date:_____________________ -- Signature and Cover Pages End -- DocuSign Envelope ID: 6DB3D529-CEB7-41AD-8C1C-5DE1503EEBB4 Lisa McGovern Procurement & Contracts Section Director 2020-04-28 2020-05-04 Controller Travis Yoder Page 3 of 3 Amendment Contract Number: 2020*3586 Amendment#2 Ver 27.01.20 1. PARTIES This Amendment (the “Amendment”) to the Original Contract shown on the Signature and Cover Page for this Amendment (the “Contract”) is entered into by and between the Contractor, and the State. 2. TERMINOLOGY Except as specifically modified by this Amendment, all terms used in this Amendment that are defined in the Contract shall be construed and interpreted in accordance with the Contract. 3. AMENDMENT EFFECTIVE DATE AND TERM A. Amendment Effective Date This Amendment shall not be valid or enforceable until the Amendment Effective Date shown under the State Controller Signature. The State shall not be bound by any provision of this Amendment before that Amendment Effective Date, and shall have no obligation to pay Contractor for any Work performed or expense incurred under this Amendment either before or after of the Amendment term shown in §3.B of this Amendment. B. Amendment Term The Parties’ respective performances under this Amendment and the changes to the Contract contained herein shall commence on the Amendment Effective Date shown under the State Controller Signature or July 1, 2020, whichever is later and shall terminate on the termination of the Contract or June 30, 2021, whichever is earlier. 4. PURPOSE The Parties entered into the agreement to provide diagnostic, patient education and treatment services for individuals with suspected/known latent TB infection (LTBI) and those classified with Class A and Class B TB status or who are suspected of having active TB. Also for individuals who are identified as newly arrived refugees, asylees and other high risk persons with LTBI. The Parties now desire to renew for an additional term and change current Contract Maximum Total for the following reason: to renew. 5. MODIFICATIONS The Contract and all prior amendments thereto, if any, are modified as follows: A. The Contract Maximum Amount table is deleted and replaced with the Current Contract Maximum Amount shown on the Signature and Cover Page for this Amendment. B. The Contract Initial Contract Expiration Date on the Contract’s Signature and Cover Page is hereby deleted and replaced with the Current Contract Expiration Date shown on the Signature and Cover Page for this Amendment. C. The Parties now agree to modify Exhibit F, Statement of Work, of the agreement. Exhibit F, Statement of Work, is deleted and replaced in its entirety with Exhibit F, Statement of Work, attached to this Amendment, for the following reason: to renew. D. The Parties now agree to modify Exhibit H, Budget is deleted and replaced in its entirety with Exhibit H, Budget, attached to this Amendment, for the following reason: to renew. 6. LIMITS OF EFFECT AND ORDER OF PRECEDENCE This Amendment is incorporated by reference into the Contract, and the Contract and all prior amendments or other modifications to the Contract, if any, remain in full force and effect except as specifically modified in this Amendment. Except for the Special Provisions contained in the Contract, in the event of any conflict, inconsistency, variance, or contradiction between the provisions of this Amendment and any of the provisions of the Contract or any prior modification to the Contract, the provisions of this Amendment shall in all respects supersede, govern, and control. The provisions of this Amendment shall only supersede, govern, and control over the Special Provisions contained in the Contract to the extent that this Amendment specifically modifies those Special Provisions.               EXHIBIT F Page 1 of 7 Amendment Contract Number: 2020*3586 Amendment #2 Ver. 01.11.19 STATEMENT OF WORK To Original Contract Number: 19 FHHA 109259 Amendment Contract Number: 2020*3586 Amendment #2 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 II. Project Description: This project serves to provide diagnostic, patient education and treatment services for individuals with suspected/known latent Tuberculosis (TB) infection (LTBI) and those classified with Class A and Class B TB status or who are suspected of having active TB. Also for individuals who are identified as newly arrived refugees, asylees and other high-risk persons with LTBI. III. Definitions: 1. AFB smear – Acid-Fast Bacilli; a rapid test used to detect infectious mycobacteria 2. Asylee -- individuals who, on their own, travel to the United States and subsequently apply for and receive a grant of asylum. 3. CDPHE – Colorado Department of Public Health and Environment 4. Class A – Pulmonary TB, the applicant has an abnormal chest radiograph suggestive of active TB disease, and one or more sputum smears positive for acid-fast bacteria 5. Class B1 – Immigrant with an abnormal CXR with evidence of TB, and/or the individual has a history of treatment for active TB disease. 6. Class B2 – The individual was diagnosed with latent TB infection (LTBI). These are typically children whose TST result was positive and CXR was normal. 7. DOT – Directly Observed Therapy 8. HIV– Human Immunodeficiency Virus 9. IGRA – interferon gamma (J) release assay (whole blood TB test) 10. LEP – limited English proficiency (Over-the-Phone Interpretation (OPI) provider only) 11. LTBI – Latent Tuberculosis Infection 12. OPI – over-the-phone interpretation 13. Refugee --any person who is outside his or her country of nationality or habitual residence and is unable or unwilling to return to or seek protection of that country due to a well-founded fear of persecution based on race, religion, nationality, membership in a particular social group, or political opinion 14. RVCT – Report of Verified Case of Tuberculosis 15. TB – Tuberculosis 16. TB-18– CDPHE’s TB surveillance form 17. TBdb – CDPHE Tuberculosis Data Base 18. TST – Tuberculin Skin Test IV. Work Plan: Goal #1:Prevent and control tuberculosis infection and active TB disease throughout the Contractor’s jurisdiction Objective #1:No later than the expiration date of the Contract, the Contractor shall assist in supporting tuberculosis prevention and control activities throughout the agency’s jurisdiction. Primary Activity #1 The Contractor shall locate all patients with suspected or confirmed TB.               EXHIBIT F Page 2 of 7 Amendment Contract Number: 2020*3586 Amendment #2 Ver. 01.11.19 Sub-Activities #1 1. The Contractor shall provide, or arrange for, chest x-rays and interpretations for individuals with suspected or confirmed TB. 2. The Contractor shall provide interpretations for individuals with suspected or confirmed TB, as necessary. 3. The Contractor shall collect specimens for mycobacteriology testing on all persons suspected of having TB. 4. The Contractor shall arrange for the transportation of the specimens to the CDPHE laboratory for testing. 5. The Contractor shall arrange for the placement of patients who require isolation. a. The Contractor shall contact CDPHE TB Program for assistance. b. The Contractor shall contact CDPHE to request reimbursement from CDPHE for those costs incurred by the Contractor in isolating a patient. 6. The Contractor shall provide, or arrange for, the treatment of patients with suspected or confirmed active TB, including DOT. 7. The Contractor shall ensure patients’ adherence to TB treatment. 8. The Contractor shall inform those individuals whom refuse testing of the risks associated with HIV/TB co-infection. 9. A minimum of once a month, the Contractor shall monitor those persons with suspected or confirmed active TB disease by in-person assessment. a. The Contractor shall evaluate those persons with suspected or confirmed active TB disease by in-person assessment. 10. As needed, the Contractor shall offer limited English proficiency services via an accredited Over-the-Phone Interpretation (OPI) provider to be reimbursed using TB DOT/Diagnostic reimbursement invoice template by the CDPHE TB Program at a rate not to exceed $0.75/minute. a. The instructions are incorporated and made part of this Contract by reference and is available on the following website under the Over-the-phone (OPI) section, https://www.colorado.gov/pacific/cdphe/tb-lpha. Primary Activity #2 The Contractor shall ensure that all contacts to newly identified infectious TB cases are identified, investigated, and receive appropriate evaluation. Sub-Activities #2 1. The Contractor shall provide, or arrange for the following for individuals with newly identified infectious, suspected, confirmed, and LTBI TB cases: a. Chest x-rays b. Chest x-ray interpretations 2. The Contractor shall provide, or arrange for, the treatment of patients, including DOT, and ensure the completion of therapy for infected patients. 3. The Contractor shall provide, or arrange for, an HIV antibody test for all persons with LTBI with HIV risk factors or who originate from an HIV-endemic area. 4. The Contractor shall inform all individuals whom refuse testing of the risks associated with HIV/TB co-infection. 5. A minimum of once a month, the Contractor shall monitor and evaluate persons with LTBI during treatment. 6. The Contractor shall ask all TB clients about current health insurance enrollment and offered materials to become insured if not currently insured. 7. The Contractor shall complete a preliminary Tuberculosis Contact Investigation Record. a. The instructions are incorporated and made part of this Contract by reference and is available at the following link, Tuberculosis Contact Investigation Record to the CDPHE TB Program after initiation of each contact investigation. Primary Activity #3 The Contractor shall provide or arrange for newly arrived refugees, asylees and other eligible individuals with Class B TB designation to complete a TB screening.               EXHIBIT F Page 3 of 7 Amendment Contract Number: 2020*3586 Amendment #2 Ver. 01.11.19 Sub-Activities #3 1. A minimum of 30 calendar days of the Contractor’s receipt of written notification from CDPHE of the arrival of a Class B immigrant or refugee, the Contactor shall provide, or arrange for a TB screening that includes the following: a. medical evaluation b. tuberculin skin test or IGRA c. chest radiograph d. three spontaneous sputum specimens for AFB smear and culture collected on consecutive days 2. Upon completion of testing and examination, the Contractor shall complete, sign, and date the CDC 75.17 form or Class B tuberculosis Follow Up worksheet, and return it within ninety (90) days to: Colorado Department of Public Health and Environment Tuberculosis Program Attn: Class B Coordinator 4300 Cherry Creek Drive South Denver, CO 80246 Primary Activity #4 The Contractor shall identify, investigate, and evaluate persons with a high risk of LTBI. Sub-Activities #4 1. The Contractor shall offer an HIV antibody test to 100% of persons with LTBI and provide, or arrange for, HIV antibody test with a test result rate >80%. a. The Contractor shall record 80% of all HIV antibody testing result rates for LBTI patients into the CDPHE TBdb. b. The Contractor shall record 95% of all HIV testing result rates among suspect and confirmed cases of active TB disease, and enter that information into the CDPHE TBdb. 2. The Contractor shall offer an HIV antibody test to 100% of persons diagnosed with active TB disease. a. The Contractor shall provide an HIV antibody test for those clients with a test result rate >95%, regardless of their age or the apparent absence of risk factors for HIV infection. 3. A minimum of once a month, the Contractor shall monitor and evaluate persons with LTBI during treatment for all such patients. 4. For those persons identified with LTBI or active TB, the Contractor shall initiate treatment in accordance with CDC guidance found at the following links, incorporated and made part of this Contract by reference: https://www.cdc.gov/tb/topic/treatment/ltbi.htm; https://www.cdc.gov/tb/topic/treatment/tbdisease.htm Primary Activity #5 The Contractor shall offer printed resource and referral materials to clients that direct them to the nearest community Medicaid and Connect for Health Colorado enrollment location(s), including online enrollment options. Sub-Activities #5 1. The Contractor shall discuss current health insurance enrollment status with each client for the purposes of becoming insured if not currently insured. a. The Contractor shall guide each client to following websites: https://www.colorado.gov/pacific/hcpf/how-to-apply and http://connectforhealthco.com/resources/person-help/, incorporated and made part of this Contract by reference. b. The Contractor shall ask all TB clients about current health insurance enrollment status, including Medicaid and offer resource materials no later than the last business day of each month. c. The Contractor shall document that all TB clients were asked about current health insurance enrollment and offered materials no later than the last business day of each month.               EXHIBIT F Page 4 of 7 Amendment Contract Number: 2020*3586 Amendment #2 Ver. 01.11.19 Standards and Requirements 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 during the Contract term. The Contractor shall monitor documents and website content for updates and comply with all updates. 2. The Contractor shall complete the appropriate treatment as stated in the CDPHE TB Manual.The CDPHE TB Manual is available on the State of Colorado website https://www.colorado.gov/pacific/cdphe/colorado-tb-manual and is incorporated and made part of this Contract by reference. 3. CDPHE shall provide templates and instructions for any additional information requests. Report forms are subject to revision and the Contractor agrees to use the most recent version. 4. The Contractor shall increase the percentage of persons that complete LTBI treatment to meet the state objective of 84% by the last day of the contract term and maintain or improve on that rate thereafter. 5. The Contractor shall develop reports of suspected or confirmed active TB disease results, and include the following information: a. reason for initiating b.patient name c. date of birth d.country of birth e. date arrived in U.S. f. demographic information g.locating information h.provider information i. TB risk factors j. results of diagnostic testing k.results of mycobacteriology including susceptibility results l. dates of infectious period m. treatment information n. changes in patients' status o. diagnosis p. any other information as appropriate 6. For those persons identified with LTBI or active TB, the Contractor shall report to CDPHE: a. patient name b. date of birth c. country of birth d. date arrived in the U.S. e. demographic information f. locating information g. provider information h. TB risk factors i. results of diagnostic testing j. treatment information k. any other information deemed appropriate by the Contractor 7. The Contractor shall complete tests including the following: a. smears for acid-fast bacilli, (using concentrated fluorescent method) b. isolation of mycobacteria (using rapid methods) c. identification of Mycobacterium tuberculosis complex (MTB) (using rapid methods) d. susceptibility testing (isoniazid, rifampin, ethambutol, and pyrazinamide) on isolates of MTB.               EXHIBIT F Page 5 of 7 Amendment Contract Number: 2020*3586 Amendment #2 Ver. 01.11.19 8. The CDPHE TB Program will notify the Contractor of all newly arrived Class B TB immigrants/refugees via a CDC 75.17 form which is incorporated herein by this reference, or Follow-up worksheet which is incorporated herein by this reference, made a part of this Contract, and available on the following website: https://www.colorado.gov/pacific/cdphe/tb-btb-arrivals 9. The Contractor shall record 95% of all HIV antibody testing result rates among suspect and confirmed cases of active TB disease, and enter that information into the CDPHE TBdb. a. The Contractor shall record 95% of all HIV antibody testing result rates among suspect and confirmed cases of active TB disease into the CDPHE TBdb no later than the day before TB treatment begins, and no later than the end date of this Contract. 9. The Contractor shall record 80% of all HIV antibody testing result rates for LBTI patients into the CDPHE TBdb. a. The Contractor shall record 80% of all HIV antibody testing result rates for LBTI patients into the CDPHE TBdb no later than the end date of this Contract. 10. The Contractor shall provide culturally appropriate patient education and information pertaining to TB treatment and the follow-up plan. 11. The Contractor shall provide services in patient’s preferred language using medical interpretation resource. 12. The Contractor shall report to CDPHE via (CDPHE TBdb) or via Tuberculosis Surveillance and Case Management Report (TB-18) when a TB patient completes treatment, moves, or transfers out of the Contractor’s service area. a. The Contractor shall complete 100% of all TB-18 and RVCT CDPHE TBdb fields no later than the last business day of each month, and by the end date of this contract. 13. The Contractor shall discuss current health insurance enrollment and offer materials with the client for the purposes of becoming insured if not currently insured. a. The Contractor shall ask all TB clients about current health insurance enrollment including Medicaid, and offer resource materials no later than the last business day of each month. 14. The Contractor shall provide or arrange for treatment and ensure completion of therapy. 15. The Contractor shall provide a final report via email or CDPHE TBdb to the TB Program’s Data Coordinator when a contact investigation is completed. 16. The Contractor shall provide all other necessary laboratory testing and medical evaluation services to identify TB. 17. The Contractor shall report all known HIV antibody test results to CDPHE. 18. The Contractor shall report information via web-based TB case/contact management system (CDPHE TBdb) or via “Tuberculosis Surveillance and Case Management Report” (TB 18),which is incorporated herein by this reference, made a part of this Contract and is available at the following link: TB-18. 19. For confirmed cases of TB, the Contractor shall include all data elements identified in the “Report of Verified Case of Tuberculosis (RVCT)”, which is incorporated herein by this reference, made a part of this Contract and is available at the following link: RVCT and is incorporated and made part of this contract by reference. 20. The Contractor shall use the CDPHE Laboratory for testing. 21. The CDPHE Laboratory will, at no charge to the Contractor, supply specimen containers and perform the above testing for the Contractor. 22. The Contractor shall order TB medications through the CDPHE TB Program. 23. The Contractor shall provide CDPHE with the medical insurance information for those patients who have medical insurance. 24. The Contractor shall provide consultation services, as needed, to providers in its service area regarding TB reporting, screening, treatment, and follow-up. 25. The Contractor shall comply with TB specimen shipping guidelines. See TB Sputum Collection Kit and Shipping Instructions https://drive.google.com/file/d/0B0tmPQ67k3NVRXRPLVlVY1ZScEE/view which is               EXHIBIT F Page 6 of 7 Amendment Contract Number: 2020*3586 Amendment #2 Ver. 01.11.19 incorporated and made part of this Contract by reference. 26. The Contractor shall provide printed resource, referral and Medicaid and Connect for Health Colorado enrollment materials for clients with Limited English Proficiency (LEP). a. Contractors that routinely offer enrollment services on-site are exempt from this requirement because the services provided go beyond this minimum requirement. 27. The Contractor shall use LEP, Over-the-Phone Interpretation (OPI) to communicate with clients telephonically or in-person (when a live in-person interpreter is not warranted). a. The Contractor shall provide a monthly reimbursement DOT/Diagnostic/OPI invoice according to the following criteria: i. The monthly DOT/Diagnostic invoice must be provided with supporting documentation confirming use is TB-related. ii. The Contractor shall request monthly DOT/Diagnostic reimbursement no later than the last business day of each month. 28. The Contractor shall complete the Semi-Annual Progress Report per the following criteria: a. The Semi-Annual Progress Reports must cover July-December and January- June. b. The Contractor shall complete the Semi-Annual Progress Report using the following website: https://drive.google.com/file/d/0B0tmPQ67k3NVbk8xemFPN3FpWU0/view which is incorporated and made part of this Contract by reference. 29. The Contractor shall use information on enrollment resources, referral locations, LEP and outreach and promotional materials is available at https://coloradopeak.secure.force.com/CPCLA which is incorporated and made a part of this Contract by reference. 30. In order to facilitate and improve client access and enrollment in health insurance, CDPHE is asking all state contractors and sub-recipients who contract with the department for direct patient care clinical service programs to provide Colorado Medicaid and Connect for Health Colorado information to clients presenting for services at their agencies. At a minimum, CDPHE Contractors must offer clients printed resource and referral materials that direct them to the nearest community Medicaid and Connect for Health Colorado enrollment location(s), including online enrollment options. These materials must be available for clients with limited English proficiency (LEP). To help locate the nearest enrollment locations in the community, the following websites are available: https://www.colorado.gov/pacific/hcpf/how-to-apply http://connectforhealthco.com/resources/person-help/, and are incorporated and made part of this Contract by reference. 31. The Contractor shall allow all existing staff designated to TB activities to attend the latest CDPHE Baseline TB 101 training at least once during the contract period, and allow all new staff designated to TB activities to attend this training TB 101 Baseline within 3 months of hire, and during the contract period. Expected Results of the Activity 1. New TB cases shall be diagnosed, documented and treated. 2. Patients with existing or newly diagnosed TB or LTBI shall be treated, as appropriate. 3. Newly arrived refugees, asylees and other eligible individuals with Class B TB designation receive treatment. Measurement of Expected Results 1. Data contained in the CDPHE TBdb. 2. Data in Semi-Annual Progress Reports. Completion Date Deliverables 1. The Contractor shall submit the Semi-Annual Progress Report covering July-December and January-June to the CDPHE Contract Monitor via email. No later than seven (7) and 13 months after execution of this contract               EXHIBIT F Page 7 of 7 Amendment Contract Number: 2020*3586 Amendment #2 Ver. 01.11.19 V. Monitoring: CDPHE’s monitoring of the Contract for compliance with performance requirements will be conducted throughout the Contract period by the CDPHE Contract Monitor. Methods used will include a review of documentation determined by CDPHE to be reflective of performance to include monthly reports and invoices 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. 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 CDPHE 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 Terms and Conditions of this Contract.               EXHIBIT H Amendment Contract Number: 2020*3586 Amendment #2 Page 1 of 1 FY2021 Budget To Original Contract Number: 19 FHHA 109259 Eagle County Public Health Agency – Prevention and Control Description Funding Source Amount TB Prevention & Control State $4,000 DOT, Diagnostic, and OPI encumbrances as needed State As available Total $ 4,000