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HomeMy WebLinkAboutC22-047 Fourth Amendment CO Dept. Human ServicesAmendment Contract Number: 22 IHIA 172850 Page 1 of 4 Rev. 1/14/19 CONTRACT AMENDMENT #4 SIGNATURE AND COVER PAGE State Agency Colorado Department of Human Services Office of Early Childhood Division of Community and Family Support 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 22 IHIA 172850 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 amount payable for GAE is subject to appropriated funds, not to exceed $190,000 which is split among other NHVP vendors. See Exhibit C: Additional Provisions. Extension Terms Current Contract Expiration Date June 30, 2022 State Fiscal Year 2021 $438,928* *An appropriation for NHVP General Accounting Encumbrance (GAE) is hereby added to this contract. The maximum amount 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. State Fiscal Year 2022 $438,747* *An appropriation for NHVP General Accounting Encumbrance (GAE) is hereby added to this contract. The maximum amount payable for GAE is subject to appropriated funds, not to exceed $140,000 which is split among other NHVP vendors. See Exhibit C: Additional Provisions. Total for All State Fiscal Years $1,344,452* DocuSign Envelope ID: D8A13AA6-D4EE-4D5D-ADED-5FC5718022E6 Amendment Contract Number: 22 IHIA 172850 Page 2 of 4 Rev. 1/14/19 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: Jeanne McQueeney, Chair Date: _________________________ STATE OF COLORADO Jared Polis, Governor Colorado Department of Human Services Michelle Barnes, Executive Director ______________________________________________ By: Lisa Castiglia, Chief Financial Officer/Director, Division of Operations, 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: D8A13AA6-D4EE-4D5D-ADED-5FC5718022E6 2/1/2022 2/1/2022 2/2/2022 Amendment Contract Number: 22 IHIA 172850 Page 3 of 4 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 increase funds for services to be provided in FY22, and amends Exhibit B. 5. MODIFICATIONS The Contract and all prior amendments thereto, if any, are modified as follows: A. Increase Contract Maximum Amount by $1,271 for services in FY22 and increase Total for All State Fiscal Years from $1,343,181 to $1,344,452. 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. B. Exhibit B – Budget Exhibit B – Amendment #4, which is attached and incorporated into this Amendment, shall hereby replace Exhibit B - Amendment #3. 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 DocuSign Envelope ID: D8A13AA6-D4EE-4D5D-ADED-5FC5718022E6 Amendment Contract Number: 22 IHIA 172850 Page 4 of 4 Rev. 1/14/19 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: D8A13AA6-D4EE-4D5D-ADED-5FC5718022E6 Exhibit B- Amendemnt #4 Project Name Nurse Home Visitor Program Counites Served Eagle Position Title/ Employee Name Gross or Annual Salary Fringe Percent of Time on Project Total Amount For Project A. Other Sources of Funding B. Medicaid Revenue C. CDHS Funding (NHVP) Nursing Staff includes one (1) Nurse Supervisor and three (3) Nurse Home Visitors $319,400 $0 $0 $319,400 Kelly Matias, 0.5 FTE $61,472 $26,348 50%$43,910 $0 $0 $43,910 $43,910 $0 $0 $43,910 $363,310 $0 $0 $363,310 Item A. Other Sources of Funding B. Medicaid Revenue C. CDHS Funding (NHVP) Office Operating Expenses (i.e. supplies) $0 $0 $1,200 Client Support Materials $0 $0 $2,015 Printing & Publications $0 $0 $800 Postal & Shipping Services $0 $0 $150 Communications (cellular, network $0 $0 $5,250 Medical Supplies $0 $0 $450 Outreach Expenses $0 $0 $550 $0 $0 $10,415 Provides data input and interpretation services 1. Total Personnel Services (including fringe benefits) Supplies & Operating Expenses FY2022 2. Total Supplies & Operating Expenses Description of Item stethoscopes, BP cuffs, items for NHV working with families necessary to purchase marketing materials, food for planned community partner in-service 1b. Non Nursing Staff Total Expenditure Categories FY2022Personnel Services - Salaried Employees basic office supplies such as pens, chart folders, paper & binders, clips, tape, etc. necessary for everyday work necessary to purchase client support materials for families beyond NFP and PIPE handouts necessary for client printed matierlas (facilitators), staff supervision & NHV forms, reference publications necessary to send matierials to clients, referral sources, and community partners cell phones & coverage, tablets necessary for everyday NHV work and safety of NHV, telehealth supports Description of Work and What is Included in Fringe Benefits Individual Nursing staff salary not to exceed $ 89,230 (A Contract Amendment is required if any additional funds are added to the total contract amount) Overall Program implementation and home visiting service delivery Non Nursing Staff Budget Period July 1, 2021 - June 30, 2022 Fiscal Contact Name, Title Nicole Sisneros Phone nicole.sisneros@eaglecounty.us 970-358-8859 59 Email Funded Caseload Colorado Department of Human Services Office of Early Childhood BUDGET WITH JUSTIFICATION FORM Contractor Name Eagle County Public Health and Environment Program Contact Name, Title Shannon Wagner Phone 970-328-8855 Email shannon.wagner@eaglecounty.us Page 1 of 2 DocuSign Envelope ID: D8A13AA6-D4EE-4D5D-ADED-5FC5718022E6 Exhibit B- Amendemnt #4 Item Total A. Other Sources of Funding B. Medicaid Revenue C. CDHS Funding (NHVP) NFP Program Participation & Education $11,561 $0 $0 $11,561 Dance Education & Licensing $935 $0 $0 $935 Professional Development $3,650 $0 $0 $3,650 $16,146 $0 $0 $16,146 Name A. Other Sources of Funding B. Medicaid Revenue C. CDHS Funding (NHVP) N/A $0 $0 $0 $0 $0 $0 Item A. Other Sources of Funding B. Medicaid Revenue C. CDHS Funding (NHVP) Visit Outreach Mileage $0 $0 $6,250 Travel to Attend Required Training $0 $0 $1,295 $0 $0 $7,545 Name A. Other Sources of Funding B. Medicaid Revenue C. CDHS Funding (NHVP) Mental Health Consultation: Julia Kozusko $0 $0 $5,000 $0 $0 $5,000 $0 $0 $402,416 $0 $0 $402,416 Item A. Other Sources of Funding B. Medicaid Revenue C. CDHS Funding (NHVP) 10% de minimis Indirect rate: $0 $0 $36,331 $0 $0 $36,331 $0 $0 $438,747 4. Total Equpment Required licensing and education for a program component Covers cost of additional training for NHVs 3. Total Training and Technical Assistance Equipment (Over $5,000 Per Item)FY2022 Description of Item No costs shall be reimbursed for this category Training and Technical Assistance Indirect Costs Description of Item Indirect rate at 10% of total personnel costs Total Indirect TOTAL 6. Total Contractors/Consultants MODIFIED TOTAL DIRECT COSTS (MTDC) FY2022 *Figures are rounded using basic accounting standards. (0.00-0.49 = 0; 0.50-0.99 = 1.0) TOTAL DIRECT COSTS 5. Total Travel Contractors/Consultants (payments to third parties or entities)FY2022 Description of Item Mental health consultation is necessary to support nurses in their work with families Cost is necessary to NHV's can travel to clients' homes to deliver services Cost is necessary for state NS meetings & other necessary Administrator and NHV/NS trainings FY2022 Description of Item Required program participation and education for nurses, supervisors and administrators Description of Item Travel FY2022 Page 2 of 2 DocuSign Envelope ID: D8A13AA6-D4EE-4D5D-ADED-5FC5718022E6