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HomeMy WebLinkAboutC24-339 Midvalley Family Practice_grant agreement
GRANT AGREEMENT BETWEEN
EAGLE COUNTY, COLORADO
AND
MIDVALLEY FAMILY PRACTICE
THIS GRANT AGREEMENT (“Agreement”) is effective as of July 1, 2024 by and between
MidValley Family Practice (hereinafter “Grant Recipient”) and Eagle County, Colorado, a body
corporate and politic (hereinafter “Grantor” or “County”).
RECITALS
WHEREAS, Eagle County works to promote the health, safety, and welfare of Eagle County
citizens of all ages through its Department of Public Health and Environment; and
WHEREAS, the County uses outside providers and professionals to enhance the ability of County
to promote such health, safety and welfare; and
WHEREAS, Eagle County Public Health & Environment (“ECPHE”) has identified a significant
community need for funding and services dedicated to the ‘promotion’ phase of care, which
addresses root causes of local health disparities, which lead to a myriad of individual high-risk
behaviors; and
WHEREAS, the observed and reported fragmentation of community organizations and non-
profits leads to a lack of strategy in provision of services and programming across systems of care;
and
WHEREAS, ECPHE would like to extend staff knowledge and experience to offer organizational
support while administering funds with the intent of infusing equity and inclusion from a systemic
level; and
WHEREAS, the parties acknowledge and agree that the programs and services detailed herein
promote the health, safety and welfare of the people of Eagle County and are intended to serve a
valid public purpose and provide services that could otherwise be performed by County directly;
and
WHEREAS, Grant Recipient has elected to perform services that help create and sustain a healthy,
environmentally and economically vital and socially diverse community in Eagle County on its
own and County has, therefore, elected to compensate Grant Recipient to perform the Services for
the public to fulfill an important public purpose; and
WHEREAS, Grant Recipient is authorized to do business in the State of Colorado and has the
time, skill, expertise, and experience necessary to provide the services as defined below in
paragraph A hereof; and
WHEREAS, this Agreement shall govern the relationship between Grant Recipient and County
in connection with the services.
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Eagle County Grant Final 5/14
GRANT AGREEMENT
NOW, THEREFORE, in consideration of the foregoing premises and the following promises,
Eagle County and Grant Recipient enter into this Agreement for payment of the grant award in the
amount of nine thousand dollars ($9,000, the “Grant Award”) to Grant Recipient.
A. Grant Recipient agrees that funds awarded by Grantor may be used and expended solely
for services and programs related to marketing, advocacy/incentive participation payments, and
engagement costs of the Commons Companion program, which creates community-informed
supportive services, advocacy, and community convening in the Crawford Properties of Eagle
County in the Roaring Fork Valley, as specified in its 2024 Advancing Systems Change Grant
Application attached hereto as Exhibit A, and incorporated herein by reference, and Grant
Application Budget Section. All funds will be expended in the one-year grant period, with the
grant period terminating exactly one-year from contract execution (the “Grant Period”). The Grant
Award set forth herein is for the specific Grant Period and the Grantor makes no representations,
nor should Grant Recipient rely on this award as a representation of any future awards for other
grant periods.
B. In return for the Grant Award, Grant Recipient agrees to the terms of funding, deliverables,
and deadlines outlined in the Scope of Work attached hereto as Exhibit B, and incorporated herein
by reference. Grant Recipient shall submit a report discussing how the funds were expended,
deliverables as outlined in the Grant Application, and how they tie back to creating and sustaining
a healthy environmentally and economically vital and socially diverse community. The report will
be due no later than July 1, 2025.
C. Payment of the Grant Award will be made in one installment.
D. Grant funds under this Grant Agreement are to be used and expended within the Grant
Period. Any funds not used or expended during the Grant Period must be returned to Grantor.
E. If, after payment of the Grant Award, Eagle County reasonably determines that payment
was improper because the purposes for which the payment was made were misrepresented, or the
terms of this Agreement were breached, then upon written notice of such determination and request
for reimbursement from Eagle County, Grant Recipient shall forthwith return such payment to
Eagle County.
F. Grant Recipient shall comply at all times and in all respects with all applicable federal,
state and local laws, resolutions and codes; and specifically, with the requirements of the Civil
Rights Act of 1964 and Section 504, Rehabilitation Act of 1973, concerning discrimination on the
basis of race, color, sex, age, religion, political beliefs, national origin or handicap.
G. Grant Recipient shall not assign any of its rights or duties under this Grant Agreement to a
third party without the prior written consent of the Grantor. The Grantor shall terminate this Grant
Agreement in the event of any assignment without its prior written consent, in which case, any
unused Grant Funds must be returned to Grantor.
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H. Grant Recipient agrees that no agent, employee or volunteer of Grant Recipient shall be
deemed an agent, employee or volunteer of County.
I. Grant Recipient shall maintain, for a minimum of three (3) years, adequate financial and
programmatic records for reporting to Grantor on performance of its responsibilities hereunder.
Grant Recipient shall be subject to financial audit by federal, state or county auditors or their
designees. Grant Recipient authorizes Grantor to perform audits or to make inspections during
normal business hours, upon 48 hour notice to Grant Recipient for the purpose of evaluating
performance under this Grant Agreement. Grant Recipient shall cooperate fully with authorized
Eagle County representatives in the observation and evaluation of the program and records. Grant
Recipient shall have the right to dispute any claims of misuse of funds and seek an amicable
resolution with Grantor.
J. This Agreement shall be governed by the laws of the State of Colorado. Jurisdiction and
venue for any suit, right or cause of action arising under, or in connection with this Agreement
shall be exclusive in Eagle County, Colorado.
K. This Grant Agreement supersedes all previous communications, negotiations, and/or
agreements between the respective parties hereto, either verbal, or written, and the same not
expressly contained herein are hereby withdrawn and annulled.
L. This Grant Agreement does not, and shall not be deemed or construed to confer upon or
grant to any third party or parties any right to claim damages or to bring any suit, action or other
proceeding against either Grant Recipient or Grantor because of any breach hereof or because of
any of the terms, covenants, agreements and conditions contained herein.
M. Invalidity or unenforceability of any provision of this Grant Agreement shall not affect the
other provisions hereof, and this Grant Agreement shall be construed as if such invalid or
unenforceable provision was omitted.
N. To the extent required to perform under this Grant Agreement, Grant Recipient represents
and warrants that it has the expertise and personnel necessary to properly perform the Grant
Agreement and its professional personnel are duly licensed to perform.
O. No failure or delay by either party in the exercise of any right hereunder shall constitute a
waiver thereof. No waiver of any breach shall be deemed a waiver of any preceding or
succeeding breach.
P. The signatories to this Grant Agreement aver to their knowledge, no employee of the
County has any personal or beneficial interest whatsoever in the matters described in this Grant
Agreement. The Grant Recipient has no beneficial interest, direct or indirect, that would conflict
in any manner or degree with the performance of the Grant Agreement and Grant Recipient shall
not employ any person having such known interests.
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Eagle County Grant Final 5/14
Q. Grant Recipient shall be responsible for the completeness and accuracy of its
performance under the Grant Agreement, including all supporting data or other documents
prepared or compiled in performance of the Grant Agreement, and shall correct, at its sole
expense, all significant errors and omissions therein. The fact that the Grantor has accepted or
approved the work performed shall not relieve Grant Recipient of any of its responsibilities.
Grant Recipient shall perform the Grant Agreement in a skillful, professional and competent
manner and in accordance with the standard of care, skill and diligence applicable to Grant
Recipients performing similar services. This paragraph shall survive termination of this Grant
Agreement.
S. Grant Recipient shall carry workers compensation insurance as required by law and
automobile and commercial general liability insurance as necessary and appropriate during the
term of the Grant Agreement.
T. The Grant Recipient shall indemnify and hold harmless Grantor, and any of its officers,
agents and employees against any losses, claims, damages or liabilities for which Grantor may
become subject to insofar as an such losses, claims, damages or liabilities arise out of, directly or
indirectly, this Grant Agreement, or are based upon any performance or nonperformance by
Grant Recipient or any of its sub-recipients hereunder including claims for bodily injury or
personal injury including death, or loss or damage to tangible or intangible property; and Grant
Recipient shall reimburse Grantor for reasonable attorney fees and costs, legal and other
expenses incurred by Grantor in connection with investigating or defending any such loss, claim,
damage, liability or action. This indemnification shall not apply to claims by third parties
against the Grantor to the extent that Grantor is liable to such third party for such claims without
regard to the involvement of the Grant Recipient. This paragraph shall survive expiration or
termination hereof.
U. Grant Recipient certifies that it has read the Grant Agreement, understands each and every
term and the requirements set forth herein, and agrees to comply with the same.
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IN WITNESS WHEREOF, the parties have executed this Agreement the day and year first set
forth above.
COUNTY OF EAGLE, STATE OF COLORADO,
By and through Its COUNTY MANAGER:
By: ________________________
Jeff Shroll, County Manager
GRANT RECIPIENT:
By: ______________________
Name:____________________
Title:_____________________
Date:_____________________
Mailing Address:__________________________
__________________________
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Director of Behavioral Health
1450 E Valley Rd Suite 102
Basalt, CO 81621
Jarid Rollins
8/12/2024
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Eagle County Grant Final 5/14
EXHIBIT A
Grant Recipient Proposal
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Advancing Systems Change Grant: Program
Application 2024
Eagle County Public Health & Environment (ECPHE) is thrilled to announce the 2024 Advancing Systems
Change Grant opportunity. Involvement will be highly interactive and adaptable to the grantee's needs,
goals, and limitations, with the intent of fostering a supportive funding relationship. This one-year grant
cycle will begin August 2024, with an application period beginning Monday, March 25th, 2024, and
closing Monday, May 6th, 2024. Virtual information sessions will be held on Thursday, April 11th &
Wednesday, April 17th at 4pm to offer applicants an oppor tunity to ask questions and learn more detail
about the grant. Any additional submitted questions will be publicly posted with coinciding answers.
The Advancing Systems Change grant program offers funding toward projects that address root causes of
health disparities, such as the promotion of social connectedness*, enhancement of inter-agency
partnerships & collaboration, and incorporation of community-based decision-making in operations. A
component of this work is intended to address needs identied in the 2024 Public Health Improvement
Plan*, specically Priority 2: Promoting Social Connectedness. These projects must directly serve
populations who experience disadvantages due to inequities in policies, practices, social norms, and the
distribution of resources. It is through dedication to these efforts that gradual system-level change can be
accomplished.
*The 2024-2028 Eagle County Public Health Improvement Plan (available through this link) is a ve-year
plan directly informed by Eagle County residents. By facilitating conversations with community members,
Eagle County Public Health and Environment was able to build a deeper understanding of needs, and
potential interventions, that can change the root causes of health disparities. This assessment led to the
determination of three priority areas, one of which being the Promoting Social Connectedness. This
priority encompasses the crucial need for the improvement of social infrastructure throughout Eagle
County, such as equal access to physical gathering spaces, programs, organizations, public
involvement, and even policies.
Eligible use of funds include:
Community outreach, engagement, and building efforts
Community building projects which create belonging
Direct voice and involvement from populations served through programs and projects
Community member empowerment (training, strengthening connections, advocacy)
Equity-focused professional development - staff and board
Strategic planning and organizational development; board (re)development, capacity building, or
sustainable funding
Recruitment of a Board of Directors or staff that represents the diverse populations of the
community
Enhancing or establishing safe gathering spaces to better accessibility and belonging
Supporting the development, or strengthening of, community-based social support groups
5/1/24, 2:56 PM Advancing Systems Change Grant: Program Application 2024
https://docs.google.com/forms/d/1zIn65_jODcu1DclDmvf77s55YUYik-IsqaPlqGALE9o/edit#response=ACYDBNh5riqb40ukSn7ayYVgSEPR2ZJ7elR-…1/11
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Email *
jrollins@mvfpspor tsmed.com
Eligibility and Requirements
Eligibility:
To be considered for funding, organizations must provide information identifying the following:
Registration as a nonprot with the State of Colorado and provide evidence of local programming or
projects which fosters community building and root cause work
Project applied for will directly impact residents of Eagle County, with the applicant’s service area
focused on the Eagle County and/or Roaring Fork Mid-Valley
Familiarity with unique needs, culture, and present services available within Eagle County and/or
Roaring Fork Mid-Valley
Awareness of the organization's role and function within the applicable systems
Requirements:
1. Sign a standard Eagle County Contract, including a Scope of Work
2. Par ticipation in coordination meetings: Minimum of three (3) meetings with ECPHE staff,
attendance in existing applicable collaboration meetings relevant to the proposed
project (ex: youth-focused organizations group convenings)
3. Data reporting: Mid-grant and post-grant outcome reporting as outlined in reporting template with
outcomes and indicators identied by grantee, annual report sharing as published in standard format
4. Evaluation: Participation in pre-grant and post-grant evaluation and quality measurement, as
identied by ECPHE staff
Attachments
Please provide the following attachments at the time of application submission:
Please email required attachments to chelsea.carnoali@eaglecounty.us. Online Google Form applications
do not need to be submitted as an attachment, virtual submission as directed after completion of the
application will suce.
The application will be open through May 6th, 2024.
For more details and information on the application, timeline, and grant process, please see the grant
information packet. Please reach out to Chelsea Carnoali at chelsea.carnoali@eaglecounty.us with
additional questions or needs.
5/1/24, 2:56 PM Advancing Systems Change Grant: Program Application 2024
https://docs.google.com/forms/d/1zIn65_jODcu1DclDmvf77s55YUYik-IsqaPlqGALE9o/edit#response=ACYDBNh5riqb40ukSn7ayYVgSEPR2ZJ7elR-…2/11
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1. Most recent organization's budget
2. Most recent nancial statement
3. Project Budget & Timeline Sheet
4. Organizational chart or staff list, including job function
5. Board Member list/description
. Optional: Community member testimonies
7. Optional: Letter of Support
Applicant Information
Jarid Rollins
Healthy All Together
jrollins@mvfpspor tsmed.com
9706189916
https://healthyalltogether.org/
First & Last Name (person who is filling out application)*
Name of Organization *
Contact Email *
Contact Phone *
Organization's Website *
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1450 E Valley Road Suite 102 Basalt CO
501(c)(3)
Using scal agent/nancial sponsor
Other:
Midvalley Family Practice (MVFP) developed Healthy All Together (HAT) to create leaders that feel
empowered to make change in their community. As we launched our nonprofit, COVID 19 hit and we pivoted
to address the social determinants of health needs in the community. This included food and housing
insecurity. We developed a food pantry that continues to run and is visited by over 600 individuals and
families per year. We also served as a pass through organization providing over $200,000 in financial
assistance for individuals to access healthcare and housing.
HAT currently operates a food pantry, that we refer to as the community cupboard that is visited by over 500
individuals and families per year. We are also working with CU Anschutz to develop a Community Commons
program that seeks to empower the residents of El Jebel to address health equity, safety and
connectedness. This grant was funded by a Colorado Depar tment of Public Health planning grant through
MVFP with a strategic plan to have HAT operate the implementation plan.
Mailing Address *
Tax Exempt Status *
Organization Background: Explain the original issue and/or opportunity the organization was
founded to address, and how that may have changed over time:
*
Current Projects: Provide a brief description of the organization’s current projects/programs.
Include population and numbers served, as well as expected results:
*
5/1/24, 2:56 PM Advancing Systems Change Grant: Program Application 2024
https://docs.google.com/forms/d/1zIn65_jODcu1DclDmvf77s55YUYik-IsqaPlqGALE9o/edit#response=ACYDBNh5riqb40ukSn7ayYVgSEPR2ZJ7elR-…4/11
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Through the winter of 23-24 HAT and MVFP completed surveys with community members and two World
Café focus groups to determine the root-cause experiences and experiences of individuals and families
living in El Jebel. These were rich exchanges that demonstrated the differences in experiences of individuals
and families living in the Roaring Fork Valley.
The target population of this project is the Crawford proper ty at El Jebel categorized as a low-income
community, formed by a wide range of ages, from newborns to seniors. 60% of the population are Latino or
have a Hispanic or Latino background, who come, in majority, from El Salvador, followed by those who come
from Mexico, Honduras, and Nicaragua, among others. The other 40% repor ted being white and Americans.
An impor tant por tion of the population is not fluent in English and one of the reasons why, repor ted during
conversation, is the lack of interest in being par t of the broader community in the area as well as the lack of
spare time to learn a new language. Most of the people work two or more jobs to be able to afford to live in
the Roaring Fork Valley and to maintain their families back in their hometown.
Concurrently, many residents repor ted dropping out of school after 8th grade and going to work. Most
school-aged children go to Basalt Elementary, Middle, and High School, where they have a strong program to
suppor t English as a second language speakers. Most of the adults repor ted being high school graduates
from their country of origin. A minority group, usually second-generation born in the United States, repor ted
some college studies.
OIder adults repor ted being disengaged and not having opportunities to socialize or to get out of the house.
The cultural offer at the nearest seniors’ center is white-centered and doesn’t offer many activities in
Spanish, despite efforts to translate newsletters and education material.
The overall image of the community is that despite the richness and similarities of culture within the
Hispanic and Latin cultures, and the many years most of the people have been living there, it has been
difficult to see it as a whole working together and having a sense of belonging. It is challenging for people
to identify what is their community and to define what community is for them.
Project Funding Request
Root-Cause Experience: Describe the organization’s experience with root-cause work
(see Grant Information Packet for definition and detailed reference).
*
5/1/24, 2:56 PM Advancing Systems Change Grant: Program Application 2024
https://docs.google.com/forms/d/1zIn65_jODcu1DclDmvf77s55YUYik-IsqaPlqGALE9o/edit#response=ACYDBNh5riqb40ukSn7ayYVgSEPR2ZJ7elR-…5/11
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Commons Companion Program
The commons companion role is an essential bridge between the community and community based
organizations. Thus, the companion will be trained with evidence based interventions including task
centered strategies and advocacy. The first three months of training will include attending community
meetings, creating relationships with organizations, becoming proficient at utilizing the care management
platform, Community Resource Network. In the ensuing months the companion will begin to work with
individuals and households developing care plans and addressing SDOH needs. MVFP and HAT will manage
Companions allowing these service providers to bill insurance when appropriate and possible, knowing that
a portion of this population will be uninsured.
Companions will serve individuals and families referred to them by community based organizations through
the Community Resource Network. Companions will meet with referral agencies completing care plans that
align with the services provided by member organizations.
Funds will suppor t a companion to serve at least 50 individuals and families coordinating with other
agencies i.e. school based case managers and Eagle County Depar tment of Human Services. The
companion will organize case presentation meetings biweekly inviting par ticipating agencies to share
successes and barriers for an individual/family. These meetings will be facilitated by a Licensed Social
Worker utilizing an ecological perspective.
Funds will suppor t the member/MOU organizations financially to participate in monthly care plan meetings.
We will complete an MOU to negotiate confidentiality and payment.
Companions will work within the El Jebel Mobile Home Park Business Center, HAT and MVFP.
The funding will also suppor t executive director work of supervising the companion, organizing commons
meetings and program evaluation. This will include mentorship and attending meetings together with the
CC.
The Common Companion will address social isolation and a lack of knowledge and access to programs to
improve quality of life. The CC will also work on developing a governance structure with the assistance of
the executive director (ED) of HAT.
Funding Request: Provide a project title and description of the proposed use of funds:*
Purpose: Describe the issue and/or oppor tunity addressed in pursuing this project, including
the systems change identified (see Grant Information Packet for definition and detailed
reference):
*
5/1/24, 2:56 PM Advancing Systems Change Grant: Program Application 2024
https://docs.google.com/forms/d/1zIn65_jODcu1DclDmvf77s55YUYik-IsqaPlqGALE9o/edit#response=ACYDBNh5riqb40ukSn7ayYVgSEPR2ZJ7elR-…6/11
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HAT has already developed an implementation plan that includes developing leadership and community
organization buy in. This plan is attached.
HAT will hire an El Jebel community member to fill the role of the Commons Companion (CC).
CC will be trained by CU Anschutz Community Health Worker training that is in development at this time.
After training and orientation is complete. CC will begin attending clinic hours at MVFP to understand issues
experienced by clients and residents of El Jebel. After 3 months the CC will push into the El Jebel Crawford
Mobile Home Park to provide care management and care planning for residents with identified needs.
The ED and CC will hold quar terly resident meetings to increase social connectedness. We will also hold
community organization meetings to develop a cohesive community plan.
ED/CC will create care plan meetings between English in Action, MIRA and Crawford Proper ty Staff to
identify and address social determinants of health for residents of the midvalley.
CC will also develop a community newsletter, as was identified as a need for the community.
CC will coordinate referrals and increase capacity of the midvalley to use the Community Resource Network.
HAT will develop a billing protocol to bill new community health worker CPT codes that are being
implemented by Rocky Mountain Health Plans in fiscal year 24. However, due to the higher uninsured rate of
the El Jebel community fur ther grant and philanthropic funding is necessary. We will also work with our
advisor on the planning grant CU Anschutz School of Family Medicine to identify and apply for various state
and national funding opportunities.
Public Health Improvement Plan Alignment
Please offer a description of how your project aligns with Priority 2: Promoting Social Connectedness of the
Eagle County Public Health Improvement Plan (available through this link)
Activities and Actions: Describe the steps and actions that will be taken to implement the
project within the grant period:
*
Sustainability planning: Describe how the program will be sustained using complementary
funding sources or other methods of financial security:
*
5/1/24, 2:56 PM Advancing Systems Change Grant: Program Application 2024
https://docs.google.com/forms/d/1zIn65_jODcu1DclDmvf77s55YUYik-IsqaPlqGALE9o/edit#response=ACYDBNh5riqb40ukSn7ayYVgSEPR2ZJ7elR-…7/11
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Through our needs assessment of the El Jebel area we discovered that there are a number of tasks that
would lead to greater social suppor t and connectedness. First, the members of our first focus group
identified a neighborhood newsletter in English and Spanish as well as regular community meetings that
provided education about healthcare and mental health.
Second, it was clear that two organizations are trusted in El Jebel, English in Action and the MIRA bus.
However, their capacity to address SDOH is limited thus the Commons Companion would work both in
person and on CRN to connect individuals and families to resources to address belonging.
MVFP will also increase the effectiveness within the three agencies (English in Action, MIRA and
HAT/MVFP) working in Roaring Fork Valley Midvalley by holding monthly case conference meetings to
develop care plans to increase the reach of our community organizations.
Evaluation and Outcomes
1. Increase sense of belonging among residents
2. Increase use of the Community Resource Network for local agencies and neighborhood management.
3. Create care plans for at least 50 residents addressing social determinants of health.
4. Create commons Cares meetings among community and government organizations to increase
collaboration amongst midvalley care agencies.
HAT values qualitative and quantitative approaches to evaluation. In a community that is difficult to reach
we were successful in going into common spaces and completing surveys. HAT will use qgen quality of life
scales to assess connection. We will attempt to complete 20 surveys assessing connection.
HAT will use CRN to track and manage care plans. This will be completed by the CC with oversight by the
ED.
ED will complete program evaluations with English in Action and MIRA for effectiveness of program and
needs that arise year to year.
Quar terly newsletters will be disseminated quar terly in Spanish and English to residents and employees
working in the El Jebel area.
Social Support & Connectiveness: Describe how the proposed project addresses Public Health
Improvement Plan Priority 2: Social Connectedness and Belonging (see Grant Information
Packet for definition and detailed reference):
*
Describe the project goals and objectives:*
Describe the organization's overall approach to evaluation:*
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Again HAT will use CRN to track outputs of care plans and referrals made for individuals and families in the
El Jebel area.
HAT will use a standard time sheet to track staff time of CC and ED.
Community belonging was something that was identified as lacking this was identified during world cafe's
in 23-24. We will continue to assess this through continuing world cafes of community organizations and El
Jebel residents.
We will also assess community organization attitudes of effectiveness through the community organization
reviews by ED.
HAT will also attempt to bring greater resources to the area through partnerships with Colorado Mountain
College, University of Denver and Metropolitan State University.
The root cause of social isolation and health disparities is much too great to address through one grant.
However, the El Jebel area has higher rates of uninsured individuals and less access physical and mental
health care. The use of a common companion can alleviate access issues through navigation and
suppor tive services. There is also a dearth of collaboration between the organizations in the midvalley that
we aim to change.
Inclusivity and Equity
How will your organization measure the outputs (the direct results of program activities such as
number of people engaged, number of hours of staff time, attendance etc.) of the project that is
the subject of this proposal?
*
Describe how your organization will measure the outcomes (specific changes in people or
organizations such as behavior, attitudes, knowledge, relationships etc.) of the project that is
the subject of this proposal.
*
How does this project address root causes (see Grant Information Packet for definition and
detailed reference)?
*
5/1/24, 2:56 PM Advancing Systems Change Grant: Program Application 2024
https://docs.google.com/forms/d/1zIn65_jODcu1DclDmvf77s55YUYik-IsqaPlqGALE9o/edit#response=ACYDBNh5riqb40ukSn7ayYVgSEPR2ZJ7elR-…9/11
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HAT and MVFP completed 25 surveys and 2 world cafe groups to develop this plan. It was planned with CU
Anschutz School of Family Medicine through a Colorado Department of Public Health Grant to complete
planning around this proposal.
HAT is staffed currently by an ED and supported by volunteers. This grant will allow the work to flourish
through the hiring of a resident of El Jebel to serve as the Community Companion.
Requirements
Please review participation requirements outlined below, checking boxes next to each identied
requirement as an indication of commitment. If you cannot, for any reason, check one of these
requirements below, please describe reasoning in the section below.
Sign a standard Eagle County Contract
Participate in required meetings or convenings as described above
Work collaboratively with Eagle County Public Health throughout grant period
HAT staff will be able to complete the above requirement for the grant.
Describe how the population(s) impacted by the proposed project were involved in expressing
need for this project (supportive document may be included, such as community member
testimonials, documentation, etc) :
*
How does your staff represent the population that the project will serve in a culturally
competent manner:
*
I Agree To:*
Reason unable to fulfill any requirements listed above:*
5/1/24, 2:56 PM Advancing Systems Change Grant: Program Application 2024
https://docs.google.com/forms/d/1zIn65_jODcu1DclDmvf77s55YUYik-IsqaPlqGALE9o/edit#response=ACYDBNh5riqb40ukSn7ayYVgSEPR2ZJ7el…10/11
Docusign Envelope ID: 029AA9B4-B7BC-4086-8283-5FEB877623FF
This form was created inside of Eagle County Government.
Additional comments or questions:
Forms
5/1/24, 2:56 PM Advancing Systems Change Grant: Program Application 2024
https://docs.google.com/forms/d/1zIn65_jODcu1DclDmvf77s55YUYik-IsqaPlqGALE9o/edit#response=ACYDBNh5riqb40ukSn7ayYVgSEPR2ZJ7el…11/11
Docusign Envelope ID: 029AA9B4-B7BC-4086-8283-5FEB877623FF
7
Eagle County Grant Final 5/14
EXHIBIT B
Scope of Work
Docusign Envelope ID: 029AA9B4-B7BC-4086-8283-5FEB877623FF
GRANT AGREEMENT
BETWEEN EAGLE COUNTY GOVERNMENT
AND
MIDVALLEY FAMILY PRACTICE
EXHIBIT B
Scope of Work: Terms of Funding, Deliverables, and Deadlines
These provisions are to be read and interpreted in conjunction with the provisions of the
Grant Award specified above.
I. Entity Name: MidValley Family Practice
II. Project Description: This project serves to provide marketing, advocacy/incentive
participation payments, and engagement costs of the Commons Companion program, which
creates community-informed supportive services, advocacy, and community convening in the
Crawford Properties of Eagle County in the Roaring Fork Valley
III. Definitions:
Community Voice: An approach to decision-making, project management, and strategic
planning which incorporates direct feedback and redistributes power to community
members most impacted by the project or programming.
Root cause: A descriptor for the underlying reasons that create the differences seen in
health outcomes which originates from the community in which people live, and the
systems that dictate accessibility to resources and opportunities necessary for survival.
Systems change/systems-level-work: The shift of responsibility for poor health outcomes
from individual behavior, to the community systems which individuals rely on, where
inequities in access to opportunities for success exist. This addresses population health
measures on social, racial/ethnic, economic, and physical factors- often referred to as social
determinants of health.
Health Equity Framework: A Public Health Framework developed to collect data,
establish and evaluate projects/resources, and approach strategic planning in a manner that
includes and addresses health disparities and inequities.
Social Connectedness: A continuum of the size and diversity of one’s social network and
roles, the functions these relationships serve, and their positive or negative qualities”,
demonstrating that social connection, and its adverse social isolation, are significant
predictors of lifespan and quality of health. The quality of social connection influences the
physical, behavioral, and economic health of a person and a community.
ECPHE: Eagle County Public Health and Environment
MVFP : MidValley Family Practice
IV. Work Plan
Docusign Envelope ID: 029AA9B4-B7BC-4086-8283-5FEB877623FF
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Eagle County-Advancing Systems Change Pilot Grant Program
Goal I: Grant Recipient will report progress/results of project specific to the funded project
which show transparency in use of funds, adherence to grant focus, and project purpose.
Objective Ia: Grant Recipient will report budgetary, programmatic, and evaluation progress with
ECPHE staff at the closure of the grant funding cycle, with an additional evaluation meeting
taking place taking place one-year after the end of the Grant Period to ensure transparency,
participation, and adherence to project-specific expectations.
Deliverables Deadlines
1. Grant Recipient will provide ECPHE with a final
budget with specificity and transparency in direct
correlation with funded project. The reporting
template/format is flexible to Grant Recipient’s
discretion, with approval from ECPHE staff.
End of grant cycle, July 2025.
2. Grant Recipient will provide ECPHE with project-
specific updates using both narrative and indicator
progress. Reporting template/format is flexible to
Grant Recipient’s discretion.
End of grant cycle, July 2025.
3. Grant Recipient will provide ECPHE with
evaluation updates using the ECPHE Evaluation
template.
End of grant cycle, July 2025.
Objective Ia: Grant Recipient will provide project-specific updates that indicate progress and
adherence to the project timeline and goals.
Deliverables Deadlines
1. Grant Recipient will provide ECPHE descriptions
of the signage developed to increase
communication of neighborhood needs in the El
Jebel area.
End of grant cycle, July 2025.
2. Grant Recipient will provide ECPHE descriptions,
including participation count, of community events
and/or individual community member
conversations related to community engagement
and organizing.
End of grant cycle, July 2025.
3. Grant Recipient will provide ECPHE
descriptions regarding specific incentives for
participation and engagement costs.
End of grant cycle, July 2025.
Goal II: Grant Recipient will incorporate community voice of population(s) most impacted
by the organization’s programming/the funded project into decision-making processes.
Docusign Envelope ID: 029AA9B4-B7BC-4086-8283-5FEB877623FF
3
Eagle County-Advancing Systems Change Pilot Grant Program
Objective IIa: Grant Recipient will assess the organization’s current decision-making process
and identify opportunities to incorporate direct community voice from the population(s) most
impacted by the organization’s programming/funded project.
Deliverables Deadlines
1. Grant Recipient will assess the organization’s
opportunities to incorporate direct community
voice into decision-making and share a description
of this in narrative form with ECPHE.
End of grant cycle, July 2025.
2. Grant Recipient will assess current organizational
capacity for the incorporation of community voice
in decision-making, including but not limited to
staff and board representation, community-member
advisory roles, community boards, etc, and share a
description of this in narrative form with ECPHE.
End of grant cycle, July 2025.
Goal III: Grant Recipient will build and/or strengthen authentic community connections
with the population(s) most impacted by the organization’s programming/funded project.
Objective IIIa: Grant Recipient will connect directly with community members of the
population most impacted by the organization with the purpose of establishing trusted
relationships and authentic community-voice inclusion in operations/decision-making.
Deliverables Deadlines
1. Grant Recipient will connect directly with
community members of the population most
impacted by the organizations via facilitation of
groups, individual interactions, participation in
community events, and/or similar methods of direct
connection, and share a narrative description of
these efforts with ECPHE.
End of grant cycle, July 2025.
Goal IV: Grant Recipient will collaborate with partners of shared population(s) served in
an effort to establish, determine, and/or strengthen the Organization’s role within the
population’s systems/system of care.
Objective IVa: Grant Recipient will communicate/collaborate with key community partners in
assessing the needs of the population most impacted by the project.
Deliverables Deadlines
1. Grant Recipient will provide ECPHE information
regarding MidValley Family Practice’s role in
End of grant cycle, July 2025.
Docusign Envelope ID: 029AA9B4-B7BC-4086-8283-5FEB877623FF
4
Eagle County-Advancing Systems Change Pilot Grant Program
participation of regular Latine and/or El
Jebel/Crawford area serving coalitions, groups,
strategies, and/or similar convenings
V. Monitoring:
Eagle County Public Health and Environment will monitor this Grant Agreement for
compliance with performance requirements throughout the Grant Period. Methods used will
include progress meetings with ECPHE as needed/requested with required documentation
provided by the Grant Recipient.
VI. Resolution of Non-Compliance:
The Grant Recipient will be notified in writing within 15 calendar days of discovery of a
compliance issue. Within 30 calendar days of discovery, the Grant Recipient and Eagle
County Government 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 timeline for completion will be documented in writing and agreed to by both
parties.
Docusign Envelope ID: 029AA9B4-B7BC-4086-8283-5FEB877623FF
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Eagle County Grant Final 5/14
EXHIBIT C
Certificate of Insurance
Docusign Envelope ID: 029AA9B4-B7BC-4086-8283-5FEB877623FF
CERTIFICATE OF PROFESSIONAL LIABILITY INSURANCE
INSURED CERTIFICATE HOLDER
Midvalley Family Practice P.C.
1450 E Valley Rd
Unit 102
Basalt, CO 81621-8352
Midvalley Family Practice P.C.
1450 E Valley Rd
Unit 102
Basalt, CO 81621-8352
Individual:Glenn E. Kotz, M.D.
This certificate is issued as a matter of information only and confers no rights upon the holder. By its
issuance, the company does not alter, change, modify or extend the provisions of said policy and does not
waive any of its rights thereunder.
POLICY NUMBER: PCC0010423
POLICY TERM: 08/17/2024 to: 08/17/2025
RETRO DATE: 08/17/2007
LIMITS OF LIABILITY:
Per Medical Incident/Peer Review Incident:
Annual Aggregate:
SPECIALTY: Entity/Corp Specialty
Dated at: Denver, Colorado Date: July 29, 2024
Countersigned by Authorized Representative
$ 1,000,000
$ 3,000,000
Post Office Box 17540 Denver, Colorado 80217-0540 (720) 858-6000 1-800-421-1834 FAX (720) 858-6004
CO-COI 09/01/2010
Docusign Envelope ID: 029AA9B4-B7BC-4086-8283-5FEB877623FF