HomeMy WebLinkAboutbocc.con.amended.272.19 E iTKIN Pitkin County
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Contract Information
Contract Number 272.19 E
Project Name Immunizations and Treatment Services
Contractor Community Health Services
Budget Line Item 11437372.531000.10072 $ 144,000.00
COVID-19 Specific coding as needed $Additional Budget Line $
Item(s) $ _
(Please fully allocate New Contract Total)
$ 144,000.00
Procurement Method: None
Type: Services/Maintenance
Contract Start Date 7/1/2019
Contract End Date 12/31/2022
Contract Type Change Order/Contract Amendment
Retainage No
If this is a new contractor, please enter the New Vendor information into Munis for workflow approval.
Contact Information:
Department Public Health
County Representative Jordana Sabella County Representative (970) 920-5062
Phone
Provide a brief description of the Contract or Change Order:
Extension of Contract term through 12/31/22 and allocation of not to exceed budget of$144,000.00 for extended
term.
Contract Value Summary:
Original Contract Amount $ 56,409.00
Previous Change Order/Amendment Amount $ 329,725.00
This Change order/Amendment amount $ 144,000.00
Contract Total $ 530,134.00
Contract#:272.19 Rev. 2018.06.13 btf
Budget Line Item#: 11437372.531000.10072&COVID-19 Specific Coding As Needed
1/44)ixKiN
COUNT
CHANGE ORDER/CONTRACT AMENDMENT
Change Order Number: 272.19 E
OWNER: CONTRACTOR:
Pitkin County, Colorado Community Health Services
530 E. Main St., Suite#302 0405 Castle Creek Road, Suite 201
Aspen, CO 81611 Aspen, CO 81611
The Provision of Immunizations and Treatment Services (the "Contract") dated September 12,
2019 between the Board of County Commissioners of Pitkin County, Colorado (the "County")
and Community Health Services (the "Contractor"), is hereby amended as follows:
Description of Change:
1. Per the terms of the Contract, the Contract term may be extended for four(4) additional
years by the express written consent of both parties. If agreeable to both parties, the
Contract term is hereby extended for a period of one (1)year and the new expiration date
will be December 31, 2022.
2. Incorporation of updated Immunization Scope of Work("Attachment A") for the 2022
extended term.
3. Allocation of not to exceed budget in the amount of One Hundred Forty-Four Thousand
dollars and Zero cents ($144,000.00) for term beginning January 1, 2022 and ending
December 31, 2022.
Reason for Change: Extension of Contract term for continuation of services and allocation of
funds for 2022 term.
Original Contract Amount $ 56,409.00
Previous Change Order/Amendment Amount $ 329,725.00
This Change Order/Amendment Amount $ 144,000.00
New Contract Total $ 530,134.00
*Increases over$25,000 and/or 10%(single increase or accumulative)of original contract must
have County Manager signature. 1
Contract#:272.19 Rev. 2018.06.13 btf
Budget Line Item#: 11437372.531000.10072&COVID-19 Specific Coding As Needed
In all other respects, the Contract is in full force and effect and remains unchanged by this
Amendment.
COMMUNITY HEALTH SERVICES
tboaan, k o1 Jan-27-2022
Logan Hood Date
Executive Director
PITKIN COUNTY, COLORADO
RECOMMENDED FOR APPROVAL:
jarizttmt abata. Jan-27-2022
Jordana Sabella Date
Public Health Director
MANAGER APPROVAL:
PLUS litattiGt, Jan-27-2022
Phyl i s Matti ce Date
assistant County Manager
*Increases over$25,000 and/or 10%(single increase or accumulative)of original contract must
have County Manager signature. 2
Immunization Scope of Work
Duties and Responsibilities: Community Health Services (CHS) shall provide the following
services to Pitkin County Public Health:
1. CHS shall perform all activities in the time period required in the attached Statements of
Work (SOW)from the Colorado Department of Public Health and Environment (CDPHE).
a. Attachment A: Immunization SOW
b. Attachment B: Immunization SOW Amendment#4
2. CHS shall work collaboratively with Pitkin County Public Health to develop measures
that will be reported quarterly.
3. CHS shall log all activities related to the Covid-19 Pandemic response for Pitkin County,
identified separate from standard immunization activities, and invoiced as a separate line
item.
4. CHS shall operate per the Pitkin County IT Department MOU
a. Attachment C: Pitkin County IT MOU
Accountability: A designated representative from CHS will participate in quarterly meetings, or
more frequently as reasonably needed or requested, with Pitkin County Public Health's CHS
Contract Manager, or designee. The meetings will be a forum to provide updates and to discuss
accomplishments, challenges, and barriers.
Compensation: CHS will send a quarterly invoice to Pitkin County Public Health together with
hours spent on the program and actual costs. The indirect rate for this contract is 10%. The
total compensation under this Agreement shall not exceed $144,000 for Immunizations for the
term ending December 31, 2022. Notify Pitkin County Public Health within 30 days of potential
overages, acknowledgment of any grants, and/or other funding that will offset costs related to
Tuberculosis work. Invoices are to be emailed to Pitkin County Public Health no later than the
15th of April, July, October, and January 2023.
ATTACHMENT A
IMMUNIZATION STATEMENT OF WORK
To Original Contract Number 19 FHHA 108899
Amendment Contract Number:2020*3425 Amendment#3
These provisions are to be read and interpreted in conjunction with the provisions of
the contract specified above.
I.Entity Name:Pitkin County Public Health Agency
II.Project Description: This project serves to reduce and eliminate vaccine-preventable
diseases in Colorado by increasing and maintaining immunization coverage.Local public
health agencies will promote and provide immunization services,and respond to strategic
priorities identified by CDPHE,according to
established best practices and standards and in alignment with the Colorado Public
Health Transformation Core Public Health Services concepts.
III.Definitions:
1.ACIP:Advisory Committee on Immunization Practices
2. CCC: Child Care Centers as defined by Colorado State
Board of Health Rule 6 CCR 1009-2
3. CCR: Code of Colorado Regulations
4. CDC: Centers for Disease Control and Prevention
5. CDPHE: Colorado Department of Public Health and Environment
6. CIB: Colorado Immunization Branch
7. CIIS: Colorado Immunization Information System
8.Deputization:The formal extension of authority to provide VFC vaccines to
eligible underinsured children from a participating FQHC or RHC to another
VFC-enrolled provider;typically a local public health agency.Previously
called Delegation of Authority.
9.Evidence-based: Conscientious use of current scientific
evidence and clinical expertise. 10.FQHC:Federally Qualified
Health Center
11.Core Immunization services:Immunization services with
community stakeholders based on evidence-based strategies to increase
vaccination rates.
12.Insured:A person who is covered by health insurance.
13.Jurisdiction:Power or right of a legal or political agency to
exercise its authority over a person,subject matter,or territory.
14.MMR Measles,mumps,and rubella vaccine.
15.MOU: Memorandum of Understanding
16.RHC:Rural Health Center
17. School:As defined by the Colorado Board of Health rule 6 CCR
1009-2,all child care facilities licensed by the Colorado Department of
Human Services including: child care centers,school-age child care
center,preschools,day camps,resident camps,day treatment centers,
family child care homes,foster care homes,and head start programs;
public,private,or parochial kindergarten,elementary or secondary
schools through grade twelve,or a college or university. 18. Section 317
Vaccine:Vaccine funding used to support infrastructure critical to
vaccine program success including vaccine for:uninsured and
underinsured adults,outbreak response and preparedness support.
19.UTD Up-to-date
20.VFC:Vaccines for Children
21.VPD:Vaccine-preventable disease
22.WIG:Wildly Important Goal-a current strategic priority of CDPHE
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Amendment Contract Number 2020*3425 Amendment#3
Ver.01.11.19
EXHIBIT G
I.Work Plan:
Goal#1:Reduce vaccine-preventable diseases in Colorado by increasing or maintaining
immunization coverage.
Objective#1:No later than the expiration of the contract,the Contractor shall provide core
immunization services intended to improve the health of individuals and communities.
Primary Activity#1 The Contractor shall implement core immunization services within
its jurisdiction.
Sub-Activities#1 1.The Contractor shall promote within their jurisdiction all ACIP
recommended VFC vaccines through the VFC program for the
population served.
2.The Contractor shall analyze the need for provision of
immunizations within their jurisdiction.
a.According to the analysis,the Contractor shall provide
immunizations within their jurisdiction.
3.The Contractor shall promote within their jurisdiction that children
eligible for VFC vaccine per ACIP recommendations are screened and
vaccinated.
4.The Contractor shall promote within their jurisdiction all ACIP
recommended Section 317 vaccines are available through the Section
317 program for the population served.
5.The Contractor shall promote within their jurisdiction that persons
eligible for Section 317 vaccine per ACIP recommendations are
screened and vaccinated.
6.The Contractor shall promote within their jurisdiction that inventory of all
ACIP-recommended private vaccines is available for the insured
population served.
a.The Contractor shall refer insured clients to health care
providers outside of their jurisdiction in instances that private
vaccine is not available within their jurisdiction.
7.The Contractor shall promote within their jurisdiction that persons
eligible for private vaccine per ACIP recommendations are screened
and vaccinated.
8.The Contractor shall submit immunization data to CIIS for all
immunizations administered by their agency within 14 days of
vaccine administration.
9.The Contractor shall promote use of CIIS to providers in their jurisdiction.
10.The Contractor shall review the county level Immunization Rates
Report for the following information:
a.Children 19-35 months of age no later than 30 days after
distribution by CIB
b.Adolescents 13-17 years of age no later than 30 days after
distribution by CIB
c.Compare to the CDC National Immunization Surveys; Child and
Teen and CIIS-generated statewide rates provided by CIB in order to
increase awareness of county versus state and national immunization
rates within the 30 days that the rates report is distributed by the CIB.
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Amendment Contract Number 2020*3425 Amendment#3
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EXHIBIT G
11.The Contractor shall provide immunization subject matter expertise to
the following:
a.Decision makers
b.Policy makers
c.Health care providers
d.The public
12.The Contractor shall meet with local stakeholders to implement a
minimum of one(1)evidence-based strategy that is culturally and
linguistically appropriate to eliminate immunization disparities by race,
ethnicity,and socio-economic status.
13.The Contractor shall promote informed vaccine decision making
by educating a minimum of one(1)of the following:
a.consumers
b.health care providers
c. staff who administer immunizations
d.policy makers
14.The Contractor shall address vaccine hesitancy by educating a minimum
of one(1)of the following:
a.consumers
b.health care providers
c. staff who administer immunizations
d.policy makers
15.The Contractor shall promote vaccine services availability by educating
a minimum of one(1)of the following:
a.consumers
b.healthcare providers
c. staff who administer immunizations
d.policy makers
16. The Contractor shall promote seasonal influenza vaccine to
improve preparedness in the event of an influenza pandemic
according to the following criteria:
a.The Contractor shall promote seasonal influenza vaccine
with new organizations.
b.The Contractor shall continue seasonal influenza vaccine
coordination with existing organizations.
c.The Contractor shall promote seasonal influenza vaccine
with commercial sector organizations.
d.The Contractor shall review the list of 2009 H1N1 providers
for their jurisdiction within 90 days of receipt of the list
provided by CDPHE.
i.The Contractor shall email CIB with additional providers in
their jurisdiction that CDPHE will contact as potential
pandemic providers in the future.
17.The Contractor shall maintain a deputization MOU with an FQHC/RHC.
18.The Contractor shall deliver information to schools and CCCs about
the Colorado State Board of Health Rule 6 CCR 1009-2 annual
reporting requirement.
a.The Contractor shall follow up with schools who fail to report data.
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Amendment Contract Number 2020*3425 Amendment#3
Ver.01.11.19
EXHIBIT G
b.The Contractor shall follow up with CCCs who fail to report data.
19.The Contractor shall support a network of VFC providers.
a.The Contractor shall perform ongoing recruitment of new
VFC providers.
b.The Contractor shall educate current VFC providers about the
VFC program requirements.
20.The Contractor shall respond to cases of VPD in their jurisdiction in
order to implement core immunization services.
21.The Contractor shall maintain staff readiness for a VPD outbreak.
22.The Contractor shall participate in the bimonthly CIB Immunization
Update call.
a.The Contractor shall listen to the audio recording of the call
provided by the CIB within 30 days when the Contractor does
not attend bimonthly call.
23.The Contractor shall attend a minimum of one(1)
immunization-related training or conference.
Objective#2:No later than the expiration of the contract,the Contractor shall implement
evidence-based strategies to improve immunization rates in populations identified as underimmunized
by CDPHE.
Primary Activity#1 The Contractor shall develop a prioritized plan to address strategic
priorities identified by CDPHE.
Sub-Activities#1 1.The Contractor shall utilize immunization strategies to address
underimmunization in populations as defined in the WIG.
2.The Contractor shall review immunization data provided by CDPHE
for each county in jurisdiction to inform development of the
prioritized plan.
3.The Contractor shall review the list of strategies from Strategies to
improve Colorado vaccination rates.
a.The Contractor shall identify a minimum of three(3)strategies
to implement within their jurisdiction.
4. The Contractor shall plan local activities to use evidence-based
strategies that are culturally and linguistically appropriate to increase
immunization rates with the following:
a.Health care providers
b.Pharmacists
c.Long-term care facility staff
d.Infection control specialists
e. School officials
f.The public
5.The Contractor shall create a prioritized plan based on immunization targets
for the Contractor's jurisdiction set by the CIB to attain a WIG.
Primary Activity#2 The Contractor shall implement a prioritized plan to address strategic
priorities identified by CDPHE.
Sub-Activities#2 1.The Contractor shall promote the prioritized plan within their jurisdiction.
2.The Contractor shall implement the prioritized plan within their
jurisdiction.
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Amendment Contract Number 2020*3425 Amendment#3
Ver.01.11.19
EXHIBIT G
Primary Activity#3 The Contractor shall evaluate the prioritized plan to address strategic
priorities identified by CDPHE.
Sub-Activities#3 1.The Contractor shall evaluate the prioritized plan by
reviewing immunization rates of specific vaccines targeted in
plan.
a.The Contractor shall review immunization rates of specific
vaccines targeted in plan before implementation of plan.
b.The Contractor shall review immunization rates of specific
vaccines targeted in plan after implementation of plan.
2.The Contractor shall report to CDPHE any progress on prioritized plan
via quarterly progress report.
Standards and 1.The content of electronic documents located on CDPHE and non-CDPHE
Requirements websites and information contained on CDPHE and non-CDPHE
websites may be updated periodically during the contract term.The
contractor shall monitor documents and website content for updates
and comply with all updates.
2.The Contractor shall use the final results of the CDC National
Immunization Surveys; Child and Teen and CIIS-generated statewide
rates provided by CIB via email communication in order to increase
awareness of county versus state and national immunization rates.
3.The Contractor shall comply with the requirements for
entering/submitting immunization data into CIIS as agreed to in the
CIIS Letter of Agreement found within the online CIIS Resource Center
located on the following website,https://www.ciisresources.com.The
content of this website is incorporated and made part of this contract by
reference.
4.The Contractor shall comply with the ACIP recommendations for
vaccine administration located on the following website,
http://www.cdc.gov/vaccines/acip/index.html.The content of this website
is incorporated and made part of this contract by reference.
5. The Contractor shall promote compliance with school immunization
rules within the Colorado State Board of Health Rule 6 CCR 1009-2
located on the following website,
Jittps://www.sos.state.co.us/CCR/GenerateRulePdf.do?ruleVersionId=7
¢�$&fileName=6%2OCCR%201009-2.This document establishes
immunization standards and is incorporated and made part of this
contract by reference.
6.The Contractor shall create a login to access the school and childcare
immunization data for their jurisdiction located on the following website,
https://www.colorado.gov/pacific/cdphe/school-and-child-care
immunization-data-reporting.The content of this website is incorporated
and made part of this contract by reference.
7.The Contractor shall maintain a signed VFC recertification agreement
when providing VFC vaccines for their jurisdiction.
8.The Contractor shall comply with the requirements for utilizing VFC
vaccine agreed to in the VFC recertification agreement packet provided
by CIB when providing VFC vaccines for their jurisdiction.
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Amendment Contract Number 2020*3425 Amendment#3
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EXHIBIT G
9.The Contractor shall comply with the eligibility requirements for
utilizing Section 317 vaccine as provided by CIB via email when
providing 317 vaccines for their jurisdiction.
10.The Contractor shall use a minimum of one(1)evidence-based strategy to
eliminate coverage disparities by race,ethnicity and socio-economic status
located on the following website,www.thecommunityguide.org.The content
of this website is incorporated and made part of this contract by reference.
11.The Contractor shall use deputization MOU guidance as provided by
CIB via email.
12. CDPHE will provide programmatic technical assistance,upon request.
13.The Contractor shall complete an electronic quarterly progress report
using the FY21 Immunization Core Services Quarterly Progress Report,
via the following website,
https://fs9.formsite.com/ColoradoIMMprogram/FY21-
Core-ProgressReport/index.html.The content of this website is
incorporated and made part of this contract by reference.
a.The Contractor shall complete the final electronic quarterly
progress report as a non-reimbursable deliverable.
14.The Contractor shall provide signed VFC recertification packet and
agreements via the following website when providing VFC vaccines for
their jurisdiction:
https://fs9.formsite.com/ColoradoIMMprogram/6dttiug6dt/index.html.
The content of this website is incorporated and made part of this
contract by reference.
15.The Contractor shall utilize strategies of CALPHO and CDPHE.
Colorado Public Health System Transformation: Core Public Health
Services Operational Definitions Manual.May 2019 located on the
following website,
https://drive.google.com/file/d/13WfziCLlym01ZcFsW_ke8W4MjRbxL8r
/vie w?usp=sharing. This document establishes immunization standards
and is incorporated and made part of this contract by reference.
16.The Contractor shall access the MMR Dashboard and Report Card via
the following website:
https://cohealthviz.dphe.state.co.us/t/DCEED Public/views/MMRFactSh
eet/
MMRFactSheetIntro?:showAppBanner=false&:display count=n&:show
Viz Home=n&:origin=viz_share link.The content of this website is
incorporated and made part of this contract by reference.
17.The Contractor shall strive to meet immunization targets for
their jurisdiction set by the CIB to attain a WIG.
18. CDPHE will provide each jurisdiction's immunization targets via
email within 90 days of the execution of the contract.
19.The Contractor shall promote immunizations by utilizing fact-based
strategies from Strategies to improve Colorado vaccination rates located
on the following website,
https://docs.google.com/document/d/lt9ZsuW2zmaY-1S-
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Amendment Contract Number 2020*3425 Amendment#3
Ver.01.11.19
EXHIBIT G
LpTrNicjCmaCXzaUtvVam62fy1J8/edit?usp=sharing.The content of
this website is incorporated and made part of this contract by
reference.
Expected Results of 1.Immunizations are offered within the Contractor's jurisdiction.2.
Activity(s) Immunizations are marketed within the Contractor's jurisdiction.3.
Immunizations are administered within the Contractor's jurisdiction.
Measurement of 1.Data contained in Immunization Rates Report.
Expected Results 2.Data contained in the CDPHE Dashboard and Report
Card.3.Data contained in quarterly progress reports.
Completion Date
Deliverables 1. All Contractors providing VFC vaccines No later than 30
shall electronically submit signed VFC business days
recertification packet and agreements. following the receipt
of the recertification
packet
2.The Contractor shall submit an electronic No later than 30
quarterly progress report using the FY21 calendar days
Immunization Core Services Quarterly Progress following the last
Report. calendar day of
September,
December, and
March
3.The Contractor shall submit the final electronic No later than
quarterly progress report using the FY21 07/15/2021
Immunization Core Services Quarterly Progress
Report.
4.The Contractor shall submit immunization data No later than 14
for all immunizations administered by the days following
Contractor's agency to CIIS. vaccine
administration
5.The Contractor shall submit prioritized plan to No later than 30
CDPHE via 1st Quarter electronic quarterly calendar days
progress report. following the last
calendar day of
September
V.Monitoring:
CDPHE's monitoring of this contract for compliance with performance requirements will be conducted
throughout the contract period by the CDPHE Contract Monitor.Methods used will include a review of
documentation determined by CDPHE to be reflective of performance to include progress reports and other
fiscal and programmatic documentation as applicable.The Contractor's performance will be evaluated at
set intervals and communicated to the contractor.
VI.Resolution of Non-Compliance:
The Contractor will be notified in writing within 15 calendar days of discovery of a compliance issue.
Within 30 calendar days of discovery,the Contractor and the State will collaborate,when appropriate,to
determine the action(s)necessary to rectify the compliance issue and determine when the action(s)must be
completed.The action(s)and timeline for completion will be documented in writing and agreed to by both
Page 7 of 8
Amendment Contract Number 2020*3425 Amendment#3
Ver.01.11.19
EXHIBIT G
parties.If extenuating circumstances arise that requires an extension to the timeline,the Contractor must
email a request to the CDPHE Contract Monitor and receive approval for a new due date.The State will
oversee the completion/implementation of the action(s)to ensure timelines are met and the issue(s)is
resolved.If the Contractor demonstrates inaction or disregard for the agreed upon compliance resolution
plan,the State may exercise its rights under the provisions of this contract.
Page 8 of 8
Amendment Contract Number 2020*3425 Amendment#3
Ver.01.11.19
DocuSign Envelope ID:A26B9129-AE6F-4634-B159-B496CB1A0E9A
Exhibit I
Federal Provisions-CDC-RFA-IP19-1901 Immunization and Vaccines for Children
For the purposes of this Exhibit only,Contractor is also identified as"Subrecipient."This Contract has
been funded, in whole or in part,with an award of Federal funds. In the event of a conflict between the
provisions of these Supplemental Provisions for Federal Awards,the Special Provisions,the Contract or
any attachments or exhibits incorporated into and made a part of the Contract,the Supplemental
Provisions for Federal Awards shall control. In the event of a conflict between the Supplemental
Provisions for Federal Awards and the FFATA Supplemental Provisions(if any),the FFATA
Supplemental Provisions shall control.
1)Federal Award Identification.
a. Subrecipient: Pitkin County Public Health Agency
b. Subrecipient DUNS number: 085278844
c. The Federal Award Identification Number (FAIN) is NH23IP922600.
d.The Federal award date is To Be Determined.
e.The subaward period of performance start date is 07/01/2019 and end date is 06/30/2024.
f.Federal Funds:
Federal Budget Period Total Amount of Amount of Federal
Federal Funds Funds Obligated to
Awarded CDPHE
7/1/2019 - 6/30/2020 $6,084,015.00 $298,466.00
g. Federal award title of project or program: Immunization and Vaccines for Children.h.The
name of the Federal awarding agency is: The Department of Health and Human Services—
Centers for Disease Control and Prevention and the contact information for the awarding
official is Maribeth Eckert, 1600 Clifton Road,Atlanta, Georgia, 30333,404-639-8800;the
name of the pass-through entity is the State of Colorado,Department of Public Health and
Environment(CDPHE), and the contact information for the CDPHE official is Lynn Trefren,
4300 Cherry Creek Drive South,A-3,Denver, Colorado 80246 303-692- 6242.
i. The Catalog of Federal Domestic Assistance(CFDA)number is 93.268 and the grant name is
Immunization and Vaccines for Children.
j.This award is not for research&development.
k. Subrecipient is not required to provide matching funds.In the event the Subrecipient is
required to provide matching funds, Section 8 of this Attachment applies.
1. The indirect cost rate for the Federal award(including if the de minimis rate is charged per 2
CFR§200.414 Indirect(F&A)costs)is pre-determined based upon the State of Colorado and
CDPHE cost allocation plan.
2) Subrecipient shall at all times during the term of this contract strictly adhere to the requirements under
the Federal Award listed above, and all applicable federal laws,Executive Orders,and implementing
regulations as they currently exist and may hereafter be amended.
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3)Any additional requirements that CDPHE imposes on Subrecipient in order for CDPHE to meet its
own responsibility to the Federal awarding agency,including identification of any required financial and
performance reports,are stated in the Exhibits.
4) Subrecipient's approved indirect cost rate is as stated in the Exhibits.
5) Subrecipient must permit CDPHE and auditors to have access to Subrecipient's records and financial
statements as necessary for CDPHE to meet the requirements of 2 CFR§200.331 Requirements for pass
through entities, §§ 200.300 Statutory and National Policy Requirements through§200.309 Period of
performance, and Subpart F—Audit Requirements of this Part.
6)The appropriate terms and conditions concerning closeout of the subaward are listed in Section 16 of
this Attachment.
7)Performance and Final Status. Subrecipient shall submit all financial,performance, and other
reports to CDPHE no later than 45 calendar days after the period of performance end date or sooner
termination of this Contract containing an evaluation and review of Subrecipient's performance and the
final status of Subrecipient's obligations hereunder.
8)Matching Funds. Subrecipient shall provide matching funds as stated in the Exhibits. Subrecipient
shall have raised the full amount of matching funds prior to the Effective Date and shall report to CDPHE
regarding the status of such funds upon request. Subrecipient's obligation to pay all or any part of any
matching funds,whether direct or contingent,only extends to funds duly and lawfully appropriated for the
purposes of this Contract by the authorized representatives of the Subrecipient and paid into the
Subrecipient's treasury or bank account. Subrecipient represents to CDPHE that the amount designated as
matching funds has been legally appropriated for the purposes of this Contract by its authorized
representatives and paid into its treasury or bank account. Subrecipient does not by this Contract
irrevocably pledge present cash reserves for payments in future fiscal years, and this Contract is not
intended to create a multiple-fiscal year debt of the Subrecipient. Subrecipient shall not pay or be liable
for any claimed interest,late charges,fees,taxes or penalties of any nature,except as required by
Subrecipient's laws or policies.
9)Record Retention Period.The record retention period previously stated in this Contract is replaced
with the record retention period prescribed in 2 CFR§200.333.
10) Single Audit Requirements. If Subrecipient expends$750,000 or more in Federal Awards during
Subrecipient's fiscal year, Subrecipient shall procure or arrange for a single or program-specific audit
conducted for that year in accordance with the provisions of Subpart F-Audit Requirements of the
Uniform Guidance,issued pursuant to the Single Audit Act Amendments of 1996,(31 U.S.C.
7501-7507). 2 CFR §200.501.
11)Contract Provisions. Subrecipient shall comply with and shall include all of the following applicable
provisions in all subcontracts entered into by it pursuant to this Contract:
a. Office of Management and Budget Circulars and The Common Rule for Uniform
Administrative Requirements for Grants and Cooperative Agreements to State and Local
Governments,as applicable;
b.when required by Federal program legislation,the"Davis-Bacon Act",as amended(40
U.S.C. 3141-3148)as supplemented by Department of Labor Regulations(29 CFR Part 5,
"Labor Standards Provisions Applicable to Contracts Covering Federally Financed and
Assisted Construction");
c.when required by Federal program legislation,the Copeland"Anti-Kickback"Act(40 U.S.C.
3145), as supplemented by Department of Labor regulations(29 CFR Part 3,"Contractors
and Subcontractors on Public Building of Public Work Financed in Whole or in Part by Loans
or Grants from the United States").
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Amendment Contract Number:2020*3425 Amendment#3 Ver.25.02.20
DocuSign Envelope ID:A26B9129-AE6F-4634-B159-B496CB1A0E9A
d.42 U.S.C. 6101 et seq.,42 U.S.C.2000d,29 U.S.C. 794(regarding discrimination);
e.the"Americans with Disabilities Act"(Public Law 101-336;42 U.S.C. 12101, 12102, 12111 -
12117, 12131 - 12134, 12141 - 12150, 12161 - 12165, 12181 - 12189, 12201 - 12213 and 47
U.S.C.225 and 47 U.S.C. 611);
f.when applicable,the Contractor shall comply with the provisions of the"Uniform
Administrative Requirements for Grants and Cooperative Agreements to State and Local
Governments"(Common Rule);
g.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.
h. Contractor shall comply with the provisions of Section 601 of Title VI of the Civil Rights Act
of 1964,as amended.
i. Except as otherwise provided under 41 CFR Part 60,all contracts that meet the definition of
"federally assisted construction contract"in 41 CFR Part 60-1.3 comply with the equal
opportunity clause provided under 41 CFR 60-1.4(b),in accordance with Executive Order
11246,"Equal Employment Opportunity: (30 FR 12319, 12935,3 CFR Part, 1964-1965
Comp.,p. 339),as amended by Executive Order 11375,"Amending Executive Order 11246
Relating to Equal Employment Opportunity,"and implementing regulations at 41 CFR part
60,"Office of Federal Contract Compliance Programs,Equal Employment Opportunity,
Department of Labor.
j.where applicable,Contract Work Hours and Safety Standards Act(40 U.S.C. 3701-3708).k. if
the Federal award meets the definition of"funding agreement"under 37 CFR§ 401.2(a) and the
recipient or subrecipient wishes to enter into an agreement with a small business firm or
nonprofit organization, comply with the requirements of 37 CFR Part 401,"Rights to
Inventions Made by Nonprofit Organizations and Small Business Firms Under Government
Grants, Contracts and Cooperative Agreements,"and any implementing regulations issued
by the awarding agency.
1. the Clean Air Act(42 U.S.C. 7401-7671q.)and the Federal Water Pollution Control Act(33
U.S.C. 1251-1387),as amended.
m. if applicable,comply with the mandatory standards and policies on energy efficiency
contained within the State of Colorado's energy conservation plan issued in compliance with
the Energy Policy and Conservation Act,42 U.S.C. 6201.
n.the Contractor and all principals are not presently debarred, suspended,proposed for
debarment,declared ineligible,or voluntarily excluded from covered transactions by any
federal department or agency;the Contractor and all principals shall comply with all
applicable regulations pursuant to Executive Order 12549(3 CFR Part 1986 Comp.,p. 189)
and Executive Order 12689(3 CFR Part 1989 Comp.,p. 235),Debarment and Suspension;
and,
o. the Contractor shall comply where applicable,the Byrd Anti-Lobbying Amendment(31
U.S.C. 1352).
12)Compliance. Subrecipient shall comply with all applicable provisions of The Office of Management
and Budget Uniform Administrative Requirements,Cost Principles,and Audit Requirements for Federal
Awards(Uniform Guidance),including but not limited to these Supplemental Provisions for Federal
Awards.Any revisions to such provisions automatically shall become a part of these Supplemental
Provisions,without the necessity of either party executing any further instrument. CDPHE may provide
Page 3 of 4
Amendment Contract Number:2020"3425 Amendment#3 Ver.25.02.20
DocuSign Envelope ID:A26B9129-AE6F-4634-B159-B496CB1A0E9A
written notification to Subrecipient of such revisions,but such notice shall not be a condition precedent
to the effectiveness of such revisions.
13)Procurement Procedures. Subrecipient shall use its own documented procurement procedures which
reflect applicable State, local,and Tribal laws and regulations,provided that the procurements conform to
applicable Federal law and the standards identified in the Uniform Guidance,including without limitation,
§§200.318 through 200.326 thereof.
14)Certifications.Unless prohibited by Federal statutes or regulations,CDPHE may require
Subrecipient to submit certifications and representations required by Federal statutes or regulations on an
annual basis(2 CFR§200.208). Submission may be required more frequently if Subrecipient fails to
meet a requirement of the Federal award. Subrecipient shall certify in writing to CDPHE at the end of
the Contract that the project or activity was completed or the level of effort was expended. 2 CFR
§200.201(b)(3). If the required level of activity or effort was not carried out,the amount of the Contract
must be adjusted.
15)Event of Default.Failure to comply with the Uniform Guidance or these Supplemental Provisions for
Federal Awards shall constitute an event of default under the Contract pursuant to 2 CFR§200.339 and
CDPHE may terminate the Contract in accordance with the provisions in the Contract.
16)Close-Out. Subrecipient shall close out this Contract within 45 days after the End Date. Contract
close out entails submission to CDPHE by Subrecipient of all documentation defined as a deliverable in
this Contract,and Subrecipient's final reimbursement request. If the project has not been closed by the
Federal awarding agency within 1 year and 45 days after the End Date due to Subrecipient's failure to
submit required documentation that CDPHE has requested from Subrecipient,then Subrecipient may
be prohibited from applying for new Federal awards through the State until such documentation has
been submitted and accepted.
17)Erroneous Payments.The closeout of a Federal award does not affect the right of the Federal
awarding agency or CDPHE to disallow costs and recover funds on the basis of a later audit or other
review.Any cost disallowance recovery is to be made within the record retention period.
EXHIBIT END
Page 4 of 4
Amendment Contract Number:2020"3425 Amendment#3 Ver.25.02.20
ATTACHMENT B
DocuSign Envelope ID.04FOFE1D-A9B7-4CF9-A5E4-53493A459F54
EXHIBIT G
STATEMENT OF WORK
To Original Contract Number 19 FHHA 108899
Amendment Contract Number:2021*3521 Amendment#4
These provisions are to be read and interpreted in conjunction with the provisions of the contract specified
above.
Entity Name:Pitkin County Public Health Agency
II. Project Description: This project serves to reduce and eliminate vaccine-preventable diseases in Colorado
by increasing and maintaining immunization coverage. Local public health agencies will promote and
provide immunization services, and respond to strategic priorities identified by CDPHE, according to
established best practices and standards and in alignment with the Colorado Public Health Transformation
Core Public Health Services concepts.This project will protect the health of the residents of Colorado.
III. Definitions:
I.ACIP: Advisory Committee on Immunization Practices
2.CALPHO Colorado Association of Local Public Health Officials
3.CCC: Child Care Centers as defined by Colorado State Board of Health Rule 6 CCR 1009-2
4.CCR: Code of Colorado Regulations
5.CDC: Centers for Disease Control and Prevention
6.CDPHE: Colorado Department of Public Health and Environment
7.CIB: Colorado Immunization Branch
8.CIIS: Colorado Immunization Information System
9.Deputization: The formal extension of authority to provide VFC vaccines to eligible underinsured
children from a participating FQHC or RIIC to another VFC-enrolled provider:typically a local public
health agency. Previously called Delegation of Authority.
10.Evidence-based:Conscientious use of current scientific evidence and clinical expertise.
I I.FAQ: Frequently Asked Questions
12.FQHC: Federally Qualified Health Center
13.Core Immunization services: Immunization services with community stakeholders based on
evidence-based strategies to increase vaccination rates.
14. Insured: A person who is covered by health insurance.
15.Jurisdiction: Power or right of a legal or political agency to exercise its authority over a
person,subject matter,or territory.
16. MMR Measles,mumps,and rubella vaccine.
17. MOU: Memorandum of Understanding
18. RHC: Rural Health Center
19. School: As defined by the Colorado Board of Health rule 6 CCR 1009-2.all child care
facilities licensed by the Colorado Department of Human Services including:child care centers.
school-age child care center,preschools,day camps,resident camps,day treatment centers,
family child care homes,foster care homes,and head start programs:public.private,or parochial
kindergarten,elementary or secondary schools through grade twelve,or a college or university.
20. Section 317 Vaccine: Vaccine funding used to support infrastructure critical to vaccine
program success including vaccine for:uninsured and underinsured adults,outbreak response
and preparedness support.
21. VFC: Vaccines for Children
22. VPD: Vaccine-preventable disease
23. WIG: Wildly Important Goal-a current strategic priority of CDPIIE
Page I of 7
Amendment Contract Number:2021*3521 Amendment#4
DocuSign Envelope ID:04FOFE1D-A967-4CF9-A5E4-53493A459F54
EXHIBIT G
IV. Work Plan:
Goal#1: Reduce vaccine-preventable diseases in Colorado by increasing or maintaining immunization
coverage.
Objective#1: No later than the expiration of the contract,provide core immunization services intended to
improve the health of individuals and communities.
Primary Activity#1 The Contractor shall implement core immunization services within its
jurisdiction.
Sub-activities#1 I. The Contractor shall promote within their jurisdiction all ACIP-
recommended VFC vaccines through the VFC program for the population
served.
2. The Contractor shall analyze the need for provision of immunizations
within their jurisdiction.
a. According to the analysis,the Contractor shall provide
immunizations within their jurisdiction.
3. The Contractor shall promote within their jurisdiction that children eligible
for VFC vaccine per ACIP recommendations are screened and vaccinated.
4. The Contractor shall promote within their jurisdiction all ACIP-
recommended Section 317 vaccines are available through the Section 317
program for the population served.
5. The Contractor shall promote within their jurisdiction that persons eligible
for Section 317 vaccine per ACIP recommendations are screened and
vaccinated.
6. The Contractor shall promote within their jurisdiction that inventory of all
ACIP-rccommcndcd private vaccines is available for the insured population
served.
a. The Contractor shall refer insured clients to health care providers
outside of their jurisdiction in instances that private vaccine is not
available within their jurisdiction.
7. The Contractor shall promote within their jurisdiction that persons eligible
for private vaccine per ACIP recommendations are screened and
vaccinated.
8. The Contractor shall submit immunization data to CIIS for all
immunizations administered by their agency within 14 days of vaccine
administration.
9. The Contractor shall promote use of CIIS to providers in their jurisdiction.
10. The Contractor shall review the county level Immunization Rates Report
for the following information:
a. Children 19-35 months of age no later than 30 days after distribution
by CIB
b. Adolescents 13-17 years of age no later than 30 days after distribution
by CIB
c. Compare to the CDC National Immunization Surveys;Child and Teen
and CIIS-generated statewide rates provided by CIB in order to
increase awareness of county versus state and national immunization
rates within the 30 days that the rates report is distributed by the CIB.
Page 2 of 7
Amcndmcnt Contract Number-2021 s3521 Amcndmcnt#4
DocuSlgn Envelope ID.04FOFEID-A9B7-4CF9-A5E4-53493A459F54
EXHIBIT G
11. The Contractor shall provide immunization subject matter expertise to the
following:
a. Decision makers
b. Policy makers
c. Health carc providers
d. The public
12. The Contractor shall meet with local stakeholders to implement a minimum
of one(1)evidence-based strategy that is culturally and linguistically
appropriate to eliminate the following:
a. immunization disparities by race
b. immunization disparities by ethnicity
c.immunization disparities by socio-cconomic status
13. The Contractor shall promote informed vaccine decision making by
educating a minimum of one(1)of the following:
a. consumers
b. health care providers
c. stall who administer immunizations
d. policy makers
14.The Contractor shall address vaccine hesitancy by educating a minimum of
one(1)of the following:
a.consumers
b.health carc providers
c.staff who administer immunizations
d.policy makers
15. The Contractor shall promote vaccine services availability by educating a
minimum of one(1)of the following:
a. consumers
b. healthcare providers
c. staff who administer immunizations
d. policy makers
16. The Contractor shall promote seasonal influenza vaccine to improve
preparedness in the event of an influenza pandemic according to the
following criteria:
a.The Contractor shall promote seasonal influenza vaccine
with new organizations.
b.The Contractor shall continue seasonal influenza vaccine
coordination with existing organizations.
c.The Contractor shall promote seasonal influenza vaccine
with commercial sector organizations.
17. Thc Contractor shall maintain a dcputization MOU with an FQHC/RHC.
18. The Contractor shall deliver information to schools and CCCs about
the Colorado State Board of Health Rule 6 CCR 1009-2 annual reporting
requirement.
a. The Contractor shall follow up with schools who fail to report data.
b. The Contractor shall follow up with CCCs who fail to report data.
19. The Contractor shall support a network of VFC providers.
a. The Contractor shall perform ongoing recruitment of new VFC
providers.
Page 3 of 7
DocuSign Envelope ID:04FOFE1D-A9B7-4CF9-A5E4-53493A459F54
EXHIBIT G
b. The Contractor shall educate current VFC providers about the VFC
program requirements.
20. The Contractor shall respond to cases of VPD in their jurisdiction in order
to implement core immunization services.
21. The Contractor shall maintain staff readiness for a VPD outbreak.
22. The Contractor shall participate in CIB Immunization calls for up-to-date
information.
a. The Contractor shall listen to the audio recording of the call
provided by the CIB within 30 days when the Contractor does not
attend call.
23.The Contractor shall attend a minimum of one(1)immunization-related
training or conference.
Objective#2: No later than the expiration of the contract,the Contractor shall implement evidence-based
strategies to improve immunization rates in populations identified as undcrimmunizcd by CDPHE.
Primary Activity#1 The Contractor shall utilize immunization strategies to address strategic
priorities identified by CDPHE.
Sub-Activities#1 1. The Contractor shall utilize immunization strategies to address
underimmunization in populations as defined in the WIG.
2. The Contractor shall review the list of strategics from Strategies to improve
Colorado vaccination rates.
3. The Contractor shall plan local activities to use evidence-based strategies
that are culturally and linguistically appropriate to increase immunization
rates with the following:
a. Health care providers
b. Pharmacists
c. Long-term care facility staff
d. Infection control specialists
c. School officials
f. The public
Standards and 1. The content of electronic documents located on CDPIIE and non-CDPIIE
Requirements websitcs and information contained on CDPHE and non-CDPHE websitcs
may be updated periodically during the contract term. The contractor shall
monitor documents and website content for updates and comply with all
updates.
2. The Contractor shall use the final results of the CDC National Immunization
Surveys:Child and Teen and CIIS-generated statewide rates provided by
CIB via email communication in order to increase awareness of county
versus state and national immunization rates.
3. The Contractor shall comply with the requirements for entering/submitting
immunization data into CIIS as agreed to in the CIIS Letter of Agreement
found within the online CIIS Resource Center located on the following
website,https:;7www.cophr.com/emrlogin.asp.The content of this website is
incorporated and made part of this contract by reference.
Page 4of7
Amendment Contract Number:2021*3521 Amendment#4
Ver.01.t t.19
DocuSign Envelope ID:04FOFE 1 D-A967-4CF9-A5E4-53493A459F54
EXHIBIT G
4. The Contractor shall comply with the ACIP recommendations for vaccine
administration located on the following website,
http: www.cdc.gov?vaccincsracipiindex.html. The content of this website is
incorporated and made part of this contract by reference.
5. The Contractor shall promote compliance with school immunization rules
within the Colorado State Board of Health Rule 6 CCR 1009-2 located on
the following website,
httns://www,sos.statc.co.usiCCRIGencrateRulePdf.do?ru l c V crs i on l d=7698
&fileName 6%20CCR".•e201009-2.This document establishes
immunization standards and is incorporated and made part of this contract
by reference.
6. The Contractor shall create a login to access the school and childcare
immunization data for the Contractor's jurisdiction located on the following
website,https:r,'www.colorado.govipacific/cdphelschool-and-child-care-
immunization-data-reporting.The content of this website is incorporated and
made part of this contract by reference.
7. The Contractor shall maintain a signed VFC recertification agreement when
providing VFC vaccines for their jurisdiction.
8. The Contractor shall comply with the requirements for utilizing VFC
vaccine agreed to in the VFC recertification agreement packet provided by
CIB when providing VFC vaccines for their jurisdiction.
9. The Contractor shall comply with the eligibility requirements for utilizing
Section 317 vaccine as provided by CIB via email when providing 317
vaccines for their jurisdiction.
10. The Contractor shall use a minimum of one(1)evidence-based strategy to
eliminate coverage disparities by race,ethnicity and socio-economic status
located on the following website,
httns:/i docs.goo elc.comidocument id/l t9ZsuW2zmaY-1S-
I.nTrNiciCmaCX7aUtvVam62fvlJ8i ediYhs-5f3b39bc.The content of this
website is incorporated and made part of this contract by reference.
11. The Contractor shall use deputization MOU guidance as provided by CIB
via email.
12. CDPHE will provide programmatic technical assistance,upon request.
13. The Contractor shall complete an electronic quarterly progress report using
the FY22 Immunization Core Services Quarterly Progress Report,via the
following website,httns:ffs9.fonnsite.com./ColoradolMMnroeramiFY22-
Core-PraeressReportlindex.html. The content of this website is incorporated
and made part of this contract by reference.
14. The Contractor shall complete the final electronic quarterly progress
report as a non-reimbursable deliverable.
15. The Contractor shall provide signed VFC recertification packet and
agreements via the following wcbsitc when providing VFC vaccines for their
jurisdiction:
httns:?'fs9 formsite.corn'ColoradolMMnroeramidvedvwe52nrrndex.html.
DocuSign Envelope ID.04FOFE1 D-A9B7-4CF9-A5E4-53493A459F54
EXHIBIT G
The content of this website is incorporated and made pan of this contract by
reference.
16. The Contractor shall utilize strategies of CALPHO and CDPHE's Colorado
Public Health System Transformation:Core Public Health Services Needs
Assessment Report.Jan 2020 located on the following website,
https://drive.google.com/file/d/13ffhiCLlvmOlZchifJkeNW4MiRhxLr it
w?usn=sharine.This document establishes immunization standards and is
incorporated and made part of this contract by reference.
17. The Contractor shall access the MMR Dashboard and Report Card via the
following website:
httpsa/cohealthviz.dphe.state.co.usit/DCEED_Publ ieiviewsIMMRFactSheeti
MMRFactShcctl ntra'?:showAppBanner—false&:di splay_count=n&:showV iz
Home—n&:origin—viz share_link.The content of this website is
incorporated and made part of this contract by reference.
18. The Contractor shall strive to meet immunization targets for their
jurisdiction set by the CIB to attain a WIG.
19. CDPHE will provide each jurisdiction's immunization targets via email
within 90 days of the execution of the contract.
20. The Contractor shall promote immunizations by utilizing fact-based
strategies from Strategies to improve Colorado vaccination rates located on
the following website,
httns:lidocs.gooule.comdocumenti di l t9Zsu W 2rmaY-IS-
LpTrNicjCmaCXzaUtvVam62fylJ8tcdit?usp=sharing.The content of this
website is incorporated and made part of this contract by reference.
21. The CIB will maintain a FAQ document to address questions regarding thi
project located on the following website:
rttps:lldocs.gongle.comldocumenti d119HwfWeWg5hv57V vWJH57.7sHp1?r
OPuRvGSRT8kzwxOh4/edit?usp=sharing. Thc content of this website is
incorporated and made part of this contract by reference.
Expected Results of 1. Immunizations arc offered within the Contractor's jurisdiction.
Activity(s) 2. Immunizations arc marketed within the Contractor's jurisdiction.
3. Immunizations arc administered within the Contractor's jurisdiction.
Measurement of Expected I. Data contained in Immunization Rates Report.
Results 2. Data contained in the CDPHE Dashboard and Report Card.
3. Data contained in quarterly progress reports.
Completion Date
Deliverables I.All Contractors providing VFC vaccines shall No later than 30
electronically submit signed VFC recertification business days
packet and agreements. following the receipt of
the recertification
packet
2.The Contractor shall submit an electronic quarterly No later than 30
progress report using the FY22 Immunization Core calendar days
Services Quarterly Progress Report. following the last
calendar day of
Page 6 of 7
Amendment Contract Number:202I*3521 Amendment#4
DocuSign Envelope ID:O4FOFE1D-A9B7-4CF9-A5E4-53493A459F54
I•:\IIIHII (�
September.December.
and March
3.The Contractor shall submit the final electronic No later than 15 days
quarterly progress report using the FY22 Immunization after the end term of
Core Services Quarterly Progress Report. the contract
4.The Contractor shall submit immunization data for No later than 14 days
all immunizations administered by the Contractor's following vaccine
agency to CIIS. administration
Monitoring:
CDPHE's monitoring of this contract for compliance with performance requirements will be conducted
throughout the contract period by the CDPI IF.Contract Monitor. Methods used will include a review of
documentation determined by CDPHE to be reflective of performance to include progress reports and other
fiscal and programmatic documentation as applicable.The Contractor's performance will be evaluated at
set intervals and communicated to the contractor.
VI. Resolution of Non-Compliance:
The Contractor will be notified in writing within 15 calendar days of discovery of a compliance issue.
Within 30 calendar days of discovery,the Contractor and the State will collaborate,when appropriate,to
determine the action(s)necessary to rectify the compliance issue and determine when the action(s)must be
completed. The action(s)and timeline for completion will be documented in writing and agreed to by both
parties. If extenuating circumstances arise that requires an extension to the timeline,the Contractor must
email a request to the CDPHE Contract Monitor and receive approval for a new due date.The State will
oversee the completion/implementation of the action(s)to ensure timelines arc met and the issue(s)is
resolved. If the Contractor demonstrates inaction or disregard for the agreed upon compliance resolution
plan,the State may exercise its rights under the provisions of this contract.
Page 7 of 7
Amendment Contract Number:2021*3521 Amendment#4
ATTACHMENT C
2021
MEMORANDUM OF UNDERSTANDING
For Information Technology Infrastructure Services and Support
Pitkin County,Colorado and Community Health Services
This Memorandum of Understanding is made this 1st day of January, 2021, between
Pitkin County, Colorado (the County) and Community Health Services (Community
Health)called,respectively,(the Parties).
The Parties understand and agree that the Information Technology Infrastructure Services
and Support(IT Support) outlined in this MOU arc subject to available appropriations by
the County who will not be obligated to provide these services if adequate appropriations
have not been made.
Pitkin County Business Information Technology Services(BITS)will provide IT support
as listed below:
Item
Unit Cost
Network Infrastructure(servers, switches, Internet, help desk,etc)
$75
Workstations, PCs,Tablets, Smart Phones
$25
Phone System
$20
Monthly Per Capita Cost
$120
Item Unit Cost Totals
Network Infrastructure
(servers, switches,
Internet, help desk, etc) S75 Per Capita Monthly Cost $120
Phone System $20 Per Capita Annual Cost $1,440
Workstations,PCs, Tablets,
Smart Phones $25 - 8 Employees Annual Cost $11,520
The following terms are agreed to by the Parties:
1. TERM
The term of this MOU will be from January 1, 2021 through December 31, 2021.
2. CLAUSES
By mutual agreement Clauses may be added to this MOU.
3. SEVERABILITY
To the extent that this MOU is executed, and performance of the obligations of the Parties
may be accomplished within the intent of the MOU, the terms of the MOU are severable.
Thus, should any Clause or provision herein be declared invalid or become inoperative
for any reason, such invalidity or failure shall not affect the validity of any other Clause
or provision herein. The waiver of any breach of term herein shall not he construed as a
waiver of any other term, or of the same term upon subsequent breach.
2
4. INTEGRATION OF UNDERSTANDING
This MOU is intended as the complete integration of the understanding between the
Parties concerning the matters negotiated between them and incorporated in this MOU.
No prior or contemporaneous addition,deletion,or other amendment hereto shall have
any force or effect whatsoever unless embodied in writing. No subsequent notation,
renewal,addition,deletion,or other amendment hereto shall have any force or effect
unless embodied in a written amendment executed by the parties.
5. NO THIRD PARTY BENEFICIARY
This MOU is binding on the Parties,as well as their respective successors and assigns. It
is agreed that the enforcement of the terms and conditions of this MOU are reserved for
the Parties, to the extent permitted by law. Nothing contained in this MOU allows a claim
or right of action by a third party.Any third party receiving benefits under the provisions
of this MOU is deemed an incidental beneficiary.
6. DISPUTE RESOLUTION
Subsequent to the execution of this document,both parties will work in good faith to
resolve any dispute arising from any provision of the Clauses of this executed MOU. If
the parties are unable to resolve such dispute, binding arbitration will be effected.
3
MOU for Information Technology Shared Services Clauses
PITKIN COUNTY COMMUNITY HEALTH SERVICES
Carrie K Fleischman, Director of IT Liz Sta Executive Director
C /l P&Aited6Pta•P
Date: 6/1112021 Date: J 7/3-(
4
Attachment C
DocuSign
Certificate Of Completion
Envelope Id: BC07C04A2E894C34A939CB23BDB18E52 Status:Completed
Subject:Community Health Services I Pitkin County Change Order 272.19 E for Review and Signature
Source Envelope:
Document Pages:36 Signatures:3 Envelope Originator:
Certificate Pages:5 Initials:0 Pitkin County Procurement
AutoNav: Enabled 530 East Main Street
Envelopeld Stamping: Disabled Suite 203
Time Zone: (UTC-07:00)Mountain Time(US&Canada) Aspen,CO 81611
Procurement@PitkinCounty.com
IP Address:216.237.91.144
Record Tracking
Status:Original Holder:Pitkin County Procurement Location: DocuSign
1/13/2022 2:51:34 PM Procurement@PitkinCounty.com
Signer Events Signature Timestamp
Jordana Sabella Sent: 1/20/2022 6:30:06 AM
Jordana.Sabella@PitkinCounty.com jo hkut Salkt,lt.a Viewed: 1/27/2022 9:58:58 AM
Public Health Director Signed: 1/27/2022 10:07:05 AM
Pitkin County
Security Level: Email,Account Authentication Signature Adoption: Pre selected Style
(None) Using IP Address:73.95.153.34
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Logan Hood Sent: 1/27/2022 10:07:06 AM
logan.hood@aspencommunityhealth.org ()Oita& &OO,4 Viewed: 1/27/2022 11:39:25 AM
Executive Director Signed: 1/27/2022 11:42:56 AM
Security Level: Email,Account Authentication
(None) Signature Adoption: Pre-selected Style
Using IP Address:67.164.181.99
Electronic Record and Signature Disclosure:
Accepted: 1/27/2022 11:44:06 AM
ID:706fcacf-c67a-4b16-b965-120a87041162
Company Name:Pitkin County,Colorado
Phylis Mattice n,L_� Sent: 1/27/2022 11:42:57 AM
,V phylis.mattice@pitkincounty.com P(u1(iS l`CL Viewed: 1/27/2022 12:07:41 PM
Assistant County Manager Signed: 1/27/2022 12:08:11 PM
Signing Group:County Manager Group
Signature Adoption: Pre-selected Style
Security Level: Email,Account Authentication
(None) Using IP Address:24.9.202.118
Electronic Record and Signature Disclosure:
Accepted: 1/27/2022 12:07:41 PM
ID:0485d70f-b405-452e-9894-94febaed9bc9
Company Name:Pitkin County,Colorado
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Kurt Dahl VIEWED Sent: 1/13/2022 3:01:02 PM
kurt.dahl@pitkincounty.com Viewed: 1/20/2022 6:30:05 AM
Security Level: Email,Account Authentication
(None)
Using IP Address:73.3.201.217
Viewed using mobile
Electronic Record and Signature Disclosure:
Accepted: 1/20/2022 6:30:05 AM
ID:4a056628-aeb7-43b1-9ad2-b9fc281ae7f0
Company Name:Pitkin County,Colorado
Carbon Copy Events Status Timestamp
Pitkin County Procurement COPIED Sent: 1/27/2022 12:08:13 PM
procurement@pitkincounty.com Resent: 1/27/2022 12:08:19 PM
Procurement Viewed: 1/27/2022 1:02:57 PM
Pitkin County
Security Level: Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Accounts Payable COPIED Sent: 1/27/2022 12:08:13 PM
AP@pitkincounty.com
Accounts Payable
Pitkin County
Security Level: Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 1/13/2022 3:01:02 PM
Certified Delivered Security Checked 1/27/2022 12:07:41 PM
Signing Complete Security Checked 1/27/2022 12:08:11 PM
Completed Security Checked 1/27/2022 12:08:13 PM
Payment Events Status Timestamps
Electronic Record and Signature Disclosure
Electronic Record and Signature Disclosure created on:3/20/2020 3:28:13 PM
Parties agreed to:Logan Hood,Phylis Mattice,Kurt Dahl
ELECTRONIC RECORD AND SIGNATURE DISCLOSURE
From time to time, Pitkin County(we, us or Pitkin County)may be required by law to provide
you with certain written notices or disclosures. Described below are the terms and conditions for
providing to you such notices and disclosures electronically when we send you documents for
electronic signature.
Acknowledging your Access, Intent, and Consent to Receive and Sign Materials
Electronically
To confirm that you can access this information electronically, which will be similar to other
electronic notices and disclosures that we will provide to you,please verify that you were able to
read this electronic disclosure and that you also were able to print on paper or electronically save
this page for your future reference and access or that you were able to e-mail this disclosure and
consent to an address where you will be able to print on paper or save it for your future reference
and access. Further, if you consent to receive notices and disclosures exclusively in electronic
format on the terms and conditions described above,please let us know by clicking the 'I agree'
button below.
By checking the 'I Agree' box, I confirm that:
• I am establishing my intent to be bound to the transaction, and indicating that I am fully
aware of the purpose for which the signature is being provided.
• I can access and read this Electronic CONSENT TO ELECTRONIC RECEIPT OF
ELECTRONIC RECORD AND SIGNATURE DISCLOSURES document; and
• I can print on paper the disclosure or save or send the disclosure to a place where I can
print it, for future reference and access; and
• Until or unless I notify Pitkin County as described above, I consent to receive from
exclusively through electronic means all notices, disclosures, authorizations,
acknowledgments, and other documents that are required to be provided or made
available to me by Pitkin County during the course of my relationship with you.
Signing Documents without a Pitkin County DocuSign Account:
Pitkin County may not require all document signers to be authorized users of the Pitkin County
DocuSign Account. Please read the information below carefully and thoroughly, and if you can
access this information electronically to your satisfaction and agree to these terms and
conditions, please confirm your agreement by clicking the 'I agree'button at the bottom of this
document. When you don't have a DocuSign account, you will be provided the opportunity to
agree to the Legal Disclosure each time you open an "envelope" for signing, at this time, you can
download and retain this disclosure. Pitkin County will forward completed documents that
you've reviewed, processed or signed via email. Should you require copies of these signed
documents (e.g., if they get deleted from your email account) you should request those
documents from Pitkin County under the Colorado Open Records Act by contacting the Pitkin
County custodian who sent you the document for signature.
Signing Documents with a Pitkin County DocuSign Account:
Please read the information below carefully and thoroughly, and if you can access this
information electronically to your satisfaction and agree to these terms and conditions,please
confirm your agreement by clicking the 'I agree'button at the bottom of this document.
Getting paper or electronic copies
At any time, you may request from us a paper or electronic copy of any record provided or made
available electronically to you by us. For such copies, as long as you are an authorized user of
the DocuSign system you will have the ability to download and print any documents we send to
you through your DocuSign user account for a limited period of time (usually 30 days) after such
documents are first sent to you. After such time, if you wish for us to send you paper or
electronic copies of any such documents from our office to you, you may be charged a per-page
fee. You may request delivery of such paper or electronic copies from us by following the
procedure described below.
Withdrawing your consent
If you are an authorized DocuSign Account holder, you can decide to receive notices and
disclosures from us electronically, you may at any time change your mind and tell us that
thereafter you want to receive required notices and disclosures only in paper format. Described
below is the process for informing us of your decision to receive future notices and disclosure in
paper format and also how to withdraw your consent to receive notices and disclosures
electronically.
Consequences of changing your mind
If you elect to receive required notices and disclosures only in paper format, it will slow the
speed at which we can complete certain steps in transactions with you and delivering services to
you because we will need first to send the required notices or disclosures to you in paper format,
and then wait until we receive back from you your acknowledgment of your receipt of such
paper notices or disclosures. To indicate to us that you are changing your mind, you must
withdraw your consent using the DocuSign'Withdraw Consent' form on the signing page of your
DocuSign account. This will indicate to us that you have withdrawn your consent to receive
required notices and disclosures electronically from us and you will no longer be able to use your
DocuSign user account to receive required notices and consents electronically from us or to sign
electronically documents from us.
All notices and disclosures will be sent to you electronically
Unless you tell us otherwise in accordance with the procedures described herein, we will provide
electronically to you through your DocuSign user account all required notices, disclosures,
authorizations, acknowledgments, and other documents that are required to be provided or made
available to you during the course of our relationship with you. To reduce the chance of you
inadvertently not receiving any notice or disclosure, we prefer to provide all of the required
notices and disclosures to you by the same method and to the same address that you have given
us. Thus, you can receive all the disclosures and notices electronically or in paper format through
the paper mail delivery system. If you do not agree with this process,please let us know as
described below. Please also see the paragraph immediately above that describes the
consequences of your electing not to receive delivery of the notices and disclosures
electronically from us.
How to contact Pitkin County:
You may contact us to let us know of your changes as to how we may contact you electronically,
to request paper copies of certain information from us, and to withdraw your prior consent to
receive notices and disclosures electronically as follows:
To contact us by email send messages to Helpdesk@provelocity.com
To advise Pitkin County of your new e-mail address
To let us know of a change in your e-mail address where we should send notices and disclosures
electronically to you, you must send an email message to us at Helpdesk@provelocity.com and
in the body of such request you must state: your previous e-mail address, your new e-mail
address .
In addition, you must notify DocuSign, Inc to arrange for your new email address to be reflected
in your DocuSign account by following the process for changing e-mail in DocuSign.
To request paper or electronic copies from Pitkin County
To request delivery from us of paper or electronic copies of the notices and disclosures
previously provided by us to you electronically, you should request those documents from Pitkin
County under the Colorado Open Records Act by contacting the Pitkin County custodian who
sent you the document for signature.
To withdraw your consent with Pitkin County
To inform us that you no longer want to receive future notices and disclosures in electronic
format you may:
i. decline to sign a document from within your DocuSign account, and on the subsequent
page, select the check-box indicating you wish to withdraw your consent, or you may;
ii. send us an e-mail to Helpdesk@provelocity.com and in the body of such a request, you
must state your e-mail, full name, Postal Address, telephone number, and account
number.