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Home My WebLink About20112540.tiff MEMORANDUM 1861 - 2011 DATE: September 22, 2011 TO: Barbara Kirkmeyer, Chair, Board of County Commissioners I� WELD—COUNTY FROM: Judy A. Griego, Director, Human es ame� RE: Weld County Addendum to the Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services between the Weld County Department of Human Services and Various Providers to be Placed on the Consent Agenda Enclosed for Board approval are Weld County Addendums to the Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services between the Weld County Department of Human Services and various providers. These Addendums were presented at the Board's June 20, 2011, Work Session. Please place on the Consent Agenda. Below are the major provisions of the attached Agreements: No. Facility Name/Term Type of Facility/Location Daily Rate 1 Arapahoe House Therapeutic Residential Child Care $178.08 July 1, 2011 —June 30, 2012 Residential Child Care Facility $178.08 Thornton, Colorado 2 Shiloh Home Therapeutic Residential Child Care $172.99 July 1, 2011 —June 30, 2012 Residential Child Care Facility $172.99 Littleton, Colorado 3 Shiloh House Therapeutic Residential Child Care $172.99 July 1, 2011 —June 30, 2012 Residential Child Care Facility $172.99 Littleton, Colorado 4 Shiloh House Therapeutic Residential Child Care $172.99 July 1, 2011 —June 30, 2012 Residential Child Care Facility $172.99 Littleton, Colorado 5 Shiloh House Therapeutic Residential Child Care $172.99 July 1, 2011 —June 30, 2012 Residential Child Care Facility $172.99 Littleton, Colorado 6 Shiloh House Therapeutic Residential Child Care $172.99 July 1, 2011 —June 30, 2012 Residential Child Care Facility $172.99 Littleton, Colorado 7 Shiloh House Therapeutic Residential Child Care $172.99 July 1, 2011 —June 30, 2012 Residential Child Care Facility $172.99 ` Littleton, Colorado [�'yLeZG9Z� d=/e/ j/�9122&c1c f yo ,hve ny questions, give me a call at extension 6510. 2011-2540 i16% �0(y9 l N c IJ c\ . �1 11 WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Arapahoe House and Weld County Department of Human Services for the period from July 1,2011 through June 30, 2012. The following provisions, made this / day of t- , 2011, are added to the referenced Agreement. Except as modified hereby, all terms of the greement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#88692, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.08 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.08 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 1. County considers the agreed upon rate, outlined in the Weld County Addendum to this contract, to be all inclusive and shall not pay for additional treatment fees; i.e. Drug/Alcohol and Sex Offender services. 3. Section 1, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. 4. Section I, Paragraph 4. Transportation may include, but is not limited to; visitation with family members, medical/dental or mental health appointments, extracurricular activities, court hearings or other specialized programming. Transportation expectations will be documented on the Child Specific Addendum, SS23B. 5. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Weld County SS-23A Addendum Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing (3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child(30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 6. Add Paragraph 8 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished by the Contractor under this contract for facilities that provide sex offender treatment. 7. Add Paragraph 9 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 8. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 9. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Service Utilization Unit. Contractor shall be notified by County staff of the date and time of the review. 10. Add Paragraph 15 to Section IV. Cooperate with any vendors hired by Weld County Department of Human Services to shorten the duration of placement. 2 Weld County SS-23A Addendum 11. Add Paragraph 16 to Section IV. Have medical examinations completed within 14 days and dental examinations completed within 8 weeks of the child being placed with Contractor. All documentation of these examinations shall be forward to the County. 12. Add Paragraph 17 to Section IV. Arrange a full evaluation of an Individualized Educational Plan(IEP) for youth designated as a Special Education Student every 3 years and coordinate reviews every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 13. Add Paragraph 18 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended,proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions 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 (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 14. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. 15. Add Paragraph 7 to Section VI. 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 or their assignees, and nothing contained 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 or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 3 Weld County SS-23A Addendum 16. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity 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 that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 17. Add Paragraph 9 to Section VI. The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor 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 the Contractor. These remedial actions are as follows: A. Withhold payment to the Contractor 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 the Contractor cannot be performed or if performed would be of no value to the Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Human Services and the Contractor, or by Human Services as a debt to Human Services or otherwise as provided by law. 18. Add Paragraph 10 to Section VI. The contractor shall promptly notify Human Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, 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, reorganizations and/or foreclosure. 4 Weld County SS-23A Addendum IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: Weld County Clerk to the Board WELD COUNTY BOARD OF SOCIAL SERVICES, ON BEHALF iiiii} I�� OF THE WELD COUNTY NN' /4�`N. DEPARTMENT OF HUMAN ¶ $% SERVICES I By:,/ . i .A /. ' fik4 �1 >tf �d a ///t Deputy " erk to the Board NZ/ �ae Chair Signature / Approval as to Substance: °Ep 2 6 2011 PP CONTRACTOR WELD COUNTY DEPARTMENT Arapahoe House OF HUMAN SERVICES 8801 Lipan St Thornton, CO 80260 By: Byc i ctor .27C//-.2161/() 5 Weld County SS-23A Addendum WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Shiloh Home and Weld County Department of Human Services for the period from July 1, 2011 through June 30,2012. The following provisions, made this / day of cS„t.I , 2011, are added to the referenced Agreement. Except as modified hereby, all terms of the /Agreement remain unchanged. County agrees to purchase and Contractor, identified as Provider ID#20335, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$172.99 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$172.99 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 1. County considers the agreed upon rate, outlined in the Weld County Addendum to this contract, to be all inclusive and shall not pay for additional treatment fees; i.e. Drug/Alcohol and Sex Offender services. 3. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. 4. Section I, Paragraph 4. Transportation may include, but is not limited to; visitation with family members, medical/dental or mental health appointments, extracurricular activities, court hearings or other specialized programming. Transportation expectations will be documented on the Child Specific Addendum, SS23B. 5. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: ©ii as yd Weld County SS-23A Addendum ./ Food, shelter, clothing,personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing (3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 6. Add Paragraph 8 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished by the Contractor under this contract for facilities that provide sex offender treatment. 7. Add Paragraph 9 to Section 1. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County,prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 8. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 9. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Service Utilization Unit. Contractor shall be notified by County staff of the date and time of the review. 10. Add Paragraph 15 to Section IV. Cooperate with any vendors hired by Weld County Department of Human Services to shorten the duration of placement. 2 Weld County SS-23A Addendum 11. Add Paragraph 16 to Section IV. Have medical examinations completed within 14 days and dental examinations completed within 8 weeks of the child being placed with Contractor. All documentation of these examinations shall be forward to the County. 12. Add Paragraph 17 to Section IV. Arrange a full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student every 3 years and coordinate reviews every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 13. Add Paragraph 18 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions 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 (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local)terminated for cause or default. 14. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. 15. Add Paragraph 7 to Section VI. 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 or their assignees, and nothing contained 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 or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 3 Weld County SS-23A Addendum 16. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity 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 that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 17. Add Paragraph 9 to Section VI. The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor 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 the Contractor. These remedial actions are as follows: A. Withhold payment to the Contractor 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 the Contractor cannot be performed or if performed would be of no value to the Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Human Services and the Contractor, or by Human Services as a debt to Human Services or otherwise as provided by law. 18. Add Paragraph 10 to Section VI. The contractor shall promptly notify Human Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, 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, reorganizations and/or foreclosure. 4 Weld County SS-23A Addendum IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: Weld County Clerk to the Board WELD COUNTY BOARD OF SOCIAL SERVICES, ON BEHALF IE.La OF THE WELD COUNTY �°� � DEPARTMENT OF HUMAN SERVICES lei By: .�/� /_ -: 1,1 / /`.4\ Liakic Deputy ' erk to the Boa Chair ignature/ Approval as to Substance: CONTRACTOR 'EP 2 6 2011 WELD COUNTY DEPARTMENT Shiloh Home OF HUMAN SERVICES 6400 W Coal Mine Ave Littleton, CO 80123 By' By: QA4.0. ct_O it ctor t ven E. Ramire} CEO 5 Weld County SS-23A Addendum WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Shiloh House and Weld County Department of Human Services for the period from July 1,2011 through June 30, 2012. The following provisions, made this / day of DL.(q , 2011, are added to the referenced Agreement. Except as modified hereby, all terms of the�greement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#54169, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$172.99 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$172.99 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 1. County considers the agreed upon rate, outlined in the Weld County Addendum to this contract, to be all inclusive and shall not pay for additional treatment fees; i.e. Drug/Alcohol and Sex Offender services. 3. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. 4. Section I, Paragraph 4. Transportation may include, but is not limited to; visitation with family members, medical/dental or mental health appointments, extracurricular activities, court hearings or other specialized programming. Transportation expectations will be documented on the Child Specific Addendum, SS23B. 5. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Weld County SS-23A Addendum Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 6. Add Paragraph 8 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished by the Contractor under this contract for facilities that provide sex offender treatment. 7. Add Paragraph 9 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 8. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 9. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Service Utilization Unit. Contractor shall be notified by County staff of the date and time of the review. 10. Add Paragraph 15 to Section IV. Cooperate with any vendors hired by Weld County Department of Human Services to shorten the duration of placement. 2 Weld County SS-23A Addendum 11. Add Paragraph 16 to Section IV. Have medical examinations completed within 14 days and dental examinations completed within 8 weeks of the child being placed with Contractor. All documentation of these examinations shall be forward to the County. 12. Add Paragraph 17 to Section IV. Arrange a full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student every 3 years and coordinate reviews every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 13. Add Paragraph 18 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions 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 (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 14. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. 15. Add Paragraph 7 to Section VI. 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 or their assignees, and nothing contained 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 or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 3 Weld County SS-23A Addendum • 16. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity 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 that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 17. Add Paragraph 9 to Section VI. The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor 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 the Contractor. These remedial actions are as follows: A. Withhold payment to the Contractor 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 the Contractor cannot be performed or if performed would be of no value to the Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Human Services and the Contractor, or by Human Services as a debt to Human Services or otherwise as provided by law. 18. Add Paragraph 10 to Section VI. The contractor shall promptly notify Human Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, 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, reorganizations and/or foreclosure. 4 Weld County SS-23A Addendum IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: Weld County Clerk to the Board WELD COUNTY BOARD OF SOCIAL SERVICES, ON BEHALF lE le OF THE WELD COUNTY ��, DEPARTMENT OF HUMAN SERVICES442 By: " f %"" / . - B ,- i a ' Deputy , erk to the ��/�� p y Chair S' nature Approval as to Substance: CONTRACTOR SEP 2 2011 WELD COUNTY DEPARTMENT Shiloh House OF HUMAN SERVICES 6400 W Coal Mine Ave Littlet By: By: : ,‘,a,,,, C re for S ven E. Ramire CEO aoii-a5%'O 5 Weld County SS-23A Addendum WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Shiloh House and Weld County Department of Human Services for the period from July 1, 2011 through June 30, 2012. The following provisions, made this / day of J" , 2011, are added to the referenced Agreement. Except as modified hereby, all terms of the A reement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#62291, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$172.99 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$172.99 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 1. County considers the agreed upon rate, outlined in the Weld County Addendum to this contract, to be all inclusive and shall not pay for additional treatment fees; i.e. Drug/Alcohol and Sex Offender services. 3. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. 4. Section I, Paragraph 4. Transportation may include, but is not limited to; visitation with family members, medical/dental or mental health appointments, extracurricular activities, court hearings or other specialized programming. Transportation expectations will be documented on the Child Specific Addendum, SS23B. 5. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: a CW--a5yC) I Weld County SS-23A Addendum 4 Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 6. Add Paragraph 8 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished by the Contractor under this contract for facilities that provide sex offender treatment. 7. Add Paragraph 9 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 8. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 9. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Service Utilization Unit. Contractor shall be notified by County staff of the date and time of the review. 10. Add Paragraph 15 to Section IV. Cooperate with any vendors hired by Weld County Department of Human Services to shorten the duration of placement. 2 Weld County SS-23A Addendum 11. Add Paragraph 16 to Section IV. Have medical examinations completed within 14 days and dental examinations completed within 8 weeks of the child being placed with Contractor. All documentation of these examinations shall be forward to the County. 12. Add Paragraph 17 to Section IV. Arrange a full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student every 3 years and coordinate reviews every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 13. Add Paragraph 18 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions 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 (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local)terminated for cause or default. 14. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. 15. Add Paragraph 7 to Section VI. 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 or their assignees, and nothing contained 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 or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 3 Weld County SS-23A Addendum s 16. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity 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 that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 17. Add Paragraph 9 to Section VI. The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor 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 the Contractor. These remedial actions are as follows: A. Withhold payment to the Contractor 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 the Contractor cannot be performed or if performed would be of no value to the Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Human Services and the Contractor, or by Human Services as a debt to Human Services or otherwise as provided by law. 18. Add Paragraph 10 to Section VI. The contractor shall promptly notify Human Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, 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, reorganizations and/or foreclosure. 4 Weld County SS-23A Addendum IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: Weld County Clerk to the Board WELD COUNTY BOARD OF SOCIAL SERVICES, ON BEHALF E Lam OF THE WELD COUNTY DEPARTMENT OF HUMAN �,�'1;2+♦1 SERVICES 462, BY' lh/ J'/ : 1d1 .r�4 �r / J .� siiixk�1�. Deputy s erk to the Boar!'� 1 /� Chair innature / ..EP262011 Approval as to Substance: CONTRACTOR WELD COUNTY DEPARTMENT Shiloh House OF HUMAN SERVICES 6400 W Coal Mine Ave Littleto , CO 80123 By: By: ' Ct, Dir ctor ven E. Ramire /CEO a?C//-a590 5 Weld County SS-23A Addendum WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Shiloh House and Weld County Department of Human Services for the period from July 1, 2011 through June 30, 2012. The following provisions, made this day of £i I, , 2011, are added to the referenced Agreement. Except as modified hereby, all terms of the Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#70967, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$172.99 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$172.99 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter C W-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section 1, Paragraph 1. County considers the agreed upon rate, outlined in the Weld County Addendum to this contract, to be all inclusive and shall not pay for additional treatment fees; i.e. Drug/Alcohol and Sex Offender services. 3. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. 4. Section I, Paragraph 4. Transportation may include, but is not limited to; visitation with family members, medical/dental or mental health appointments, extracurricular activities, court hearings or other specialized programming. Transportation expectations will be documented on the Child Specific Addendum, SS23B. 5. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Weld County SS-23A Addendum • Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing (3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child(30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 6. Add Paragraph 8 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished by the Contractor under this contract for facilities that provide sex offender treatment. 7. Add Paragraph 9 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 8. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number (970) 304-2749. 9. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Service Utilization Unit. Contractor shall be notified by County staff of the date and time of the review. 10. Add Paragraph 15 to Section IV. Cooperate with any vendors hired by Weld County Department of Human Services to shorten the duration of placement. 2 Weld County SS-23A Addendum 11. Add Paragraph 16 to Section IV. Have medical examinations completed within 14 days and dental examinations completed within 8 weeks of the child being placed with Contractor. All documentation of these examinations shall be forward to the County. 12. Add Paragraph 17 to Section IV. Arrange a full evaluation of an Individualized Educational Plan(IEP) for youth designated as a Special Education Student every 3 years and coordinate reviews every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed LEP. A copy will then be forwarded to the County. 13. Add Paragraph 18 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions 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 (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 14. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. 15. Add Paragraph 7 to Section VI. 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 or their assignees, and nothing contained 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 or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 3 Weld County SS-23A Addendum 16. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity 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 that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 17. Add Paragraph 9 to Section VI. The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor 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 the Contractor. These remedial actions are as follows: A. Withhold payment to the Contractor 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 the Contractor cannot be performed or if performed would be of no value to the Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Human Services and the Contractor, or by Human Services as a debt to Human Services or otherwise as provided by law. 18. Add Paragraph 10 to Section VI. The contractor shall promptly notify Human Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, 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, reorganizations and/or foreclosure. 4 Weld County SS-23A Addendum IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: Weld County Clerk to the Board WELD COUNTY BOARD OF SOCIAL SERVICES, ON BEHALF OF THE WELD COUNTY DEPARTMENT OF HUMAN �� SERVICES s P I _�'� By' lia., i ! , ,iii� Bx— 4,/k . . /// . e C Deput lerk to the Bo1 / ` � Chair ignature/ Approval as to Substance: CONTRACTOR SEP 2 2011 WELD COUNTY DEPARTMENT Shiloh House OF HUMAN SERVICES 6400 W Coal Mine Ave Littletpn; 23 f By: By:cl _ Dir ct r S even E. Ramir /CEO O,9D//-07596 5 Weld County SS-23A Addendum WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Shiloh Home and Weld County Department of Human Services for the period from July 1,2011 through June 30,2012. The following provisions, made this / day of au 44 , 2011, are added to the referenced Agreement. Except as modified hereby, all terms of the Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#1528492, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$172.99 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$172.99 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section 1, Paragraph 1. County considers the agreed upon rate, outlined in the Weld County Addendum to this contract, to be all inclusive and shall not pay for additional treatment fees; i.e. Drug/Alcohol and Sex Offender services. 3. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. 4. Section I, Paragraph 4. Transportation may include, but is not limited to; visitation with family members, medical/dental or mental health appointments, extracurricular activities, court hearings or other specialized programming. Transportation expectations will be documented on the Child Specific Addendum, SS23B. 5. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Weld County SS-23A Addendum V Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing (3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 6. Add Paragraph 8 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished by the Contractor under this contract for facilities that provide sex offender treatment. 7. Add Paragraph 9 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County,prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 8. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number (970) 304-2749. 9. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Service Utilization Unit. Contractor shall be notified by County staff of the date and time of the review. 10. Add Paragraph 15 to Section IV. Cooperate with any vendors hired by Weld County Department of Human Services to shorten the duration of placement. 2 Weld County SS-23A Addendum 11. Add Paragraph 16 to Section IV. Have medical examinations completed within 14 days and dental examinations completed within 8 weeks of the child being placed with Contractor. All documentation of these examinations shall be forward to the County. 12. Add Paragraph 17 to Section IV. Arrange a full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student every 3 years and coordinate reviews every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 13. Add Paragraph 18 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions 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 (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local)terminated for cause or default. 14. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. 15. Add Paragraph 7 to Section VI. 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 or their assignees, and nothing contained 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 or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 3 Weld County SS-23A Addendum 16. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity 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 that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 17. Add Paragraph 9 to Section VI. The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor 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 the Contractor. These remedial actions are as follows: A. Withhold payment to the Contractor 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 the Contractor cannot be performed or if performed would be of no value to the Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Human Services and the Contractor, or by Human Services as a debt to Human Services or otherwise as provided by law. 18. Add Paragraph 10 to Section VI. The contractor shall promptly notify Human Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, 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, reorganizations and/or foreclosure. 4 Weld County SS-23A Addendum IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: Weld County Clerk to the Board WELD COUNTY BOARD OF SOCIAL SERVICES, ON BEHALF ` OF THE WELD COUNTY 4 - DEPARTMENT OF HUMAN SERVICES By C 71: Deputy ! erk to the Boars�� jli ; � Chair/Signaturef r °EP262011 Approval as to Substance: CONTRACTOR WELD COUNTY DEPARTMENT Shiloh Home OF HUMAN SERVICES 6400 W Coal Mine Ave Littleton CO B • y By.Die or � / r � St von E. Ramir /CEO OW)//-Q54 5 Weld County SS-23A Addendum . WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Shiloh House and Weld County Department of Human Services for the period from July 1,2011 through June 30, 2012. The following provisions, made this / day of S , 2011, are added to the referenced Agreement. Except as modified hereby, all terms of the greement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#1539982, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$172.99 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$172.99 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section 1, Paragraph 1. County considers the agreed upon rate, outlined in the Weld County Addendum to this contract, to be all inclusive and shall not pay for additional treatment fees; i.e. Drug/Alcohol and Sex Offender services. 3. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. 4. Section I, Paragraph 4. Transportation may include, but is not limited to; visitation with family members, medical/dental or mental health appointments, extracurricular activities, court hearings or other specialized programming. Transportation expectations will be documented on the Child Specific Addendum, SS23B. 5. Add Paragraph 6 to Section 1. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: o?D//-a55'C 1 Weld County SS-23A Addendum Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 6. Add Paragraph 8 to Section 1. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished by the Contractor under this contract for facilities that provide sex offender treatment. 7. Add Paragraph 9 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 8. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 9. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Service Utilization Unit. Contractor shall be notified by County staff of the date and time of the review. 10. Add Paragraph 15 to Section IV. Cooperate with any vendors hired by Weld County Department of Human Services to shorten the duration of placement. 2 Weld County SS-23A Addendum v 11. Add Paragraph 16 to Section IV. Have medical examinations completed within 14 days and dental examinations completed within 8 weeks of the child being placed with Contractor. All documentation of these examinations shall be forward to the County. 12. Add Paragraph 17 to Section IV. Arrange a full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student every 3 years and coordinate reviews every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 13. Add Paragraph 18 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions 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 (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 14. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. 15. Add Paragraph 7 to Section VI. 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 or their assignees, and nothing contained 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 or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 3 Weld County SS-23A Addendum i 16. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity 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 that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 17. Add Paragraph 9 to Section VI. The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor 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 the Contractor. These remedial actions are as follows: A. Withhold payment to the Contractor 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 the Contractor cannot be performed or if performed would be of no value to the Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Human Services and the Contractor, or by Human Services as a debt to Human Services or otherwise as provided by law. 18. Add Paragraph 10 to Section VI. The contractor shall promptly notify Human Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, 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, reorganizations and/or foreclosure. 4 Weld County SS-23A Addendum IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: Weld County Clerk to the Board WELD COUNTY BOARD OF �..� SOCIAL SERVICES, ON BEHALF Side OF THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES tto By. �/ / - ! /Ii'tli3i IJM � Po --/ -flue /cCtbAcF Deputy ' erk to the Boar Chair— Chair Signature Approval as to Substance: CONTRACTOR SEP 2 2011 WELD COUNTY DEPARTMENT Shiloh House OF HUMAN SERVICES 6400 W Coal Mine Ave Littleto , CO 80 3 By: By: tivt Dir ctor St ven E. Ramire /CEO ao//-075/0 5 Weld County 5S-BA Addendum Hello