Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAboutC20-322 Colorado Department of Human Services Nurse Home VisitorAmendment Contract Number: 21 IHIA 160145 Page 1 of 3 Rev. 1/14/19
CONTRACT AMENDMENT #2
SIGNATURE AND COVER PAGE
State Agency
Colorado Department of Human Services
Office of Early Childhood
Division of
Original Contract Number
20 IHIA 129458
Contractor
Eagle County Government, dba Health and Human Services
551 Broadway, PO Box 600
Eagle, CO 81631
Amendment Contract Number
21 IHIA 160145
Current Contract Maximum Amount
Initial Term
Contract Performance Beginning Date
July 1, 2019
State Fiscal Year 2020 $466,777*
*An appropriation for NHVP General Accounting
Encumbrance (GAE) is hereby added to this contract.
The maximum payable for GAE is subject to
appropriated funds, not to exceed $50,000 which is split
among other NHVP vendors. See Exhibit C: Additional
Provisions.
Extension Terms Current Contract Expiration Date
June 30, 2021 State Fiscal Year 2021 $438,928*
*An appropriation for NHVP General Accounting
Encumbrance (GAE) is hereby added to this contract.
The maximum payable for GAE is subject to
appropriated funds, not to exceed $70,000 which is split
among other NHVP vendors. See Exhibit C: Additional
Provisions.
Total for All State Fiscal Years $905,705*
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 Government, dba Health and Human Services
______________________________________________
By: Kathy Chandler Henry, Chair, Board of County
Commissioner
Date: _________________________
STATE OF COLORADO
Jared Polis, Governor
Colorado Department of Human Services
Michelle Barnes, Executive Director
______________________________________________
By: Mary Anne Snyder, Director, Office of Early Childhood
Date: _________________________
In accordance with §24-30-202 C.R.S., this Amendment is not valid until signed and dated below by the State Controller or an
authorized delegate.
STATE CONTROLLER
Robert Jaros, CPA, MBA, JD
By:___________________________________________
Andrea Eurich / Janet Miks / Toni Williamson
Amendment Effective Date:_____________________
DocuSign Envelope ID: 963CC2AA-BB26-4B05-BCA0-AA1C54E1BCC7
8/26/2020
8/26/2020
8/28/2020
C20-322
Amendment Contract Number: 21 IHIA 160145 Page 2 of 3 Rev. 1/14/19
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 on the Signature and Cover Page for this Amendment. 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 on the
Signature and Cover Page for this Amendment and shall terminate on the termination of the
Contract.
4. PURPOSE
In accordance with the provisions of this contract and its exhibits and attachments, the Contractor
shall: Provide trained visiting nurses to help educate mothers on the importance of nutrition and
avoiding alcohol and drugs, including nicotine, and to assist and education mothers in providing
general care for their children. This Amendment shall extend the contract term for FY21,
increase funds for services to be provided in FY21, and amends Exhibits B and C.
5. MODIFICATIONS
The Contract and all prior amendments thereto, if any, are modified as follows:
A. Extend Contract Expiration Date from June 30, 2020 to June 30, 2021.
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.
B. Increase Contract Maximum Amount by $438,928 for services in FY21 and increase
Total for All State Fiscal Years from $466,777 to $905,705.
The Contract Maximum Amount table on the Contract’s Signature and Cover Page is
hereby deleted and replaced with the Current Contract Maximum Amount table shown on
the Signature and Cover Page for this Amendment.
C. Exhibit B – Budget
Exhibit B – Amendment #2, which is attached and incorporated into this Amendment, is
hereby added to Exhibit B of the Original Contract.
DocuSign Envelope ID: 963CC2AA-BB26-4B05-BCA0-AA1C54E1BCC7
Amendment Contract Number: 21 IHIA 160145 Page 3 of 3 Rev. 1/14/19
D. Exhibit C – Additional Provisions
Exhibit C – Amendment #2, which is attached and incorporated into this Amendment,
hereby replaces Exhibit C – Amendment #1.
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.
DocuSign Envelope ID: 963CC2AA-BB26-4B05-BCA0-AA1C54E1BCC7
Exhibit B ‐ Amendment #2Project NameNurse Home Visitor ProgramCounites ServedEaglePosition Title/Employee NameGross or Annual SalaryFringePercent of Time on ProjectTotal Amount For ProjectA. Other Sources of FundingB. Medicaid Revenue C. CDHS Funding (NHVP)Nursing Staff includes one (1) Nurse Supervisor and three (3) Nurse Home Visitors$316,622 $0 $0 $316,622Kelly Matias$30,041 $4,533 100% $34,574 $0 $0 $34,574$34,574 $0 $0 $34,574$351,196 $0 $0 $351,196Description of Work and Fringe benefits are actual percentage rate of agency calculated against all salaries. Includes workers' comp insurance, unemployment insurance, long‐term disability, FICA, retirement, wellness program, health, dental, and vision insurance. Overall Program implementation and home visiting service deliveryANY AMOUNT PAID AGAINST HOLDOVER NOTICE 21 IHIA 161181 WILL BE REDUCED FROM THE MAXIMUM AMOUNT PAYABLE ON THIS CONTRACT. FY 2021Expenditure CategoriesPersonnel Services - Salaried EmployeesProgram Contact Name, TitleColorado Department of Human ServicesOffice of Early ChildhoodBUDGET WITH JUSTIFICATION FORM EmailFiscal Contact Name, TitlePhoneEmailFunded CaseloadRebecca Larson970‐328‐9820phgrants_contracts@eaglecounty.usMarie Hermosillo970‐328‐8849marie.hermosillo@eaglecounty.us59July 1, 2020 ‐ June 30, 2021Eagle County Public Health & EnvironmentContractor NameBudget PeriodPhoneIndividual Nursing staff salary not to exceed $88,868 (A Contract Amendment is required if any additional funds are added to the total contract amount)Non Nursing Staff1b. Non Nursing Staff Total 1. Total Personnel Services (including fringe benefits)Provides data input & interpretation servicesPage 1 of 3DocuSign Envelope ID: 963CC2AA-BB26-4B05-BCA0-AA1C54E1BCC7
Exhibit B ‐ Amendment #2ItemA. Other Sources of FundingB. Medicaid Revenue C. CDHS Funding (NHVP)Office Operating Expenses (i.e. supplies) $0 $0 $1,136Client Support Materials$0 $0 $2,015Printing & Publications$0 $0 $800Postal & Shipping Services$0 $0 $150Communications (cellular, network $0 $0 $3,790Medical Supplies $0 $0 $300$0 $0 $8,191ItemA. Other Sources of FundingB. Medicaid Revenue C. CDHS Funding (NHVP)Dance Education Fees$0 $0 $913Nurse Family Partnership National Service Office Mandatory Training$0 $0 $18,538Professional Development$0 $0 $2,400$0 $0 $0 $21,851NameA. Other Sources of FundingB. Medicaid Revenue C. CDHS Funding (NHVP)$0 $0 $0$0 $0 $0ItemA. Other Sources of FundingB. Medicaid Revenue C. CDHS Funding (NHVP)State Nurse Supervisor Meetings$0 $0 $1,934Home visitor mileage$0 $0 $11,000Training and Meeting Travel $0 $0 $4,636$0 $0 $17,570FY 2021Description of ItemNo costs in this category will be reimbursed by CDHS. Description of ItemCost is necessary so that NS can attend necessary meetingsCost is necessary so that NHVs can travel to clients' homes to deliver services 4. Total Equpment5. Total TravelCost is necessary for Adminstator, NHVs & NS can attend necessary meetings & trainingsFY 2021Equipment (Over $5,000 Per Item) FY 2021FY 2021TravelTraining and Technical AssistanceSupplies & Operating Expenses3. Total Training and Technical AssistanceDescription of Item basic offices supplies such as pens, chart folders, paper & binder, clips, tape, etc. necessary for everyday work necessary to purchase client support materials for families beyond NHVP & PIPE handoutsnecessary for client printed materials (facilitators), staff supervision & NHV forms, reference publicationsFEDEX cost for shipping grant materials to CDHS, letters to familiescell phones & coverage, tablets necessary for everyday NHV work and safety of NHVstethoscopes, BP cuffs, items for NHV working with familiesDescription of ItemRequired Training to facilitate nurses' work with families on important aspects of the caregiver‐child relationship that is core to the Nurse Family Partnership Model. Training happens required in years 2, 3, 4, 7, 9 2. Total Supplies & Operating ExpensesIncludes mandatory training for new nurses, supervisors, and administrators; consultation for supervisors; and the program support feeCovers cost of additional training for NHVsPage 2 of 3DocuSign Envelope ID: 963CC2AA-BB26-4B05-BCA0-AA1C54E1BCC7
Exhibit B ‐ Amendment #2NameA. Other Sources of FundingB. Medicaid Revenue C. CDHS Funding (NHVP)Mental Health Consultation$0 $0 $5,000$0 $0 $5,000$0 $0 $403,808ItemA. Other Sources of FundingB. Medicaid Revenue C. CDHS Funding (NHVP)10% de minimis Indirect rate: $0 $0 $35,120$0 $0 $35,120$0 $0 $438,928FY 2020-2021Indirect CostsFY 2021Contractors/Consultants (payments to third parties or entities)Description of ItemMental Health consultation is necessary to support nurses in their work with families6. Total Contractors/ConsultantsDescription of Item Indirect rate at 10% of total personnel costsTotal IndirectMODIFIED TOTAL DIRECT COSTS (MTDC)TOTAL Page 3 of 3DocuSign Envelope ID: 963CC2AA-BB26-4B05-BCA0-AA1C54E1BCC7
Exhibit C – Amendment #2
Page 1 of 3 Revision Date January 29, 2020
ADDITIONAL PROVISIONS
1. SERVICE PROVISIONS
The Contractor shall provide the services according to the plans submitted in the “Statement of Work”, attached
and incorporated herein by this reference as EXHIBIT A. In all cases, the descriptions, plans, timetables, tasks,
duties, and responsibilities of the Contractor as described in the Statement of Work, shall be adhered to in the
performance of the requirements of this contract. In the event of a conflict, the terms and conditions of this
contract shall control over the Statement of Work. Any significant changes to the Statement of Work (SOW)
require an amendment to the contract.
2. GOALS AND OBJECTIVES
The Contractor shall be responsible for the achievement of any goals and objectives as specified within the
Statement of Work (EXHIBIT A) of this contract unless written notice of any modifications are furnished by
the State to the Contractor allowing adequate time for compliance during the term of this contract.
3. COPY OF SUBCONTRACT
The Contractor shall provide to the State a copy of any executed subcontract between the Contractor and any
provider of services to fulfill any requirements of this contract. Subcontracts shall be emailed to the Contract
Representative upon execution.
4. PAYMENT
In consideration of the provision of services and reporting and subject to all payment and price provisions and
further subject to verification by the State of full and satisfactory compliance with the terms of this contract, the
State shall pay to the Contractor an amount not to exceed the amount specified in the Budget (EXHIBIT B), of
this contract.
A. The Contractor shall submit requests for payment to CDHS_OEC_Invoicing@state.co.us no less than
monthly on forms prescribed and provided by the State.
B. Payment shall be made on a cost reimbursement basis for services rendered.
C. IT IS UNDERSTOOD ANY COSTS THAT EXCEED THE CONTRACTED AMOUNT SHALL NOT
BE PAID BY CDHS. If Contractor has a legitimate need for additional funds, the Contractor shall request
additional funds from the CDHS 60 days prior to projected depletion of contracted funds. CDHS shall
review each request and notify Contractor in writing of approval or denial. Approval of additional funds
shall require an official modification to the Contract by Amendment or Option Letter.
D. Timely Invoicing - Invoices shall be submitted no later than 45 days following the last day of the month.
End of State Fiscal Year invoices are on a compressed timeframe. Invoices for all services provided prior
to June 30th shall be invoiced by July 5th. Contractors who are unable to provide the invoice by July 5th
shall notify the state of the amount to be booked as accounts payable by July 13th by sending an email to
CDHS_OEC_Invoicing@state.co.us. Final invoices for services prior to June 30th shall be submitted by
September 14th. Invoices received after September 14th may not be paid.
E. The Contractor shall maintain source documentation to support all payment requested pursuant to this
contract. All source documentation shall be provided to the State by the Contractor upon request.
F. It is understood that the State reserves the right to offset funds pursuant to this contract based on the
discovery of overpayment or improper use of funds by the Contractor. Overpayment or improper use of
DocuSign Envelope ID: 963CC2AA-BB26-4B05-BCA0-AA1C54E1BCC7
Exhibit C – Amendment #2
Page 2 of 3 Revision Date January 29, 2020
funds is interpreted to apply to specific terms of prior year contracts, and includes without limitation
requirements of the Generally Accepted Accounting Principles (GAAP) issued by the American Institute
of Certified Public Accountants, and applicable sections of the Colorado Revised Statutes.
5. PARTICIPATION
The Contractor representative(s) is required to participate in any Office of Early Childhood sponsored meetings
related to this contract.
6. SUPPLANTING
Payments made to the Contractor under this contract will supplement and not supplant other state, local or
federal expenditures for services associated with this contract.
7. BUDGET CHANGES
Contractor may request in writing adjustments to the direct costs in the current year budget (EXHIBIT B) not
to exceed 10% of the total budget. Requests shall be made in the form of a written budget revision request to
the appropriate program staff. Written approval for the budget revision shall be required prior to any changes to
the budget related to the budget revision request. The total dollar amount of the contract budget cannot be
changed as a result of the budget revision request. Budget adjustment requests over 10%, adding new expense
lines, and/or changes to the total dollar amount of the budget require a formal amendment. No adjustments to
the Indirect Costs portion of the budget are allowable without a formal amendment.
Contractor may request in writing up to a 5% increase to the "Gross or Annual Salary" of an individual
employee if a position currently listed in the contract becomes vacant and the new incoming employee will be
hired at a higher or lower salary. No increase within the salary range is authorized without prior written
approval from CDHS. Adding additional staff requires an amendment to the contract. Vacancy savings cannot
be used to change salary amounts for existing personnel without an amendment. Any change to personnel
requires prior written approval from CDHS staff. This process will never change the Contract Maximum
Amount. Contractor must use available unused funds from either vacancy savings or another category within
the contract. The revision request may not at any time compromise the integrity of the funded program as
determined by CDHS program staff.
8. TRAVEL
A. Mileage shall not exceed the State mileage rate per https://www.colorado.gov/pacific/osc/travel-fiscal-rule.
B. Per Diem shall not exceed State per diem rate for the area of travel per
https://www.colorado.gov/pacific/osc/travel-fiscal-rule.
C. Hotel rates cannot exceed any rate established for conference attendance.
D. Usage of airfare or Out of State Travel requires pre-approval from CDHS.
9. CRITICAL INCIDENT REPORTING
Within 48 hours of the occurrence of a critical incident involving any child or family and/or an on duty agency
staff member of any family support program staff funded through the Office of Early Childhood (OEC), the
agency must report in writing the details of the critical incident to the OEC Program Manager for the involved
family support program. Critical incidents may include, but are not limited to, awareness of an egregious
incident of abuse and/or neglect, near fatality, or fatality of any child currently enrolled in a family support
program; involuntary termination of a program staff’s employment; criminal allegations involving program staff
DocuSign Envelope ID: 963CC2AA-BB26-4B05-BCA0-AA1C54E1BCC7
Exhibit C – Amendment #2
Page 3 of 3 Revision Date January 29, 2020
and related to his/her employment; negative media attention about the family support program; any major injury
or threat to the security of an agency staff member while on duty and visiting an enrolled child or family.
10. MANDATED REPORTING
A. All program staff are required by law to report suspected child abuse and neglect. Mandatory reporters
must report suspected child abuse and neglect to the local county child welfare agency, the local law
enforcement agency, or by calling the child abuse reporting hotline system at 1-844-CO-4KIDS (1-844-
264-5437).
B. All program staff are required to take the online mandatory reporter training on the CDHS Child Welfare
Training System: https://www.coloradocwts.com/mandated-reporter-training.
11. GENERAL ACCOUNTING ENCUMBRANCE (GAE)
A. Payment for Nurse Home Visitor Program (NHVP) to all contractors will be made as incurred, in whole
or in part, from the total available funds not to exceed $120,000 ($50,000 for FY20; $70,000 for FY21),
to be utilized for NHVP as follows:
i. Nurse Family Partnership (NFP) training costs, often sites experience staff turnover in a fiscal year
and they will be permitted to use the GAE to cover costs of NFP required training that was not
included in their budget.
ii. Travel costs associated with NFP training. For example, if a site hires a new Nurse Home Visitor,
and this staff member is required to attend NFP orientation, the site will be able to bill the GAE for
the training registration and travel expenses for the training. Travel costs may include mileage, hotel
accommodations and per diem for the staff member attending the training.
iii. Operational items not included in their budget such as cell phones, tablets, laptops. Due to staff
turnover, sites are to not include potential operational item expenses in their budgets, but rather
utilize the GAE in order to purchase necessary items for new staff.
It is understood each contractor shall obtain prior written approval from CDHS prior to incurring any
costs related to NHVP GAE funds. It is further understood and agreed that the maximum amount of
funds available state wide for the current fiscal year will be divided between all of the NHVP contracts.
The State shall not be liable for any costs incurred without obtaining prior approval for the expenditure
of NHVP GAE funds. The NHVP program manager will approve GAE expenditures on a case-by case
basis and the state intermediary must concur that they believe the expenditure to be necessary to
improving the program. NHVP program manager must approve the expenditure in writing.
B. Payment to Contractor is made from available funds encumbered and shared across multiple contractors.
The State may increase or decrease the total funds encumbered at its sole discretion and without formal
notice to Contractor. No minimum payment is guaranteed to Contractor. The liability of the State for
such payments is limited to the encumbered amount remaining of such funds.
C. Invoices shall be submitted separately for pre-approved expenditures.
i. The Contractor shall submit requests for payment to CDHS_OEC_Invoicing@state.co.us.
DocuSign Envelope ID: 963CC2AA-BB26-4B05-BCA0-AA1C54E1BCC7