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Home My WebLink About20111611.tiff MEMORANDUM 1861 - 2011 DATE: June 28, 2011 W E L D„C O U N T Y TO: Barbara Kirkmeyer, Chair, Board of Co nty ommissioners FR: Judy A. Griego, Director, Human ervice RE: Respite Agreements between the eld County Department of Human Services and Various Providers To Be Placed on Consent Agenda Enclosed for Board approval are Respite Agreements between the Department and Various Providers. These Agreements can be placed on the Consent Agenda. The major provisions for these Agreements are as follows: No. Provider Term Rate 1 Dodge, Trena July 1, 2011—June 30, 2012 $16.75 per each four hour period Max. $67.00 per month for 16 hours 2 Ficek, Jone July 1, 2011—June 30, 2012 $16.75 per each four hour period Max. $67.00 per month for 16 hours 3 Foster, Denise July 1, 2011—June 30, 2012 $16.75 per each four hour period Max. $67.00 per month for 16 hours 4 Gomez, Christina and July 1, 2011—June 30, 2012 $16.75 per each four hour period Oswald Max. $67.00 per month for 16 hours 5 Hernandez, Roberto July 1, 2011—June 30, 2012 $16.75 per each four hour period Max. $67.00 per month for 16 hours 6 Jude, Rebecca July 1, 2011—June 30, 2012 $16.75 per each four hour period Max. $67.00 per month for 16 hours 7 Klotzbach, Anthony July 1, 2011—June 30, 2012 $16.75 per each four hour period Max. $67.00 per month for 16 hours J 8 Luckeroth, Dayna July 1, 2011—June 30, 2012 $16.75 per each four hour period Max. $67.00 per month for 16 hours '-s N 9 Mauk, Harriett July 1, 2011—June 30, 2012 $16.75 per each four hour period S Max. $67.00 per month for 16 hours 10 Maronek, Pat July I, 2011—June 30, 2012 $16.75 per each four hour period // /"C sG Max. $67.00 per month for 16 .13 ,`f1/ hours fie// 2011-1611 7—/ - 11 Meyer, Debra July 1, 2011—June 30, 2012 $16.75 per each four hour period Max. $67.00 per month for 16 hours 12 Middleton, Deborah July 1, 2011—June 30, 2012 $16.75 per each four hour period Max. $67.00 per month for 16 hours 13 Miller, Jane July 1, 2011—June 30, 2012 $16.75 per each four hour period Max. $67.00 per month for 16 hours 14 Miller, Pamela July 1, 2011—June 30, 2012 $16.75 per each four hour period Max. $67.00 per month for 16 hours 15 Moore, Earl July 1, 2011—June 30, 2012 $16.75 per each four hour period Max. $67.00 per month for 16 hours 16 Olivas, Cynthia July 1, 2011—June 30, 2012 $16.75 per each four hour period Max. $67.00 per month for 16 hours 17 Ramos, Julian July 1, 2011—June 30, 2012 $16.75 per each four hour period Max. $67.00 per month for 16 hours 18 Riehm, Fred and July I, 2011—June 30, 2012 $16.75 per each four hour period Pauline Max. $67.00 per month for 16 hours 19 Roderick, Chelsi July 1, 2011—June 30, 2012 $16.75 per each four hour period Max. $67.00 per month for 16 hours 20 Rodriguez, Mary July 1, 2011—June 30, 2012 $16.75 per each four hour period Max. $67.00 per month for 16 hours 21 Skeldum, Willliam July 1, 2011—June 30, 2012 $16.75 per each four hour period Max. $67.00 per month for 16 hours 22 Vincent, Jessica and July 1, 2011—June 30, 2012 $16.75 per each four hour period Ryan Max. $67.00 per month for 16 hours 23 Weber-Malpiede, Pat July 1, 2011—June 30, 2012 $16.75 per each four hour period Max. $67.00 per month for 16 hours If you have questions, please give me a call at extension 6510. 11-l2-RESPITE CARE CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND PROVIDER This Agreement, made and entered into the day of ,20 ,by and between the Board of Weld County Commissioners, sitting as the Board of Human on behalf of the Weld County Department of Human Services, hereinafter referred to as"Human Services," and Tr4.c& Do tile_ referred to as"Provider". WITNESSETH WHEREAS,required approval, clearance, and coordination have been accomplished from and with appropriate agencies; and WHEREAS, the Colorado Department of Human Services has provided Child Welfare Regular Administration funding for respite care for county foster care PROVIDERS and WHEREAS, Provider is a for-profit Sole-Proprietor. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: 1. Term This Agreement shall become effective on July 1,20,«, upon proper execution of this Agreement and shall expire June 30,20 (unless sooner terminated as provided herein. 2. Scope of Services Services shall be provided by Provider to any person(s)eligible for child protection services in compliance with Exhibit A "Scope of Services,"a copy of which is attached by reference. 3. Payment a. Payment shall be made on the basis of Exhibit B, "Payment Schedule,"copies of which are attached hereto and incorporated herein by reference. b. "Payment Schedule"shall establish the maximum reimbursement, which will be paid from Child Welfare Regular Administration funds during the duration of this Agreement. c. PROVIDER shall submit an itemized monthly bill to Human Services for all costs incurred and services provided pursuant to Exhibit A of this Agreement in accordance with criteria established by Human Services. PROVIDER shall submit all itemized monthly billings to Human Services no later than the twenty-fifth (25)day of the month following the month the cost was incurred. d. Payments of costs incurred pursuant to this Agreement are expressly contingent upon the availability of Child Welfare Regular Administration funds to Human Services. e. Human Services shall not be billed for, and reimbursement shall not be made for time involved in activities outside of those defined in Exhibit A. Work performed prior to the execution of this Contract shall not be reimbursed or considered part of this Agreement. 4. Financial Management At all times from the effective date of this Contract until completion of this Contract, PROVIDER shall comply with the administrative requirements, cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expend l under Child Welfare Regular Administration funding must conform to the Single Audit Act of 1984 and 003 Circular A-133. Page 1 of 9 I1-12-RESPITE CARE 5. Payment Method Unless otherwise provided in the Scope of Services and Payment Schedule: a. PROVIDER shall provide proper monthly invoices and itemization of services performed for costs incurred in the performance of the agreement. b. Human Services may withhold any payment if PROVIDER has failed to comply with the Financial Management Requirements,program objectives, contractual terms, or reporting requirements. In the event of a forfeiture of reimbursements, PROVIDER may appeal such circumstance to the Director of Human Services. The decision of the Director of Human Services shall be final. 6. Assurances PROVIDER shall abide by all assurances as set forth in the attached Exhibit C,which is attached hereto and incorporated herein by reference. 7. Compliance with Applicable Laws At all times during the performance of this contract, PROVIDER shall strictly adhere to all applicable federal and state laws, orders, and all applicable standards,regulations, interpretations or guidelines issued pursuant thereto. This includes the protection of the confidentiality of all applicant/recipient records,papers, documents, tapes and any other materials that have been or may hereafter be established which relate to the Contract. PROVIDER acknowledges that the following laws are included: - Title VI of the Civil Rights Act of 1964,42 U.S.C. Sections 2000d—1 et. seq.and its implementing regulation, 45 C.F.R. Part 80 et seq.• and - Section 504 of the Rehabilitation Act of 1973,29 U.S.C. Section 794,and its implementing regulations,45 C.F.R.Part 84;and - the Age Discrimination Act of 1975,42 U.S.C.Sections 6101 eL seq. and its implementation regulations,45 C.F.R. Part 91;and - Title VII of the Civil Rights Act of 1964;and - the Age Discrimination in Employment Act of 1967;and - the Equal Pay Act of 1963;and - the Education Amendments of 1972;and - immigration Reform and Control Act of 1986,P.L.99-603; - 42 C.F.R.Part 2 and all regulations applicable to these laws prohibiting discrimination because of race, color, National origin, and sex, religion and handicap, including Acquired Immune Deficiency syndrome (AIDS) or AIDS related conditions, covered under Section 504 of the Rehabilitation Act of 1973, as amended, cited above. If necessary, PROVIDER and Human Services will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 CFR Part 2. Included in 45 C.F.R. Part 74 Appendix G 9, which requires that affirmative steps be taken to assure that small and minority businesses are utilized, when possible, as sources of supplies, equipment, construction and services. This assurance is given in consideration of and for the purpose of obtaining any and all federal and/or state financial assistance. Any person who feels that s/he has been discriminated against has the right to file a complaint either with the Colorado Department of Human Services or with the U.S. Department of Health and Human Services, Office for Civil Rights. 8. Certifications PROVIDER certifies that, at the time of entering into this Contract, it has currently in effect all necessary licenses, approvals, insurance, etc., required to properly provide the services and/or supplies covered by this contract. A copy of certificate will be provided to Human Services upon completion of this agreement. Failure to do so will null and void this contract in its entirety. Page 2 of 9 11-12-RESPITE CARE 9. Monitoring.and Evaluation PROVIDER and Human Services agree that monitoring and evaluation of the performance of this Agreement shall be conducted by PROVIDER and Human Services. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners and PROVIDER. PROVIDER shall permit Human Services, and any other duly authorized agent or governmental agency,to monitor all activities conducted by PROVIDER pursuant to the terms of this Agreement. As the monitoring agency may in its sole discretion deem necessary or appropriate, such program data, special analyses, on-site checking, formal audit examinations, or any other reasonable procedures. All such monitoring shall be performed in a manner that will not unduly interfere with agreement work. 10. Modification of Agreement All modifications to this agreement shall be in writing and signed by both parties. 11. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find PROVIDER substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by PROVIDER. These remedial actions are as follows: a. Withhold payment to PROVIDER until the necessary services or corrections in performance are satisfactorily completed; h. Deny payment or recover reimbursement for those services or deliverables, which have not been performed and which due to circumstances caused by PROVIDER cannot be performed or if performed would be of no value to I Iuman Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; c. Incorrect payment to PROVIDER due to omission,error,fraud,and/or defalcation shall be recovered from PROVIDER by deduction from subsequent payments under this Agreement or other agreements between I luman Services and PROVIDER,or by Iluman Services as a debt due to Human Services or otherwise as provided by law. 12. Representatives For the purpose of this Agreement, the individuals identified below are hereby designated representatives of the respective parties. Either party may from time to time designate in writing a new or substitute representative(s): For Human Services: Gloria Romansik Human Services Administrator Name Title For Provider: p (' Ted Ache, Respite Care Provider Name d Title 13. Notice All notices required to be given by the parties hereunder shall be given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing a substitute person(s) or address to whom such notices shall be sent: To: Human Services To: �,Qpylca_ ZkXJge, Judy A.Griego,Director /4-S-9.c .Ene p¢, ,4,pttre, P.O. Box A _ l(Mk fpiJNr PO &O/!6 Greeley.CO 80632 Page 3 of 9 11-12-RESPITE CARE 14. Litigation PROVIDER shall promptly notify Human Services in the event that PROVIDER learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement. PROVIDER, within five(5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Iluman Services Director. [he term"litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganization and/or foreclosure. 15. Termination This Agreement may be terminated at any time by either party given thirty(30)days written notice and is subject to the availability of funding. PROVIDER reserves the right to suspend services to clients if funding is no longer available. 16. Entire Agreement This Agreement, together with all attachments hereto, constitutes the entire understanding between the parties with respect to the subject matter hereof, and may not be changed or modified except as stated in Paragraph 10 herein. 17. No Third Party Beneficiary. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall he an incidental beneficiary only. 18. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care which did not previously exist with respect to any person not a party to this Agreement. IN WITNESS WHEREOF,the parties hereto have duly executed the Agreement as of the day,month,and year first above written. BOARD OF COUNTY COMMISSIONERS WELD COUNTY,COLORAD ATTEST: Wel :ounty Clerk to the Board .*S+sxis Barbara Kir eyer • a JUL 002011 Deputy Clerk to re Bba ' ..lk%1861 . .Ro 'EDASvair ��.� � m �� I� ' y Attorney � 0 WELD COUNTY DEPARTMENT OF HUMAN SERVICES PROVIDER .lu . Uri ,o, Dir or Respite Provider Page 4 of 9 c9D//- /a'// 11-12-RESPITE CARE EXHIBIT A SCOPE OF SERVICES Each Provider will: 1. Complete a fingerprint card for a background check at the PROVIDERS expense with the Colorado Bureau of Investigation. A Federal Bureau of Investigation background check will be done if the Provider has been a resident of the State of Colorado for less than two years. Human Services will clear the Provider through CBI and FBI; 2. Complete a course in CPR and first aid, in which a current copy of the certifications must be provided to Human Services with this agreement. If either certification should expire during the contracted period,the Provider will send a new current certification copy to Human Services; 3. Provide transportation for the child to appointments during the hours of service as agreed upon with the foster parent; 4. Become familiar with State rules and regulations governing certified foster homes; 5. Must be eighteen years of age or older. Page 5 of 9 I I-12-RESPITE CARE EXHIBIT B PAYMENT SCHEDULE 1. Funding and Method of Payment Human Services agrees to reimburse PROVIDER in consideration for the work and services performed under Child Welfare Regular Administration funding. Expenses incurred by PROVIDER, in association with said project prior to the term of this agreement, are not eligible Human Services expenditures and shall not be reimbursed by Human Services. Payment pursuant to this Contract, if Child Welfare Regular Administration funds, whether in whole or in part, is subject to and contingent upon the continuing availability of Child Welfare Regular Administration funds for the purposes hereof In the event that said funds, or any part thereof,become unavailable as determined by Human Services, Human Services may immediately terminate this Contract or amend it accordingly. 2. Fees for Services Respite care is limited to four hours per week per child. The hours of care may be provided in any combination throughout a month, but not to exceed 16 hours per month. Payment will be$16.75 per each four hour period, but not to exceed$67.00 per month for 16 hours. Human Services referrals will not be sent to collections by PROVIDER for default of co-pay/fees. Services will be performed regardless of client's refusal or inability to pay co-pay. PROVIDER will collect any applicable sliding scale co-pays and credit Human Services for any payments received on the monthly billing statements. 3. Submittal of Vouchers PROVIDER shall prepare and submit monthly,the itemized voucher and certify that the services authorized were provided on the date indicated and the charges made were pursuant to the terms and conditions of Exhibit A. Page 6 of 9 I 1-12-RESPITE CARE EXHIBIT C ASSURANCES PROVIDER agrees it is an independent contractor and that its officers and employees do not become employees of Weld County, nor are they entitled to any employee benefits as Weld County employees, as the result of the execution of this Agreement. 2. Weld County, the Board of County Commissioners of Weld County,its officers and employees, shall not be held liable for injuries or damages caused by any negligent acts or omissions of PROVIDER-contracted PROVIDERS or its employees, volunteers,or agents while performing duties as described in this Agreement. PROVIDER shall indemnify, defend, and hold harmless Weld County,the Board of County Commissioners of Weld County, its employees, volunteers, and agents. PROVIDER shall provide adequate liability and worker's compensation insurance for all its employees, volunteers,and agents engaged in the performance of the Agreement upon request,PROVIDER shall provide Human Services with the acceptable evidence that such coverage is in effect. 3. No portion of this Contract shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may possess, not shall any portion of this Agreement be deemed to have treated a duty of care with respect to any persons not a party of this Agreement. 4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld, State of Colorado, to expend funds not otherwise appropriated in each succeeding year. 5. If any section, subsection,paragraph, sentence,clause, or phrase of this Contract is for any reason held or decided to he unconstitutional, such decision shall not affect the validity of the remaining portions. The parties hereto declare that they would have entered into this Contract and each and every section, subsection, paragraph, sentence, clause, and phrase thereof irrespective of the fact that any one or more sections, subsections, paragraphs, sentences, clauses, or pleases might be declared to be unconstitutional or invalid. 6. No officer, member or employee of Weld County and no member of their governing bodies shall have any pecuniary interest, direct or indirect, in the approved Agreement or the proceeds thereof 7. PROVIDER assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that no person shall, on the grounds of race, creed, color, sex, or national origin,be excluded from participation in,be denied the benefits of, or be otherwise subjected to discrimination under this approved Contract. 8. PROVIDER assures that sufficient,auditable, and otherwise adequate records that will provide accurate, current, separate, and complete disclosure of the status of the funds received under the Contract are maintained for three(3)years or the completion and resolution of an audit. Such records shall be sufficient to allow authorized local,Federal, and State auditors, and representatives to audit and monitor PROVIDER. 9. All such records, documents, communications, and other materials shall be the property of Human Services and shall be maintained by PROVIDER, in a central location and custodian, in behalf of Human Services, for a period of four(4) years from the date of final payment under this Contract, or for such further period as may be necessary to resolve any matters which may be pending, or until an audit has been completed with the following qualifications: If an audit by or on behalf of the federal and/or state government has begun but is not completed at the end of the four(4)year period, or if audit findings have not been resolved after a four(4) year period, the materials shall be retained until the resolution of the audit finding. 10. PROVIDER assures that authorized local, federal, and state auditors and representatives shall, during business hours, have access to inspect any copy records, and shall be allowed to monitor and review through on-site visits, all contract activities, supported with funds under this Contract to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. Page 7 of 9 11-12-RESPITE CARE 11. This Contract shall be binding upon the parties hereto, their successors,heirs, legal representatives,and assigns. PROVIDER or Human Services may not assign any of its rights or obligations hereunder without the prior written consent of both parties. 12. PROVIDER certifies that federal appropriated funds have not been paid or will be paid,by or on behalf of PROVIDER,to any person for influencing or attempting to influence an officer or employee of an agency,a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any federal grant,the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, loan, grant, or cooperative agreement. 13. PROVIDER assures that it will fully comply with all other applicable federal and state laws. PROVIDER understands that the source of funds to be used under this Contract is Child Welfare Regular Administration funds. 14. PROVIDER assures and certifies that it and its principals: a. Are not presently debarred, suspended,proposed for debarment, declared ineligible or voluntarily excluded from covered transaction by a federal department or agency. h. Have not, within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain,or performing a public(federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery,bribery, falsification or destruction of records, making false statements, or receiving stolen property: c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph 14(b)of this certification; and d. Have not within a three-year period preceding this Contract,had one or more public transactions (federal, state, and local)terminated for cause or default. 15. The Appearance of Conflict of Interest applies to the relationship of a contractor with Human Services when the contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest, it is not necessary for the contractor to gain from knowledge of these opposing interests. It is only necessary that the contractor know that the two relationships are in opposition. During the term of the Contract,PROVIDER shall not enter any third party relationship that gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation, PROVIDER shall submit to I Inman Services, a full disclosure statement setting forth the details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for Iluman Services' termination, for cause, of its contract with PROVIDER. 16. PROVIDER shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Contract. Except for purposes directly connected with the administration of Child Protection, no information about or obtained from any applicant/recipient in possession of PROVIDER shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with PROVIDER written policies governing access to, duplication and dissemination of, all such information. PROVIDER shall advise its employees, agents, and subcontractors, if any,that they are subject to these confidentiality requirements. PROVIDER shall provide its employees, agents,and subcontractors, if any, with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. Page 8 of 9 • 11-12-RESPITE CARE 17. Proprietary information for the proposes of this contract is information relating to a party's research, development, trade secrets,business affairs, internal operations and management procedures and those of its customers, clients or affiliates, but does not include information(1)lawfully obtained from third parties, (2) that which is in the public domain, or(3) that which is developed independently. Neither party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of this Contract. Any proprietary information removed from the State's site by PROVIDER in the course of providing services under this Contract will be accorded at least the same precautions as are employed by PROVIDER for similar information in the course of its own business. 18. PROVIDER certifies that s/he will abide by Colorado Revised Statute(C.R.S.)26-6-104, requiring criminal background checks for all employees, contractors,and sub-contractors. Page 9 of 9 I 1-12-RESPITE CARE r",, t 9 CHILD PROTECTION AGREEMENT FOR SERVICES l BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVIeES' r 9 AND PROVIDER This Agreement,made and entered into the day of ,20_,by and between the Board of Weld County Commissioners,sitting as the Board of Human on behalf o the Weld County Department of Human Services,hereinafter referred to as"Human Services,"and 5tyte f l &L C referred to as"Provider". WITNESSETH WHEREAS,required approval,clearance,and coordination have been accomplished from and with appropriate agencies;and WHEREAS,the Colorado Department of Human Services has provided Child Welfare Regular Administration funding for respite care for county foster care PROVIDERS and WHEREAS,Provider is a for-profit Sole-Proprietor. NOW THEREFORE,in consideration of the premises,the parties hereto covenant and agree as follows: 1. Term This Agreement shall become effective on July 1,20!1,upon proper execution of this Agreement and shall expire June 30,204-unless sooner terminated as provided herein. 2. Scope of Services Services shall be provided by Provider to any person(s)eligible for child protection services in compliance with Exhibit A"Scope of Services,"a copy of which is attached by reference. 3. Payment a. Payment shall be made on the basis of Exhibit B,"Payment Schedule,"copies of which are attached hereto and incorporated herein by reference. b. "Payment Schedule"shall establish the maximum reimbursement,which will be paid from Child Welfare Regular Administration funds during the duration of this Agreement. c. PROVIDER shall submit an itemized monthly bill to Human Services for all costs incurred and services provided pursuant to Exhibit A of this Agreement in accordance with criteria established by Human Services. PROVIDER shall submit all itemized monthly billings to Human Services no later than the twenty-fifth(25)day of the month following the month the cost was incurred. d. Payments of costs incurred pursuant to this Agreement are expressly contingent upon the availability of Child Welfare Regular Administration funds to Human Services. e. Human Services shall not be billed for,and reimbursement shall not be made for time involved in activities outside of those defined in Exhibit A. Work performed prior to the execution of this Contract shall not be reimbursed or considered part of this Agreement. 4. Financial Management At all times from the effective date of this Contract until completion of this Contract,PROVIDER shall comply with the administrative requirements,cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under Child Welfare Regular Administration funding must conform to the Single Audit Act of 1984 and OMB Circular A-133. Page 1 of 9 moo//-/6// 11-12-RESPITE CARE 5. Payment Method Unless otherwise provided in the Scope of Services and Payment Schedule: a. PROVIDER shall provide proper monthly invoices and itemization of services performed for costs incurred in the performance of the agreement. b. Human Services may withhold any payment if PROVIDER has failed to comply with the Financial Management Requirements,program objectives,contractual terms,or reporting requirements. In the event of a forfeiture of reimbursements,PROVIDER may appeal such circumstance to the Director of Human Services. The decision of the Director of Human Services shall be final. 6. Assurances PROVIDER shall abide by all assurances as set forth in the attached Exhibit C,which is attached hereto and incorporated herein by reference. 7. Compliance with Applicable Laws At all times during the performance of this contract,PROVIDER shall strictly adhere to all applicable federal and state laws,orders,and all applicable standards,regulations,interpretations or guidelines issued pursuant thereto. This includes the protection of the confidentiality of all applicant/recipient records,papers,documents, tapes and any other materials that have been or may hereafter be established which relate to the Contract. PROVIDER acknowledges that the following laws are included: - Title VI of the Civil Rights Act of 1964,42 U.S.C.Sections 2000d—1 et.seq.and its implementing regulation, 45 C.F.R.Part 80 et seq.;and - Section 504 of the Rehabilitation Act of 1973,29 U.S.C.Section 794,and its implementing regulations,45 C.F.R.Part 84;and - the Age Discrimination Act of 1975,42 U.S.C.Sections 6101 et.seq.and its implementation regulations,45 C.F.R. Part 91;and - Title VII of the Civil Rights Act of 1964;and - the Age Discrimination in Employment Act of 1967;and - the Equal Pay Act of 1963;and - the Education Amendments of 1972;and - Immigration Reform and Control Act of 1986,P.L.99-603; - 42 C.F.R.Part 2 and all regulations applicable to these laws prohibiting discrimination because of race, color,National origin,and sex,religion and handicap,including Acquired Immune Deficiency syndrome (AIDS)or AIDS related conditions,covered under Section 504 of the Rehabilitation Act of 1973,as amended,cited above. If necessary,PROVIDER and Human Services will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 CFR Part 2. Included in 45 C.F.R.Part 74 Appendix G 9,which requires that affirmative steps be taken to assure that small and minority businesses are utilized,when possible,as sources of supplies,equipment,construction and services. This assurance is given in consideration of and for the purpose of obtaining any and all federal and/or state financial assistance. Any person who feels that s/he has been discriminated against has the right to file a complaint either with the Colorado Department of Human Services or with the U.S.Department of Health and Human Services,Office for Civil Rights. 8. Certifications PROVIDER certifies that,at the time of entering into this Contract,it has currently in effect all necessary licenses,approvals,insurance,etc.,required to properly provide the services and/or supplies covered by this contract. A copy of certificate will be provided to Human Services upon completion of this agreement. Failure to do so will null and void this contract in its entirety. Page 2 of 9 11-12-RESPITE CARE 9. Monitoring and Evaluation PROVIDER and Human Services agree that monitoring and evaluation of the performance of this Agreement shall be conducted by PROVIDER and Human Services. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners and PROVIDER. PROVIDER shall permit Human Services,and any other duly authorized agent or governmental agency,to monitor all activities conducted by PROVIDER pursuant to the terms of this Agreement. As the monitoring agency may in its sole discretion deem necessary or appropriate,such program data,special analyses,on-site checking,formal audit examinations,or any other reasonable procedures. All such monitoring shall be performed in a manner that will not unduly interfere with agreement work. 10. Modification of Agreement All modifications to this agreement shall be in writing and signed by both parties. 11. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he fmd PROVIDER substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by PROVIDER. These remedial actions are as follows: a. Withhold payment to PROVIDER until the necessary services or corrections in performance are satisfactorily completed; b. Deny payment or recover reimbursement for those services or deliverables,which have not been performed and which due to circumstances caused by PROVIDER cannot be performed or if performed would be of no value to Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; c. Incorrect payment to PROVIDER due to omission,error,fraud,and/or defalcation shall be recovered from PROVIDER by deduction from subsequent payments under this Agreement or other agreements between Human Services and PROVIDER,or by Human Services as a debt due to Human Services or otherwise as provided by law. 12. Representatives For the purpose of this Agreement,the individuals identified below are hereby designated representatives of the respective parties. Either party may from time to time designate in writing a new or substitute representative(s): For Human Services: Gloria Romansik Human Services Administrator Name Title For Provider: Jane \I C_E Respite Care Provider Name Title c 13. Notice ?rrt< All notices required to be given by the parties hereunder shall be given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing a substitute person(s)or address to whom such notices shall be sent: To: Human Services To: —.J ore, c P r- Judy A.Griego.Director 50 y C\ 1 C t ri ,j�r P.O.BoxA Great CC 9l) (0Rg Greeley,CO 80632 Page 3 of 9 11-12-RESPITE CARE 14. Litigation PROVIDER shall promptly notify Human Services in the event that PROVIDER learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement.PROVIDER, within five(5)calendar days after being served with a summons,complaint,or other pleading which has been filed in any federal or state court or administrative agency,shall deliver copies of such document(s)to the Human Services Director. The term"litigation"includes an assignment for the benefit of creditors,and filings in bankruptcy,reorganization and/or foreclosure. 15. Termination This Agreement may be terminated at any time by either party given thirty(30)days written notice and is subject to the availability of funding. PROVIDER reserves the right to suspend services to clients if funding is no longer available. 16. Entire Agreement This Agreement,together with all attachments hereto,constitutes the entire understanding between the parties with respect to the subject matter hereof,and may not be changed or modified except as stated in Paragraph 10 herein. 17. No Third Party Beneficiary. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement,and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 18. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may posses,nor shall any portion of this Agreement be deemed to have created a duty of care which did not previously exist with respect to any person not a party to this Agreement. IN WITNESS WHEREOF,the parties hereto have duly executed the Age cement as of the day,month,and year first above written. BOARD OF COUNTY COMMISSIONERS WELD COUNTY,COLORADO ATTE�SfT: Wesel County Clerk to the Board te Barbara irkmeye. JUL02011 By: Ll� iis �. > ►.�� _ .�_ . 1 I �,,` Deputy Clerk to Board Ike AP ' ir iAS �i a 101 I:�j. Co !�t. orne WELD COUNTY DEPARTMENT OF HUMAN SERVICES PROVIDER 11-7&E J A.Gri go,if r Re ite Provider Page 4 of 9 �?17i/—/ // 11-12-RESPITE CARE EXHIBIT A SCOPE OF SERVICES Each Provider will: I. Complete a fingerprint card for a background check at the PROVIDERS expense with the Colorado Bureau of Investigation. A Federal Bureau of Investigation background check will be done if the Provider has been a resident of the State of Colorado for less than two years. Human Services will clear the Provider through CBI and FBI; 2. Complete a course in CPR and first aid, in which a current copy of the certifications must be provided to Human Services with this agreement. If either certification should expire during the contracted period,the Provider will send a new current certification copy to Human Services; 3. Provide transportation for the child to appointments during the hours of service as agreed upon with the foster parent; 4. Become familiar with State rules and regulations governing certified foster homes; 5. Must be eighteen years of age or older. Page 5 of 9 11-12-RESPITE CARE EXHIBIT B PAYMENT SCHEDULE I. Funding and Method of Payment Human Services agrees to reimburse PROVIDER in consideration for the work and services performed under Child Welfare Regular Administration funding. Expenses incurred by PROVIDER, in association with said project prior to the term of this agreement,are not eligible Human Services expenditures and shall not be reimbursed by Human Services. Payment pursuant to this Contract, if Child Welfare Regular Administration funds,whether in whole or in part, is subject to and contingent upon the continuing availability of Child Welfare Regular Administration funds for the purposes hereof. In the event that said funds,or any part thereof,become unavailable as determined by Human Services,Human Services may immediately terminate this Contract or amend it accordingly. 2. Fees for Services Respite care is limited to four hours per week per child. The hours of care may be provided in any combination throughout a month,but not to exceed 16 hours per month. Payment will be$16.75 per each four hour period,but not to exceed$67.00 per month for 16 hours. Human Services referrals will not be sent to collections by PROVIDER for default of co-pay/fees. Services will be performed regardless of client's refusal or inability to pay co-pay. PROVIDER will collect any applicable sliding scale co-pays and credit Human Services for any payments received on the monthly billing statements. 3. Submittal of Vouchers PROVIDER shall prepare and submit monthly,the itemized voucher and certify that the services authorized were provided on the date indicated and the charges made were pursuant to the terms and conditions of Exhibit A. Page 6 of 9 11-12-RESPITE CARE EXHIBIT C ASSURANCES 1. PROVIDER agrees it is an independent contractor and that its officers and employees do not become employees of Weld County,nor are they entitled to any employee benefits as Weld County employees,as the result of the execution of this Agreement. 2. Weld County,the Board of County Commissioners of Weld County, its officers and employees,shall not be held liable for injuries or damages caused by any negligent acts or omissions of PROVIDER-contracted PROVIDERS or its employees,volunteers,or agents while performing duties as described in this Agreement. PROVIDER shall indemnify,defend,and hold harmless Weld County,the Board of County Commissioners of Weld County, its employees, volunteers,and agents. PROVIDER shall provide adequate liability and worker's compensation insurance for all its employees, volunteers,and agents engaged in the performance of the Agreement upon request,PROVIDER shall provide Human Services with the acceptable evidence that such coverage is in effect. 3. No portion of this Contract shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may possess,not shall any portion of this Agreement be deemed to have treated a duty of care with respect to any persons not a party of this Agreement. 4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld, State of Colorado,to expend funds not otherwise appropriated in each succeeding year. 5. If any section, subsection,paragraph, sentence,clause,or phrase of this Contract is for any reason held or decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The parties hereto declare that they would have entered into this Contract and each and every section,subsection, paragraph,sentence,clause,and phrase thereof irrespective of the fact that any one or more sections, subsections,paragraphs,sentences, clauses,or phrases might be declared to be unconstitutional or invalid. 6. No officer,member or employee of Weld County and no member of their governing bodies shall have any pecuniary interest,direct or indirect,in the approved Agreement or the proceeds thereof. 7. PROVIDER assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that no person shall, on the grounds of race,creed, color,sex, or national origin,be excluded from participation in,be denied the benefits of,or be otherwise subjected to discrimination under this approved Contract. 8. PROVIDER assures that sufficient,auditable,and otherwise adequate records that will provide accurate, current, separate,and complete disclosure of the status of the funds received under the Contract are maintained for three(3)years or the completion and resolution of an audit. Such records shall be sufficient to allow authorized local, Federal,and State auditors,and representatives to audit and monitor PROVIDER. 9. All such records,documents,communications,and other materials shall be the property of Human Services and shall be maintained by PROVIDER,in a central location and custodian, in behalf of Human Services, for a period of four(4)years from the date of final payment under this Contract,or for such further period as may be necessary to resolve any matters which may be pending,or until an audit has been completed with the following qualifications: If an audit by or on behalf of the federal and/or state government has begun but is not completed at the end of the four(4)year period,or if audit findings have not been resolved after a four(4)year period,the materials shall be retained until the resolution of the audit finding. 10. PROVIDER assures that authorized local, federal,and state auditors and representatives shall, during business hours,have access to inspect any copy records, and shall be allowed to monitor and review through on-site visits, all contract activities,supported with funds under this Contract to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. Page 7 of 9 11-12-RESPITE CARE 11. This Contract shall be binding upon the parties hereto,their successors,heirs, legal representatives,and assigns. PROVIDER or Human Services may not assign any of its rights or obligations hereunder without the prior written consent of both parties. 12. PROVIDER certifies that federal appropriated funds have not been paid or will be paid,by or on behalf of PROVIDER,to any person for influencing or attempting to influence an officer or employee of an agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any federal grant,the making of any federal loan,the entering into of any cooperative agreement,and the extension,continuation,renewal, amendment,or modification of any Federal contract, loan,grant,or cooperative agreement. 13. PROVIDER assures that it will fully comply with all other applicable federal and state laws. PROVIDER understands that the source of funds to be used under this Contract is Child Welfare Regular Administration funds. 14. PROVIDER assures and certifies that it and its principals: a. Are not presently debarred,suspended,proposed for debarment,declared ineligible or voluntarily excluded from covered transaction by a federal department or agency. b. Have not,within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining,attempting to obtain,or performing a public(federal,state,or local)transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery,bribery, falsification or destruction of records,making false statements,or receiving stolen property; c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state,or local)with commission of any of the offenses enumerated in paragraph 14(b)of this certification;and d. Have not within a three-year period preceding this Contract,had one or more public transactions (federal, state, and local)terminated for cause or default. 15. The Appearance of Conflict of Interest applies to the relationship of a contractor with Human Services when the contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest, it is not necessary for the contractor to gain from knowledge of these opposing interests. It is only necessary that the contractor know that the two relationships are in opposition. During the term of the Contract, PROVIDER shall not enter any third party relationship that gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation,PROVIDER shall submit to Human Services,a full disclosure statement setting forth the details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for Human Services' termination,for cause,of its contract with PROVIDER. 16. PROVIDER shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Contract. Except for purposes directly connected with the administration of Child Protection,no information about or obtained from any applicant/recipient in possession of PROVIDER shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with PROVIDER written policies governing access to,duplication and dissemination of,all such information. PROVIDER shall advise its employees,agents,and subcontractors,if any,that they are subject to these confidentiality requirements. PROVIDER shall provide its employees,agents,and subcontractors,if any, with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. Page 8 of 9 11-12-RESPITE CARE 17. Proprietary information for the purposes of this contract is information relating to a party's research, development,trade secrets,business affairs,internal operations and management procedures and those of its customers, clients or affiliates, but does not include information(1)lawfully obtained from third parties,(2) that which is in the public domain,or(3)that which is developed independently. Neither party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of this Contract. Any proprietary information removed from the State's site by PROVIDER in the course of providing services under this Contract will be accorded at least the same precautions as are employed by PROVIDER for similar information in the course of its own business. 18. PROVIDER certifies that s/he will abide by Colorado Revised Statute(C.R.S.)26-6-104,requiring criminal background checks for all employees,contractors,and sub-contractors. Page 9 of 9 11-12-RESPITE CARE CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND PROVIDER This Agreement,made and entered into the day of ,20 ,by and between the Board of Weld County Commissioners, sitting as the Board of Human on behalf of the W Id County Department of Human Services,hereinafter referred to as"Human Services,"and 0 en 3t Fn 5-e r referred to as"Provider". WITNESSETH WHEREAS,required approval,clearance, and coordination have been accomplished from and with appropriate agencies; and WHEREAS,the Colorado Department of Human Services has provided Child Welfare Regular Administration funding for respite care for county foster care PROVIDERS and WHEREAS, Provider is a for-profit Sole-Proprietor. NOW THEREFORE, in consideration of the premises,the parties hereto covenant and agree as follows: I. Term This Agreement shall become effective on July 1, 20 ,upon proper execution of this Agreement and shall expire June 30,20 , unless sooner terminated as provided herein. 2. Scope of Services Services shall be provided by Provider to any person(s)eligible for child protection services in compliance with Exhibit A"Scope of Services,"a copy of which is attached by reference. 3. Payment a. Payment shall be made on the basis of Exhibit B,"Payment Schedule,"copies of which are attached hereto and incorporated herein by reference. b. "Payment Schedule"shall establish the maximum reimbursement, which will be paid from Child Welfare Regular Administration funds during the duration of this Agreement. c. PROVIDER shall submit an itemized monthly bill to Human Services for all costs incurred and services provided pursuant to Exhibit A of this Agreement in accordance with criteria established by Human Services. PROVIDER shall submit all itemized monthly billings to Human Services no later than the twenty-fifth(25)day of the month following the month the cost was incurred. d. Payments of costs incurred pursuant to this Agreement are expressly contingent upon the availability of Child Welfare Regular Administration funds to Human Services. e. Human Services shall not be billed for,and reimbursement shall not be made for time involved in activities outside of those defined in Exhibit A. Work performed prior to the execution of this Contract shall not be reimbursed or considered part of this Agreement. 4. Financial Management At all times from the effective date of this Contract until completion of this Contract,PROVIDER shall comply with the administrative requirements,cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under Child Welfare Regular Administration funding must conform to the Single Audit Act of 1984 and OMB Circular A-133. Page 1 of 9 0121)//-/6// 11-12-RESPITE CARE 5. Payment Method Unless otherwise provided in the Scope of Services and Payment Schedule: a. PROVIDER shall provide proper monthly invoices and itemization of services performed for costs incurred in the performance of the agreement. b. Human Services may withhold any payment if PROVIDER has failed to comply with the Financial Management Requirements,program objectives,contractual terms,or reporting requirements. In the event of a forfeiture of reimbursements, PROVIDER may appeal such circumstance to the Director of Human Services. The decision of the Director of Human Services shall be final. 6. Assurances PROVIDER shall abide by all assurances as set forth in the attached Exhibit C,which is attached hereto and incorporated herein by reference. 7. Compliance with Applicable Laws At all times during the performance of this contract, PROVIDER shall strictly adhere to all applicable federal and state laws, orders, and all applicable standards,regulations,interpretations or guidelines issued pursuant thereto. This includes the protection of the confidentiality of all applicant/recipient records,papers,documents, tapes and any other materials that have been or may hereafter be established which relate to the Contract. PROVIDER acknowledges that the following laws are included: - Title VI of the Civil Rights Act of 1964,42 U.S.C. Sections 2000d—1 et.seq.and its implementing regulation, 45 C.F.R.Part 80 et.seq.;and - Section 504 of the Rehabilitation Act of 1973,29 U.S.C.Section 794,and its implementing regulations,45 C.F.R.Part 84;and - the Age Discrimination Act of 1975,42 U.S.C. Sections 6101 et.seq.and its implementation regulations,45 C.F.R. Part 91;and - Title VII of the Civil Rights Act of 1964;and - the Age Discrimination in Employment Act of 1967;and - the Equal Pay Act of 1963;and - the Education Amendments of 1972;and - Immigration Reform and Control Act of 1986,P.L.99-603; - 42 C.F.R.Part 2 and all regulations applicable to these laws prohibiting discrimination because of race, color,National origin,and sex,religion and handicap, including Acquired Immune Deficiency syndrome (AIDS)or AIDS related conditions,covered under Section 504 of the Rehabilitation Act of 1973, as amended, cited above. If necessary, PROVIDER and Human Services will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 CFR Part 2. Included in 45 C.F.R. Part 74 Appendix G 9,which requires that affirmative steps be taken to assure that small and minority businesses are utilized, when possible,as sources of supplies,equipment,construction and services. This assurance is given in consideration of and for the purpose of obtaining any and all federal and/or state financial assistance. Any person who feels that s/he has been discriminated against has the right to file a complaint either with the Colorado Department of Human Services or with the U.S. Department of Health and Human Services,Office for Civil Rights. 8. Certifications PROVIDER certifies that,at the time of entering into this Contract, it has currently in effect all necessary licenses, approvals, insurance, etc.,required to properly provide the services and/or supplies covered by this contract. A copy of certificate will be provided to Human Services upon completion of this agreement. Failure to do so will null and void this contract in its entirety. Page 2 of 9 I 1-12-RESPITE CARE 9. Monitoring and Evaluation PROVIDER and Human Services agree that monitoring and evaluation of the performance of this Agreement shall be conducted by PROVIDER and Human Services. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners and PROVIDER. PROVIDER shall permit Human Services,and any other duly authorized agent or governmental agency,to monitor all activities conducted by PROVIDER pursuant to the terms of this Agreement. As the monitoring agency may in its sole discretion deem necessary or appropriate,such program data,special analyses, on-site checking,formal audit examinations,or any other reasonable procedures. All such monitoring shall be performed in a manner that will not unduly interfere with agreement work. 10. Modification of Agreement All modifications to this agreement shall be in writing and signed by both parties. 11. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find PROVIDER substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by PROVIDER. These remedial actions are as follows: a. Withhold payment to PROVIDER until the necessary services or corrections in performance are satisfactorily completed; b. Deny payment or recover reimbursement for those services or deliverables,which have not been performed and which due to circumstances caused by PROVIDER cannot be performed or if performed would be of no value to Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; c. Incorrect payment to PROVIDER due to omission,error,fraud,and/or defalcation shall be recovered from PROVIDER by deduction from subsequent payments under this Agreement or other agreements between Human Services and PROVIDER,or by Human Services as a debt due to Human Services or otherwise as provided by law. 12. Representatives For the purpose of this Agreement,the individuals identified below are hereby designated representatives of the respective parties. Either party may from time to time designate in writing a new or substitute representative(s): For Human Services: Gloria Romansik Human Services Administrator Name Title For Provider: Respite Care Provider Name Title 13. Notice All notices required to be given by the parties hereunder shall be given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing a substitute person(s)or address to whom such notices shall be sent: To: Human Services To: Judy A.Griego,Director P.O.Box A Greeley,CO 80632 Page 3 of 9 11-12-RESPITE CARE 14. Litigation PROVIDER shall promptly notify Human Services in the event that PROVIDER learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement. PROVIDER, within five(5)calendar days after being served with a summons, complaint,or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s)to the Human Services Director. The term"litigation"includes an assignment for the benefit of creditors,and filings in bankruptcy,reorganization and/or foreclosure. 15. Termination This Agreement may be terminated at any time by either party given thirty(30)days written notice and is subject to the availability of funding. PROVIDER reserves the right to suspend services to clients if funding is no longer available. 16. Entire Agreement This Agreement,together with all attachments hereto,constitutes the entire understanding between the parties with respect to the subject matter hereof,and may not be changed or modified except as stated in Paragraph 10 herein. 17. No Third Party Beneficiary. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 18. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may posses,nor shall any portion of this Agreement be deemed to have created a duty of care which did not previously exist with respect to any person not a party to this Agreement. IN WITNESS WHEREOF,the parties hereto have duly executed the Agreement as of the day,month,and year first above written. BOARD OF COUNTY COMMISSIONERS WELD COUNTY,COLORADO ATTEST: • Weld County Clerk to the :oard J �bara K'rkmeyer BY: JUL 0 02011 out.Deputy Clerk to ?tee Board � �Q-�t��1♦' 1861 'eaii'0' APP AS ®pRrir IC�'I Cou Attorney WELD COUNTY DEPARTMENT OF HUMAN SERVICES PROVIDER t Judy .Gnego, irector Respite Provider Page 4 of 9 ( 2t//-76// I I-12-RESPITE CARE EXHIBIT A SCOPE OF SERVICES Each Provider will: 1. Complete a fingerprint card for a background check at the PROVIDERS expense with the Colorado Bureau of • Investigation. A Federal Bureau of Investigation background check will be done if the Provider has been a resident of the State of Colorado for less than two years. Human Services will clear the Provider through CBI and FBI; 2. Complete a course in CPR and first aid,in which a current copy of the certifications must be provided to Human Services with this agreement. If either certification should expire during the contracted period,the Provider will send a new current certification copy to Human Services; 3. Provide transportation for the child to appointments during the hours of service as agreed upon with the foster parent; 4. Become familiar with State rules and regulations governing certified foster homes; 5. Must be eighteen years of age or older. Page 5 of 9 11-12-RESPITE CARE EXHIBIT B PAYMENT SCHEDULE 1. Funding and Method of Payment Human Services agrees to reimburse PROVIDER in consideration for the work and services performed under Child Welfare Regular Administration funding. Expenses incurred by PROVIDER, in association with said project prior to the term of this agreement,are not eligible Human Services expenditures and shall not be reimbursed by Human Services. Payment pursuant to this Contract, if Child Welfare Regular Administration funds, whether in whole or in part, is subject to and contingent upon the continuing availability of Child Welfare Regular Administration funds for the purposes hereof. In the event that said funds, or any part thereof,become unavailable as determined by Human Services, Human Services may immediately terminate this Contract or amend it accordingly. 2. Fees for Services Respite care is limited to four hours per week per child. The hours of care may be provided in any combination throughout a month,but not to exceed 16 hours per month. Payment will be$16.75 per each four hour period,but not to exceed$67.00 per month for 16 hours. Human Services referrals will not be sent to collections by PROVIDER for default of co-pay/fees. Services will be performed regardless of client's refusal or inability to pay co-pay. PROVIDER will collect any applicable sliding scale co-pays and credit Human Services for any payments received on the monthly billing statements. 3. Submittal of Vouchers PROVIDER shall prepare and submit monthly,the itemized voucher and certify that the services authorized were provided on the date indicated and the charges made were pursuant to the terms and conditions of Exhibit A. Page 6 of 9 11-12-RESPITE CARE EXHIBIT C ASSURANCES 1. PROVIDER agrees it is an independent contractor and that its officers and employees do not become employees of Weld County, nor are they entitled to any employee benefits as Weld County employees,as the result of the execution of this Agreement. 2. Weld County,the Board of County Commissioners of Weld County, its officers and employees,shall not be held liable for injuries or damages caused by any negligent acts or omissions of PROVIDER-contracted PROVIDERS or its employees, volunteers,or agents while performing duties as described in this Agreement. PROVIDER shall indemnify,defend,and hold harmless Weld County,the Board of County Commissioners of Weld County, its employees,volunteers,and agents. PROVIDER shall provide adequate liability and worker's compensation insurance for all its employees,volunteers,and agents engaged in the performance of the Agreement upon request, PROVIDER shall provide Human Services with the acceptable evidence that such coverage is in effect. 3. No portion of this Contract shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may possess,not shall any portion of this Agreement be deemed to have treated a duty of care with respect to any persons not a party of this Agreement. 4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld, State of Colorado,to expend funds not otherwise appropriated in each succeeding year. 5. If any section, subsection,paragraph, sentence,clause,or phrase of this Contract is for any reason held or decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The parties hereto declare that they would have entered into this Contract and each and every section, subsection, paragraph,sentence,clause,and phrase thereof irrespective of the fact that any one or more sections, subsections,paragraphs,sentences, clauses, or phrases might be declared to be unconstitutional or invalid. 6. No officer,member or employee of Weld County and no member of their governing bodies shall have any pecuniary interest,direct or indirect, in the approved Agreement or the proceeds thereof. 7. PROVIDER assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that no person shall,on the grounds of race,creed,color, sex,or national origin,be excluded from participation in,be denied the benefits of,or be otherwise subjected to discrimination under this approved Contract. 8. PROVIDER assures that sufficient,auditable,and otherwise adequate records that will provide accurate, current, separate,and complete disclosure of the status of the funds received under the Contract are maintained for three(3)years or the completion and resolution of an audit. Such records shall be sufficient to allow authorized local, Federal,and State auditors,and representatives to audit and monitor PROVIDER. 9. All such records,documents, communications,and other materials shall be the property of Human Services and shall be maintained by PROVIDER, in a central location and custodian, in behalf of Human Services,for a period of four(4)years from the date of final payment under this Contract, or for such further period as may be necessary to resolve any matters which may be pending,or until an audit has been completed with the following qualifications: If an audit by or on behalf of the federal and/or state government has begun but is not completed at the end of the four(4)year period,or if audit findings have not been resolved after a four(4)year period,the materials shall be retained until the resolution of the audit finding. 10. PROVIDER assures that authorized local,federal,and state auditors and representatives shall, during business hours,have access to inspect any copy records,and shall be allowed to monitor and review through on-site visits,all contract activities, supported with funds under this Contract to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. Page 7 of 9 11-12-RESPITE CARE 11. This Contract shall be binding upon the parties hereto,their successors,heirs,legal representatives, and assigns. PROVIDER or Human Services may not assign any of its rights or obligations hereunder without the prior written consent of both parties. 12. PROVIDER certifies that federal appropriated funds have not been paid or will be paid,by or on behalf of PROVIDER,to any person for influencing or attempting to influence an officer or employee of an agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any federal grant,the making of any federal loan,the entering into of any cooperative agreement,and the extension,continuation,renewal, amendment,or modification of any Federal contract, loan,grant,or cooperative agreement. 13. PROVIDER assures that it will fully comply with all other applicable federal and state laws. PROVIDER understands that the source of funds to be used under this Contract is Child Welfare Regular Administration funds. 14. PROVIDER assures and certifies that it and its principals: a. Are not presently debarred,suspended,proposed for debarment,declared ineligible or voluntarily excluded from covered transaction by a federal department or agency. b. Have not, within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining,attempting to obtain,or performing a public(federal, state,or local)transaction or contract under a public transaction;violation of federal or state antitrust statutes or commission of embezzlement, theft,forgery,bribery, falsification or destruction of records,making false statements,or receiving stolen property; c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state,or local)with commission of any of the offenses enumerated in paragraph 14(b)of this certification;and d. Have not within a three-year period preceding this Contract,had one or more public transactions (federal,state,and local)terminated for cause or default. 15. The Appearance of Conflict of Interest applies to the relationship of a contractor with Human Services when the contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest,it is not necessary for the contractor to gain from knowledge of these opposing interests. It is only necessary that the contractor know that the two relationships are in opposition. During the term of the Contract,PROVIDER shall not enter any third party relationship that gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation, PROVIDER shall submit to Human Services,a full disclosure statement setting forth the details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for Human Services' termination,for cause,of its contract with PROVIDER. 16. PROVIDER shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Contract. Except for purposes directly connected with the administration of Child Protection,no information about or obtained from any applicant/recipient in possession of PROVIDER shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with PROVIDER written policies governing access to,duplication and dissemination of,all such information. PROVIDER shall advise its employees,agents,and subcontractors, if any,that they are subject to these confidentiality requirements. PROVIDER shall provide its employees,agents,and subcontractors, if any,with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. Page 8 of 9 11-12-RESPITE CARE 17. Proprietary information for the purposes of this contract is information relating to a party's research, development,trade secrets,business affairs,internal operations and management procedures and those of its customers,clients or affiliates,but does not include information(1)lawfully obtained from third parties,(2) that which is in the public domain,or(3)that which is developed independently. Neither party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of this Contract. Any proprietary information removed from the State's site by PROVIDER in the course of providing services under this Contract will be accorded at least the same precautions as are employed by PROVIDER for similar information in the course of its own business. 18. PROVIDER certifies that s/he will abide by Colorado Revised Statute(C.R.S.)26-6-104,requiring criminal background checks for all employees,contractors,and sub-contractors. Page 9 of 9 5T 7- 11-12-RESPITE CARE • CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND PROVIDER This Agreement,made and entered into the day of ,20 by and between the Board of Weld County Commissioners,sitting as the Board of Human on behalf of the WeWSounty Department of Human Services,hereinafter referred to as"Human Services,"and n irth?„ i Nixed pi y(07 referred to as"Provider". WITNESSETH WHEREAS,required approval,clearance,and coordination have been accomplished from and with appropriate agencies;and WHEREAS,the Colorado Department of Human Services has provided Child Welfare Regular Administration funding for respite care for county foster care PROVIDERS and WHEREAS,Provider is a for-profit Sole-Proprietor. NOW THEREFORE,in consideration of the premises,the parties hereto covenant and agree as follows: 1. Term This Agreement shall become effective on July 1,201 f,upon proper execution of this Agreement and shall expire June 30,20 jY,unless sooner terminated as provided herein. 2. Scope of Services Services shall be provided by Provider to any person(s)eligible for child protection services in compliance with Exhibit A"Scope of Services,"a copy of which is attached by reference. 3. Payment a. Payment shall be made on the basis of Exhibit B,"Payment Schedule,"copies of which are attached hereto and incorporated herein by reference. b. "Payment Schedule"shall establish the maximum reimbursement,which will be paid from Child Welfare Regular Administration funds during the duration of this Agreement. c. PROVIDER shall submit an itemized monthly bill to Human Services for all costs incurred and services provided pursuant to Exhibit A of this Agreement in accordance with criteria established by Human Services. PROVIDER shall submit all itemized monthly billings to Human Services no later than the twenty-fifth(25)day of the month following the month the cost was incurred. d. Payments of costs incurred pursuant to this Agreement are expressly contingent upon the availability of Child Welfare Regular Administration funds to Human Services. e. Human Services shall not be billed for,and reimbursement shall not be made for time involved in activities outside of those defined in Exhibit A. Work performed prior to the execution of this Contract shall not be reimbursed or considered part of this Agreement. 4. Financial Management At all times from the effective date of this Contract until completion of this Contract,PROVIDER shall comply with the administrative requirements,cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expendeunder Child Welfare Regular Administration funding must conform to the Single Audit Act of 1984 and OIJB Circular A-133. � Page 1 of 9 • 2C// // 11-12-RESPITE CARE 5. Payment Method Unless otherwise provided in the Scope of Services and Payment Schedule: a. PROVIDER shall provide proper monthly invoices and itemization of services performed for costs incurred in the performance of the agreement. b. Human Services may withhold any payment if PROVIDER has failed to comply with the Financial Management Requirements,program objectives,contractual terms,or reporting requirements. In the event of a forfeiture of reimbursements,PROVIDER may appeal such circumstance to the Director of Human Services. The decision of the Director of Human Services shall be final. 6. Assurances PROVIDER shall abide by all assurances as set forth in the attached Exhibit C,which is attached hereto and incorporated herein by reference. 7. Compliance with Applicable Laws At all times during the performance of this contract,PROVIDER shall strictly adhere to all applicable federal and state laws,orders,and all applicable standards,regulations, interpretations or guidelines issued pursuant thereto. This includes the protection of the confidentiality of all applicant/recipient records,papers,documents, tapes and any other materials that have been or may hereafter be established which relate to the Contract. PROVIDER acknowledges that the following laws are included: - Title VI of the Civil Rights Act of 1964,42 U.S.C.Sections 2000d—1 et.seq.and its implementing regulation, 45 C.F.R.Part 80 et.seq.;and - Section 504 of the Rehabilitation Act of 1973,29 U.S.C. Section 794,and its implementing regulations,45 C.F.R Part 84;and - the Age Discrimination Act of 1975,42 U.S.C.Sections 6101 et.seq.and its implementation regulations,45 C.F.R. Part 91;and - Title VII of the Civil Rights Act of 1964;and - the Age Discrimination in Employment Act of 1967;and - the Equal Pay Act of 1963;and - the Education Amendments of 1972;and - Immigration Reform and Control Act of 1986,P.L.99-603; - 42 C.F.R.Part 2 and all regulations applicable to these laws prohibiting discrimination because of race, color,National origin,and sex,religion and handicap,including Acquired Immune Deficiency syndrome (AIDS)or AIDS related conditions,covered under Section 504 of the Rehabilitation Act of 1973,as amended,cited above. If necessary,PROVIDER and Human Services will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 CFR Part 2. Included in 45 C.F.R. Part 74 Appendix G 9,which requires that affirmative steps be taken to assure that small and minority businesses are utilized, when possible,as sources of supplies,equipment,construction and services. This assurance is given in consideration of and for the purpose of obtaining any and all federal and/or state financial assistance. Any person who feels that s/he has been discriminated against has the right to file a complaint either arith the Colorado Department of Human Services or with the U.S. Department of Health and Human Services,Office J for Civil Rights. (,) 8. Certifications :V PROVIDER certifies that,at the time of entering into this Contract, it has currently in effi all necessary licenses,approvals, insurance,etc.,required to properly provide the services and/or supplies covered by this contract. A copy of certificate will be provided to Human Services upon completion of this agreement. Failure to do so will null and void this contract in its entirety. Page 2 of 9 I I-12-RESPITE CARE 9. Monitoring and Evaluation PROVIDER and Human Services agree that monitoring and evaluation of the performance of this Agreement shall be conducted by PROVIDER and Human Services. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners and PROVIDER. PROVIDER shall permit Human Services,and any other duly authorized agent or governmental agency,to monitor all activities conducted by PROVIDER pursuant to the terms of this Agreement. As the monitoring agency may in its sole discretion deem necessary or appropriate,such program data,special analyses,on-site checking,formal audit examinations,or any other reasonable procedures. All such monitoring shall be performed in a manner that will not unduly interfere with agreement work. 10. Modification of Agreement All modifications to this agreement shall be in writing and signed by both parties. 11. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find PROVIDER substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by PROVIDER. These remedial actions are as follows: a. Withhold payment to PROVIDER until the necessary services or corrections in performance are satisfactorily completed; b. Deny payment or recover reimbursement for those services or deliverables,which have not been performed and which due to circumstances caused by PROVIDER cannot be performed or if performed would be of no value to Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; c. Incorrect payment to PROVIDER due to omission,error,fraud,and/or defalcation shall be recovered from PROVIDER by deduction from subsequent payments under this Agreement or other agreements between Human Services and PROVIDER,or by Human Services as a debt due to Human Services or otherwise as provided by law. 12. Representatives For the purpose of this Agreement,the individuals identified below are hereby designated representatives of the respective parties. Either party may from time to time designate in writing a new or substitute representative(s): For Human Services: Gloria Romansik Human Services Administrator Name Title For Provider: " (Are s h?-& c lurne2 Respite Care Provider Name Title 13. Notice All notices required to be given by the parties hereunder shall be given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing a '` substitute person(s)or address to whom such notices shall be sent: Li; To: Human Services To:elt1)5 h'✓l(,t 1 DS1AJa-U ebw€ Z- Judy A.Griego,Director 12210 (Y10 141e--MA-- D✓ P.O.BoxA Gl—Gplli✓IS) co goS2.r Greeley,CO 80632 Page 3 of 9 I1-12-RESPITE CARE • 14. Litigation PROVIDER shall promptly notify Human Services in the event that PROVIDER learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement. PROVIDER, within five(5)calendar days after being served with a summons,complaint,or other pleading which has been filed in any federal or state court or administrative agency,shall deliver copies of such document(s)to the Human Services Director. The term"litigation"includes an assignment for the benefit of creditors,and filings in bankruptcy,reorganization and/or foreclosure. 15. Termination This Agreement may be terminated at any time by either party given thirty(30)days written notice and is subject to the availability of funding. PROVIDER reserves the right to suspend services to clients if funding is no longer available. 16. Entire Agreement This Agreement,together with all attachments hereto,constitutes the entire understanding between the parties with respect to the subject matter hereof, and may not be changed or modified except as stated in Paragraph 10 herein. 17. No Third Party Beneficiary. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 18. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may posses,nor shall any portion of this Agreement be deemed to have created a duty of care which did not previously exist with respect to any person not a party to this Agreement. IN WITNESS WHEREOF,the parties hereto have duly executed the Agreement as of the day,month,and year first above written. BOARD OF COUNTY COMMISSIONERS WELD COUNTY,COLORA i• A l 1 EST: Weld County Clerk to the :oard �/t4n n! larbara Ki. meyer BY: / �i,. , 1 4 /�� lE1La�� JUL 0 62019 Deputy Clerk t i e Soar ]b61 ��t,I.' APPRO 'RYAS ' Coun Forney �` 1 WELD COUNTY DEPARTMENT OF HUMAN SERVICES PROVIDER J A. rie ,Director Ctevide Page 4 of 9 ale//-/6// 11-12-RESPITE CARE EXHIBIT A SCOPE OF SERVICES Each Provider will: I. Complete a fingerprint card for a background check at the PROVIDERS expense with the Colorado Bureau of • Investigation. A Federal Bureau of Investigation background check will be done if the Provider has been a resident of the State of Colorado for less than two years. Human Services will clear the Provider through CBI and FBI; 2. Complete a course in CPR and first aid, in which a current copy of the certifications must be provided to Human Services with this agreement. If either certification should expire during the contracted period,the Provider will send a new current certification copy to Human Services; 3. Provide transportation for the child to appointments during the hours of service as agreed upon with the foster parent; 4. Become familiar with State rules and regulations governing certified foster homes; 5. Must be eighteen years of age or older. . J Page 5 of 9 11-12-RESPITE CARE EXHIBIT B PAYMENT SCHEDULE 1. Funding and Method of Payment Human Services agrees to reimburse PROVIDER in consideration for the work and services performed under Child Welfare Regular Administration funding. Expenses incurred by PROVIDER, in association with said project prior to the term of this agreement,are not eligible Human Services expenditures and shall not be reimbursed by Human Services. Payment pursuant to this Contract, if Child Welfare Regular Administration funds,whether in whole or in part, is subject to and contingent upon the continuing availability of Child Welfare Regular Administration funds for the purposes hereof. In the event that said funds,or any part thereof,become unavailable as determined by Human Services,Human Services may immediately terminate this Contract or amend it accordingly. 2. Fees for Services Respite care is limited to four hours per week per child. The hours of care may be provided in any combination throughout a month,but not to exceed 16 hours per month. Payment will be$16.75 per each four hour period,but not to exceed$67.00 per month for 16 hours. Human Services referrals will not be sent to collections by PROVIDER for default of co-pay/fees. Services will be performed regardless of client's refusal or inability to pay co-pay. PROVIDER will collect any applicable sliding scale co-pays and credit Human Services for any payments received on the monthly billing statements. 3. Submittal of Vouchers PROVIDER shall prepare and submit monthly,the itemized voucher and certify that the services authorized were provided on the date indicated and the charges made were pursuant to the terms and conditions of Exhibit A. J 5 ) Page 6 of 9 11-12-RESPITE CARE EXHIBIT C ASSURANCES 1. PROVIDER agrees it is an independent contractor and that its officers and employees do not become employees of Weld County,nor are they entitled to any employee benefits as Weld County employees,as the result of the execution of this Agreement. 2. Weld County,the Board of County Commissioners of Weld County, its officers and employees,shall not be held liable for injuries or damages caused by any negligent acts or omissions of PROVIDER-contracted PROVIDERS or its employees, volunteers,or agents while performing duties as described in this Agreement. PROVIDER shall indemnify,defend,and hold harmless Weld County,the Board of County Commissioners of Weld County,its employees,volunteers,and agents. PROVIDER shall provide adequate liability and worker's compensation insurance for all its employees,volunteers,and agents engaged in the performance of the Agreement upon request, PROVIDER shall provide Human Services with the acceptable evidence that such coverage is in effect. 3. No portion of this Contract shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may possess,not shall any portion of this Agreement be deemed to have treated a duty of care with respect to any persons not a party of this Agreement. 4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld, State of Colorado,to expend funds not otherwise appropriated in each succeeding year. 5. If any section, subsection,paragraph,sentence,clause,or phrase of this Contract is for any reason held or decided to be unconstitutional,such decision shall not affect the validity of the remaining portions. The parties hereto declare that they would have entered into this Contract and each and every section,subsection, paragraph,sentence,clause, and phrase thereof irrespective of the fact that any one or more sections, subsections,paragraphs, sentences, clauses,or phases might be declared to be unconstitutional or invalid. 6. No officer,member or employee of Weld County and no member of their governing bodies shall have any pecuniary interest, direct or indirect, in the approved Agreement or the proceeds thereof. 7. PROVIDER assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that no person shall, on the grounds of race,creed,color,sex,or national origin,be excluded from participation in,be denied the benefits of,or be otherwise subjected to discrimination under this approved Contract. 8. PROVIDER assures that sufficient,auditable,and otherwise adequate records that will provide accurate, current, separate,and complete disclosure of the status of the funds received under the Contract are maintained for three(3)years or the completion and resolution of an audit. Such records shall be sufficient to allow authorized local,Federal, and State auditors,and representatives to audit and monitor PROVIDER. 9. All such records,documents,communications,and other materials shall be the property of Human Services and shall be maintained by PROVIDER, in a central location and custodian,in behalf of Human Services, for a period of four(4)years from the date of final payment under this Contract, or for such further period as may be necessary to resolve any matters which may be pending,or until an audit has been completed with the following qualifications: If an audit by or on behalf of the federal and/or state government has begun but is not completed at the end of the four(4)year period,or if audit findings have not been resolved after a four(4)year period,the materials shall be retained until the resolution of the audit finding. 10. PROVIDER assures that authorized local,federal,and state auditors and representatives shall,during buitness hours,have access to inspect any copy records,and shall be allowed to monitor and review through ou-3'ite visits,all contract activities,supported with funds under this Contract to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the,} Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. Page 7 of 9 11-12-RESPITE CARE 11. This Contract shall be binding upon the parties hereto,their successors,heirs,legal representatives,and assigns. PROVIDER or Human Services may not assign any of its rights or obligations hereunder without the prior written consent of both parties. 12. PROVIDER certifies that federal appropriated funds have not been paid or will be paid,by or on behalf of PROVIDER,to any person for influencing or attempting to influence an officer or employee of an agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any federal grant,the making of any federal loan,the entering into of any cooperative agreement, and the extension,continuation,renewal, amendment,or modification of any Federal contract, loan,grant,or cooperative agreement. 13. PROVIDER assures that it will fully comply with all other applicable federal and state laws. PROVIDER understands that the source of funds to be used under this Contract is Child Welfare Regular Administration funds. 14. PROVIDER assures and certifies that it and its principals: a. Are not presently debarred,suspended,proposed for debarment,declared ineligible or voluntarily excluded from covered transaction by a federal department or agency. b. Have not,within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain,or performing a public(federal,state,or local)transaction or contract under a public transaction;violation of federal or state antitrust statutes or commission of embezzlement, theft,forgery,bribery,falsification or destruction of records,making false statements,or receiving stolen property; c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state,or local)with commission of any of the offenses enumerated in paragraph 14(b)of this certification;and d. Have not within a three-year period preceding this Contract,had one or more public transactions (federal,state, and local)terminated for cause or default. 15. The Appearance of Conflict of Interest applies to the relationship of a contractor with Human Services when the contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest,it is not necessary for the contractor to gain from knowledge of these opposing interests. It is only necessary that the contractor know that the two relationships are in opposition. During the term of the Contract,PROVIDER shall not enter any third party relationship that gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation,PROVIDER shall submit to Human Services,a full disclosure statement setting forth the details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for Human Services'termination,for cause,of its contract with PROVIDER. 16. PROVIDER shall protect the confidentiality of all applicant records and other materials that are maint4hed in accordance with this Contract. Except for purposes directly connected with the administration of NM Protection,no information about or obtained from any applicant/recipient in possession of PROVIDER shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unl4s in accordance with PROVIDER written policies governing access to,duplication and disseminatioiof, all such information. PROVIDER shall advise its employees,agents, and subcontractors, if any,that they are subject to these confidentiality requirements. PROVIDER shall provide its employees,agents,and Silbcontractors, if any, with a copy or written explanation of these confidentiality requirements before access,econfidential data is permitted. Page 8 of 9 11-12-RESPITE CARE 17. Proprietary information for the purposes of this contract is information relating to a party's research, development,trade secrets,business affairs, internal operations and management procedures and those of its customers,clients or affiliates,but does not include information(1) lawfully obtained from third parties, (2) that which is in the public domain,or(3)that which is developed independently. Neither party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of this Contract. Any proprietary information removed from the State's site by PROVIDER in the course of providing services under this Contract will be accorded at least the same precautions as are employed by PROVIDER for similar information in the course of its own business. 18. PROVIDER certifies that s/he will abide by Colorado Revised Statute(C.R.S.)26-6-104,requiring criminal background checks for all employees,contractors,and sub-contractors. r� ti ' Page 9 of 9 1I-12-RESPITE CARE CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND PROVIDER This Agreement,made and entered into the day of ,20,by and between the Board of Weld County Commissioners,sitting as the Board of Hum on beh If of the Weld^ County Department of Human Services,hereinafter referred to as"Human Services,"and f'hM/M Ae.47 referred to as"Provider". WITNESSETH WHEREAS,required approval,clearance, and coordination have been accomplished from and with appropriate agencies;and WHEREAS,the Colorado Department of Human Services has provided Child Welfare Regular Administration funding for respite care for county foster care PROVIDERS and WHEREAS,Provider is a for-profit Sole-Proprietor. NOW THEREFORE,in consideration of the premises,the parties hereto covenant and agree as follows: 1. Term This Agreement shall become effective on July 1,20,,upon proper execution of this Agreement and shall expire June 30,20 0,,.unless sooner terminated as provided herein. 2. Scope of Services Services shall be provided by Provider to any person(s)eligible for child protection services in compliance with Exhibit A"Scope of Services,"a copy of which is attached by reference. 3. Payment a. Payment shall be made on the basis of Exhibit B,"Payment Schedule,"copies of which are attached hereto and incorporated herein by reference. b. "Payment Schedule"shall establish the maximum reimbursement,which will be paid from Child Welfare Regular Administration funds during the duration of this Agreement. c. PROVIDER shall submit an itemized monthly bill to Human Services for all costs incurred and services provided pursuant to Exhibit A of this Agreement in accordance with criteria established by Human Services. PROVIDER shall submit all itemized monthly billings to Human Services no later than the twenty-fifth(25)day of the month following the month the cost was incurred. d. Payments of costs incurred pursuant to this Agreement are expressly contingent upon the availability of Child Welfare Regular Administration funds to Human Services. e. Human Services shall not be billed for,and reimbursement shall not be made for time involved in activities outside of those defined in Exhibit A. Work performed prior to the execution of this Contract shall not be reimbursed or considered part of this Agreement. 4. Financial Management At all times from the effective date of this Contract until completion of this Contract, PROVIDER shall comply with the administrative requirements,cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under Child Welfare Regular Administration funding must conform to the Single Audit Act of 1984 and OMB Circular A-133. Page 1 of 9 &o///& // 11-12-RESPITE CARE 5. Payment Method Unless otherwise provided in the Scope of Services and Payment Schedule: a. PROVIDER shall provide proper monthly invoices and itemization of services performed for costs incurred in the performance of the agreement. b. Human Services may withhold any payment if PROVIDER has failed to comply with the Financial Management Requirements,program objectives,contractual terms,or reporting requirements. In the event of a forfeiture of reimbursements, PROVIDER may appeal such circumstance to the Director of Human Services. The decision of the Director of Human Services shall be final. 6. Assurances PROVIDER shall abide by all assurances as set forth in the attached Exhibit C,which is attached hereto and incorporated herein by reference. 7. Compliance with Applicable Laws At all times during the performance of this contract,PROVIDER shall strictly adhere to all applicable federal and state laws,orders,and all applicable standards,regulations, interpretations or guidelines issued pursuant thereto. This includes the protection of the confidentiality of all applicant/recipient records,papers,documents, tapes and any other materials that have been or may hereafter be established which relate to the Contract. PROVIDER acknowledges that the following laws are included: - Title VI of the Civil Rights Act of 1964,42 U.S.C.Sections 2000d—1 et.seq.and its implementing regulation, 45 C.F.R.Part 80 et.seq.;and - Section 504 of the Rehabilitation Act of 1973,29 U.S.C.Section 794,and its implementing regulations,45 C.F.R.Part 84;and - the Age Discrimination Act of 1975,42 U.S.C.Sections 6101 et.seq.and its implementation regulations,45 C.F.R. Part 91;and - Title VII of the Civil Rights Act of 1964;and - the Age Discrimination in Employment Act of 1967;and - the Equal Pay Act of 1963;and - the Education Amendments of 1972;and - Immigration Reform and Control Act of 1986,P.L.99-603; - 42 C.F.R.Part 2 and all regulations applicable to these laws prohibiting discrimination because of race, color,National origin, and sex,religion and handicap,including Acquired Immune Deficiency syndrome (AIDS)or AIDS related conditions, covered under Section 504 of the Rehabilitation Act of 1973,as amended,cited above. If necessary,PROVIDER and Human Services will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 CFR Part 2. Included in 45 C.F.R. Part 74 Appendix G 9,which requires that affirmative steps be taken to assure that small and minority businesses are utilized,when possible,as sources of supplies,equipment,construction and services. This assurance is given in consideration of and for the purpose of obtaining any and all federal and/or state financial assistance. Any person who feels that s/he has been discriminated against has the right to file a complaint either with the Colorado Department of Human Services or with the U.S.Department of Health and Human Services,Office for Civil Rights. 8. Certifications PROVIDER certifies that,at the time of entering into this Contract, it has currently in effect all necessary licenses,approvals, insurance,etc.,required to properly provide the services and/or supplies covered by this contract. A copy of certificate will be provided to Human Services upon completion of this agreement. Failure to do so will null and void this contract in its entirety. Page 2 of 9 11-12-RESPITE CARE 9. Monitoring and Evaluation PROVIDER and Human Services agree that monitoring and evaluation of the performance of this Agreement shall be conducted by PROVIDER and Human Services. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners and PROVIDER. PROVIDER shall permit Human Services,and any other duly authorized agent or governmental agency,to monitor all activities conducted by PROVIDER pursuant to the terms of this Agreement. As the monitoring agency may in its sole discretion deem necessary or appropriate,such program data,special analyses,on-site checking,formal audit examinations,or any other reasonable procedures. All such monitoring shall be performed in a manner that will not unduly interfere with agreement work. 10. Modification of Agreement All modifications to this agreement shall be in writing and signed by both parties. 11. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he fmd PROVIDER substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by PROVIDER. These remedial actions are as follows: a. Withhold payment to PROVIDER until the necessary services or corrections in performance are satisfactorily completed; b. Deny payment or recover reimbursement for those services or deliverables,which have not been performed and which due to circumstances caused by PROVIDER cannot be performed or if performed would be of no value to Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; c. Incorrect payment to PROVIDER due to omission,error,fraud,and/or defalcation shall be recovered from PROVIDER by deduction from subsequent payments under this Agreement or other agreements between Human Services and PROVIDER,or by Human Services as a debt due to Human Services or otherwise as provided by law. 12. Representatives For the purpose of this Agreement,the individuals identified below are hereby designated representatives of the respective parties. Either party may from time to time designate in writing a new or substitute representative(s): For Human Services: Gloria Romansik Human Services Administrator Name Title For Provider: p j C / T (" Le-rib )-e ola n de Respite Care Provider Name Title 13. Notice All notices required to be given by the parties hereunder shall be given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing a substitute person(s)or address to whom such notices shall be sent: To: Human Services To: Ask Judy A.Griego,Director / 'l1- P.O.Box A -F¢, Liegt 6) YQk I Greeley,CO 80632 Page 3 of 9 11-12-RESPITE CARE 14. Litigation PROVIDER shall promptly notify Human Services in the event that PROVIDER learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement. PROVIDER, within five(5)calendar days after being served with a summons,complaint,or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s)to the Human Services Director. The term"litigation" includes an assignment for the benefit of creditors,and filings in bankruptcy,reorganization and/or foreclosure. 15. Termination This Agreement may be terminated at any time by either party given thirty(30)days written notice and is subject to the availability of funding. PROVIDER reserves the right to suspend services to clients if funding is no longer available. 16. Entire Agreement This Agreement,together with all attachments hereto, constitutes the entire understanding between the parties with respect to the subject matter hereof,and may not be changed or modified except as stated in Paragraph 10 herein. 17. No Third Party Beneficiary. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 18. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may posses,nor shall any portion of this Agreement be deemed to have created a duty of care which did not previously exist with respect to any person not a party to this Agreement. IN WITNESS WHEREOF,the parties hereto have duly executed the Agreement as of the day,month,and year first above written. BOARD OF COUNTY COMMISSIONERS WELD COUNTY,COLORA • ATTEST: We County Clerk to the Boar. air Barbara Kir: eyer BY: 1 � ►/ _�i�� Wa Li♦ JUL 0 0 2011 Deputy Cler 'the :oard f �� w =� O Dom.•: • . •RM: MI ten o omey lV ®p 0 WELD COUNTY DEPARTMENT OF HUMAN SERVICES PROVIDER Ju y .Gricg 'rector Respite Provider Page 4 of 9 aoi/-i // 11-12-RESPITE CARE EXHIBIT A SCOPE OF SERVICES Each Provider will: 1. Complete a fingerprint card for a background check at the PROVIDERS expense with the Colorado Bureau of • Investigation. A Federal Bureau of Investigation background check will be done if the Provider has been a resident of the State of Colorado for less than two years. Human Services will clear the Provider through CBI and FBI; 2. Complete a course in CPR and first aid,in which a current copy of the certifications must be provided to Human Services with this agreement. If either certification should expire during the contracted period,the Provider will send a new current certification copy to Human Services; 3. Provide transportation for the child to appointments during the hours of service as agreed upon with the foster parent; 4. Become familiar with State rules and regulations governing certified foster homes; 5. Must be eighteen years of age or older. Page 5 of 9 11-12-RESPITE CARE EXHIBIT B PAYMENT SCHEDULE 1. Funding and Method of Payment Human Services agrees to reimburse PROVIDER in consideration for the work and services performed under Child Welfare Regular Administration funding. Expenses incurred by PROVIDER, in association with said project prior to the term of this agreement,are not eligible Human Services expenditures and shall not be reimbursed by Human Services. Payment pursuant to this Contract, if Child Welfare Regular Administration funds,whether in whole or in part, is subject to and contingent upon the continuing availability of Child Welfare Regular Administration funds for the purposes hereof. In the event that said funds,or any part thereof,become unavailable as determined by Human Services,Human Services may immediately terminate this Contract or amend it accordingly. 2. Fees for Services Respite care is limited to four hours per week per child. The hours of care may be provided in any combination throughout a month,but not to exceed 16 hours per month. Payment will be$16.75 per each four hour period,but not to exceed$67.00 per month for 16 hours. Human Services referrals will not be sent to collections by PROVIDER for default of co-pay/fees. Services will be performed regardless of client's refusal or inability to pay co-pay. PROVIDER will collect any applicable sliding scale co-pays and credit Human Services for any payments received on the monthly billing statements. 3. Submittal of Vouchers PROVIDER shall prepare and submit monthly,the itemized voucher and certify that the services authorized were provided on the date indicated and the charges made were pursuant to the terms and conditions of Exhibit A. Page 6 of 9 11-12-RESPITE CARE EXHIBIT C ASSURANCES 1. PROVIDER agrees it is an independent contractor and that its officers and employees do not become employees of Weld County,nor are they entitled to any employee benefits as Weld County employees,as the result of the execution of this Agreement. 2. Weld County,the Board of County Commissioners of Weld County, its officers and employees,shall not be held liable for injuries or damages caused by any negligent acts or omissions of PROVIDER-contracted PROVIDERS or its employees,volunteers,or agents while performing duties as described in this Agreement. PROVIDER shall indemnify, defend,and hold harmless Weld County,the Board of County Commissioners of Weld County, its employees,volunteers,and agents. PROVIDER shall provide adequate liability and worker's compensation insurance for all its employees,volunteers,and agents engaged in the performance of the Agreement upon request, PROVIDER shall provide Human Services with the acceptable evidence that such coverage is in effect. 3. No portion of this Contract shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may possess,not shall any portion of this Agreement be deemed to have treated a duty of care with respect to any persons not a party of this Agreement. 4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld,State of Colorado,to expend funds not otherwise appropriated in each succeeding year. 5. If any section,subsection,paragraph,sentence,clause,or phrase of this Contract is for any reason held or decided to be unconstitutional,such decision shall not affect the validity of the remaining portions. The parties hereto declare that they would have entered into this Contract and each and every section,subsection, paragraph,sentence,clause,and phrase thereof irrespective of the fact that any one or more sections, subsections,paragraphs,sentences,clauses,or phrases might be declared to be unconstitutional or invalid. 6. No officer,member or employee of Weld County and no member of their governing bodies shall have any pecuniary interest,direct or indirect, in the approved Agreement or the proceeds thereof. 7. PROVIDER assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that no person shall, on the grounds of race,creed,color,sex,or national origin,be excluded from participation in,be denied the benefits of,or be otherwise subjected to discrimination under this approved Contract. 8. PROVIDER assures that sufficient,auditable,and otherwise adequate records that will provide accurate, current, separate, and complete disclosure of the status of the funds received under the Contract are maintained for three(3)years or the completion and resolution of an audit. Such records shall be sufficient to allow authorized local,Federal, and State auditors,and representatives to audit and monitor PROVIDER. 9. All such records,documents, communications,and other materials shall be the property of Human Services and shall be maintained by PROVIDER, in a central location and custodian, in behalf of Human Services,for a period of four(4)years from the date of final payment under this Contract,or for such further period as may be necessary to resolve any matters which may be pending,or until an audit has been completed with the following qualifications: If an audit by or on behalf of the federal and/or state government has begun but is not completed at the end of the four(4)year period,or if audit findings have not been resolved after a four(4)year period,the materials shall be retained until the resolution of the audit finding. 10. PROVIDER assures that authorized local,federal,and state auditors and representatives shall,during business hours,have access to inspect any copy records,and shall be allowed to monitor and review through on-site visits,all contract activities,supported with funds under this Contract to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. Page 7 of 9 11-12-RESPITE CARE 11. This Contract shall be binding upon the parties hereto,their successors,heirs, legal representatives,and assigns. PROVIDER or Human Services may not assign any of its rights or obligations hereunder without the prior written consent of both parties. 12. PROVIDER certifies that federal appropriated funds have not been paid or will be paid,by or on behalf of PROVIDER,to any person for influencing or attempting to influence an officer or employee of an agency,a Member of Congress, an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any federal grant,the making of any federal loan,the entering into of any cooperative agreement,and the extension,continuation,renewal, amendment,or modification of any Federal contract,loan,grant,or cooperative agreement. 13. PROVIDER assures that it will fully comply with all other applicable federal and state laws. PROVIDER understands that the source of funds to be used under this Contract is Child Welfare Regular Administration funds. 14. PROVIDER assures and certifies that it and its principals: a. Are not presently debarred,suspended,proposed for debarment,declared ineligible or voluntarily excluded from covered transaction by a federal department or agency. b. Have not,within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining,attempting to obtain,or performing a public(federal,state,or local)transaction or contract under a public transaction;violation of federal or state antitrust statutes or commission of embezzlement, theft,forgery,bribery, falsification or destruction of records,making false statements,or receiving stolen property; c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state,or local)with commission of any of the offenses enumerated in paragraph 14(b)of this certification;and d. Have not within a three-year period preceding this Contract,had one or more public transactions (federal,state,and local)terminated for cause or default. 15. The Appearance of Conflict of Interest applies to the relationship of a contractor with Human Services when the contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest,it is not necessary for the contractor to gain from knowledge of these opposing interests. It is only necessary that the contractor know that the two relationships are in opposition. During the term of the Contract, PROVIDER shall not enter any third party relationship that gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation, PROVIDER shall submit to Human Services,a full disclosure statement setting forth the details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for Human Services'termination,for cause,of its contract with PROVIDER. 16. PROVIDER shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Contract. Except for purposes directly connected with the administration of Child Protection,no information about or obtained from any applicant/recipient in possession of PROVIDER shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with PROVIDER written policies governing access to,duplication and dissemination of,all such information. PROVIDER shall advise its employees,agents,and subcontractors, if any,that they are subject to these confidentiality requirements. PROVIDER shall provide its employees,agents,and subcontractors, if any,with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. Page 8 of 9 11-12-RESPITE CARE 17. Proprietary information for the purposes of this contract is information relating to a party's research, development,trade secrets,business affairs,internal operations and management procedures and those of its customers,clients or affiliates,but does not include information(1)lawfully obtained from third parties,(2) that which is in the public domain,or(3)that which is developed independently. Neither party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of this Contract. Any proprietary information removed from the State's site by PROVIDER in the course of providing services under this Contract will be accorded at least the same precautions as are employed by PROVIDER for similar information in the course of its own business. 18. PROVIDER certifies that s/he will abide by Colorado Revised Statute(C.R.S.)26-6-104,requiring criminal background checks for all employees,contractors,and sub-contractors. Page 9 of 9 I I-12-RESPITE CARE CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND PROVIDER This Agreement,made and entered into the day of ,20 ,by and between the Board of Weld County Commissioners,sitting as the Board of Human on be al of the Wed County Department of Human Services,hereinafter referred to as"Human Services,"and N.66 6 ac4 referred to as "Provider". WITNESSETH WHEREAS,required approval,clearance,and coordination have been accomplished from and with appropriate agencies; and WHEREAS,the Colorado Department of Human Services has provided Child Welfare Regular Administration funding for respite care for county foster care PROVIDERS and WHEREAS, Provider is a for-profit Sole-Proprietor. NOW THEREFORE, in consideration of the premises,the parties hereto covenant and agree as follows: 1. Term This Agreement shall become effective on July 1,20 11,upon proper execution of this Agreement and shall expire June 30,20Lt(unless sooner terminated as provided herein. 2. Scope of Services Services shall be provided by Provider to any person(s)eligible for child protection services in compliance with Exhibit A"Scope of Services,"a copy of which is attached by reference. 3. Payment a. Payment shall be made on the basis of Exhibit B."Payment Schedule,"copies of which are attached hereto and incorporated herein by reference. b. "Payment Schedule"shall establish the maximum reimbursement,which will be paid from Child Welfare Regular Administration funds during the duration of this Agreement. c. PROVIDER shall submit an itemized monthly bill to Human Services for all costs incurred and services provided pursuant to Exhibit A of this Agreement in accordance with criteria established by Human Services. PROVIDER shall submit all itemized monthly billings to Human Services no later than the twenty-fifth(25)day of the month following the month the cost was incurred. d. Payments of costs incurred pursuant to this Agreement are expressly contingent upon the availability of Child Welfare Regular Administration funds to Human Services. e. Human Services shall not be billed for,and reimbursement shall not be made for time involved in activities outside of those defined in Exhibit A. Work performed prior to the execution of this Contract shall not be reimbursed or considered part of this Agreement. 4. Financial Management At all times from the effective date of this Contract until completion of this Contract, PROVIDER shall comply with the administrative requirements, cost principles and other requirements set forth in the Financial Page 1 of 9 o?o//-/e// • 1 I-12-RESPITE CARE Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under Child Welfare Regular Administration funding must conform to the Single Audit Act of 1984 and OMB Circular A-133. 5. Payment Method Unless otherwise provided in the Scope of Services and Payment Schedule: a. PROVIDER shall provide proper monthly invoices and itemization of services performed for costs incurred in the performance of the agreement. b. Human Services may withhold any payment if PROVIDER has failed to comply with the Financial Management Requirements,program objectives,contractual terms,or reporting requirements. In the event of a forfeiture of reimbursements, PROVIDER may appeal such circumstance to the Director of Human Services. The decision of the Director of Human Services shall be final. 6. Assurances PROVIDER shall abide by all assurances as set forth in the attached Exhibit C,which is attached hereto and incorporated herein by reference. 7. Compliance with Applicable Laws At all times during the performance of this contract, PROVIDER shall strictly adhere to all applicable federal and state laws, orders, and all applicable standards, regulations, interpretations or guidelines issued pursuant thereto. This includes the protection of the confidentiality of all applicant/recipient records,papers, documents, tapes and any other materials that have been or may hereafter be established which relate to the Contract. PROVIDER acknowledges that the following laws are included: - Title VI of the Civil Rights Act of 1964,42 U.S.C. Sections 2000d—I et. seq.and its implementing regulation, 45 C.F.R. Part 80 et.seq. and - Section 504 of the Rehabilitation Act of 1973,29 U.S.C.Section 794,and its implementing regulations,45 C.F.R. Part 84;and - the Age Discrimination Act of 1975,42 U.S.C. Sections 6101 et.seq.and its implementation regulations,45 C.F.R. Part 91;and - Title VII of the Civil Rights Act of 1964;and - the Age Discrimination in Employment Act of 1967;and - the Equal Pay Act of 1963;and - the Education Amendments of 1972;and - Immigration Reform and Control Act of 1986,P.L.99-603; - 42 C.F.R. Part 2 and all regulations applicable to these laws prohibiting discrimination because of race, color,National origin,and sex, religion and handicap. including Acquired Immune Deficiency syndrome (AIDS)or AIDS related conditions,covered under Section 504 of the Rehabilitation Act of 1973, as amended, cited above. If necessary, PROVIDER and Human Services will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 CFR Part 2. Included in 45 C.F.R. Part 74 Appendix G 9,which requires that affirmative steps be taken to assure that small and minority businesses are utilized,when possible,as sources of supplies,equipment,construction and services. This assurance is given in consideration of and for the purpose of obtaining any and all federal and/or state financial assistance. Any person who feels that s/he has been discriminated against has the right to file a complaint either with the Colorado Department of Human Services or with the U.S. Department of Health and Human Services,Office for Civil Rights. Page 2 of 9 • 11-12-RESPITE CARE 8. Certifications PROVIDER certifies that, at the time of entering into this Contract, it has currently in effect all necessary licenses.approvals, insurance,etc.,required to properly provide the services and/or supplies covered by this contract. A copy of certificate will be provided to Human Services upon completion of this agreement. Failure to do so will null and void this contract in its entirety. 9. Monitoring and Evaluation PROVIDER and Human Services agree that monitoring and evaluation of the performance of this Agreement shall be conducted by PROVIDER and Human Services. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners and PROVIDER. PROVIDER shall permit Human Services,and any other duly authorized agent or govemmental agency,to monitor all activities conducted by PROVIDER pursuant to the terms of this Agreement. As the monitoring agency may in its sole discretion deem necessary or appropriate,such program data,special analyses,on-site checking, formal audit examinations,or any other reasonable procedures. All such monitoring shall be performed in a manner that will not unduly interfere with agreement work. 10. Modification of Agreement All modifications to this agreement shall be in writing and signed by both parties. II. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find PROVIDER substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by PROVIDER. These remedial actions are as follows: a. Withhold payment to PROVIDER until the necessary services or corrections in performance are satisfactorily completed; b. Deny payment or recover reimbursement for those services or deliverables,which have not been performed and which due to circumstances caused by PROVIDER cannot be performed or if performed would be of no value to Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; c. Incorrect payment to PROVIDER due to omission,error,fraud,and/or defalcation shall be recovered from PROVIDER by deduction from subsequent payments under this Agreement or other agreements between Human Services and PROVIDER,or by Human Services as a debt due to Human Services or otherwise as provided by law. 12. Representatives For the purpose of this Agreement,the individuals identified below are hereby designated representatives of the respective parties. Either party may from time to time designate in writing a new or substitute representative(s): For Human Services: Gloria Romansik Human Services Administrator Name Title For Provider:� n4 ho,- 1 ``t`-1Wr1 ,t1 Respite Care Provider Name Title Page 3 of 9 • 11-12-RESPITE CARE 13. Notice All notices required to be given by the parties hereunder shall be given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing a substitute person(s)or address to whom such notices shall be sent: To: Human Services To:14 Judy A.Griego,Director P.O.Box A S/ 3 4 .! Greeley,CO 80632 fatal i Cas rocs-3y 14. Litigation PROVIDER shall promptly notify Human Services in the event that PROVIDER learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement. PROVIDER, within five(5)calendar days after being served with a summons,complaint,or other pleading which has been filed in any federal or state court or administrative agency,shall deliver copies of such document(s)to the Human Services Director. The term"litigation" includes an assignment for the benefit of creditors,and filings in bankruptcy, reorganization and/or foreclosure. 15. Termination This Agreement may be terminated at any time by either party given thirty(30)days written notice and is subject to the availability of funding. PROVIDER reserves the right to suspend services to clients if finding is no longer available. 16. Entire Agreement This Agreement,together with all attachments hereto, constitutes the entire understanding between the parties with respect to the subject matter hereof, and may not be changed or modified except as stated in Paragraph 10 herein. 17. No Third Party Beneficiary. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 18. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may posses,nor shall any portion of this Agreement be deemed to have created a duty of care which did not previously exist with respect to any person not a party to this Agreement. IN WITNESS WHEREOF,the parties hereto have duly executed the Agreement as of the day, month,and year first above written. BOARD OF COUNTY COMMISSIONERS WELD COUNTY,COLORADO ATTEST: Weld County Clerk to the Board F y La i'isir Barbara IC kmeyer JUL 0 S 2011 BY: Deputy/� . Clerk t:the Board t>6 ®u .�� 4of9 o O,76)//__/&// 11-12-RESPITE CARE RM: my omey WELD COUNTY DEPARTMENT OF HUMAN SERVICES PROVIDER Ju y .Grieg Director Respit eider EXHIBIT A SCOPE OF SERVICES Each Provider will: 1. Complete a fingerprint card for a background check at the PROVIDERS expense with the Colorado Bureau of Investigation. A Federal Bureau of Investigation background check will be done if the Provider has been a resident of the State of Colorado for less than two years. Human Services will clear the Provider through CBI and FBI; 2. Complete a course in CPR and first aid,in which a current copy of the certifications must be provided to Human Services with this agreement. If either certification should expire during the contracted period,the Provider will send a new current certification copy to Human Services; 3. Provide transportation for the child to appointments during the hours of service as agreed upon with the foster parent; 4. Become familiar with State rules and regulations governing certified foster homes; 5. Must be eighteen years of age or older. Page 5 of 9 11-12-RESPITE CARE EXHIBIT B PAYMENT SCHEDULE 1. Funding and Method of Payment Human Services agrees to reimburse PROVIDER in consideration for the work and services performed under Child Welfare Regular Administration funding. Expenses incurred by PROVIDER, in association with said project prior to the term of this agreement,are not eligible Human Services expenditures and shall not be reimbursed by Human Services. Payment pursuant to this Contract, if Child Welfare Regular Administration funds,whether in whole or in part, is subject to and contingent upon the continuing availability of Child Welfare Regular Administration funds for the purposes hereof In the event that said funds,or any part thereof,become unavailable as determined by Human Services, Human Services may immediately terminate this Contract or amend it accordingly. 2. Fees for Services Respite care is limited to four hours per week per child. The hours of care may be provided in any combination throughout a month,but not to exceed 16 hours per month. Payment will be$16.75 per each four hour period,but not to exceed$67.00 per month for 16 hours. Human Services referrals will not be sent to collections by PROVIDER for default of co-pay/fees. Services will be performed regardless of client's refusal or inability to pay co-pay. PROVIDER will collect any applicable sliding scale co-pays and credit Human Services for any payments received on the monthly billing statements. 3. Submittal of Vouchers PROVIDER shall prepare and submit monthly,the itemized voucher and certify that the services authorized were provided on the date indicated and the charges made were pursuant to the terms and conditions of Exhibit A. Page 6 of 9 11-12-RESPITE CARE EXHIBIT C ASSURANCES 1. PROVIDER agrees it is an independent contractor and that its officers and employees do not become employees of Weld County, nor are they entitled to any employee benefits as Weld County employees,as the result of the execution of this Agreement. 2. Weld County,the Board of County Commissioners of Weld County, its officers and employees,shall not be held liable for injuries or damages caused by any negligent acts or omissions of PROVIDER-contracted PROVIDERS or its employees, volunteers,or agents while performing duties as described in this Agreement. PROVIDER shall indemnify, defend, and hold harmless Weld County,the Board of County Commissioners of Weld County, its employees, volunteers, and agents. PROVIDER shall provide adequate liability and worker's compensation insurance for all its employees, volunteers,and agents engaged in the performance of the Agreement upon request, PROVIDER shall provide Human Services with the acceptable evidence that such coverage is in effect. 3. No portion of this Contract shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may possess, not shall any portion of this Agreement be deemed to have treated a duty of care with respect to any persons not a party of this Agreement. 4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld, State of Colorado,to expend funds not otherwise appropriated in each succeeding year. 5. If any section, subsection,paragraph, sentence,clause, or phrase of this Contract is for any reason held or decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The parties hereto declare that they would have entered into this Contract and each and every section, subsection, paragraph, sentence,clause,and phrase thereof irrespective of the fact that any one or more sections, subsections, paragraphs,sentences,clauses,or phrases might be declared to be unconstitutional or invalid. 6. No officer, member or employee of Weld County and no member of their governing bodies shall have any pecuniary interest,direct or indirect, in the approved Agreement or the proceeds thereof. 7. PROVIDER assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that no person shall, on the grounds of race, creed,color, sex,or national origin,be excluded from participation in,be denied the benefits of, or be otherwise subjected to discrimination under this approved Contract. 8. PROVIDER assures that sufficient,auditable,and otherwise adequate records that will provide accurate, current, separate, and complete disclosure of the status of the funds received under the Contract are maintained for three(3)years or the completion and resolution of an audit. Such records shall be sufficient to Page 7 of 9 11-12-RESPITE CARE allow authorized local, Federal,and State auditors,and representatives to audit and monitor PROVIDER. 9. All such records,documents,communications, and other materials shall be the property of Human Services and shall be maintained by PROVIDER, in a central location and custodian, in behalf of Human Services, for a period of four(4)years from the date of final payment under this Contract,or for such further period as may be necessary to resolve any matters which may be pending,or until an audit has been completed with the following qualifications: If an audit by or on behalf of the federal and/or state government has begun but is not completed at the end of the four(4)year period,or if audit findings have not been resolved after a four(4) year period,the materials shall be retained until the resolution of the audit finding. 10. PROVIDER assures that authorized local,federal,and state auditors and representatives shall,during business hours,have access to inspect any copy records,and shall be allowed to monitor and review through on-site visits,all contract activities, supported with funds under this Contract to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. 11. This Contract shall be binding upon the parties hereto,their successors, heirs, legal representatives,and assigns. PROVIDER or Human Services may not assign any of its rights or obligations hereunder without the prior written consent of both parties. 12. PROVIDER certifies that federal appropriated funds have not been paid or will be paid, by or on behalf of PROVIDER,to any person for influencing or attempting to influence an officer or employee of an agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any federal grant,the making of any federal loan, the entering into of any cooperative agreement,and the extension, continuation,renewal, amendment, or modification of any Federal contract, loan,grant,or cooperative agreement. 13. PROVIDER assures that it will fully comply with all other applicable federal and state laws. PROVIDER understands that the source of funds to be used under this Contract is Child Welfare Regular Administration funds. 14. PROVIDER assures and certifies that it and its principals: a. Are not presently debarred, suspended,proposed for debarment,declared ineligible or voluntarily excluded from covered transaction by a federal department or agency. b. Have not, within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain,or performing a public(federal, state,or local)transaction or contract under a public transaction;violation of federal or state antitrust statutes or commission of embezzlement,theft, forgery,bribery, falsification or destruction of records,making false statements,or receiving stolen property; c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local)with commission of any of the offenses enumerated in paragraph 14(b)of this certification;and d. Have not within a three-year period preceding this Contract, had one or more public transactions (federal, state, and local)terminated for cause or default. 15. The Appearance of Conflict of Interest applies to the relationship of a contractor with Human Services when the contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest, it is not necessary for the contractor to gain from knowledge of these opposing interests. It is only necessary that the contractor know that the two relationships Page 8 of 9 1 I-12-RESPITE CARE are in opposition. During the term of the Contract, PROVIDER shall not enter any third party relationship that gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation, PROVIDER shall submit to Human Services,a full disclosure statement setting forth the details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for Human Services' termination,for cause,of its contract with PROVIDER. 16. PROVIDER shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Contract. Except for purposes directly connected with the administration of Child Protection, no information about or obtained from any applicant/recipient in possession of PROVIDER shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with PROVIDER written policies governing access to,duplication and dissemination of,all such information. PROVIDER shall advise its employees,agents,and subcontractors, if any,that they are subject to these confidentiality requirements. PROVIDER shall provide its employees, agents,and subcontractors,if any,with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. 17. Proprietary information for the purposes of this contract is information relating to a party's research, development,trade secrets,business affairs, internal operations and management procedures and those of its customers,clients or affiliates,but does not include information(1) lawfully obtained from third parties,(2) that which is in the public domain,or(3)that which is developed independently. Neither party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of this Contract. Any proprietary information removed from the State's site by PROVIDER in the course of providing services under this Contract will be accorded at least the same precautions as are employed by PROVIDER for similar information in the course of its own business. 18. PROVIDER certifies that s/he will abide by Colorado Revised Statute(C.R.S.)26-6-104,requiring criminal background checks for all employees,contractors,and sub-contractors. Page 9 of 9 11-12-RESPITE CARE CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND PROVIDER This Agreement, made and entered into the S day of t.,-U ,20k, by and between the Board of Weld County Commissioners, sitting as the Board of Human on behalf of the Weld County Department of Human Services, hereinafter referred to as"Human Services,"and K oy)&cc _, M referred to as"Provider". WITNESSETH WHEREAS,required approval,clearance, and coordination have been accomplished from and with appropriate agencies; and WHEREAS, the Colorado Department of Human Services has provided Child Welfare Regular Administration funding for respite care for county foster care PROVIDERS and WHEREAS, Provider is a for-profit Sole-Proprietor. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: 1. Term This Agreement shall become effective on July 1, 2011, upon proper execution of this Agreement an&Fshall expire June 30,20a unless sooner terminated as provided herein. 2. Scope of Services Services shall be provided by Provider to any person(s)eligible for child protection services in compliance with Exhibit A"Scope of Services,"a copy of which is attached by reference. .p 3. Payment a. Payment shall be made on the basis of Exhibit B,"Payment Schedule,"copies of which are attached hereto and incorporated herein by reference. b. "Payment Schedule"shall establish the maximum reimbursement, which will be paid from Child Welfare Regular Administration funds during the duration of this Agreement. c. PROVIDER shall submit an itemized monthly bill to Human Services for all costs incurred and services provided pursuant to Exhibit A of this Agreement in accordance with criteria established by Human Services. PROVIDER shall submit all itemized monthly billings to Human Services no later than the twenty-fifth(25)day of the month following the month the cost was incurred. d. Payments of costs incurred pursuant to this Agreement are expressly contingent upon the availability of Child Welfare Regular Administration funds to Human Services. e. Human Services shall not be killed for,and reimbursement shall not be made for time involved in activities outside of those defined in Exhibit A. Work performed prior to the execution of this Contract shall not he reimbursed or considered part of this Agreement. 4. Financial Mana eg ment At all times from the effective date of this Contract until completion of this Contract, PROVIDER shall comply with the administrative requirements,cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under Child Welfare Regular Administration funding must conform to the Single Audit Act of 1984 and OMB Circular A-133. Page 1 of 9 c9rg--/�// 11-12-RESPITE CARE 5. Payment Method Unless otherwise provided in the Scope of Services and Payment Schedule: a. PROVIDER shall provide proper monthly invoices and itemization of services performed for costs incurred in the performance of the agreement. b. Human Services may withhold any payment if PROVIDER has failed to comply with the Financial Management Requirements,program objectives,contractual terms,or reporting requirements. In the event of a forfeiture of reimbursements, PROVIDER may appeal such circumstance to the Director of Human Services. The decision of the Director of Human Services shall be final. 6. Assurances PROVIDER shall abide by all assurances as set forth in the attached Exhibit C,which is attached hereto and incorporated herein by reference. 7. Compliance with Applicable Laws At all times during the performance of this contract,PROVIDER shall strictly adhere to all applicable federal and state laws,orders,and all applicable standards, regulations, interpretations or guidelines issued pursuant thereto. This includes the protection of the confidentiality of all applicant/recipient records,papers, documents, tapes and any other materials that have been or may hereafter be established which relate to the Contract. PROVIDER acknowledges that the following laws are included: - Title VI of the Civil Rights Act of 1964,42 U.S.C.Sections 2000d-1 et.seq.and its implementing regulation, 45 C.F.R.Part 80 et.seq.;and - Section 504 of the Rehabilitation Act of 1973,29 U.S.C. Section 794,and its implementing regulations,45 C.F.R.Part 84;and - the Age Discrimination Act of 1975,42 U.S.C.Sections 6101 et.seq.and its implementation regulations,45 C.F.R. Part 91;and - Title VII of the Civil Rights Act of 1964;and - the Age Discrimination in Employment Act of 1967;and - the Equal Pay Act of 1963;and - the Education Amendments of 1972;and - Immigration Reform and Control Act of 1986,P.L.99-603; - 42 G.F.R.Part 2 and all regulations applicable to these laws prohibiting discrimination because of race, color, National origin, and sex,religion and handicap,including Acquired Immune Deficiency syndrome (AIDS)or AIDS related conditions,covered under Section 504 of the Rehabilitation Act of 1973, as amended, cited above. If necessary, PROVIDER and Human Services will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 CFR Part 2. Included in 45 C.F.R. Part 74 Appendix G 9,which requires that affirmative steps be taken to assure that small and minority businesses are utilized, when possible, as sources of supplies, equipment,construction and services. This assurance is given in consideration of and for the purpose of obtaining any and all federal and/or state financial assistance. Any person who feels that s/he has been discriminated against has the right to file a complaint either with the Colorado Department of Human Services or with the U.S. Department of Health and Human Services, Office for Civil Rights. 8. Certifications PROVIDER certifies that,at the time of entering into this Contract,it has currently in effect all necessary licenses,approvals, insurance, etc.,required to properly provide the services and/or supplies covered by this contract. A copy of certificate will be provided to Human Services upon completion of this agreement. Failure to do so will null and void this contract in its entirety. Page 2 of 9 11-12-RESPITE CARE 9. Monitoring and Evaluation PROVIDER and Human Services agree that monitoring and evaluation of the performance of this Agreement shall be conducted by PROVIDER and Human Services. The results of the monitoring and evaluation shall he provided to the Board of Weld County Commissioners and PROVIDER. PROVIDER shall permit Human Services, and any other duly authorized agent or governmental agency, to monitor all activities conducted by PROVIDER pursuant to the terms of this Agreement. As the monitoring agency may in its sole discretion deem necessary or appropriate,such program data,special analyses, on-site checking, formal audit examinations, or any other reasonable procedures. All such monitoring shall be performed in a manner that will not unduly interfere with agreement work. 10. Modification of Agreement All modifications to this agreement shall be in writing and signed by both parties. 11. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find PROVIDER substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by PROVIDER. These remedial actions are as follows: a. Withhold payment to PROVIDER until the necessary services or corrections in performance are satisfactorily completed; b. Deny payment or recover reimbursement for those services or deliverables, which have not been performed and which due to circumstances caused by PROVIDER cannot he performed or if performed would be of no value to Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; c. Incorrect payment to PROVIDER due to omission,error,fraud,and/or defalcation shall be recovered from PROVIDER by deduction from subsequent payments under this Agreement or other agreements between Human Services and PROVIDER,or by Human Services as a debt due to Human Services or otherwise as provided by law. 12. Representatives For the purpose of this Agreement, the individuals identified below are hereby designated representatives of the respective parties. Either party may from time to time designate in writing a new or substitute representative(s): For Human Services: Gloria Romansik Human Services Administrator Name Title For Provider: / ' , rti C n'V JuW - Respite Care Provider Name Title 13. Notice All notices required to be given by the parties hereunder shall be given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing a substitute person(s)or address to whom such notices shall he sent: To: Human Services Top' � 2 Judy A.Griego,Director ^GC�,(.�.6 rL P.O. Box A 2V / Greeley,CO 80632 /_1� A ea 3/ Page 3 of 9 11-12-RESPITE CARE 14. Litigation PROVIDER shall promptly notify Human Services in the event that PROVIDER learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement. PROVIDER, within five(5)calendar days after being served with a summons,complaint,or other pleading which has been filed in any federal or state court or administrative agency,shall deliver copies of such document(s)to the Human Services Director. The term"litigation"includes an assignment for the benefit of creditors, and filings in bankruptcy,reorganization and/or foreclosure. 15. Termination This Agreement may be terminated at any time by either party given thirty(30)days written notice and is subject to the availability of funding. PROVIDER reserves the right to suspend services to clients if funding is no longer available. 16. Entire Agreement This Agreement,together with all attachments hereto,constitutes the entire understanding between the parties with respect to the subject matter hereof,and may not be changed or modified except as stated in Paragraph 10 herein. 17. No Third Party Beneficiary. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 18. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care which did not previously exist with respect to any person not a party to this Agreement. IN WITNESS WHEREOF,the parties hereto have duly executed the Agreement as of the day,month,and year first above written. BOARD OF COUNTY COMMISSIONERS WELD COUNTY,COLORADI3 ATTES / � Y .111/47___ Weld County Clerk to th- oard R �► arbara • Deputy Clerk t e Board � �� ti� . . D A _:, • tbbt .4* i** Cou At erney a�► WELD COUNTY DEPARTMENT OF HUMAN SERVICES PROVIDER J d A. rie ,Direct r Resp e Prov -er Page 4 of 9 J 11-12-RESPITE CARE EXHIBIT A SCOPE OF SERVICES Each Provider will: 1. Complete a fingerprint card for a background check at the PROVIDERS expense with the Colorado Bureau of Investigation. A Federal Bureau of Investigation background check will be done if the Provider has been a resident of the State of Colorado for less than two years. Human Services will clear the Provider through CBI and FBI; 2. Complete a course in CPR and first aid, in which a current copy of the certifications must be provided to Human Services with this agreement. If either certification should expire during the contracted period,the Provider will send a new current certification copy to Human Services; 3. Provide transportation for the child to appointments during the hours of service as agreed upon with the foster parent; 4. Become familiar with State rules and regulations governing certified foster homes; 5. Must be eighteen years of age or older. Page 5 of 9 11-12-RESPITE CARE EXHIBIT B PAYMENT SCHEDULE 1. Funding and Method of Payment Human Services agrees to reimburse PROVIDER in consideration for the work and services performed under Child Welfare Regular Administration funding. Expenses incurred by PROVIDER, in association with said project prior to the term of this agreement, are not eligible Human Services expenditures and shall not be reimbursed by Human Services. Payment pursuant to this Contract, if Child Welfare Regular Administration funds,whether in whole or in part, is subject to and contingent upon the continuing availability of Child Welfare Regular Administration funds for the purposes hereof. In the event that said funds,or any part thereof, become unavailable as determined by Human Services, Human Services may immediately terminate this Contract or amend it accordingly. 2. Fees for Services Respite care is limited to four hours per week per child. The hours of care may be provided in any combination throughout a month,but not to exceed 16 hours per month. Payment will be$16.75 per each four hour period,but not to exceed $67.00 per month for 16 hours. Human Services referrals will not be sent to collections by PROVIDER for default of co-pay/fees. Services will be performed regardless of client's refusal or inability to pay co-pay. PROVIDER will collect any applicable sliding scale co-pays and credit Human Services for any payments received on the monthly billing statements. 3. Submittal of Vouchers PROVIDER shall prepare and submit monthly, the itemized voucher and certify that the services authorized were provided on the date indicated and the charges made were pursuant to the terms and conditions of Exhibit A. Page 6 of 9 11-12-RESPITE CARE EXHIBIT C ASSURANCES 1. PROVIDER agrees it is an independent contractor and that its officers and employees do not become employees of Weld County, nor are they entitled to any employee benefits as Weld County employees,as the result of the execution of this Agreement. 2. Weld County, the Board of County Commissioners of Weld County, its officers and employees, shall not be held liable for injuries or damages caused by any negligent acts or omissions of PROVIDER-contracted PROVIDERS or its employees,volunteers,or agents while performing duties as described in this Agreement. PROVIDER shall indemnify, defend, and hold harmless Weld County, the Board of County Commissioners of Weld County, its employees,volunteers,and agents. PROVIDER shall provide adequate liability and worker's compensation insurance for all its employees,volunteers,and agents engaged in the performance of the Agreement upon request, PROVIDER shall provide Human Services with the acceptable evidence that such coverage is in effect. 3. No portion of this Contract shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may possess, not shall any portion of this Agreement he deemed to have treated a duty of care with respect to any persons not a party of this Agreement. 4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld, State of Colorado, to expend funds not otherwise appropriated in each succeeding year. 5. If any section, subsection,paragraph,sentence,clause,or phrase of this Contract is for any reason held or decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The parties hereto declare that they would have entered into this Contract and each and every section,subsection, paragraph, sentence,clause, and phrase thereof irrespective of the fact that any one or more sections, subsections,paragraphs, sentences,clauses,or phrases might be declared to be unconstitutional or invalid. 6. No officer, member or employee of Weld County and no member of their governing bodies shall have any pecuniary interest,direct or indirect, in the approved Agreement or the proceeds thereof. 7. PROVIDER assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that no person shall, on the grounds of race,creed,color, sex,or national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under this approved Contract. 8. PROVIDER assures that sufficient, auditable, and otherwise adequate records that will provide accurate, current, separate, and complete disclosure of the status of the funds received under the Contract are maintained for three(3)years or the completion and resolution of an audit. Such records shall be sufficient to allow authorized local, Federal, and State auditors, and representatives to audit and monitor PROVIDER. 9. All such records,documents, communications,and other materials shall be the property of Human Services and shall be maintained by PROVIDER, in a central location and custodian, in behalf of Human Services, for a period of four(4)years from the date of final payment under this Contract, or for such further period as may be necessary to resolve any matters which may be pending,or until an audit has been completed with the following qualifications: If an audit by or on behalf of the federal and/or state government has begun but is not completed at the end of the four(4)year period,or if audit findings have not been resolved after a four(4)year period, the materials shall he retained until the resolution of the audit finding. 10. PROVIDER assures that authorized local,federal, and state auditors and representatives shall,during business hours, have access to inspect any copy records,and shall he allowed to monitor and review through on-site visits,all contract activities, supported with funds under this Contract to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. Page 7 of 9 11-12-RESPITE CARE 11. This Contract shall be binding upon the parties hereto, their successors, heirs, legal representatives, and assigns. PROVIDER or Human Services may not assign any of its rights or obligations hereunder without the prior written consent of both parties. 12. PROVIDER certifies that federal appropriated funds have not been paid or will be paid, by or on behalf of PROVIDER, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension,continuation,renewal, amendment, or modification of any Federal contract, loan, grant,or cooperative agreement. 13. PROVIDER assures that it will fully comply with all other applicable federal and state laws. PROVIDER understands that the source of funds to be used under this Contract is Child Welfare Regular Administration funds. 14. PROVIDER assures and certifies that it and its principals: a. Are not presently debarred, suspended,proposed for debarment, declared ineligible or voluntarily excluded from covered transaction by a federal department or agency. b. Have not, within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining,attempting to obtain,or performing a public(federal, state, or local)transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery,bribery, falsification or destruction of records,making false statements,or receiving stolen property; c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state,or local)with commission of any of the offenses enumerated in paragraph 14(h)of this certification; and d. Have not within a three-year period preceding this Contract, had one or more public transactions (federal, state, and local)terminated for cause or default. 15. The Appearance of Conflict of Interest applies to the relationship of a contractor with Human Services when the contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest, it is not necessary for the contractor to gain from knowledge of these opposing interests. It is only necessary that the contractor know that the two relationships arc in opposition. During the term of the Contract,PROVIDER shall not enter any third party relationship that gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation, PROVIDER shall submit to Human Services, a full disclosure statement setting forth the details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for Human Services' termination, for cause, of its contract with PROVIDER. 16. PROVIDER shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Contract. Except for purposes directly connected with the administration of Child Protection,no information about or obtained from any applicant/recipient in possession of PROVIDER shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with PROVIDER written policies governing access to,duplication and dissemination of, all such information. PROVIDER shall advise its employees, agents,and subcontractors,if any, that they are subject to these confidentiality requirements. PROVIDER shall provide its employees, agents,and subcontractors, if any, with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. Page 8 of 9 11-12-RESPITE CARE 17. Proprietary information for the purposes of this contract is information relating to a party's research, development, trade secrets,business affairs, internal operations and management procedures and those of its customers,clients or affiliates, but does not include information(1)lawfully obtained from third parties,(2) that which is in the public domain, or(3)that which is developed independently. Neither party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of this Contract. Any proprietary information removed from the State's site by PROVIDER in the course of providing services under this Contract will be accorded at least the same precautions as arc employed by PROVIDER for similar information in the course of its own business. 18. PROVIDER certifies that s/he will abide by Colorado Revised Statute (C.R.S.)26-6-104,requiring criminal background checks for all employees, contractors, and sub-contractors. Page 9 of 9 1 1-12-RESPITE CARE CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES „0 AND PROVIDER This Agreement,made and entered into the i5 day of ✓0C ,2011,by and between the Board of Weld County Commissioners,sitting as the Board of Human on behalf of the Weld County Department of Human Services,hereinafter referred to as"Human Services,"and nal,4k-LIUteYdt- referred to as"Provider". WITNESSETH WHEREAS,required approval,clearance,and coordination have been accomplished from and with appropriate agencies;and WHEREAS,the Colorado Department of Human Services has provided Child Welfare Regular Administration funding for respite care for county foster care PROVIDERS and WHEREAS,Provider is a for-profit Sole-Proprietor. NOW THEREFORE,in consideration of the premises,the parties hereto covenant and agree as follows: 1. Term This Agreement shall become effective on July 1,2011,upon proper execution of this Agreement and shall expire June 30,2011,unless sooner terminated as provided herein. 2. Scope of Services Services shall be provided by Provider to any person(s)eligible for child protection services in compliance with Exhibit A"Scope of Services,"a copy of which is attached by reference. 3. Payment a. Payment shall be made on the basis of Exhibit B,"Payment Schedule,"copies of which are attached hereto and incorporated herein by reference. b. "Payment Schedule"shall establish the maximum reimbursement, which will be paid from Child Welfare Regular Administration funds during the duration of this Agreement. c. PROVIDER shall submit an itemized monthly bill to Human Services for all costs incurred and services provided pursuant to Exhibit A of this Agreement in accordance with criteria established by Human Services. PROVIDER shall submit all itemized monthly billings to Human Services no later than the twenty-fifth(25)day of the month following the month the cost was incurred. d. Payments of costs incurred pursuant to this Agreement are expressly contingent upon the availability of Child Welfare Regular Administration funds to Human Services. e. Human Services shall not be billed for,and reimbursement shall not be made for time involved in activities outside of those defined in Exhibit A. Work performed prior to the execution of this Contract shall not be reimbursed or considered part of this Agreement. 4. Financial Management At all times from the effective date of this Contract until completion of this Contract,PROVIDER shall comply with the administrative requirements,cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under Child Welfare Regular Administration funding must conform to the Single Audit Act of 1984 and OMB Circular A-133. Page 1 of 9 tccD//-/l// 11-12-RESPITE CARE 5. Payment Method Unless otherwise provided in the Scope of Services and Payment Schedule: a. PROVIDER shall provide proper monthly invoices and itemization of services performed for costs incurred in the performance of the agreement. b. Human Services may withhold any payment if PROVIDER has failed to comply with the Financial Management Requirements,program objectives,contractual terms,or reporting requirements. In the event of a forfeiture of reimbursements,PROVIDER may appeal such circumstance to the Director of Human Services. The decision of the Director of Human Services shall be final. 6. Assurances PROVIDER shall abide by all assurances as set forth in the attached Exhibit C,which is attached hereto and incorporated herein by reference. 7. Compliance with Applicable Laws At all times during the performance of this contract,PROVIDER shall strictly adhere to all applicable federal and state laws,orders,and all applicable standards,regulations,interpretations or guidelines issued pursuant thereto. This includes the protection of the confidentiality of all applicant/recipient records,papers,documents, tapes and any other materials that have been or may hereafter be established which relate to the Contract. PROVIDER acknowledges that the following laws are included: - Title VI of the Civil Rights Act of 1964,42 U.S.C.Sections 2000d—1 et.seq.and its implementing regulation, 45 C.F.R.Part 80 et.seq..and - Section 504 of the Rehabilitation Act of 1973,29 U.S.C.Section 794,and its implementing regulations,45 C.F.R.Part 84;and - the Age Discrimination Act of 1975,42 U.S.C.Sections 6101 et.seq.and its implementation regulations,45 C.F.R. Part 91;and - Title VII of the Civil Rights Act of 1964;and - the Age Discrimination in Employment Act of 1967;and - the Equal Pay Act of 1963;and - the Education Amendments of 1972;and - Immigration Reform and Control Act of 1986,P.L.99-603; - 42 C.F.R.Part 2 and all regulations applicable to these laws prohibiting discrimination because of race, color,National origin,and sex,religion and handicap,including Acquired Immune Deficiency syndrome (AIDS)or AIDS related conditions,covered under Section 504 of the Rehabilitation Act of 1973,as amended,cited above. If necessary,PROVIDER and Human Services will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 CFR Part 2. Included in 45 C.F.R.Part 74 Appendix G 9,which requires that affirmative steps be taken to assure that small and minority businesses are utilized,when possible,as sources of supplies,equipment,construction and services. This assurance is given in consideration of and for the purpose of obtaining any and all federal and/or state financial assistance. Any person who feels that s/he has been discriminated against has the right to file a complaint either with the Colorado Department of Human Services or with the U.S.Department of Health and Human Services,Office for Civil Rights. 8. Certifications PROVIDER certifies that,at the time of entering into this Contract,it has currently in effect all necessary licenses,approvals,insurance,etc.,required to properly provide the services and/or supplies covered by this contract. A copy of certificate will be provided to Human Services upon completion of this agreement. Failure to do so will null and void this contract in its entirety. Page 2 of 9 11-12-RESPITE CARE 9. Monitoring and Evaluation PROVIDER and Human Services agree that monitoring and evaluation of the performance of this Agreement shall be conducted by PROVIDER and Human Services. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners and PROVIDER. PROVIDER shall permit Human Services,and any other duly authorized agent or governmental agency,to monitor all activities conducted by PROVIDER pursuant to the terms of this Agreement. As the monitoring agency may in its sole discretion deem necessary or appropriate,such program data,special analyses,on-site checking,formal audit examinations,or any other reasonable procedures. All such monitoring shall be performed in a manner that will not unduly interfere with agreement work. 10. Modification of Agreement All modifications to this agreement shall be in writing and signed by both parties. II. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find PROVIDER substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by PROVIDER. These remedial actions are as follows: a. Withhold payment to PROVIDER until the necessary services or corrections in performance are satisfactorily completed; b. Deny payment or recover reimbursement for those services or deliverables,which have not been performed and which due to circumstances caused by PROVIDER cannot be performed or if performed would be of no value to Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; c. Incorrect payment to PROVIDER due to omission,error,fraud,and/or defalcation shall be recovered from PROVIDER by deduction from subsequent payments under this Agreement or other agreements between Human Services and PROVIDER,or by Human Services as a debt due to Human Services or otherwise as provided by law. 12. Representatives For the purpose of this Agreement,the individuals identified below are hereby designated representatives of the respective parties. Either party may from time to time designate in writing a new or substitute representative(s): For Human Services: Gloria Romansik Human Services Administrator Name Tide For Provider: Oa. c.i& ULt-t i 0 tiN Respite Care Provider Name Title 13. Notice All notices required to be given by the parties hereunder shall be given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing a substitute person(s)or address to whom such notices shall be sent: To: Human Services To: t✓a1/4.IR(/—' LW-Q.f0t Judy A.Griego,Director y I I ufj11 LLMe-\i.J(L 1 O.Box ,C Pel�4 co G reelev,CO 80632 — Page 3 of 9 11-12-RESPITE CARE 14. Litigation PROVIDER shall promptly notify Human Services in the event that PROVIDER learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement.PROVIDER, within five(5)calendar days after being served with a summons,complaint,or other pleading which has been filed in any federal or state court or administrative agency,shall deliver copies of such document(s)to the Human Services Director. The term"litigation"includes an assignment for the benefit of creditors,and filings in bankruptcy,reorganization and/or foreclosure. 15. Termination This Agreement may be terminated at any time by either party given thirty(30)days written notice and is subject to the availability of funding. PROVIDER reserves the right to suspend services to clients if funding is no longer available. 16. Entire Agreement This Agreement,together with all attachments hereto,constitutes the entire understanding between the parties with respect to the subject matter hereof,and may not be changed or modified except as stated in Paragraph 10 herein. 17. No Third Party Beneficiary. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement,shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 18. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may posses,nor shall any portion of this Agreement be deemed to have created a duty of care which did not previously exist with respect to any person not a party to this Agreement. IN WITNESS WHEREOF,the parties hereto have duly executed the Agreement as of the day,month,and year first above written. BOARD OF COUNTY COMMISSIONERS WELD COUNTY,COLO' U• ATTEST: Weld County Clerk to the r oaml rbara K•rkme ye r BY: /�/Jill.., /, .� /,I JUL��,a 0 6 2011 Deputy Clerk to e BY , 1%61 >Pic Cou t :ttorney lrot WELD COUNTY DEPARTMENT OF HUMAN SERVIC S PROVIDER J(tpyn )NiUt h.u9 3( J A.Grie o,Direc Respite Provider Page 4 of 9 I 1-12-RESPITE CARE EXHIBIT A SCOPE OF SERVICES Each Provider will: I. Complete a fingerprint card for a background check at the PROVIDERS expense with the Colorado Bureau of Investigation. A Federal Bureau of Investigation background check will be done if the Provider has been a resident of the State of Colorado for less than two years. Human Services will clear the Provider through CBI and FBI; 2. Complete a course in CPR and first aid,in which a current copy of the certifications must be provided to Human Services with this agreement. If either certification should expire during the contracted period,the Provider will send a new current certification copy to Human Services; 3. Provide transportation for the child to appointments during the hours of service as agreed upon with the foster parent; 4. Become familiar with State rules and regulations governing certified foster homes; 5. Must be eighteen years of age or older. Page 5 of 9 l 1-12-RESPITE CARE EXHIBIT B PAYMENT SCHEDULE 1. Funding and Method of Payment Human Services agrees to reimburse PROVIDER in consideration for the work and services performed under Child Welfare Regular Administration funding. Expenses incurred by PROVIDER,in association with said project prior to the term of this agreement,are not eligible Human Services expenditures and shall not be reimbursed by Human Services. Payment pursuant to this Contract,if Child Welfare Regular Administration funds,whether in whole or in part, is subject to and contingent upon the continuing availability of Child Welfare Regular Administration funds for the purposes hereof. In the event that said funds,or any part thereof,become unavailable as determined by Human Services,Human Services may immediately terminate this Contract or amend it accordingly. 2. Fees for Services Respite care is limited to four hours per week per child. The hours of care may be provided in any combination throughout a month,but not to exceed 16 hours per month. Payment will be$16.75 per each four hour period,but not to exceed$67.00 per month for 16 hours. Human Services referrals will not be sent to collections by PROVIDER for default of co-pay/fees. Services will be performed regardless of client's refusal or inability to pay co-pay. PROVIDER will collect any applicable sliding scale co-pays and credit Human Services for any payments received on the monthly billing statements. 3. Submittal of Vouchers PROVIDER shall prepare and submit monthly,the itemized voucher and certify that the services authorized were provided on the date indicated and the charges made were pursuant to the terms and conditions of Exhibit A. Page 6 of 9 11-12-RESPITE CARE EXHIBIT C ASSURANCES I. PROVIDER agrees it is an independent contractor and that its officers and employees do not become employees of Weld County,nor are they entitled to any employee benefits as Weld County employees,as the result of the execution of this Agreement. 2. Weld County,the Board of County Commissioners of Weld County,its officers and employees,shall not be held liable for injuries or damages caused by any negligent acts or omissions of PROVIDER-contracted PROVIDERS or its employees,volunteers,or agents while performing duties as described in this Agreement. PROVIDER shall indemnify,defend,and hold harmless Weld County,the Board of County Commissioners of Weld County,its employees,volunteers,and agents. PROVIDER shall provide adequate liability and worker's compensation insurance for all its employees,volunteers,and agents engaged in the performance of the Agreement upon request,PROVIDER shall provide Human Services with the acceptable evidence that such coverage is in effect. 3. No portion of this Contract shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may possess,not shall any portion of this Agreement be deemed to have treated a duty of care with respect to any persons not a party of this Agreement. 4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld,State of Colorado,to expend funds not otherwise appropriated in each succeeding year. 5. If any section,subsection,paragraph,sentence,clause,or phrase of this Contract is for any reason held or decided to be unconstitutional,such decision shall not affect the validity of the remaining portions. The parties hereto declare that they would have entered into this Contract and each and every section,subsection, paragraph,sentence,clause,and phrase thereof irrespective of the fact that any one or more sections, subsections,paragraphs,sentences,clauses,or phrases might be declared to be unconstitutional or invalid. 6. No officer,member or employee of Weld County and no member of their governing bodies shall have any pecuniary interest,direct or indirect,in the approved Agreement or the proceeds thereof. 7. PROVIDER assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that no person shall,on the grounds of race,creed,color,sex,or national origin,be excluded from participation in,be denied the benefits of,or be otherwise subjected to discrimination under this approved Contract. 8. PROVIDER assures that sufficient,auditable,and otherwise adequate records that will provide accurate, current,separate,and complete disclosure of the status of the funds received under the Contract are maintained for three(3)years or the completion and resolution of an audit. Such records shall be sufficient to allow authorized local,Federal,and State auditors,and representatives to audit and monitor PROVIDER. 9. All such records,documents,communications,and other materials shall be the property of Human Services and shall be maintained by PROVIDER, in a central location and custodian,in behalf of Human Services,for a period of four(4)years from the date of final payment under this Contract,or for such further period as may be necessary to resolve any matters which may be pending,or until an audit has been completed with the following qualifications: If an audit by or on behalf of the federal and/or state government has begun but is not completed at the end of the four(4)year period,or if audit findings have not been resolved after a four(4)year period,the materials shall be retained until the resolution of the audit finding. 10. PROVIDER assures that authorized local,federal,and state auditors and representatives shall,during business hours,have access to inspect any copy records,and shall be allowed to monitor and review through on-site visits,all contract activities,supported with funds under this Contract to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. Page 7 of 9 11-12-RESPITE CARE 11. This Contract shall be binding upon the parties hereto,their successors,heirs,legal representatives,and assigns. PROVIDER or Human Services may not assign any of its rights or obligations hereunder without the prior written consent of both parties. 12. PROVIDER certifies that federal appropriated funds have not been paid or will be paid,by or on behalf of PROVIDER,to any person for influencing or attempting to influence an officer or employee of an agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any federal grant,the making of any federal loan,the entering into of any cooperative agreement,and the extension,continuation,renewal, amendment,or modification of any Federal contract, loan,grant,or cooperative agreement. 13. PROVIDER assures that it will fully comply with all other applicable federal and state laws. PROVIDER understands that the source of funds to be used under this Contract is Child Welfare Regular Administration funds. 14. PROVIDER assures and certifies that it and its principals: a. Are not presently debarred,suspended,proposed for debarment,declared ineligible or voluntarily excluded from covered transaction by a federal department or agency. b. Have not,within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining,attempting to obtain,or performing a public(federal,state,or local)transaction or contract under a public transaction;violation of federal or state antitrust statutes or commission of embezzlement, theft,forgery,bribery,falsification or destruction of records,making false statements,or receiving stolen property; c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state,or local)with commission of any of the offenses enumerated in paragraph 14(b)of this certification;and d. Have not within a three-year period preceding this Contract,had one or more public transactions (federal,state,and local)terminated for cause or default. 15. The Appearance of Conflict of Interest applies to the relationship of a contractor with Human Services when the contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest,it is not necessary for the contractor to gain from knowledge of these opposing interests. It is only necessary that the contractor know that the two relationships are in opposition.During the term of the Contract,PROVIDER shall not enter any third party relationship that gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation,PROVIDER shall submit to Human Services,a full disclosure statement setting forth the details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for Human Services' termination,for cause,of its contract with PROVIDER. 16. PROVIDER shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Contract. Except for purposes directly connected with the administration of Child Protection,no information about or obtained from any applicant/recipient in possession of PROVIDER shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with PROVIDER written policies governing access to,duplication and dissemination of,all such information. PROVIDER shall advise its employees,agents,and subcontractors,if any,that they are subject to these confidentiality requirements. PROVIDER shall provide its employees,agents,and subcontractors,if any, with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. Page 8 of 9 I1-12-RESPITE CARE 17. Proprietary information for the purposes of this contract is information relating to a party's research, development,trade secrets,business affairs,internal operations and management procedures and those of its customers,clients or affiliates,but does not include information(1)lawfully obtained from third parties,(2) that which is in the public domain,or(3)that which is developed independently. Neither party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of this Contract. Any proprietary information removed from the State's site by PROVIDER in the course of providing services under this Contract will be accorded at least the same precautions as are employed by PROVIDER for similar information in the course of its own business. 18. PROVIDER certifies that s/he will abide by Colorado Revised Statute(C.R.S.)26-6-104,requiring criminal background checks for all employees,contractors,and sub-contractors. Page 9 of 9 11-12-RESPITE CARE CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND PROVIDER This Agreement,made and entered into the day of ,20_,by and between the Board of Weld County Commissioners,sitting as the Board of Human n beha f of the Weld County Department of Human Services,hereinafter referred to as"Human Services,"and toter({ tc k referred to as"Provider". WITNESSETH WHEREAS,required approval,clearance,and coordination have been accomplished from and with appropriate agencies;and WHEREAS,the Colorado Department of Human Services has provided Child Welfare Regular Administration funding for respite care for county foster care PROVIDERS and WHEREAS,Provider is a for-profit Sole-Proprietor. NOW THEREFORE,in consideration of the premises,the parties hereto covenant and agree as follows: 1. Term This Agreement shall become effective on July 1,2011,upon proper execution of this Agreement and shall expire June 30,20atmless sooner terminated as provided herein. 2. Scope of Services Services shall be provided by Provider to any person(s)eligible for child protection services in compliance with Exhibit A"Scope of Services,"a copy of which is attached by reference. 3. Payment a. Payment shall be made on the basis of Exhibit B,"Payment Schedule,"copies of which are attached hereto and incorporated herein by reference. b. "Payment Schedule"shall establish the maximum reimbursement,which will be paid from Child Welfare Regular Administration funds during the duration of this Agreement. c. PROVIDER shall submit an itemized monthly bill to Human Services for all costs incurred and services provided pursuant to Exhibit A of this Agreement in accordance with criteria established by Human Services. PROVIDER shall submit all itemized monthly billings to Human Services no later than the twenty-fifth(25)day of the month following the month the cost was incurred. d. Payments of costs incurred pursuant to this Agreement are expressly contingent upon the availability of Child Welfare Regular Administration funds to Human Services. e. Human Services shall not be billed for,and reimbursement shall not be made for time involved in activities outside of those defined in Exhibit A. Work performed prior to the execution of this Contract shall not be reimbursed or considered part of this Agreement. 4. Financial Management At all times from the effective date of this Contract until completion of this Contract,PROVIDER shall comply with the administrative requirements,cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under Child Welfare Regular Administration funding must conform to the Single Audit Act of 1984 and OMB Circular A-133. Page 1 of 9 ( 7d//-/e// 11-12-RESPITE CARE 5. Payment Method Unless otherwise provided in the Scope of Services and Payment Schedule: a. PROVIDER shall provide proper monthly invoices and itemization of services performed for costs incurred in the performance of the agreement. b. Human Services may withhold any payment if PROVIDER has failed to comply with the Financial Management Requirements,program objectives,contractual terms,or reporting requirements. In the event of a forfeiture of reimbursements, PROVIDER may appeal such circumstance to the Director of Human Services. The decision of the Director of Human Services shall be final. 6. Assurances PROVIDER shall abide by all assurances as set forth in the attached Exhibit C,which is attached hereto and incorporated herein by reference. 7. Compliance with Applicable Laws At all times during the performance of this contract,PROVIDER shall strictly adhere to all applicable federal and state laws,orders,and all applicable standards,regulations, interpretations or guidelines issued pursuant thereto. This includes the protection of the confidentiality of all applicant/recipient records,papers,documents, tapes and any other materials that have been or may hereafter be established which relate to the Contract. PROVIDER acknowledges that the following laws are included: - Title VI of the Civil Rights Act of 1964,42 U.S.C.Sections 2000d—1 et.seq.and its implementing regulation, 45 C.F.R.Part 80 et.seq.;and - Section 504 of the Rehabilitation Act of 1973,29 U.S.C.Section 794,and its implementing regulations,45 C.F.R.Part 84;and - the Age Discrimination Act of 1975,42 U.S.C.Sections 6101 et.seq.and its implementation regulations,45 C.F.R. Part 91;and - Title VII of the Civil Rights Act of 1964;and - the Age Discrimination in Employment Act of 1967;and - the Equal Pay Act of 1963;and - the Education Amendments of 1972;and - Immigration Reform and Control Act of 1986,P.L.99-603; - 42 C.F.R.Part 2 and all regulations applicable to these laws prohibiting discrimination because of race, color,National origin, and sex,religion and handicap,including Acquired Immune Deficiency syndrome (AIDS)or AIDS related conditions,covered under Section 504 of the Rehabilitation Act of 1973,as amended, cited above. If necessary, PROVIDER and Human Services will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 CFR Part 2. Included in 45 C.F.R. Part 74 Appendix G 9,which requires that affirmative steps be taken to assure that small and minority businesses are utilized,when possible,as sources of supplies,equipment,construction and services. This assurance is given in consideration of and for the purpose of obtaining any and all federal and/or state financial assistance. Any person who feels that s/he has been discriminated against has the right to file a complaint either with the Colorado Department of Human Services or with the U.S. Department of Health and Human Services,Office for Civil Rights. 8. Certifications PROVIDER certifies that,at the time of entering into this Contract,it has currently in effect all necessary licenses,approvals, insurance,etc.,required to properly provide the services and/or supplies covered by this contract. A copy of certificate will be provided to Human Services upon completion of this agreement. Failure to do so will null and void this contract in its entirety. Page 2 of 9 I 1-12-RESPITE CARE 9. Monitoring and Evaluation PROVIDER and Human Services agree that monitoring and evaluation of the performance of this Agreement shall be conducted by PROVIDER and Human Services. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners and PROVIDER. PROVIDER shall permit Human Services,and any other duly authorized agent or governmental agency,to monitor all activities conducted by PROVIDER pursuant to the terms of this Agreement. As the monitoring agency may in its sole discretion deem necessary or appropriate, such program data,special analyses,on-site checking,formal audit examinations,or any other reasonable procedures. All such monitoring shall be performed in a manner that will not unduly interfere with agreement work. 10. Modification of Agreement All modifications to this agreement shall be in writing and signed by both parties. II. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find PROVIDER substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by PROVIDER. These remedial actions are as follows: a. Withhold payment to PROVIDER until the necessary services or corrections in performance are satisfactorily completed; b. Deny payment or recover reimbursement for those services or deliverables,which have not been performed and which due to circumstances caused by PROVIDER cannot be performed or if performed would be of no value to Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; c. Incorrect payment to PROVIDER due to omission,error,fraud,and/or defalcation shall be recovered from PROVIDER by deduction from subsequent payments under this Agreement or other agreements between Human Services and PROVIDER,or by Human Services as a debt due to Human Services or otherwise as provided by law. 12. Representatives For the purpose of this Agreement,the individuals identified below are hereby designated representatives of the respective parties. Either party may from time to time designate in writing a new or substitute representative(s): For Human Services: Gloria Romansik Human Services Administrator Name Title For Provider: Respite Care Provider Name Title 13. Notice All notices required to be given by the parties hereunder shall be given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing a substitute person(s)or address to whom such notices shall be sent: To: Human Services To: Judy A.Griego,Director P.O.Box A Greeley,CO 80632 Page 3 of 9 11-12-RESPITE CARE 14. Litigation PROVIDER shall promptly notify Human Services in the event that PROVIDER learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement.PROVIDER, within five(5)calendar days after being served with a summons,complaint,or other pleading which has been filed in any federal or state court or administrative agency,shall deliver copies of such document(s)to the Human Services Director. The term"litigation"includes an assignment for the benefit of creditors,and filings in bankruptcy,reorganization and/or foreclosure. 15. Termination This Agreement may be terminated at any time by either party given thirty(30)days written notice and is subject to the availability of funding. PROVIDER reserves the right to suspend services to clients if funding is no longer available. 16. Entire Agreement This Agreement,together with all attachments hereto,constitutes the entire understanding between the parties with respect to the subject matter hereof,and may not be changed or modified except as stated in Paragraph 10 herein. 17. No Third Party Beneficiary. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 18. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may posses,nor shall any portion of this Agreement be deemed to have created a duty of care which did not previously exist with respect to any person not a party to this Agreement. IN WITNESS WHEREOF,the parties hereto have duly executed the Agreement as of the day,month,and year first above written. BOARD OF COUNTY COMMISSIONERS WELD COUNTY,COLO' • ATTEST: WedCo Clerk to the Board L•am�=' arbara K• kmeyer Deputy Clerk t- fe :oar !BY: ~ Q,® �� JUL 0 6 2011 flit, o AScar � �1 C.A °U WELD WELD COUNTY DEPARTMENT OF HUMAN SERVICES PROVIDER; Ju . rieg irecto pite Pr Page 4 of 9 c>?(//—/d2// I1-12-RESPITE CARE EXHIBIT A SCOPE OF SERVICES Each Provider will: 1. Complete a fingerprint card for a background check at the PROVIDERS expense with the Colorado Bureau of • Investigation. A Federal Bureau of Investigation background check will be done if the Provider has been a resident of the State of Colorado for less than two years. Human Services will clear the Provider through CBI and FBI; 2. Complete a course in CPR and first aid, in which a current copy of the certifications must be provided to Human Services with this agreement. If either certification should expire during the contracted period,the Provider will send a new current certification copy to Human Services; 3. Provide transportation for the child to appointments during the hours of service as agreed upon with the foster parent; 4. Become familiar with State rules and regulations governing certified foster homes; 5. Must be eighteen years of age or older. Page 5 of 9 11-12-RESPITE CARE EXHIBIT B PAYMENT SCHEDULE 1. Funding and Method of Payment Human Services agrees to reimburse PROVIDER in consideration for the work and services performed under Child Welfare Regular Administration funding. Expenses incurred by PROVIDER, in association with said project prior to the term of this agreement,are not eligible Human Services expenditures and shall not be reimbursed by Human Services. Payment pursuant to this Contract, if Child Welfare Regular Administration funds,whether in whole or in part, is subject to and contingent upon the continuing availability of Child Welfare Regular Administration funds for the purposes hereof. In the event that said funds,or any part thereof,become unavailable as determined by Human Services, Human Services may immediately terminate this Contract or amend it accordingly. 2. Fees for Services Respite care is limited to four hours per week per child. The hours of care may be provided in any combination throughout a month,but not to exceed 16 hours per month. Payment will be$16.75 per each four hour period,but not to exceed$67.00 per month for 16 hours. Human Services referrals will not be sent to collections by PROVIDER for default of co-pay/fees. Services will be performed regardless of client's refusal or inability to pay co-pay. PROVIDER will collect any applicable sliding scale co-pays and credit Human Services for any payments received on the monthly billing statements. 3. Submittal of Vouchers PROVIDER shall prepare and submit monthly,the itemized voucher and certify that the services authorized were provided on the date indicated and the charges made were pursuant to the terms and conditions of Exhibit A. Page 6 of 9 11-12-RESPITE CARE EXHIBIT C ASSURANCES 1. PROVIDER agrees it is an independent contractor and that its officers and employees do not become employees of Weld County,nor are they entitled to any employee benefits as Weld County employees,as the result of the execution of this Agreement. 2. Weld County,the Board of County Commissioners of Weld County, its officers and employees,shall not be held liable for injuries or damages caused by any negligent acts or omissions of PROVIDER-contracted PROVIDERS or its employees,volunteers,or agents while performing duties as described in this Agreement. PROVIDER shall indemnify,defend,and hold harmless Weld County,the Board of County Commissioners of Weld County,its employees,volunteers,and agents. PROVIDER shall provide adequate liability and worker's compensation insurance for all its employees,volunteers,and agents engaged in the performance of the Agreement upon request, PROVIDER shall provide Human Services with the acceptable evidence that such coverage is in effect. 3. No portion of this Contract shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may possess,not shall any portion of this Agreement be deemed to have treated a duty of care with respect to any persons not a party of this Agreement. 4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld,State of Colorado,to expend funds not otherwise appropriated in each succeeding year. 5. If any section,subsection,paragraph,sentence,clause,or phrase of this Contract is for any reason held or decided to be unconstitutional,such decision shall not affect the validity of the remaining portions. The parties hereto declare that they would have entered into this Contract and each and every section,subsection, paragraph,sentence,clause,and phrase thereof irrespective of the fact that any one or more sections, subsections,paragraphs, sentences, clauses,or phrases might be declared to be unconstitutional or invalid. 6. No officer,member or employee of Weld County and no member of their governing bodies shall have any pecuniary interest, direct or indirect,in the approved Agreement or the proceeds thereof. 7. PROVIDER assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that no person shall, on the grounds of race,creed,color, sex,or national origin,be excluded from participation in,be denied the benefits of,or be otherwise subjected to discrimination under this approved Contract. 8. PROVIDER assures that sufficient,auditable, and otherwise adequate records that will provide accurate, current,separate,and complete disclosure of the status of the funds received under the Contract are maintained for three(3)years or the completion and resolution of an audit. Such records shall be sufficient to allow authorized local,Federal,and State auditors,and representatives to audit and monitor PROVIDER. 9. All such records,documents,communications,and other materials shall be the property of Human Services and shall be maintained by PROVIDER, in a central location and custodian,in behalf of Human Services, for a period of four(4)years from the date of final payment under this Contract,or for such further period as may be necessary to resolve any matters which may be pending,or until an audit has been completed with the following qualifications: If an audit by or on behalf of the federal and/or state government has begun but is not completed at the end of the four(4)year period,or if audit findings have not been resolved after a four(4)year period,the materials shall be retained until the resolution of the audit finding. 10. PROVIDER assures that authorized local,federal,and state auditors and representatives shall,during business hours,have access to inspect any copy records, and shall be allowed to monitor and review through on-site visits,all contract activities, supported with funds under this Contract to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. Page 7 of 9 11-12-RESPITE CARE 11. This Contract shall be binding upon the parties hereto,their successors,heirs, legal representatives,and assigns. PROVIDER or Human Services may not assign any of its rights or obligations hereunder without the prior written consent of both parties. 12. PROVIDER certifies that federal appropriated funds have not been paid or will be paid,by or on behalf of PROVIDER,to any person for influencing or attempting to influence an officer or employee of an agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any federal grant,the making of any federal loan,the entering into of any cooperative agreement,and the extension,continuation,renewal, amendment,or modification of any Federal contract, loan,grant,or cooperative agreement. 13. PROVIDER assures that it will fully comply with all other applicable federal and state laws. PROVIDER understands that the source of funds to be used under this Contract is Child Welfare Regular Administration funds. 14. PROVIDER assures and certifies that it and its principals: a. Are not presently debarred,suspended,proposed for debarment,declared ineligible or voluntarily excluded from covered transaction by a federal department or agency. b. Have not,within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining,attempting to obtain,or performing a public(federal,state,or local)transaction or contract under a public transaction;violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery,bribery, falsification or destruction of records,making false statements,or receiving stolen property; c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state,or local)with commission of any of the offenses enumerated in paragraph 14(b)of this certification;and d. Have not within a three-year period preceding this Contract,had one or more public transactions (federal,state,and local)terminated for cause or default. 15. The Appearance of Conflict of Interest applies to the relationship of a contractor with Human Services when the contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest,it is not necessary for the contractor to gain from knowledge of these opposing interests. It is only necessary that the contractor know that the two relationships are in opposition. During the term of the Contract,PROVIDER shall not enter any third party relationship that gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation,PROVIDER shall submit to Human Services,a full disclosure statement setting forth the details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for Human Services'termination,for cause,of its contract with PROVIDER. 16. PROVIDER shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Contract. Except for purposes directly connected with the administration of Child Protection,no information about or obtained from any applicant/recipient in possession of PROVIDER shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with PROVIDER written policies governing access to,duplication and dissemination of,all such information. PROVIDER shall advise its employees,agents,and subcontractors, if any,that they are subject to these confidentiality requirements. PROVIDER shall provide its employees,agents,and subcontractors, if any,with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. Page 8 of 9 11-12-RESPITE CARE 17. Proprietary information for the purposes of this contract is information relating to a party's research, development,trade secrets,business affairs, internal operations and management procedures and those of its customers,clients or affiliates,but does not include information(1)lawfully obtained from third parties,(2) that which is in the public domain,or(3)that which is developed independently. Neither party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of this Contract. Any proprietary information removed from the State's site by PROVIDER in the course of providing services under this Contract will be accorded at least the same precautions as are employed by PROVIDER for similar information in the course of its own business. 18. PROVIDER certifies that s/he will abide by Colorado Revised Statute(C.R.S.)26-6-104,requiring criminal background checks for all employees,contractors,and sub-contractors. Page 9 of 9 11-12-RESPITE CARE CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND PROVIDER /, This Agreement,made and entered into the_day of ,20_,by and between the Board off's Weld County Commissioners, sitting as the Board of Human toiq behalf County�of the Weld o Department of Human Services,hereinafter referred to as"Human Services,"and red— 1 n'11LjWy1PA, referred to as"Provider". WITNESSETH �4 WHEREAS,required approval,clearance,and coordination have been accomplished from and with appropriate agencies;and WHEREAS,the Colorado Department of Human Services has provided Child Welfare Regular Administration funding for respite care for county foster care PROVIDERS and WHEREAS,Provider is a for-profit Sole-Proprietor. NOW THEREFORE,in consideration of the premises,the parties hereto covenant and agree as follows: 1. Term This Agreement shall become effective on July 1,20L,upon proper execution of this Agreement and shall expire June 30,20n/unless sooner terminated as provided herein. 2. Scope of Services Services shall be provided by Provider to any person(s)eligible for child protection services in compliance with Exhibit A"Scope of Services,"a copy of which is attached by reference. 3. Payment a. Payment shall be made on the basis of Exhibit B,"Payment Schedule,"copies of which are attached hereto and incorporated herein by reference. b. "Payment Schedule"shall establish the maximum reimbursement,which will be paid from Child Welfare Regular Administration funds during the duration of this Agreement. c. PROVIDER shall submit an itemized monthly bill to Human Services for all costs incurred and services provided pursuant to Exhibit A of this Agreement in accordance with criteria established by Human Services. PROVIDER shall submit all itemized monthly billings to Human Services no later than the twenty-fifth(25)day of the month following the month the cost was incurred. d. Payments of costs incurred pursuant to this Agreement are expressly contingent upon the availability of Child Welfare Regular Administration funds to Human Services. e. Human Services shall not be billed for,and reimbursement shall not be made for time involved in activities outside of those defined in Exhibit A. Work performed prior to the execution of this Contract shall not be reimbursed or considered part of this Agreement. 4. Financial Management At all times from the effective date of this Contract until completion of this Contract,PROVIDER shall comply with the administrative requirements,cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under Child Welfare Regular Administration funding must conform to the Single Audit Act of 1984 and OMB Circular A-133. Page 1 of 9 11-12-RESPITE CARE 5. Payment Method Unless otherwise provided in the Scope of Services and Payment Schedule: a. PROVIDER shall provide proper monthly invoices and itemization of services performed for costs incurred in the performance of the agreement. b. Human Services may withhold any payment if PROVIDER has failed to comply with the Financial Management Requirements,program objectives,contractual terms,or reporting requirements. In the event of a forfeiture of reimbursements,PROVIDER may appeal such circumstance to the Director of Human Services. The decision of the Director of Human Services shall be final. 6. Assurances PROVIDER shall abide by all assurances as set forth in the attached Exhibit C,which is attached hereto and incorporated herein by reference. 7. Compliance with Applicable Laws At all times during the performance of this contract,PROVIDER shall strictly adhere to all applicable federal and state laws,orders,and all applicable standards,regulations,interpretations or guidelines issued pursuant thereto. This includes the protection of the confidentiality of all applicant/recipient records,papers,documents, tapes and any other materials that have been or may hereafter be established which relate to the Contract. PROVIDER acknowledges that the following laws are included: - Title VI of the Civil Rights Act of 1964,42 U.S.C.Sections 2000d—1 et.seq.and its implementing regulation, 45 C.F.R.Part 80 et.seq:and - Section 504 of the Rehabilitation Act of 1973,29 U.S.C.Section 794,and its implementing regulations,45 C.F.R.Part 84;and - the Age Discrimination Act of 1975,42 U.S.C.Sections 6101 et.seq.and its implementation regulations,45 C.F.R. Part 91;and - Title VII of the Civil Rights Act of 1964;and - the Age Discrimination in Employment Act of 1967;and - the Equal Pay Act of 1963;and - the Education Amendments of 1972;and - Immigration Reform and Control Act of 1986,P.L.99-603; - 42 C.F.R.Part 2 and all regulations applicable to these laws prohibiting discrimination because of race, color,National origin,and sex,religion and handicap,including Acquired Immune Deficiency syndrome (AIDS)or AIDS related conditions,covered under Section 504 of the Rehabilitation Act of 1973,as amended,cited above. If necessary,PROVIDER and Human Services will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 CFR Part 2. Included in 45 C.F.R.Part 74 Appendix G 9,which requires that affirmative steps be taken to assure that small and minority businesses are utilized,when possible,as sources of supplies,equipment,construction and services. This assurance is given in consideration of and for the purpose of obtaining any and all federal and/or state financial assistance. Any person who feels that s/he has been discriminated against has the right to file a complaint either with the Colorado Department of Human Services or with the U.S.Department of Health and Human Services,Office for Civil Rights. 8. Certifications PROVIDER certifies that,at the time of entering into this Contract,it has currently in effect all necessary licenses,approvals,insurance,etc.,required to properly provide the services and/or supplies covered by this contract. A copy of certificate will be provided to Human Services upon completion of this agreement. Failure to do so will null and void this contract in its entirety. Page 2 of 9 1 1-12-RESPITE CARE 9. Monitoring and Evaluation PROVIDER and Human Services agree that monitoring and evaluation of the performance of this Agreement shall be conducted by PROVIDER and Human Services. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners and PROVIDER. PROVIDER shall permit Human Services,and any other duly authorized agent or governmental agency,to monitor all activities conducted by PROVIDER pursuant to the terms of this Agreement. As the monitoring agency may in its sole discretion deem necessary or appropriate,such program data,special analyses,on-site checking,formal audit examinations,or any other reasonable procedures. All such monitoring shall be performed in a manner that will not unduly interfere with agreement work. 10. Modification of Agreement All modifications to this agreement shall be in writing and signed by both parties. 11. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find PROVIDER substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by PROVIDER. These remedial actions are as follows: a. Withhold payment to PROVIDER until the necessary services or corrections in performance are satisfactorily completed; b. Deny payment or recover reimbursement for those services or deliverables,which have not been performed and which due to circumstances caused by PROVIDER cannot be performed or if performed would be of no value to Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; c. Incorrect payment to PROVIDER due to omission,error,fraud,and/or defalcation shall be recovered from PROVIDER by deduction from subsequent payments under this Agreement or other agreements between Human Services and PROVIDER,or by Human Services as a debt due to Human Services or otherwise as provided by law. 12. Representatives For the purpose of this Agreement,the individuals identified below are hereby designated representatives of the respective parties. Either party may from time to time designate in writing a new or substitute representative(s): For Human Services: Gloria Romansik Human Services Administrator Name Title For Provider: PO4 'n'1 a.r n n el( Respite Care Provider Name Title 13. Notice All notices required to be given by the parties hereunder shall be given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing a substitute person(s)or address to whom such notices shall be sent: To: Human Services Judy A.Griego,Director �Y�-� �f n .'J/ P.O.Box A P O/ t�t't►' Gg�'.r'P et vci Greeley,CO 80632 h'reS1Ori/ abay Page 3 of 9 11-12-RESPITE CARE 14. Litigation PROVIDER shall promptly notify Human Services in the event that PROVIDER learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement.PROVIDER, within five(5)calendar days after being served with a summons,complaint,or other pleading which has been filed in any federal or state court or administrative agency,shall deliver copies of such document(s)to the Human Services Director. The term"litigation"includes an assignment for the benefit of creditors,and filings in bankruptcy,reorganization and/or foreclosure. 15. Termination This Agreement may be terminated at any time by either party given thirty(30)days written notice and is subject to the availability of funding. PROVIDER reserves the right to suspend services to clients if funding is no longer available. 16. Entire Agreement This Agreement,together with all attachments hereto,constitutes the entire understanding between the parties with respect to the subject matter hereof,and may not be changed or modified except as stated in Paragraph 10 herein. 17. No Third Party Beneficiary. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement,and all rights of action relating to such enforcement,shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 18. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may posses,nor shall any portion of this Agreement be deemed to have created a duty of care which did not previously exist with respect to any person not a party to this Agreement. IN WITNESS WHEREOF,the parties hereto have duly executed the Agreement as of the day,month,and year first above written. BOARD OF COUNTY COMMISSIONERS WELD COUNTY,COLO' • J O ATTEST: , G nal Weld Co utyClerkto ; oard ,I�'=`� �:y-rbara K'rkmeyer BY: / '�1 JUL 062011 Deputy Clerk '(the 1/42 APP' r , ..i sf� • 1161 t Co Attorney WELD COUNTY DEPARTMENT OF HUMAN SERVICES PROVIDER c7O— NAOllerk-O-A" J A.Grieg Director Respite Provider Page 4 of 9 o?C//—/lc// 11-12-RESPITE CARE EXHIBIT A SCOPE OF SERVICES Each Provider will: 1. Complete a fingerprint card for a background check at the PROVIDERS expense with the Colorado Bureau of Investigation. A Federal Bureau of Investigation background check will be done if the Provider has been a resident of the State of Colorado for less than two years. Human Services will clear the Provider through CBI and FBI; 2. Complete a course in CPR and first aid,in which a current copy of the certifications must be provided to Human Services with this agreement. If either certification should expire during the contracted period,the Provider will send a new current certification copy to Human Services; 3. Provide transportation for the child to appointments during the hours of service as agreed upon with the foster parent; 4. Become familiar with State rules and regulations governing certified foster homes; 5. Must be eighteen years of age or older. Page 5 of 9 1 L 12-RESPITE CARE EXHIBIT B PAYMENT SCHEDULE 1. Funding and Method of Payment Human Services agrees to reimburse PROVIDER in consideration for the work and services performed under Child Welfare Regular Administration funding. Expenses incurred by PROVIDER,in association with said project prior to the term of this agreement,are not eligible Human Services expenditures and shall not be reimbursed by Human Services. Payment pursuant to this Contract,if Child Welfare Regular Administration funds,whether in whole or in part, is subject to and contingent upon the continuing availability of Child Welfare Regular Administration funds for the purposes hereof. In the event that said funds,or any part thereof,become unavailable as determined by Human Services,Human Services may immediately terminate this Contract or amend it accordingly. 2. Fees for Services Respite care is limited to four hours per week per child. The hours of care may be provided in any combination throughout a month,but not to exceed 16 hours per month. Payment will be$16.75 per each four hour period,but not to exceed$67.00 per month for 16 hours. Human Services referrals will not be sent to collections by PROVIDER for default of co-pay/fees. Services will be performed regardless of client's refusal or inability to pay co-pay. PROVIDER will collect any applicable sliding scale co-pays and credit Human Services for any payments received on the monthly billing statements. 3. Submittal of Vouchers PROVIDER shall prepare and submit monthly,the itemized voucher and certify that the services authorized were provided on the date indicated and the charges made were pursuant to the terms and conditions of Exhibit A. Page 6 of 9 11-12-RESPITE CARE EXHIBIT C ASSURANCES I. PROVIDER agrees it is an independent contractor and that its officers and employees do not become employees of Weld County,nor are they entitled to any employee benefits as Weld County employees,as the result of the execution of this Agreement. 2. Weld County,the Board of County Commissioners of Weld County,its officers and employees,shall not be held liable for injuries or damages caused by any negligent acts or omissions of PROVIDER-contracted PROVIDERS or its employees,volunteers,or agents while performing duties as described in this Agreement. PROVIDER shall indemnify,defend,and hold harmless Weld County,the Board of County Commissioners of Weld County,its employees,volunteers,and agents. PROVIDER shall provide adequate liability and worker's compensation insurance for all its employees,volunteers,and agents engaged in the performance of the Agreement upon request,PROVIDER shall provide Human Services with the acceptable evidence that such coverage is in effect. 3. No portion of this Contract shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may possess,not shall any portion of this Agreement be deemed to have treated a duty of care with respect to any persons not a party of this Agreement. 4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld,State of Colorado,to expend funds not otherwise appropriated in each succeeding year. 5. If any section,subsection,paragraph,sentence,clause,or phrase of this Contract is for any reason held or decided to be unconstitutional,such decision shall not affect the validity of the remaining portions. The parties hereto declare that they would have entered into this Contract and each and every section,subsection, paragraph,sentence,clause,and phrase thereof irrespective of the fact that any one or more sections, subsections,paragraphs,sentences,clauses,or phrases might be declared to be unconstitutional or invalid. 6. No officer,member or employee of Weld County and no member of their governing bodies shall have any pecuniary interest,direct or indirect,in the approved Agreement or the proceeds thereof. 7. PROVIDER assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that no person shall,on the grounds of race,creed,color,sex,or national origin,be excluded from participation in,be denied the benefits of,or be otherwise subjected to discrimination under this approved Contract. 8. PROVIDER assures that sufficient,auditable,and otherwise adequate records that will provide accurate, current,separate,and complete disclosure of the status of the funds received under the Contract are maintained for three(3)years or the completion and resolution of an audit. Such records shall be sufficient to allow authorized local,Federal,and State auditors,and representatives to audit and monitor PROVIDER. 9. All such records,documents,communications,and other materials shall be the property of Human Services and shall be maintained by PROVIDER,in a central location and custodian,in behalf of Human Services,for a period of four(4)years from the date of final payment under this Contract,or for such further period as may be necessary to resolve any matters which may be pending,or until an audit has been completed with the following qualifications: If an audit by or on behalf of the federal and/or state government has begun but is not completed at the end of the four(4)year period,or if audit findings have not been resolved after a four(4)year period,the materials shall be retained until the resolution of the audit finding. 10. PROVIDER assures that authorized local,federal,and state auditors and representatives shall,during business hours,have access to inspect any copy records,and shall be allowed to monitor and review through on-site visits,all contract activities,supported with funds under this Contract to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. Page 7 of 9 I 1-12-RESPITE CARE 11. This Contract shall be binding upon the parties hereto,their successors,heirs,legal representatives,and assigns. PROVIDER or Human Services may not assign any of its rights or obligations hereunder without the prior written consent of both parties. 12. PROVIDER certifies that federal appropriated funds have not been paid or will be paid,by or on behalf of PROVIDER,to any person for influencing or attempting to influence an officer or employee of an agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any federal grant,the making of any federal loan,the entering into of any cooperative agreement,and the extension,continuation,renewal, amendment,or modification of any Federal contract,loan,grant,or cooperative agreement. 13. PROVIDER assures that it will fully comply with all other applicable federal and state laws. PROVIDER understands that the source of funds to be used under this Contract is Child Welfare Regular Administration funds. 14. PROVIDER assures and certifies that it and its principals: a. Are not presently debarred,suspended,proposed for debarment,declared ineligible or voluntarily excluded from covered transaction by a federal department or agency. b. Have not,within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining,attempting to obtain,or performing a public(federal,state,or local)transaction or contract under a public transaction;violation of federal or state antitrust statutes or commission of embezzlement, theft,forgery,bribery,falsification or destruction of records,making false statements,or receiving stolen property; c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state,or local)with commission of any of the offenses enumerated in paragraph 14(b)of this certification;and d. Have not within a three-year period preceding this Contract,had one or more public transactions (federal,state,and local)terminated for cause or default. 15. The Appearance of Conflict of Interest applies to the relationship of a contractor with Human Services when the contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest,it is not necessary for the contractor to gain from knowledge of these opposing interests. It is only necessary that the contractor know that the two relationships are in opposition.During the term of the Contract,PROVIDER shall not enter any third party relationship that gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation,PROVIDER shall submit to Human Services,a full disclosure statement setting forth the details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for Human Services' termination,for cause,of its contract with PROVIDER. 16. PROVIDER shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Contract. Except for purposes directly connected with the administration of Child Protection,no information about or obtained from any applicant/recipient in possession of PROVIDER shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with PROVIDER written policies governing access to,duplication and dissemination of,all such information. PROVIDER shall advise its employees,agents,and subcontractors,if any,that they are subject to these confidentiality requirements. PROVIDER shall provide its employees,agents,and subcontractors,if any,with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. Page 8 of 9 11-12-RESPITE CARE CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND PROVIDER This Agreement,made and entered into the day of ,20_,by and between the Board of Weld County Commissioners,sitting as the Board of Huma on behalf of the Weld County Department of Human Services,hereinafter referred to as"Human Services,"and �(tC fVl e t/ referred to as"Provider". WITNESSETH 1( WHEREAS, required approval,clearance,and coordination have been accomplished from and with appropriate agencies;and WHEREAS,the Colorado Department of Human Services has provided Child Welfare Regular Administration funding for respite care for county foster care PROVIDERS and WHEREAS,Provider is a for-profit Sole-Proprietor. NOW THEREFORE, in consideration of the premises,the parties hereto covenant and agree as follows: I. Term This Agreement shall become effective on July 1,20(l,upon proper execution of this Agreement and shall expire June 30,20O1-unless sooner terminated as provided herein. 2. Scope of Services Services shall be provided by Provider to any person(s)eligible for child protection services in compliance with Exhibit A"Scope of Services,"a copy of which is attached by reference. 3. Payment a. Payment shall be made on the basis of Exhibit B,"Payment Schedule,"copies of which are attached hereto and incorporated herein by reference. b. "Payment Schedule" shall establish the maximum reimbursement,which will be paid from Child Welfare Regular Administration funds during the duration of this Agreement. c. PROVIDER shall submit an itemized monthly bill to Human Services for all costs incurred and services provided pursuant to Exhibit A of this Agreement in accordance with criteria established by Human Services. PROVIDER shall submit all itemized monthly billings to Human Services no later than the twenty-fifth(25)day of the month following the month the cost was incurred. d. Payments of costs incurred pursuant to this Agreement are expressly contingent upon the availability of Child Welfare Regular Administration funds to Human Services. e. Human Services shall not be billed for,and reimbursement shall not be made for time involved in activities outside of those defined in Exhibit A. Work performed prior to the execution of this Contract shall not be reimbursed or considered part of this Agreement. 4. Financial Management At all times from the effective date of this Contract until completion of this Contract,PROVIDER shall comply with the administrative requirements,cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under Child Welfare Regular Administration funding must conform to the Single Audit Act of 1984 and OMB Circular A-133. Page 1 of 9 c)(//--/6/ // I 1-12-RESPITE CARE 5. Payment Method Unless otherwise provided in the Scope of Services and Payment Schedule: a. PROVIDER shall provide proper monthly invoices and itemization of services performed for costs incurred in the performance of the agreement. b. Human Services may withhold any payment if PROVIDER has failed to comply with the Financial Management Requirements,program objectives,contractual terms,or reporting requirements. In the event of a forfeiture of reimbursements,PROVIDER may appeal such circumstance to the Director of Human Services. The decision of the Director of Human Services shall be final. 6. Assurances PROVIDER shall abide by all assurances as set forth in the attached Exhibit C,which is attached hereto and incorporated herein by reference. 7. Compliance with Applicable Laws At all times during the performance of this contract, PROVIDER shall strictly adhere to all applicable federal and state laws,orders,and all applicable standards,regulations,interpretations or guidelines issued pursuant thereto. This includes the protection of the confidentiality of all applicant/recipient records,papers,documents, tapes and any other materials that have been or may hereafter be established which relate to the Contract. PROVIDER acknowledges that the following laws are included: - Title VI of the Civil Rights Act of 1964,42 U.S.C.Sections 2000d—1 et.seq.and its implementing regulation, 45 C.F.R.Part 80 et.seq.;and - Section 504 of the Rehabilitation Act of 1973,29 U.S.C. Section 794,and its implementing regulations,45 C.F.R. Part 84;and - the Age Discrimination Act of 1975,42 U.S.C.Sections 6101 et.seq.and its implementation regulations,45 C.F.R. Part 91;and - Title VII of the Civil Rights Act of 1964;and - the Age Discrimination in Employment Act of 1967;and - the Equal Pay Act of 1963;and - the Education Amendments of 1972;and - Immigration Reform and Control Act of 1986,P.L.99-603; - 42 C.F.R. Part 2 and all regulations applicable to these laws prohibiting discrimination because of race, color,National origin,and sex,religion and handicap, including Acquired Immune Deficiency syndrome (AIDS)or AIDS related conditions,covered under Section 504 of the Rehabilitation Act of 1973,as amended,cited above. If necessary, PROVIDER and Human Services will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 CFR Part 2. Included in 45 C.F.R. Part 74 Appendix G 9,which requires that affirmative steps be taken to assure that small and minority businesses are utilized,when possible,as sources of supplies,equipment,construction and services. This assurance is given in consideration of and for the purpose of obtaining any and all federal and/or state financial assistance. Any person who feels that s/he has been discriminated against has the right to file a complaint either with the Colorado Department of Human Services or with the U.S. Department of Health and Human Services,Office for Civil Rights. 8. Certifications PROVIDER certifies that,at the time of entering into this Contract,it has currently in effect all necessary licenses,approvals, insurance, etc.,required to properly provide the services and/or supplies covered by this contract. A copy of certificate will be provided to Human Services upon completion of this agreement. Failure to do so will null and void this contract in its entirety. Page 2 of 9 I I-I2-RESPITE CARE 9. Monitoring and Evaluation PROVIDER and Human Services agree that monitoring and evaluation of the performance of this Agreement shall be conducted by PROVIDER and Human Services. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners and PROVIDER. PROVIDER shall permit Human Services,and any other duly authorized agent or governmental agency,to monitor all activities conducted by PROVIDER pursuant to the terms of this Agreement. As the monitoring agency may in its sole discretion deem necessary or appropriate, such program data,special analyses,on-site checking,formal audit examinations,or any other reasonable procedures. All such monitoring shall be performed in a manner that will not unduly interfere with agreement work. 10. Modification of Agreement All modifications to this agreement shall be in writing and signed by both parties. 11. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find PROVIDER substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by PROVIDER. These remedial actions are as follows: a. Withhold payment to PROVIDER until the necessary services or corrections in performance are satisfactorily completed; b. Deny payment or recover reimbursement for those services or deliverables,which have not been performed and which due to circumstances caused by PROVIDER cannot be performed or if performed would be of no value to Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; c. Incorrect payment to PROVIDER due to omission,error,fraud,and/or defalcation shall be recovered from PROVIDER by deduction from subsequent payments under this Agreement or other agreements between Human Services and PROVIDER,or by Human Services as a debt due to Human Services or otherwise as provided by law. 12. Representatives For the purpose of this Agreement,the individuals identified below are hereby designated representatives of the respective parties. Either party may from time to time designate in writing a new or substitute representative(s): For Human Services: Gloria Romansik Human Services Administrator Name Title For Provider: IDelora S Meyer Respite Care Provider Name Title 13. Notice All notices required to be given by the parties hereunder shall be given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing a substitute person(s)or address to whom such notices shall be sent: To: Human Services To: Debra S Mege Judy A.Griego,Director 9/C/$ too R 7Y.) P.O.Box A Windsor, Co 'Os6-6 Greeley,CO 80632 Page 3 of 9 11-12-RESPITE CARE 14. Litigation PROVIDER shall promptly notify Human Services in the event that PROVIDER learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement. PROVIDER, within five(5)calendar days after being served with a summons,complaint,or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s)to the Human Services Director. The term"litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy,reorganization and/or foreclosure. 15. Termination This Agreement may be terminated at any time by either party given thirty(30)days written notice and is subject to the availability of funding. PROVIDER reserves the right to suspend services to clients if funding is no longer available. 16. Entire Agreement This Agreement,together with all attachments hereto,constitutes the entire understanding between the parties with respect to the subject matter hereof,and may not be changed or modified except as stated in Paragraph 10 herein. 17. No Third Party Beneficiary. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 18. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may posses,nor shall any portion of this Agreement be deemed to have created a duty of care which did not previously exist with respect to any person not a party to this Agreement. IN WITNESS WHEREOF,the parties hereto have duly executed the Agreement as of the day,month,and year first above written. BOARD OF COUNTY COMMISSIONERS WELD COUNTY,COLO DO ATTEST:_ Weld County Clerk to the Boar Barbara `irkmeye SIL ''`K BY: JUI� 0 0 2011 Deputy Clerk t- i e Board at!'• APP' s • AS T : 186t -*sal Cou ey WELD COUNTY DEPARTMENT OF HUMAN SERVICE PROVIDER Ju .Grie o, irector Respite Provider Page 4 of 9 &C///H// 11-12-RESPITE CARE EXHIBIT A SCOPE OF SERVICES Each Provider will: I. Complete a fingerprint card for a background check at the PROVIDERS expense with the Colorado Bureau of Investigation. A Federal Bureau of Investigation background check will be done if the Provider has been a resident of the State of Colorado for less than two years. Human Services will clear the Provider through CBI and FBI; 2. Complete a course in CPR and first aid, in which a current copy of the certifications must be provided to Human Services with this agreement. If either certification should expire during the contracted period,the Provider will send a new current certification copy to Human Services; 3. Provide transportation for the child to appointments during the hours of service as agreed upon with the foster parent; 4. Become familiar with State rules and regulations governing certified foster homes; 5. Must be eighteen years of age or older. Page 5 of 9 11-12-RESPITE CARE EXHIBIT B PAYMENT SCHEDULE 1. Funding and Method of Payment Human Services agrees to reimburse PROVIDER in consideration for the work and services performed under Child Welfare Regular Administration funding. Expenses incurred by PROVIDER, in association with said project prior to the term of this agreement,are not eligible Human Services expenditures and shall not be reimbursed by Human Services. Payment pursuant to this Contract,if Child Welfare Regular Administration funds,whether in whole or in part, is subject to and contingent upon the continuing availability of Child Welfare Regular Administration funds for the purposes hereof In the event that said funds,or any part thereof,become unavailable as determined by Human Services, Human Services may immediately terminate this Contract or amend it accordingly. 2. Fees for Services Respite care is limited to four hours per week per child. The hours of care may be provided in any combination throughout a month,but not to exceed 16 hours per month. Payment will be$16.75 per each four hour period,but not to exceed$67.00 per month for 16 hours. Human Services referrals will not be sent to collections by PROVIDER for default of co-pay/fees. Services will be performed regardless of client's refusal or inability to pay co-pay. PROVIDER will collect any applicable sliding scale co-pays and credit Human Services for any payments received on the monthly billing statements. 3. Submittal of Vouchers PROVIDER shall prepare and submit monthly,the itemized voucher and certify that the services authorized were provided on the date indicated and the charges made were pursuant to the terms and conditions of Exhibit A. Page 6 of 9 11-12-RESPITE CARE EXHIBIT C ASSURANCES 1. PROVIDER agrees it is an independent contractor and that its officers and employees do not become employees of Weld County,nor are they entitled to any employee benefits as Weld County employees,as the result of the execution of this Agreement. 2. Weld County,the Board of County Commissioners of Weld County, its officers and employees,shall not be held liable for injuries or damages caused by any negligent acts or omissions of PROVIDER-contracted PROVIDERS or its employees,volunteers,or agents while performing duties as described in this Agreement. PROVIDER shall indemnify,defend,and hold harmless Weld County,the Board of County Commissioners of Weld County, its employees, volunteers,and agents. PROVIDER shall provide adequate liability and worker's compensation insurance for all its employees, volunteers,and agents engaged in the performance of the Agreement upon request, PROVIDER shall provide Human Services with the acceptable evidence that such coverage is in effect. 3. No portion of this Contract shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may possess,not shall any portion of this Agreement be deemed to have treated a duty of care with respect to any persons not a party of this Agreement. 4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld,State of Colorado,to expend funds not otherwise appropriated in each succeeding year. 5. If any section,subsection,paragraph,sentence,clause,or phrase of this Contract is for any reason held or decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The parties hereto declare that they would have entered into this Contract and each and every section,subsection, paragraph,sentence,clause,and phrase thereof irrespective of the fact that any one or more sections, subsections,paragraphs, sentences,clauses,or phrases might be declared to be unconstitutional or invalid. 6. No officer,member or employee of Weld County and no member of their goveming bodies shall have any pecuniary interest,direct or indirect, in the approved Agreement or the proceeds thereof. 7. PROVIDER assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that no person shall, on the grounds of race,creed,color, sex,or national origin,be excluded from participation in,be denied the benefits of,or be otherwise subjected to discrimination under this approved Contract. 8. PROVIDER assures that sufficient,auditable,and otherwise adequate records that will provide accurate, current,separate,and complete disclosure of the status of the funds received under the Contract are maintained for three(3)years or the completion and resolution of an audit. Such records shall be sufficient to allow authorized local, Federal,and State auditors,and representatives to audit and monitor PROVIDER. 9. All such records,documents,communications,and other materials shall be the property of Human Services and shall be maintained by PROVIDER,in a central location and custodian, in behalf of Human Services, for a period of four(4)years from the date of final payment under this Contract,or for such further period as may be necessary to resolve any matters which may be pending,or until an audit has been completed with the following qualifications: If an audit by or on behalf of the federal and/or state government has begun but is not completed at the end of the four(4)year period, or if audit findings have not been resolved after a four(4)year period,the materials shall be retained until the resolution of the audit finding. 10. PROVIDER assures that authorized local,federal,and state auditors and representatives shall,during business hours, have access to inspect any copy records,and shall be allowed to monitor and review through on-site visits,all contract activities,supported with funds under this Contract to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. Page 7 of 9 11-12-RESPITE CARE 11. This Contract shall be binding upon the parties hereto,their successors,heirs,legal representatives,and assigns. PROVIDER or Human Services may not assign any of its rights or obligations hereunder without the prior written consent of both parties. 12. PROVIDER certifies that federal appropriated funds have not been paid or will be paid,by or on behalf of PROVIDER,to any person for influencing or attempting to influence an officer or employee of an agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any federal grant,the making of any federal loan,the entering into of any cooperative agreement,and the extension,continuation,renewal, amendment,or modification of any Federal contract, loan,grant,or cooperative agreement. 13. PROVIDER assures that it will fully comply with all other applicable federal and state laws. PROVIDER understands that the source of funds to be used under this Contract is Child Welfare Regular Administration funds. 14. PROVIDER assures and certifies that it and its principals: a. Are not presently debarred,suspended,proposed for debarment,declared ineligible or voluntarily excluded from covered transaction by a federal department or agency. b. Have not,within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining,attempting to obtain,or performing a public(federal,state,or local)transaction or contract under a public transaction;violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery,bribery,falsification or destruction of records,making false statements,or receiving stolen property; c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state,or local)with commission of any of the offenses enumerated in paragraph 14(b)of this • certification;and d. Have not within a three-year period preceding this Contract,had one or more public transactions (federal, state,and local)terminated for cause or default. 15. The Appearance of Conflict of Interest applies to the relationship of a contractor with Human Services when the contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest,it is not necessary for the contractor to gain from knowledge of these opposing interests. It is only necessary that the contractor know that the two relationships are in opposition. During the term of the Contract,PROVIDER shall not enter any third party relationship that gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation, PROVIDER shall submit to Human Services,a full disclosure statement setting forth the details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for Human Services'termination,for cause,of its contract with PROVIDER. 16. PROVIDER shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Contract. Except for purposes directly connected with the administration of Child Protection,no information about or obtained from any applicant/recipient in possession of PROVIDER shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with PROVIDER written policies governing access to,duplication and dissemination of,all such information. PROVIDER shall advise its employees,agents,and subcontractors, if any,that they are subject to these confidentiality requirements. PROVIDER shall provide its employees,agents,and subcontractors, if any,with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. Page 8 of 9 11-12-RESPITE CARE 17. Proprietary information for the purposes of this contract is information relating to a party's research, development,trade secrets, business affairs,internal operations and management procedures and those of its customers,clients or affiliates,but does not include information(1)lawfully obtained from third parties, (2) that which is in the public domain, or(3)that which is developed independently. Neither party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of this Contract. Any proprietary information removed from the State's site by PROVIDER in the course of providing services under this Contract will be accorded at least the same precautions as are employed by PROVIDER for similar information in the course of its own business. 18. PROVIDER certifies that s/he will abide by Colorado Revised Statute(C.R.S.)26-6-104,requiring criminal background checks for all employees,contractors,and sub-contractors. Page 9 of 9 11-12-RESPITE CARE CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND PROVIDER This Agreement,made and entered into the day of ,20 ,by and between the Board of Weld County Commissioners, sitting as the Board of Human on behalf the W l Co my Department of Human Services,hereinafter referred to as"Human Services,"and-gavot-i a Mijditi tattreferred to as"Provider". W ITNESSETH WHEREAS,required approval,clearance,and coordination have been accomplished from and with appropriate agencies;and WHEREAS,the Colorado Department of Human Services has provided Child Welfare Regular Administration funding for respite care for county foster care PROVIDERS and WHEREAS,Provider is a for-profit Sole-Proprietor. NOW THEREFORE,in consideration of the premises,the parties hereto covenant and agree as follows: 1. Term This Agreement shall become effective on July 1,20 j/,upon proper execution of this Agreement and shall expire June 30,20(Aimless sooner terminated as provided herein. 2. Scope of Services Services shall be provided by Provider to any person(s)eligible for child protection services in compliance with Exhibit A"Scope of Services,"a copy of which is attached by reference. 3. Payment a. Payment shall be made on the basis of Exhibit B,"Payment Schedule,"copies of which are attached hereto and incorporated herein by reference. b. "Payment Schedule"shall establish the maximum reimbursement,which will be paid from Child Welfare Regular Administration funds during the duration of this Agreement. c. PROVIDER shall submit an itemized monthly bill to Human Services for all costs incurred and services provided pursuant to Exhibit A of this Agreement in accordance with criteria established by Human Services. PROVIDER shall submit all itemized monthly billings to Human Services no later than the twenty-fifth(25)day of the month following the month the cost was incurred. d. Payments of costs incurred pursuant to this Agreement are expressly contingent upon the availability of Child Welfare Regular Administration funds to Human Services. e. Human Services shall not be billed for,and reimbursement shall not be made for time involved in activities outside of those defined in Exhibit A. Work performed prior to the execution of this Contract shall not be reimbursed or considered part of this Agreement. 4. Financial Management At all times from the effective date of this Contract until completion of this Contract,PROVIDER shall comply with the administrative requirements,cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under Child Welfare Regular Administration funding must conform to the Single Audit Act of 1984 and OMB Circular A-133. Page 1 of 9 ail/�-/lc// 11-12-RESPITE CARE 5. Payment Method Unless otherwise provided in the Scope of Services and Payment Schedule: a. PROVIDER shall provide proper monthly invoices and itemization of services performed for costs incurred in the performance of the agreement. b. Human Services may withhold any payment if PROVIDER has failed to comply with the Financial Management Requirements,program objectives,contractual terms,or reporting requirements. In the event of a forfeiture of reimbursements,PROVIDER may appeal such circumstance to the Director of Human Services. The decision of the Director of Human Services shall be final. 6. Assurances PROVIDER shall abide by all assurances as set forth in the attached Exhibit C,which is attached hereto and incorporated herein by reference. 7. Compliance with Applicable Laws At all times during the performance of this contract,PROVIDER shall strictly adhere to all applicable federal and state laws,orders,and all applicable standards,regulations,interpretations or guidelines issued pursuant thereto. This includes the protection of the confidentiality of all applicant/recipient records,papers,documents, tapes and any other materials that have been or may hereafter be established which relate to the Contract. PROVIDER acknowledges that the following laws are included: - Title VI of the Civil Rights Act of 1964,42 U.S.C.Sections 2000d—1 et.seq.and its implementing regulation, 45 C.F.R.Part 80 et.seq.;and - Section 504 of the Rehabilitation Act of 1973,29 U.S.C.Section 794,and its implementing regulations,45 C.F.R.Part 84;and - the Age Discrimination Act of 1975,42 U.S.C. Sections 6101 et.seq.and its implementation regulations,45 C.F.R. Part 91;and - Title VII of the Civil Rights Act of 1964;and - the Age Discrimination in Employment Act of 1967;and - the Equal Pay Act of 1963;and - the Education Amendments of 1972;and - Immigration Reform and Control Act of 1986,P.L.99-603; - 42 C.F.R.Part 2 and all regulations applicable to these laws prohibiting discrimination because of race, color,National origin,and sex,religion and handicap, including Acquired Immune Deficiency syndrome (AIDS)or AIDS related conditions,covered under Section 504 of the Rehabilitation Act of 1973,as amended,cited above. If necessary,PROVIDER and Human Services will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 CFR Part 2. Included in 45 C.F.R.Part 74 Appendix G 9,which requires that affirmative steps be taken to assure that small and minority businesses are utilized,when possible,as sources of supplies,equipment,construction and services. This assurance is given in consideration of and for the purpose of obtaining any and all federal and/or state financial assistance. Any person who feels that s/he has been discriminated against has the right to file a complaint either with the Colorado Department of Human Services or with the U.S. Department of Health and Human Services,Office for Civil Rights. 8. Certifications PROVIDER certifies that,at the time of entering into this Contract,it has currently in effect all necessary licenses,approvals, insurance,etc.,required to properly provide the services and/or supplies covered by this contract. A copy of certificate will be provided to Human Services upon completion of this agreement. Failure to do so will null and void this contract in its entirety. Page 2 of 9 11-12-RESPITE CARE 9. Monitoring and Evaluation PROVIDER and Human Services agree that monitoring and evaluation of the performance of this Agreement shall be conducted by PROVIDER and Human Services. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners and PROVIDER. PROVIDER shall permit Human Services,and any other duly authorized agent or governmental agency,to monitor all activities conducted by PROVIDER pursuant to the terms of this Agreement. As the monitoring agency may in its sole discretion deem necessary or appropriate,such program data,special analyses,on-site checking,formal audit examinations,or any other reasonable procedures. All such monitoring shall be performed in a manner that will not unduly interfere with agreement work. 10. Modification of Agreement All modifications to this agreement shall be in writing and signed by both parties. 11. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find PROVIDER substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by PROVIDER. These remedial actions are as follows: a. Withhold payment to PROVIDER until the necessary services or corrections in performance are satisfactorily completed; b. Deny payment or recover reimbursement for those services or deliverables,which have not been performed and which due to circumstances caused by PROVIDER cannot be performed or if performed would be of no value to Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; c. Incorrect payment to PROVIDER due to omission,error,fraud,and/or defalcation shall be recovered from PROVIDER by deduction from subsequent payments under this Agreement or other agreements between Human Services and PROVIDER,or by Human Services as a debt due to Human Services or otherwise as provided by law. 12. Representatives For the purpose of this Agreement,the individuals identified below are hereby designated representatives of the respective parties. Either party may from time to time designate in writing a new or substitute representative(s): For Human Services: Gloria Romansik Human Services Administrator Name Title For Provider: • PO6ciniik t t UO4 Respite Care Provider Name Title 13. Notice All notices required to be given by the parties hereunder shall be given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing a substitute person(s)or address to whom such notices shall be sent: To: Human Services T • Judy A.Griego,Director P.O.Box A ayjt 4) zy Greeley,CO 80632 O_(Gy £3M Page 3 of 9 (// 11-12-RESPITE CARE 14. Litigation PROVIDER shall promptly notify Human Services in the event that PROVIDER learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement.PROVIDER, within five(5)calendar days after being served with a summons,complaint,or other pleading which has been filed in any federal or state court or administrative agency,shall deliver copies of such document(s)to the Human Services Director. The term"litigation"includes an assignment for the benefit of creditors,and filings in bankruptcy,reorganization and/or foreclosure. 15. Termination This Agreement may be terminated at any time by either party given thirty(30)days written notice and is subject to the availability of funding. PROVIDER reserves the right to suspend services to clients if funding is no longer available. 16. Entire Agreement This Agreement,together with all attachments hereto,constitutes the entire understanding between the parties with respect to the subject matter hereof,and may not be changed or modified except as stated in Paragraph 10 herein. 17. No Third Party Beneficiary. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 18. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may posses,nor shall any portion of this Agreement be deemed to have created a duty of care which did not previously exist with respect to any person not a party to this Agreement. IN WITNESS WHEREOF,the parties hereto have duly executed the Agreement as of the day,month,and year first above written. BOARD OF COUNTY COMMISSIONERS WELD COUNTY,COLORADO A I t EST: We County Clerktoth- :oard Jf� Barbara Ki kmeyer BY: �� 7 .L I' , '��, ./. 'I,� E JUL 0 6 2011 puty Clerk e ' .ard 0; O i ./�: ARM: t861 kar C AttV ey U WELD COUNTY DEPARTMENT OF HUMAN SERVICES PROVIDER ii:)\24) (344h1:1)0G" J A.G g ,Di Respite Page 4 of 9 ca//—/ // 11-12-RESPITE CARE EXHIBIT A SCOPE OF SERVICES Each Provider will: 1. Complete a fmgerprint card for a background check at the PROVIDERS expense with the Colorado Bureau of Investigation. A Federal Bureau of Investigation background check will be done if the Provider has been a resident of the State of Colorado for less than two years. Human Services will clear the Provider through CBI and FBI; 2. Complete a course in CPR and first aid, in which a current copy of the certifications must be provided to Human Services with this agreement. If either certification should expire during the contracted period,the Provider will send a new current certification copy to Human Services; 3. Provide transportation for the child to appointments during the hours of service as agreed upon with the foster parent; 4. Become familiar with State rules and regulations governing certified foster homes; 5. Must be eighteen years of age or older. Page 5 of 9 11-12-RESPITE CARE EXHIBIT B PAYMENT SCHEDULE 1. Funding and Method of Payment Human Services agrees to reimburse PROVIDER in consideration for the work and services performed under Child Welfare Regular Administration funding. Expenses incurred by PROVIDER,in association with said project prior to the term of this agreement,are not eligible Human Services expenditures and shall not be reimbursed by Human Services. Payment pursuant to this Contract, if Child Welfare Regular Administration funds,whether in whole or in part, is subject to and contingent upon the continuing availability of Child Welfare Regular Administration funds for the purposes hereof. In the event that said funds,or any part thereof,become unavailable as determined by Human Services,Human Services may immediately terminate this Contract or amend it accordingly. 2. Fees for Services Respite care is limited to four hours per week per child. The hours of care may be provided in any combination throughout a month,but not to exceed 16 hours per month. Payment will be$16.75 per each four hour period,but not to exceed$67.00 per month for 16 hours. Human Services referrals will not be sent to collections by PROVIDER for default of co-pay/fees. Services will be performed regardless of client's refusal or inability to pay co-pay. PROVIDER will collect any applicable sliding scale co-pays and credit Human Services for any payments received on the monthly billing statements. 3. Submittal of Vouchers PROVIDER shall prepare and submit monthly,the itemized voucher and certify that the services authorized were provided on the date indicated and the charges made were pursuant to the terms and conditions of Exhibit A. Page 6 of 9 I I-12-RESPITE CARE EXHIBIT C ASSURANCES 1. PROVIDER agrees it is an independent contractor and that its officers and employees do not become employees of Weld County,nor are they entitled to any employee benefits as Weld County employees,as the result of the execution of this Agreement. 2. Weld County,the Board of County Commissioners of Weld County,its officers and employees, shall not be held liable for injuries or damages caused by any negligent acts or omissions of PROVIDER-contracted PROVIDERS or its employees,volunteers,or agents while performing duties as described in this Agreement. PROVIDER shall indemnify, defend,and hold harmless Weld County,the Board of County Commissioners of Weld County,its employees,volunteers,and agents. PROVIDER shall provide adequate liability and worker's compensation insurance for all its employees,volunteers,and agents engaged in the performance of the Agreement upon request, PROVIDER shall provide Human Services with the acceptable evidence that such coverage is in effect. 3. No portion of this Contract shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may possess,not shall any portion of this Agreement be deemed to have treated a duty of care with respect to any persons not a party of this Agreement. 4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld, State of Colorado,to expend funds not otherwise appropriated in each succeeding year. 5. If any section,subsection,paragraph,sentence,clause,or phrase of this Contract is for any reason held or decided to be unconstitutional,such decision shall not affect the validity of the remaining portions. The parties hereto declare that they would have entered into this Contract and each and every section,subsection, paragraph,sentence,clause,and phrase thereof irrespective of the fact that any one or more sections, subsections,paragraphs,sentences,clauses,or phrases might be declared to be unconstitutional or invalid. 6. No officer,member or employee of Weld County and no member of their governing bodies shall have any pecuniary interest,direct or indirect, in the approved Agreement or the proceeds thereof. 7. PROVIDER assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that no person shall,on the grounds of race,creed,color,sex,or national origin,be excluded from participation in,be denied the benefits of,or be otherwise subjected to discrimination under this approved Contract. 8. PROVIDER assures that sufficient,auditable,and otherwise adequate records that will provide accurate, current,separate,and complete disclosure of the status of the funds received under the Contract are maintained for three(3)years or the completion and resolution of an audit. Such records shall be sufficient to allow authorized local,Federal,and State auditors,and representatives to audit and monitor PROVIDER. 9. All such records,documents,communications,and other materials shall be the property of Human Services and shall be maintained by PROVIDER, in a central location and custodian, in behalf of Human Services, for a period of four(4)years from the date of final payment under this Contract,or for such further period as may be necessary to resolve any matters which may be pending,or until an audit has been completed with the following qualifications: If an audit by or on behalf of the federal and/or state government has begun but is not completed at the end of the four(4)year period,or if audit findings have not been resolved after a four(4)year period,the materials shall be retained until the resolution of the audit finding. 10. PROVIDER assures that authorized local,federal,and state auditors and representatives shall,during business hours,have access to inspect any copy records,and shall be allowed to monitor and review through on-site visits,all contract activities,supported with funds under this Contract to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. Page 7 of 9 11-12-RESPITE CARE 11. This Contract shall be binding upon the parties hereto,their successors,heirs, legal representatives,and assigns. PROVIDER or Human Services may not assign any of its rights or obligations hereunder without the prior written consent of both parties. 12. PROVIDER certifies that federal appropriated funds have not been paid or will be paid,by or on behalf of PROVIDER,to any person for influencing or attempting to influence an officer or employee of an agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any federal grant,the making of any federal loan,the entering into of any cooperative agreement,and the extension,continuation,renewal, amendment,or modification of any Federal contract, loan,grant,or cooperative agreement. 13. PROVIDER assures that it will fully comply with all other applicable federal and state laws. PROVIDER understands that the source of funds to be used under this Contract is Child Welfare Regular Administration funds. 14. PROVIDER assures and certifies that it and its principals: a. Are not presently debarred,suspended,proposed for debarment,declared ineligible or voluntarily excluded from covered transaction by a federal department or agency. b. Have not,within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining,attempting to obtain,or performing a public(federal,state,or local)transaction or contract under a public transaction;violation of federal or state antitrust statutes or commission of embezzlement, theft,forgery,bribery,falsification or destruction of records,making false statements,or receiving stolen property; c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state,or local)with commission of any of the offenses enumerated in paragraph 14(b)of this certification;and d. Have not within a three-year period preceding this Contract,had one or more public transactions (federal,state,and local)terminated for cause or default. 15. The Appearance of Conflict of Interest applies to the relationship of a contractor with Human Services when the contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest,it is not necessary for the contractor to gain from knowledge of these opposing interests. It is only necessary that the contractor know that the two relationships are in opposition.During the term of the Contract,PROVIDER shall not enter any third party relationship that gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation,PROVIDER shall submit to Human Services,a full disclosure statement setting forth the details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for Human Services' termination,for cause,of its contract with PROVIDER. 16. PROVIDER shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Contract. Except for purposes directly connected with the administration of Child Protection,no information about or obtained from any applicant/recipient in possession of PROVIDER shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with PROVIDER written policies governing access to,duplication and dissemination of,all such information. PROVIDER shall advise its employees,agents,and subcontractors, if any,that they are subject to these confidentiality requirements. PROVIDER shall provide its employees,agents,and subcontractors,if any,with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. Page 8 of 9 I I-12-RESPITE CARE 17. Proprietary information for the purposes of this contract is information relating to a party's research, development,trade secrets,business affairs,internal operations and management procedures and those of its customers,clients or affiliates,but does not include information(1)lawfully obtained from third parties,(2) that which is in the public domain,or(3)that which is developed independently. Neither party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of this Contract. Any proprietary information removed from the State's site by PROVIDER in the course of providing services under this Contract will be accorded at least the same precautions as are employed by PROVIDER for similar information in the course of its own business. 18. PROVIDER certifies that s/he will abide by Colorado Revised Statute(C.R.S.)26-6-104,requiring criminal background checks for all employees,contractors,and sub-contractors. Page 9 of 9 11-12-RESPITE CARE CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND PROVIDER This Agreement,made and entered into the day of ,20 ,by and between the Board of Weld County Commissioners,sitting as the Board of Human on behalf of the Weld County Department of Human Services,hereinafter referred to as"Human Services,"and a )'miller referred to as"Provider". WITNESSETH � WHEREAS,required approval,clearance,and coordination have been accomplished fl m and wit' appropriate agencies;and v teig WHEREAS,the Colorado Department of Human Services has provided Child Welfare Regular Administration funding for respite care for county foster care PROVIDERS and '1h WHEREAS, Provider is a for-profit Sole-Proprietor. NOW THEREFORE, in consideration of the premises,the parties hereto covenant and agree as follows: 1. Term This Agreement shall become effective on July 1,20a,upon proper execution of this Agreement and shall expire June 30,20 lfianless sooner terminated as provided herein. 2. Scope of Services Services shall be provided by Provider to any person(s)eligible for child protection services in compliance with Exhibit A"Scope of Services,"a copy of which is attached by reference. 3. Payment a. Payment shall be made on the basis of Exhibit B,"Payment Schedule,"copies of which are attached hereto and incorporated herein by reference. b. "Payment Schedule"shall establish the maximum reimbursement,which will be paid from Child Welfare Regular Administration funds during the duration of this Agreement. c. PROVIDER shall submit an itemized monthly bill to Human Services for all costs incurred and services provided pursuant to Exhibit A of this Agreement in accordance with criteria established by Human Services. PROVIDER shall submit all itemized monthly billings to Human Services no later than the twenty-fifth(25)day of the month following the month the cost was incurred. d. Payments of costs incurred pursuant to this Agreement are expressly contingent upon the availability of Child Welfare Regular Administration funds to Human Services. e. Human Services shall not be billed for,and reimbursement shall not be made for time involved in activities outside of those defined in Exhibit A. Work performed prior to the execution of this Contract shall not be reimbursed or considered part of this Agreement. 4. Financial Management At all times from the effective date of this Contract until completion of this Contract,PROVIDER shall comply with the administrative requirements,cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under Child Welfare Regular Administration funding must conform to the Single Audit Act of 1984 and OMB Circular A-133. Page 1 of 9 &19//—/ -,// 11-12-RESPITE CARE 5. Payment Method Unless otherwise provided in the Scope of Services and Payment Schedule: a. PROVIDER shall provide proper monthly invoices and itemization of services performed for costs incurred in the performance of the agreement. b. Human Services may withhold any payment if PROVIDER has failed to comply with the Financial Management Requirements,program objectives,contractual terms,or reporting requirements. In the event of a forfeiture of reimbursements,PROVIDER may appeal such circumstance to the Director of Human Services. The decision of the Director of Human Services shall be final. 6. Assurances PROVIDER shall abide by all assurances as set forth in the attached Exhibit C,which is attached hereto and incorporated herein by reference. 7. Compliance with Applicable Laws At all times during the performance of this contract,PROVIDER shall strictly adhere to all applicable federal and state laws,orders,and all applicable standards,regulations,interpretations or guidelines issued pursuant thereto. This includes the protection of the confidentiality of all applicant/recipient records,papers,documents, tapes and any other materials that have been or may hereafter be established which relate to the Contract. PROVIDER acknowledges that the following laws are included: - Title VI of the Civil Rights Act of 1964,42 U.S.C.Sections 2000d—1 et.seq.and its implementing regulation, 45 C.F.R.Part 80 et.seq.;and - Section 504 of the Rehabilitation Act of 1973,29 U.S.C.Section 794,and its implementing regulations,45 C.F.R.Part 84;and - the Age Discrimination Act of 1975,42 U.S.C.Sections 6101 et.seq.and its implementation regulations,45 C.F.R. Part 91;and - Title VII of the Civil Rights Act of 1964;and - the Age Discrimination in Employment Act of 1967;and - the Equal Pay Act of 1963;and - the Education Amendments of 1972;and - Immigration Reform and Control Act of 1986,P.L.99-603; - 42 C.F.R.Part 2 and all regulations applicable to these laws prohibiting discrimination because of race, color,National origin,and sex,religion and handicap,including Acquired Immune Deficiency syndrome (AIDS)or AIDS related conditions,covered under Section 504 of the Rehabilitation Act of 1973,as amended,cited above. If necessary,PROVIDER and Human Services will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 CFR Part 2. Included in 45 C.F.R.Part 74 Appendix G 9,which requires that affirmative steps be taken to assure that small and minority businesses are utilized, when possible,as sources of supplies,equipment,construction and services. This assurance is given in consideration of and for the purpose of obtaining any and all federal and/or state financial assistance. Any person who feels that s/he has been discriminated against has the right to file a complaint either with the Colorado Department of Human Services or with the U.S. Department of Health and Human Services,Office for Civil Rights. 8. Certifications PROVIDER certifies that,at the time of entering into this Contract,it has currently in effect all necessary licenses,approvals,insurance,etc.,required to properly provide the services and/or supplies covered by this contract. A copy of certificate will be provided to Human Services upon completion of this agreement. Failure to do so will null and void this contract in its entirety. Page 2 of 9 11-12-RESPITE CARE 9. Monitoring and Evaluation PROVIDER and Human Services agree that monitoring and evaluation of the performance of this Agreement shall be conducted by PROVIDER and Human Services. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners and PROVIDER. PROVIDER shall permit Human Services,and any other duly authorized agent or governmental agency,to monitor all activities conducted by PROVIDER pursuant to the terms of this Agreement. As the monitoring agency may in its sole discretion deem necessary or appropriate,such program data,special analyses,on-site checking,formal audit examinations,or any other reasonable procedures. All such monitoring shall be performed in a manner that will not unduly interfere with agreement work. 10. Modification of Agreement All modifications to this agreement shall be in writing and signed by both parties. II. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find PROVIDER substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by PROVIDER. These remedial actions are as follows: a. Withhold payment to PROVIDER until the necessary services or corrections in performance are satisfactorily completed; b. Deny payment or recover reimbursement for those services or deliverables,which have not been performed and which due to circumstances caused by PROVIDER cannot be performed or if performed would be of no value to Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; c. Incorrect payment to PROVIDER due to omission,error,fraud,and/or defalcation shall be recovered from PROVIDER by deduction from subsequent payments under this Agreement or other agreements between Human Services and PROVIDER,or by Human Services as a debt due to Human Services or otherwise as provided by law. 12. Representatives For the purpose of this Agreement,the individuals identified below are hereby designated representatives of the respective parties. Either party may from time to time designate in writing a new or substitute representative(s): For Human Services: Gloria Romansik Human Services Administrator Name Title For Provider. e Net\, \\ Respite Care Provider Name Title 13. Notice All notices required to be given by the parties hereunder shall be given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing a substitute person(s)or address to whom such notices shall be sent: To: Human Services To: Je.vte 'M'.\k a v- JudvA.Griego,Director 1g1G Sovrnvrt,.tte `ts,,( iye_ P.O.Box A srur \- Q 1 Co QC, a6 Greeley,CO 80632 Page 3 of 9 11-I2-RESPITE CARE 14. Litigation PROVIDER shall promptly notify Human Services in the event that PROVIDER learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement.PROVIDER, within five(5)calendar days after being served with a summons,complaint,or other pleading which has been filed in any federal or state court or administrative agency,shall deliver copies of such document(s)to the Human Services Director. The term"litigation" includes an assignment for the benefit of creditors,and filings in bankruptcy,reorganization and/or foreclosure. 15. Termination This Agreement may be terminated at any time by either party given thirty(30)days written notice and is subject to the availability of funding. PROVIDER reserves the right to suspend services to clients if funding is no longer available. 16. Entire Agreement This Agreement,together with all attachments hereto,constitutes the entire understanding between the parties with respect to the subject matter hereof,and may not be changed or modified except as stated in Paragraph 10 herein. 17. No Third Party Beneficiary. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 18. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may posses,nor shall any portion of this Agreement be deemed to have created a duty of care which did not previously exist with respect to any person not a party to this Agreement. IN WITNESS WHEREOF,the parties hereto have duly executed the Agreement as of the day,month,and year first above written. BOARD OF COUNTY COMMISSIONERS WELD COUNTY,COLO : DO ATTEST: Welty Clerk to a Boar � " • / / >� � �IJ�arbara K rkmeyer BY: ( ,dtzmt_, y_dAA ' JUL 0 6 2011 Deputy Clerk the B.. d rot," 1i61 � APP • Co WELD COUNTY DEPARTMENT OF HUMAN SERVICES PROVIDER arlAj J A. rie o,Directo spite Provider Page 4 of 9 ,)7O//-/lo// 11-12-RESPITE CARE EXHIBIT A SCOPE OF SERVICES Each Provider will: 1. Complete a fingerprint card for a background check at the PROVIDERS expense with the Colorado Bureau of Investigation. A Federal Bureau of Investigation background check will be done if the Provider has been a resident of the State of Colorado for less than two years. Human Services will clear the Provider through CBI and FBI; 2. Complete a course in CPR and first aid, in which a current copy of the certifications must be provided to Human Services with this agreement. If either certification should expire during the contracted period,the Provider will send a new current certification copy to Human Services; 3. Provide transportation for the child to appointments during the hours of service as agreed upon with the foster parent; 4. Become familiar with State rules and regulations governing certified foster homes; 5. Must be eighteen years of age or older. Page 5 of 9 11-12-RESPITE CARE EXHIBIT B PAYMENT SCHEDULE I. Funding and Method of Payment Human Services agrees to reimburse PROVIDER in consideration for the work and services performed under Child Welfare Regular Administration funding. Expenses incurred by PROVIDER, in association with said project prior to the term of this agreement,are not eligible Human Services expenditures and shall not be reimbursed by Human Services. Payment pursuant to this Contract, if Child Welfare Regular Administration funds,whether in whole or in part, is subject to and contingent upon the continuing availability of Child Welfare Regular Administration funds for the purposes hereof. In the event that said funds,or any part thereof,become unavailable as determined by Human Services, Human Services may immediately terminate this Contract or amend it accordingly. 2. Fees for Services Respite care is limited to four hours per week per child. The hours of care may be provided in any combination throughout a month,but not to exceed 16 hours per month. Payment will be$16.75 per each four hour period,but not to exceed$67.00 per month for 16 hours. Human Services referrals will not be sent to collections by PROVIDER for default of co-pay/fees. Services will be performed regardless of client's refusal or inability to pay co-pay. PROVIDER will collect any applicable sliding scale co-pays and credit Human Services for any payments received on the monthly billing statements. 3. Submittal of Vouchers PROVIDER shall prepare and submit monthly,the itemized voucher and certify that the services authorized were provided on the date indicated and the charges made were pursuant to the terms and conditions of Exhibit A. Page 6 of 9 l 1-12-RESPITE CARE EXHIBIT C ASSURANCES 1. PROVIDER agrees it is an independent contractor and that its officers and employees do not become employees of Weld County,nor are they entitled to any employee benefits as Weld County employees,as the result of the execution of this Agreement. 2. Weld County,the Board of County Commissioners of Weld County, its officers and employees,shall not be held liable for injuries or damages caused by any negligent acts or omissions of PROVIDER-contracted PROVIDERS or its employees,volunteers,or agents while performing duties as described in this Agreement. PROVIDER shall indemnify,defend,and hold harmless Weld County,the Board of County Commissioners of Weld County, its employees, volunteers,and agents. PROVIDER shall provide adequate liability and worker's compensation insurance for all its employees,volunteers,and agents engaged in the performance of the Agreement upon request,PROVIDER shall provide Human Services with the acceptable evidence that such coverage is in effect. 3. No portion of this Contract shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may possess,not shall any portion of this Agreement be deemed to have treated a duty of care with respect to any persons not a party of this Agreement. 4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld,State of Colorado,to expend funds not otherwise appropriated in each succeeding year. 5. If any section,subsection,paragraph, sentence,clause,or phrase of this Contract is for any reason held or decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The parties hereto declare that they would have entered into this Contract and each and every section,subsection, paragraph,sentence,clause,and phrase thereof irrespective of the fact that any one or more sections, subsections,paragraphs,sentences,clauses,or phrases might be declared to be unconstitutional or invalid. 6. No officer,member or employee of Weld County and no member of their governing bodies shall have any pecuniary interest,direct or indirect, in the approved Agreement or the proceeds thereof. 7. PROVIDER assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that no person shall,on the grounds of race,creed,color,sex,or national origin,be excluded from participation in,be denied the benefits of,or be otherwise subjected to discrimination under this approved Contract. 8. PROVIDER assures that sufficient,auditable,and otherwise adequate records that will provide accurate, current,separate,and complete disclosure of the status of the funds received under the Contract are maintained for three(3)years or the completion and resolution of an audit. Such records shall be sufficient to allow authorized local, Federal,and State auditors,and representatives to audit and monitor PROVIDER. 9. All such records,documents,communications,and other materials shall be the property of Human Services and shall be maintained by PROVIDER, in a central location and custodian, in behalf of Human Services,for a period of four(4)years from the date of final payment under this Contract,or for such further period as may be necessary to resolve any matters which may be pending, or until an audit has been completed with the following qualifications: If an audit by or on behalf of the federal and/or state government has begun but is not completed at the end of the four(4)year period,or if audit findings have not been resolved after a four(4)year period,the materials shall be retained until the resolution of the audit finding. 10. PROVIDER assures that authorized local, federal,and state auditors and representatives shall,during business hours,have access to inspect any copy records,and shall be allowed to monitor and review through on-site visits,all contract activities,supported with funds under this Contract to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. Page 7 of 9 1 I-12-RESPITE CARE II. This Contract shall be binding upon the parties hereto,their successors,heirs, legal representatives,and assigns. PROVIDER or Human Services may not assign any of its rights or obligations hereunder without the prior written consent of both parties. 12. PROVIDER certifies that federal appropriated funds have not been paid or will be paid,by or on behalf of PROVIDER,to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any federal grant,the making of any federal loan,the entering into of any cooperative agreement,and the extension,continuation,renewal, amendment,or modification of any Federal contract, loan,grant,or cooperative agreement. 13. PROVIDER assures that it will fully comply with all other applicable federal and state laws. PROVIDER understands that the source of funds to be used under this Contract is Child Welfare Regular Administration funds. 14. PROVIDER assures and certifies that it and its principals: a. Are not presently debarred,suspended,proposed for debarment,declared ineligible or voluntarily excluded from covered transaction by a federal department or agency. b. Have not, within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining,attempting to obtain,or performing a public(federal,state,or local)transaction or contract under a public transaction;violation of federal or state antitrust statutes or commission of embezzlement, theft,forgery,bribery,falsification or destruction of records,making false statements,or receiving stolen property; c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state,or local)with commission of any of the offenses enumerated in paragraph 14(b)of this certification;and d. Have not within a three-year period preceding this Contract,had one or more public transactions (federal,state,and local)terminated for cause or default. 15. The Appearance of Conflict of Interest applies to the relationship of a contractor with Human Services when the contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest,it is not necessary for the contractor to gain from knowledge of these opposing interests. It is only necessary that the contractor know that the two relationships are in opposition. During the term of the Contract, PROVIDER shall not enter any third party relationship that gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation,PROVIDER shall submit to Human Services,a full disclosure statement setting forth the details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for Human Services'termination, for cause,of its contract with PROVIDER. 16. PROVIDER shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Contract. Except for purposes directly connected with the administration of Child Protection,no information about or obtained from any applicant/recipient in possession of PROVIDER shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with PROVIDER written policies governing access to,duplication and dissemination of,all such information. PROVIDER shall advise its employees,agents,and subcontractors, if any,that they are subject to these confidentiality requirements. PROVIDER shall provide its employees,agents,and subcontractors, if any,with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. Page 8 of 9 11-12-RESPITE CARE 17. Proprietary information for the purposes of this contract is information relating to a party's research, development,trade secrets,business affairs,internal operations and management procedures and those of its customers,clients or affiliates,but does not include information(I)lawfully obtained from third parties,(2) that which is in the public domain,or(3)that which is developed independently. Neither party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of this Contract. Any proprietary information removed from the State's site by PROVIDER in the course of providing services under this Contract will be accorded at least the same precautions as are employed by PROVIDER for similar information in the course of its own business. 18. PROVIDER certifies that s/he will abide by Colorado Revised Statute(C.R.S.)26-6-104,requiring criminal background checks for all employees,contractors,and sub-contractors. Page 9 of 9 11-12-RESPITE CARE CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND PROVIDER "t't - r7 Q. This Agreement,made and entered into the day of ,20_, by and between the Board Or Weld County Commissioners, sitting as the Board of Human,pn beh if of,q�th.e� Weld County Department of Human Services,hereinafter referred to as"Human Services,"and UOnei4 r V hl (l a/ referred to as"Provider". WITNESSETH WHEREAS,required approval, clearance, and coordination have been accomplished from and with appropriate agencies;and WHEREAS,the Colorado Department of Human Services has provided Child Welfare Regular Administration funding for respite care for county foster care PROVIDERS and WHEREAS, Provider is a for-profit Sole-Proprietor. NOW THEREFORE, in consideration of the premises,the parties hereto covenant and agree as follows: 1. Term This Agreement shall become effective on July 1,2011, upon proper execution of this Agreement and shall expire June 30,20(yunless sooner terminated as provided herein. 2. Scope of Services Services shall be provided by Provider to any person(s)eligible for child protection services in compliance with Exhibit A"Scope of Services,"a copy of which is attached by reference. 3. Payment a. Payment shall be made on the basis of Exhibit B,"Payment Schedule," copies of which are attached hereto and incorporated herein by reference. b. "Payment Schedule"shall establish the maximum reimbursement, which will be paid from Child Welfare Regular Administration funds during the duration of this Agreement. c. PROVIDER shall submit an itemized monthly bill to Human Services for all costs incurred and services provided pursuant to Exhibit A of this Agreement in accordance with criteria established by Human Services. PROVIDER shall submit all itemized monthly billings to Human Services no later than the twenty-fifth (25)day of the month following the month the cost was incurred. d. Payments of costs incurred pursuant to this Agreement are expressly contingent upon the availability of Child Welfare Regular Administration funds to Human Services. e. Human Services shall not be billed for,and reimbursement shall not be made for time involved in activities outside of those defined in Exhibit A. Work performed prior to the execution of this Contract shall not be reimbursed or considered part of this Agreement. 4. Financial Management At all times from the effective date of this Contract until completion of this Contract, PROVIDER shall comply with the administrative requirements, cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under Child Welfare Regular Administration funding must conform to the Single Audit Act of 1984 and OMB Circular A-133. Page 1 of 9 32O//—/6// 11-12-RESPITE CARE 5. Payment Method Unless otherwise provided in the Scope of Services and Payment Schedule: a. PROVIDER shall provide proper monthly invoices and itemization of services performed for costs incurred in the performance of the agreement. b. Human Services may withhold any payment if PROVIDER has failed to comply with the Financial Management Requirements,program objectives, contractual terms, or reporting requirements. In the event of a forfeiture of reimbursements, PROVIDER may appeal such circumstance to the Director of Human Services. The decision of the Director of Human Services shall be final. 6. Assurances PROVIDER shall abide by all assurances as set forth in the attached Exhibit C,which is attached hereto and incorporated herein by reference. 7. Compliance with Applicable Laws At all times during the performance of this contract, PROVIDER shall strictly adhere to all applicable federal and state laws,orders,and all applicable standards,regulations, interpretations or guidelines issued pursuant thereto. This includes the protection of the confidentiality of all applicant/recipient records,papers,documents, tapes and any other materials that have been or may hereafter be established which relate to the Contract. PROVIDER acknowledges that the following laws are included: - Title VI of the Civil Rights Act of 1964,42 U.S.C. Sections 2000d—I et.seq. and its implementing regulation, 45 C.F.R.Part 80 et.seq.;and - Section 504 of the Rehabilitation Act of 1973,29 U.S.C. Section 794,and its implementing regulations,45 C.F.R.Part 84;and - the Age Discrimination Act of 1975,42 U.S.C. Sections 6101 et.seq.and its implementation regulations,45 C.F.R. Part 91;and - Title VII of the Civil Rights Act of 1964;and - the Age Discrimination in Employment Act of 1967;and - the Equal Pay Act of 1963;and - the Education Amendments of 1972;and - Immigration Reform and Control Act of 1986,P.L. 99-603; - 42 C.F.R. Part 2 and all regulations applicable to these laws prohibiting discrimination because of race, color,National origin,and sex,religion and handicap, including Acquired Immune Deficiency syndrome (AIDS)or AIDS related conditions, covered under Section 504 of the Rehabilitation Act of 1973, as amended, cited above. If necessary,PROVIDER and Human Services will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 CFR Part 2. Included in 45 C.F.R. Part 74 Appendix G 9,which requires that affirmative steps be taken to assure that small and minority businesses are utilized,when possible, as sources of supplies, equipment,construction and services. This assurance is given in consideration of and for the purpose of obtaining any and all federal and/or state financial assistance. Any person who feels that s/he has been discriminated against has the right to file a complaint either with the Colorado Department of Human Services or with the U.S. Department of Health and Human Services,Office for Civil Rights. 8. Certifications PROVIDER certifies that, at the time of entering into this Contract, it has currently in effect all necessary licenses, approvals, insurance,etc.,required to properly provide the services and/or supplies covered by this contract. A copy of certificate will be provided to Human Services upon completion of this agreement. Failure to do so will null and void this contract in its entirety. Page 2 of 9 I1-12-RESPITE CARE 9. Monitoring and Evaluation PROVIDER and Human Services agree that monitoring and evaluation of the performance of this Agreement shall be conducted by PROVIDER and Human Services. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners and PROVIDER. PROVIDER shall permit Human Services, and any other duly authorized agent or governmental agency,to monitor all activities conducted by PROVIDER pursuant to the terms of this Agreement. As the monitoring agency may in its sole discretion deem necessary or appropriate, such program data,special analyses, on-site checking,formal audit examinations, or any other reasonable procedures. All such monitoring shall be performed in a manner that will not unduly interfere with agreement work. 10. Modification of Agreement All modifications to this agreement shall be in writing and signed by both parties. II. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find PROVIDER substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by PROVIDER. These remedial actions are as follows: a. Withhold payment to PROVIDER until the necessary services or corrections in performance are satisfactorily completed; b. Deny payment or recover reimbursement for those services or deliverables, which have not been performed and which due to circumstances caused by PROVIDER cannot be performed or if performed would be of no value to Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; c. Incorrect payment to PROVIDER due to omission,error,fraud,and/or defalcation shall be recovered from PROVIDER by deduction from subsequent payments under this Agreement or other agreements between Human Services and PROVIDER,or by Human Services as a debt due to Human Services or otherwise as provided by law. 12. Representatives For the purpose of this Agreement,the individuals identified below are hereby designated representatives of the respective parties. Either party may from time to time designate in writing a new or substitute representative(s): For Human Services: Gloria Romansik Human Services Administrator Name Title For Provider: eRI Y II(ley Respite Care Provider Name Title 13. Notice All notices required to be given by the parties hereunder shall be given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing a substitute person(s)or address to whom such notices � l shall be sent: To: Human Services To: —f W. Re-r Judy A. Griego, Director 51 5 I u q'1.1, 5 P.O. Box A ('>✓t 64 ( t & ,34 Greeley,CO 80632 Page 3 of 9 11-12-RESPITE CARE 14. Litigation PROVIDER shall promptly notify Human Services in the event that PROVIDER learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement. PROVIDER, within five(5)calendar days after being served with a summons, complaint,or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s)to the Human Services Director. The term"litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy,reorganization and/or foreclosure. 15. Termination This Agreement may be terminated at any time by either party given thirty(30)days written notice and is subject to the availability of funding. PROVIDER reserves the right to suspend services to clients if funding is no longer available. 16. Entire Agreement This Agreement,together with all attachments hereto,constitutes the entire understanding between the parties with respect to the subject matter hereof,and may not be changed or modified except as stated in Paragraph 10 herein. 17. No Third Party Beneficiary. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 18. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care which did not previously exist with respect to any person not a party to this Agreement. IN WITNESS WHEREOF,the parties hereto have duly executed the Agreement as of the day,month,and year first above written. BOARD OF COUNTY COMMISSIONERS WELD COUNTY,COLORA O ATTEST: Li • I-- Weld County Clerk to the Boar. hair ' / Ste ► Barbara K'rkmeyer BY: �( �� i �!��i Ste JUL 0 0 2011 Deputy Clerk ' the-Bo , AP .t�D ; ��• •RM: '�� / 361 tH�•� C., ty •tmey WELD COUNTY DEPARTMENT OF HUMAN SERVICES PROVIDER J y .Grieg ,D recto Respite Provider Page 4 of 9 &9//—/&// • 11-12-RESPITE CARE EXHIBIT A SCOPE OF SERVICES Each Provider will: 1. Complete a fingerprint card for a background check at the PROVIDERS expense with the Colorado Bureau of Investigation. A Federal Bureau of Investigation background check will be done if the Provider has been a resident of the State of Colorado for less than two years. Human Services will clear the Provider through CBI and FBI; 2. Complete a course in CPR and first aid, in which a current copy of the certifications must be provided to Human Services with this agreement. If either certification should expire during the contracted period,the Provider will send a new current certification copy to Human Services; 3. Provide transportation for the child to appointments during the hours of service as agreed upon with the foster parent; 4. Become familiar with State rules and regulations governing certified foster homes; 5. Must be eighteen years of age or older. t • GI Page 5 of 9 • 11-12-RESPITE CARE EXHIBIT B PAYMENT SCHEDULE 1. Funding and Method of Payment Human Services agrees to reimburse PROVIDER in consideration for the work and services performed under Child Welfare Regular Administration funding. Expenses incurred by PROVIDER, in association with said project prior to the term of this agreement,are not eligible Human Services expenditures and shall not be reimbursed by Human Services. Payment pursuant to this Contract, if Child Welfare Regular Administration funds, whether in whole or in part, is subject to and contingent upon the continuing availability of Child Welfare Regular Administration funds for the purposes hereof. In the event that said funds, or any part thereof,become unavailable as determined by Human Services, Human Services may immediately terminate this Contract or amend it accordingly. 2. Fees for Services Respite care is limited to four hours per week per child. The hours of care may be provided in any combination throughout a month,but not to exceed 16 hours per month. Payment will be$16.75 per each four hour period,but not to exceed$67.00 per month for 16 hours. Human Services referrals will not be sent to collections by PROVIDER for default of co-pay/fees. Services will be performed regardless of client's refusal or inability to pay co-pay. PROVIDER will collect any applicable sliding scale co-pays and credit Human Services for any payments received on the monthly billing statements. 3. Submittal of Vouchers PROVIDER shall prepare and submit monthly,the itemized voucher and certify that the services authorized were provided on the date indicated and the charges made were pursuant to the terms and conditions of Exhibit A. Page 6 of 9 11-12-RESPITE CARE EXHIBIT C ASSURANCES I. PROVIDER agrees it is an independent contractor and that its officers and employees do not become employees of Weld County,nor are they entitled to any employee benefits as Weld County employees,as the result of the execution of this Agreement. 2. Weld County,the Board of County Commissioners of Weld County, its officers and employees, shall not be held liable for injuries or damages caused by any negligent acts or omissions of PROVIDER-contracted PROVIDERS or its employees, volunteers, or agents while performing duties as described in this Agreement. PROVIDER shall indemnify,defend,and hold harmless Weld County,the Board of County Commissioners of Weld County, its employees,volunteers, and agents. PROVIDER shall provide adequate liability and worker's compensation insurance for all its employees,volunteers,and agents engaged in the performance of the Agreement upon request, PROVIDER shall provide Human Services with the acceptable evidence that such coverage is in effect. 3. No portion of this Contract shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may possess,not shall any portion of this Agreement be deemed to have treated a duty of care with respect to any persons not a party of this Agreement. 4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld, State of Colorado,to expend funds not otherwise appropriated in each succeeding year. 5. If any section, subsection, paragraph, sentence,clause,or phrase of this Contract is for any reason held or decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The parties hereto declare that they would have entered into this Contract and each and every section, subsection, paragraph,sentence,clause,and phrase thereof irrespective of the fact that any one or more sections, subsections,paragraphs, sentences, clauses, or phrases might be declared to be unconstitutional or invalid. 6. No officer,member or employee of Weld County and no member of their governing bodies shall have any pecuniary interest, direct or indirect, in the approved Agreement or the proceeds thereof. 7. PROVIDER assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that no person shall, on the grounds of race, creed,color,sex,or national origin,be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under this approved Contract. 8. PROVIDER assures that sufficient, auditable, and otherwise adequate records that will provide accurate, current,separate,and complete disclosure of the status of the funds received under the Contract are maintained for three(3)years or the completion and resolution of an audit. Such records shall be sufficient to allow authorized local,Federal, and State auditors, and representatives to audit and monitor PROVIDER. 9. All such records, documents, communications,and other materials shall be the property of Human Services and shall be maintained by PROVIDER, in a central location and custodian, in behalf of Human Services, for a period of four(4)years from the date of final payment under this Contract,or for such further period as may be necessary to resolve any matters which may be pending, or until an audit has been completed with the following qualifications: If an audit by or on behalf of the federal and/or state government has begun but is not completed at the end of the four(4)year period,or if audit findings have not been resolved after a four(4)year period,the materials shall be retained until the resolution of the audit finding. 10. PROVIDER assures that authorized local, federal, and state auditors and representatives shall,during business hours,have access to inspect any copy records,and shall be allowed to monitor and review through on-site visits, all contract activities, supported with funds under this Contract to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. Page 7 of 9 11-12-RESPITE CARE 11. This Contract shall be binding upon the parties hereto,their successors,heirs, legal representatives,and assigns. PROVIDER or Human Services may not assign any of its rights or obligations hereunder without the prior written consent of both parties. 12. PROVIDER certifies that federal appropriated funds have not been paid or will be paid,by or on behalf of PROVIDER,to any person for influencing or attempting to influence an officer or employee of an agency,a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any federal grant,the making of any federal loan,the entering into of any cooperative agreement, and the extension,continuation,renewal, amendment, or modification of any Federal contract, loan,grant, or cooperative agreement. 13. PROVIDER assures that it will fully comply with all other applicable federal and state laws. PROVIDER understands that the source of funds to be used under this Contract is Child Welfare Regular Administration funds. 14. PROVIDER assures and certifies that it and its principals: a. Are not presently debarred, suspended,proposed for debarment,declared ineligible or voluntarily excluded from covered transaction by a federal department or agency. b. Have not,within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining,attempting to obtain,or performing a public(federal,state,or local)transaction or contract under a public transaction;violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery,bribery,falsification or destruction of records, making false statements, or receiving stolen property; c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local)with commission of any of the offenses enumerated in paragraph 14(b)of this certification; and d. Have not within a three-year period preceding this Contract, had one or more public transactions (federal, state, and local)terminated for cause or default. 15. The Appearance of Conflict of Interest applies to the relationship of a contractor with Human Services when the contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest, it is not necessary for the contractor to gain from knowledge of these opposing interests. It is only necessary that the contractor know that the two relationships are in opposition. During the term of the Contract, PROVIDER shall not enter any third party relationship that gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation,PROVIDER shall submit to Human Services, a full disclosure statement setting forth the details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for Human Services' termination, for cause, of its contract with PROVIDER. 16. PROVIDER shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Contract. Except for purposes directly connected with the administration of Child Protection,no information about or obtained from any applicant/recipient in possession of PROVIDER shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with PROVIDER written policies governing access to,duplication and dissemination of, all such information. PROVIDER shall advise its employees,agents,and subcontractors, if any,that they are subject to these confidentiality requirements. PROVIDER shall provide its employees, agents, and subcontractors, if any,with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. Page 8 of 9 1I-I2-RESPITE CARE 17. Proprietary information for the purposes of this contract is information relating to a party's research, development,trade secrets, business affairs, internal operations and management procedures and those of its customers,clients or affiliates,but does not include information(I)lawfully obtained from third parties,(2) that which is in the public domain,or(3)that which is developed independently. Neither party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of this Contract. Any proprietary information removed from the State's site by PROVIDER in the course of providing services under this Contract will be accorded at least the same precautions as are employed by PROVIDER for similar information in the course of its own business. 18. PROVIDER certifies that s/he will abide by Colorado Revised Statute(C.R.S.)26-6-104,requiring criminal background checks for all employees,contractors, and sub-contractors. Page 9 of 9 p, o. p9 1 I-12-RESPITE CARE CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND PROVIDER This Agreement,made and entered into the day of ,20_,by and between the Board of Weld County Commissioners,sitting as the Board of Human on behalf of the Weld County Department of Human Services,hereinafter referred to as"Human Services,"and gar1 rn jyrG referred to as"Provider". WITNESSETH WHEREAS,required approval,clearance,and coordination have been accomplished from and with appropriate agencies;and WHEREAS,the Colorado Department of Human Services has provided Child Welfare Regular Administration funding for respite care for county foster care PROVIDERS and WHEREAS,Provider is a for-profit Sole-Proprietor. NOW THEREFORE,in consideration of the premises,the parties hereto covenant and agree as follows: I. Term This Agreement shall become effective on July 1,2011,upon proper execution of this Agreement and shall expire June 30,20.1 unless sooner terminated as provided herein. 2. Scope of Services Services shall be provided by Provider to any person(s)eligible for child protection services in compliance with Exhibit A"Scope of Services,"a copy of which is attached by reference. 3. Payment a. Payment shall be made on the basis of Exhibit B,"Payment Schedule,"copies of which are attached hereto and incorporated herein by reference. b. "Payment Schedule"shall establish the maximum reimbursement,which will be paid from Child Welfare Regular Administration funds during the duration of this Agreement. c. PROVIDER shall submit an itemized monthly bill to Human Services for all costs incurred and services provided pursuant to Exhibit A of this Agreement in accordance with criteria established by Human Services. PROVIDER shall submit all itemized monthly billings to Human Services no later than the twenty-fifth(25)day of the month following the month the cost was incurred. d. Payments of costs incurred pursuant to this Agreement are expressly contingent upon the availability of Child Welfare Regular Administration funds to Human Services. e. Human Services shall not be billed for,and reimbursement shall not be made for time involved in activities outside of those defined in Exhibit A. Work performed prior to the execution of this Contract shall not be reimbursed or considered part of this Agreement. 4. Financial Management At all times from the effective date of this Contract until completion of this Contract,PROVIDER shall comply with the administrative requirements,cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under Child Welfare Regular Administration funding must conform to the Single Audit Act of 1984 and OMB Circular A-133. Page 1 of 9 11-12-RESPITE CARE 5. Payment Method Unless otherwise provided in the Scope of Services and Payment Schedule: a. PROVIDER shall provide proper monthly invoices and itemization of services performed for costs incurred in the performance of the agreement. b. Human Services may withhold any payment if PROVIDER has failed to comply with the Financial Management Requirements,program objectives,contractual terms,or reporting requirements. In the event of a forfeiture of reimbursements,PROVIDER may appeal such circumstance to the Director of Human Services. The decision of the Director of Human Services shall be final. 6. Assurances PROVIDER shall abide by all assurances as set forth in the attached Exhibit C,which is attached hereto and incorporated herein by reference. 7. Compliance with Applicable Laws At all times during the performance of this contract,PROVIDER shall strictly adhere to all applicable federal and state laws,orders,and all applicable standards,regulations,interpretations or guidelines issued pursuant thereto. This includes the protection of the confidentiality of all applicant/recipient records,papers,documents, tapes and any other materials that have been or may hereafter be established which relate to the Contract. PROVIDER acknowledges that the following laws are included: - Title VI of the Civil Rights Act of 1964,42 U.S.C.Sections 2000d—1 et.seq.and its implementing regulation, 45 C.F.R.Part 80 et seq.;and - Section 504 of the Rehabilitation Act of 1973,29 U.S.C.Section 794,and its implementing regulations,45 C.F.R.Part 84;and - the Age Discrimination Act of 1975,42 U.S.C.Sections 6101 et.seq.and its implementation regulations,45 C.F.R. Part 91;and - Title VII of the Civil Rights Act of 1964;and - the Age Discrimination in Employment Act of 1967;and - the Equal Pay Act of 1963;and - the Education Amendments of 1972;and - Immigration Reform and Control Act of 1986,P.L.99-603; - 42 C.F.R.Part 2 and all regulations applicable to these laws prohibiting discrimination because of race, color,National origin,and sex,religion and handicap,including Acquired Immune Deficiency syndrome (AIDS)or AIDS related conditions,covered under Section 504 of the Rehabilitation Act of 1973,as amended,cited above. If necessary,PROVIDER and Human Services will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 CFR Part 2. Included in 45 C.F.R.Part 74 Appendix G 9,which requires that affirmative steps be taken to assure that small and minority businesses are utilized, when possible,as sources of supplies,equipment,construction and services. This assurance is given in consideration of and for the purpose of obtaining any and all federal and/or state financial assistance. Any person who feels that s/he has been discriminated against has the right to file a complaint either with the Colorado Department of Human Services or with the U.S.Department of Health and Human Services,Office for Civil Rights. 8. Certifications PROVIDER certifies that,at the time of entering into this Contract, it has currently in effect all necessary licenses,approvals, insurance,etc.,required to properly provide the services and/or supplies covered by this contract. A copy of certificate will be provided to Human Services upon completion of this agreement. Failure to do so will null and void this contract in its entirety. Page 2 of 9 11-12-RESPITE CARE 9. Monitoring and Evaluation PROVIDER and Human Services agree that monitoring and evaluation of the performance of this Agreement shall be conducted by PROVIDER and Human Services. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners and PROVIDER. PROVIDER shall permit Human Services,and any other duly authorized agent or governmental agency,to monitor all activities conducted by PROVIDER pursuant to the terms of this Agreement. As the monitoring agency may in its sole discretion deem necessary or appropriate,such program data,special analyses,on-site checking,formal audit examinations,or any other reasonable procedures. All such monitoring shall be performed in a manner that will not unduly interfere with agreement work. 10. Modification of Agreement All modifications to this agreement shall be in writing and signed by both parties. 11. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find PROVIDER substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by PROVIDER. These remedial actions are as follows: a. Withhold payment to PROVIDER until the necessary services or corrections in performance are satisfactorily completed; b. Deny payment or recover reimbursement for those services or deliverables,which have not been performed and which due to circumstances caused by PROVIDER cannot be performed or if performed would be of no value to Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; c. Incorrect payment to PROVIDER due to omission,error,fraud,and/or defalcation shall be recovered from PROVIDER by deduction from subsequent payments under this Agreement or other agreements between Human Services and PROVIDER,or by Human Services as a debt due to Human Services or otherwise as provided by law. 12. Representatives For the purpose of this Agreement,the individuals identified below are hereby designated representatives of the respective parties. Either party may from time to time designate in writing a new or substitute representative(s): For Human Services: Gloria Romansik Human Services Administrator Name Title For Provider: lfrie Ot . Respite Care Provider Name Title 13. Notice All notices required to be given by the parties hereunder shall be given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing a substitute person(s)or address to whom such notices shall be sent: To: Human Services To: Judy A.Griego,Director ®1/ P.O.Box A C! 4 Greeley,CO 80632 ‘--6-C40-C-41-ett o f Page 3 of 9 11-12-RESPITE CARE 14. Litigation PROVIDER shall promptly notify Human Services in the event that PROVIDER learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement. PROVIDER, within five(5)calendar days after being served with a summons,complaint,or other pleading which has been filed in any federal or state court or administrative agency,shall deliver copies of such document(s)to the Human Services Director. The term"litigation" includes an assignment for the benefit of creditors,and filings in bankruptcy,reorganization and/or foreclosure. 15. Termination This Agreement may be terminated at any time by either party given thirty(30)days written notice and is subject to the availability of funding. PROVIDER reserves the right to suspend services to clients if funding is no longer available. 16. Entire Agreement This Agreement,together with all attachments hereto,constitutes the entire understanding between the parties with respect to the subject matter hereof,and may not be changed or modified except as stated in Paragraph 10 herein. 17. No Third Party Beneficiary. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement,and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 18. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may posses,nor shall any portion of this Agreement be deemed to have created a duty of care which did not previously exist with respect to any person not a party to this Agreement. IN WITNESS WHEREOF,the parties hereto have duly executed the Agreement as of the day,month,and year first above written. BOARD OF COUNTY COMMISSIONERS WELD COUNTY,COLORADO ATTEST: Wel ounty Clerk to ueB �'�`� Barbara Kirkmey r BY: ' ,ii/ s ilr �� JUL 0 6 2011 Deputy Cleric the Bo: d „'�� t:� D 'i O 361tiiir -, trei Co • Attorney �� %ft�, WELD COUNTY DEPARTMENT OF HUMAN SERVICES PROVIDER Car- the-> r.,1/4____ J d A. 'e o,D. Respite Provider Page 4 of 9 &C//-/lam// 11-12-RESPITE CARE EXHIBIT A SCOPE OF SERVICES Each Provider will: 1. Complete a fingerprint card for a background check at the PROVIDERS expense with the Colorado Bureau of Investigation. A Federal Bureau of Investigation background check will be done if the Provider has been a resident of the State of Colorado for less than two years. Human Services will clear the Provider through CBI and FBI; 2. Complete a course in CPR and first aid,in which a current copy of the certifications must be provided to Human Services with this agreement. If either certification should expire during the contracted period,the Provider will send a new current certification copy to Human Services; 3. Provide transportation for the child to appointments during the hours of service as agreed upon with the foster parent; 4. Become familiar with State rules and regulations governing certified foster homes; 5. Must be eighteen years of age or older. Page 5 of 9 1 1-12-RESPITE CARE EXHIBIT B PAYMENT SCHEDULE 1. Funding and Method of Payment Human Services agrees to reimburse PROVIDER in consideration for the work and services performed under Child Welfare Regular Administration funding. Expenses incurred by PROVIDER,in association with said project prior to the term of this agreement,are not eligible Human Services expenditures and shall not be reimbursed by Human Services. Payment pursuant to this Contract,if Child Welfare Regular Administration funds,whether in whole or in part, is subject to and contingent upon the continuing availability of Child Welfare Regular Administration funds for the purposes hereof. In the event that said funds,or any part thereof,become unavailable as determined by Human Services, Human Services may immediately terminate this Contract or amend it accordingly. 2. Fees for Services Respite care is limited to four hours per week per child. The hours of care may be provided in any combination throughout a month,but not to exceed 16 hours per month. Payment will be$16.75 per each four hour period,but not to exceed$67.00 per month for 16 hours. Human Services referrals will not be sent to collections by PROVIDER for default of co-pay/fees. Services will be performed regardless of client's refusal or inability to pay co-pay. PROVIDER will collect any applicable sliding scale co-pays and credit Human Services for any payments received on the monthly billing statements. 3. Submittal of Vouchers PROVIDER shall prepare and submit monthly,the itemized voucher and certify that the services authorized were provided on the date indicated and the charges made were pursuant to the terms and conditions of Exhibit A. Page 6 of 9 11-12-RESPITE CARE EXHIBIT C ASSURANCES 1. PROVIDER agrees it is an independent contractor and that its officers and employees do not become employees of Weld County,nor are they entitled to any employee benefits as Weld County employees,as the result of the execution of this Agreement. 2. Weld County,the Board of County Commissioners of Weld County, its officers and employees,shall not be held liable for injuries or damages caused by any negligent acts or omissions of PROVIDER-contracted PROVIDERS or its employees,volunteers,or agents while performing duties as described in this Agreement. PROVIDER shall indemnify,defend,and hold harmless Weld County,the Board of County Commissioners of Weld County,its employees,volunteers,and agents. PROVIDER shall provide adequate liability and worker's compensation insurance for all its employees,volunteers,and agents engaged in the performance of the Agreement upon request, PROVIDER shall provide Human Services with the acceptable evidence that such coverage is in effect. 3. No portion of this Contract shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may possess,not shall any portion of this Agreement be deemed to have treated a duty of care with respect to any persons not a party of this Agreement. 4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld,State of Colorado,to expend funds not otherwise appropriated in each succeeding year. 5. If any section,subsection,paragraph,sentence,clause,or phrase of this Contract is for any reason held or decided to be unconstitutional,such decision shall not affect the validity of the remaining portions. The parties hereto declare that they would have entered into this Contract and each and every section,subsection, paragraph,sentence,clause,and phrase thereof irrespective of the fact that any one or more sections, subsections, paragraphs,sentences,clauses,or phrases might be declared to be unconstitutional or invalid. 6. No officer,member or employee of Weld County and no member of their governing bodies shall have any pecuniary interest,direct or indirect,in the approved Agreement or the proceeds thereof. 7. PROVIDER assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that no person shall,on the grounds of race,creed,color,sex,or national origin,be excluded from participation in,be denied the benefits of, or be otherwise subjected to discrimination under this approved Contract. 8. PROVIDER assures that sufficient,auditable,and otherwise adequate records that will provide accurate, current,separate,and complete disclosure of the status of the funds received under the Contract are maintained for three(3)years or the completion and resolution of an audit. Such records shall be sufficient to allow authorized local,Federal,and State auditors,and representatives to audit and monitor PROVIDER. 9. All such records,documents,communications,and other materials shall be the property of Human Services and shall be maintained by PROVIDER,in a central location and custodian, in behalf of Human Services,for a period of four(4)years from the date of final payment under this Contract,or for such further period as may be necessary to resolve any matters which may be pending,or until an audit has been completed with the following qualifications: If an audit by or on behalf of the federal and/or state government has begun but is not completed at the end of the four(4)year period,or if audit findings have not been resolved after a four(4)year period,the materials shall be retained until the resolution of the audit finding. 10. PROVIDER assures that authorized local, federal,and state auditors and representatives shall,during business hours,have access to inspect any copy records,and shall be allowed to monitor and review through on-site visits, all contract activities,supported with funds under this Contract to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. Page 7 of 9 11-12-RESPITE CARE 11. This Contract shall be binding upon the parties hereto,their successors,heirs,legal representatives,and assigns. PROVIDER or Human Services may not assign any of its rights or obligations hereunder without the prior written consent of both parties. 12. PROVIDER certifies that federal appropriated funds have not been paid or will be paid,by or on behalf of PROVIDER,to any person for influencing or attempting to influence an officer or employee of an agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any federal grant,the making of any federal loan,the entering into of any cooperative agreement,and the extension,continuation,renewal, amendment,or modification of any Federal contract,loan,grant,or cooperative agreement. 13. PROVIDER assures that it will fully comply with all other applicable federal and state laws. PROVIDER understands that the source of funds to be used under this Contract is Child Welfare Regular Administration funds. 14. PROVIDER assures and certifies that it and its principals: a. Are not presently debarred,suspended,proposed for debarment,declared ineligible or voluntarily excluded from covered transaction by a federal department or agency. b. Have not,within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining,attempting to obtain,or performing a public(federal,state,or local)transaction or contract under a public transaction;violation of federal or state antitrust statutes or commission of embezzlement, theft,forgery,bribery,falsification or destruction of records,making false statements,or receiving stolen property; c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state,or local)with commission of any of the offenses enumerated in paragraph 14(b)of this certification;and d. Have not within a three-year period preceding this Contract,had one or more public transactions (federal,state,and local)terminated for cause or default. 15. The Appearance of Conflict of Interest applies to the relationship of a contractor with Human Services when the contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest, it is not necessary for the contractor to gain from knowledge of these opposing interests. It is only necessary that the contractor know that the two relationships are in opposition.During the term of the Contract, PROVIDER shall not enter any third party relationship that gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation,PROVIDER shall submit to Human Services,a full disclosure statement setting forth the details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for Human Services'termination,for cause,of its contract with PROVIDER. 16. PROVIDER shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Contract. Except for purposes directly connected with the administration of Child Protection,no information about or obtained from any applicant/recipient in possession of PROVIDER shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with PROVIDER written policies governing access to,duplication and dissemination of,all such information. PROVIDER shall advise its employees,agents,and subcontractors,if any,that they are subject to these confidentiality requirements. PROVIDER shall provide its employees,agents,and subcontractors, if any, with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. Page 8 of 9 11-12-RESPITE CARE 17. Proprietary information for the purposes of this contract is information relating to a party's research, development,trade secrets,business affairs,internal operations and management procedures and those of its customers,clients or affiliates,but does not include information(1)lawfully obtained from third parties,(2) that which is in the public domain,or(3)that which is developed independently. Neither party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of this Contract. Any proprietary information removed from the State's site by PROVIDER in the course of providing services under this Contract will be accorded at least the same precautions as are employed by PROVIDER for similar information in the course of its own business. 18. PROVIDER certifies that s/he will abide by Colorado Revised Statute(C.R.S.)26-6-104,requiring criminal background checks for all employees,contractors,and sub-contractors. Page 9 of 9 I I-12-RESPITE CARE CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND PROVIDER This Agreement, made and entered into the day of , 20 , by and between the Board of Weld County Commissioners, sitting as the Board of Huma on behalf of thy Weld County Department of Human Services, hereinafter referred to as"Human Services," and A 1f VQ5 referred to as"Provider". WITNESSETH WHEREAS, required approval, clearance, and coordination have been accomplished from and with appropriate agencies; and WHEREAS, the Colorado Department of Human Services has provided Child Welfare Regular Administration funding for respite care for county foster care PROVIDERS and WHEREAS, Provider is a for-profit Sole-Proprietor. NOW THEREFORE, in consideration of the premises,the parties hereto covenant and agree as follows: 1. Term This Agreement shall become effective on July 1, 20 it, upon proper execution of this Agreement and shall expire June 30,20(Yunless sooner terminated as provided herein. 2. Scope of Services Services shall be provided by Provider to any person(s)eligible for child protection services in compliance with Exhibit A"Scope of Services," a copy of which is attached by reference. 3. Payment a. Payment shall be made on the basis of Exhibit B, "Payment Schedule,"copies of which are attached hereto and incorporated herein by reference. b. "Payment Schedule" shall establish the maximum reimbursement, which will be paid from Child Welfare Regular Administration funds during the duration of this Agreement. c. PROVIDER shall submit an itemized monthly bill to Human Services for all costs incurred and services provided pursuant to Exhibit A of this Agreement in accordance with criteria established by Human Services. PROVIDER shall submit all itemized monthly billings to Human Services no later than the twenty-fifth(25)day of the month following the month the cost was incurred. d. Payments of costs incurred pursuant to this Agreement are expressly contingent upon the availability of Child Welfare Regular Administration funds to Human Services. e. Human Services shall not be billed for, and reimbursement shall not be made for time involved in activities outside of those defined in Exhibit A. Work performed prior to the execution of this Contract shall not be reimbursed or considered part of this Agreement. 4. Financial Management At all times from the effective date of this Contract until completion of this Contract, PROVIDER shall comply with the administrative requirements, cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under Child Welfare Regular Administration funding must conform to the Single Audit Act of 1984 and OMB Circular A-133. Page 1 of 9 (9G//—/ ,// 1 I-12-RESPITE CARE 5. Payment Method Unless otherwise provided in the Scope of Services and Payment Schedule: a. PROVIDER shall provide proper monthly invoices and itemization of services performed for costs incurred in the performance of the agreement. b. Human Services may withhold any payment if PROVIDER has failed to comply with the Financial Management Requirements, program objectives, contractual terms, or reporting requirements. In the event of a forfeiture of reimbursements, PROVIDER may appeal such circumstance to the Director of Human Services. The decision of the Director of Human Services shall be final. 6. Assurances PROVIDER shall abide by all assurances as set forth in the attached Exhibit C,which is attached hereto and incorporated herein by reference. 7. Compliance with Applicable Laws At all times during the performance of this contract, PROVIDER shall strictly adhere to all applicable federal and state laws, orders, and all applicable standards,regulations, interpretations or guidelines issued pursuant thereto. This includes the protection of the confidentiality of all applicant/recipient records,papers,documents, tapes and any other materials that have been or may hereafter be established which relate to the Contract. PROVIDER acknowledges that the following laws are included: - Title VI of the Civil Rights Act of 1964,42 U.S.C. Sections 2000d—I et.seq.and its implementing regulation, 45 C.F.R. Part 80 et.seq.,and - Section 504 of the Rehabilitation Act of 1973,29 U.S.C. Section 794,and its implementing regulations,45 C.F.R. Pan 84;and - the Age Discrimination Act of 1975,42 U.S.C. Sections 6101 et.seq.and its implementation regulations,45 C.F.R. Part 91;and - Title VII of the Civil Rights Act of 1964;and - the Age Discrimination in Employment Act of 1967;and - the Equal Pay Act of 1963;and - the Education Amendments of 1972;and - Immigration Reform and Control Act of 1986,P.L.99-603; - 42 C.F.R.Part 2 and all regulations applicable to these laws prohibiting discrimination because of race, color,National origin, and sex, religion and handicap, including Acquired Immune Deficiency syndrome (AIDS)or AIDS related conditions, covered under Section 504 of the Rehabilitation Act of 1973,as amended, cited above. If necessary, PROVIDER and Human Services will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 CFR Part 2. Included in 45 C.F.R. Part 74 Appendix G 9, which requires that affirmative steps be taken to assure that small and minority businesses are utilized, when possible,as sources of supplies, equipment, construction and services. This assurance is given in consideration of and for the purpose of obtaining any and all federal and/or state financial assistance. Any person who feels that s/he has been discriminated against has the right to file a complaint either with the Colorado Department of Human Services or with the U.S. Department of Health and Human Services, Office for Civil Rights. 8. Certifications PROVIDER certifies that, at the time of entering into this Contract, it has currently in effect all necessary licenses, approvals, insurance, etc., required to properly provide the services and/or supplies covered by this contract. A copy of certificate will be provided to Human Services upon completion of this agreement. Failure to do so will null and void this contract in its entirety. Page 2 of 9 11-12-RESPITE CARE 9. Monitoring and Evaluation PROVIDER and Human Services agree that monitoring and evaluation of the performance of this Agreement shall be conducted by PROVIDER and Human Services. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners and PROVIDER. PROVIDER shall permit Human Services, and any other duly authorized agent or governmental agency, to monitor all activities conducted by PROVIDER pursuant to the terms of this Agreement. As the monitoring agency may in its sole discretion deem necessary or appropriate, such program data, special analyses, on-site checking, formal audit examinations,or any other reasonable procedures. All such monitoring shall be performed in a manner that will not unduly interfere with agreement work. 10. Modification of Agreement All modifications to this agreement shall be in writing and signed by both parties. 11. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find PROVIDER substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by PROVIDER. These remedial actions are as follows: a. Withhold payment to PROVIDER until the necessary services or corrections in performance are satisfactorily completed; b. Deny payment or recover reimbursement for those services or deliverables, which have not been performed and which due to circumstances caused by PROVIDER cannot be performed or if performed would be of no value to Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; c. Incorrect payment to PROVIDER due to omission,error, fraud,and/or defalcation shall be recovered from PROVIDER by deduction from subsequent payments under this Agreement or other agreements between Human Services and PROVIDER, or by Human Services as a debt due to Human Services or otherwise as provided by law. 12. Representatives For the purpose of this Agreement, the individuals identified below are hereby designated representatives of the respective parties. Either party may from time to time designate in writing a new or substitute representative(s): For Human Services: Gloria Romansik Human Services Administrator Name Title For Provider: Ylkl Q. 13CtAittS Respite Care Provider :Wne Title 13. Notice All notices required to be given by the parties hereunder shall be given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing a substitute person(s)or address to whom such notices shall be sent: To: Human Services To:_ G l.: Judy A. Griego,Director P.O. Box A c{ Greeley,CO 80632 Page 3 of 9 11-12-RESPITE CARE 14. Litigation PROVIDER shall promptly notify Human Services in the event that PROVIDER learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement. PROVIDER, within five (5)calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s)to the Human Services Director. The term"litigation" includes an assignment for the benefit of creditors,and filings in bankruptcy, reorganization and/or foreclosure. 15. Termination This Agreement may be terminated at any time by either party given thirty(30)days written notice and is subject to the availability of funding. PROVIDER reserves the right to suspend services to clients if funding is no longer available. 16. Entire Agreement This Agreement,together with all attachments hereto, constitutes the entire understanding between the parties with respect to the subject matter hereof, and may not be changed or modified except as stated in Paragraph 10 herein. 17. No Third Party Beneficiary. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 18. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care which did not previously exist with respect to any person not a party to this Agreement. IN WITNESS WHEREOF,the parties hereto have duly executed the Agreement as of the day, month,and year first above written. BOARD OF COUNTY COMMISSIONERS WELD COUNTY,COLORADO ATTEST: Weld ounty Clerk tot Board 4Lr4rkrneyeY BY. aig // INN. 9 \ JUL 0 0 2011 Deputy Clerk the Boar, APPR• 'm'A � • ' • iggl ter• aI Couch:y t;® Vs WELD COUNTY DEPARTMENT OF HUMAN SERVICES PROVIDER +ictQkt Srovidf 1. a er Page 4 of 9 :92'//—/6. // 11-12-RESPITE CARE EXHIBIT A SCOPE OF SERVICES Each Provider will: I. Complete a fingerprint card for a background check at the PROVIDERS expense with the Colorado Bureau of Investigation. A Federal Bureau of Investigation background check will be done if the Provider has been a resident of the State of Colorado for less than two years. Human Services will clear the Provider through CBI and FBI; 2. Complete a course in CPR and first aid,in which a current copy of the certifications must be provided to Human Services with this agreement. If either certification should expire during the contracted period,the Provider will send a new current certification copy to Human Services; 3. Provide transportation for the child to appointments during the hours of service as agreed upon with the foster parent; 4. Become familiar with State rules and regulations governing certified foster homes; 5. Must be eighteen years of age or older. Page 5 of 9 11-12-RESPITE CARE EXHIBIT B PAYMENT SCHEDULE 1. Funding and Method of Payment Human Services agrees to reimburse PROVIDER in consideration for the work and services performed under Child Welfare Regular Administration funding. Expenses incurred by PROVIDER,in association with said project prior to the term of this agreement,are not eligible Human Services expenditures and shall not be reimbursed by Human Services. Payment pursuant to this Contract,if Child Welfare Regular Administration funds,whether in whole or in part, is subject to and contingent upon the continuing availability of Child Welfare Regular Administration funds for the purposes hereof. In the event that said funds,or any part thereof,become unavailable as determined by Human Services,Human Services may immediately terminate this Contract or amend it accordingly. 2. Fees for Services Respite care is limited to four hours per week per child. The hours of care may be provided in any combination throughout a month,but not to exceed 16 hours per month. Payment will be$16.75 per each four hour period,but not to exceed$67.00 per month for 16 hours. Human Services referrals will not be sent to collections by PROVIDER for default of co-pay/fees. Services will be performed regardless of client's refusal or inability to pay co-pay. PROVIDER will collect any applicable sliding scale co-pays and credit Human Services for any payments received on the monthly billing statements. 3. Submittal of Vouchers PROVIDER shall prepare and submit monthly,the itemized voucher and certify that the services authorized were provided on the date indicated and the charges made were pursuant to the terms and conditions of Exhibit A. Page 6 of 9 I1-12-RESPITE CARE EXHIBIT C ASSURANCES I. PROVIDER agrees it is an independent contractor and that its officers and employees do not become employees of Weld County,nor are they entitled to any employee benefits as Weld County employees,as the result of the execution of this Agreement. 2. Weld County,the Board of County Commissioners of Weld County,its officers and employees,shall not be held liable for injuries or damages caused by any negligent acts or omissions of PROVIDER-contracted PROVIDERS or its employees,volunteers,or agents while performing duties as described in this Agreement. PROVIDER shall indemnify,defend,and hold harmless Weld County,the Board of County Commissioners of Weld County,its employees,volunteers,and agents. PROVIDER shall provide adequate liability and worker's compensation insurance for all its employees,volunteers,and agents engaged in the performance of the Agreement upon request,PROVIDER shall provide Human Services with the acceptable evidence that such coverage is in effect. 3. No portion of this Contract shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may possess,not shall any portion of this Agreement be deemed to have treated a duty of care with respect to any persons not a party of this Agreement. 4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld,State of Colorado,to expend funds not otherwise appropriated in each succeeding year. 5. If any section,subsection,paragraph,sentence,clause,or phrase of this Contract is for any reason held or decided to be unconstitutional,such decision shall not affect the validity of the remaining portions. The parties hereto declare that they would have entered into this Contract and each and every section,subsection, paragraph,sentence,clause,and phrase thereof irrespective of the fact that any one or more sections, subsections,paragraphs,sentences,clauses,or phrases might be declared to be unconstitutional or invalid. 6. No officer,member or employee of Weld County and no member of their governing bodies shall have any pecuniary interest,direct or indirect,in the approved Agreement or the proceeds thereof. 7. PROVIDER assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that no person shall,on the grounds of race,creed,color,sex,or national origin,be excluded from participation in,be denied the benefits of,or be otherwise subjected to discrimination under this approved Contract. 8. PROVIDER assures that sufficient,auditable,and otherwise adequate records that will provide accurate, current,separate,and complete disclosure of the status of the funds received under the Contract are maintained for three(3)years or the completion and resolution of an audit. Such records shall be sufficient to allow authorized local,Federal,and State auditors,and representatives to audit and monitor PROVIDER. 9. All such records,documents,communications,and other materials shall be the property of Human Services and shall be maintained by PROVIDER,in a central location and custodian,in behalf of Human Services,for a period of four(4)years from the date of final payment under this Contract,or for such further period as may be necessary to resolve any matters which may be pending,or until an audit has been completed with the following qualifications: If an audit by or on behalf of the federal and/or state government has begun but is not completed at the end of the four(4)year period,or if audit findings have not been resolved after a four(4)year period,the materials shall be retained until the resolution of the audit finding. 10. PROVIDER assures that authorized local,federal,and state auditors and representatives shall,during business hours,have access to inspect any copy records,and shall be allowed to monitor and review through on-site visits,all contract activities,supported with funds under this Contract to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. Page 7 of 9 11-l2-RESPITE CARE 11. This Contract shall be binding upon the parties hereto,their successors,heirs,legal representatives,and assigns. PROVIDER or Human Services may not assign any of its rights or obligations hereunder without the prior written consent of both parties. 12. PROVIDER certifies that federal appropriated funds have not been paid or will be paid,by or on behalf of PROVIDER,to any person for influencing or attempting to influence an officer or employee of an agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any federal grant,the making of any federal loan,the entering into of any cooperative agreement,and the extension,continuation,renewal, amendment,or modification of any Federal contract,loan,grant,or cooperative agreement. 13. PROVIDER assures that it will fully comply with all other applicable federal and state laws. PROVIDER understands that the source of funds to be used under this Contract is Child Welfare Regular Administration funds. 14. PROVIDER assures and certifies that it and its principals: a. Are not presently debarred,suspended,proposed for debarment,declared ineligible or voluntarily excluded from covered transaction by a federal department or agency. b. Have not,within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining,attempting to obtain,or performing a public(federal,state,or local)transaction or contract under a public transaction;violation of federal or state antitrust statutes or commission of embezzlement, theft,forgery,bribery,falsification or destruction of records,making false statements,or receiving stolen property; c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state,or local)with commission of any of the offenses enumerated in paragraph 14(b)of this certification;and d. Have not within a three-year period preceding this Contract,had one or more public transactions (federal,state,and local)terminated for cause or default. 15. The Appearance of Conflict of Interest applies to the relationship of a contractor with Human Services when the contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest,it is not necessary for the contractor to gain from knowledge of these opposing interests. It is only necessary that the contractor know that the two relationships are in opposition.During the term of the Contract,PROVIDER shall not enter any third party relationship that gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation,PROVIDER shall submit to Human Services,a full disclosure statement setting forth the details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for Human Services'termination,for cause,of its contract with PROVIDER. 16. PROVIDER shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Contract. Except for purposes directly connected with the administration of Child Protection,no information about or obtained from any applicantrecipient in possession of PROVIDER shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with PROVIDER written policies governing access to,duplication and dissemination of,all such information. PROVIDER shall advise its employees,agents,and subcontractors,if any,that they are subject to these confidentiality requirements. PROVIDER shall provide its employees,agents,and subcontractors,if any,with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. Page 8 of 9 11-12-RESPITE CARE 17. Proprietary information for the purposes of this contract is information relating to a party's research, development,trade secrets,business affairs,internal operations and management procedures and those of its customers,clients or affiliates,but does not include information(1)lawfully obtained from third parties,(2) that which is in the public domain,or(3)that which is developed independently. Neither party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of this Contract. Any proprietary information removed from the State's site by PROVIDER in the course of providing services under this Contract will be accorded at least the same precautions as are employed by PROVIDER for similar information in the course of its own business. 18. PROVIDER certifies that s/he will abide by Colorado Revised Statute(C.R.S.)26-6-104,requiring criminal background checks for all employees,contractors,and sub-contractors. Page 9 of 9 11-12-RESPITE CARE CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND PROVIDER 201) MAY 19 AID48 This Agreement,made and entered into the thy of ,20_,by and between the Board of Weld County Commissioners,sitting as the Board of Humannn behalf p(the Weld County Department of Human Services,hereinafter referred to as"Human Services,"and OV%--• S referred to as"Provider". WITNESSETH WHEREAS,required approval,clearance,and coordination have been accomplished from and with appropriate agencies;and WHEREAS,the Colorado Department of Human Services has provided Child Welfare Regular Administration funding for respite care for county foster care PROVIDERS and WHEREAS, Provider is a for-profit Sole-Proprietor. NOW THEREFORE,in consideration of the premises,the parties hereto covenant and agree as follows: 1. Term This Agreement shall become effective on July 1,201(,upon proper execution of this Agreement and shall expire June 30,2012rUnless sooner terminated as provided herein. 2. Scope of Services Services shall be provided by Provider to any person(s)eligible for child protection services in compliance with Exhibit A"Scope of Services,"a copy of which is attached by reference. 3. Payment a. Payment shall be made on the basis of Exhibit B,"Payment Schedule,"copies of which are attached hereto and incorporated herein by reference. b. "Payment Schedule"shall establish the maximum reimbursement,which will be paid from Child Welfare Regular Administration funds during the duration of this Agreement. c. PROVIDER shall submit an itemized monthly bill to Human Services for all costs incurred and services provided pursuant to Exhibit A of this Agreement in accordance with criteria established by Human Services. PROVIDER shall submit all itemized monthly billings to Human Services no later than the twenty-fifth(25)day of the month following the month the cost was incurred. d. Payments of costs incurred pursuant to this Agreement are expressly contingent upon the availability of Child Welfare Regular Administration funds to Human Services. e. Human Services shall not be billed for,and reimbursement shall not be made for time involved in activities outside of those defined in Exhibit A. Work performed prior to the execution of this Contract shall not be reimbursed or considered part of this Agreement. 4. Financial Management At all times from the effective date of this Contract until completion of this Contract,PROVIDER shall comply with the administrative requirements,cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under Child Welfare Regular Administration funding must conform to the Single Audit Act of 1984 and OMB Circular A-133. Page 1 of 9 ( C//-/e// 11-12-RESPITE CARE 5. Payment Method Unless otherwise provided in the Scope of Services and Payment Schedule: a. PROVIDER shall provide proper monthly invoices and itemization of services performed for costs incurred in the performance of the agreement. b. Human Services may withhold any payment if PROVIDER has failed to comply with the Financial Management Requirements,program objectives,contractual terms,or reporting requirements. In the event of a forfeiture of reimbursements, PROVIDER may appeal such circumstance to the Director of Human Services. The decision of the Director of Human Services shall be final. 6. Assurances PROVIDER shall abide by all assurances as set forth in the attached Exhibit C,which is attached hereto and incorporated herein by reference. 7. Compliance with Applicable Laws At all times during the performance of this contract,PROVIDER shall strictly adhere to all applicable federal and state laws,orders,and all applicable standards,regulations, interpretations or guidelines issued pursuant thereto. This includes the protection of the confidentiality of all applicant/recipient records,papers,documents, tapes and any other materials that have been or may hereafter be established which relate to the Contract. PROVIDER acknowledges that the following laws are included: - Title VI of the Civil Rights Act of 1964,42 U.S.C.Sections 2000d—I et.seq.and its implementing regulation, 45 C.F.R.Part 80 et.seq.;and - Section 504 of the Rehabilitation Act of 1973,29 U.S.C.Section 794,and its implementing regulations,45 C.F.R.Part 84;and - the Age Discrimination Act of 1975,42 U.S.C. Sections 6101 et.seq.and its implementation regulations,45 C.F.R. Part 91;and - Title VII of the Civil Rights Act of 1964;and - the Age Discrimination in Employment Act of 1967;and - the Equal Pay Act of 1963;and - the Education Amendments of 1972;and - Immigration Reform and Control Act of 1986,P.L.99-603; - 42 C.F.R.Part 2 and all regulations applicable to these laws prohibiting discrimination because of race, color,National origin,and sex,religion and handicap,including Acquired Immune Deficiency syndrome (AIDS)or AIDS related conditions,covered under Section 504 of the Rehabilitation Act of 1973,as amended,cited above. If necessary,PROVIDER and Human Services will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 CFR Part 2. Included in 45 C.F.R. Part 74 Appendix G 9,which requires that affirmative steps be taken to assure that small and minority businesses are utilized,when possible,as sources of supplies,equipment,construction and services. This assurance is given in consideration of and for the purpose of obtaining any and all federal and/or state financial assistance. Any person who feels that s/he has been discriminated against has the right to file a complaint either with the Colorado Department of Human Services or with the U.S. Department of Health and Human Services,Office for Civil Rights. 8. Certifications PROVIDER certifies that,at the time of entering into this Contract,it has currently in effect all necessary licenses,approvals,insurance,etc.,required to properly provide the services and/or supplies covered by this contract. A copy of certificate will be provided to Human Services upon completion of this agreement. Failure to do so will null and void this contract in its entirety. Page 2 of 9 11-12-RESPITE CARE 9. Monitoring and Evaluation PROVIDER and Human Services agree that monitoring and evaluation of the performance of this Agreement shall be conducted by PROVIDER and Human Services. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners and PROVIDER. PROVIDER shall permit Human Services,and any other duly authorized agent or governmental agency,to monitor all activities conducted by PROVIDER pursuant to the terms of this Agreement. As the monitoring agency may in its sole discretion deem necessary or appropriate,such program data,special analyses,on-site checking,formal audit examinations,or any other reasonable procedures. All such monitoring shall be performed in a manner that will not unduly interfere with agreement work. 10. Modification of Agreement All modifications to this agreement shall be in writing and signed by both parties. 11. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find PROVIDER substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by PROVIDER. These remedial actions are as follows: a. Withhold payment to PROVIDER until the necessary services or corrections in performance are satisfactorily completed; b. Deny payment or recover reimbursement for those services or deliverables,which have not been performed and which due to circumstances caused by PROVIDER cannot be performed or if performed would be of no value to Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; c. Incorrect payment to PROVIDER due to omission,error,fraud,and/or defalcation shall be recovered from PROVIDER by deduction from subsequent payments under this Agreement or other agreements between Human Services and PROVIDER,or by Human Services as a debt due to Human Services or otherwise as provided by law. 12. Representatives For the purpose of this Agreement,the individuals identified below are hereby designated representatives of the respective parties. Either party may from time to time designate in writing a new or substitute representative(s): For Human Services: Gloria Romansik Human Services Administrator Name Title For Provider: UA lZan'1OS Respite Care Provider Name Title 13. Notice All notices required to be given by the parties hereunder shall be given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing a substitute person(s)or address to whom such notices shall be sent: , To: Human Services To: J ♦,�l1Q.n lair rOS Judy A.Griego.Director fln SI" P.O.Box A (or la( CO q0(43 Greeley,CO 80632 Page 3 of 9 11-12-RESPITE CARE 14. Litigation PROVIDER shall promptly notify Human Services in the event that PROVIDER learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement.PROVIDER, within five(5)calendar days after being served with a summons,complaint,or other pleading which has been filed in any federal or state court or administrative agency,shall deliver copies of such document(s)to the Human Services Director. The term"litigation" includes an assignment for the benefit of creditors,and filings in bankruptcy,reorganization and/or foreclosure. 15. Termination This Agreement may be terminated at any time by either party given thirty(30)days written notice and is subject to the availability of funding. PROVIDER reserves the right to suspend services to clients if funding is no longer available. 16. Entire Agreement This Agreement,together with all attachments hereto,constitutes the entire understanding between the parties with respect to the subject matter hereof,and may not be changed or modified except as stated in Paragraph 10 herein. 17. No Third Party Beneficiary. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 18. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may posses,nor shall any portion of this Agreement be deemed to have created a duty of care which did not previously exist with respect to any person not a party to this Agreement. IN WITNESS WHEREOF,the parties hereto have duly executed the Agreement as of the day,month,and year first above written. BOARD OF COUNTY COMMISSIONERS WELD COUNTY,COLORADO ATTEST: Welunty Clerk tgtA4 ard ,V g arbara K' kmeyer BY: Deputy y/eI �f°La JUL 0 6 2011 — d •APPsue ,,,.,..% s1 1P ,•• Coun _r WELD COUNTY DEPARTMENT OF HUMAN SERVICES PROVIDER A.Grie o,Direct pite Provid Page 4 of 9 ;2D//--//o// 11-12-RESPITE CARE EXHIBIT A SCOPE OF SERVICES Each Provider will: 1. Complete a fmgerprint card for a background check at the PROVIDERS expense with the Colorado Bureau of Investigation. A Federal Bureau of Investigation background check will be done if the Provider has been a resident of the State of Colorado for less than two years. Human Services will clear the Provider through CBI and FBI; 2. Complete a course in CPR and first aid,in which a current copy of the certifications must be provided to Human Services with this agreement. If either certification should expire during the contracted period,the Provider will send a new current certification copy to Human Services; 3. Provide transportation for the child to appointments during the hours of service as agreed upon with the foster parent; 4. Become familiar with State rules and regulations governing certified foster homes; 5. Must be eighteen years of age or older. Page 5 of 9 11-12-RESPITE CARE EXHIBIT B PAYMENT SCHEDULE 1. Funding and Method of Payment Human Services agrees to reimburse PROVIDER in consideration for the work and services performed under Child Welfare Regular Administration funding. Expenses incurred by PROVIDER,in association with said project prior to the term of this agreement,are not eligible Human Services expenditures and shall not be reimbursed by Human Services. Payment pursuant to this Contract, if Child Welfare Regular Administration funds,whether in whole or in part, is subject to and contingent upon the continuing availability of Child Welfare Regular Administration funds for the purposes hereof In the event that said funds,or any part thereof,become unavailable as determined by Human Services,Human Services may immediately terminate this Contract or amend it accordingly. 2. Fees for Services Respite care is limited to four hours per week per child. The hours of care may be provided in any combination throughout a month,but not to exceed 16 hours per month. Payment will be$16.75 per each four hour period,but not to exceed$67.00 per month for 16 hours. Human Services referrals will not be sent to collections by PROVIDER for default of co-pay/fees. Services will be performed regardless of client's refusal or inability to pay co-pay. PROVIDER will collect any applicable sliding scale co-pays and credit Human Services for any payments received on the monthly billing statements. 3. Submittal of Vouchers PROVIDER shall prepare and submit monthly,the itemized voucher and certify that the services authorized were provided on the date indicated and the charges made were pursuant to the terms and conditions of Exhibit A. Page 6 of 9 11-12-RESPITE CARE EXHIBIT C ASSURANCES I. PROVIDER agrees it is an independent contractor and that its officers and employees do not become employees of Weld County,nor are they entitled to any employee benefits as Weld County employees,as the result of the execution of this Agreement. 2. Weld County,the Board of County Commissioners of Weld County, its officers and employees,shall not be held liable for injuries or damages caused by any negligent acts or omissions of PROVIDER-contracted PROVIDERS or its employees,volunteers,or agents while performing duties as described in this Agreement. PROVIDER shall indemnify,defend,and hold harmless Weld County,the Board of County Commissioners of Weld County,its employees, volunteers,and agents. PROVIDER shall provide adequate liability and worker's compensation insurance for all its employees,volunteers,and agents engaged in the performance of the Agreement upon request, PROVIDER shall provide Human Services with the acceptable evidence that such coverage is in effect. 3. No portion of this Contract shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may possess,not shall any portion of this Agreement be deemed to have treated a duty of care with respect to any persons not a party of this Agreement. 4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld,State of Colorado,to expend funds not otherwise appropriated in each succeeding year. 5. If any section,subsection,paragraph,sentence,clause,or phrase of this Contract is for any reason held or decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The parties hereto declare that they would have entered into this Contract and each and every section,subsection, paragraph,sentence,clause,and phrase thereof irrespective of the fact that any one or more sections, subsections,paragraphs,sentences,clauses,or phrases might be declared to be unconstitutional or invalid. 6. No officer, member or employee of Weld County and no member of their governing bodies shall have any pecuniary interest,direct or indirect,in the approved Agreement or the proceeds thereof. 7. PROVIDER assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that no person shall,on the grounds of race,creed,color,sex,or national origin,be excluded from participation in,be denied the benefits of,or be otherwise subjected to discrimination under this approved Contract. 8. PROVIDER assures that sufficient,auditable,and otherwise adequate records that will provide accurate, current,separate,and complete disclosure of the status of the funds received under the Contract are maintained for three(3)years or the completion and resolution of an audit. Such records shall be sufficient to allow authorized local,Federal,and State auditors,and representatives to audit and monitor PROVIDER. 9. All such records,documents,communications,and other materials shall be the property of Human Services and shall be maintained by PROVIDER,in a central location and custodian,in behalf of Human Services,for a period of four(4)years from the date of final payment under this Contract,or for such further period as may be necessary to resolve any matters which may be pending,or until an audit has been completed with the following qualifications: If an audit by or on behalf of the federal and/or state government has begun but is not completed at the end of the four(4)year period,or if audit findings have not been resolved after a four(4)year period,the materials shall be retained until the resolution of the audit finding. 10. PROVIDER assures that authorized local,federal,and state auditors and representatives shall,during business hours,have access to inspect any copy records,and shall be allowed to monitor and review through on-site visits,all contract activities,supported with funds under this Contract to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. Page 7 of 9 11-12-RESPITE CARE 11. This Contract shall be binding upon the parties hereto,their successors,heirs, legal representatives,and assigns. PROVIDER or Human Services may not assign any of its rights or obligations hereunder without the prior written consent of both parties. 12. PROVIDER certifies that federal appropriated funds have not been paid or will be paid,by or on behalf of PROVIDER,to any person for influencing or attempting to influence an officer or employee of an agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any federal grant,the making of any federal loan,the entering into of any cooperative agreement,and the extension,continuation,renewal, amendment,or modification of any Federal contract,loan,grant,or cooperative agreement. 13. PROVIDER assures that it will fully comply with all other applicable federal and state laws. PROVIDER understands that the source of funds to be used under this Contract is Child Welfare Regular Administration funds. 14. PROVIDER assures and certifies that it and its principals: a. Are not presently debarred,suspended,proposed for debarment,declared ineligible or voluntarily excluded from covered transaction by a federal department or agency. b. Have not,within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining,attempting to obtain,or performing a public(federal,state,or local)transaction or contract under a public transaction;violation of federal or state antitrust statutes or commission of embezzlement, theft,forgery,bribery, falsification or destruction of records,making false statements,or receiving stolen property; c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state,or local)with commission of any of the offenses enumerated in paragraph 14(b)of this certification;and d. Have not within a three-year period preceding this Contract,had one or more public transactions (federal,state,and local)terminated for cause or default. 15. The Appearance of Conflict of Interest applies to the relationship of a contractor with Human Services when the contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest,it is not necessary for the contractor to gain from knowledge of these opposing interests. It is only necessary that the contractor know that the two relationships are in opposition. During the term of the Contract, PROVIDER shall not enter any third party relationship that gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation,PROVIDER shall submit to Human Services,a full disclosure statement setting forth the details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for Human Services'termination,for cause,of its contract with PROVIDER 16. PROVIDER shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Contract. Except for purposes directly connected with the administration of Child Protection,no information about or obtained from any applicant/recipient in possession of PROVIDER shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with PROVIDER written policies governing access to,duplication and dissemination of,all such information. PROVIDER shall advise its employees,agents,and subcontractors, if any,that they are subject to these confidentiality requirements. PROVIDER shall provide its employees,agents,and subcontractors, if any,with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. Page 8 of 9 11-12-RESPITE CARE 17. Proprietary information for the purposes of this contract is information relating to a party's research, development,trade secrets,business affairs,internal operations and management procedures and those of its customers,clients or affiliates,but does not include information(1)lawfully obtained from third parties,(2) that which is in the public domain,or(3)that which is developed independently. Neither party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of this Contract. Any proprietary information removed from the State's site by PROVIDER in the course of providing services under this Contract will be accorded at least the same precautions as are employed by PROVIDER for similar information in the course of its own business. 18. PROVIDER certifies that s/he will abide by Colorado Revised Statute(C.R.S.)26-6-104,requiring criminal background checks for all employees,contractors,and sub-contractors. Page 9 of 9 11-12-RESPITE CARE CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND PROVIDER This Agreement, made and entered into the day of ,20 ,by and between the Board of Weld County Commissioners, sitting as the Board of Huma n beh of the W d Co9unty Department of Human Services, hereinafter referred to as"Human Services,"and e4,F Le[ki}41 (.4hM referred to as"Provider". WITNESSETH WHEREAS,required approval,clearance,and coordination have been accomplished from and with appropriate agencies;and WHEREAS,the Colorado Department of Human Services has provided Child Welfare Regular Administration funding for respite care for county foster care PROVIDERS and WHEREAS,Provider is a for-profit Sole-Proprietor. NOW THEREFORE, in consideration of the premises,the parties hereto covenant and agree as follows: 1. Term This Agreement shall become effective on July 1,201(,upon proper execution of this Agreement and shall expire June 30,20ainnless sooner terminated as provided herein. 2. Scope of Services Services shall be provided by Provider to any person(s)eligible for child protection services in compliance with Exhibit A"Scope of Services,"a copy of which is attached by reference. 3. Payment a. Payment shall be made on the basis of Exhibit B,"Payment Schedule,"copies of which are attached hereto and incorporated herein by reference. b. "Payment Schedule"shall establish the maximum reimbursement,which will be paid from Child Welfare Regular Administration funds during the duration of this Agreement. c. PROVIDER shall submit an itemized monthly bill to Human Services for all costs incurred and services provided pursuant to Exhibit A of this Agreement in accordance with criteria established by Human Services. PROVIDER shall submit all itemized monthly billings to Human Services no later than the twenty-fifth(25)day of the month following the month the cost was incurred. d. Payments of costs incurred pursuant to this Agreement are expressly contingent upon the availability of Child Welfare Regular Administration funds to Human Services. e. Human Services shall not be billed for,and reimbursement shall not be made for time involved in activities outside of those defined in Exhibit A. Work performed prior to the execution of this Contract shall not be reimbursed or considered part of this Agreement. 4. Financial Management At all times from the effective date of this Contract until completion of this Contract,PROVIDER shall comply with the administrative requirements,cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under Child Welfare Regular Administration funding must conform to the Single Audit Act of 1984 and OMB Circular A-133. Page 1 of 9 &CC//-//// 11-12-RESPITE CARE 5. Payment Method Unless otherwise provided in the Scope of Services and Payment Schedule: a. PROVIDER shall provide proper monthly invoices and itemization of services performed for costs incurred in the performance of the agreement. b. Human Services may withhold any payment if PROVIDER has failed to comply with the Financial Management Requirements,program objectives,contractual terms,or reporting requirements. In the event of a forfeiture of reimbursements,PROVIDER may appeal such circumstance to the Director of Human Services. The decision of the Director of Human Services shall be final. 6. Assurances PROVIDER shall abide by all assurances as set forth in the attached Exhibit C,which is attached hereto and incorporated herein by reference. 7. Compliance with Applicable Laws At all times during the performance of this contract,PROVIDER shall strictly adhere to all applicable federal and state laws,orders,and all applicable standards,regulations, interpretations or guidelines issued pursuant thereto. This includes the protection of the confidentiality of all applicant/recipient records,papers,documents, tapes and any other materials that have been or may hereafter be established which relate to the Contract. PROVIDER acknowledges that the following laws are included: - Title VI of the Civil Rights Act of 1964,42 U.S.C. Sections 2000d—I et.seq.and its implementing regulation, 45 C.F.R.Part 80 et.seq.;and - Section 504 of the Rehabilitation Act of 1973,29 U.S.C. Section 794,and its implementing regulations,45 C.F.R.Part 84;and - the Age Discrimination Act of 1975,42 U.S.C.Sections 6101 et.seq.and its implementation regulations,45 C.F.R. Part 91;and - Title VII of the Civil Rights Act of 1964;and - the Age Discrimination in Employment Act of 1967;and - the Equal Pay Act of 1963;and - the Education Amendments of 1972;and - Immigration Reform and Control Act of 1986,P.L.99-603; - 42 C.F.R.Part 2 and all regulations applicable to these laws prohibiting discrimination because of race, color,National origin,and sex,religion and handicap, including Acquired Immune Deficiency syndrome (AIDS)or AIDS related conditions, covered under Section 504 of the Rehabilitation Act of 1973,as amended,cited above. If necessary,PROVIDER and Human Services will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 CFR Part 2. Included in 45 C.F.R. Part 74 Appendix G 9,which requires that affirmative steps be taken to assure that small and minority businesses are utilized,when possible,as sources of supplies,equipment,construction and services. This assurance is given in consideration of and for the purpose of obtaining any and all federal and/or state fmancial assistance. Any person who feels that s/he has been discriminated against has the right to file a complaint either with the Colorado Department of Human Services or with the U.S. Department of Health and Human Services,Office for Civil Rights. 8. Certifications PROVIDER certifies that,at the time of entering into this Contract,it has currently in effect all necessary licenses,approvals, insurance, etc.,required to properly provide the services and/or supplies covered by this contract. A copy of certificate will be provided to Human Services upon completion of this agreement. Failure to do so will null and void this contract in its entirety. Page 2 of 9 11-12-RESPITE CARE 9. Monitoring and Evaluation PROVIDER and Human Services agree that monitoring and evaluation of the performance of this Agreement shall be conducted by PROVIDER and Human Services. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners and PROVIDER. PROVIDER shall permit Human Services,and any other duly authorized agent or governmental agency,to monitor all activities conducted by PROVIDER pursuant to the terms of this Agreement. As the monitoring agency may in its sole discretion deem necessary or appropriate,such program data,special analyses,on-site checking,formal audit examinations,or any other reasonable procedures. All such monitoring shall be performed in a manner that will not unduly interfere with agreement work. 10. Modification of Agreement All modifications to this agreement shall be in writing and signed by both parties. 11. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find PROVIDER substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by PROVIDER. These remedial actions are as follows: a. Withhold payment to PROVIDER until the necessary services or corrections in performance are satisfactorily completed; b. Deny payment or recover reimbursement for those services or deliverables,which have not been performed and which due to circumstances caused by PROVIDER cannot be performed or if performed Would be of no value to Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; c. Incorrect payment to PROVIDER due to omission,error,fraud,and/or defalcation shall be recovered from PROVIDER by deduction from subsequent payments under this Agreement or other agreements between Human Services and PROVIDER,or by Human Services as a debt due to Human Services or otherwise as provided by law. 12. Representatives For the purpose of this Agreement,the individuals identified below are hereby designated representatives of the respective parties. Either party may from time to time designate in writing a new or substitute representative(s): For Human Services: Gloria Romansik Human Services Administrator Name Title For Provider: id L 1at)n t rad 6 1-Au I t r i€J 1 IA Respite Care Provider Name Title 13. Notice All notices required to be given by the parties hereunder shall be given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing a substitute person(s)or address to whom such notices shall be sent: To: Human Services To: Fm A\ E-PR. i Ni el Judy A.Griego,Director O P.O.BoxA .4 Q Greeley,CO 80632 `2\O e�' Page 3 of 9 11-12-RESPITE CARE 14. Litigation PROVIDER shall promptly notify Human Services in the event that PROVIDER learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement.PROVIDER, within five(5)calendar days after being served with a summons,complaint,or other pleading which has been filed in any federal or state court or administrative agency,shall deliver copies of such document(s)to the Human Services Director. The term"litigation"includes an assignment for the benefit of creditors,and filings in bankruptcy,reorganization and/or foreclosure. 15. Termination This Agreement may be terminated at any time by either party given thirty(30)days written notice and is subject to the availability of finding. PROVIDER reserves the right to suspend services to clients if funding is no longer available. 16. Entire Agreement This Agreement,together with all attachments hereto, constitutes the entire understanding between the parties with respect to the subject matter hereof,and may not be changed or modified except as stated in Paragraph 10 herein. 17. No Third Party Beneficiary. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 18. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care which did not previously exist with respect to any person not a party to this Agreement. IN WITNESS WHEREOF,the parties hereto have duly executed the Agreement as of the day,month,and year first above written. BOARD OF COUNTY COMMISSIONERS WELD COUNTY,COLORADO ATTEST: .460 Wel Co .tyClerktotheBoard I ^`'srba Kirkm= er BY: ILeLL,a JUL 0 ti2011 Deputy Clerk t e e .:.d 0 ft)1 APPR AS i • • t161 �`' C � � _y • 11DD ttorney WELD COUNTY DEPARTMENT OF HUMAN SERVICES t Aj j,ltaTo )'9�.w u .Griego, hector Respite Provider Page 4 of 9 .a70// 11-12-RESPITE CARE EXHIBIT A SCOPE OF SERVICES Each Provider will: 1. Complete a fingerprint card for a background check at the PROVIDERS expense with the Colorado Bureau of Investigation. A Federal Bureau of Investigation background check will be done if the Provider has been a resident of the State of Colorado for less than two years. Human Services will clear the Provider through CBI and FBI; 2. Complete a course in CPR and first aid,in which a current copy of the certifications must be provided to Human Services with this agreement. If either certification should expire during the contracted period,the Provider will send a new current certification copy to Human Services; 3. Provide transportation for the child to appointments during the hours of service as agreed upon with the foster parent; 4. Become familiar with State rules and regulations governing certified foster homes; 5. Must be eighteen years of age or older. Page 5 of 9 11-I2-RESPITE CARE EXHIBIT B PAYMENT SCHEDULE 1. Funding and Method of Payment Human Services agrees to reimburse PROVIDER in consideration for the work and services performed under Child Welfare Regular Administration funding. Expenses incurred by PROVIDER, in association with said project prior to the term of this agreement,are not eligible Human Services expenditures and shall not be reimbursed by Human Services. Payment pursuant to this Contract, if Child Welfare Regular Administration funds,whether in whole or in part, is subject to and contingent upon the continuing availability of Child Welfare Regular Administration funds for the purposes hereof. In the event that said funds,or any part thereof,become unavailable as determined by Human Services,Human Services may immediately terminate this Contract or amend it accordingly. 2. Fees for Services Respite care is limited to four hours per week per child. The hours of care may be provided in any combination throughout a month,but not to exceed 16 hours per month. Payment will be$16.75 per each four hour period,but not to exceed$67.00 per month for 16 hours. Human Services referrals will not be sent to collections by PROVIDER for default of co-pay/fees. Services will be performed regardless of client's refusal or inability to pay co-pay. PROVIDER will collect any applicable sliding scale co-pays and credit Human Services for any payments received on the monthly billing statements. 3. Submittal of Vouchers PROVIDER shall prepare and submit monthly,the itemized voucher and certify that the services authorized were provided on the date indicated and the charges made were pursuant to the terms and conditions of Exhibit A. Page 6 of 9 11-12-RESPITE CARE EXHIBIT C ASSURANCES . PROVIDER agrees it is an independent contractor and that its officers and employees do not become employees of Weld County,nor are they entitled to any employee benefits as Weld County employees,as the result of the execution of this Agreement. 2. Weld County,the Board of County Commissioners of Weld County, its officers and employees,shall not be held liable for injuries or damages caused by any negligent acts or omissions of PROVIDER-contracted PROVIDERS or its employees,volunteers,or agents while performing duties as described in this Agreement. PROVIDER shall indemnify, defend,and hold harmless Weld County,the Board of County Commissioners of Weld County,its employees,volunteers,and agents. PROVIDER shall provide adequate liability and worker's compensation insurance for all its employees,volunteers,and agents engaged in the performance of the Agreement upon request,PROVIDER shall provide Human Services with the acceptable evidence that such coverage is in effect. 3. No portion of this Contract shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may possess,not shall any portion of this Agreement be deemed to have treated a duty of care with respect to any persons not a party of this Agreement. 4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld, State of Colorado,to expend funds not otherwise appropriated in each succeeding year. 5. If any section, subsection,paragraph,sentence,clause,or phrase of this Contract is for any reason held or decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The parties hereto declare that they would have entered into this Contract and each and every section, subsection, paragraph,sentence, clause,and phrase thereof irrespective of the fact that any one or more sections, subsections,paragraphs,sentences,clauses, or phrases might be declared to be unconstitutional or invalid. 6. No officer,member or employee of Weld County and no member of their governing bodies shall have any pecuniary interest,direct or indirect,in the approved Agreement or the proceeds thereof. 7. PROVIDER assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that no person shall,on the grounds of race, creed,color, sex,or national origin,be excluded from participation in,be denied the benefits of,or be otherwise subjected to discrimination under this approved Contract. 8. PROVIDER assures that sufficient,auditable,and otherwise adequate records that will provide accurate, current,separate,and complete disclosure of the status of the funds received under the Contract are maintained for three(3)years or the completion and resolution of an audit. Such records shall be sufficient to allow authorized local,Federal,and State auditors,and representatives to audit and monitor PROVIDER. 9. All such records, documents,communications,and other materials shall be the property of Human Services and shall be maintained by PROVIDER, in a central location and custodian, in behalf of Human Services, for a period of four(4)years from the date of final payment under this Contract,or for such further period as may be necessary to resolve any matters which may be pending,or until an audit has been completed with the following qualifications: If an audit by or on behalf of the federal and/or state government has begun but is not completed at the end of the four(4)year period,or if audit findings have not been resolved after a four(4)year period,the materials shall be retained until the resolution of the audit finding. 10. PROVIDER assures that authorized local, federal,and state auditors and representatives shall,during business hours,have access to inspect any copy records,and shall be allowed to monitor and review through on-site visits,all contract activities,supported with funds under this Contract to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. Page 7 of 9 11-12-RESPITE CARE 11. This Contract shall be binding upon the parties hereto,their successors,heirs,legal representatives,anti assigns. PROVIDER or Human Services may not assign any of its rights or obligations hereunder without the nor written consent of both parties. 12. PROVIDER certifies that federal appropriated funds have not been paid or will be paid,by or on behalf of PROVIDER,to any person for influencing or attempting to influence an officer or employee of an agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any federal grant,the making of any federal loan,the entering into of any cooperative agreement,and the extension,continuation,renewal, amendment, or modification of any Federal contract, loan,grant,or cooperative agreement. 13. PROVIDER assures that it will fully comply with all other applicable federal and state laws. PROVIDER understands that the source of funds to be used under this Contract is Child Welfare Regular Administration funds. 14. PROVIDER assures and certifies that it and its principals: a. Are not presently debarred, suspended,proposed for debarment, declared ineligible or voluntarily excluded from covered transaction by a federal department or agency. b. Have not,within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining,attempting to obtain,or performing a public(federal, state,or local)transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft,forgery,bribery,falsification or destruction of records,making false statements,or receiving stolen property; c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state,or local)with commission of any of the offenses enumerated in paragraph 14(b)of this certification;and d. Have not within a three-year period preceding this Contract,had one or more public transactions (federal,state,and local)terminated for cause or default. 15. The Appearance of Conflict of Interest applies to the relationship of a contractor with Human Services when the contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest, it is not necessary for the contractor to gain from knowledge of these opposing interests. It is only necessary that the contractor know that the two relationships are in opposition.During the term of the Contract,PROVIDER shall not enter any third party relationship that gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation,PROVIDER shall submit to Human Services,a full disclosure statement setting forth the details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for Human Services'termination,for cause,of its contract with PROVIDER. 16. PROVIDER shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Contract. Except for purposes directly connected with the administration of Child Protection,no information about or obtained from any applicant/recipient in possession of PROVIDER shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with PROVIDER written policies governing access to,duplication and dissemination of,all such information. PROVIDER shall advise its employees,agents,and subcontractors, if any,that they are subject to these confidentiality requirements. PROVIDER shall provide its employees,agents,and subcontractors, if any,with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. Page 8 of 9 11-12-RESPITE CARE 17. Proprietary information for the purposes of this contract is information relating to a party's research, development,trade secrets,business affairs,internal operations and management procedures and those of its customers. clients or affiliates,but does not include information(1)lawfully obtained from third parties,(2) that which is in the public domain,or(3)that which is developed independently. Neither party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of this Contract. Any proprietary information removed from the State's site by PROVIDER in the course of providing services under this Contract will be accorded at least the same precautions as are employed by PROVIDER for similar information in the course of its own business. 18. PROVIDER certifies that s/he will abide by Colorado Revised Statute(C.R.S.)26-6-104,requiring criminal background checks for all employees, contractors,and sub-contractors. Page 9 of 9 11-12-RESPITE CARE CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND PROVIDER This Agreement,made and entered into the day of ,20_,by and between the Board of Weld County Commissioners,sitting as the Board of Human o beha of t e Weld County Department of Human Services,hereinafter referred to as"Human Services," and tan) referred to as"Provider". WITNESSETH WHEREAS,required approval,clearance,and coordination have been accomplished from and with appropriate agencies;and WHEREAS,the Colorado Department of Human Services has provided Child Welfare Regular Administration funding for respite care for county foster care PROVIDERS and WHEREAS,Provider is a for-profit Sole-Proprietor. NOW THEREFORE, in consideration of the premises,the parties hereto covenant and agree as follows: 1. Term This Agreement shall become effective on July 1,2011 ,upon proper execution of this Agreement and shall expire June 30,2011/unless sooner terminated as provided herein. 2. Scope of Services Services shall be provided by Provider to any person(s)eligible for child protection services in compliance with Exhibit A"Scope of Services,"a copy of which is attached by reference. 3. Payment a. Payment shall be made on the basis of Exhibit B,"Payment Schedule,"copies of which are attached hereto and incorporated herein by reference. b. "Payment Schedule"shall establish the maximum reimbursement,which will be paid from Child Welfare Regular Administration funds during the duration of this Agreement. c. PROVIDER shall submit an itemized monthly bill to Human Services for all costs incurred and services provided pursuant to Exhibit A of this Agreement in accordance with criteria established by Human Services. PROVIDER shall submit all itemized monthly billings to Human Services no later than the twenty-fifth(25)day of the month following the month the cost was incurred. d. Payments of costs incurred pursuant to this Agreement are expressly contingent upon the availability of Child Welfare Regular Administration funds to Human Services. e. Human Services shall not be billed for,and reimbursement shall not be made for time involvefl in activities outside of those defined in Exhibit A. Work performed prior to the execution of this Contract shall not be reimbursed or considered part of this Agreement. 4. Financial Management At all times from the effective date of this Contract until completion of this Contract, PROVIDER shall comply with the administrative requirements,cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under Child Welfare Regular Administration funding must conform to the Single Audit Act of 1984 and OMB Circular A-133. Page 1 of 9 11-12-RESPITE CARE 5. Payment Method Unless otherwise provided in the Scope of Services and Payment Schedule: a. PROVIDER shall provide proper monthly invoices and itemization of services performed for costs incurred in the performance of the agreement. b. Human Services may withhold any payment if PROVIDER has failed to comply with the Financial Management Requirements,program objectives,contractual terms,or reporting requirements. In the event of a forfeiture of reimbursements,PROVIDER may appeal such circumstance to the Director of Human Services. The decision of the Director of Human Services shall be final. 6. Assurances PROVIDER shall abide by all assurances as set forth in the attached Exhibit C,which is attached hereto and incorporated herein by reference. 7. Compliance with Applicable Laws At all times during the performance of this contract,PROVIDER shall strictly adhere to all applicable federal and state laws,orders,and all applicable standards,regulations,interpretations or guidelines issued pursuant thereto. This includes the protection of the confidentiality of all applicant/recipient records,papers,documents, tapes and any other materials that have been or may hereafter be established which relate to the Contract. PROVIDER acknowledges that the following laws are included: - Title VI of the Civil Rights Act of 1964,42 U.S.C.Sections 2000d—1 et.seq.and its implementing regulation, 45 C.F.R.Part 80 et seq.;and - Section 504 of the Rehabilitation Act of 1973,29 U.S.C.Section 794,and its implementing regulations,45 C.F.R.Part 84;and - the Age Discrimination Act of 1975,42 U.S.C.Sections 6101 et.seq.and its implementation regulations,45 C.F.R. Part 91;and - Title VII of the Civil Rights Act of 1964;and - the Age Discrimination in Employment Act of 1967;and - the Equal Pay Act of 1963;and - the Education Amendments of 1972;and - Immigration Reform and Control Act of 1986,P.L.99-603; - 42 C.F.R.Part 2 and all regulations applicable to these laws prohibiting discrimination because of race, color,National origin,and sex,religion and handicap,including Acquired Immune Deficiency syndrome (AIDS)or AIDS related conditions, covered under Section 504 of the Rehabilitation Act of 1973,as amended,cited above. If necessary,PROVIDER and Human Services will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 CFR Part 2. Included in 45 C.F.R. Part 74 Appendix G 9,which requires that affirmative steps be taken to assure that small and minority businesses are utilized,when possible,as sources of supplies,equipment,construction and services. This assurance is given in consideration of and for the purpose of obtaining any and all federal and/or state financial assistance. Any person who feels that s/he has been discriminated against has the right to file a complaint either with the Colorado Department of Human Services or with the U.S. Department of Health and Human Services,Office for Civil Rights. 8. Certifications PROVIDER certifies that, at the time of entering into this Contract,it has currently in effect all necessary licenses,approvals, insurance, etc.,required to properly provide the services and/or supplies covered by this contract. A copy of certificate will be provided to Human Services upon completion of this agreement. Failure to do so will null and void this contract in its entirety. Page 2 of 9 11-12-RESPITE CARE 9. Monitoring and Evaluation PROVIDER and Human Services agree that monitoring and evaluation of the performance of this Agreement shall be conducted by PROVIDER and Human Services. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners and PROVIDER. PROVIDER shall permit Human Services,and any other duly authorized agent or governmental agency,to monitor all activities conducted by PROVIDER pursuant to the terms of this Agreement. As the monitoring agency may in its sole discretion deem necessary or appropriate,such program data,special analyses,on-site checking,formal audit examinations,or any other reasonable procedures. All such monitoring shall be performed in a manner that will not unduly interfere with agreement work. 10. Modification of Agreement All modifications to this agreement shall be in writing and signed by both parties. 11. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find PROVIDER substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by PROVIDER. These remedial actions are as follows: a. Withhold payment to PROVIDER until the necessary services or corrections in performance are satisfactorily completed; b. Deny payment or recover reimbursement for those services or deliverables,which have not been performed and which due to circumstances caused by PROVIDER cannot be performed or if performed would be of no value to Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; c. Incorrect payment to PROVIDER due to omission,error,fraud,and/or defalcation shall be recovered from PROVIDER by deduction from subsequent payments under this Agreement or other agreements between Human Services and PROVIDER,or by Human Services as a debt due to Human Services or otherwise as provided by law. 12. Representatives For the purpose of this Agreement,the individuals identified below are hereby designated representatives of the respective parties. Either party may from time to time designate in writing a new or substitute representative(s): For Human Services: Gloria Romansik Human Services Administrator Name Title For Provider:017.4f.)017.4f.) iy�� Respite Care Provider Name o / , l\ Title 13. Notice �J All notices required to be given by the parties hereunder shall be given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing a substitute person(s)or address to whom such notices shall be sent: To: Human Services To: n1 Judy A.Griego,Director fpi Q r�C P.O.Box A nQD, puldi.A Greeley,CO 80632 Page 3 of 9 11-12-RESPITE CARE 14. Litigation PROVIDER shall promptly notify Human Services in the event that PROVIDER learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement.PROVIDER, within five(5)calendar days after being served with a summons,complaint,or other pleading which has been filed in any federal or state court or administrative agency,shall deliver copies of such document(s)to the Human Services Director. The term"litigation"includes an assignment for the benefit of creditors, and filings in bankruptcy,reorganization and/or foreclosure. 15. Termination This Agreement may be terminated at any time by either party given thirty(30)days written notice and is subject to the availability of funding. PROVIDER reserves the right to suspend services to clients if funding is no longer available. 16. Entire Agreement This Agreement,together with all attachments hereto,constitutes the entire understanding between the parties with respect to the subject matter hereof,and may not be changed or modified except as stated in Paragraph 10 herein. 17. No Third Party Beneficiary. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 18. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may posses,nor shall any portion of this Agreement be deemed to have created a duty of care which did not previously exist with respect to any person not a party to this Agreement. IN WITNESS WHEREOF,the parties hereto have duly executed the Agreement as of the day,month,and year first above written. BOARD OF COUNTY COMMISSIONERS WELD COUNTY,COLORADO ATTEST: Weld ounty Clerk to the Board �+��/ f �;arbara Kir meyer BY: ��,, � .� d " �+ JUL 0 6 2011 Deputy Clerk the Board ' -, APP t ! "yr AS 1 "....Alt.r 11WC�1 e•i�� Itar Co Aoey (2116 WELD COUNTY DEPARTMENT OF HUMAN SERVICES PROVIDER sC /i i Lt/L!n it • Ju .Griego, Director Respite er Page 4 of 9 ac/i-/i // 11-12-RESPITE CARE EXHIBIT A SCOPE OF SERVICES Each Provider will: 1. Complete a fingerprint card for a background check at the PROVIDERS expense with the Colorado Bureau of • Investigation. A Federal Bureau of Investigation background check will be done if the Provider has been a resident of the State of Colorado for less than two years. Human Services will clear the Provider through CBI and FBI; 2. Complete a course in CPR and first aid, in which a current copy of the certifications must be provided to Human Services with this agreement. If either certification should expire during the contracted period,the Provider will send a new current certification copy to Human Services; 3. Provide transportation for the child to appointments during the hours of service as agreed upon with the foster parent; 4. Become familiar with State rules and regulations governing certified foster homes; 5. Must be eighteen years of age or older. Page 5 of 9 • 11-12-RESPITE CARE EXHIBIT B PAYMENT SCHEDULE 1. Funding and Method of Payment Human Services agrees to reimburse PROVIDER in consideration for the work and services performed under Child Welfare Regular Administration funding. Expenses incurred by PROVIDER, in association with said project prior to the term of this agreement,are not eligible Human Services expenditures and shall not be reimbursed by Human Services. Payment pursuant to this Contract, if Child Welfare Regular Administration funds,whether in whole or in part, is subject to and contingent upon the continuing availability of Child Welfare Regular Administration funds for the purposes hereof. In the event that said funds,or any part thereof,become unavailable as determined by Human Services,Human Services may immediately terminate this Contract or amend it accordingly. 2. Fees for Services Respite care is limited to four hours per week per child. The hours of care may be provided in any combination throughout a month,but not to exceed 16 hours per month. Payment will be$16.75 per each four hour period,but not to exceed$67.00 per month for 16 hours. Human Services referrals will not be sent to collections by PROVIDER for default of co-pay/fees. Services will be performed regardless of client's refusal or inability to pay co-pay. PROVIDER will collect any applicable sliding scale co-pays and credit Human Services for any payments received on the monthly billing statements. 3. Submittal of Vouchers PROVIDER shall prepare and submit monthly,the itemized voucher and certify that the services authorized were provided on the date indicated and the charges made were pursuant to the terms and conditions of Exhibit A. Page 6 of 9 • 11-12-RESPITE CARE EXHIBIT C ASSURANCES I. PROVIDER agrees it is an independent contractor and that its officers and employees do not become employees of Weld County,nor are they entitled to any employee benefits as Weld County employees,as the result of the execution of this Agreement. 2. Weld County,the Board of County Commissioners of Weld County, its officers and employees,shall not be held liable for injuries or damages caused by any negligent acts or omissions of PROVIDER-contracted PROVIDERS or its employees, volunteers,or agents while performing duties as described in this Agreement. PROVIDER shall indemnify,defend,and hold harmless Weld County,the Board of County Commissioners of Weld County, its employees,volunteers,and agents. PROVIDER shall provide adequate liability and worker's compensation insurance for all its employees,volunteers,and agents engaged in the performance of the Agreement upon request, PROVIDER shall provide Human Services with the acceptable evidence that such coverage is in effect. 3. No portion of this Contract shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may possess,not shall any portion of this Agreement be deemed to have treated a duty of care with respect to any persons not a party of this Agreement. 4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld,State of Colorado,to expend funds not otherwise appropriated in each succeeding year. 5. If any section,subsection,paragraph,sentence,clause,or phrase of this Contract is for any reason held or decided to be unconstitutional,such decision shall not affect the validity of the remaining portions. The parties hereto declare that they would have entered into this Contract and each and every section,subsection, paragraph,sentence,clause,and phrase thereof irrespective of the fact that any one or more sections, subsections,paragraphs,sentences,clauses,or phases might be declared to be unconstitutional or invalid. 6. No officer,member or employee of Weld County and no member of their governing bodies shall have any pecuniary interest,direct or indirect,in the approved Agreement or the proceeds thereof. 7. PROVIDER assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that no person shall,on the grounds of race,creed,color,sex,or national origin,be excluded from participation in,be denied the benefits of,or be otherwise subjected to discrimination under this approved Contract. 8. PROVIDER assures that sufficient,auditable,and otherwise adequate records that will provide accurate, current, separate,and complete disclosure of the status of the funds received under the Contract are maintained for three(3)years or the completion and resolution of an audit. Such records shall be sufficient to allow authorized local, Federal,and State auditors,and representatives to audit and monitor PROVIDER. 9. All such records,documents, communications,and other materials shall be the property of Human Services and shall be maintained by PROVIDER,in a central location and custodian,in behalf of Human Services,for a period of four(4)years from the date of final payment under this Contract,or for such further period as may be necessary to resolve any matters which may be pending, or until an audit has been completed with the following qualifications: If an audit by or on behalf of the federal and/or state government has begun but is not completed at the end of the four(4)year period,or if audit findings have not been resolved after a four(4)year period,the materials shall be retained until the resolution of the audit finding. 10. PROVIDER assures that authorized local,federal,and state auditors and representatives shall,during business hours,have access to inspect any copy records,and shall be allowed to monitor and review through on-site visits,all contract activities,supported with funds under this Contract to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. Page 7 of 9 11-12-RESPITE CARE 11. This Contract shall be binding upon the parties hereto,their successors,heirs,legal representatives,and assigns. PROVIDER or Human Services may not assign any of its rights or obligations hereunder without the prior written consent of both parties. 12. PROVIDER certifies that federal appropriated funds have not been paid or will be paid,by or on behalf of PROVIDER,to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any federal grant,the making of any federal loan,the entering into of any cooperative agreement,and the extension,continuation,renewal, amendment,or modification of any Federal contract, loan,grant,or cooperative agreement. 13. PROVIDER assures that it will fully comply with all other applicable federal and state laws. PROVIDER understands that the source of funds to be used under this Contract is Child Welfare Regular Administration funds. 14. PROVIDER assures and certifies that it and its principals: a. Are not presently debarred,suspended,proposed for debarment,declared ineligible or voluntarily excluded from covered transaction by a federal department or agency. b. Have not,within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining,attempting to obtain,or performing a public(federal,state,or local)transaction or contract under a public transaction;violation of federal or state antitrust statutes or commission of embezzlement, theft,forgery,bribery,falsification or destruction of records,making false statements,or receiving stolen property; c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state,or local)with commission of any of the offenses enumerated in paragraph 14(b)of this certification;and d. Have not within a three-year period preceding this Contract,had one or more public transactions (federal,state,and local)terminated for cause or default. 15. The Appearance of Conflict of Interest applies to the relationship of a contractor with Human Services when the contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest,it is not necessary for the contractor to gain from knowledge of these opposing interests. It is only necessary that the contractor know that the two relationships are in opposition. During the term of the Contract,PROVIDER shall not enter any third party relationship that gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation, PROVIDER shall submit to Human Services,a full disclosure statement setting forth the details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for Human Services'termination,for cause,of its contract with PROVIDER. 16. PROVIDER shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Contract. Except for purposes directly connected with the administration of Child Protection,no information about or obtained from any applicant/recipient in possession of PROVIDER shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with PROVIDER written policies governing access to,duplication and dissemination of,all such information. PROVIDER shall advise its employees,agents,and subcontractors,if any,that they are subject to these confidentiality requirements. PROVIDER shall provide its employees,agents,and subcontractors, if any, with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. Page 8 of 9 • 11-12-RESPITE CARE 17. Proprietary information for the purposes of this contract is information relating to a party's research, development,trade secrets,business affairs,internal operations and management procedures and those of its customers,clients or affiliates,but does not include information(I)lawfully obtained from third parties,(2) that which is in the public domain,or(3)that which is developed independently. Neither party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of this Contract. Any proprietary information removed from the State's site by PROVIDER in the course of providing services under this Contract will be accorded at least the same precautions as are employed by PROVIDER for similar information in the course of its own business. 18. PROVIDER certifies that s/he will abide by Colorado Revised Statute(C.R.S.)26-6-104,requiring criminal background checks for all employees,contractors,and sub-contractors. Page 9 of 9 11-12-RESPITE CARE CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND PROVIDER This Agreement,made and entered into the_day of ,20_,by and between the Board of Weld County Commissioners,sitting as the Board of Human on behalf of Wyld County Department of Human Services,hereinafter referred to as"Human Services,"and (t,�tebn vs ti F f�referred to as"Provider". WITNESSETH WHEREAS,required approval,clearance,and coordination have been accomplished from and with appropriate agencies;and WHEREAS,the Colorado Department of Human Services has provided Child Welfare Regular Administration funding for respite care for county foster care PROVIDERS and WHEREAS,Provider is a for-profit Sole-Proprietor. NOW THEREFORE,in consideration of the premises,the parties hereto covenant and agree as follows: 1. Term This Agreement shall become effective on July 1,201 ,upon proper execution of this Agreement and shall expire June 30,20 fkunless sooner terminated as provided herein. 2. Scope of Services Services shall be provided by Provider to any person(s)eligible for child protection services in compliance with Exhibit A"Scope of Services,"a copy of which is attached by reference. 3. Payment a. Payment shall be made on the basis of Exhibit B,"Payment Schedule,"copies of which are attached hereto and incorporated herein by reference. b. "Payment Schedule"shall establish the maximum reimbursement,which will be paid from Child Welfare Regular Administration funds during the duration of this Agreement. c. PROVIDER shall submit an itemized monthly bill to Human Services for all costs incurred and services provided pursuant to Exhibit A of this Agreement in accordance with criteria established by Human Services. PROVIDER shall submit all itemized monthly billings to Human Services no later than the twenty-fifth(25)day of the month following the month the cost was incurred. d. Payments of costs incurred pursuant to this Agreement are expressly contingent upon the availability of Child Welfare Regular Administration funds to Human Services. e. Human Services shall not be billed for,and reimbursement shall not be made for time involved in activities outside of those defined in Exhibit A. Work performed prior to the execution of this Contract shall not be reimbursed or considered part of this Agreement. 4. Financial Management At all times from the effective date of this Contract until completion of this Contract,PROVIDER shall comply with the administrative requirements,cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under Child Welfare Regular Administration funding must conform to the Single Audit Act of 1984 and OMB Circular A-133. Page 1 of 9 &cv//d'// 11-12-RESPITE CARE 5. Payment Method Unless otherwise provided in the Scope of Services and Payment Schedule: a. PROVIDER shall provide proper monthly invoices and itemization of services performed for costs incurred in the performance of the agreement. b. Human Services may withhold any payment if PROVIDER has failed to comply with the Financial Management Requirements,program objectives,contractual terms,or reporting requirements. In the event of a forfeiture of reimbursements, PROVIDER may appeal such circumstance to the Director of Human Services. The decision of the Director of Human Services shall be final. 6. Assurances PROVIDER shall abide by all assurances as set forth in the attached Exhibit C,which is attached hereto and incorporated herein by reference. 7. Compliance with Applicable Laws At all times during the performance of this contract,PROVIDER shall strictly adhere to all applicable federal and state laws,orders,and all applicable standards, regulations,interpretations or guidelines issued pursuant thereto. This includes the protection of the confidentiality of all applicant/recipient records,papers,documents, tapes and any other materials that have been or may hereafter be established which relate to the Contract. PROVIDER acknowledges that the following laws are included: - Title VI of the Civil Rights Act of 1964,42 U.S.C.Sections 2000d—1 et.seq.and its implementing regulation, 45 C.F.R.Part 80 et.seq.;and - Section 504 of the Rehabilitation Act of 1973,29 U.S.C.Section 794,and its implementing regulations,45 C.F.R. Part 84;and - the Age Discrimination Act of 1975,42 U.S.C. Sections 6101 et.seq.and its implementation regulations,45 C.F.R. Part 91;and - Title VII of the Civil Rights Act of 1964;and - the Age Discrimination in Employment Act of 1967;and - the Equal Pay Act of 1963;and - the Education Amendments of 1972;and - Immigration Reform and Control Act of 1986,P.L.99-603; - 42 C.F.R.Part 2 and all regulations applicable to these laws prohibiting discrimination because of race, color,National origin,and sex,religion and handicap, including Acquired Immune Deficiency syndrome (AIDS)or AIDS related conditions,covered under Section 504 of the Rehabilitation Act of 1973,as amended,cited above. If necessary, PROVIDER and Human Services will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 CFR Part 2. Included in 45 C.F.R. Part 74 Appendix G 9,which requires that affirmative steps be taken to assure that small and minority businesses are utilized,when possible,as sources of supplies,equipment,construction and services. This assurance is given in consideration of and for the purpose of obtaining any and all federal and/or state financial assistance. Any person who feels that s/he has been discriminated against has the right to file a complaint either with the Colorado Department of Human Services or with the U.S. Department of Health and Human Services,Office for Civil Rights. 8. Certifications PROVIDER certifies that,at the time of entering into this Contract, it has currently in effect all necessary licenses,approvals,insurance,etc.,required to properly provide the services and/or supplies covered by this contract. A copy of certificate will be provided to Human Services upon completion of this agreement. Failure to do so will null and void this contract in its entirety. Page 2 of 9 11-12-RESPITE CARE 9. Monitoring and Evaluation PROVIDER and Human Services agree that monitoring and evaluation of the performance of this Agreement shall be conducted by PROVIDER and Human Services. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners and PROVIDER. PROVIDER shall permit Human Services,and any other duly authorized agent or governmental agency,to monitor all activities conducted by PROVIDER pursuant to the terms of this Agreement. As the monitoring agency may in its sole discretion deem necessary or appropriate,such program data,special analyses,on-site checking,formal audit examinations,or any other reasonable procedures. All such monitoring shall be performed in a manner that will not unduly interfere with agreement work. 10. Modification of Agreement All modifications to this agreement shall be in writing and signed by both parties. 11. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find PROVIDER substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by PROVIDER. These remedial actions are as follows: a. Withhold payment to PROVIDER until the necessary services or corrections in performance are satisfactorily completed; b. Deny payment or recover reimbursement for those services or deliverables,which have not been performed and which due to circumstances caused by PROVIDER cannot be performed or if performed would be of no value to Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; c. Incorrect payment to PROVIDER due to omission,error,fraud,and/or defalcation shall be recovered from PROVIDER by deduction from subsequent payments under this Agreement or other agreements between Human Services and PROVIDER,or by Human Services as a debt due to Human Services or otherwise as provided by law. 12. Representatives For the purpose of this Agreement,the individuals identified below are hereby designated representatives of the respective parties. Either party may from time to time designate in writing a new or substitute representative(s): For Human Services: Gloria Romansik Human Services Administrator Name Title For Provider: Che1s t h DL\t v 14 t- Respite Care Provider Name Title 13. Notice All notices required to be given by the parties hereunder shall be given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing a substitute person(s)or address to whom such notices shall be sent: To: Human Services To: Judy A.Griego,Director PI Si l o (4 P.O. Box A tic Greeley,CO 80632 Grs,/Gri Ca ?off 3'/ Page 3 of 9 11-12-RESPITE CARE 14. Litigation PROVIDER shall promptly notify Human Services in the event that PROVIDER learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement.PROVIDER, within five(5)calendar days after being served with a summons,complaint,or other pleading which has been filed in any federal or state court or administrative agency,shall deliver copies of such document(s)to the Human Services Director. The term"litigation" includes an assignment for the benefit of creditors,and filings in bankruptcy,reorganization and/or foreclosure. 15. Termination This Agreement may be terminated at any time by either party given thirty(30)days written notice and is subject to the availability of funding. PROVIDER reserves the right to suspend services to clients if funding is no longer available. 16. Entire Agreement This Agreement,together with all attachments hereto,constitutes the entire understanding between the parties with respect to the subject matter hereof,and may not be changed or modified except as stated in Paragraph 10 herein. 17. No Third Party Beneficiary. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement,shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 18. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may posses,nor shall any portion of this Agreement be deemed to have created a duty of care which did not previously exist with respect to any person not a party to this Agreement. IN WITNESS WHEREOF,the parties hereto have duly executed the Agreement as of the day,month,and year first above written. BOARD OF COUNTY COMMISSIONERS WELD COUNTY,COLORA ATTEST: Wel CouuntyClerktoth- soa LairBarbara Ki ieyer BY: /tt i. � t.! �' Asti E.La JUL 0 6 2011 Deputy Cl- k,1 e :oar. f .1, OV AS o 1161 i�72s SI Jo Co rA fey ��.►/ 1 ��, WELD COUNTY DEPARTMENT OF HUMAN SERVICES PROVIDER t444Mt Respite Provier Page 4 of 9 aai/- // 11-12-RESPITE CARE EXHIBIT A SCOPE OF SERVICES Each Provider will: 1. Complete a fingerprint card for a background check at the PROVIDERS expense with the Colorado Bureau of Investigation. A Federal Bureau of Investigation background check will be done if the Provider has been a resident of the State of Colorado for less than two years. Human Services will clear the Provider through CBI and FBI; 2. Complete a course in CPR and first aid, in which a current copy of the certifications must be provided to Human Services with this agreement. If either certification should expire during the contracted period,the Provider will send a new current certification copy to Human Services; 3. Provide transportation for the child to appointments during the hours of service as agreed upon with the foster parent; 4. Become familiar with State rules and regulations governing certified foster homes; 5. Must be eighteen years of age or older. Page 5 of 9 11-12-RESPITE CARE EXHIBIT B PAYMENT SCHEDULE 1. Funding and Method of Payment Human Services agrees to reimburse PROVIDER in consideration for the work and services performed under Child Welfare Regular Administration funding. Expenses incurred by PROVIDER, in association with said project prior to the term of this agreement,are not eligible Human Services expenditures and shall not be reimbursed by Human Services. Payment pursuant to this Contract, if Child Welfare Regular Administration funds,whether in whole or in part, is subject to and contingent upon the continuing availability of Child Welfare Regular Administration funds for the purposes hereof. In the event that said funds,or any part thereof,become unavailable as determined by Human Services,Human Services may immediately terminate this Contract or amend it accordingly. 2. Fees for Services Respite care is limited to four hours per week per child. The hours of care may be provided in any combination throughout a month,but not to exceed 16 hours per month. Payment will be$16.75 per each four hour period,but not to exceed$67.00 per month for 16 hours. Human Services referrals will not be sent to collections by PROVIDER for default of co-pay/fees. Services will be performed regardless of client's refusal or inability to pay co-pay. PROVIDER will collect any applicable sliding scale co-pays and credit Human Services for any payments received on the monthly billing statements. 3. Submittal of Vouchers PROVIDER shall prepare and submit monthly,the itemized voucher and certify that the services authorized were provided on the date indicated and the charges made were pursuant to the terms and conditions of Exhibit A. Page 6 of 9 11-12-RESPITE CARE EXHIBIT C ASSURANCES 1. PROVIDER agrees it is an independent contractor and that its officers and employees do not become employees of Weld County,nor are they entitled to any employee benefits as Weld County employees,as the result of the execution of this Agreement. 2. Weld County,the Board of County Commissioners of Weld County,its officers and employees, shall not be held liable for injuries or damages caused by any negligent acts or omissions of PROVIDER-contracted PROVIDERS or its employees,volunteers,or agents while performing duties as described in this Agreement. PROVIDER shall indemnify,defend,and hold harmless Weld County,the Board of County Commissioners of Weld County,its employees,volunteers,and agents. PROVIDER shall provide adequate liability and worker's compensation insurance for all its employees,volunteers,and agents engaged in the performance of the Agreement upon request, PROVIDER shall provide Human Services with the acceptable evidence that such coverage is in effect. 3. No portion of this Contract shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may possess,not shall any portion of this Agreement be deemed to have treated a duty of care with respect to any persons not a party of this Agreement. 4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld, State of Colorado,to expend funds not otherwise appropriated in each succeeding year. 5. If any section,subsection,paragraph,sentence,clause,or phrase of this Contract is for any reason held or decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The parties hereto declare that they would have entered into this Contract and each and every section,subsection, paragraph,sentence,clause,and phrase thereof irrespective of the fact that any one or more sections, subsections,paragraphs,sentences,clauses,or phrases might be declared to be unconstitutional or invalid. 6. No officer,member or employee of Weld County and no member of their governing bodies shall have any pecuniary interest,direct or indirect,in the approved Agreement or the proceeds thereof. 7. PROVIDER assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that no person shall,on the grounds of race,creed,color,sex,or national origin,be excluded from participation in,be denied the benefits of,or be otherwise subjected to discrimination under this approved Contract. 8. PROVIDER assures that sufficient,auditable,and otherwise adequate records that will provide accurate, current,separate,and complete disclosure of the status of the funds received under the Contract are maintained for three(3)years or the completion and resolution of an audit. Such records shall be sufficient to allow authorized local,Federal,and State auditors,and representatives to audit and monitor PROVIDER. 9. All such records,documents,communications,and other materials shall be the property of Human Services and shall be maintained by PROVIDER,in a central location and custodian, in behalf of Human Services, for a period of four(4)years from the date of final payment under this Contract,or for such further period as may be necessary to resolve any matters which may be pending,or until an audit has been completed with the following qualifications: If an audit by or on behalf of the federal and/or state government has begun but is not completed at the end of the four(4)year period,or if audit findings have not been resolved after a four(4)year period,the materials shall be retained until the resolution of the audit finding. 10. PROVIDER assures that authorized local, federal,and state auditors and representatives shall,during business hours,have access to inspect any copy records,and shall be allowed to monitor and review through on-site visits,all contract activities,supported with funds under this Contract to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. Page 7 of 9 I I-I2-RESPITE CARE 1 1. This Contract shall be binding upon the parties hereto,their successors,heirs,legal representatives,and assigns. PROVIDER or Human Services may not assign any of its rights or obligations hereunder without the prior written consent of both parties. 12. PROVIDER certifies that federal appropriated funds have not been paid or will be paid,by or on behalf of PROVIDER,to any person for influencing or attempting to influence an officer or employee of an agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any federal grant,the making of any federal loan,the entering into of any cooperative agreement,and the extension,continuation,renewal, amendment,or modification of any Federal contract, loan,grant,or cooperative agreement. 13. PROVIDER assures that it will fully comply with all other applicable federal and state laws. PROVIDER understands that the source of funds to be used under this Contract is Child Welfare Regular Administration funds. 14. PROVIDER assures and certifies that it and its principals: a. Are not presently debarred,suspended,proposed for debarment,declared ineligible or voluntarily excluded from covered transaction by a federal department or agency. b. Have not,within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining,attempting to obtain,or performing a public(federal,state,or local)transaction or contract under a public transaction;violation of federal or state antitrust statutes or commission of embezzlement, theft,forgery,bribery, falsification or destruction of records,making false statements,or receiving stolen property; c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state,or local)with commission of any of the offenses enumerated in paragraph 14(b)of this certification;and d. Have not within a three-year period preceding this Contract,had one or more public transactions (federal,state,and local)terminated for cause or default. 15. The Appearance of Conflict of Interest applies to the relationship of a contractor with Human Services when the contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest, it is not necessary for the contractor to gain from knowledge of these opposing interests. It is only necessary that the contractor know that the two relationships are in opposition. During the term of the Contract,PROVIDER shall not enter any third party relationship that gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation, PROVIDER shall submit to Human Services,a full disclosure statement setting forth the details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for Human Services' termination,for cause,of its contract with PROVIDER. 16. PROVIDER shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Contract. Except for purposes directly connected with the administration of Child Protection,no information about or obtained from any applicant/recipient in possession of PROVIDER shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with PROVIDER written policies governing access to,duplication and dissemination of,all such information. PROVIDER shall advise its employees,agents,and subcontractors, if any,that they are subject to these confidentiality requirements. PROVIDER shall provide its employees,agents,and subcontractors,if any,with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. Page 8 of 9 11-12-RESPITE CARE 17. Proprietary information for the purposes of this contract is information relating to a party's research, development,trade secrets,business affairs, internal operations and management procedures and those of its customers,clients or affiliates,but does not include information(1)lawfully obtained from third parties,(2) that which is in the public domain,or(3)that which is developed independently. Neither party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of this Contract. Any proprietary information removed from the State's site by PROVIDER in the course of providing services under this Contract will be accorded at least the same precautions as are employed by PROVIDER for similar information in the course of its own business. 18. PROVIDER certifies that s/he will abide by Colorado Revised Statute(C.R.S.)26-6-104,requiring criminal background checks for all employees,contractors,and sub-contractors. Page 9 of 9 I 1-12-RESPITE CARE CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES''''' ,Li AND PROVIDER fy q. ?� This Agreement,made and entered into the day of ,20_,by and between the Board of Weld County Commissioners, sitting as the Board of Huma¢pn behalf of theeWe}d Co ty Department of Human Services,hereinafter referred to as"Human Services,"and rut-Wag,-lr«t(rltdl referred to as"Provider". WITNESSETH WHEREAS,required approval,clearance,and coordination have been accomplished from and with appropriate agencies; and WHEREAS,the Colorado Department of Human Services has provided Child Welfare Regular Administration funding for respite care for county foster care PROVIDERS and WHEREAS,Provider is a for-profit Sole-Proprietor. NOW THEREFORE, in consideration of the premises,the parties hereto covenant and agree as follows: I. Term This Agreement shall become effective on July 1,20((,upon proper execution of this Agreement and shall expire June 30,20 Pi-unless sooner terminated as provided herein. 2. Scone of Services Services shall be provided by Provider to any person(s)eligible for child protection services in compliance with Exhibit A"Scope of Services,"a copy of which is attached by reference. 3. Payment a. Payment shall be made on the basis of Exhibit B,"Payment Schedule,"copies of which are attached hereto and incorporated herein by reference. b. "Payment Schedule"shall establish the maximum reimbursement,which will be paid from Child Welfare Regular Administration funds during the duration of this Agreement. c. PROVIDER shall submit an itemized monthly bill to Human Services for all costs incurred and services provided pursuant to Exhibit A of this Agreement in accordance with criteria established by Human Services. PROVIDER shall submit all itemized monthly billings to Human Services no later than the twenty-fifth(25)day of the month following the month the cost was incurred. d. Payments of costs incurred pursuant to this Agreement are expressly contingent upon the availability of Child Welfare Regular Administration funds to Human Services. e. Human Services shall not be billed for, and reimbursement shall not be made for time involved in activities outside of those defined in Exhibit A. Work performed prior to the execution of this Contract shall not be reimbursed or considered part of this Agreement. 4. Financial Management At all times from the effective date of this Contract until completion of this Contract,PROVIDER shall comply with the administrative requirements,cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under Child Welfare Regular Administration funding must conform to the Single Audit Act of 1984 and OMB Circular A-I33. Page 1 of 9 DW/mil%/ 11-12-RESPITE CARE 5. Payment Method Unless otherwise provided in the Scope of Services and Payment Schedule: a. PROVIDER shall provide proper monthly invoices and itemization of services performed for costs incurred in the performance of the agreement. b. Human Services may withhold any payment if PROVIDER has failed to comply with the Financial Management Requirements,program objectives,contractual terms,or reporting requirements. In the event of a forfeiture of reimbursements,PROVIDER may appeal such circumstance to the Director of Human Services. The decision of the Director of Human Services shall be final. 6. Assurances PROVIDER shall abide by all assurances as set forth in the attached Exhibit C,which is attached hereto and incorporated herein by reference. 7. Compliance with Applicable Laws At all times during the performance of this contract, PROVIDER shall strictly adhere to all applicable federal and state laws,orders,and all applicable standards,regulations,interpretations or guidelines issued pursuant thereto. This includes the protection of the confidentiality of all applicant/recipient records,papers,documents, tapes and any other materials that have been or may hereafter be established which relate to the Contract. PROVIDER acknowledges that the following laws are included: - Title VI of the Civil Rights Act of 1964,42 U.S.C.Sections 2000d—1 et.seq.and its implementing regulation, 45 C.F.R.Part 80 et.seq.;and - Section 504 of the Rehabilitation Act of 1973,29 U.S.C. Section 794,and its implementing regulations,45 C.F.R.Part 84;and - the Age Discrimination Act of 1975,42 U.S.C. Sections 6101 et.seq.and its implementation regulations,45 C.F.R. Part 91;and - Title VII of the Civil Rights Act of 1964;and - the Age Discrimination in Employment Act of 1967;and - the Equal Pay Act of 1963;and - the Education Amendments of 1972;and - Immigration Reform and Control Act of 1986,P.L.99-603; - 42 C.F.R.Part 2 and all regulations applicable to these laws prohibiting discrimination because of race, color,National origin, and sex,religion and handicap, including Acquired Immune Deficiency syndrome (AIDS)or AIDS related conditions,covered under Section 504 of the Rehabilitation Act of 1973,as amended, cited above. If necessary,PROVIDER and Human Services will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 CFR Part 2. Included in 45 C.F.R.Part 74 Appendix G 9,which requires that affirmative steps be taken to assure that small and minority businesses are utilized,when possible,as sources of supplies,equipment,construction and services. This assurance is given in consideration of and for the purpose of obtaining any and all federal and/or state financial assistance. Any person who feels that s/he has been discriminated against has the right to file a complaint either with the Colorado Department of Human Services or with the U.S. Department of Health and Human Services,Office for Civil Rights. 8. Certifications PROVIDER certifies that,at the time of entering into this Contract, it has currently in effect all necessary licenses,approvals,insurance,etc.,required to properly provide the services and/or supplies covered by this contract. A copy of certificate will be provided to Human Services upon completion of this agreement. Failure to do so will null and void this contract in its entirety. Page 2 of 9 11-12-RESPITE CARE 9. Monitoring and Evaluation PROVIDER and Human Services agree that monitoring and evaluation of the performance of this Agreement shall be conducted by PROVIDER and Human Services. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners and PROVIDER. PROVIDER shall permit Human Services,and any other duly authorized agent or governmental agency,to monitor all activities conducted by PROVIDER pursuant to the terms of this Agreement. As the monitoring agency may in its sole discretion deem necessary or appropriate, such program data,special analyses,on-site checking,formal audit examinations,or any other reasonable procedures. All such monitoring shall be performed in a manner that will not unduly interfere with agreement work. 10. Modification of Agreement All modifications to this agreement shall be in writing and signed by both parties. II. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find PROVIDER substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by PROVIDER. These remedial actions are as follows: a. Withhold payment to PROVIDER until the necessary services or corrections in performance are satisfactorily completed; b. Deny payment or recover reimbursement for those services or deliverables,which have not been performed @nd which due to circumstances caused by PROVIDER cannot be performed or if performed would be of no value to Human Services: Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; c. Incorrect oavment to PROVIDER due to omission,error,hut and/or defalcation shall be recovered from 12. Representatives For the purpose of this Agreement,the individuals identified below are hereby designated representatives of the respective parties. Either party may from time to time designate in writing a new or substitute representative(s): For Human Services: Gloria Romansik Human Services Administrator Name Title For Provider: �/s�fG(i'tcc G2/� �oi e--Respite Care Provider Name Title 13. Notice All notices required to be given by the parties hereunder shall be given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing a substitute person(s)or address to whom such notices shall be sent: J To: Human Services To: // I��-Wier e d'P_ Judy A.Griego,Director . Sb 7/ UU'C s Z P.O.Box A � Greeley,CO 80632 gr IG V,/ Page 3 of 9 • 11-12-RESPITE CARE 14. Litigation PROVIDER shall promptly notify Human Services in the event that PROVIDER learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement. PROVIDER, within five(5)calendar days after being served with a summons,complaint,or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s)to the Human Services Director. The term"litigation"includes an assignment for the benefit of creditors, and filings in bankruptcy,reorganization and/or foreclosure. 15. Termination This Agreement may be terminated at any time by either party given thirty(30)days written notice and is subject to the availability of funding. PROVIDER reserves the right to suspend services to clients if funding is no longer available. 16. Entire Agreement This Agreement,together with all attachments hereto,constitutes the entire understanding between the parties with respect to the subject matter hereof,and may not be changed or modified except as stated in Paragraph 10 herein. 17. No Third Party Beneficiary. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 18. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may posses,nor shall any portion of this Agreement be deemed to have created a duty of care which did not previously exist with respect to any person not a party to this Agreement. IN WITNESS WHEREOF,the parties hereto have duly executed the Agreement as of the day,month,and year first above written. BOARD OF COUNTY COMMISSIONERS WELD COUNTY,COLO' 'DO ATTEST: • Weld ounty Clerk to the Boar �` ..y Barbara Kirkmeye yu` 0 020„ BY: :7 Deputy Clerk, the :oard kite 10 APP DAS Co omey WELD COUNTY DEPARTMENT OF HUMAN SERVICES PROV DER Jud . riego, hector Re ite Provider Page 4 of 9 L376/7-/61/ • 11-12-RESPITE CARE EXHIBIT A SCOPE OF SERVICES Each Provider will: 1. Complete a fingerprint card for a background check at the PROVIDERS expense with the Colorado Bureau of Investigation. A Federal Bureau of Investigation background check will be done if the Provider has been a resident of the State of Colorado for less than two years. Human Services will clear the Provider through CBI and FBI; 2. Complete a course in CPR and first aid, in which a current copy of the certifications must be provided to Human Services with this agreement. If either certification should expire during the contracted period,the Provider will send a new current certification copy to Human Services; 3. Provide transportation for the child to appointments during the hours of service as agreed upon with the foster parent; 4. Become familiar with State rules and regulations governing certified foster homes; 5. Must be eighteen years of age or older. Page 5 of 9 • I1-12-RESPITE CARE EXHIBIT B PAYMENT SCHEDULE I. Funding and Method of Payment Human Services agrees to reimburse PROVIDER in consideration for the work and services performed under Child Welfare Regular Administration funding. Expenses incurred by PROVIDER,in association with said project prior to the term of this agreement,are not eligible Human Services expenditures and shall not be reimbursed by Human Services. Payment pursuant to this Contract, if Child Welfare Regular Administration funds,whether in whole or in part, is subject to and contingent upon the continuing availability of Child Welfare Regular Administration funds for the purposes hereof. In the event that said funds,or any part thereof,become unavailable as determined by Human Services,Human Services may immediately terminate this Contract or amend it accordingly. 2. Fees for Services Respite care is limited to four hours per week per child. The hours of care may be provided in any combination throughout a month,but not to exceed 16 hours per month. Payment will be$16.75 per each four hour period,but not to exceed$67.00 per month for 16 hours. Human Services referrals will not be sent to collections by PROVIDER for default of co-pay/fees. Services will be performed regardless of client's refusal or inability to pay co-pay. PROVIDER will collect any applicable sliding scale co-pays and credit Human Services for any payments received on the monthly billing statements. 3. Submittal of Vouchers PROVIDER shall prepare and submit monthly,the itemized voucher and certify that the services authorized were provided on the date indicated and the charges made were pursuant to the terms and conditions of Exhibit A. Page 6 of 9 11-12-RESPITE CARE EXHIBIT C ASSURANCES 1. PROVIDER agrees it is an independent contractor and that its officers and employees do not become employees of Weld County,nor are they entitled to any employee benefits as Weld County employees, as the result of the execution of this Agreement. 2. Weld County,the Board of County Commissioners of Weld County, its officers and employees,shall not be held liable for injuries or damages caused by any negligent acts or omissions of PROVIDER-contracted PROVIDERS or its employees,volunteers, or agents while performing duties as described in this Agreement. PROVIDER shall indemnify, defend,and hold harmless Weld County,the Board of County Commissioners of Weld County, its employees,volunteers,and agents. PROVIDER shall provide adequate liability and worker's compensation insurance for all its employees,volunteers, and agents engaged in the performance of the Agreement upon request, PROVIDER shall provide Human Services with the acceptable evidence that such coverage is in effect. 3. No portion of this Contract shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may possess, not shall any portion of this Agreement be deemed to have treated a duty of care with respect to any persons not a party of this Agreement. 4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld, State of Colorado,to expend funds not otherwise appropriated in each succeeding year. 5. If any section, subsection,paragraph, sentence,clause,or phrase of this Contract is for any reason held or decided to be unconstitutional,such decision shall not affect the validity of the remaining portions. The parties hereto declare that they would have entered into this Contract and each and every section,subsection, paragraph,sentence,clause,and phrase thereof irrespective of the fact that any one or more sections, subsections,paragraphs, sentences, clauses, or phrases might be declared to be unconstitutional or invalid. 6. No officer,member or employee of Weld County and no member of their governing bodies shall have any pecuniary interest,direct or indirect, in the approved Agreement or the proceeds thereof. 7. PROVIDER assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that no person shall,on the grounds of race,creed,color,sex,or national origin,be excluded from participation in,be denied the benefits of,or be otherwise subjected to discrimination under this approved Contract. 8. PROVIDER assures that sufficient,auditable,and otherwise adequate records that will provide accurate, current, separate,and complete disclosure of the status of the funds received under the Contract are maintained for three(3)years or the completion and resolution of an audit. Such records shall be sufficient to allow authorized local,Federal,and State auditors,and representatives to audit and monitor PROVIDER. 9. All such records,documents,communications,and other materials shall be the property of Human Services and shall be maintained by PROVIDER, in a central location and custodian,in behalf of Human Services,for a period of four(4)years from the date of final payment under this Contract,or for such further period as may be necessary to resolve any matters which may be pending, or until an audit has been completed with the following qualifications: If an audit by or on behalf of the federal and/or state govemment has begun but is not completed at the end of the four(4)year period,or if audit findings have not been resolved after a four(4)year period,the materials shall be retained until the resolution of the audit finding. 10. PROVIDER assures that authorized local,federal,and state auditors and representatives shall,during business hours, have access to inspect any copy records,and shall be allowed to monitor and review through on-site visits, all contract activities, supported with funds under this Contract to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. Page 7 of 9 11-12-RESPITE CARE 11. This Contract shall be binding upon the parties hereto,their successors,heirs,legal representatives,and assigns. PROVIDER or Human Services may not assign any of its rights or obligations hereunder without the prior written consent of both parties. 12. PROVIDER certifies that federal appropriated funds have not been paid or will be paid,by or on behalf of PROVIDER,to any person for influencing or attempting to influence an officer or employee of an agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any federal grant,the making of any federal loan,the entering into of any cooperative agreement,and the extension,continuation,renewal, amendment,or modification of any Federal contract, loan,grant,or cooperative agreement. 13. PROVIDER assures that it will fully comply with all other applicable federal and state laws. PROVIDER understands that the source of funds to be used under this Contract is Child Welfare Regular Administration funds. 14. PROVIDER assures and certifies that it and its principals: a. Are not presently debarred,suspended,proposed for debarment,declared ineligible or voluntarily excluded from covered transaction by a federal department or agency. b. Have not,within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain,or performing a public(federal,state,or local)transaction or contract under a public transaction;violation of federal or state antitrust statutes or commission of embezzlement, theft,forgery,bribery, falsification or destruction of records,making false statements,or receiving stolen property; c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state,or local)with commission of any of the offenses enumerated in paragraph 14(b)of this certification;and d. Have not within a three-year period preceding this Contract,had one or more public transactions (federal,state,and local)terminated for cause or default. 15. The Appearance of Conflict of Interest applies to the relationship of a contractor with Human Services when the contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest, it is not necessary for the contractor to gain from knowledge of these opposing interests. It is only necessary that the contractor know that the two relationships are in opposition.During the term of the Contract, PROVIDER shall not enter any third party relationship that gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation,PROVIDER shall submit to Human Services,a full disclosure statement setting forth the details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for Human Services'termination,for cause,of its contract with PROVIDER. 16. PROVIDER shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Contract. Except for purposes directly connected with the administration of Child Protection,no information about or obtained from any applicant/recipient in possession of PROVIDER shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with PROVIDER written policies governing access to,duplication and dissemination of,all such information. PROVIDER shall advise its employees, agents,and subcontractors,if any,that they are subject to these confidentiality requirements. PROVIDER shall provide its employees,agents,and subcontractors, if any,with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. Page 8 of 9 11-12-RESPITE CARE 17. Proprietary information for the purposes of this contract is information relating to a party's research, development,trade secrets,business affairs,internal operations and management procedures and those of its customers,clients or affiliates, but does not include information(1)lawfully obtained from third parties,(2) that which is in the public domain,or(3)that which is developed independently. Neither party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of this Contract. Any proprietary information removed from the State's site by PROVIDER in the course of providing services under this Contract will be accorded at least the same precautions as are employed by PROVIDER for similar information in the course of its own business. 18. PROVIDER certifies that s/he will abide by Colorado Revised Statute(C.R.S.)26-6-104,requiring criminal background checks for all employees,contractors,and sub-contractors. Page 9 of 9 12( ►NSURANCECA► I) INSURED WEBER-MALPIEDE,PATRICIA MUTL VOL • POLICY NUMBER 6249211-F25.065 EFFECTIVE YR 2008 MAKE TOYOTA JUN 252011 TO DEC 252011 MODEL HIGHLANDER VIN JTEES42AX82079959 AGENT LARSON WS AGENCY INC PHONE (970)8564700 THE COVERAGE PROVIDED BY THE POLICY MEETS THE MINIMUM UABILITY LIMITS PRESCRIBED BY LAW. A BODILY INJURY/PROPERTY DAMAGE LIABILITY D 100 DEDUCT COMPREHENSIVE G 500 DEDUCT COLLISION H,R1,U riFF RIR FORE RI or FOR AnnnnNAI rn%roe r.r Wi ,PGA ii,41 I1-12-RESPITE CARE CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND PROVIDER This Agreement,made and entered into the day of ,20 ,by and between the Board of Weld County Commissioners,sitting as the Board of Human on behalf o,k the WeJ4 County Department of Human Services,hereinafter referred to as"Human Services,"and J55(C0. xl 40-4 V MC4n't— referred to as"Provider". WITNESSETII WHEREAS,required approval,clearance,and coordination have ben accomplished from and with appropriate agencies;and WHEREAS,the Colorado Department of Human Services has provided Child Welfare Regular Administration funding for respite care for county foster care PROVIDERS and WHEREAS,Provider is a for-profit Sole-Proprietor. NOW THEREFORE,in consideration of the premises,the parties hereto covenant and agree as follows: 1. Term This Agreement shall become effective on July I,20 It upon proper execution of this Agreement and shall expire June 30,20 1Z-unless sooner terminated as provided herein. 2. Scope of Services Services shall be provided by Provider to any person(s)eligible for child protection services in compliance with Exhibit A"Scope of Services," a copy of which is attached by reference. 3. Payment a. Payment shall be made on the basis of Exhibit B,"Payment Schedule,"copies of which are attached hereto and incorporated herein by reference. b. "Payment Schedule"shall establish the maximum reimbursement,which will be paid from Child Welfare Regular Administration funds during the duration of this Agreement. c. PROVIDER shall submit an itemized monthly bill to I luman Services for all costs incurred and services provided pursuant to Exhibit A of this Agreement in accordance with criteria established by human Services. PROVIDER shall submit all itemized monthly billings to Human Services no later than the twenty-fifth(25)day of the month following the month the cost was incurred. d. Payments of costs incurred pursuant to this Agreement are expressly contingent upon the availability of Child Welfare Regular Administration funds to human Services. e. Human Services shall not be billed for,and reimbursement shall not be made for time involved in activities outside of those defined in Exhibit A. Work performed prior to the execution of this Contract shall not be reimbursed or considered part of this Agreement. 4. Financial Management At all times from the effective date of this Contract until completion of this Contract,PROVIDER shall comply with the administrative requirements,cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under Child Welfare Regular Administration funding must conform to the Single Audit Act of 1984 and OMB Circular A-133. Page 1 of 9 11-12-RESPITE CARE 5. Payment Method Unless otherwise provided in the Scope of Services and Payment Schedule: a. PROVIDER shall provide propel-monthly invoices and itemization of services performed for costs incurred in the performance of the agreement_ b. Human Services may withhold any payment if PROVIDER has failed to comply with the Financial Management Requirements,program objectives,contractual terms,or reporting requirements. In the event of a forfeiture of reimbursements,PROVIDER may appeal such circumstance to the Director of Human Services. The decision of the Director of Human Services shall be final. 6. Assurances PROVIDER shall abide by all assurances as set forth in the attached Exhibit C,which is attached hereto and incorporated herein by reference. 7. Compliance with Applicable Laws At all times during the performance of this contract,PROVIDER shall strictly adhere to all applicable federal and state laws, orders, and all applicable standards,regulations,interpretations or guidelines issued pursuant thereto. This includes the protection of the confidentiality of all applicant/recipient records,papers,documents, tapes and any other materials that have been or may hereafter be established which relate to the Contract. PROVIDER acknowledges that the following laws are included: - Title VI of the Civil Rights Act of 1964,42 U.S.C. Sections 2000d-1 et.seq.and its implementing regulation, 45 C.F.R. Part SO et. s ri.- and - Section 504 of the Rehabilitation Act of 1973,29 U.S.C. Section 794,and its implementing regulations,45 C.F.R.Part 84;and - the Age Discrimination Act of 1975,42 U.S.C. Sections 6101 et. seq.and its implementation regulations,45 C.F.R. Part 91;and - Title VII of the Civil Rights Act of 1964;and - the Agc Discrimination in Employment Act of 1967;and - the Equal Pay Act of 1963;and - the Education Amendments of 1972;and - Immigration Reform and Control Act of 1986,P.L. 99-603; - 42 C.F.R. Part 2 and all regulations applicable to these laws prohibiting discrimination because of race, color,National origin,and sex,religion and handicap,including Acquired Immune Deficiency syndrome (AIDS)or AIDS related conditions,covered under Section 504 of the Rehabilitation Act of 1973, as amended,cited above. If necessary,PROVIDER and Human Services will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 CFR Part 2. Included in 45 C.F.R. Part 74 Appendix (1 9,which requires that affirmative steps be taken to assure that small and minority businesses are utilized,when possible, as sources of supplies,equipment,construction and services. This assurance is given in consideration of and for the purpose of obtaining any and all federal and/or state financial assistance. Any person who feels that s/he has been discriminated against has the right to file a complaint either with the Colorado Department of Human Services or with the U.S. Department of Health and Iluman Services,Office for Civil Rights. S. Certifications PROVIDER certifies that,at the time of entering into this Contract,it has currently in effect all necessary licenses, approvals, insurance,etc.,required to properly provide the services and/or supplies covered by this contract. A copy of certificate will be provided to Human Services upon completion of this agreement. Failure to do so will null and void this contract in its entirety. Page 2 of 9 I1-12-RESPITE CARE 9. Monitoring and Evaluation PROVIDER and Human Services agree that monitoring and evaluation of the performance of this Agreement shall be conducted by PROVIDER and Human Services. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners and PROVIDER. PROVIDER shall permit Human Services,and any other duly authorized agent or governmental agency,to monitor all activities conducted by PROVIDER pursuant to the terms of this Agreement. As the monitoring agency may in its sole discretion deem necessary or appropriate,such program data,sp..eial analyses,on-site checking,formal audit examinations,or any other reasonable procedures. All such monitoring shall be performed in a manner that will not unduly interfere with agreement work. 10. Modification of Agreement All modifications to this agreement shall be in writing and signed by both parties. 11. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find PROVIDER substantially failed to satisfy' the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by PROVIDER. These remedial actions arc as follows: a. Withhold payment to PROVIDER until the necessary services or conections in performance are satisfactorily completed; b. Deny payment or recover reimbursement for those services or deliverables,which have not been performed and which due to circumstances caused by PROVIDER cannot be performed or if performed would be of no value to Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; c. Incorrect payment to PROVIDER due to omission,error,fraud,and/or defalcation shall be recovered from PROVIDER by deduction from subsequent payments under this Agreement or other agreements between Human Services and PROVIDER,or by Human Services as a debt due to Human Services or otherwise as provided by law. 12. Representatives For the purpose of this Agreement,the individuals identified below are hereby designated representatives of the respective parties. Either party may from time to time designate in writing a new or substitute representative(s): For Human Services: Gloria Romansik Human Services Administrator Name Title For Provider: g0 d erstc \Iincent Respite Care Provider N' e Title 13. Notice All notices required to be given by the parties hereunder shall be given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing a substitute person(s)or address to whom such notices shall be sent: ' / To: Human Services To:Je<c I CG4 V,h Cehf Judy A. Grego,Director 9`110 11-1 bM2 ST P.O. Box A C7r#e f j , C° c60623y Greeley,CO 80632 Page 3 of 9 11-12-RESPITE CARE 14. Litigation PROVIDER shall promptly notify Human Services in the event that PROVIDER learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement.PROVIDER, within five(5)calendar days after being served with a summons,complaint,or other pleading which has been filed in any federal or state court or administrative agency,shall deliver copies of such document(s)to the Human Services Director. The term"litigation"includes an assignment for the benefit of creditors, and filings in bankruptcy,reorganization and/or foreclosure. 15. Termination This Agreement may be terminated at any time by either party given thirty(30)days written notice and is subject to the availability of funding. PROVIDER reserves the right to suspend services to clients if funding is no longer available. 16. Entire Agreement This Agreement,together with all attachments hereto,constitutes the entire understanding between the parties with respect to the subject matter hereof,and may not be changed or modified except as stated in Paragraph 10 herein. 17. No Third Party Beneficiary. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 18. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may posses,nor shall any portion of this Agreement be deemed to have created a duty of care which did not previously exist with respect to any person not a party to this Agreement_ IN WITNESS WHEREOF,the parties hereto have duly executed the Agreement as of the day,month,and year first above written. BOARD OF COUNTY COMMISSIONERS WELD COUNTY,COLOR SO AT, Weld County Clerk to the Boar• 4 air Barbara rkmeyer SL ii� „'noun BY: , puty Cl/ othe B...,, APP 14.61 A %..a.. � , r� Co �,.� ey CUWC WELD COUNTY DEPARTMENT OF HUMAN SERVICES PROVIDER 3�1 i 1— 7Arn\(,:gfrk Ju A. ('.rieg Director N', rte Provider Page 4 of 9 ani/-/e// 1 I-12-RESPITE CARE EXHIBIT A SCOPE OF SERVICES Each Provider will: I. Complete a fingerprint card for a background check at the PROVIDERS expense with the Colorado Bureau of Investigation. A Federal Bureau of Investigation background check will be done if the Provider has been a resident of the State of Colorado for less than two years. Human Services will clear the Provider through CBI and FBI; 2. Complete a course in CPR and first aid,in which a current copy of the certifications must be provided to Human Services with this agreement. If either certification should expire during the contracted period,the Provider will send a new current certification copy to Human Services; 3. Provide transportation for the child to appointments during the hours of service as agreed upon with the foster parent; 4. Become familiar with State rules and regulations governing certified foster homes; 5. Must be eighteen years of age or older. Page 5 of 9 11-12-RESPITE CARE EXHIBIT B PAYMENT SCHEDULE 1. Funding and Method of Payment Human Services agrees to reimburse PROVIDER in consideration for the work and services performed under Child Welfare Regular Administration funding. Expenses incurred by PROVIDER,in association with said project prior to the term of this agreement,are not eligible Human Services expenditures and shall not be reimbursed by Human Services. Payment pursuant to this Contract,if Child Welfare Regular Administration funds, whether in whole or in part, is subject to and contingent upon the continuing availability of Child Welfare Regular Administration funds for the purposes hereof. In the event that said funds,or any part thereof,become unavailable as determined by Human Services,Human Services may immediately terminate this Contract or amend it accordingly. 2. Fees for Services Respite care is limited to four hours per week per child. The hours of care may be provided in any combination throughout a month,but not to exceed 16 hours per month. Payment will be$16.75 per each four hour period,but not to exceed$67.00 per month for 16 hours. Human Services referrals will not be sent to collections by PROVIDER for default of co-pay/fees. Services will be performed regardless of client's refusal or inability to pay co-pay. PROVIDER will collect any applicable sliding scale co-pays and credit Human Services for any payments received on the monthly billing statements. 3. Submittal of Vouchers PROVIDER shall prepare and submit monthly,the itemized voucher and certify that the services authorized were provided on the date indicated and the charges made were pursuant to the terms and conditions of Exhibit A. Page 6 of 9 11-12-RESPITE CARE EXHIBIT C ASSURANCES 1. PROVIDER agrees it is an independent contractor and that its officers and employees do not become employees of Weld County,nor are they entitled to any employee benefits as Weld County employees,as the result of the execution of this Agreement. 2. Weld County,the Board of County Commissioners of Weld County,its officers and employees,shall not be held liable for injuries or damages caused by any negligent acts or omissions of PROVIDER-contracted PROVIDERS or its employees,volunteers,or agents while performing duties as described in this Agreement. PROVIDER shall indemnify,defend,and hold harmless Weld County,the Board of County Commissioners of Weld County,its employees,volunteers,and agents. PROVIDER shall provide adequate liability and worker's compensation insurance for all its employees,volunteers,and agents engaged in the performance of the Agreement upon request,PROVIDER shall provide Human Services with the acceptable evidence that such coverage is in effect. 3. No portion of this Contract shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may possess,not shall any portion of this Agreement be deemed to have treated a duty of care with respect to any persons not a party of this Agreement. 4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld,State of Colorado,to expend funds not otherwise appropriated in each succeeding year. 5. If any section,subsection,paragraph,sentence,clause,or phrase of this Contract is for any reason held or decided to be unconstitutional,such decision shall not affect the validity of the remaining portions. The parties hereto declare that they would have entered into this Contract and each and every section,subsection, paragraph,sentence,clause,and phrase thereof irrespective of the fact that any one or more sections, subsections,paragraphs,sentences,clauses,or phrases might be declared to be unconstitutional or invalid. 6. No officer,member or employee of Weld County and no member of their governing bodies shall have any pecuniary interest,direct or indirect,in the approved Agreement or the proceeds thereof. 7. PROVIDER assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that no person shall,on the grounds of race,creed,color,sex,or national origin,be excluded from participation in,be denied the benefits of,or be otherwise subjected to discrimination under this approved Contract. 8. PROVIDER assures that sufficient,auditable,and otherwise adequate records that will provide accurate, current,separate,and complete disclosure of the status of the funds received under the Contract are maintained for three(3)years or the completion and resolution of an audit. Such records shall be sufficient to allow authorized local,Federal,and State auditors,and representatives to audit and monitor PROVIDER. 9. All such records,documents,communications,and other materials shall be the property of Human Services and shall be maintained by PROVIDER,in a central location and custodian,in behalf of Human Services,for a period of four(4)years from the date of final payment under this Contract,or for such further period as may be necessary to resolve any matters which may be pending,or until an audit has been completed with the following qualifications: If an audit by or on behalf of the federal and/or state government has begun but is not completed at the end of the four(4)year period,or if audit findings have not been resolved after a four(4)year period,the materials shall be retained until the resolution of the audit finding. 10. PROVIDER assures that authorized local,federal,and state auditors and representatives shall,during business hours,have access to inspect any copy records,and shall be allowed to monitor and review through on-site visits,all contract activities,supported with funds under this Contract to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. Page 7 of 9 11-12-RESPITE CARE 11. This Contract shall be binding upon the parties hereto,their successors,heirs,legal representatives,and assigns. PROVIDER or Human Services may not assign any of its rights or obligations hereunder without the prior written consent of both parties. 12. PROVIDER certifies that federal appropriated funds have not been paid or will be paid,by or on behalf of PROVIDER,to any person for influencing or attempting to influence an officer or employee of an agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any federal grant,the making of any federal loan,the entering into of any cooperative agreement,and the extension,continuation,renewal, amendment,or modification of any Federal contract,loan,grant,or cooperative agreement. 13. PROVIDER assures that it will fully comply with all other applicable federal and state laws. PROVIDER understands that the source of funds to be used under this Contract is Child Welfare Regular Administration funds. 14. PROVIDER assures and certifies that it and its principals: a. Are not presently debarred,suspended,proposed for debarment,declared ineligible or voluntarily excluded from covered transaction by a federal department or agency. b. Have not,within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining,attempting to obtain,or performing a public(federal,state,or local)transaction or contract under a public transaction;violation of federal or state antitrust statutes or commission of embezzlement, theft,forgery,bribery,falsification or destruction of records,making false statements,or receiving stolen property; c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state,or local)with commission of any of the offenses enumerated in paragraph I4(b)of this certification;and d. Have not within a three-year period preceding this Contract,had one or more public transactions (federal,state,and local)terminated for cause or default. 15. The Appearance of Conflict of Interest applies to the relationship of a contractor with Human Services when the contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest,it is not necessary for the contractor to gain from knowledge of these opposing interests. It is only necessary that the contractor know that the two relationships are in opposition.During the term of the Contract,PROVIDER shall not enter any third party relationship that gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation,PROVIDER shall submit to Human Services,a full disclosure statement setting forth the details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for Human Services' termination,for cause,of its contract with PROVIDER. 16. PROVIDER shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Contract. Except for purposes directly connected with the administration of Child Protection,no information about or obtained from any applicant/recipient in possession of PROVIDER shall be disclosed in a form identifiable with the applican/recipient or a minor's parent or guardian unless in accordance with PROVIDER written policies governing access to,duplication and dissemination of,all such information. PROVIDER shall advise its employees,agents,and subcontractors,if any,that they are subject to these confidentiality requirements. PROVIDER shall provide its employees,agents,and subcontractors,if any,with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. Page 8 of 9 11-12-RESPITE CARE 17. Proprietary information for the purposes of this contract is information relating to a party's research, development,trade secrets,business affairs,internal operations and management procedures and those of its customers,clients or affiliates,but does not include information(1)lawfully obtained from third parties,(2) that which is in the public domain,or(3)that which is developed independently. Neither party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of this Contract. Any proprietary information removed from the State's site by PROVIDER in the course of providing services under this Contract will be accorded at least the same precautions as are employed by PROVIDER for similar information in the course of its own business. 18. PROVIDER certifies that s/he will abide by Colorado Revised Statute(C.R.S.)26-6-104,requiring criminal background checks for all employees,contractors,and sub-contractors. Page 9 of 9 11-12-RESPITE CARE CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND PROVIDER This Agreement, made and entered into the day of ,20_,by and between the Board of Weld County Commissioners, sitting as the Board of Human on ehalf of W d County Department of Human Services,hereinafter referred to as"Human Services,"and l lla{M kit- referred to as"Provide[". WITNESSETH WHEREAS,required approval,clearance,and coordination have been accomplished from and with appropriate agencies;and WHEREAS,the Colorado Department of Human Services has provided Child Welfare Regular Administration funding for respite care for county foster care PROVIDERS and WHEREAS,Provider is a for-profit Sole-Proprietor. NOW THEREFORE,in consideration of the premises,the parties hereto covenant and agree as follows: 1. Term This Agreement shall become effective on July 1,20/1,upon proper execution of this Agreement and shall expire June 30,20 aimless sooner terminated as provided herein. 2. Scope of Services Services shall be provided by Provider to any person(s)eligible for child protection services in compliance with Exhibit A"Scope of Services,"a copy of which is attached by reference. 3. Payment a. Payment shall be made on the basis of Exhibit B,"Payment Schedule,"copies of which are attached hereto and incorporated herein by reference. b. "Payment Schedule"shall establish the maximum reimbursement, which will be paid from Child Welfare Regular Administration funds during the duration of this Agreement. c. PROVIDER shall submit an itemized monthly bill to Human Services for all costs incurred and services provided pursuant to Exhibit A of this Agreement in accordance with criteria established by Human Services. PROVIDER shall submit all itemized monthly billings to Human Services no later than the twenty-fifth(25)day of the month following the month the cost was incurred. d. Payments of costs incurred pursuant to this Agreement are expressly contingent upon the availability of Child Welfare Regular Administration funds to Human Services. e. Human Services shall not be billed for,and reimbursement shall not be made for time involved in activities outside of those defined in Exhibit A. Work performed prior to the execution of this Contract shall not be reimbursed or considered part of this Agreement. 4. Financial Management At all times from the effective date of this Contract until completion of this Contract,PROVIDER shall comply with the administrative requirements,cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under Child Welfare Regular Administration funding must conform to the Single Audit Act of 1984 and OMB Circular A-133. Page 1 of 9 1 l-12-RESPITE CARE 5. Payment Method Unless otherwise provided in the Scope of Services and Payment Schedule: a. PROVIDER shall provide proper monthly invoices and itemization of services performed for costs incurred in the performance of the agreement. b. Human Services may withhold any payment if PROVIDER has failed to comply with the Financial Management Requirements,program objectives,contractual terms,or reporting requirements. In the event of a forfeiture of reimbursements,PROVIDER may appeal such circumstance to the Director of Human Services. The decision of the Director of Human Services shall be final. 6. Assurances PROVIDER shall abide by all assurances as set forth in the attached Exhibit C,which is attached hereto and incorporated herein by reference. 7. Compliance with Applicable Laws At all times during the performance of this contract,PROVIDER shall strictly adhere to all applicable federal and state laws,orders,and all applicable standards,regulations,interpretations or guidelines issued pursuant thereto. This includes the protection of the confidentiality of all applicant/recipient records,papers,documents, tapes and any other materials that have been or may hereafter be established which relate to the Contract. PROVIDER acknowledges that the following laws are included: - Title VI of the Civil Rights Act of 1964,42 U.S.C.Sections 2000d—I et.seq.and its implementing regulation, 45 C.F.R.Part 80 et.seq.•and - Section 504 of the Rehabilitation Act of 1973,29 U.S.C.Section 794,and its implementing regulations,45 C.F.R.Part 84;and - the Age Discrimination Act of 1975,42 U.S.C.Sections 6101 et.seq.and its implementation regulations,45 C.F.R. Part 91;and - Title VII of the Civil Rights Act of 1964;and - the Age Discrimination in Employment Act of 1967;and - the Equal Pay Act of 1963;and - the Education Amendments of 1972;and - Immigration Reform and Control Act of 1986,P.L.99-603; - 42 C.F.R.Part 2 and all regulations applicable to these laws prohibiting discrimination because of race, color,National origin,and sex,religion and handicap,including Acquired Immune Deficiency syndrome (AIDS)or AIDS related conditions,covered under Section 5044 of the Rehabilitation Act of 1973,as amended,cited above. If necessary,PROVIDER and Human Services will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 CFR Part 2. Included in 45 C.F.R.Pan 74 Appendix G 9, which requires that affirmative steps be taken to assure that small and minority businesses are utilized,when possible,as sources of supplies,equipment,construction and services. This assurance is given in consideration of and for the purpose of obtaining any and all federal and/or state financial assistance. Any person who feels that s/he has been discriminated against has the right to file a complaint either with the Colorado Department of Human Services or with the U.S. Department of Health and Human Services,Office for Civil Rights. 8. Certifications PROVIDER certifies that,at the time of entering into this Contract,it has currently in effect all necessary licenses,approvals,insurance,etc.,required to properly provide the services and/or supplies covered by this contract. A copy of certificate will be provided to Human Services upon completion of this agreement. Failure to do so will null and void this contract in its entirety. Page 2 of 9 11-12-RESPITE CARE 9. Monitoring and Evaluation PROVIDER and Human Services agree that monitoring and evaluation of the performance of this Agreement shall be conducted by PROVIDER and Human Services. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners and PROVIDER. PROVIDER shall permit Human Services,and any other duly authorized agent or governmental agency,to monitor all activities conducted by PROVIDER pursuant to the terms of this Agreement. As the monitoring agency may in its sole discretion deem necessary or appropriate,such program data,special analyses,on-site checking,formal audit examinations,or any other reasonable procedures. All such monitoring shall be performed in a manner that will not unduly interfere with agreement work. 10. Modification of Agreement All modifications to this agreement shall be in writing and signed by both parties. 11. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find PROVIDER substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by PROVIDER. These remedial actions are as follows: a. Withhold payment to PROVIDER until the necessary services or corrections in performance are satisfactorily completed; b. Deny payment or recover reimbursement for those services or deliverables, which have not been performed and which due to circumstances caused by PROVIDER cannot be performed or if performed would be of no value to Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; c. Incorrect payment to PROVIDER due to omission,error,fraud,and/or defalcation shall be recovered from PROVIDER by deduction from subsequent payments under this Agreement or other agreements between Human Services and PROVIDER,or by Human Services as a debt due to Human Services or otherwise as provided by law. 12. Representatives For the purpose of this Agreement,the individuals identified below are hereby designated representatives of the respective parties. Either party may from time to time designate in writing a new or substitute representative(s): For Human Services: Gloria Romansik Human Services Administrator Name Title For Provider: wl •I/ ,C{M She/Q/t9r' -Respite Care Provider Name Title 13. Notice All notices required to be given by the parties hereunder shall be given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing a substitute person(s)or address to whom such notices shall be sent: • To: Human Services To: t i " O-•"'s 5 ke ide7 Judy A.Griego,Director Sa(3 5/`, Uarce C t P.O.BoxA SC917n `.'tot)ti CO ( OS b/ Greeley.CO 80632 Page 3 of 9 11-12-RESPITE CARE 14, Litigation PROVIDER shall promptly notify Human Services in the event that PROVIDER learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement.PROVIDER, within five(5)calendar days after being served with a summons,complaint,or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s)to the Human Services Director. The term"litigation"includes an assignment for the benefit of creditors,and filings in bankruptcy,reorganization and/or foreclosure. IS. Termination This Agreement may be terminated at any time by either party given thirty(30)days written notice and is subject to the availability of funding. PROVIDER reserves the right to suspend services to clients if funding is no longer available. 16. Entire Agreement This Agreement,together with all attachments hereto,constitutes the entire understanding between the parties with respect to the subject matter hereof,and may not be changed or modified except as stated in Paragraph 10 herein. 17. No Third Party Beneficiary. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. IS. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may posses,nor shall any portion of this Agreement be deemed to have created a duty of care which did not previously exist with respect to any person not a party to this Agreement. IN WITNESS WHEREOF,the parties hereto have duly executed the Agreement as of the day,month,and year first above written. BOARD OF COUNTY COMMISSIONERS WELD COUNTY,COLO' •,00 ATTEST: AV, , A yer Wel County Clerk to the Board ,�taetsls`arbara K' kmeyer SaLBY: - / ii - �.�. , .. i /'�,) �- �� JUL 0 6 2011 Ieputy Clerk tr e Board V 0,- "Ad, ED AS $ 1861 r7? "� fa ty Attorney WELD COUNTY DEPARTMENT OF HUMAN SERVICES PROVIDER AL kidLx_t_ A.Grie ,Director Respite Provider Page 4 of 9 o2Ol/—/é/� 11-12-RESPITE CARE EXHIBIT A SCOPE OF SERVICES Each Provider will: 1. Complete a fingerprint card for a background check at the PROVIDERS expense with the Colorado Bureau of Investigation. A Federal Bureau of Investigation background check will be done if the Provider has been a resident of the State of Colorado for less than two years. Human Services will clear the Provider through CBI and FBI; 2. Complete a course in CPR and first aid,in which a current copy of the certifications must be provided to Human Services with this agreement. If either certification should expire during the contracted period,the Provider will send a new current certification copy to Human Services; 3. Provide transportation for the child to appointments during the hours of service as agreed upon with the foster parent; 4. Become familiar with State rules and regulations governing certified foster homes; 5. Must be eighteen years of age or older. Page 5 of 9 I I-12-RESPITE CARE EXHIBIT B PAYMENT SCHEDULE 1. Funding and Method of Payment Human Services agrees to reimburse PROVIDER in consideration for the work and services performed under Child Welfare Regular Administration funding. Expenses incurred by PROVIDER, in association with said project prior to the term of this agreement,are not eligible Human Services expenditures and shall not be reimbursed by Human Services. Payment pursuant to this Contract,if Child Welfare Regular Administration funds,whether in whole or in part, is subject to and contingent upon the continuing availability of Child Welfare Regular Administration funds for the purposes hereof. In the event that said funds,or any part thereof,become unavailable as determined by Human Services, Human Services may immediately terminate this Contract or amend it accordingly. 2. Fees for Services Respite care is limited to four hours per week per child. The hours of care may be provided in any combination throughout a month,but not to exceed 16 hours per month. Payment will be$16.75 per each four hour period,but not to exceed$67.(X)per month for 16 hours. Human Services referrals will not be sent to collections by PROVIDER for default of co-pay/fees. Services will be performed regardless of client's refusal or inability to pay co-pay. PROVIDER will collect any applicable sliding scale co-pays and credit Human Services for any payments received on the monthly billing statements. 3. Submittal of Vouchers PROVIDER shall prepare and submit monthly,the itemized voucher and certify that the services authorized were provided on the date indicated and the charges made were pursuant to the terms and conditions of Exhibit A. Page 6 of 9 1 I-I2-RESPITE CARE EXHIBIT C ASSURANCES I. PROVIDER agrees it is an independent contractor and that its officers and employees do not become employees of Weld County, nor are they entitled to any employee benefits as Weld County employees, as the result of the execution of this Agreement. 2. Weld County,the Board of County Commissioners of Weld County,its officers and employees,shall not be held liable for injuries or damages caused by any negligent acts or omissions of PROVIDER-contracted PROVIDERS or its employees,volunteers,or agents while performing duties as described in this Agreement. PROVIDER shall indemnify,defend,and hold harmless Weld County,the Board of County Commissioners of Weld County,its employees, volunteers,and agents. PROVIDER shall provide adequate liability and worker's compensation insurance for all its employees,volunteers,and agents engaged in the performance of the Agreement upon request,PROVIDER shall provide Human Services with the acceptable evidence that such coverage is in effect. 3. No portion of this Contract shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may possess, not shall any portion of this Agreement be deemed to have treated a duty of care with respect to any persons not a party of this Agreement. 4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld,State of Colorado,to expend funds not otherwise appropriated in each succeeding year. 5. If any section, subsection,paragraph,sentence,clause,or phrase of this Contract is for any reason held or decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The parties hereto declare that they would have entered into this Contract and each and every section,subsection, paragraph, sentence,clause,and phrase thereof irrespective of the fact that any one or more sections, subsections,paragraphs, sentences,clauses,or phrases might be declared to be unconstitutional or invalid. 6. No officer,member or employee of Weld County and no member of their governing bodies shall have any pecuniary interest,direct or indirect,in the approved Agreement or the proceeds thereof. 7. PROVIDER assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that no person shall,on the grounds of race,creed,color,sex,or national origin,be excluded from participation in,be denied the benefits of,or be otherwise subjected to discrimination under this approved Contract. 8. PROVIDER assures that sufficient, auditable,and otherwise adequate records that will provide accurate, current,separate,and complete disclosure of the status of the funds received under the Contract are maintained for three(3)years or the completion and resolution of an audit. Such records shall be sufficient to allow authorized local,Federal,and State auditors,and representatives to audit and monitor PROVIDER. 9. All such records,documents,communications,and other materials shall be the property of Human Services and shall be maintained by PROVIDER,in a central location and custodian,in behalf of Human Services, for a period of four(4)years from the date of final payment under this Contract,or for such further period as may be necessary to resolve any matters which may be pending,or until an audit has been completed with the following qualifications: If an audit by or on behalf of the federal and/or state government has begun but is not completed at the end of the four(4)year period,or if audit findings have not been resolved after a four(4)year period,the materials shall be retained until the resolution of the audit finding. 10. PROVIDER assures that authorized local,federal,and state auditors and representatives shall,during business hours, have access to inspect any copy records,and shall be allowed to monitor and review through on-site visits, all contract activities,supported with funds under this Contract to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. Page 7 of 9 11-12-RESPITE CARE 11. This Contract shall be binding upon the parties hereto,their successors,heirs,legal representatives,and assigns. PROVIDER or Human Services may not assign any of its rights or obligations hereunder without the prior written consent of both parties. 12. PROVIDER certifies that federal appropriated funds have not been paid or will be paid,by or on behalf of PROVIDER,to any person for influencing or attempting to influence an officer or employee of an agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any federal grant,the making of any federal loan,the entering into of any cooperative agreement. and the extension,continuation,renewal, amendment,or modification of any Federal contract,loan,grant,or cooperative agreement. 13. PROVIDER assures that it will fully comply with all other applicable federal and state laws. PROVIDER understands that the source of funds to be used under this Contract is Child Welfare Regular Administration funds. 14. PROVIDER assures and certifies that it and its principals: a. Are not presently debarred,suspended,proposed for debarment,declared ineligible or voluntarily excluded from covered transaction by a federal department or agency. b. Have not, within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining,attempting to obtain,or performing a public(federal,state,or local)transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft,forgery,bribery,falsification or destruction of records,making false statements,or receiving stolen property; c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state,or local) with commission of any of the offenses enumerated in paragraph 14(b)of this certification;and d. Have not within a three-year period preceding this Contract,had one or more public transactions (federal,state,and local)terminated for cause or default. 15. The Appearance of Conflict of Interest applies to the relationship of a contractor with Human Services when the contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest,it is not necessary for the contractor to gain from knowledge of these opposing interests. It is only necessary that the contractor know that the two relationships are in opposition.During the term of the Contract,PROVIDER shall not enter any third party relationship that gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation,PROVIDER shall submit to Human Services,a full disclosure statement setting forth the details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for Human Services' termination,for cause,of its contract with PROVIDER. I6. PROVIDER shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Contract. Except for purposes directly connected with the administration of Child Protection,no information about or obtained from any applicant/recipient in possession of PROVIDER shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with PROVIDER written policies governing access to,duplication and dissemination of,all such information. PROVIDER shall advise its employees,agents,and subcontractors, if any,that they are subject to these confidentiality requirements. PROVIDER shall provide its employees,agents,and subcontractors,if any, with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. Page 8 of 9 1I-12-RESPITE CARE 17. Proprietary information for the purposes of this contract is information relating to a party's research, development,trade secrets,business affairs,internal operations and management procedures and those of its customers,clients or affiliates,but does not include information(I)lawfully obtained from third parties,(2) that which is in the public domain,or(3)that which is developed independently. Neither party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of this Contract. Any proprietary information removed from the State's site by PROVIDER in the course of providing services under this Contract will be accorded at least the same precautions as are employed by PROVIDER for similar information in the course of its own business. 18. PROVIDER certifies that s/he will abide by Colorado Revised Statute(C.R.S.)26-6-104,requiring criminal background checks for all employees,contractors,and sub-contractors. Page 9 of 9 Hello