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HomeMy WebLinkAboutR12-099 Soy Sano Project Commissioner J - Oithoved adoption of the following resolution: BOARD OF COUNTY COMMISSIONERS COUNTY OF EAGLE, STATE OF COLORADO O RESOLUTION NO. 2012- 0 t y ` RESOLUTION RATIFYING APPROVED TASK ORDER CONTRACT - WAIVER #154 BETWEEN THE STATE OF COLORADO AND EAGLE COUNTY, COLORADO FOR DEVELOPMENT OF THE SOY SANO PROJECT WHEREAS, the Board of County Commissioners of Eagle County, Colorado ("Board") approved a Master Contract with the State of Colorado dated January 17, 2012 with routing number 13 FAA 00016; and WHEREAS, the State of Colorado has approved an amendment to the Master Contract in the form of Task Order Contract- Waiver #154, Routing No. 13 FAA 48409, that grants $141,828 to County to develop the Soy Sano Project which aims to reduce health disparities and decrease cardiovascular disease by promoting nutrition, providing access to healthy food and reducing obesity risk factors, and requires immediate signature by Eagle County; and WHEREAS, the Board desires to ratify and approve Task Order Contract- Waiver #154, Routing No. 13 FAA 48409, between the State of Colorado and Eagle County, Colorado. NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF THE COUNTY OF EAGLE, STATE OF COLORADO: THAT, the Board hereby approves and ratifies Task Order Contract - Waiver #154, Routing No. 13 FAA 48409, between the State of Colorado and Eagle County, Colorado in the form attached as Exhibit A. THAT, the Board of County Commissioners finds, determines and declares that this Resolution is necessary for the public health, safety and welfare of the citizens of the County of Eagle, State of Colorado. MOVED, READ AND ADOPTED by the Board of County Commissioners of the County of Eagle, State of Colorado, at its regular meeting held this lb day of f1,, 2012. COUNTY OF EAGLE, STATE OF COLORADO, By and Through Its e� y c4, G OARD OF COUNTY COMMISSIONERS t n ATTEST: • s ;; � / ) 2 1 risk.. _ _., .,: .•s..t 4 ''' ' 'orb ; 147 : l. Cler o the Bo. r of Peter F. Runyon / County Commissioners C - . / 41 4 '•IV Num Jon -y Co :loner --il—Q4.44- Sara J. Fisher l Commissioner Commissioner " I14 -- seconded adoption of the foregoing resolution. The roll having been called, the vote was as follows: Commissioner Runyon Commissioner Stavney I�--4 k Commissioner Fisher �, w This resolution passed by /6 vote of the Board of County Commissioners of the County of Eagle, State of Colorado. DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT ROUTING NO. 13 FAA 48409 APPROVED TASK ORDER CONTRACT — WAIVER #154 This Task Order Contract is issued pursuant to Master Contract made on 01/17/2012, with routing number 13 FAA 00016 STATE: CONTRACTOR State of Colorado for the use & benefit of the Board of County Commissioners of Eagle Department of Public Health and County (a political subdivision of the state of Environment Colorado) Office of Health Disparities 500 Broadway 4300 Cherry Creek Drive South Eagle, Colorado 81631 -0850 Denver, Colorado 80246 for the use and benefit of the Eagle County Public Health Agency 551 Broadway Eagle, Colorado 81631 TASK ORDER MADE DATE: CONTRACTOR ENTITY TYPE: 8/31/2012 Colorado Political Subdivision PO /SC ENCUMBRANCE NUMBER: PO FAA ADM1348409 TERM: BILLING STATEMENTS RECEIVED: This Task Order shall be effective upon Monthly approval by the State Controller, or designee, or on 10/01/201Z whichever is later. The STATUTORY AUTHORITY: Task Order shall end on 06/30/2013. C.R.S. 25-4-2203 PRICE STRUCTURE: CONTRACT PRICE NOT TO EXCEED: Cost Reimbursement $141,828 PROCUREMENT METHOD: FEDERAL FUNDING DOLLARS: $f Exempt STATE FUNDING DOLLARS $141,828 BID /RFP /LIST PRICE AGREEMENT NUMBER: MAXIMUM AMOUNT AVAILABLE PER FISCAL YEAR: Not Applicable FY 13: $141,828 LAW SPECIFIED VENDOR STATUTE: Not Applicable STATE REPRESENTATIVE: CONTRACTOR REPRESENTATIVE: Kathy Jacobsen Jennifer Ludwig Department of Public Health and Environment Eagle County Public Health PSD- FSU -A5 P. O. Box 660 4300 Cherry Creek Drive South Eagle, Colorado 81631 -0660 Denver, CO 80246 SCOPE OF WORK: Develop the iSoy Sano! Project to promote nutrition, provide access to healthy food, and reduce obesity risk factors all for the purpose of decreasing cardiovascular disease. Page 1 of 6 Rev 6/25/09 EXHIBrrs: The following exhibits are hereby incorporated: Exhibit A - Additional Provisions (and its attachments if any — e.g., A -1, A -2, etc.) Exhibit B - Statement of Work (and its attachments if any — e.g., B -1, B -2, etc.) Exhibit C - Budget (and its attachments if any — e.g., C -1, C -2, etc.) Exhibit D Grant Funding Change Letter Sample GENERAL PROVISIONS The following clauses apply to this Task Order Contract. These general clauses may have been expanded upon or made more specific in some instances in exhibits to this Task Order Contract. To the extent that other provisions of this Task Order Contract provide more specificity than these general clauses, the more specific provision shall control. 1. This Task Order Contract is being entered into pursuant to the terms and conditions of the Master Contract including, but not limited to, Exhibit One thereto. The total term of this Task Order Contract, including any renewals or extensions, may not exceed five (5) years. The parties intend and agree that all work shall be performed according to the standards, terms and conditions set forth in the Master Contract. 2. In accordance with section 24 -30- 202(1), C.R.S., as amended, this Task Order Contract is not valid until it has been approved by the State Controller, or an authorized delegee thereof. The Contractor is not authorized to, and shall not; commence performance under this Task Order Contract until this Task Order Contract has been approved by the State Controller or delegee. The State shall have no financial obligation to the Contractor whatsoever for any work or services or, any costs or expenses, incurred by the Contractor prior to the effective date of this Task Order Contract. If the State Controller approves this Task Order Contract on or before its proposed effective date, then the Contractor shall commence performance under this Task Order Contract on the proposed effective date. If the State Controller approves this Task Order Contract after its proposed effective date, then the Contractor shall only commence performance under this Task Order Contract on that later date. The initial term of this Task Order Contract shall continue through and including the date specified on page one of this Task Order Contract, unless sooner terminated by the parties pursuant to the terms and conditions of this Task Order Contract and/or the Master Contract. Contractor's commencement of performance under this Task Order Contract shall be deemed acceptance of the terms and conditions of this Task Order Contract. 3. The Master Contract and its exhibits and/or attachments are incorporated herein by this reference and made a part hereof as if fully set forth herein. Unless otherwise stated, all exhibits and/or attachments to this Task Order Contract are incorporated herein and made a part of this Task Order Contract. Unless otherwise stated, the terms of this Task Order Contract shall control over any conflicting terms in any of its exhibits. In the event of conflicts or inconsistencies between the Master Contract and this Task Order Contract (including its exhibits and/or attachments), or between this Task Order Contract and its exhibits and/or attachments, such conflicts or inconsistencies shall be resolved by reference to the documents in the following order of priority: 1) the Page 2 of 6 Rev 6/25/09 Special Provisions of the Master Contract; 2) the Master Contract (other than the Special Provisions) and its exhibits and attachments in the order specified in the Master Contract; 3) this Task Order Contract; 4) the Additional Provisions -_Exhibit A, and its attachments if included, to this Task Order Contract; 5) the Scope /Statement of Work - Exhibit B, and its attachments if included, to this Task Order Contract; 6) other exhibits /attachments to this Task Order Contract in their order of appearance. 4. The Contractor, in accordance with the terms and conditions of the Master Contract and this Task Order Contract, shall perform and complete, in a timely and satisfactory manner, all work items described in the Statement of Work and Budget, which are incorporated herein by this reference, made a part hereof and attached hereto as "Exhibit B" and "Exhibit C ". 5. The State, with the concurrence of the Contractor, may, among other things, prospectively renew or extend the term of this Task Order Contract, subject to the limitations set forth in the Master Contract, increase or decrease the amount payable under this Task Order Contract, or add to, delete from, and/or modify this Task Order Contract's Statement of Work through a contract amendment. To be effective, the amendment must be signed by the State and the Contractor, and be approved by the State Controller or an authorized delegate thereof. This contract is subject to such modifications as may be required by changes in Federal or State law, or their implementing regulations. Any such required modification shall automatically be incorporated into and be part of this Task Order Contract on the effective date of such change as if fully set forth herein. 6. The conditions, provisions, and terms of any RFP attached hereto, if applicable, establish the minimum standards of performance that the Contractor must meet under this Task Order Contract. If the Contractor's Proposal, if attached hereto, or any attachments or exhibits thereto, or the Scope /Statement of Work - Exhibit B, establishes or creates standards of performance greater than those set forth in the RFP, then the Contractor shall also meet those standards of performance under this Task Order Contract. 7. STATEWIDE CONTRACT MANAGEMENT SYSTEM [This section shall apply when the Effective Date is on or after July 1, 2009 and the maximum amount payable to Contractor hereunder is $100,000 or higher] By entering into this Task Order Contract, Contractor agrees to be governed, and to abide, by the provisions of CRS §24 -102 - 205, §24- 102 -206, §24 -103 -601, §24- 103.5 -101 and §24- 105 -102 concerning the monitoring of vendor performance on state contracts and inclusion of contract performance information in a statewide contract management system. Contractor's performance shall be evaluated in accordance with the terms and conditions of this Task Order Contract, State law, including CRS §24- 103.5 -101, and State Fiscal Rules, Policies and Guidance. Evaluation of Contractor's performance shall be part of the normal contract administration process and Contractor's performance will be systematically recorded in the statewide Contract Management System. Areas of review shall include, but shall not be limited to quality, cost and timeliness. Collection of information relevant to the performance of Contractor's obligations under this Task Order Contract shall be determined by the specific requirements of such obligations and shall include factors tailored to match the requirements of the Statement of Project of this Task Order Contract. Such performance information shall be entered into the statewide Contract Management System at intervals established in the Statement of Project and a final review and rating shall be rendered within 30 days of the end of the Task Order Contract term. Contractor shall be notified following each performance and shall address or correct any identified problem in a timely manner and maintain work progress. Should the final performance evaluation determine that Contractor demonstrated a gross failure to meet the performance measures established under the Statement of Project, the Executive Director of the Colorado Department of Personnel and Administration (Executive Director), upon request by the Colorado Department of Public Health and Environment and showing of good cause, may debar Contractor and Page 3 of 6 Rev 6/25/09 prohibit Contractor from bidding on future contracts. Contractor may contest the final evaluation and result by: (i) filing rebuttal statements, which may result in either removal or correction of the evaluation (CRS §24 -105- 102(6)), or (ii) under CRS §24 -105- 102(6), exercising the debarment protest and appeal rights provided in CRS § §24- 109 -106, 107, 201 or 202, which may result in the reversal of the debarment and reinstatement of Contractor, by the Executive Director, upon showing of good cause. 8. If this Contract involves federal funds or compliance is otherwise federally mandated, the Contractor and its agent(s) shall at all times during the term of this contract strictly adhere to all applicable federal laws, state laws, Executive Orders and implementing regulations as they currently exist and may hereafter be amended. Without limitation, these federal laws and regulations include the Federal Funding Accountability and Transparency Act of 2006 (Public Law 109 -282), as amended by §6062 of Public Law 110 -252, including without limitation all data reporting requirements required there under. This Act is also referred to as FFATA. Page 4 of 6 Rev 6/25/09 TIIE PARTIES HERETO HAVE EXECUTED THIS CONTRACT * Persons signing for Contractor hereby swear and affirm that they are authorized to act on Contractor's behalf and acknowledge that the State is relying on their representations to that effect. CONTRACTOR: STATE OF COLORADO: BOARD OF COUNTY COMMISSIONERS OF John W. Hickenlooper, GOVERNOR EAGLE COUNTY (a political subdivision of the state of Colorado) for the use and benefit of EAGLE COUNTY PUBLIC HEALTH AGENCY Legal Name of Contracting Entity By For Executive Director Department of Public Health and Environment Signature of Authorized Officer Print Name of Authorized Officer Department Program Approval: By Print Title of Authorized Officer ALL CONTRACTS MUST BE APPROVED BY THE STATE CONTROLLER CRS §24-30-202 requires the State Controller to approve all State Contracts. This Contract is not valid until signed and dated below by the State Controller or delegate. Contractor is not authorized to begin performance until such time. If Contractor begins performing prior thereto, the State of Colorado is not obligated to pay Contractor for such performance or for any goods and/or services provided hereunder. STATE CONTROLLER: David J. McDermott, CPA By Date Page 5 of 6 Rev 6/25/09 • This page left intentionally blank. Page 6 of 6 Rev 6/25/09 EXHIBIT A ADDITIONAL PROVISIONS To Task Order Contract Dated 08/31/2012- Contract Routing Number 13 FAA 48411 These provisions are to be read and interpreted in conjunction with the provisions of the Task Order Contract specified above. 1. The list of acronyms attached hereto as Attachment A -1 may be referenced to in Exhibit A, Exhibit B, and all and any attachments thereof in this Task Order Contract. 2. This Task Order Contract contains state funds. 3. To receive compensation under this Task Order Contract, the Contractor shall submit a signed monthly, CDPHE Reimbursement Invoice Form. This form is accessible from the CDPHE internet website http: / /www.cdphe. state. co. us /Standardizedlnvoice /index.html. CDPHE will provide technical assistance in accessing and completing the form. The CDPHE Reimbursement Invoice Form must be submitted within sixty (60) calendar days of the end of the billing period for which services were rendered. Expenditures shall be in accordance with the Statement of Work attached hereto as Exhibit B and incorporated herein and the associated Budget attached hereto as Exhibit C and incorporated herein. All expenditures must be reasonable and necessary for the performance of this Contract, and must comply with The State of Colorado, specifically the Colorado Department of Public Health and Environment, fiscal guidelines and rules. Costs associated with curricula and new cessation program/model development, individual cessation aides and nicotine replacement therapy, subscriptions and professional organization membership fees and dues, cell phone acquisition and monthly costs, out of state travel, rent, capital projects, equipment and maintenance shall not be reimbursed without prior written consent of the State. Submit completed CDPHE Reimbursement Invoice Form to: Colorado Department of Public Health and Environment Accounting/Grants Unit PSD- OHD -A5 4300 Cherry Creek Drive South Denver, CO 80246 To be considered for payment, billings for payments pursuant to this Task Order Contract must be received within a reasonable time after the period for which payment is requested, but in no event no later than sixty (60) calendar days after the relevant performance period has passed. Final billings under this Task Order Contract must be received by the State within a reasonable time after the expiration or termination of this Task Order Contract; but in no event no later than sixty (60) calendar days from the effective expiration or termination date of this Task Order Contract. Unless otherwise provided for in this Task Order Contract, "Local Match ", if any, shall be included on all invoices as required by funding source. 4. Time Limit For Acceptance Of Deliverables. a. Evaluation Period. The State shall have thirty (30) calendar days from the date a deliverable is delivered to the State by the Contractor to evaluate that deliverable, except for those deliverables that have a different time negotiated by the State and the Contractor. b. Notice of Defect. If the State believes in good faith that a deliverable fails to meet the design specifications for that particular deliverable, or is otherwise deficient, then the State shall notify the Contractor of the failure or deficiencies, in writing, within thirty (30) calendar days of: 1) the date the deliverable is delivered to the State by the Contractor if the State is aware of the failure or To be attached to CDPHE Page 1 of 3 Revised: 12/19/06 Task Order v1.0 (3/12) contract template EXHIBIT A deficiency at the time of delivery; or 2) the date the State becomes aware of the failure or deficiency. The above time frame shall apply to all deliverables except for those deliverables that have a different time negotiated by the State and the Contractor in writing pursuant to the State's fiscal rules. c. Time to Correct Defect. Upon receipt of timely written notice of an objection to a completed deliverable, the Contractor shall have a reasonable period of time, not to exceed ten (10) calendar days, to correct the noted deficiencies. If the Contractor fails to correct such deficiencies within ten (10) calendar days, the Contractor shall be in default of its obligations under this Task Order Contract and the State, at its option, may elect to terminate this Task Order Contract or the Master Contract and all Task Order Contracts entered into pursuant to the Master Contract. 5. Health Insurance Portability and Accountability Act (HIPAA) Business Associate Determination. The State has determined that this Task Order Contract does not constitute a Business Associate relationship under HIPAA. 6. Contractor must notify the State within thirty (30) days of a change of the Project Director or Principal Investigator responsible for the performance of services provided under this Task Order Contract. 7. Contractor shall request prior approval in writing from the State for all modifications to the Statement of Work/Work Plan or for any modification to direct costs in excess of ten percent (10 %) of the total budget for direct costs. Any request for a modification to the Budget in excess of ten percent (10 %) of the total budget for direct costs shall be submitted to the State by February 28, 2013 and may require an amendment in accordance with Section 5 of this Task Order Contract. Requests for modifications to the Statement of Work/Work Plan may require an amendment regardless of dollar amount. 8. Contractor shall participate in state -level evaluation efforts as requested by the State including, but not limited to, progress reports on the implementation and accomplishments of the approved Work Plan in a format provided by the State. Progress reports shall be due fifteen (15) days after each calendar quarter. Calendar quarters shall be July 1 through September 30, October 1 through December 31, January 1 through March 31, and April 1 through June 30, as applicable. Failure to submit progress reports in accordance with the above time frames may result in a delay or denial of the reimbursement request for those periods. 9. Notwithstanding the terms contained in General Provisions of the Master Contract, Section 9, Rights in Data, Documents and Computer Software or Other Intellectual Property, unless otherwise provided for, all data collected or produced or derived exclusively from the Contractor's or subcontractor's work under this Task Order Contract shall remain the sole property of the State, whether in individual, aggregate, identified or de- identified form or any other form required by the State. To facilitate follow -up, research, surveillance and evaluation, any such data collected, used or acquired shall be made available in any form required by the State, to the State and any other entity designated by the State. Any such data collected, used or acquired shall be used solely for the purposes of this Task Order Contract. The Contractor and its subcontractors agree not to release, divulge, publish, transfer, sell, or otherwise make known any such data to unauthorized persons without the express prior written consent of the State or as otherwise required by law. This includes a prior written request by the Contractor to the State for submission of abstracts or reports to conferences, which utilize data collected under this Task Order Contract. Notwithstanding the foregoing, the Contractor shall be entitled to retain a set of any such data collected or work papers necessary to perform its duties under this Task Order Contract and in accordance with professional standards. 10. Notwithstanding the terms contained in General Provisions of the Master Contract, Section 9, Rights in Data, Documents and Computer Software or Other Intellectual Property, or Section 23.i, General To be . .ched to CDPHE Page 2 of 3 Revised: 12/19/06 Task • • er v1.0 (3/12) contract template EXHIBIT A Provisions, Media or Public Announcements, the State of Colorado, specifically the Department of Public Health and Environment, shall be the owner of all printed materials, graphic representations, educational materials, audio - visual products, or any other media, in whatever form, created under this Task Order Contract. This requirement applies, but is not limited to, any brochure, flyer, presentation, billboard, radio spot, website, banner advertisement. The State reserves the right to require logos, or other wording on any material, representation, product or other media form created under this Task Order Contract. Any material, representation, product or other media form that will use the State's or logo or information must be approved by the State prior to production and distribution. A minimum of ten (10) business days is required for the review and approval process. 11. Notwithstanding the terms contained in the General Provisions of the Master Contract, Section 25, Conformance with Law, the Contractor shall comply with the provisions of Section 601 of Title VI of the Civil Rights Act of 1964, as amended, which states that "no person in the United States shall on the grounds of race, color or national origin, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program actively receiving Federal financial assistance." The Office for Civil Rights has established that it is the responsibility of any program that is a recipient of federal funds to ensure that any Limited English Proficient (LEP) person or beneficiary have meaningful access to programs, services and information. The Contractor and contract personnel shall adopt and implement policies and procedures in which reasonable steps are taken to provide language assistance in order to ensure equal access to LEP persons or beneficiaries. The Contractor and contract personnel shall advise LEP individuals that language assistance will be provided at no cost to the LEP person or beneficiary. 12. The Contractor affirms that it maintains no affiliations or contractual relationships, direct or indirect, with tobacco companies, owners, affiliate, subsidiaries, holding companies or companies involved in any way in the production, processing, distribution, promotion, sales, or use of tobacco. 13. Notwithstanding anything in this Task Order to the contrary, the parties understand and agree that all terms and conditions of this Task Order which may require continued performance, compliance, or effect beyond the termination date of this Task Order and shall survive such termination date and shall be enforceable by the State as provided herein in the event of failure to perform or comply by the Contractor. 14. The State of Colorado, specifically the Colorado Department of Public Health and Environment, shall be the owner of all equipment as defined by Federal Accounting Standards Advisory Board (FASAB) Generally Accepted Accounting Principles (GAAP) purchased under this Task Order Contract. At the end of the term of this Task Order Contract, the State shall approve the disposition of all equipment. 15. The Contractor shall not use funds provided under this Task Order Contract for the purpose of lobbying as defined in Colorado Revised Statutes (C.R. S.) 24- 6- 301(3.5)(a). 16. In accordance with paragraph 5 of the General Provisions, this contract can be modified as a result of an increase or decrease in the grant award. Such modification can be accomplished using the Grant Funding Change Letter, attached and reference herein as Exhibit D. To be attached to CDPHE Page 3 of 3 Revised: 12 /19/06 Task Order v1.0 (3/12) contract template Attachment A -1 Commonly Used Acronyms and Abbreviations That May Be Referenced In the Scope of Work: ACS American Cancer Society ACNS Alamosa County Nursing Service ACF Administration for Children and Families ADA Americans with Disabilities Act ADAD Alcohol and Drug Abuse Division AHA American Heart Association AIDS Acquired Immune Deficiency Syndrome ALA American Lung Association ALA(C) American Lung Association (of Colorado) AMCHP Association of Matemal Child Health Programs ANR Americans for Non - Smokers' Rights ARC Addiction Recovery Centers ARRA American Recovery and Reinvestment Act ASC Adams State College ASSIST American Stop Smoking Intervention Study ASTHO Association of State and Territorial Health Office B &G Boys & Girls BACCHUS BACCHUS Peer Education Network BAG Build a Generation BBLHC Boulder Broomfield Latino Health Coalition BC Boulder County BCCP Breast and Cervical Cancer Program BCHD Bent County Health Dept BCPH Boulder County Public Health BCPHA Baca County Public Health Agency BCDSS Baca County Dept Social Services BCTEPP Bent County Tobacco Education Prevention Partnership BGC Boys & Girls Club BGCMD Boys & Girls of Metro Denver BHS Broomfield High School BMTF Baby & Me Tobacco Free BOCES Board of Cooperative Educational Services BOH Board of Health BRFSS Behavioral Risk Factor Surveillance System BVBAG Buena Vista Build a Generation BVSD Boulder Valley School District Bx Biopsy C Choice CAD Coronary Artery Disease CASB Colorado Association of School Board CB Community -based System CBE Clinical Breast Exam CBO Community -based Organization CC Clear Creek CC Custer County CC Community Coordination/Coordinator CCAP Larimer County Child Care Assistance Program CCC Colorado Cancer Coalition CCCHE Colorado Community Coalition for health Equity CCGC Colorado Clinical Guidelines Collaborative CCIAA Colorado Clean Indoor Air Act CCMC Colorado Clinical Managed Care Network CCMC Commission for Case Manager Certification CCPD Cancer, Cardiovascular, and Pulmonary Disease Page 1 of 6 Attachment A -1 CCTCI Colorado Chew Tobacco Collaborative Initiative CCTEPP Custer County Tobacco Education Prevention Partnership CDC Centers for Disease Control and Prevention CDE Colorado Department of Education CDPHE Colorado Department of Public Health and Environment CDU Chronic Disease Unit CEC Career Education Center CEO Chief Executive Officer CFDA Catalog of Federal Domestic Assistance CFFC Colorado Foundation for Families and Children CFPI Colorado Family Planning Initiative CHIN Community Health Information Network CICP Colorado Indigent Care Program CJD Colorado Judicial Department CM Case Management CMC Colorado Mountain College CMS Contract Management System CMS Creative Media Solutions CNCC Colorado Northwestern Community College CNS County Nursing Service CO Colorado COD Colorado Donated Dental Services Program COPAN Colorado Physical Activity and Nutrition Program COV Colorado Van Program CPCF Colorado Parent and Child Foundation CPHA Colorado Public Health Association CPT Current Procedural Technology CRCCP Colorectal Cancer Screening Program CRUE Culturally Responsive Urban Education CSAP Colorado Student Assessment Program CSH Coordinated School Health CSU Colorado State University CSU -P Colorado State University- Pueblo's CTC Connect to Care CTEPA Colorado Tobacco Education and Prevention Alliance CTFK Campaign for Tobacco -Free Kids CTRP Colorado Tobacco Research Program CTP Crossroads Turning Point CU University of Colorado, Boulder CWCCI Colorado Women's Cancer Control Initiative CY Contract Year DAISI Denver At -home Intervention Service Initiative DASH Division of Adolescent & School Health (CDC) DCMH Delta County Memorial Hospital DH Denver Health DHHA Denver Health and Hospital Authority DHS Department of Human Services DHHS Unites States Department of Health and Human Services DOR Department of Revenue DOS Delta Opportunity School DSS Department of Social Services E &I Education and Information EAP Employee Assistance Program EBHV Evidence -Based Home Visiting to Prevent Child Maltreatment Grant Program ECC Early childhood council ECC Electrocardiogram ECCLC Early Childhood Council of Larimer County ECLC Early Childhood Leadership Council/Commission Page 2 of 6 Attachment A -1 E.D. Executive Director EHS Early Head Start EMR Electronic Medical Record EMT Emergency Medical Technicians EPA Environmental Protection Agency EPE Epidemiology Planning and Evaluation ESL English as a Second Language ETS Environmental Tobacco Smoke (a.k.a. secondhand smoke) FIRC Family and Intercultural Resource Center FICA The Federal Insurance Contribution Act FDA Food and Drug Administration FNA Final Needle Aspiration FPP Family Planning Program FPL Federal Poverty Level FRCC Front Range Community College FTE Full Time Equivalent FTP File Transfer Protocol FY Fiscal Year FYI Family Youth Initiatives GASO Great American Smoke -out GED General Education Development GASP CO Group to Alleviate Smoking Pollution of Colorado Get R!EAL (GR) Resist! Expose Advertising Lies (Youth Empowerment Program) GLBT Gay, Lesbian, Bisexual, and Transgender GYN Gynecological HCP Health Care Program For Children with Special Needs HCYS Huerfano County Youth Services HHS Health and Human Services HIPPA Health Insurance Portability and Accountability Act of 1996 HIPPY Home Instruction for Parents of Preschool Youngster HIT Health Improvement Team HIV Human Immunodeficiency Virus HPV Human Papillomamavirus HR Human Resources hr hour HRSA Health Resources and Services Administration HSL High School Leadership ID Identification IIK Invest in Kids ISHT Interagency School Health Team IT Information Technology JAC Juvenile Assessment Center KIS Keeping in STEPP KMH Keefe Memorial Hospital KPC Kevin Patrick Caleum LAHCDHD Las Animas Huerfano Counties District Health Department LBW Low Birth Weight LC Learning Community LGBT Lesbian, Gay, Bisexual, Transgender LEM Latinas en Movimiento LHA Local Health Agency LHD Local Health Department LLC Limited Liability Company LRCC Latino Regional Community Coalition LRPC Latino a Research and Policy Center LST Life Skills Training LSTPEN Latino Statewide Tobacco Prevention and Education Netw LWB Live Well Broomfield Page 3 of 6 Attachment A -1 MCHA Montezuma Housing Authority MCHD Montezuma County Health Department MCHS Montezuma -Cortez High School MCPN Metro Community Provider Network MCRC Media Campaign Resource Center — CDC MD Medical Doctor MHCBBC Mental Health Center Serving Boulder and Broomfield Counties MIECHV Maternal, Infant and Early Childhood Home Visiting Program MO Month MOB Medical Office Building MOU Memorandum of Understanding MPA Master of Public Administration in Health and Human Services MPH Master of Public Health MRI Magnetic Resonance Imaging Scan MS Master of Science MSA Master Settlement Agreement MUH Multi -user Housing MYAT Multi- Disciplinary Youth Assessment Team N/A Not Applicable NACCHO National Association of County and City Health Officials NACR Native American Cancer Research NAQC North American Quitline Consortium NASBE National Association of State Board of Education NCHD Northeast Colorado Health Department NCI National Cancer Institute NE North East NFP Nurse- Family Partnership NFPNSO Nurse - Family Partnership National Service Office NHVP Nurse Home Visitor Program NIDA National Institute on Drug Abuse NIH National Institute of Health NJH National Jewish Medical and Research Center N -O -T Not -on- Tobacco, (ALA's Youth Smoking Cessation Program) NP Nurse Practitioner NPP Nurturing Parenting Program NRT Nicotine Replacement Therapy NSBA National School Boards Association OSH Office on Smoking or Health (CDC) OTC Over the Counter PA Physician's Assistant PAC Prevention Awareness Crew PACT Partners Assessing Chew Tobacco PAT Parents as Teachers PCCHD Pueblo City- County Health Department PPC Personal Care Providers PE Presumptive Eligibility PEN Parent Engagement Network PVCHC Peak Vista Community Health Center PHN Public Health Nurse PIO Public Information Officer PM Peer Mentor PMC Parkview Medical Center PMR Planning Management Region PN Patient Navigator PO Purchase Order PPC Policy Partner Committee PPFC Pikes Peak Family Connections PPN Prevention Policy Network Page 4 of 6 Attachment A -1 PRA Policy Resource Alliance PRAMS Pregnancy Risk Assessment and Monitoring Survey PRIDE Pure Respect Initiative Direct Education PSA Public Service Announcement PSD Prevention Service Division PTEPP Pueblo Tobacco Education and Prevention Partnership PVC Prairie View Clinic Q1 Quarter One Q2 Quarter Two Q3 Quarter Three Q4 Quarter Four QI Quality Improvement QOL Quality of Life RDAC Regional Disparities Advisory Council RFA Request for Applications RFP Request For Proposals RIE Reach, Implementation and Effectiveness RIHEL Regional Institute for Health and Environment RMC Rocky Mountain Center for Health Promotion & Education RMRH Rocky Mountain Rural Health RMYC Rocky Mountain Youth Corps RN Registered Nurse Rx Prescription RY Reconnecting Youth SafeCare SAMHSA Substance Abuse Mental Health Services Administration SB School -based System SBAG Salida Build A Generation SBHC School -Based Health Centers SCYC School Community Youth Coalition SCRHC Southern Colorado Regional Health Collaborative SD Service Delivery SECH Southeast Colorado Hospital SEMHS Southeast Mental Health Services SES Socio- Economic Status SEW School Employee Wellness SGR Surgeon General's Report SHAC Smoke -free Housing Action Committee SHI School Health Index SHS Secondhand Smoke SIDS Sudden Infant Death Syndrome SLV San Luis Valley SMART Staying Motivated at Reducing Temptations SMART OUTCOME OBJECTIVE Specific, Measurable, Achievable, Realistic, Time -Bound SMSU Self Management Service Unit SRO School Resource Officer STD Sexually Transmitted Disease STEPP State Tobacco Education and Prevention Partnership STW Straight -to -Work SVVSD St. Vrain Valley School District SWOT Strengths, Weaknesses, Opportunities, Threats SYNAR Synar Regulation TA Technical Assistance TABS Tobacco Attitudes and Behavior Survey TAG Technical Advisory Group (for evaluation & TPEG) TANF Temporary Aid to Needy Families TARP Tobacco Advocacy and Resource Partnership TBD To Be Determine Page 5 of 6 Attachment A -1 TCP Tobacco Control Partners TDAC Tobacco Disparities Advisory Council TDG Tobacco Disparities Grant TDS Tobacco Disparities Subcommittee TEACH Teaching Equity to Advance Community Health TEFAP The Emergency Food Assistance Program TEPCGP Tobacco Education Prevention and Cessation Grant Program TEPP Tobacco Education Prevention Partnership TFCCI Tobacco -Free Colorado Communities Initiative TFLC Tobacco Free Larimer County TFS Tobacco -Free Schools TFS Law Tobacco -Free Schools Law TGYS Tony Grampsas Youth Services Title V Title V of the Social Security Act TND Project Toward No Drug Abuse TPEG Tobacco Program Evaluation Group TPI Tobacco Prevention Initiative TRC Tobacco Education and Prevention and Cessation Program Review Committee TRI Tobacco Rapid Improvement Activity TRIA Tobacco Rapid Improvement Assessment TTI Tony Grampsas Tobacco Initiative UCD University of Colorado — Denver UCDHSC Health Sciences Center at UCD (sometimes abr. UCHSC) UCDHSC University of Colorado at Denver and Health Sciences Center US United States of America USSTC US Smokeless Tobacco Company VP Vice President Well COA Wellness Councils of America WHU Women's Health Unit WIC Women, Infants, Children WWC Women's Wellness Connection Y @C Youth at Crossroads YE Youth Empowerment YPH Youth Partnership for Health Yr Year YRBS Youth Risk Behavior Survey YSAP Youth Substance Abuse Prevention Coalition YTS Youth Tobacco Survey YVMC Yampa Valley Medical Center 5 A's Ask, Advise, Assess, Assist, Arrange 2A's R Ask, Advise, Refer Page 6of6 m m . a, et 0 Y a W et � � O W / a) o Y U o • „ - g . 0 „\ Y v o 0 4 3 a a .. = 0v� b 2 2 vl oed Wx�o w o o - 0 0v o 01 .5 "CI •0 O a g U >1 [ 4 . 0 P. 0 O W CO T ° U U a) £ o - 0 - ct au) 0 co N si- d -.4 W p c O O vl W as mt 0 a.. a) M an v O T 0 O M U O U U -∎ O b U a U 8 • � - 0 CA W Q � E a ) " ccs y ' y = at V1 O ct ti • " 0 =., N = o . ..0 a) ,....• > y V) -t • U ;� in' a) Z 0 •0 � , 0.l 0 U 0 >, °, , ° O CCS 5 ra L 3 a o a� ° 0 ° .: a) 3 0 0 i -0 W ( j o 0 `� 0 E o a LI 'Z: ".5 0 -0 i" Y o >,. . 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L Z p L 5 t > O_ 0 0. 0 7 0_ 0 0_ 0 .2 C 7 L (O a) co N gy p • , =.= = L Cr 0 L 0 d co V) 0 .J N 0 Z 0 Y to N V) N N W V) V) N N H CO U ° o C rn co co _ r, rn CD m ER o W v n n 0 uJ T r O> crr N n j tor, R = LC ‘F aD R ca" CO E = ER Err d CD M 6.q E 6r9 X 0 0 64 64 W 0 0 r - d d b4 a) 0) = = d a> et Ce C _ C T T C C co c3 R co CV •r O 0 = _ c 0 0 '') 0 0 'D CS; ED Cl (D 4: — a> co co ce cc Ef3 Eft Eft d' 0.1 0 co ce cu a w v d a> w a> - ~O a N Q i > o c a> O a Eft C - C71 I C cn 'm a Q a> E '" -6 E a> > N a> E ° Es m O .O m a> a O C 0 N C O_ m N a O O O .O co O_ i> E a 6s c> co a> c o a) 4) I a- C a> 0 Q O o a> 0 C 4) .Q 0 Q c0 d ns Y . O C a a> y co c LL a> D x '< a> X y E o> co CO W 0 n .- a CO U o a , j O co ca a> s_ d R o -c _m as. d O 0- ++ C m° 0.1 m a U 0 1- o a> m CO d E E y Y N 0 > `m U p L _ C1 01 C H O a> co co O) N c0 cC . `� .+ _ 0 J 2 1- f- H 5 H EXHIBIT D GRANT FUNDING CHANGE LETTER 1 Date: 1 State Fiscal Year: 1 Grant Funding Change Letter # 1 CMS Routing # TO: Insert Grantee's name In accordance with Section of the Original Contract routing number , [insert the following language here if previous amendment(s), renewal(s) have been processed] as amended by [include all previous amendment(s), renewal(s) and their routing numbers], [insert the following word here if previous amendment(s), renewal(s) have been processed] between the State of Colorado, Department of Public Health and Environment and Contractor's Name beginning Insert start date <insert start date of original contract> and ending on Insert ending date <insert ending date of current contract amendment >, the undersigned commits the following funds to the Grant: The amount of grant funds available and specified in Section of <insert contract amendment number and routing number> is ❑ increased or ❑ decreased by $amount of change to a new total funds available of $ < insert new cumulative total> for the following reason: . Section is hereby modified accordingly. This Grant Funding Change Letter does not constitute an order for services under this Grant. The effective date of hereof is upon approval of the State Controller or , whichever is later. STATE OF COLORADO John W. Hickenlooper, GOVERNOR Department of Public Health and Environment PROGRAM APPROVAL: By: Lisa Ellis, Purchasing & Contracts Unit Director By: Date: ALL GRANTS REQUIRE APPROVAL BY THE STATE CONTROLLER CRS §24 -30 -202 requires the State Controller to approve all State Grants. This Grant is not valid until signed and dated below by the State Controller or delegate. Grantee is not authorized to begin performance until such time. If Grantee begins performing prior thereto, the State of Colorado is not obligated to pay Grantee for such performance or for any goods and /or services provided hereunder. STATE CONTROLLER David J. McDermott, CPA By: Date Page 1 of 1 Effective Date: 1 /6/09 -Rev 8/25/09 1 I i I