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HomeMy WebLinkAboutC23-111 Statement of Work_Tuberculosis Prevention and ControlDocuSign Envelope ID: 7116E232-1 F14-4C8A-A74E-208ABC8E422A
C40
EAGLE COUNTY
STATEMENT OF WORK
I. Entity Name: Eagle County Public Health Agency
Public Health & Environment
970-328-8840
www.eaglecounty.us
II. Project Description: This project serves to implement a Tuberculosis (TB) preventive health service
program to decrease widespread incidence of TB disease via pass -through funds to the Local Public
Health Agencies (LPHAs) experiencing an elevated burden of TB infection and TB disease. TB
remains the primary infectious disease killer in the world. The Colorado Department of Public Health
and Environment (CDPHE) is funded by state general fund dollars and the Centers for Disease
Control and Prevention (CDC) to address the potentially life -threatening TB illness, which is spread
through the air from one person to another, impacts the lungs and any other part of the body, and can
cause serious sickness and even death in humans. The Division of Disease Control and Public Health
Response (DCPHR) supports TB health service activities as a part of the mandatory Class A and B
medical testing process for Refugees entering the United States. The project seeks to screen, test, and
treat TB infection (LTBI) and prevent onward transmission of the TB bacterial infection by offering
appropriate treatment to all at elevated risk for TB infection and onward progression to TB disease as
well as those presumptive for or with confirmed TB disease. The project also seeks to offer guidance
and resources to help confirmed TB disease patients through to completion of appropriate TB disease
treatment. The funds exist to reduce rates of illness, and increase use of the Tuberculosis Data Base
(TBdb) among LPHAs caring for patients statewide. The project will collect vital statistics, and
enable the technological capability needed to track and evaluate patient cases. The program seeks to
identify latent TB illness in at -risk patients including close contacts to pulmonary TB patients through
active surveillance, provide free TB medications, and reimburse LPHAs managing or ruling -out
patients for Medicaid rate diagnostic testing recommended by the TB program. The project will
improve the ability to evaluate TB cases, and bolster access to data for the medical community. A key
program goal is to connect at -risk individuals including Refugees born in endemic areas to
appropriate medical care, control epidemiologic outbreaks, and protect the health of the residents of
Colorado.
III. Definitions:
1. Active surveillance: Active disease surveillance is the process of actively searching for
information through clinical testing and data management. For the purposes of this contract,
active surveillance means the monitoring of testing class B 1 and B2 Refugee patients, and
entering relevant data to the TBdb system.
2. AFB smear: Acid -Fast Bacilli; a rapid test used to detect infectious mycobacteria
3. Asylee: Individuals who, on their own, travel to the United States and subsequently apply for
and receive a grant of asylum.
4. CDPHE: Colorado Department of Public Health and Environment
5. Chest X-ray: a type of high-energy radiation that can go through the body and onto film,
making pictures of areas inside the chest, which can be used to diagnose disease.
6. Class A: defines Refugee applicants who have medical conditions that render a person
inadmissible and ineligible for a visa or adjustment of status.
7. Class B 1: Immigrant with an abnormal chest X-Ray with evidence of TB, and/or the
individual has a history of treatment for active TB disease.
DocuSign Envelope ID: 7116E232-1 F14-4C8A-A74E-208ABC8E422A
8. Class B2: The individual was diagnosed with latent TB infection (LTBI). These are typically
children whose Tuberculin Skin Test result was positive and Chest X-ray was normal.
9. DOT: Directly Observed Therapy is a process where a trained health care worker or other
designated individual (excluding a family member) provides the prescribed TB drugs and
watches the patient swallow every dose.
10. HIV: Human Immunodeficiency Virus - Human immunodeficiency virus is a virus that
attacks the body's immune system. If HIV is not treated, it can lead to AIDS (acquired
immunodeficiency syndrome). Learning the basics about HIV can keep you healthy and
prevent HIV transmission. TB is the primary killer of people with AIDS globally.
11. IGRA: Interferon gamma (y) release assay is a whole blood TB test.
12. LEP: Limited English proficiency (Over -the -Phone Interpretation (OPI) - lets you
communicate with Limited -English Proficient (LEP) individuals using a phone interpreter.
People use phone interpreters when they don't have an onsite interpreter, and to make phone
calls to people who speak limited English.
13. LTBI: Latent Tuberculosis Infection commonly referred to as TB infection
14. OPI: Over -the -phone interpretation
15. 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
16. Pulmonary disease: A type of disease that affects the lungs and other parts of the respiratory
system. Pulmonary sites of TB disease is the primary public health concerns as TB is spread
through the inhalation of airborne bacilli.
17. RVCT: Report of Verified Case of Tuberculosis; a CDC surveillance report
18. Screening: the act of performing a test on a patient or patient's sputum, blood, urine, etc., to
look for evidence of a disease. For the purposes of this contract, screening involves the
testing and identification of at -risk persons including class B 1 and B2 Refugees with LTBI,
HIV, pulmonary disease, and those without health insurance.
19. Service area: The jurisdiction (typically one or more counties) for with the LPHA is
responsible.
20. Spirometry: A test that can help show how well lungs are working.
21. Tuberculosis (TB): An infectious bacterial disease characterized by the growth of nodules
(tubercles) in the tissues, especially the lungs.
22. TB-18: CDPHE Tuberculosis Surveillance and Case Management Report
23. TBdb system: CDPHE Tuberculosis Data Base
IV. Work Plan:
Goal #1: Support public health disease control and intervention through the provision of public health monitoring. 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, improve tuberculosis prevention and control through the provision of
TB health services and active surveillance.
Primary Activity #1
The Contractor shall locate all patients with suspected or confirmed TB.
1. The Contractor shall provide TB health screening for the following patient groups:
a. Refugee Class B 1
b. Refugee Class B2
c. All other persons found to be at elevated risk for TB infection or TB disease
2. The Contactor shall provide the following medical screening services to each patient:
Sub -Activities #1
a. Medical evaluation
b. Tuberculin skin test or IGRA (IGRA is preferred)
c. Chest X-ray
d. Three spontaneous sputum specimens for AFB smear to determine the
biological culture of cells on consecutive days
3. The Contractor shall administer TB disease testing to all patients to identify individuals
with LTBI.
DocuSign Envelope ID: 7116E232-1 F14-4C8A-A74E-208ABC8E422A
a. The Contractor shall administer LTBI testing to 95% of patients identified with
elevated risk.
b. The Contractor shall document 95% of confirmed LTBI cases.
c. The Contractor shall administer the following LTBI evaluation methods to all
patients:
i. Chest x-rays
ii. Chest x-ray interpretations
4. The Contractor shall test patients for HIV.
a. The Contractor shall administer HIV antibody tests to 95% of B 1 and B2 Refugee
patients.
b. The Contractor shall administer HIV antibody tests to 95% of all patients presumptive
for or with confirmed TB infection or TB disease.
c. The Contractor shall identify patients with HIV.
d. The Contractor shall inform those individuals whom refuse HIV testing of the
risks associated with HIV/TB co -infection.
e. The Contractor shall document HIV testing results for all patients in TBdb.
5. The Contractor shall monitor patients for adverse reactions from TB drugs.
6. The Contractor shall monitor patients for other clinical concerns.
7. The Contractor shall offer limited English proficiency services to patients who do not speak
English.
a. The Contractor shall provide translation services in the patient's preferred
language.
i. The Contractor shall offer in -person, certified translation services.
ii. The Contractor shall offer Over -the -Phone Interpretation (OPI) services.
The Contractor shall ensure that all contacts to newly identified infectious TB cases are
Primary Activity #2
identified, investigated, and receive appropriate evaluation.
1. The Contractor shall provide, or arrange for the following for individuals with newly
identified suspected or confirmed TB, as well as patients with LTBI:
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 all TB patients.
3. The Contractor shall provide, or arrange for, an HIV antibody test for all persons with
LTBI with HIV risk factors including those who originate from an HIV -endemic area.
Sub -Activities #2
4. The Contractor shall inform all individuals whom refuse HIV testing of the risks
associated with HIV/TB co -infection.
5. A minimum of once a month, the Contractor shall evaluate patients face-to-face who are
on LTBI treatment.
6. Throughout LTBI treatment, the Contractor shall monitor patients for adverse reactions
or other clinical concerns.
7. The Contractor shall ask all TB clients about current health insurance enrollment and
offered materials on how to become insured if not currently insured.
8. The Contractor shall complete a preliminary Tuberculosis Contact Investigation Record
for all pulmonary TB patients.
The Contractor shall participate in an electronic TB surveillance process (TBdb or other
Primary Activity #3
designated TB database)
1. The Contractor shall enter data for each patient tested, treated, and cared for into the TBdb.
a. The Contractor shall report each data element specified in the "Report of
Sub -Activities #3
Verified Case of Tuberculosis (RVCT) for all patients who test positive for
LTBI.
b. The Contractor shall enter laboratory results for each patient tested for LTBI.
c. The Contractor shall enter laboratory results for each patient tested for HIV.
d. The Contractor shall enter laboratory results for each patient tested for
DocuSign Envelope ID: 7116E232-1 F14-4C8A-A74E-208ABC8E422A
pulmonary TB disease.
e. The Contractor shall enter into TBdb other clinical concerns identified during
testing.
f. The Contractor shall enter current medical insurance enrollment status
information.
2. The Contractor shall complete a preliminary Tuberculosis Contact Investigation
Record (TB-18) for all presumptive or confirmed TB disease and LTBI patients.
a. The Contractor shall complete a Class B tuberculosis Follow Up worksheet for:
i. Class B 1 patients
ii. Class B2 patients
3. The Contractor shall complete the Semi-annual Progress Report that includes the following
information:
a. Number of patients screened, tested and treated with LTBI.
i. All report info should be de -identified. The Contractor shall identify patients
by TBdb number only.
ii. The Contractor shall include medical insurance information for insured
patients.
iii. The Contractor shall identify patients without medical insurance.
b. Number of Class B 1 Refugees with confirmed LTBI
c. Number of Class B2 Refugees with confirmed LTBI
d. Number of Class B 1 patients confirmed with HIV
e. Number of Class B2 patients confirmed with HIV
e. Number of Class B 1 patients with TB disease
f. Number of Class B2 patients with TB disease
g. Number of patients with adverse reactions
h. Other clinical concerns identified per patient
i. Number of uninsured patients guided to medical insurance resources
j. Number of patients that used the OPI interpretation services
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
Primary Activity #4
location(s), including online enrollment options.
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 ask all TB patients about current health insurance
Sub -Activities #4
enrollment status, including Medicaid and offer resource materials no later
than the last business day of each month.
b. The Contractor shall document that all TB patients were asked about
current health insurance enrollment and offered materials no later than the
last business day of each month.
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 purchase order term. The Contractor shall monitor documents and website
content for updates and comply with all updates.
Standards and
2. CDPHE will provide access to the CDPHE TBdb system to the Contractor.
Requirements
a. CDPHE will register the Contractor.
i. CDPHE will provide user log -in to the Contractor.
3. CDPHE will provide written notification to the Contractor a minimum of 30 calendar days
of the arrival of:
a. Class B 1 Refugees
b. Class B2 Refugees
DocuSign Envelope ID: 7116E232-1 F14-4C8A-A74E-208ABC8E422A
4. The Contractor shall initiate treatment with patients 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/Itbi.htm and
https://www.cdc.gov/tb/toj2ic/treatment/tbdisease.htm
5. The Contractor shall complete the appropriate treatment as stated in the CDPHE TB
Manual. The CDPHE TB Manual once updates and revisions are completed will be available
on the CDPHE TB Program website and will be incorporated and made part of this Contract
by reference.
6. The Contractor shall complete a Tuberculosis Contact Investigation Record at the following
link,
https://drive.gooale.com/file/d/OBOtmPO67k3NVRUtPRF8tcUZaV lE/view?resourcekey=0-
KS5U1gQR g4yyouD4cgIXA incorporated and made part of this contract by reference.
7. The Contractor shall complete 100% of all RVCT fields no later than the end date of this
Contract.
8. The Contractor shall include all data elements identified in the "Report of Verified Case of
Tuberculosis (RVCT)", found at:
https://drive.google.com/file/d/OBOtniPQ67k3NVekO I Q3JxZGdzYUE/view?resourcekey=0-
sf_bObPR Zg rxhQRhTOU8Lg incorporated and made part of this contract by reference.
a. The Contractor shall complete 100% of all RVCT fields.
9. The Contractor shall guide each patient to following insurance resource websites:
a. https://www.colorado.aov/pacific/hcpf/how-to-apply, and
b. http://connectforhealthco.com/resources/person-help/, incorporated and made part of this
Contract by reference.
10. The Contractor shall provide CDPHE with the medical insurance information for
those patients who have medical insurance.
11. The Contractor shall contact CDPHE for assistance with patients that need isolation
services.
a. The Contractor shall contact CDPHE to request reimbursement from CDPHE
for costs incurred by the Contractor for isolating a patient.
12. The Contractor shall complete the Semi-annual Progress Report using the following
website:
https://drive.google.com/file/d/OBOtmPQ67k3NVbk8xemFPN3FpWU0/view, incorporated
and made part of this Contract by reference.
13. 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.
14. The Contractor shall administer LTBI testing to 95% of patients identified with
elevated risk using the
https://drive.google.com/file/d/lwp,tRX8lC3EBgZLE08z3WL15bkwu2ic6 /g view This link is
incorporated and made part of this Contract by reference.
15. The Contractor shall complete a preliminary Tuberculosis Contact Investigation Record
for all pulmonary TB patients after initiation of each contact investigation:
a.
https://drive. gooale.com/file/d/OBOtmPO67k3NVRUtPRF8tcUZaV 1 E/view?resourcekey=0-
KS5U1gQR g4yyouD4cgIXA to the CDPHE TB Program after initiation of each contact
investigation. This link is incorporated and made part of this Contract by reference.
1. Sustained TB disease testing for all at -risk persons identified in Colorado.
2. Sustained identification of at -risk persons with LTBI.
3. Increased identification of presumptive or confirmed TB patients with HIV.
Expected Results of the Activity 4. Increased identification of Refugees with pulmonary TB disease.
5. Increased identification of persons at -risk for TB with other medical concerns.
6. Sustained and correct use of the TBdb case management database.
7. Improved adherence to national standards that govern health services for Refugees and
others with TB disease.
DocuSign Envelope ID: 7116E232-1 F14-4C8A-A74E-208ABC8E422A
8. Increased medical insurance information provided to Refugees and other uninsured
persons.
1. Increase HIV antibody tests to 95% of all patients.
2. Document 95% of confirmed LTBI cases.
Measurement of Expected Results
3. Data contained in the CDPHE TBdb.
4. Data contained in the Tuberculosis Surveillance and Case Management Report.
5. Data contained in the Semi-annual Progress Reports.
Completion Date
Deliverables
No later than ten
1. The Contractor shall submit the TB health services point of contact
(10) days after the
to the CDPHE Contract Monitor via email.
start date of the
contract
2. The Contractor shall submit the Semi-annual Progress Reports to
No later than one
the CDPHE Contract Monitor via email.
month after the July -
Dec and Jan -June
reporting eriods
V. Budget:
Description
Funding Source
Amount
Tuberculosis Control and Prevention
State
$6,500.00
PO Total
$6,500.00
1. Additional Provisions:
To receive compensation under the Purchase Order, the Contractor shall submit a signed Monthly CDPHE
Reimbursement Invoice Form. This form is accessible from the CDPHE internet website
http://www.colorado.goy/pacific/cdphe/standardized-invoice-form-and-links and is incorporated and made part
of this Purchase Order 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 the following method.
Scan the completed and signed CDPHE Reimbursement Invoice Form into an electronic document. Email the
scanned invoice with the Excel workbook containing the Expenditure Details page to: the CDPHE Contract
monitor, cdphe dcphrpayablesgstate.co.us.
Final billings under the Purchase Order must be received by the State within a reasonable time after the
expiration or termination of the Purchase Order; but in any event no later than forty-five (45) calendar days
from the effective expiration or termination date of the Purchase Order.
Unless otherwise provided for in the Purchase Order, "Local Match", if any, shall be included on all invoices
as required by funding source.
The Contractor shall not use federal funds to satisfy federal cost sharing and matching requirements unless
approved in writing by the appropriate federal agency.
a. BENEFITS DISCLOSURE
Vendor and its employees and agents are not entitled to unemployment insurance or workers compensation
benefits through the State and the State shall not pay for or otherwise provide such coverage for Vendor or any
of its agents or employees. Unemployment insurance benefits shall be available to Vendor and its employees
DocuSign Envelope ID: 7116E232-1 F14-4C8A-A74E-208ABC8E422A
and agents only if such coverage is made available by Vendor or a third party. Vendor shall pay when due all
applicable employment taxes and income taxes and local head taxes incurred pursuant to this Contract. Vendor
shall (a) provide and keep in force workers' compensation and unemployment compensation insurance in the
amounts required by law, (b) provide proof thereof when requested by the State, and (c) be solely responsible
for its acts and those of its employees and agents.
b. ENTIRE AGREEMENT
These Provisions together with the Purchase Order constitute the entire agreement between the parties, and
supersedes all prior proposals, agreements or other communications between the parties.
VI. Monitoring:
CDPHE's monitoring of the purchase order for compliance with performance requirements will be
conducted throughout the purchase order 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.
VII. 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 Purchase Order.
DocuSign Envelope ID: 7116E232-1 F14-4C8A-A74E-208ABC8E422A
VIII. Attestation:
The Vendor agrees to perform services in accordance with the terms and conditions of the Purchase
Order to include Statement of Work and Budget.
Jeff Shroll, County Manager
Contractor Name (Print) and Title
[-Signed by:
3/31/2023
Datc