HomeMy WebLinkAbout20101395.tiff MEMORANDUM
6
fre
.. DATE: June 24, 2010
inik� TO: Douglas Rademacher, Chair, Board of ounty Co issioners t lii,FROM: Judy A. Griego, Director, Human Se lc s�Dep iiine tj• `
COLORADO RE: Respite Agreement between the Weld County Department
of Human Services and Wade and Loni Corliss for Consent
Agenda
Enclosed for Board approval is a Respite Agreement between the Department and Wade and Loni
Corliss. This Agreement can be placed on the Consent Agenda.
The major provisions for this Agreement are:
No. Provider Term Rate
1 Roderick, Chelsi July 1, 2009 — June 30, 2010 $16.75 per four hours
Max. $67.00 per month
for 16 hours
If you have questions, please give me a call at extension 6510.
(moo)vaL't L out-- C,C. I t-}5
lP- 8-a ° -1 -I -lo
2010-1395
f/2cX)Pi
09-10-RESPITE CARE
CHILD PROTECTION AGREEMENT FOR SERVICES
BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES
AND PnnRgwD9t P 3: til
This Agreement, made and entered into the,; day of J Lula_ ,20/0,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 (rf.gbi .trick 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,"and Exhibit C,"Fee 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
Page 1 of 10
o?o/o- /395
09-10-RESPITE CARE
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.
5. Payment Method
J -14 P 3: 4I
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 D,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
implementing regulations,45 C.F.R. Part 84;and
-the Age Discrimination Act of 1975,42 U.S.C. Sections 6101 a 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 10
09-10-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. ( L -it4 't t P 3: 4
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 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. 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:
Chti\S 1 VA5C,VCV ICI` Respite Care Provider
Name Title
Page 3 of 10
09-10-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: t!^== —fl P 3= 41
Judy A.Griego,Director
P.O.Box A
Greeley,CO 80632
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.
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.
ATTEST:
WELD COUNTY �`\ �• 1_ /� BOARD OF COUNTY
CLERK TO THE BOARD ,tl/ �. , ` OMMISSIONERS WELD
-�tO Y,COLORADO
Deputy Clerk 5 r' q , air, /Dougla Rademacher
� nD'b, JUN 2 82010
Page 4of10
°Ro/o- !3395
09-10-RESPITE CARE
APP ED A Provider
" BY
County Attorney Respite Provi r p 3: 4
WELD COUNTY DEPARTMENT
OF HUMAN SERVICES
By:
J y A.Gri o, Direct
Page 5 of 10
09-10-RESPITE CARE
EXHIBIT A
SCOPE OF SERVICES
Each Provider will: Z !j',j lI p 3 42
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 6 of 10
09-10-RESPITE CARE
EXHIBIT B
PAYMENT SCHEDULE
I. Funding and Method of Payment ;, -11 P 3: 42
---
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 according to the criteria listed under
"Standards of Responsibility" in Exhibit E,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 7 of 10
09-10-RESPITE CARE
EXHIBIT C
ASSURANCES. P 3: q2
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,subsections,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 8 of 10
09-10-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.
20!0 L'u:! -U P 3: 42
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 of 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 11(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 subcontractor, 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 9 of 10
09-10-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 TOiO
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?,
' Ceti
C
C
Page 10 of 10
WELD COUNTY LICENSED HOME MANADATORY REPORTERS
As a Foster Parent for any licensed WCDHS Home, you are a mandated reporter and required by Colorado Statute 11
304 Persons required to report child abuse or neglect AND Colorado Department of Human Services Rules and
Regulations, Volume 7, section 7.701.53 Reporting of Child Abuse. Please read the Statute and CDHS Rule below;
7.701.53 Reporting of Child Abuse
A. A child care facility must require each staff member of the facility to read and sign a statement clea
defining child abuse and neglect pursuant to state law and outlining the staff member's personal
responsibility to report all incidents of child abuse or neglect according to state law.
B. Any caregiver or staff member in a child care facility who has reasonable cause to know or suspect that a c
has been subjected to abuse or neglect or who has observed the child being subjected to circumstances or
conditions that would reasonably result in abuse or neglect must immediately report or cause a report to be m
of such fact to the county department of social services or local law enforcement agency.
C. If the suspected child abuse occurred at the child care facility, the report of suspected child abuse must be
made to the county department of social services, police department, or other law enforcement agency in the
community or county in which the child care facility is located.
D. If the suspected child abuse did not occur at the child care facility, the report of suspected child abuse mus
made to the county department of social services in the county in which the child resides or to the local law
enforcement agency in the community in which the incident is believed to have occurred.
E. At the time of admission the facility must give the child's parent or guardian information that explains how tc
report suspected child abuse or child neglect.
19-3-304. Persons required to report child abuse or neglect
(1)Except as otherwise provided by section 19-3-307 and sections 25-1-122 (4) (d) and 25-4-1404 (1) (d), C.R
any person specified in subsection (2) of this section who has reasonable cause to know or suspect that a chil
has been subjected to abuse or neglect or who has observed the child being subjected to circumstances or
conditions which would reasonably result in abuse or neglect shall immediately upon receiving such informatic
report or cause a report to be made of such fact to the county department or local law enforcement agency.
(2) Persons required to report such abuse or neglect or circumstances or conditions shall include any:
(a) Physician or surgeon, including a physician in training;
(b) Child health associate;
(c) Medical examiner or coroner;
(d) Dentist;
(e) Osteopath;
(f) Optometrist;
(g) Chiropractor;
(h) Chiropodist or podiatrist;
(i) Registered nurse or licensed practical nurse;
(j) Hospital personnel engaged in the admission, care, or treatment of patients;
(k) Christian science practitioner;
(I) Public or private school official or employee;
(m) Social worker or worker in any facility or agency that is licensed or certified pursuant to part 1 of
article 6 of title 26, C.R.S.; •
(n) Mental health professional;
(o) Dental hygienist;
(p) Psychologist;
(q) Physical therapist;
(r) Veterinarian;
(s) Peace officer as described in section 16-2.5-101, C.R.S.;
(t) Pharmacist;
(u) Commercial film and photographic print processor as provided in subsection (2.5) of this section;
(v) Firefighter as defined in section 18-3-201 (1), C.R.S.;
Revised April 15, 2010
(w) Victim's advocate, as defined in section 13-90-107 (1) (k) (II), C.R.S.;
(x) Licensed professional counselors;
(y) Licensed marriage and family therapists;
(z) Unlicensed psychotherapists;
(aa) (I) Clergy member.
(II) The provisions of this paragraph (aa) shall not apply to a person who acquires reasonable cause to know or
suspect that a child has been subjected to abuse.prinIgieat d1-'!i incj:ak2mmunication about which the person may
not be examined as a witness pursuant to secN tt-90-107 (1) (c), C.R.S., unless the person also acquires such
reasonable cause from a source other than such a communication.
(III) For purposes of this paragraph (aa), unless the context otherwise requires, "clergy member' means a priest,
rabbi, duly ordained, commissioned, or licensed minister of a church, member of a religious order, or recognized
leader of any religious body.
(bb) Registered dietitian who holds a certificate through the commission on dietetic registration and who is
otherwise prohibited by 7 CFR 246.26 from making a report absent a state law requiring the release of this
information;
(cc)Worker in the state department of human services;
(dd) Juvenile parole and probation officers;
(ee) Child and family investigators, as described in section 14-10-116.5, C.R.S.;
(ff) Officers and agents of the state bureau of animal protection, and animal control officers.
(2.5)Any commercial film and photographic print processor who has knowledge of or observes, within the scope
of his or her professional capacity or employment, any film, photograph, video tape, negative, or slide depicting a
child engaged in an act of sexual conduct shall report such fact to a local law enforcement agency immediately or
as soon as practically possible by telephone and shall prepare and send a written report of it with a copy of the
film, photograph, video tape, negative, or slide attached within thirty-six hours of receiving the information
concerning the incident.
•
(3) In addition to those persons specifically required by this section to report known or suspected child abuse or
neglect and circumstances or conditions which might reasonably result in abuse or neglect, any other person may
report known or suspected child abuse or neglect and circumstances or conditions which might reasonably result
in child abuse or neglect to the local law enforcement agency or the county department.
(3.5) No person, including a person specified in subsection (1) of this section, shall knowingly make a false report
of abuse or neglect to a county department or local law enforcement agency.
(4)Any person who willfully violates the provisions of subsection (1) of this section or who violates the provisions
of subsection (3.5) of this section:
(a) Commits a class 3 misdemeanor and shall be punished as provided in section 18-1.3-501, C.R.S.;
(b) Shall be liable for damages proximately caused thereby.
(l nCIS I C Y Cs( , acknowledge that I/we have been informed and reviewed
the Mandated Repo ' and understand its content and am/are responsible to implement the required procedures.
CA- 5_5O-
FosterParent Sig Si
gnature Date Foster Parent Si nature Date
N
Original: FC Certification Specialist Yellow: Foster Parent
Revised April 15, 2010
WELD COUNTY DISCIPLINE POLICY FOR ALL LICENSED HOMES
Discipline is a means of teaching new behavior, providing structure, and setting limit:
It is a tool designed to direct and give children a sense of security and consistency :
their lives. Discipline may include; talking to children, praise for appropriate
behaviors, diversion, separation and/or withholding privileges.
7.708.34 The Prohibited Use of Cruel and Aversive Therapy
The family foster care home shall refrain from engaging in all cruel and aversive treatment or therapy including, but nc
limited to, the following:
A. Any intervention designed to or likely to cause a foster child physical pain.
B. Releasing noxious, or toxic, sprays, mists, or substances in proximity to the foster child's face.
C. Any intervention that denies a foster child sleep, food, water, shelter, access to bathroom facilities,
adequate bedding or appropriate physical comfort.
D. Any intervention or type of treatment that subjects a foster child to verbal abuse, ridicule, humiliation c
that can be expected to cause excessive emotional trauma.
E. Interventions that use a device, material, or object that is designed to simultaneously immobilize all fo
the foster child's extremities.
F. Any treatment intervention that deprives a foster child of the use of his/her senses, including sight,
hearing, touch, taste, or smell.
G. The use of mechanical restraints, including but not limited to, the use of handcuffs, shackles, straight
jackets, posey vests, ankle and wrist restraints, craig beds, vail beds, and chest restraints.
H. Physical restraint, except as described at 7.714.90, and locked seclusion.
Use of rebirthing therapy or any therapy technique that may be considered similar to rebirthing therap,
a therapeutic treatment, as defined by Section 12-43-222(1)(t)(IV), C.R.S.
7.708.35 Discipline
A. The family foster care home or certifying authority shall have written policies and procedures regardini
discipline that must be explained to all foster children, parent(s), guardian(s), staff, and placing agenci
These policies must include positive responses to a foster child's appropriate behavior.
B. Discipline shall be constructive or educational in nature and may include talking with the foster child al
the situation, praise for appropriate behavior, diversion, separation from the problem situation, and
withholding privileges.
C. Basic rights shall not be denied as a disciplinary measure.
D. Separation when used as discipline must be brief and appropriate to the foster child's age and
-- circumstances. The foster child shall always be within hearing of an adult in a safe, clean, well-lightec
well-ventilated room in the family foster care home that contains at least 50 square feet of floor space.
No foster child shall be isolated in a bathroom, closet or pantry.
E. Foster children in care at the family foster care home shall not discipline other foster children.
F. A family foster care home shall prohibit all cruel and unusual discipline including, but not limited to, the
following:
1. Any type of physical hitting or any type of physical punishment inflicted in any manner upon th
body of the foster child, such as spanking, striking, swatting, punching, shaking, biting, hair
pulling, rough handling a foster child, striking with an inanimate object, or any humiliating or
frightening method of discipline to control the actions of any foster child or group of foster
children.
2. Discipline that is designed to, or likely to, cause physical pain.
3. Physical exercises such as running laps, push-ups, or carrying heavy rocks, bricks, or lumber
when used solely as a means of punishment.
4. Assignment of physically strenuous or harsh work that could result in harm to the foster child.
5. Requiring or forcing a foster child to take an uncomfortable position such as squatting or bend'
or requiring a foster child to stay in a position for an extended length of time such as standing
nose to the wall, holding hands over head, or sitting in a cross-legged position on the floor, or
requiring or forcing a foster child to repeat physical movements when used solely as a means
punishment.
6. Verbal abuse or derogatory remarks about the foster child, his/her family, his/her race, religion
cultural background.
Revised April 15, 2010
7. Denial of any essential/basic program service solely for disciplinary purposes.
8. Deprivation of meals or snacks, although scheduled meals or snacks may be provided
individually. 2013 „ii✓ -t[ P 3: 43
9. Denial of visiting or communication privileges with family, clergy, attorney, or caseworker solely
as a means of punishment.
10. Releasing noxious, toxic, or otherwise unpleasant sprays, mists, or aerosol substances in
proximity to the foster child's face.
11. Denial of sleep.
12. Requiring the foster child to remain silent for a period of time inconsistent with the foster child's
age, developmental level, or medical condition.
13. Denial of shelter, clothing or bedding.
14. Withholding of emotional response or stimulation.
15. Discipline associated with toileting, toileting accidents or lapses in toilet training.
16. Sending a foster child to bed as punishment. This does not prohibit a family foster care home
from setting individual bed times for foster children.
17. Force feeding a foster child.
18. Isolating a foster child in a locked room for discipline.
19. Use of physical or mechanical restraint as discipline for a foster child, including, but not limited to,
the use of handcuffs, shackles, straight jackets, posey vests, ankle and wrist restraints, craig
beds, vail beds, hospital cribs, and chest restraints.
7.708.36 Physical Restraint [Rev. eff. 1/1/07] If a family foster care home uses physical restraint with
a foster child(ren) in care in an emergency situation when the foster child is a danger to himself/herself or others, the
family foster care home must be pre-approved by the certifying authority to conduct restraints and must be in compliance
with all the rules concerning physical restraint as found at Sections 7.714.53 -7.714.536. The family foster care home
must notify the placing caseworker when a child is restrained.
DISREGARD OF ANY OF THE ABOVE RULES OR DISCIPLINARY MEASURES RESULTING IN PHYSICAL INJURY
OR ABUSE TO ANY CHILD SHALL BE GROUNDS FOR DENIAL OR REVOCATION OF THE FOSTER CARE
CERTIFICATION. THIS MAY ALSO RESULT IN CRIMINAL CHARGES BEING FILED AGAINST THE FOSTER
PARENTS.
Please direct all questions with the child's caseworker and your Foster Care Coordinator.
I HAVE RE A D U ERSTAND THE ABOVE STATEMENTS AND WILL ABIDE BY THEM.
5 -3DD -lb
Foster Parent'kicX l C Date
Foster Parent Date
Foster Care Certification Specialist Date
Original: Certification Specialist Yellow: Foster Parent
Revised April 15, 2010
Hello