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HomeMy WebLinkAboutC84-013 Colorado Department of Health- Form 6-AC-02A r 13EPARTMENT OR AGENCY NUMBER
• ONTRACT ROUTING NUMBER
s--J
rorvTaAcT �_�ar-a 73
THIS CONTRACT, made this 1 S t day of July 19 84 by and between the
State of Colorado for the use and benefit of the Department of " _ d 0 14EAI TDivision of Med i cal
Affairs ---and Sppr_i l Progr�BS 4210 Fa_-,l l lth ,Avr. Colorado 80220
hereinafter referred to as the State, and .2 THE BOARD OF COUNTY COMMISSIONERS, EAGLE COUNTY,
hereinafter referred to as the contractor,
WHEREAS, authority exists in the Law and Funds have been budgeted, appropriated and otherwise made
available and a sufficient unencumbered balance thereof remains ava i l � / payment in Fund Number_._,
G/L Account Number �3�_, Contract Encumbrance Number �� ; wid
WHEREAS, required approval, clearance and coordination has been accomplished from and with appropriate
agencies; and
WHEREAS, .3 the State has been awarded monies to implement "A Protocol to
Accompany a Contract to Provide Non -Medical Case Management and Outreach to
Eligible E.P.S.D.T. Families (Early and Periodic Screening, Diagnosis and Treat-
ment)" by the Colorado Department of Social Services; and
WHEREAS, the .said "Protocol" calls for non -medical case management and outreach
activities to be implemented through subcontracts with local health agencies; and
WHEREAS, the State will contract with the contractor to assure that Aid to
Families with Dependent Children (AFDC) who are eligible for EPSDT receive pre-
ventive and curative health care and treatment and that the families of said
children are informed about the benefits of health prevention and promotion in
such a way as to encourage their participation in the EPSDT Program.
NOW THEREFORE, it is hereby agreed that for and in consideration of their mutual
promises to each other hereinafter stated, the parties hereto agree as follows:
1. The contractor will perform an EPSDT non -medical outreach component by
contacting EPSDT-eligible families in Eagle
county(ies) on the priority basis as designated in the "Protocol" to explain the
value of EPSDT and the importance of preventive health care measures and to offer
and provide assistance in overcoming obstacles for obtaining EPSDT services.
2. The contractor shall be responsible for carrying out the activities as
defined by the October 1, 1979 EPSDT Regulations and making any changes in pro
cedures which may be warranted by Federal reviews.
3. The contractor shall provide to the Colorado Department of Health on a
monthly basis information documenting contact and case management procedures, in
accordance with the written directives of the State.
4. Upon written notification by Social Services of iwplementation of Medicaid
Management Information System (MMIS), contractor shall utilize the MMIS information
for individual case management activities there appropriate.
5. The contractor shall docui,ient and make available the following i nfonna ti on
to the Colorado Department of Social Services and/or federal reviewers upon receipt
of a written request from the State:
a. The date a recipient was contacted by the contractor.
b. The date(s) a recipient requested assistance for EPSDT services and the
date(s) a recipient refused assistance for EPSDT and reason, if possible.
c. The date the recipient was offered initial or periodic EPSDT services
and the date of declination of services.
d. The name and address of provider chosen by recipient except for Primary
Care Physician.
e. The names of AFDC families or recipients who chose to receive services
from a provider who does not provide the full ranee of EPSDT services,
the date on which they requested services that are not covered by that
provider, and the dates that the requested services were provided.
f. The type of support services provided to recipient; e.g., transportation,
scheduling of appointments.
395-53-01-CO 10
Page I of 5 pages
*(See instructions on reverse of last page.)
CONTRACT
g. The date EPSDT services were provided to the recipient as reported
by the recipient.
h. Documentation and reasons for all recipients requiring no further
case management responsibility; e.g., number refusing assistance,
breaking appointments for initial or follow-up screen, no longer
eligible.
i. Documentation of follow-up to ascertain if treatment was provided.
j . The names of the recipients who required treatment for conditions
not covered by the plan and documentation of the efforts to refer
them to providers willing to treat them at little or no expense to
the family.
k. Dates of all periodic recontact.
1. Documentation of referral, when needed, to Title V programs.
6. The contractor shall assist families requiring transportation to providers
of EPSDT services in obtaining said transportation in the most cost efficient and
reasonable manner possible.
7. The contractor shall assure that all personnel employed to provide EPSDT
non -medical outreach and case management activities will receive professional
supervision by public health nursing personnel or other skilled medical personnel.
8. The contractor will assure that all personnel assigned to perform EPSDT
non -medical outreach and case management activities will be available for all
training to be deemed necessary.
9. The State will, in consideration , of said services and reporting by the
contractor, cause to be paid to the contractor a sum not to exceed Five Thousand
Three Hundred Eighty -One and no/100 Dollars ($5,381.00) _
in the following manner, subject to verification by the State of full and satis-
factory compliance with the terms of the contract; including,, but not limited to:
a. Upon receipt by the State of a signed monthly statement in duplicate
from the contractor requesting reimbursement, in accordance with the cate-
gories and line i ten?s of the budget set forth in Attachment A of this
contract. Said statement shall also report amounts expended from matching
funds if such funds have been stipulated in the budget, Attachment A. of
this contract. Monthly statements shall be rendered by the contractor,
in conformity with the format to be supplied to the contractor by the
State. An initial supply of the subject statement forms will be supplied
to the contractor and additional forms as requested thereafter.
b. Satisfactory compl i ance wi th al 1 reporti nq requirements as set forth
in this contract.
10. This contract is not assignable without written consent of the State.
11. Expenditures of funds by the contractor shall be governed by the budget,
Attachment A, which by this reference is incorporated herein. Transfers of funds
from one category or line item by the contractor must have the prior, written
approval of the State.
12. The term of this contract is fro;j: Jul, 1_, _1'?84 through June 30, 1985.
13. Time is of the essence in the performance of this contract.
14. All material and information provided to the contractor by the State or
obtained by the contractor pursuant to its duties hereunder shall be regarded as
confidential and all necessary steps shall be taken by the contractor to safeguard
the confidentiality of such material and information in conformance with Federal
and State laws and regulations.
Page 2 of 5 pages
COLORAOO.OEPARTMENT OF HEALTH - hereinafter, under the General Provisions,
referred to as "Health".
GENERAL PROVISIONS.
The parties of this Contract intend that the relationship between
them contemplated by this Contract is that of employer -independent contractor.,''
No agent, employee, or servant of Contractor shall be or shall be deemed to
be an employee, agent, or servant of Health. Contractor will be solely and
entirely responsible for its acts and the acts of its agents, employees,
servants, and subcontractors during the performance of this Contract.
At all times during the performance of this Contract, the Contractor
shall strictly adhere to all applicable federal and state laws that have been
or may hereafter be established.
Contractor authorizes Health to perform audits and to make inspections
for the purpose of evaluating performance under this Contract.
Contractor shall indemnify Health against all liability and loss,
and against all claims and actions based upon or arising out of damage or
injury, including death, to persons or property caused by or sustained in
connection with the performance of the Contract or by conditions created
thereby, or based upon any violation of any statute, ordinance, or regula-
tion and the defense of any such claims or actions.
Either party shall have the right to terminate this agreement by
giving the other party thirty days notice by registered mail, return receipt
requested. If notice is so given, this agreement shall terminate on the
expiration of the thirty days, and the liability of the parties hereunder
for the further performance of the terms of this agreement shall thereupon
cease, but the parties shall not be relieved of the duty to perform their.
obligations up to the date of termination.
This agreement is intended as the complete integration of all
understandings between the parties. No prior or contemporaneous addition
deletion, or other amendment hereto shall have any force or effect whatso-
ever, unless embodied herein in writing. No subsequent novation, renewal,
addition, deletion, or -other amendment hereto shall have any force or effect
unless embodied in a written contract executed and approved pursuant to the
State Fiscal Rules.
If this contract involves the expenditure of Federal funds, this
contract is contingent upon continued availability of federal funds For
payment pursuant to the terms of this agreement.
if this contract includes reimbursement for personal services,
payrolls must be supported by time and attendance or equivalent records for
individual employees. Salaries and wages of employees chargeable to more
than one grant program or other cost objective will be supported by appro-
priate time distribution records.
To be considered for payment, billings for reimbursement pursuant to
this contract must be received within 60 days after the period for which
reimbursement is being requested and final billings on the contract must be
received by the Stare Health Department within 60 days after the end of the
contract term.
If applicable, Local Match is to be submitted on the monthly
reimbursement statements, in the column provided, as required by the funding
source.
Page 3 of 5 paces
Form 6-AC-02B SPECIAL PROVISIONS
i
CONTROLLER'S APPROVAL
1. This contract shall not he deemed valid until it shall have been approved by the Controller of the State of Colorado or such
assistant as he may designate. This provision is applicable to any contract involving the payment of money by the State.
FUND AVAILABILITY
2. Financial obligations of the State payable after the current fiscal year are contingent upon funds for that purpose being appropriated,
budgeted and otherwise made available.
BOND REQUIREMENT
3. If this contract involves the payment of more than fifty thousand dollars fir the construction, erection, repair, maintenance,
or improvement of any building, road, bridge, viaduct, tunnel, excavation or other public work for this State, the contractor shall,
before entering upon the performance of any such work included in this contract, duly execute arid deliver to arid file with the official
whose signature appears below for the State. a gooxf and sufficient bond or other acceptable Surety to be approved by said official
in a penal sum not less than one-half of the total amount payahlc by the terms of this contract. Such bond shall be duly executed
by a qualified corporate surety, conditioned for the due and faithful performance of the contract, and in addition, shall provide that
if the contractor or his subcontractors fail to duly pay for any labor. materials, team hire, sustenance. provisions, provendor or other
supplies used or consumed by such contractor or his subcontractor in performance of the work contracted to be done, the surety will
pay the same in an amount not exceeding the sum specified in the bond, together with interest at the rate of eight per cent per annum.
Unless such bond, when so required, is executed, delivered and filed, no claini in favor of the contractor arising under this contract
shall be audited, allowed or paid. A certified or cashier's check or a bank money order made payable to the Treasurer of the State
of Colorado may be accepted in leiu of a bond.
MINIMUM WAGE
4. Except as otherwise provided by law, if this contract provides for the payment of more than five thousand
dollars and requires or involves the employment of laborers or mechanics in the construction, alteration or repair of
any building or other public work, (except highways, highway bridges, underpasses and highway structures of all
kinds) within the geographical limits of the State, the rate of wake for all laborers and mechanics employed by the
contractor or any subcontractor on the building or public work covered h% this contract shall he not less than the
prevailing rate of wages for work of a similar nature in the city, town, village or other civil subdivision of the State in
which the building or other public work is located. Disputes respecting; prevailing rates will be resolved as provided in
8-16-101. CRS 1973, as amended.
DISCRIMINATION AND AFFIRMATIVE ACTION
5. The contractor agrees to comply with the letter and spirit of the Colorado Antidiscrimination Act of 1957, as amended
and other applicable law respecting discrimination and unfair employment practices (24-34-402, CRS 197 () supplement), and as
required by Executive Order, Equal Opportunity and Affirmative Action, dated April 16. 1975. Pursuant thereto, the: followirra provi-
sions shall be contained in all Stare contracts or sub -contracts.
During the performance of this contract. the contractor agues as follows
(1) The contractor will not discriminate against any employee or applicant for employment because of
race, creed, color, national origin, sex, marital status, religion, ancestry, mental or physical handicap, or age.
The contractor will take affirmative action to insure that applicants are employed, and that .employees are
treated during employment, without regard to the above mentioned characteristics. Such action shall include,
but not be limited to the following: employment, upgrading, demotion, or transfer, recruitment or
recruitment advertisings; lay-offs or tenninations: rates of pay or other fornis of compensation; and selection
for training, including apprenticeship. The contractor agrees to post in conspicuous places, available to
employees and applicants for employment, notices to he provided by the contracting officer setting forth
provisions of this non-discrimination clause.
(2) The contractor will, in all solicitations or advertisements for employees placed by or on behalf of the
contractor, state that all qualified applicants N%ill receive consideration for employment without regard to
race, creed, color, national origin, sex, marital status, religion, ancestry, ment-,d or physical handicap, or age.
(3) The contractor will send to each labor union or representative of workers with which he has collective
bargaining agreement or other contract or understanding, notice to be provided by the contracting officer,
advising the labor union or workers' representative of the contractor's committment under the Executive
Order, Equal Opportunity and Affirmative Action, dated April 16, 1975, and of the rules, regulations, and
relevant Orders of the Governor.
(4) The contractor and labor unions will furnish all information and reports required by Executive Order,
Equal Opportunity and Affirmative Action of April 16, 1975, and by the rules, regulations and Orders of the
Governor, or pursuant thereto, and will pennit access to his books, records, and accounts by the contracting
agency and the office of the Governor or his designee for purposes of investigation to ascertain compliance
with such rules, regulations and orders.
(5) A labor organization will not exclude any individual otherwise qualified from full membership rights in
such labor organization, or expel any such individual from membership in such labor organization or
discriminate against any of its members in the full enjoyment of work opportunity, because of race, creed,
color, sex, national origin, or ancestry.
(6) A labor organization, or the employees or members thereof will not aid, abet, incite, compel or coerce
the doing of any act defined in this contract to be discriminatory or obstruct or prevent any person from
complying with the provisions of this contract or any order issued thereunder; or attempt, either directly or
indirectly, to commit any act defined in this contract to be discriminatory.
395-53-01-1022 page 4—of 5 pages
Form 6-AC-02C
(7) In* the event of the contractor's non-compliance with the non-discrimination clauses of this contract or
with any of such rules, regulations, or orders, this contract may be cancelled, terminated or suspendefi in
whole or in part and the contractor may be declared ineligible for further State contracts in accordance with
procedures, authorized in Executive Order, Equal Opportunity and Affirmative Action of April 16, 1975 and
the rules, regulations, or orders promulgated in accordance therewith, and such other sanctions as may be
imposed and remedies as may be invoked as provided in Executive Order, Equal Opportunity and Affirmative
Action of April 16, 1975, or by rules, regulations, or orders promulgated in accordance therewith, or as
otherwise provided by law.
(8) The contractor will include the provisions of paragraphs (1) through (8) in every sub -contract and
sub -contractor purchase order unless exempted by rules, regulations, or orders issued pursuant to Executive
Order, Equal Opportunity and Affirmative Action of April 16, 1975, so that such provisions will be binding
upon each sub -contractor or vendor. The contractor will take such action with respect to any sub -contracting
or purchase order as the contracting agency may direct, as a means of enforcing such provisions, including
sanctions for non-compliance; provided, however, that in the event the contractor becomes involved in, or is
threatened with, litigation with the subcontractor or vendor as a result of such direction, by the contracting
agency, the contractor may request the State of Colorado to enter into such litigation to protect the interest
of the State of Colorado.
COLORADO LABOR PREFERENCE
6. Provisions of 8-1 7-101, & 102, CRS 1973 for preference of Colorado labor are applicable to this contract if
public works within the State are undertaken hereunder and are financed in whole or in part by State funds.
GENERAL
7. The laws of the State of Colorado and rules and regulations issued pursuant thereto shall be applied in
the interpretation, execution and enforcement of this contract. Any provision of this contract whether or not
incorporated herein by reference which provides for arbitration by any extrajudicial body or person or which is
otherwise in conflict with said laws, rules and regulations shall be considered null and void. Nothing contained in
any provision incorporated herein by reference which purports to negate this or any other special provision in
whole or in part shall be valid or enforceable or available in any action at law whether by way of complaint,
defense or otherwise. Any provision rendered null and void by the operation of this provision will not invalidate
the remainder of this contract to the extent that the contract is capable of execution.
8. The signatories hereto aver that they are familiar with 18-8-301, et seq., (Bribery and Corrupt Influences)
and 18-8-401, et seq., (Abuse of Public Office), C.R.S. 1973, as amended, and that no violation of such provisions is
present.
9. The signatories aver that to their kno%viedge. no state employee has any personal or beneficial interest
whatsoever in the service or property described herein.
IN WITNESS WHEREOF, the parties hereto have executed this Agreetnent on the day first above written.
THE BOARD OF COUNTY COMMISSIONERS
EAGLE COUNTY
�� '
Contractor - -_
STATI. OF COLORADO
filt:ll:�Rl) I). 1.A.11ti1. GOVERNOR
for e'` ,,,I ( I''rl�'t UIKI CTUK.
DEPAR-t'%1ENT
PositioOF HEALTH--
or=c Imm;rv-
Federal I.D. Number
APPROVAI S
J1
ATTORNEY Gt:n�:K,�t �-4�L� � ?�_ C 011.1 K -- --- -----
By
Program Approval by:
395-53-01-1030 Page _-5 which is the last of, 5pages
*See instructions on reverse side.
i
0
Attachment A
E.P.S.D.T. BUDGET
Eagle County
July 1, 1984 to June 30, 1985
Case Managers .•25.FTE. . . . . . , . . . . . . . . , . . $ 4,280
Fringe Benefits . . . . . . . . . . . . . . . . . . . . . S
Administrative Cost . . . . . . . . . . . . . . . . . . . S
Travel S
Da to : 6- 25-84
TOTAL
274
377
450
$ 5,381