HomeMy WebLinkAbout20091388.tiffRESOLUTION
RE: APPROVE EIGHTEEN CHILD PROTECTION AGREEMENTS FOR SERVICES WITH
VARIOUS PROVIDERS AND AUTHORIZE CHAIR TO SIGN
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board has been presented with eighteen Child Protection Agreements for
Services between the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County, on behalf of the Department of Human Services, and the
providers listed below, commencing June 1, 2009, and ending May 31, 2010, with further terms
and conditions being as stated in said agreements, and
1. Collaborative Services for Change, PC (Mental Health Services)
2. Collaborative Services for Change, PC (Sex Abuse Treatment)
3. El Pueblo (Day Treatment)
4. Jonathan Garson, LCSW (Mental Health Services)
5. Griffith Centers for Children - Chins Up (Home -Based Intensive Services)
6. Griffith Centers for Children - Chins Up (Lifeskills)
7. Griffith Centers for Children - Chins Up (Mental Health Services)
8. Griffith Centers for Children - Chins Up (Sex Abuse Treatment)
9. Milestones Counseling Services, LLC (Foster Parent Consultation)
10. Milestones Counseling Services, LLC (Home Study)
11. Savio House (Home -Based Services)
12. Turning Point Center for Youth and Family Development, Inc. (Foster Parent
Consultation)
13. Turning Point Center for Youth and Family Development, Inc. (Day Treatment)
14. Turning Point Center for Youth and Family Development, Inc. (Group Home
Therapy)
15. Turning Point Center for Youth and Family Development, Inc. (Home -Based
Services)
16. Turning Point Center for Youth and Family Development, Inc. (Mental Health
Services)
17. Victor Cordero, Psy.D., P.C. (Mental Health Services)
18. Victor Cordero, Psy.D., P.C. (Sex Abuse Treatment)
WHEREAS, after review, the Board deems it advisable to approve said agreements, copies
of which are attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County, Colorado, that the eighteen Child Protection Agreements for Services between the County
of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County,
on behalf of the Department of Human Services, and the providers listed above be, and hereby are,
approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to
sign said agreements.
00 N5
2009-1388
H R0080
c /o7/0/
EIGHTEEN CHILD PROTECTION AGREEMENTS FOR SERVICES WITH VARIOUS PROVIDERS
PAGE 2
The above and foregoing Resolution was, on motion duly made and seconded, adopted by
the following vote on the 17th day of June, A.D., 2009, nunc pro tune June 1, 2009.
ATTEST:
Weld County Clerk t
BY
and
Deputy Clerk to the Boa'd�
APPROVE AS TO
Minty A orney
Date of signature U'�`9/09
_BOARD OF COUNTY COMMISSIONERS
:WELD Y, COLORADO
William F. Garcia Chair
Douglas demacher, ro-Tem
Se n P. Conway
tatuu
lidellar
arbara Kirkmey r
EXCUSED
David E. Long
2009-1388
HR0080
M
F
MEMORANDUM
fiRe.
DATE: June 15, 2009
TO: William F. Garcia, Chair, Board of County Commissioners
J✓ LA LA
FROM: Judy A. Griego, Director, Human Services De artmenn
COLORADO
RE: Child Protection Agreements between the Weld County
Department of Human Services and Various Providers
Enclosed for Board approval are Child Protection Agreements between the Weld County
Department of Human Services and Various Providers. These Agreements were presented at the
Board's April 27, 2009, Work Session.
Below are the major provisions of the attached Agreements:
Provider/Term
Program Areal
Funding Source
PY09-10 Proposed Rate(s)
Collaborative Services
Mental Health
$75.00/Episode (Individual, Couples and Family
for Change (Marci
Services
Therapy, Stallings)
Brewer)
$50.00/Mth (Case Management)
Core
06/01/2009-05/31/2010
Max. $10,000.00
Collaborative Services
Sex Abuse Treatment
$50.00/Hr (Offense -specific Evaluation)
for Change (Marci
$75.00/Episode (Intake, 50 -min Session)
Brewer)
Core
$75.00/Episode (Individual or Family Therapy,
50 -min Session)
06/01/2009-05/31/2010
$50.00/Episode (Group Therapy, 90 -min
Session)
$75.00/Episode (Specialty Services for Disabled
Youth, 50 -min Session)
$100.00/Episode (Field/Off-site Therapy, 50 -min
Session)
$75.00/Episode (Informed Supervision, 1
Person)
$100.00/Episode (2-3 People)
$200.00/Episode (4-6 People)
$300.00/Episode (7-9 People)
$50.00/Mth (Case Management)
Max. $10,000.00
2009-1388
El Pueblo
06/01/2009-05/31/2010
Day Treatment
Core
$69.50/Day (Therapeutic Services)
$51.06/Day (Educational Services)
Max. $36,000.00
Garson, Jon LCSW
06/01/2009-05/31/2010
Mental Health
Services
Core
$95.00/Episode (Individual and Family Therapy)
$50.00/Episode (Group Therapy)
Max. $15,000.00
Griffith Centers for
Children - Chins Up
06/01/2009-05/31/2010
Home -Based
Services
Core
$48.00/Hr (Family Preservation Services)
Max. $15,000.00
Griffith Centers for
Children - Chins Up
06/01/2009-05/31/2010
Lifeskills
Core
$36.00/Hr (Parenting Skills)
$30.00/Hr/Fam. (Parenting Skills Grp, >6)
$45.00/1.5 Hr/Fam. (Parenting Skills Grp., =/> 6)
Max. $15,000.00
Griffith Centers for
Children - Chins Up
06/01/2009-05/31/2010
Mental Health
Services
Core
$52.00/Hr (Ind. Therapy)
$56.00/Hr (Fain. Therapy)
$75.00/Hr (EMDR)
$150.00 (MHA)
Max. $15,000.00
Griffith Centers for
Children - Chins Up
06/W /2009-05/31/2010
Sex Abuse Treatment
Core
$30.00/Hr/PP (SO TX Grp, <6)
$45.00/1.5 Hr/PP (SO TX Grp, =/> 6)
$50.00/Hr (SAI)
$30.00/Hr/Fam (Informed Supervision Grp, <6)
$60.00/Sess/Fam (Informed Supervision Grp,
>6)
$50.00/Hr/PP or $100.00/Sess. (Informed
Supervision - Ind.)
Max. $15,000.00
Milestones Counseling
Services, LLC
06/01/2009-05/31/2010
Foster Parent
Consultation
Core
$540.00 (Evaluation, Intervention, Feedback)
$90.00/Hr (Add. Follow up)
Max. $10,000.00
Milestones Counseling
Services, LLC
06/01/2009-05/31/2010
Home Study
CW Admin
$950.00 (Full HS) $250.00 (Ea. Add. Adult)
$550.00 (Update HS)
$250.00 (Cancelled HS/1-4 hrs of service)
$ .30/Mile (Mileage - HS outside Weld)
$100.00/Hr (Court Testimony)
Max. $10,000.00
Savio House
06/01/2009-05/31/2010
Home -Based
Services
Core
$1,600.00/Mth
Max. $50,000.00
Turning Point Center for
Youth and Family
Development, Inc.
06/01/2009-05/31/2010
Foster Parent
Consultation
Core
$82.00/Hr (Greeley, Evans, La Salle, Eaton,
Windsor)
$120.00/Hr (Areas other than those listed
above.)
$40.00/Hr (24/7 Crisis Support)
$50.00/Hr (Court Testimony)
Max. $35,000.00
Turning Point Center for
Youth and Family
Development, Inc.
06/01/2009-05/31/2010
Day Treatment
Core
$85.00/Day (w/ In -home Therapy)
$75.00/Day (w/o In -home Therapy
Max. $50,000.00
Turning Point Center for
Youth and Family
Development, Inc.
06/01/2009-05/31/2010
Group Home Therapy
CW Admin
$4,500.00/Mth (All inclusive - 5 group homes)
Max. $54,000.00
Turning Point Center for
Youth and Family
Development, Inc.
06/01/2009-05/31/2010
Home -Based
Services
Core
$82.00/Hr (Greeley, Evans, La Salle, Eaton,
Windsor)
$120.00/Hr (Areas other than those listed
above.)
Max. $10,000.00
Turning Point Center for
Youth and Family
Development, Inc.
06/01/2009-05/31/2010
Mental Health
Services
Core
$82.00/Hr (Greeley, Evans, La Salle, Eaton,
Windsor)
$120.00/Hr (Areas other than those listed
above.)
Max. $10,000.00
Victor H. Cordero,
Psy.D., P.C.
06/01/2009-05/31/2010
Mental Health
Services
Core
$1,200.00 (Psych or Interactional)
$700.00 (MHA)
$100.00/Hr (Ind./Cpl/Fam. Therapy)
$100.00/Hr (Court
Facilitation/Staffing/Testimony)
Max. $25,000.00
Victor H. Cordero,
Psy.D., P.C.
06/01/2009-05/31/2010
Sex Abuse Treatment
Core
$60.00/Hr
Max. $5,000.00
If you have any questions, give me a call at extension 6510.
(%I&C�1�r1c
PY-09-10-CORE-0135
CHILD PROTECTION AGREEMENT FOR SERVICES
BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES
AND COLLABORATIVE SERVICES FOR CHANGE, PC
This Agreement, made and entered into the I day of3,2, .t 2009, by and between the Board of
Weld County Commissioners, sifting as the Board of Human Services, on behalf of the Weld County Department of
Human Services, hereinafter referred to as the "Department," and Collaborative Services for Change, PC,
hereinafter referred to as "Contractor".
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 Core Services funding to the
Department for Mental Health Services; and
NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows:
1. Term
This Agreement shall become effective on June 1, 2009, upon proper execution of this Agreement and
shall expire May 31, 2010, unless sooner terminated as provided herein.
2. Scope of Services
Services shall be provided by CONTRACTOR 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," of which are attached
hereto and incorporated herein by reference.
"Payment Schedule" shall establish the maximum reimbursement, which will be paid from
Core Services funding during the duration of this Agreement.
b. CONTRACTOR shall submit an itemized monthly bill to the Department for all costs incurred
and services provided pursuant to Exhibit A of this Agreement in accordance with criteria
established by the Department. CONTRACTOR shall submit all itemized monthly billings to
the Department by the 7th day of the month following the month the cost was incurred. If the
billing is not submitted within twenty-five (25) calendar days of the month following service, it
may result in forfeiture of payment.
c. Payments of costs incurred pursuant to this Agreement is expressly contingent upon the
availability of Core Services to the Department.
d. The Department 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.
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PY-09-10-CORE-0135
4. Financial Management
At all times from the effective date of this Contract until completion of this Contract, CONTRACTOR
shall
comply with the administrative requirements, cost principles and other requirements set forth in the
Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds
expended under Core Service funding must conform to the Single Audit Act of 1984 and OMB Circular A-
133.
5. Payment Method
Unless otherwise provided in the Scope of Services and Payment Schedule:
a. CONTRACTOR shall provide proper monthly invoices and itemization of services performed for
costs incurred in the performance of the agreement.
b. The Department may withhold any payment if CONTRACTOR has failed to comply with the
Financial Management Requirements, program objectives, contractual terms, or reporting
requirements. In the event of a forfeiture of reimbursements, CONTRACTOR may appeal such
circumstance to the Director of Human Services. The decision of the Director of Human Services
shall be final.
6. Assurances
CONTRACTOR shall abide by all assurances as set forth in the attached Exhibit C, which is attached hereto
and incorporated herein by reference.
7. Compliance with Applicable Laws
At all times during the performance of this contract, CONTRACTOR 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. CONTRACTOR acknowledges that the following laws are included:
Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d —1 et. seq. and its implementing
regulation, 45 C.F.R. Part 80 et seq.' and
Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 794, and
its implementing regulations, 45 C.F.R. Part 84; and
the Age Discrimination Act of 1975, 42 U.S.C. Sections 6101 et. seq. and
its implementation regulations, 45 C.F.R. Part 91; and
Title VII of the Civil Rights Act of 1964; and
the Age Discrimination in Employment Act of 1967; and
the Equal Pay Act of 1963; and
the Education Amendments of 1972; and
Immigration Reform and Control Act of 1986, P.L. 99-603;
42 C.F.R. Part 2
and all regulations applicable to these laws prohibiting discrimination because of race, color,
National origin, and sex, religion and handicap, including Acquired Immune Deficiency Syndrome (AIDS)
or AIDS related conditions, covered under Section 504 of the Rehabilitation Act of 1973, as amended,
cited above. If necessary, CONTRACTOR and the Department will resist in judicial proceedings any
efforts to obtain access to client records except as permitted by 42 CFR Part 2.
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PY-09-10-CORE-0135
Included is 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.
S. Compliance with Child and Family Services Review
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas;
Safety, Permanency and Well Being of families. For each outcome, data and performance indicators
measure each state's performance according to national standards and monitor progress over time.
Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance
services to families.
CONTRACTORS providing services to the Department families and children must continually strive for
positive outcomes in the areas of safety, permanency and well being. Contractors providing services in
program areas identified by the Department are required to comply with a standard assessment and
reporting system set forth in Exhibit D which will address the aforementioned three areas.
9. Insurance
CONTRACTOR, shall procure, either personally or through its employer as applicable to the Contractor's
business, at its own expense, and maintain for the duration of the work, the following insurance coverage;
Weld County, Colorado, by and through the Board of County Commissioners of Weld County, its
employees and agents, shall be named as additional named insured on the insurance, where permissible by
the insurance provider.
a. Standard Workman's Compensation and Employer's Liability.
I. As required by state statute including occupational disease, covering all employees at
work site.
b. General Liability (PL & PD) (Minimum).
1. Combined single limit - $500,000 written on an occurrence basis.
2. Any aggregate limit will not be less than $1 million.
3. Provider must purchase additional insurance if claims reduce the annual aggregate below
$500,000.
4. State of Colorado to be named as additional insured on each comprehensive general
liability policy.
5. Certificate of insurance to be provided to Weld County and must be attached to the
contract.
6. Insurance shall include provisions preventing cancellation without 60 days prior notice
by certified mail to Weld County.
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PY-09-10-CORE-0135
c. Automobile Liability (Minimum) for any Contractor transporting children or any party to whom
Department services are being provided.
d. Additional coverage may be required in specific program areas. For any insurances that are
required by this contract, a completed Standard Certificate of Insurance Form shall be provided to
the Department by the Contractor prior to the start of any contract.
10. Certifications
CONTRACTOR 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. Copies of all necessary licenses shall be provided to the Department by the
Contractor prior to the start of any contract.
11. Training
Contractor shall attend a Court Testimony and Ethics Training to be paid for by the Department. The
Contractor may be required to attend additional training at the request of the Department. The cost of such
training will be paid for the Department. The Department will not compensate the Contractor for the time
spent attending the required trainings.
12. Monitoring and Evaluation
CONTRACTOR and the Department agree that monitoring and evaluation of the performance of this
Agreement shall be conducted by CONTRACTOR and the Department. The results of the monitoring and
evaluation shall be provided to the Board of Weld County Commissioners, the Department and
CONTRACTOR.
CONTRACTOR shall permit the Department, and any other duly authorized agent or governmental
agency, to monitor all activities conducted by CONTRACTOR 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.
13. Modification of Agreement
All modifications to this agreement shall be in writing and signed by both parties.
14. Remedies
The Director of Human Services or designee may exercise the following remedial actions should s/he find
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
CONTRACTOR. These remedial actions are as follows:
a. Withhold payment to 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 CONTRACTOR cannot be performed or if
performed would be of no value to the Department. Denial of the amount of payment shall be
reasonably related to the amount of work or deliverables lost to the Department;
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PY-09-10-CORE-0135
c. Incorrect payment to CONTRACTOR due to omission, error, fraud, and/or defalcation shall be
recovered from CONTRACTOR by deduction from subsequent payments under this Agreement or
other agreements between the Department and CONTRACTOR, or by the Department as a debt due to
the Department or otherwise as provided by law.
15. 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 the Department:
Gloria Romansik
Name
For CONTRACTOR:
Marci Brewer, LCSW
Name
Social Services Administrator
Title
Clinical Director/Co-Owner
Title
16. 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: The Department
Judy A. Griego, Director
P.O. Box A
Greeley, CO 80632
(970) 352-1551
To: CONPRACIUR
Marci Brewer, LCSW
2480 W. 26th Avenue, #130-B
Denver, CO 80211
(303) 433-0188
17. Litigation
CONTRACTOR shall promptly notify the Department in the event that CONTRACTOR learns of any
actual litigation in which it is a party defendant in a case that involves services provided under this
Agreement. 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, reorganization and/or foreclosure.
18. 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. CONTRACTOR reserves the right to suspend services to clients if
funding is no longer available.
19. 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 13 herein.
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IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first
above written.
WELD COUNTY DEPARTMENT
OF HUMAN S RVICES
BOARD OF COUNTY
COMMISSIONERS WELD
COUNTY,CpL DO
By:
Chair William F. Garcia
06/17/2009
CONTRACTOR:
BY
By:
Contractor
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PY-09-10-CORE-0135
EXHIBIT A
SCOPE OF SERVICES
1. CONTRACTOR will provide mental health services to clients referred by the Department, in the Denver area.
Services include individual, couples and family therapy to address specific problematic issues that may
include, but are not limited to, abuse recovery, anger management, trauma recovery, behavior disorders, mood
disorders and social skills interventions.
2. All services will be provided by Marci Brewer, LCSW.
3. CONTRACTOR will identify in detail areas of continued concern and make recommendations to the
Department regarding continuation of services and/or the need for additional services.
4. CONTRACTOR will document in detail any and all observed or verbalized concerns regarding any child
whom the CONTRACTOR is working with under an active referral. Areas of concern may include, but are not
limited to, any physical, emotional, educational or behavioral issues. Areas of concern should be reported
immediately AND on the required monthly report.
5. CONTRACTOR will submit reports on a monthly basis for each active referral. Reports will be submitted per
the online format required by the Department.
6. CONTRACTOR will participate in team reviews of ongoing services as requested.
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EXHIBIT B
PAYMENT SCHEDULE
1. Funding and Method of Payment
The Department agrees to reimburse CONTRACTOR in consideration for the work and services
performed from Core Services funding, not to exceed $10,000.00.
Expenses incurred by CONTRACTOR, in association with said project prior to the term of this agreement,
are not eligible Department expenditures and shall not be reimbursed by the Department.
Payment pursuant to this Contract, if Core Services funds, whether in whole or in part, is subject to and
contingent upon the continuing availability of said funds for the purposes hereof. In the event that said
funds, or any part thereof, become unavailable as determined by the Department, the Department may
immediately terminate this Contract or amend it accordingly.
2. Fees for Services
$75.00/Episode (Individual/Couples/Family Counseling, Face -to -Face Contact)
$50.00/Month (Case Management)
Department referrals will not be sent to collections by Contractor for default of co-pay/fees. Services will
be performed regardless of client's refusal or inability to pay co -pay.
Contractor will collect any applicable sliding scale co -pays and credit the Department for any payments
received on the monthly billing statements.
3. Submittal of Vouchers
CONTRACTOR shall prepare and submit monthly the itemized voucher and certify that the services
authorized were provided on the date indicated and the charges made were pursuant to the terms and
conditions of Exhibit A.
a. All billings are to be submitted by the 7th day of the month following the month of
service. If the billing is not submitted within twenty-five (25) calendar days of the month
following service, it may result in forfeiture of payment.
b. Billings must be submitted with the attached required forms, Authorization for
Contractual Services, Request for Reimbursement, Client Verification Form and monthly
report. The Authorization for Contractual Services and Client Verification Form must be
submitted with original signatures.
c. For monitored sobriety, proof of services rendered shall be a sign -in sheet with client
signatures or the test result.
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EXHIBIT C
ASSURANCES
I . CONTRACTOR 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 CONTRACTOR -
contracted CONTRACTOR or its employees, volunteers, or agents while performing duties as described in
this Agreement. CONTRACTOR shall indemnify, defend, and hold harmless Weld County, the Board of
County Commissioners of Weld County, its employees, volunteers, and agents. CONTRACTOR 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, CONTRACTOR shall provide the
Department 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 created a
duty of care with respect to any persons not a party of this Agreement.
4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld, State
of Colorado, to expend funds not otherwise appropriated in each succeeding year.
5. If any section, subsection, paragraph, sentence, clause, or phrase of this Contract is for any reason held or
decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The
parties hereto declare that they would have entered into this Contract and each and every section,
subsection, paragraph, sentence, clause, and phrase thereof irrespective of the fact that any one or more
sections, subsections, paragraphs, sentences, clauses, or phrases might be declared to be unconstitutional or
invalid.
6. No officer, member or employee of Weld County and no member of their governing bodies shall have any
pecuniary interest, direct or indirect, in the approved Agreement or the proceeds thereof.
7. CONTRACTOR 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. CONTRACTOR 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
CONTRACTOR.
9. All such records, documents, communications, and other materials created pursuant or related to this
contract shall be maintained by CONTRACTOR, in a central location and shall be made available to
Social Services upon its request, for a period of seven (7) 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 seven (7) year period, or if
audit findings have not been resolved after a seven (7) period, the materials shall be retained until the
resolution of the audit finding.
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10. CONTRACTOR assures that authorized local, federal, and state auditors and representatives shall, during
business hours, have access to inspect any copy records, and shall be allowed to monitor and review
through on -site visits, all contract activities, supported with funds under this Contract to ensure compliance
with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the
performance of the Agreement shall be conducted by appropriate funding sources. The results of the
monitoring and evaluation activities shall be provided to the appropriate and interested parties.
11. This Contract shall be binding upon the parties hereto, their successors, heirs, legal representatives, and
assigns. CONTRACTOR or the Department may not assign any of its rights or obligations hereunder
without the prior written consent of both parties.
12. CONTRACTOR certifies that federal appropriated funds have not been paid or will be paid, by or on
behalf of CONTRACTOR, 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. CONTRACTOR assures that it will fully comply with all other applicable federal and state laws.
CONTRACTOR understands that the source of funds to be used under this Contract is Core Services
funds.
14. CONTRACTOR 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 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 12 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 the
Department 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,
CONTRACTOR 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, CONTRACTOR
shall submit to the Department, 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 the Department's termination, for cause, of its contract with
CONTRACTOR.
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16. CONTRACTOR 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 CONTRACTOR shall be disclosed in a form identifiable with the applicant/recipient or a
minor's parent or guardian unless in accordance with CONTRACTOR written policies governing access
to, duplication and dissemination of, all such information. CONTRACTOR shall advise its employees,
agents, and subcontractor, if any, that they are subject to these confidentiality requirements.
CONTRACTOR 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.
CONTRACTOR shall have its employees, agents, and subcontractors, if any, sign a written confidentiality
agreement and shall provide a copy of such agreement to the Department, if requested.
17. Proprietary information for the purposes of this contract is information relating to a party's research,
development, trade secrets, business affairs, internal operations and management procedures and those of
its customers, clients or affiliates, but does not include information (I) lawfully obtained from third parties,
(2) that which is in the public domain, or (3) that which is developed independently. Neither party
shall use or disclose directly or indirectly without prior written authorization any proprietary information
conceming the other party obtained as a result of this Contract. Any proprietary information removed from
the State's site by CONTRACTOR in the course of providing services under this Contract will be accorded
at least the same precautions as are employed by CONTRACTOR for similar information in the course of
its own business.
18. CONTRACTOR certifies it will abide by Colorado Revised Statue (C.R.S.) 26-6-104, requiring criminal
background record checks for all employees, contractors, and sub -contractors.
19. Contractor certifies that it shall comply with the provisions of Colorado Revised Statutes (C.R.S.) 8-17.5-
101, et seq. Contractor shall not knowingly employ or contract with an illegal alien to perform work under
this Contract or enter into a contract with a subcontractor that fails to certify to Contractor that the
subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this
Contract. Contractor represents, warrants, and agrees that it (a) has verified that it does not employ any
illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by
the Social Security Administration and Department of Homeland Security, and (b) otherwise will comply
with the requirements of C.R.S. 8-17.5-102(2)(6). Contractor shall comply with all reasonable requests
made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and
Employment. If Contractor fails to comply with any requirement of this provision or C.R.S. 8-17.5-101, et
seq., the Department may terminate this Contract for breach and Contractor shall be liable for actual and
consequential damages to the Department.
Except where exempted by federal law and except as provided in C.R.S. 24-76.5-103(3), if Contractor
receives federal or state funds under this Contract, Contractor must confirm that any individual natural
person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. 24-
76.5-103(4) if such individual applies for public benefits provided under this Contract. If Contractor
operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it (a) is a citizen of
the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall
produce one of the forms of identification required by C.R.S. 24-76.5-101, et seq., and (c) shall produce
one of the forms of identification required by C.R.S. 24-76.5-103 prior to the effective date of this
Contract.
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EXHIBIT D
CHILD and FAMILY SERVICES REVIEWS (CFSR)
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas; Safety,
Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's
performance according to national standards and monitors progress over time. Following the review, a Performance
Improvement Program (PIP) will be implemented for the state to enhance services to families.
Additionally, the review will assess statewide, systemic factors to determine if the systems necessary to achieve
positive outcomes for families are in place.
All agencies that contract to provide service to families and children in Weld County must continually strive for
positive outcomes in the areas of safety, permanency and well-being for our youth. In order to insure continued
progress in this area, the Department is requiring providers to comply with a standard assessment and reporting
system which will address these three areas.*
The Department is requesting that provider reports include observations and recommendations regarding clients in a
way that specifically addresses the areas of safety, permanency and well-being. Below are the specific outcomes
that will be assessed by the CFSR in the areas of safety, permanency and well-being, followed by specific
considerations and tasks which must be addressed by the Department contracted providers.
Safety Outcomes
CFSR Outcome Measures
Safety I Children are, first and foremost, protected from abuse and neglect.
Safety 2 Children are safely maintained in their homes whenever possible and appropriate.
Considerations for the Department's providers
• Providers should always consider the following definitions regarding child safety when assessing families.
o Children are considered safe when there are no present dangers or impending danger threats, or
the caregivers' protective capacities control existing threats.
o Children are considered unsafe when they are vulnerable to present or impending danger threats,
and caregivers are unable or unwilling to provide protection.
o Risk is the likelihood (chance, potential, prospect) for parenting behavior that is harmful and
destructive to a child's cognitive, social, emotional and/or physical development, and those with
parenting responsibility are unwilling or unable to behave differently.
• Monthly reports should continually document an assessment of risk and safety concerns and the
interventions that are being offered by the provider to ameliorate those concerns.
• Monthly reports should make recommendations regarding services and/or safety measures that the provider
believes should be implemented to insure safety of the child(ren).
• Providers must specifically document efforts to engage families in services and to control for safety.
Permanency Outcomes
CFSR Outcome Measures
Permanency I Children have permanency and stability in their living situations.
Permanency 2 The continuity of family relationships and connections is preserved for children.
Considerations for the Department's providers:
• Provider reports should always note the primary permanency goal for the child and document how
interventions are working toward achieving that goal.
Provider reports must indicate progress toward achieving the permanency goal and should make specific
recommendations regarding how the continuation of the service may assist in achieving the goal.
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• Providers should continually provide recommendations about whether any out -of -home placement
continues to be appropriate and should make recommendations regarding when changes in this area should
be made, in the providers' opinion.
• Providers should continually assess family relationships (parent/child, sibling/sibling, extended
family/child, etc.) and should report any concerning relationship issues which may be a barrier to achieving
permanency. Providers should document ongoing efforts to resolve those issues and/or make
recommendations regarding additional services that may be required to address relationship issues.
• Providers must document specific time frames when recommending ongoing services and/or
recommending changes to services and/or placements.
Child and Family Well -Being Outcomes
CFSR Outcome Measures
Well Being I Families have enhanced capacity to provide for their children's needs.
Well Being 2 Children receive appropriate services to meet their educational needs.
Well Being 3 Children receive adequate services to meet their physical and mental health needs.
Considerations for the Department's providers:
• Providers must engage in ongoing assessments of the parents' capacity to appropriately care for their
children and whether or not the service being provided continues to be appropriate. This must be clearly
documented in monthly reports.
• Providers should specifically detail areas of continued concern within the family and make
recommendations regarding whether that provider's service continues to be appropriate. Reports should
also document what barriers may be impeding progress.
• Providers should document any and all observed concerns regarding any child with whom the provider is
working. This should include concerns regarding physical, emotional, educational and behavioral well-
being of the child. When appropriate, providers should make recommendations regarding evaluations
and/or additional services that may address these concerns.
*Standardized reports will be provided and should be utilized by all agencies providing ongoing services to the
Department's families unless otherwise noted.
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CHILD PROTECTION AGREEMENT FOR SERVICES
BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES
AND COLLABORATIVE SERVICES FOR CHANGE, PC
This Agreement, made and entered into the I day of -iI Al L 2009, by and between the Board of
Weld County Commissioners, sitting as the Board of Human Services, on behalf of the Weld County Department of
Human Services, hereinafter referred to as the "Department," and Collaborative Services for Change, PC,
hereinafter referred to as "Contractor".
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 Core Services funding to the
Department for Sex Abuse Treatment (Offense Specific); and
NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows:
1. Term
This Agreement shall become effective on June 1, 2009, upon proper execution of this Agreement and
shall expire May 31, 2010, unless sooner terminated as provided herein.
2. Scope of Services
Services shall be provided by CONTRACTOR 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," of which are attached
hereto and incorporated herein by reference.
"Payment Schedule" shall establish the maximum reimbursement, which will be paid from
Core Services funding during the duration of this Agreement.
b. CONTRACTOR shall submit an itemized monthly bill to the Department for all costs incurred
and services provided pursuant to Exhibit A of this Agreement in accordance with criteria
established by the Department. CONTRACTOR shall submit all itemized monthly billings to
the Department by the 7'h day of the month following the month the cost was incurred. If the
billing is not submitted within twenty-five (25) calendar days of the month following service, it
may result in forfeiture of payment.
c. Payments of costs incurred pursuant to this Agreement is expressly contingent upon the
availability of Core Services to the Department.
d. The Department 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.
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4. Financial Management
At all times from the effective date of this Contract until completion of this Contract, CONTRACTOR
shall
comply with the administrative requirements, cost principles and other requirements set forth in the
Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds
expended under Core Service funding must conform to the Single Audit Act of 1984 and OMB Circular A-
133.
5. Payment Method
Unless otherwise provided in the Scope of Services and Payment Schedule:
a. CONTRACTOR shall provide proper monthly invoices and itemization of services performed for
costs incurred in the performance of the agreement.
b. The Department may withhold any payment if CONTRACTOR has failed to comply with the
Financial Management Requirements, program objectives, contractual terms, or reporting
requirements. In the event of a forfeiture of reimbursements, CONTRACTOR may appeal such
circumstance to the Director of Human Services. The decision of the Director of Human Services
shall be final.
6. Assurances
CONTRACTOR shall abide by all assurances as set forth in the attached Exhibit C, which is attached hereto
and incorporated herein by reference.
7. Compliance with Applicable Laws
At all times during the performance of this contract, CONTRACTOR 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. CONTRACTOR acknowledges that the following laws are included:
Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d —1 et. seq. and its implementing
regulation, 45 C.F.R. Part 80 et. seq.- and
Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 794, and
its implementing regulations, 45 C.F.R. Part 84; and
the Age Discrimination Act of 1975, 42 U.S.C. Sections 6101 et. seq. and
its implementation regulations, 45 C.F.R. Part 91; and
Title VII of the Civil Rights Act of 1964; and
the Age Discrimination in Employment Act of 1967; and
the Equal Pay Act of 1963; and
the Education Amendments of 1972; and
- Immigration Reform and Control Act of 1986, P.L. 99-603;
- 42 C.F.R. Part 2
and all regulations applicable to these laws prohibiting discrimination because of race, color,
National origin, and sex, religion and handicap, including Acquired Immune Deficiency Syndrome (AIDS)
or AIDS related conditions, covered under Section 504 of the Rehabilitation Act of 1973, as amended,
cited above. If necessary, CONTRACTOR and the Department will resist in judicial proceedings any
efforts to obtain access to client records except as permitted by 42 CFR Part 2.
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Included is 45 C.F.R. Part 74 Appendix G 9, which requires that affirmative steps be taken to assure that
small and minority businesses are utilized, when possible, as sources of supplies, equipment, construction
and services. This assurance is given in consideration of and for the purpose of obtaining any and all
federal and/or state financial assistance.
Any person who feels that s/he has been discriminated against has the right to file a complaint either with
the Colorado Department of Human Services or with the U.S. Department of Health and Human Services,
Office for Civil Rights.
8. Compliance with Child and Family Services Review
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas;
Safety, Permanency and Well Being of families. For each outcome, data and performance indicators
measure each state's performance according to national standards and monitor progress over time.
Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance
services to families.
CONTRACTORS providing services to the Department families and children must continually strive for
positive outcomes in the areas of safety, permanency and well being. Contractors providing services in
program areas identified by the Department are required to comply with a standard assessment and
reporting system set forth in Exhibit D which will address the aforementioned three areas.
9. Insurance
CONTRACTOR, shall procure, either personally or through its employer as applicable to the Contractor's
business, at its own expense, and maintain for the duration of the work, the following insurance coverage;
Weld County, Colorado, by and through the Board of County Commissioners of Weld County, its
employees and agents, shall be named as additional named insured on the insurance, where permissible by
the insurance provider.
a. Standard Workman's Compensation and Employer's Liability.
1. As required by state statute including occupational disease, covering all employees at
work site.
b. General Liability (PL & PD) (Minimum).
1. Combined single limit - $500,000 written on an occurrence basis.
2. Any aggregate limit will not be less than $1 million.
3. Provider must purchase additional insurance if claims reduce the annual aggregate below
$500,000.
4. State of Colorado to be named as additional insured on each comprehensive general
liability policy.
5. Certificate of insurance to be provided to Weld County and must be attached to the
contract.
6. Insurance shall include provisions preventing cancellation without 60 days prior notice
by certified mail to Weld County.
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c. Automobile Liability (Minimum) for any Contractor transporting children or any party to whom
Department services are being provided.
d. Additional coverage may be required in specific program areas. For any insurances that are
required by this contract, a completed Standard Certificate of Insurance Form shall be provided to
the Department by the Contractor prior to the start of any contract.
10. Certifications
CONTRACTOR 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. Copies of all necessary licenses shall be provided to the Department by the
Contractor prior to the start of any contract.
11. Training
Contractor shall attend a Court Testimony and Ethics Training to be paid for by the Department. The
Contractor may be required to attend additional training at the request of the Department. The cost of such
training will be paid for the Department. The Department will not compensate the Contractor for the time
spent attending the required trainings.
12. Monitoring and Evaluation
CONTRACTOR and the Department agree that monitoring and evaluation of the performance of this
Agreement shall be conducted by CONTRACTOR and the Department. The results of the monitoring and
evaluation shall be provided to the Board of Weld County Commissioners, the Department and
CONTRACTOR.
CONTRACTOR shall permit the Department, and any other duly authorized agent or governmental
agency, to monitor all activities conducted by CONTRACTOR 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.
13. Modification of Agreement
All modifications to this agreement shall be in writing and signed by both parties.
14. Remedies
The Director of Human Services or designee may exercise the following remedial actions should s/he find
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
CONTRACTOR. These remedial actions are as follows:
a. Withhold payment to 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 CONTRACTOR cannot be performed or if
performed would be of no value to the Department. Denial of the amount of payment shall be
reasonably related to the amount of work or deliverables lost to the Department;
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c. Incorrect payment to CONTRACTOR due to omission, error, fraud, and/or defalcation shall be
recovered from CONTRACTOR by deduction from subsequent payments under this Agreement or
other agreements between the Department and CONTRACTOR, or by the Department as a debt due to
the Department or otherwise as provided by law.
15. 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 the Department:
Gloria Romansik
Name
For CONTRACTOR
Marci Brewer. LCSW
Name
16. Notice
Social Services Administrator
Title
Clinical Director/Co-Owner
Title
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: The Department
Judy A. Griego, Director
P.O. Box A
Greeley, CO 80632
(970) 352-1551
17. Litigation
To: CONTRACTOR
Marci Brewer, LCSW
2480 W. 26th Avenue, #130-B
Denver, CO 80211
(303) 433-0188
CONTRACTOR shall promptly notify the Department in the event that CONTRACTOR learns of any
actual litigation in which it is a party defendant in a case that involves services provided under this
Agreement. 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, reorganization and/or foreclosure.
18. 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. CONTRACTOR reserves the right to suspend services to clients if
funding is no longer available.
19. 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 13 herein.
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IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first
above written.
By:
APP
Cou • •ttomey
WELD COUNTY DEPARTMENT
OF HUMAN SRVICES ,‘
By:
BOARD OF COUNTY
BOARD COMMISSIONERS WEL
COUNTY, COLOJAI
C� By:
Chair William F. Garcia
06/17/2009
CONTRACTOR:
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EXHIBIT A
SCOPE OF SERVICES
1. CONTRACTOR will provide offense specific services to clients referred by the Department, in the Denver
area. Services include intake assessments, offense specific evaluations, individual, family and group therapy,
specialty services for special needs and developmentally disabled youth, field (in -home) therapy in the
community, healthy sexuality curriculum and informed supervision training.
2. All services will be provided by Marci Brewer, LCSW
3. CONTRACTOR will identify in detail areas of continued concern and make recommendations to the
Department regarding continuation of services and/or the need for additional services.
4. CONTRACTOR will document in detail any and all observed or verbalized concerns regarding any child whom
the CONTRACTOR is working with under an active referral. Areas of concern may include, but are not limited
to, any physical, emotional, educational or behavioral issues. Areas of concern should be reported immediately
AND on the required monthly report.
5. CONTRACTOR will submit reports on a monthly basis for each active referral. Reports will be submitted per
the online format required by the Department.
6. CONTRACTOR will participate in team reviews of ongoing services as requested.
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EXHIBIT B
PAYMENT SCHEDULE
1. Funding and Method of Payment
The Department agrees to reimburse CONTRACTOR in consideration for the work and services
performed from Core Services funding, not to exceed $10,000.00.
Expenses incurred by CONTRACTOR, in association with said project prior to the term of this agreement,
are not eligible Department expenditures and shall not be reimbursed by the Department.
Payment pursuant to this Contract, if Core Services funds, whether in whole or in part, is subject to and
contingent upon the continuing availability of said funds for the purposes hereof. In the event that said
funds, or any part thereof, become unavailable as determined by the Department, the Department may
immediately terminate this Contract or amend it accordingly.
2. Fees for Services
$50.00/Hour (Offense Specific Evaluation, Max = $950.00)
$75.00/Episode (Intake, 50 -minute session)
$75.00/Episode (Individual or Family Therapy, 50 -minute Session)
$50.00/Episode (Group Therapy, 90 -minute Session)
$75.00/Episode (Specialty Services for Disabled Youth, 50 -minute Session)
$100.00/Episode (Field/Off-site Therapy, 50 -minute Session)
$75.00/Episode (Informed Supervision, 1 Person)
$100.00/Episode (Informed Supervision, 2-3 People)
$200.00/Episode (Informed Supervision, 4-6 People)
$300.00/Episode (Informed Supervision, 7-9 People)
$50.00/Month/Case (Case Management)
Department referrals will not be sent to collections by Contractor for default of co-pay/fees. Services will
be performed regardless of client's refusal or inability to pay co -pay.
Contractor will collect any applicable sliding scale co -pays and credit the Department for any payments
received on the monthly billing statements.
3. Submittal of Vouchers
CONTRACTOR shall prepare and submit monthly the itemized voucher and certify that the services
authorized were provided on the date indicated and the charges made were pursuant to the terms and
conditions of Exhibit A.
a. All billings are to be submitted by the 7'" day of the month following the month of
service. If the billing is not submitted within twenty-five (25) calendar days of the month
following service, it may result in forfeiture of payment.
b. Billings must be submitted with the attached required forms, Authorization for
Contractual Services, Request for Reimbursement, Client Verification Form and monthly
report. The Authorization for Contractual Services and Client Verification Form must be
submitted with original signatures.
c. For monitored sobriety, proof of services rendered shall be a sign -in sheet with client
signatures or the test result.
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EXHIBIT C
ASSURANCES
I . CONTRACTOR 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 CONTRACTOR -
contracted CONTRACTOR or its employees, volunteers, or agents while performing duties as described in
this Agreement. CONTRACTOR shall indemnify, defend, and hold harmless Weld County, the Board of
County Commissioners of Weld County, its employees, volunteers, and agents. CONTRACTOR 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, CONTRACTOR shall provide the
Department 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 created a
duty of care with respect to any persons not a party of this Agreement.
4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld, State
of Colorado, to expend funds not otherwise appropriated in each succeeding year.
5. If any section, subsection, paragraph, sentence, clause, or phrase of this Contract is for any reason held or
decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The
parties hereto declare that they would have entered into this Contract and each and every section,
subsection, paragraph, sentence, clause, and phrase thereof irrespective of the fact that any one or more
sections, subsections, paragraphs, sentences, clauses, or phrases might be declared to be unconstitutional or
invalid.
6. No officer, member or employee of Weld County and no member of their governing bodies shall have any
pecuniary interest, direct or indirect, in the approved Agreement or the proceeds thereof.
7. CONTRACTOR 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. CONTRACTOR 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
CONTRACTOR.
9. All such records, documents, communications, and other materials created pursuant or related to this
contract shall be maintained by CONTRACTOR, in a central location and shall be made available to
Social Services upon its request, for a period of seven (7) 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 seven (7) year period, or if
audit findings have not been resolved after a seven (7) period, the materials shall be retained until the
resolution of the audit finding.
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10. CONTRACTOR assures that authorized local, federal, and state auditors and representatives shall, during
business hours, have access to inspect any copy records, and shall be allowed to monitor and review
through on -site visits, all contract activities, supported with funds under this Contract to ensure compliance
with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the
performance of the Agreement shall be conducted by appropriate funding sources. The results of the
monitoring and evaluation activities shall be provided to the appropriate and interested parties.
11. This Contract shall be binding upon the parties hereto, their successors, heirs, legal representatives, and
assigns. CONTRACTOR or the Department may not assign any of its rights or obligations hereunder
without the prior written consent of both parties.
12. CONTRACTOR certifies that federal appropriated funds have not been paid or will be paid, by or on
behalf of CONTRACTOR, 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. CONTRACTOR assures that it will fully comply with all other applicable federal and state laws.
CONTRACTOR understands that the source of funds to be used under this Contract is Core Services
funds.
14. CONTRACTOR 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 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 12 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 the
Department 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,
CONTRACTOR 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, CONTRACTOR
shall submit to the Department, 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 the Department's termination, for cause, of its contract with
CONTRACTOR.
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16. CONTRACTOR 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 CONTRACTOR shall be disclosed in a form identifiable with the applicant/recipient or a
minor's parent or guardian unless in accordance with CONTRACTOR written policies governing access
to, duplication and dissemination of, all such information. CONTRACTOR shall advise its employees,
agents, and subcontractor, if any, that they are subject to these confidentiality requirements.
CONTRACTOR 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.
CONTRACTOR shall have its employees, agents, and subcontractors, if any, sign a written confidentiality
agreement and shall provide a copy of such agreement to the Department, if requested.
17. Proprietary information for the purposes of this contract is information relating to a party's research,
development, trade secrets, business affairs, internal operations and management procedures and those of
its customers, clients or affiliates, but does not include information (1) lawfully obtained from third parties,
(2) that which is in the public domain, or (3) that which is developed independently. Neither party
shall use or disclose directly or indirectly without prior written authorization any proprietary information
concerning the other party obtained as a result of this Contract. Any proprietary information removed from
the State's site by CONTRACTOR in the course of providing services under this Contract will be accorded
at least the same precautions as are employed by CONTRACTOR for similar information in the course of
its own business.
18. CONTRACTOR certifies it will abide by Colorado Revised Statue (C.R.S.) 26-6-104, requiring criminal
background record checks for all employees, contractors, and sub -contractors.
19. Contractor certifies that it shall comply with the provisions of Colorado Revised Statutes (C.R.S.) 8-17.5-
101, et seq. Contractor shall not knowingly employ or contract with an illegal alien to perform work under
this Contract or enter into a contract with a subcontractor that fails to certify to Contractor that the
subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this
Contract. Contractor represents, warrants, and agrees that it (a) has verified that it does not employ any
illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by
the Social Security Administration and Department of Homeland Security, and (b) otherwise will comply
with the requirements of C.R.S. 8-17.5-102(2)(b). Contractor shall comply with all reasonable requests
made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and
Employment. If Contractor fails to comply with any requirement of this provision or C.R.S. 8-17.5-101, et
seq., the Department may terminate this Contract for breach and Contractor shall be liable for actual and
consequential damages to the Department.
Except where exempted by federal law and except as provided in C.R.S. 24-76.5-103(3), if Contractor
receives federal or state funds under this Contract, Contractor must confirm that any individual natural
person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. 24-
76.5-103(4) if such individual applies for public benefits provided under this Contract. If Contractor
operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it (a) is a citizen of
the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall
produce one of the forms of identification required by C.R.S. 24-76.5-101, et seq., and (c) shall produce
one of the forms of identification required by C.R.S. 24-76.5-103 prior to the effective date of this
Contract.
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EXHIBIT D
CHILD and FAMILY SERVICES REVIEWS (CFSR)
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas; Safety,
Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's
performance according to national standards and monitors progress over time. Following the review, a Performance
Improvement Program (PIP) will be implemented for the state to enhance services to families.
Additionally, the review will assess statewide, systemic factors to determine if the systems necessary to achieve
positive outcomes for families are in place.
All agencies that contract to provide service to families and children in Weld County must continually strive for
positive outcomes in the areas of safety, permanency and well-being for our youth. In order to insure continued
progress in this area, the Department is requiring providers to comply with a standard assessment and reporting
system which will address these three areas.*
The Department is requesting that provider reports include observations and recommendations regarding clients in a
way that specifically addresses the areas of safety, permanency and well-being. Below are the specific outcomes
that will be assessed by the CFSR in the areas of safety, permanency and well-being, followed by specific
considerations and tasks which must be addressed by the Department contracted providers.
Safety Outcomes
CFSR Outcome Measures
Safety I Children are, first and foremost, protected from abuse and neglect.
Safety 2 Children are safely maintained in their homes whenever possible and appropriate.
Considerations for the Department's providers
• Providers should always consider the following definitions regarding child safety when assessing families.
o Children are considered safe when there are no present dangers or impending danger threats, or
the caregivers' protective capacities control existing threats.
o Children are considered unsafe when they are vulnerable to present or impending danger threats,
and caregivers are unable or unwilling to provide protection.
o Risk is the likelihood (chance, potential, prospect) for parenting behavior that is harmful and
destructive to a child's cognitive, social, emotional and/or physical development, and those with
parenting responsibility are unwilling or unable to behave differently.
Monthly reports should continually document an assessment of risk and safety concerns and the
interventions that are being offered by the provider to ameliorate those concerns.
• Monthly reports should make recommendations regarding services and/or safety measures that the provider
believes should be implemented to insure safety of the child(ren).
• Providers must specifically document efforts to engage families in services and to control for safety.
Permanency Outcomes
CFSR Outcome Measures
Permanency 1 Children have permanency and stability in their living situations.
Permanency 2 The continuity of family relationships and connections is preserved for children.
Considerations for the Department's providers:
• Provider reports should always note the primary permanency goal for the child and document how
interventions are working toward achieving that goal.
• Provider reports must indicate progress toward achieving the permanency goal and should make specific
recommendations regarding how the continuation of the service may assist in achieving the goal.
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• Providers should continually provide recommendations about whether any out -of -home placement
continues to be appropriate and should make recommendations regarding when changes in this area should
be made, in the providers' opinion.
• Providers should continually assess family relationships (parent/child, sibling/sibling, extended
family/child, etc.) and should report any concerning relationship issues which may be a barrier to achieving
permanency. Providers should document ongoing efforts to resolve those issues and/or make
recommendations regarding additional services that may be required to address relationship issues.
• Providers must document specific time frames when recommending ongoing services and/or
recommending changes to services and/or placements.
Child and Family Well -Being Outcomes
CFSR Outcome Measures
Well Being 1 Families have enhanced capacity to provide for their children's needs.
Well Being 2 Children receive appropriate services to meet their educational needs.
Well Being 3 Children receive adequate services to meet their physical and mental health needs.
Considerations for the Department's providers:
• Providers must engage in ongoing assessments of the parents' capacity to appropriately care for their
children and whether or not the service being provided continues to be appropriate. This must be clearly
documented in monthly reports.
• Providers should specifically detail areas of continued concern within the family and make
recommendations regarding whether that provider's service continues to be appropriate. Reports should
also document what barriers may be impeding progress.
• Providers should document any and all observed concerns regarding any child with whom the provider is
working. This should include concerns regarding physical, emotional, educational and behavioral well-
being of the child. When appropriate, providers should make recommendations regarding evaluations
and/or additional services that may address these concerns.
*Standardized reports will be provided and should be utilized by all agencies providing ongoing services to the
Department's families unless otherwise noted.
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CHILD PROTECTION AGREEMENT FOR SERVICES
BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES
AND EL PUEBLO
5t 2009, by and between the Board of
,
Weld County Commissioners, sitting as the Board of
This Agreement, made and entered into the day of �;N�'
uman Services, on behalf of the Weld County Department of
Human Services, hereinafter referred to as the "Department," and El Pueblo, hereinafter referred to as "Contractor".
W ITNESSETH
WHEREAS, required approval, clearance, and coordination have been accomplished from and with
appropriate agencies; and
WHEREAS, the Colorado Department of Human Services has provided Core Services funding to the
Department for Day Treatment Services; and
NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows:
1. Term
This Agreement shall become effective on June 1, 2009, upon proper execution of this Agreement and
shall expire May 31, 2010, unless sooner terminated as provided herein.
2. Scope of Services
Services shall be provided by CONTRACTOR 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.
Payment
a. Payment shall be made on the basis of Exhibit B, "Payment Schedule," of which are attached
hereto and incorporated herein by reference.
"Payment Schedule" shall establish the maximum reimbursement, which will be paid from
Core Services funding during the duration of this Agreement.
b. CONTRACTOR shall submit an itemized monthly bill to the Department for all costs incurred
and services provided pursuant to Exhibit A of this Agreement in accordance with criteria
established by the Department. CONTRACTOR shall submit all itemized monthly billings to
the Department by the 7th day of the month following the month the cost was incurred. If the
billing is not submitted within twenty-five (25) calendar days of the month following service, it
may result in forfeiture of payment.
c. Payments of costs incurred pursuant to this Agreement is expressly contingent upon the
availability of Core Services to the Department.
d. The Department 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.
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4. Financial Management
At all times from the effective date of this Contract until completion of this Contract, CONTRACTOR
shall comply with the administrative requirements, cost principles and other requirements set forth in the
Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds
expended under Core Service funding must conform to the Single Audit Act of 1984 and OMB Circular A-
133.
5. Payment Method
Unless otherwise provided in the Scope of Services and Payment Schedule:
a. CONTRACTOR shall provide proper monthly invoices and itemization of services performed for
costs incurred in the performance of the agreement.
b. The Department may withhold any payment if CONTRACTOR has failed to comply with the
Financial Management Requirements, program objectives, contractual terms, or reporting
requirements. In the event of a forfeiture of reimbursements, CONTRACTOR may appeal such
circumstance to the Director of Human Services. The decision of the Director of Human Services
shall be final,
6. Assurances
CONTRACTOR shall abide by all assurances as set forth in the attached Exhibit C, which is attached hereto
and incorporated herein by reference.
7. Compliance with Applicable Laws
At all times during the performance of this contract, CONTRACTOR 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. CONTRACTOR acknowledges that the following laws are included:
Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d —1 et. seq. and its implementing
regulation, 45 C.F.R. Part 80 et. seq.: and
Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 794, and
its implementing regulations, 45 C.F.R. Part 84; and
- the Age Discrimination Act of 1975, 42 U.S.C. Sections 6101 et. seq. and
its implementation regulations, 45 C.F.R. Part 91; and
- Title VII of the Civil Rights Act of 1964; and
- the Age Discrimination in Employment Act of 1967; and
the Equal Pay Act of 1963; and
the Education Amendments of 1972; and
Immigration Reform and Control Act of 1986, P.L. 99-603;
42 C.F.R. Part 2
and all regulations applicable to these laws prohibiting discrimination because of race, color,
National origin, and sex, religion and handicap, including Acquired Immune Deficiency Syndrome (AIDS)
or AIDS related conditions, covered under Section 504 of the Rehabilitation Act of 1973, as amended,
cited above. If necessary, CONTRACTOR and the Department will resist in judicial proceedings any
efforts to obtain access to client records except as permitted by 42 CFR Part 2.
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Included is 45 C.F.R. Part 74 Appendix G 9, which requires that affirmative steps be taken to assure that
small and minority businesses are utilized, when possible, as sources of supplies, equipment, construction
and services. This assurance is given in consideration of and for the purpose of obtaining any and all
federal and/or state financial assistance.
Any person who feels that s/he has been discriminated against has the right to file a complaint either with
the Colorado Department of Human Services or with the U.S. Department of Health and Human Services,
Office for Civil Rights.
8. Compliance with Child and Family Services Review
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas;
Safety, Permanency and Well Being of families. For each outcome, data and performance indicators
measure each state's performance according to national standards and monitor progress over time.
Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance
services to families.
CONTRACTORS providing services to the Department families and children must continually strive for
positive outcomes in the areas of safety, permanency and well being. Contractors providing services in
program areas identified by the Department are required to comply with a standard assessment and
reporting system set forth in Exhibit D which will address the aforementioned three areas.
9. Insurance
CONTRACTOR, shall procure, either personally or through its employer as applicable to the Contractor's
business, at its own expense, and maintain for the duration of the work, the following insurance coverage;
Weld County, Colorado, by and through the Board of County Commissioners of Weld County, its
employees and agents, shall be named as additional named insured on the insurance, where permissible by
the insurance provider.
a. Standard Workman's Compensation and Employer's Liability.
As required by state statute including occupational disease, covering all employees at
work site.
b. General Liability (PL & PD) (Minimum).
1. Combined single limit - $500,000 written on an occurrence basis.
2. Any aggregate limit will not be less than $1 million.
3. Provider must purchase additional insurance if claims reduce the annual aggregate below
$500,000.
4. State of Colorado to be named as additional insured on each comprehensive general
liability policy.
5. Certificate of insurance to be provided to Weld County and must be attached to the
contract.
6. Insurance shall include provisions preventing cancellation without 60 days prior notice
by certified mail to Weld County.
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c. Automobile Liability (Minimum) for any Contractor transporting children or any party to whom
Department services are being provided.
d. Additional coverage may be required in specific program areas. For any insurances that are
required by this contract, a completed Standard Certificate of Insurance Form shall be provided to
the Department by the Contractor prior to the start of any contract.
10. Certifications
CONTRACTOR 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. Copies of all necessary licenses shall be provided to the Department by the
Contractor prior to the start of any contract.
11. Training
Contractor shall attend a Court Testimony and Ethics Training to be paid for by the Department. The
Contractor may be required to attend additional training at the request of the Department. The cost of such
training will be paid for the Department. The Department will not compensate the Contractor for the time
spent attending the required trainings.
12. Monitoring and Evaluation
CONTRACTOR and the Department agree that monitoring and evaluation of the performance of this
Agreement shall be conducted by CONTRACTOR and the Department. The results of the monitoring and
evaluation shall be provided to the Board of Weld County Commissioners, the Department and
CONTRACTOR.
CONTRACTOR shall permit the Department, and any other duly authorized agent or governmental
agency, to monitor all activities conducted by CONTRACTOR 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.
13. Modification of Agreement
All modifications to this agreement shall be in writing and signed by both parties.
14. Remedies
The Director of Human Services or designee may exercise the following remedial actions should s/he find
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
CONTRACTOR. These remedial actions are as follows:
a. Withhold payment to 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 CONTRACTOR cannot be performed or if
performed would be of no value to the Department. Denial of the amount of payment shall be
reasonably related to the amount of work or deliverables lost to the Department;
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c. Incorrect payment to CONTRACTOR due to omission, error, fraud, and/or defalcation shall be
recovered from CONTRACTOR by deduction from subsequent payments under this Agreement or
other agreements between the Department and CONTRACTOR, or by the Department as a debt due to
the Department or otherwise as provided by law.
15. 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 the Department:
Gloria Romansik
Name
For CONTRACTOR:
Patty A. Etjavec
Name
16. Notice
Social Services Administrator
Title
President/Chief Executive Officer
Title
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: The Department
Judy A. Griego, Director
P.O. Box A
Greeley, CO 80632
(970) 352-1551
17. Litigation
To: CONTRACTOR
Patty A. Erjavec, President/Chief Executive Officer
1 El Pueblo Ranch Way
Pueblo, CO 81001
(719) 544-7496
CONTRACTOR shall promptly notify the Department in the event that CONTRACTOR learns of any
actual litigation in which it is a party defendant in a case that involves services provided under this
Agreement. 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, reorganization and/or foreclosure.
18. 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. CONTRACTOR reserves the right to suspend services to clients if
funding is no longer available.
19. 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 13 herein.
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IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first
above written.
WELD COUNTY DEPARTMENT
OF HUMAN SERVICES
By:
BOARD OF COUNTY
COMMISSIONERS WELD
COUNTY, COLORAD
•
By:
Chair
William F. Garcia
06/17/2009
CONTRACTOR:
BY i (! �/6,/i
Contractor
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EXHIBIT A
SCOPE OF SERVICES
1. CONTRACTOR will provide comprehensive, highly structured day treatment services to male youth, ages 14-
17, as referred by the Department.
2. CONTRACTOR will provide day treatment services at 1 El Pueblo Ranch Way, Pueblo, CO 81006.
3. CONTRACTOR is licensed by the Colorado Department of Human Services State Child Care Licensing.
4. Services include Education, Therapeutic Intervention, Individual Therapy, Family Therapy, Group Therapy,
and Substance Use/Abuse Education.
5. CONTRACTOR will provide individual, group and family therapy to all referred youth unless otherwise
directed by the Department.
6. When deemed applicable, and approved by the Department, Medication Management and Mentoring/Case
Management will be provided.
a. Medication Management will include one session per month, and more frequently if the youth is in
crisis.
b. Mentoring/Case Management will include a family support partner that will:
i. Provide weekly fact -to -face support with skill implementation and community activities.
ii. Be a surrogate natural support.
iii. Provide monthly report.
iv. Have contact with school, caseworker, or other support persons.
7. Length of services is dependent upon the referred youth's daily/weekly progress, individual/family needs and
availability of funding.
8. CONTRACTOR will submit monthly progress reports for each referred client. Reports will be submitted with
the monthly billing.
9. CONTRACTOR will participate in team reviews of ongoing services as needed.
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EXHIBIT B
PAYMENT SCHEDULE
1. Funding and Method of Payment
The Department agrees to reimburse CONTRACTOR in consideration for the work and services
performed from Core Services funding, not to exceed $50,000.00.
Expenses incurred by CONTRACTOR, in association with said project prior to the term of this agreement,
are not eligible Department expenditures and shall not be reimbursed by the Department.
Payment pursuant to this Contract, if Core Services funds, whether in whole or in part, is subject to and
contingent upon the continuing availability of said funds for the purposes hereof. In the event that said
funds, or any part thereof, become unavailable as determined by the Department, the Department may
immediately terminate this Contract or amend it accordingly.
2. Fees for Services
$69.50/Day (Therapeutic Services)
$51.06/Day (Educational Services)
$75.00/Episode (Medication Management)
$40.00/Hour (Mentoring and Case Management)
Department referrals will not be sent to collections by Contractor for default of co-pay/fees. Services will
be performed regardless of client's refusal or inability to pay co -pay.
Contractor will collect any applicable sliding scale co -pays and credit the Department for any payments
received on the monthly billing statements.
3. Submittal of Vouchers
CONTRACTOR shall prepare and submit monthly the itemized voucher and certify that the services
authorized were provided on the date indicated and the charges made were pursuant to the terms and
conditions of Exhibit A.
a. All billings are to be submitted by the 7'h day of the month following the month service.
If the billing is not submitted within twenty-five (25) calendar days of the month
following service, it may result in forfeiture of payment.
b. Billings must be submitted with the attached required forms, Authorization for
Contractual Services, Request for Reimbursement, Client Verification Form and monthly
report. The Authorization for Contractual Services and Client Verification Form must be
submitted with original signatures.
c. For monitored sobriety, proof of services rendered shall be a sign -in sheet with client
signatures or the test result.
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EXHIBIT C
ASSURANCES
1. CONTRACTOR 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 CONTRACTOR -
contracted CONTRACTOR or its employees, volunteers, or agents while performing duties as described in
this Agreement. CONTRACTOR shall indemnify, defend, and hold harmless Weld County, the Board of
County Commissioners of Weld County, its employees, volunteers, and agents. CONTRACTOR 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, CONTRACTOR shall provide the
Department 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 created a
duty of care with respect to any persons not a party of this Agreement.
4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld, State
of Colorado, to expend funds not otherwise appropriated in each succeeding year.
5. If any section, subsection, paragraph, sentence, clause, or phrase of this Contract is for any reason held or
decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The
parties hereto declare that they would have entered into this Contract and each and every section,
subsection, paragraph, sentence, clause, and phrase thereof irrespective of the fact that any one or more
sections, subsections, paragraphs, sentences, clauses, or phrases might be declared to be unconstitutional or
invalid.
6. No officer, member or employee of Weld County and no member of their governing bodies shall have any
pecuniary interest, direct or indirect, in the approved Agreement or the proceeds thereof.
7. CONTRACTOR 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. CONTRACTOR 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
CONTRACTOR.
9. All such records, documents, communications, and other materials created pursuant or related to this
contract shall be maintained by CONTRACTOR, in a central location and shall be made available to
Social Services upon its request, for a period of seven (7) 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 seven (7) year period, or if
audit findings have not been resolved after a seven (7) period, the materials shall be retained until the
resolution of the audit finding.
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10. CONTRACTOR assures that authorized local, federal, and state auditors and representatives shall, during
business hours, have access to inspect any copy records, and shall be allowed to monitor and review
through on -site visits, all contract activities, supported with funds under this Contract to ensure compliance
with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the
performance of the Agreement shall be conducted by appropriate funding sources. The results of the
monitoring and evaluation activities shall be provided to the appropriate and interested parties.
11. This Contract shall be binding upon the parties hereto, their successors, heirs, legal representatives, and
assigns. CONTRACTOR or the Department may not assign any of its rights or obligations hereunder
without the prior written consent of both parties.
12. CONTRACTOR certifies that federal appropriated funds have not been paid or will be paid, by or on
behalf of CONTRACTOR, 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. CONTRACTOR assures that it will fully comply with all other applicable federal and state laws.
CONTRACTOR understands that the source of funds to be used under this Contract is Core Services
funds.
14. CONTRACTOR 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 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 12 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 the
Department 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,
CONTRACTOR shall not enter any third party relationship that gives the appearance of creating a conflict
of interest. Upon teaming of an existing appearance of a conflict of interest situation, CONTRACTOR
shall submit to the Department, 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 the Department's termination, for cause, of its contract with
CONTRACTOR.
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16. CONTRACTOR 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 CONTRACTOR shall be disclosed in a form identifiable with the applicant/recipient or a
minor's parent or guardian unless in accordance with CONTRACTOR written policies governing access
to, duplication and dissemination of, all such information. CONTRACTOR shall advise its employees,
agents, and subcontractor, if any, that they are subject to these confidentiality requirements.
CONTRACTOR 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.
CONTRACTOR shall have its employees, agents, and subcontractors, if any, sign a written confidentiality
agreement and shall provide a copy of such agreement to the Department, if requested.
17. Proprietary information for the purposes of this contract is information relating to a party's research,
development, trade secrets, business affairs, internal operations and management procedures and those of
its customers, clients or affiliates, but does not include information (1) lawfully obtained from third parties,
(2) that which is in the public domain, or (3) that which is developed independently. Neither party
shall use or disclose directly or indirectly without prior written authorization any proprietary information
concerning the other party obtained as a result of this Contract. Any proprietary information removed from
the State's site by CONTRACTOR in the course of providing services under this Contract will be accorded
at least the same precautions as are employed by CONTRACTOR for similar information in the course of
its own business.
18. CONTRACTOR certifies it will abide by Colorado Revised Statue (C.R.S.) 26-6-104, requiring criminal
background record checks for all employees, contractors, and sub -contractors.
19. Contractor certifies that it shall comply with the provisions of Colorado Revised Statutes (C.R.S.) 8-17.5-
101, et seq. Contractor shall not knowingly employ or contract with an illegal alien to perform work under
this Contract or enter into a contract with a subcontractor that fails to certify to Contractor that the
subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this
Contract. Contractor represents, warrants, and agrees that it (a) has verified that it does not employ any
illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by
the Social Security Administration and Department of Homeland Security, and (b) otherwise will comply
with the requirements of C.R.S. 8-17.5-102(2)(b). Contractor shall comply with all reasonable requests
made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and
Employment. If Contractor fails to comply with any requirement of this provision or C.R.S. 8-17.5-101, et
seq., the Department may terminate this Contract for breach and Contractor shall be liable for actual and
consequential damages to the Department.
Except where exempted by federal law and except as provided in C.R.S. 24-76.5-103(3), if Contractor
receives federal or state funds under this Contract, Contractor must confirm that any individual natural
person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. 24-
76.5-103(4) if such individual applies for public benefits provided under this Contract. If Contractor
operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it (a) is a citizen of
the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall
produce one of the forms of identification required by C.R.S. 24-76.5-101, et seq., and (c) shall produce
one of the forms of identification required by C.R.S. 24-76.5-103 prior to the effective date of this
Contract.
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EXHIBIT D
CHILD and FAMILY SERVICES REVIEWS (CFSR)
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas; Safety,
Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's
performance according to national standards and monitors progress over time. Following the review, a Performance
Improvement Program (PIP) will be implemented for the state to enhance services to families.
Additionally, the review will assess statewide, systemic factors to determine if the systems necessary to achieve
positive outcomes for families are in place.
All agencies that contract to provide service to families and children in Weld County must continually strive for
positive outcomes in the areas of safety, permanency and well-being for our youth. In order to insure continued
progress in this area, the Department is requiring providers to comply with a standard assessment and reporting
system which will address these three areas.*
The Department is requesting that provider reports include observations and recommendations regarding clients in a
way that specifically addresses the areas of safety, permanency and well-being. Below are the specific outcomes
that will be assessed by the CFSR in the areas of safety, permanency and well-being, followed by specific
considerations and tasks which must be addressed by the Department contracted providers.
Safety Outcomes
CFSR Outcome Measures
Safety I Children are, first and foremost, protected from abuse and neglect.
Safety 2 Children are safely maintained in their homes whenever possible and appropriate.
Considerations for the Department's providers
• Providers should always consider the following definitions regarding child safety when assessing families.
o Children are considered safe when there are no present dangers or impending danger threats, or
the caregivers' protective capacities control existing threats.
o Children are considered unsafe when they are vulnerable to present or impending danger threats,
and caregivers are unable or unwilling to provide protection.
o Risk is the likelihood (chance, potential, prospect) for parenting behavior that is harmful and
destructive to a child's cognitive, social, emotional and/or physical development, and those with
parenting responsibility are unwilling or unable to behave differently.
• Monthly reports should continually document an assessment of risk and safety concerns and the
interventions that are being offered by the provider to ameliorate those concerns.
• Monthly reports should make recommendations regarding services and/or safety measures that the provider
believes should be implemented to insure safety of the child(ren).
• Providers must specifically document efforts to engage families in services and to control for safety.
Permanency Outcomes
CFSR Outcome Measures
Permanency 1 Children have permanency and stability in their living situations.
Permanency 2 The continuity of family relationships and connections is preserved for children.
Considerations for the Department's providers:
• Provider reports should always note the primary permanency goal for the child and document how
interventions are working toward achieving that goal.
• Provider reports must indicate progress toward achieving the permanency goal and should make specific
recommendations regarding how the continuation of the service may assist in achieving the goal.
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• Providers should continually provide recommendations about whether any out -of -home placement
continues to be appropriate and should make recommendations regarding when changes in this area should
be made, in the providers' opinion.
• Providers should continually assess family relationships (parent/child, sibling/sibling, extended
family/child, etc.) and should report any concerning relationship issues which may be a barrier to achieving
permanency. Providers should document ongoing efforts to resolve those issues and/or make
recommendations regarding additional services that may be required to address relationship issues.
• Providers must document specific time frames when recommending ongoing services and/or
recommending changes to services and/or placements.
Child and Family Well -Being Outcomes
CFSR Outcome Measures
Well Being I Families have enhanced capacity to provide for their children's needs.
Well Being 2 Children receive appropriate services to meet their educational needs.
Well Being 3 Children receive adequate services to meet their physical and mental health needs.
Considerations for the Department's providers:
• Providers must engage in ongoing assessments of the parents' capacity to appropriately care for their
children and whether or not the service being provided continues to be appropriate. This must be clearly
documented in monthly reports.
• Providers should specifically detail areas of continued concern within the family and make
recommendations regarding whether that provider's service continues to be appropriate. Reports should
also document what barriers may be impeding progress.
• Providers should document any and all observed concerns regarding any child with whom the provider is
working. This should include concerns regarding physical, emotional, educational and behavioral well-
being of the child. When appropriate, providers should make recommendations regarding evaluations
and/or additional services that may address these concerns.
*Standardized reports will be provided and should be utilized by all agencies providing ongoing services to the
Department's families unless otherwise noted.
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CHILD PROTECTION AGREEMENT FOR SERVICES
BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SER$ICE ,
AND JONATHAN W. CARSON, LCSW
P t"' 1!: 18
'M,
This Agreement, made and entered into the / day of3`4 2009, by and between the Board of /f/y
Weld County Commissioners, sitting as the Board of Human Services, on behalf of the Weld County Department of
Human Services, hereinafter referred to as the "Department," and Jonathan W. Garson, LCSW, hereinafter referred
to as "Contractor".
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 Core Services funding to the
Department for Mental Health Services; and
NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows:
1. Term
This Agreement shall become effective on June I, 2009, upon proper execution of this Agreement and
shall expire May 31, 2010, unless sooner terminated as provided herein.
2. Scope of Services
Services shall be provided by CONTRACTOR 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," of which are attached
hereto and incorporated herein by reference.
"Payment Schedule" shall establish the maximum reimbursement, which will be paid from
Core Services funding during the duration of this Agreement.
b. CONTRACTOR shall submit an itemized monthly bill to the Department for all costs incurred
and services provided pursuant to Exhibit A of this Agreement in accordance with criteria
established by the Department. CONTRACTOR shall submit all itemized monthly billings to
the Department by the 7th day of the month following the month the cost was incurred. If the
billing is not submitted within twenty-five (25) calendar days of the month following service, it
may result in forfeiture of payment.
c. Payments of costs incurred pursuant to this Agreement is expressly contingent upon the
availability of Core Services to the Department.
d. The Department 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.
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PY-09-10-CORE-0138
4. Financial Management
At all times from the effective date of this Contract until completion of this Contract, CONTRACTOR
shall
comply with the administrative requirements, cost principles and other requirements set forth in the
Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds
expended under Core Service funding must conform to the Single Audit Act of 1984 and OMB Circular A-
133.
5. Payment Method
Unless otherwise provided in the Scope of Services and Payment Schedule:
a. CONTRACTOR shall provide proper monthly invoices and itemization of services performed for
costs incurred in the performance of the agreement.
b. The Department may withhold any payment if CONTRACTOR has failed to comply with the
Financial Management Requirements, program objectives, contractual terms, or reporting
requirements. In the event of a forfeiture of reimbursements, CONTRACTOR may appeal such
circumstance to the Director of Human Services. The decision of the Director of Human Services
shall be final.
6. Assurances
CONTRACTOR shall abide by all assurances as set forth in the attached Exhibit C, which is attached hereto
and incorporated herein by reference.
7. Compliance with Applicable Laws
At all times during the performance of this contract, CONTRACTOR 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. CONTRACTOR acknowledges that the following laws are included:
Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d —1 et. seq. and its implementing
regulation, 45 C.F.R. Part 80 et. seq.; and
Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 794, and
its implementing regulations, 45 C.F.R. Part 84; and
the Age Discrimination Act of 1975, 42 U.S.C. Sections 6101 et seq. and
its implementation regulations, 45 C.F.R. Part 91; and
Title VII of the Civil Rights Act of 1964; and
the Age Discrimination in Employment Act of 1967; and
the Equal Pay Act of 1963; and
the Education Amendments of 1972; and
Immigration Reform and Control Act of 1986, P.L. 99-603;
42 C.F.R. Part 2
and all regulations applicable to these laws prohibiting discrimination because of race, color,
National origin, and sex, religion and handicap, including Acquired Immune Deficiency Syndrome (AIDS)
or AIDS related conditions, covered under Section 504 of the Rehabilitation Act of 1973, as amended,
cited above. If necessary, CONTRACTOR and the Department will resist in judicial proceedings any
efforts to obtain access to client records except as permitted by 42 CFR Part 2.
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Included is 45 C.F.R. Part 74 Appendix G 9, which requires that affirmative steps be taken to assure that
small and minority businesses are utilized, when possible, as sources of supplies, equipment, construction
and services. This assurance is given in consideration of and for the purpose of obtaining any and all
federal and/or state financial assistance.
Any person who feels that s/he has been discriminated against has the right to file a complaint either with
the Colorado Department of Human Services or with the U.S. Department of Health and Human Services,
Office for Civil Rights.
8. Compliance with Child and Family Services Review
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas;
Safety, Permanency and Well Being of families. For each outcome, data and performance indicators
measure each state's performance according to national standards and monitor progress over time.
Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance
services to families.
CONTRACTORS providing services to the Department families and children must continually strive for
positive outcomes in the areas of safety, permanency and well being. Contractors providing services in
program areas identified by the Department are required to comply with a standard assessment and
reporting system set forth in Exhibit D which will address the aforementioned three areas.
9. Insurance
CONTRACTOR, shall procure, either personally or through its employer as applicable to the Contractor's
business, at its own expense, and maintain for the duration of the work, the following insurance coverage;
Weld County, Colorado, by and through the Board of County Commissioners of Weld County, its
employees and agents, shall be named as additional named insured on the insurance, where permissible by
the insurance provider.
a. Standard Workman's Compensation and Employer's Liability.
1. As required by state statute including occupational disease, covering all employees at
work site.
b. General Liability (PL & PD) (Minimum).
1. Combined single limit - $500,000 written on an occurrence basis.
2. Any aggregate limit will not be less than $1 million.
3. Provider must purchase additional insurance if claims reduce the annual aggregate below
$500,000.
4. State of Colorado to be named as additional insured on each comprehensive general
liability policy.
5. Certificate of insurance to be provided to Weld County and must be attached to the
contract.
6. Insurance shall include provisions preventing cancellation without 60 days prior notice
by certified mail to Weld County.
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c. Automobile Liability (Minimum) for any Contractor transporting children or any party to whom
Department services are being provided.
d. Additional coverage may be required in specific program areas. For any insurances that are
required by this contract, a completed Standard Certificate of Insurance Form shall be provided to
the Department by the Contractor prior to the start of any contract.
10. Certifications
CONTRACTOR 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. Copies of all necessary licenses shall be provided to the Department by the
Contractor prior to the start of any contract.
11. Training
Contractor shall attend a Court Testimony and Ethics Training to be paid for by the Department. The
Contractor may be required to attend additional training at the request of the Department. The cost of such
training will be paid for the Department. The Department will not compensate the Contractor for the time
spent attending the required trainings.
12. Monitoring and Evaluation
CONTRACTOR and the Department agree that monitoring and evaluation of the performance of this
Agreement shall be conducted by CONTRACTOR and the Department. The results of the monitoring and
evaluation shall be provided to the Board of Weld County Commissioners, the Department and
CONTRACTOR.
CONTRACTOR shall permit the Department, and any other duly authorized agent or governmental
agency, to monitor all activities conducted by CONTRACTOR 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.
13. Modification of Agreement
All modifications to this agreement shall be in writing and signed by both parties.
14. Remedies
The Director of Human Services or designee may exercise the following remedial actions should s/he find
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
CONTRACTOR. These remedial actions are as follows:
a. Withhold payment to 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 CONTRACTOR cannot be performed or if
performed would be of no value to the Department. Denial of the amount of payment shall be
reasonably related to the amount of work or deliverables lost to the Department;
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PY-09-10-CORE-0138
c. Incorrect payment to CONTRACTOR due to omission, error, fraud, and/or defalcation shall be
recovered from CONTRACTOR by deduction from subsequent payments under this Agreement or
other agreements between the Department and CONTRACTOR, or by the Department as a debt due to
the Department or otherwise as provided by law.
15. 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 the Department:
Gloria Romansik
Name
For CONTRACTOR:
Jonathan W. Garson, LCSW
Name
16. Notice
Social Services Administrator
Title
Private Practice
Title
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: The Department
Judy A. Griego, Director
P.O. Box A
Greeley, CO 80632
(970) 352-1551
17. Litigation
To: CONTRACTOR
Jonathan W. Garson, LCSW
229 Terry Street
Longmont, CO 80501
(303)494-1634
CONTRACTOR shall promptly notify the Department in the event that CONTRACTOR learns of any
actual litigation in which it is a party defendant in a case that involves services provided under this
Agreement. 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, reorganization and/or foreclosure.
18. 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. CONTRACTOR reserves the right to suspend services to clients if
funding is no longer available.
19. 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 13 herein.
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IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first
above written.
A11ES
LI$ CO
CLERK TO THE 3OARD
By:
APP
is
Co Attorney
WELD COUNTY DEPARTMENT
OF HUMA SERVICE
By:
BOARD OF COUNTY
COMMISSIONERS WELD
COUNTY, COLORADO
By:
l
Chair William F. Garcia
06/17/2009
6
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PY-09-10-CORE-0138
EXHIBIT A
SCOPE OF SERVICES
I. CONTRACTOR will provide offense -specific treatment services to youth referred by the Department.
2. Treatment services will be provided utilizing group sessions, individual sessions and family sessions.
3. Services will only be provided under the terms of this contract by Jonathan W. Garson, LCSW.
4. CONTRACTOR is sensitive to multicultural issues and will utilize interpretive services as necessary.
5. CONTRACTOR will bill the Department on a monthly basis per the terms of this contract.
6. CONTRACTOR will submit a report on a monthly basis for each active referral. Reports will be submitted
per the online format required by the Department, unless otherwise directed by the Department.
7. CONTRACTOR will participate in team reviews of ongoing services as needed.
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EXHIBIT B
PAYMENT SCHEDULE
1. Funding and Method of Payment
The Department agrees to reimburse CONTRACTOR in consideration for the work and services
performed from Core Services funding, not to exceed $15,000.00.
Expenses incurred by CONTRACTOR, in association with said project prior to the term of this agreement,
are not eligible Department expenditures and shall not be reimbursed by the Department.
Payment pursuant to this Contract, if Core Services funds, whether in whole or in part, is subject to and
contingent upon the continuing availability of said funds for the purposes hereof. In the event that said
funds, or any part thereof, become unavailable as determined by the Department, the Department may
immediately terminate this Contract or amend it accordingly.
2. Fees for Services
$95.00/Hour (Individual Therapy)
$95.00/Hour (Family Therapy)
$50.00/Hour (Group Therapy)
Department referrals will not be sent to collections by Contractor for default of co-pay/fees. Services will
be performed regardless of client's refusal or inability to pay co -pay.
Contractor will collect any applicable sliding scale co -pays and credit the Department for any payments
received on the monthly billing statements.
3. Submittal of Vouchers
CONTRACTOR shall prepare and submit monthly the itemized voucher and certify that the services
authorized were provided on the date indicated and the charges made were pursuant to the terms and
conditions of Exhibit A.
a. All billings are to be submitted by the 7th day of the month following the month of
service. If the billing is not submitted within twenty-five (25) calendar days of the month
following service, it may result in forfeiture of payment.
b. Billings must be submitted with the attached required forms, Authorization for
Contractual Services, Request for Reimbursement, Client Verification Form and monthly
report. The Authorization for Contractual Services and Client Verification Form must be
submitted with original signatures.
c. For monitored sobriety, proof of services rendered shall be a sign -in sheet with client
signatures or the test result.
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EXHIBIT C
ASSURANCES
1. CONTRACTOR 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 CONTRACTOR -
contracted CONTRACTOR or its employees, volunteers, or agents while performing duties as described in
this Agreement. CONTRACTOR shall indemnify, defend, and hold harmless Weld County, the Board of
County Commissioners of Weld County, its employees, volunteers, and agents. CONTRACTOR 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, CONTRACTOR shall provide the
Department 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 created a
duty of care with respect to any persons not a party of this Agreement.
4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld, State
of Colorado, to expend funds not otherwise appropriated in each succeeding year.
5. If any section, subsection, paragraph, sentence, clause, or phrase of this Contract is for any reason held or
decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The
parties hereto declare that they would have entered into this Contract and each and every section,
subsection, paragraph, sentence, clause, and phrase thereof irrespective of the fact that any one or more
sections, subsections, paragraphs, sentences, clauses, or phrases might be declared to be unconstitutional or
invalid.
6. No officer, member or employee of Weld County and no member of their governing bodies shall have any
pecuniary interest, direct or indirect, in the approved Agreement or the proceeds thereof.
7. CONTRACTOR 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. CONTRACTOR 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
CONTRACTOR.
9. All such records, documents, communications, and other materials created pursuant or related to this
contract shall be maintained by CONTRACTOR, in a central location and shall be made available to
Social Services upon its request, for a period of seven (7) 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 seven (7) year period, or if
audit findings have not been resolved after a seven (7) period, the materials shall be retained until the
resolution of the audit finding.
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10. CONTRACTOR assures that authorized local, federal, and state auditors and representatives shall, during
business hours, have access to inspect any copy records, and shall be allowed to monitor and review
through on -site visits, all contract activities, supported with funds under this Contract to ensure compliance
with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the
performance of the Agreement shall be conducted by appropriate funding sources. The results of the
monitoring and evaluation activities shall be provided to the appropriate and interested parties.
11. This Contract shall be binding upon the parties hereto, their successors, heirs, legal representatives, and
assigns. CONTRACTOR or the Department may not assign any of its rights or obligations hereunder
without the prior written consent of both parties.
12. CONTRACTOR certifies that federal appropriated funds have not been paid or will be paid, by or on
behalf of CONTRACTOR, 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. CONTRACTOR assures that it will fully comply with all other applicable federal and state laws.
CONTRACTOR understands that the source of funds to be used under this Contract is Core Services
funds.
14. CONTRACTOR 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 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 12 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 the
Department 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,
CONTRACTOR 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, CONTRACTOR
shall submit to the Department, 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 the Department's termination, for cause, of its contract with
CONTRACTOR.
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16. CONTRACTOR 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 CONTRACTOR shall be disclosed in a form identifiable with the applicant/recipient or a
minor's parent or guardian unless in accordance with CONTRACTOR written policies governing access
to, duplication and dissemination of, all such information. CONTRACTOR shall advise its employees,
agents, and subcontractor, if any, that they are subject to these confidentiality requirements.
CONTRACTOR 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.
CONTRACTOR shall have its employees, agents, and subcontractors, if any, sign a written confidentiality
agreement and shall provide a copy of such agreement to the Department, if requested.
17. Proprietary information for the purposes of this contract is information relating to a party's research,
development, trade secrets, business affairs, internal operations and management procedures and those of
its customers, clients or affiliates, but does not include information (1) lawfully obtained from third parties,
(2) that which is in the public domain, or (3) that which is developed independently. Neither party
shall use or disclose directly or indirectly without prior written authorization any proprietary information
concerning the other party obtained as a result of this Contract. Any proprietary information removed from
the State's site by CONTRACTOR in the course of providing services under this Contract will be accorded
at least the same precautions as are employed by CONTRACTOR for similar information in the course of
its own business.
18. CONTRACTOR certifies it will abide by Colorado Revised Statue (C.R.S.) 26-6-104, requiring criminal
background record checks for all employees, contractors, and sub -contractors.
19. Contractor certifies that it shall comply with the provisions of Colorado Revised Statutes (C.R.S.) 8-17.5-
101, et seq. Contractor shall not knowingly employ or contract with an illegal alien to perform work under
this Contract or enter into a contract with a subcontractor that fails to certify to Contractor that the
subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this
Contract. Contractor represents, warrants, and agrees that it (a) has verified that it does not employ any
illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by
the Social Security Administration and Department of Homeland Security, and (b) otherwise will comply
with the requirements of C.R.S. 8-17.5-102(2)(b). Contractor shall comply with all reasonable requests
made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and
Employment. If Contractor fails to comply with any requirement of this provision or C.R.S. 8-17.5-101, et
seq., the Department may terminate this Contract for breach and Contractor shall be liable for actual and
consequential damages to the Department.
Except where exempted by federal law and except as provided in C.R.S. 24-76.5-103(3), if Contractor
receives federal or state funds under this Contract, Contractor must confirm that any individual natural
person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. 24-
76.5-103(4) if such individual applies for public benefits provided under this Contract. If Contractor
operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it (a) is a citizen of
the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall
produce one of the forms of identification required by C.R.S. 24-76.5-101, et seq., and (c) shall produce
one of the forms of identification required by C.R.S. 24-76.5-103 prior to the effective date of this
Contract.
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EXHIBIT D
CHILD and FAMILY SERVICES REVIEWS (CFSR)
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas; Safety,
Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's
performance according to national standards and monitors progress over time. Following the review, a Performance
Improvement Program (PIP) will be implemented for the state to enhance services to families.
Additionally, the review will assess statewide, systemic factors to determine if the systems necessary to achieve
positive outcomes for families are in place.
All agencies that contract to provide service to families and children in Weld County must continually strive for
positive outcomes in the areas of safety, permanency and well-being for our youth. In order to insure continued
progress in this area, the Department is requiring providers to comply with a standard assessment and reporting
system which will address these three areas.*
The Department is requesting that provider reports include observations and recommendations regarding clients in a
way that specifically addresses the areas of safety, permanency and well-being. Below are the specific outcomes
that will be assessed by the CFSR in the areas of safety, permanency and well-being, followed by specific
considerations and tasks which must be addressed by the Department contracted providers.
Safety Outcomes
CFSR Outcome Measures
Safety 1 Children are, first and foremost, protected from abuse and neglect.
Safety 2 Children are safely maintained in their homes whenever possible and appropriate.
Considerations for the Department's providers
• Providers should always consider the following defmitions regarding child safety when assessing families.
o Children are considered safe when there are no present dangers or impending danger threats, or
the caregivers' protective capacities control existing threats.
o Children are considered unsafe when they are vulnerable to present or impending danger threats,
and caregivers are unable or unwilling to provide protection.
o Risk is the likelihood (chance, potential, prospect) for parenting behavior that is harmful and
destructive to a child's cognitive, social, emotional and/or physical development, and those with
parenting responsibility are unwilling or unable to behave differently.
• Monthly reports should continually document an assessment of risk and safety concerns and the
interventions that are being offered by the provider to ameliorate those concerns.
• Monthly reports should make recommendations regarding services and/or safety measures that the provider
believes should be implemented to insure safety of the child(ren).
• Providers must specifically document efforts to engage families in services and to control for safety.
Permanency Outcomes
CFSR Outcome Measures
Permanency 1 Children have permanency and stability in their living situations.
Permanency 2 The continuity of family relationships and connections is preserved for children.
Considerations for the Department's providers:
• Provider reports should always note the primary permanency goal for the child and document how
interventions are working toward achieving that goal.
• Provider reports must indicate progress toward achieving the permanency goal and should make specific
recommendations regarding how the continuation of the service may assist in achieving the goal.
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• Providers should continually provide recommendations about whether any out -of -home placement
continues to be appropriate and should make recommendations regarding when changes in this area should
be made, in the providers' opinion.
• Providers should continually assess family relationships (parent/child, sibling/sibling, extended
family/child, etc.) and should report any concerning relationship issues which may be a barrier to achieving
permanency. Providers should document ongoing efforts to resolve those issues and/or make
recommendations regarding additional services that may be required to address relationship issues.
• Providers must document specific time frames when recommending ongoing services and/or
recommending changes to services and/or placements.
Child and Family Well -Being Outcomes
CFSR Outcome Measures
Well Being 1 Families have enhanced capacity to provide for their children's needs.
Well Being 2 Children receive appropriate services to meet their educational needs.
Well Being 3 Children receive adequate services to meet their physical and mental health needs.
Considerations for the Department's providers:
• Providers must engage in ongoing assessments of the parents' capacity to appropriately care for their
children and whether or not the service being provided continues to be appropriate. This must be clearly
documented in monthly reports.
• Providers should specifically detail areas of continued concem within the family and make
recommendations regarding whether that provider's service continues to be appropriate. Reports should
also document what barriers may be impeding progress.
• Providers should document any and all observed concerns regarding any child with whom the provider is
working. This should include concems regarding physical, emotional, educational and behavioral well-
being of the child. When appropriate, providers should make recommendations regarding evaluations
and/or additional services that may address these concerns.
*Standardized reports will be provided and should be utilized by all agencies providing ongoing services to the
Department's families unless otherwise noted.
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CHILD PROTECTION AGREEMENT FOR SERVICES
BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES
AND GRIFFITH CENTERS FOR CHILDREN -CHINS UP CENTER
This Agreement, made and entered into the St_day of ..�j C 2009, by and between the Board of
Weld County Commissioners, sitting as the Board ofliuman Services, on behalf of the Weld County Department of
Human Services, hereinafter referred to as the "Department," and Griffith Centers for Children -Chins Up Center,
hereinafter referred to as "Contractor".
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 Core Services funding to the
Department for Home -Based Intensive Services (Family Preservation Services); and
NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows:
1. Term
This Agreement shall become effective on June 1, 2009, upon proper execution of this Agreement and shall
expire May 31, 2010, unless sooner terminated as provided herein.
2. Scope of Services
Services shall be provided by CONTRACTOR 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," of which are attached
hereto and incorporated herein by reference.
"Payment Schedule" shall establish the maximum reimbursement, which will be paid from
Core Services funding during the duration of this Agreement.
b. CONTRACTOR shall submit an itemized monthly bill to the Department for all costs incurred
and services provided pursuant to Exhibit A of this Agreement in accordance with criteria
established by the Department. CONTRACTOR shall submit all itemized monthly billings to
the Department by the 7°i day of the month following the month the cost was incurred. If the
billing is not submitted within twenty-five (25) calendar days of the month following service, it
may result in forfeiture of payment.
c. Payments of costs incurred pursuant to this Agreement is expressly contingent upon the availability
of Core Services funding to the Department.
d. The Department 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.
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4. Financial Management
At all times from the effective date of this Contract until completion of this Contract, CONTRACTOR shall
comply with the administrative requirements, cost principles and other requirements set forth in the
Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds
expended under Core Service funding must conform to the Single Audit Act of 1984 and OMB Circular A-
133.
5. Payment Method
Unless otherwise provided in the Scope of Services and Payment Schedule:
a. CONTRACTOR shall provide proper monthly invoices and itemization of services performed for
costs incurred in the performance of the agreement.
b. The Department may withhold any payment if CONTRACTOR has failed to comply with the
Financial Management Requirements, program objectives, contractual terms, or reporting
requirements. In the event of a forfeiture of reimbursements, CONTRACTOR may appeal such
circumstance to the Director of Human Services. The decision of the Director of Human Services
shall be final.
6. Assurances
CONTRACTOR shall abide by all assurances as set forth in the attached Exhibit C, which is attached hereto
and incorporated herein by reference.
7. Compliance with Applicable Laws
At all times during the performance of this contract, CONTRACTOR 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. CONTRACTOR acknowledges that the following laws are included:
Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d —1 et. seq. and its implementing
regulation, 45 C.F.R. Part 80 et. seq.• and
Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 794, and
its implementing regulations, 45 C.F.R. Part 84; and
the Age Discrimination Act of 1975, 42 U.S.C. Sections 6101 et. seq. and
its implementation regulations, 45 C.F.R. Part 91; and
Title VII of the Civil Rights Act of 1964; and
the Age Discrimination in Employment Act of 1967; and
the Equal Pay Act of 1963; and
the Education Amendments of 1972; and
Immigration Reform and Control Act of 1986, P.L. 99-603;
42 C.F.R. Part 2
and all regulations applicable to these laws prohibiting discrimination because of race, color,
National origin, and sex, religion and handicap, including Acquired Immune Deficiency Syndrome (AIDS)
or AIDS related conditions, covered under Section 504 of the Rehabilitation Act of 1973, as amended, cited
above. If necessary, CONTRACTOR and the Department will resist in judicial proceedings any efforts to
obtain access to client records except as permitted by 42 CFR Part 2.
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Included is 45 C.F.R. Part 74 Appendix G 9, which requires that affirmative steps be taken to assure that
small and minority businesses are utilized, when possible, as sources of supplies, equipment, construction
and services. This assurance is given in consideration of and for the purpose of obtaining any and all
federal and/or state financial assistance.
Any person who feels that s/he has been discriminated against has the right to file a complaint either with
the Colorado Department of Human Services or with the U.S. Department of Health and Human Services,
Office for Civil Rights.
8. Compliance with Child and Family Services Review
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas;
Safety, Permanency and Well Being of families. For each outcome, data and performance indicators
measure each state's performance according to national standards and monitor progress over time.
Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance
services to families.
CONTRACTORS providing services to the Department's families and children must continually strive for
positive outcomes in the areas of safety, permanency and well being. Contractors providing services in
program areas identified by the Department are required to comply with a standard assessment and
reporting system set forth in Exhibit D which will address the aforementioned three areas.
Insurance
CONTRACTOR, shall procure, either personally or through its employer as applicable to the Contractor's
business, at its own expense, and maintain for the duration of the work, the following insurance coverage;
Weld County, Colorado, by and through the Board of County Commissioners of Weld County, its
employees and agents, shall be named as additional named insured on the insurance, where permissible by
the insurance provider.
a. Standard Workman's Compensation and Employer's Liability.
1. As required by state statute including occupational disease, covering all employees at
work site.
b. General Liability (PL & PD) (Minimum).
1. Combined single limit - $500,000 written on an occurrence basis.
2. Any aggregate limit will not be less than $ I million.
3. Provider must purchase additional insurance if claims reduce the annual aggregate below
$500,000.
4. State of Colorado to be named as additional insured on each comprehensive general
liability policy.
5. Certificate of insurance to be provided to Weld County and must be attached to the
contract.
6. Insurance shall include provisions preventing cancellation without 60 days prior notice
by certified mail to Weld County.
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c. Automobile Liability (Minimum) for any Contractor transporting children or any party to whom
Department services are being provided.
d. Additional coverage may be required in specific program areas. For any insurances that are
required by this contract, a completed Standard Certificate of Insurance Form shall be provided to
the Department by the Contractor prior to the start of any contract.
10. Certifications
CONTRACTOR 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. Copies of all necessary licenses shall be provided to the Department by the
Contractor prior to the start of any contract.
11. Training
Contractor shall attend a Court Testimony and Ethics Training to be paid for by the Department. The
Contractor may be required to attend additional training at the request of the Department. The cost of such
training will be paid for the Department. The Department will not compensate the Contractor for the time
spent attending the required trainings.
12. Monitoring and Evaluation
CONTRACTOR and the Department agree that monitoring and evaluation of the performance of this
Agreement shall be conducted by CONTRACTOR and the Department. The results of the monitoring and
evaluation shall be provided to the Board of Weld County Commissioners, the Department and
CONTRACTOR.
CONTRACTOR shall permit the Department, and any other duly authorized agent or governmental agency,
to monitor all activities conducted by CONTRACTOR 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.
13. Modification of Agreement
All modifications to this agreement shall be in writing and signed by both parties.
14. Remedies
The Director of Human Services or designee may exercise the following remedial actions should s/he find
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
CONTRACTOR. These remedial actions are as follows:
a. Withhold payment to 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 CONTRACTOR cannot be performed or if
performed would be of no value to the Department. Denial of the amount of payment shall be
reasonably related to the amount of work or deliverables lost to the Department;
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c. Incorrect payment to CONTRACTOR due to omission, error, fraud, and/or defalcation shall be
recovered from CONTRACTOR by deduction from subsequent payments under this Agreement or
other agreements between the Department and CONTRACTOR, or by the Department as a debt due
to the Department or otherwise as provided by law.
15. 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 the Department:
Gloria Romansik
Name
For CONTRACTOR:
Nicole Politis, M.A.
Name
16. Notice
Social Services Administrator
Title
Program Manager
Title
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: The Department
Judy A. Griego, Director
P.O. Box A
Greeley, CO 80632
(970) 352-1551
17. Litigation
To: CONTRACTOR
Nicole Politis, M.A., Program Manager
14142 Denver West Parkway, Suite 225
Lakewood, CO 80401
(303) 906-4909
CONTRACTOR shall promptly notify the Department in the event that CONTRACTOR learns of any
actual litigation in which it is a party defendant in a case that involves services provided under this
Agreement. 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, reorganization and/or foreclosure.
18. 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. CONTRACTOR reserves the right to suspend services to clients if
funding is no longer available.
19. 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 13 herein.
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IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first
above
By:
WELD COUNTY DEPARTMENT
OF HUMAN S RVICES
Ju
Griego,
BOARD OF COUNTY
COMMISSIONERS WELD
COUNTY, COLQR�O
By:
Chair William F. Garcia
06/17/2009
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EXHIBIT A
SCOPE OF SERVICES
1. CONTRACTOR will provide Home -Based Intensive Services (Family Preservation Services) for high -risk
families designed to prevent out -of -home placements or prepare families for reunification, as referred by the
Department. Target populations include:
• Families who are in crisis or experiencing major struggles in functioning.
• Families with you in the home who are acting out behaviorally or sexually.
• Families with children and youth ages 0-17 years.
• Children who are at risk for out -of -home placement, or transitioning back into the home from
foster care, residential treatment, Department of Youth Corrections or other out -of -home
placement.
• Foster families with children or youth who meet the above criteria.
2. Family Preservation Services are modeled after the National Family Preservation Network's definition of
Intensive Family Preservation Services (IFPS). IFPS is defined as:
• "IFPS services are designed to support families in crisis in which children are either at imminent
risk of placement or have been placed out of the home. The services are for birth and adoptive
families and are effective as reunification services as well as for placement prevention."
3. The goal of the program is to keep children safe and avoid both unnecessary removal and long separations
from family in out -of -home care. Aspects of the program include:
• Services are flexible and individualized to each family.
• The home -based model offers service delivery that overcomes barriers to service access and
services are provided in the environment in which issues most likely arise.
• Services are utilized to stabilize family functioning and address safety risks. This is done through
teaching families to work with community agencies, appropriate parenting skills, stress reduction,
problem -solving and increased communication skills.
• Services are available 24 hours per day, 7 days per week.
• Services include 3-6 hours per week in the referred families' home. Services can be increased as
needed.
• Appointment times are flexible and include evenings and weekends.
4. Average length of services is 2 to 6 months.
5. CONTRACTOR will coordinate and advocate with school systems, court and the Department.
6. Follow up services are available for one year after discharge to aide in long-term success with pre -approval
from the Department.
7. CONTRACTOR is sensitive to family ethnicity, culture, values and beliefs.
8. CONTRACTOR will participate in reviews of ongoing services as requested.
9. CONTRACTOR will submit monthly reports and billing for each active referral to the Core and Service
Contract Coordinator. Reports will be submitted via the Department's online system unless otherwise
directed by the Department.
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EXHIBIT B
PAYMENT SCHEDULE
1. Funding and Method of Payment
The Department agrees to reimburse CONTRACTOR in consideration for the work and services performed
from Core Services funding, not to exceed $15,000.00.
Expenses incurred by CONTRACTOR, in association with said project prior to the term of this agreement,
are not eligible Department expenditures and shall not be reimbursed by the Department.
Payment pursuant to this Contract, if Core Services funds, whether in whole or in part, is subject to and
contingent upon the continuing availability of said funds for the purposes hereof. In the event that said
funds, or any part thereof, become unavailable as determined by the Department, the Department may
immediately terminate this Contract or amend it accordingly.
2. Fees for Services
$48.00/Hour (Family Preservation Services)
Department referrals will not be sent to collections by Contractor for default of co-pay/fees. Services will
be performed regardless of client's refusal or inability to pay co -pay.
Contractor will collect any applicable sliding scale co -pays and credit the Department for any payments
received on the monthly billing statements.
3. Submittal of Vouchers
CONTRACTOR shall prepare and submit monthly the itemized voucher and certify that the services
authorized were provided on the date indicated and the charges made were pursuant to the terms and
conditions of Exhibit A.
a. All billings are to be submitted by the 7th day of the month following the month of service.
If the billing is not submitted within twenty-five (25) calendar days of the month
following service, it may result in forfeiture of payment.
Billings must be submitted with the following required forms: Authorization for
Contractual Services, Request for Reimbursement, Client Verification Form and monthly
report. The Authorization for Contractual Services and Client Verification Form must be
submitted with original signatures.
c. For monitored sobriety, proof of services rendered shall be a sign -in sheet with client
signatures or the test result.
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EXHIBIT C
ASSURANCES
1. CONTRACTOR 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 CONTRACTOR -contracted
CONTRACTOR or its employees, volunteers, or agents while performing duties as described in this
Agreement. CONTRACTOR shall indemnify, defend, and hold harmless Weld County, the Board of
County Commissioners of Weld County, its employees, volunteers, and agents. CONTRACTOR 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, CONTRACTOR shall provide the Department
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 created a
duty of care with respect to any persons not a party of this Agreement.
4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld, State
of Colorado, to expend funds not otherwise appropriated in each succeeding year.
5. If any section, subsection, paragraph, sentence, clause, or phrase of this Contract is for any reason held or
decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The
parties hereto declare that they would have entered into this Contract and each and every section,
subsection, paragraph, sentence, clause, and phrase thereof irrespective of the fact that any one or more
sections, subsections, paragraphs, sentences, clauses, or phrases might be declared to be unconstitutional or
invalid.
6. No officer, member or employee of Weld County and no member of their governing bodies shall have any
pecuniary interest, direct or indirect, in the approved Agreement or the proceeds thereof.
7. CONTRACTOR 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. CONTRACTOR 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
CONTRACTOR.
9. All such records, documents, communications, and other materials created pursuant or related to this
contract shall be maintained by CONTRACTOR, in a central location and shall be made available to Social
Services upon its request, for a period of seven (7) 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 seven (7) year period, or if audit findings
have not been resolved after a seven (7) period, the materials shall be retained until the resolution of the
audit finding.
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10. CONTRACTOR assures that authorized local, federal, and state auditors and representatives shall, during
business hours, have access to inspect any copy records, and shall be allowed to monitor and review
through on -site visits, all contract activities, supported with funds under this Contract to ensure compliance
with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the
performance of the Agreement shall be conducted by appropriate funding sources. The results of the
monitoring and evaluation activities shall be provided to the appropriate and interested parties.
11. This Contract shall be binding upon the parties hereto, their successors, heirs, legal representatives, and
assigns. CONTRACTOR or the Department may not assign any of its rights or obligations hereunder
without the prior written consent of both parties.
12. CONTRACTOR certifies that federal appropriated funds have not been paid or will be paid, by or on behalf
of CONTRACTOR, 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. CONTRACTOR assures that it will fully comply with all other applicable federal and state laws.
CONTRACTOR understands that the source of funds to be used under this Contract is Core Services funds.
14. CONTRACTOR 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 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 12 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 the Department 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, CONTRACTOR 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, CONTRACTOR shall submit to the Department, 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 the
Department's termination, for cause, of its contract with CONTRACTOR.
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16. CONTRACTOR 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 CONTRACTOR shall be disclosed in a form identifiable with the applicant/recipient or a
minor's parent or guardian unless in accordance with CONTRACTOR written policies governing access to,
duplication and dissemination of, all such information. CONTRACTOR shall advise its employees, agents,
and subcontractor, if any, that they are subject to these confidentiality requirements. CONTRACTOR 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. CONTRACTOR shall have its
employees, agents, and subcontractors, if any, sign a written confidentiality agreement and shall provide a
copy of such agreement to the Department, if requested.
17. Proprietary information for the purposes of this contract is information relating to a party's research,
development, trade secrets, business affairs, internal operations and management procedures and those of its
customers, clients or affiliates, but does not include information (1) lawfully obtained from third parties, (2)
that which is in the public domain, or (3) that which is developed independently. Neither party shall use or
disclose directly or indirectly without prior written authorization any proprietary information concerning the
other party obtained as a result of this Contract. Any proprietary information removed from the State's site
by CONTRACTOR in the course of providing services under this Contract will be accorded at least the
same precautions as are employed by CONTRACTOR for similar information in the course of its own
business.
18. CONTRACTOR certifies it will abide by Colorado Revised Statue (C.R.S.) 26-6-104, requiring criminal
background record checks for all employees, contractors, and sub -contractors.
19. Contractor certifies that it shall comply with the provisions of Colorado Revised Statutes (C.R.S.) 8-17.5-
101, et seq. Contractor shall not knowingly employ or contract with an illegal alien to perform work under
this Contract or enter into a contract with a subcontractor that fails to certify to Contractor that the
subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this
Contract. Contractor represents, warrants, and agrees that it (a) has verified that it does not employ any
illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by
the Social Security Administration and Department of Homeland Security, and (b) otherwise will comply
with the requirements of C.R.S. 8-17.5-102(2)(b). Contractor shall comply with all reasonable requests
made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and
Employment. If Contractor fails to comply with any requirement of this provision or C.R.S. 8-17.5-101, et
seq., the Department may terminate this Contract for breach and Contractor shall be liable for actual and
consequential damages to the Department.
Except where exempted by federal law and except as provided in C.R.S. 24-76.5-103(3), if Contractor
receives federal or state funds under this Contract, Contractor must confirm that any individual natural
person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. 24-
76.5-103(4) if such individual applies for public benefits provided under this Contract. If Contractor
operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it (a) is a citizen of
the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall
produce one of the forms of identification required by C.R.S. 24-76.5-101, et seq., and (c) shall produce
one of the forms of identification required by C.R.S. 24-76.5-103 prior to the effective date of this Contract.
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EXHIBIT D
CHILD and FAMILY SERVICES REVIEWS (CFSR)
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas; Safety,
Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's
performance according to national standards and monitors progress over time. Following the review, a Performance
Improvement Program (PIP) will be implemented for the state to enhance services to families.
Additionally, the review will assess statewide, systemic factors to determine if the systems necessary to achieve
positive outcomes for families are in place.
All agencies that contract to provide service to families and children in Weld County must continually strive for
positive outcomes in the areas of safety, permanency and well-being for our youth. In order to insure continued
progress in this area, the Department is requiring providers to comply with a standard assessment and reporting
system which will address these three areas.*
The Department is requesting that provider reports include observations and recommendations regarding clients in a
way that specifically addresses the areas of safety, permanency and well-being. Below are the specific outcomes that
will be assessed by the CFSR in the areas of safety, permanency and well-being, followed by specific considerations
and tasks which must be addressed by the Department's contracted providers.
Safety Outcomes
CFSR Outcome Measures
Safety 1 Children are, first and foremost, protected from abuse and neglect.
Safety 2 Children are safely maintained in their homes whenever possible and appropriate.
Considerations for the Department's providers
• Providers should always consider the following definitions regarding child safety when assessing families.
o Children are considered safe when there are no present dangers or impending danger threats, or the
caregivers' protective capacities control existing threats.
o Children are considered unsafe when they are vulnerable to present or impending danger threats,
and caregivers are unable or unwilling to provide protection.
o Risk is the likelihood (chance, potential, prospect) for parenting behavior that is harmful and
destructive to a child's cognitive, social, emotional and/or physical development, and those with
parenting responsibility are unwilling or unable to behave differently.
• Monthly reports should continually document an assessment of risk and safety concerns and the
interventions that are being offered by the provider to ameliorate those concerns.
• Monthly reports should make recommendations regarding services and/or safety measures that the provider
believes should be implemented to insure safety of the child(ren).
• Providers must specifically document efforts to engage families in services and to control for safety.
Permanency Outcomes
CFSR Outcome Measures
Permanency 1 Children have permanency and stability in their living situations.
Permanency 2 The continuity of family relationships and connections is preserved for children.
Considerations for the Department's providers:
• Provider reports should always note the primary permanency goal for the child and document how
interventions are working toward achieving that goal.
• Provider reports must indicate progress toward achieving the permanency goal and should make specific
recommendations regarding how the continuation of the service may assist in achieving the goal.
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• Providers should continually provide recommendations about whether any out -of -home placement
continues to be appropriate and should make recommendations regarding when changes in this area should
be made, in the providers' opinion.
• Providers should continually assess family relationships (parent/child, sibling/sibling, extended
family/child, etc.) and should report any concerning relationship issues which may be a barrier to achieving
permanency. Providers should document ongoing efforts to resolve those issues and/or make
recommendations regarding additional services that may be required to address relationship issues.
• Providers must document specific time frames when recommending ongoing services and/or recommending
changes to services and/or placements.
Child and Family Well -Being Outcomes
CFSR Outcome Measures
Well Being 1 Families have enhanced capacity to provide for their children's needs.
Well Being 2 Children receive appropriate services to meet their educational needs.
Well Being 3 Children receive adequate services to meet their physical and mental health needs.
Considerations for the Department's providers:
• Providers must engage in ongoing assessments of the parents' capacity to appropriately care for their
children and whether or not the service being provided continues to be appropriate. This must be clearly
documented in monthly reports.
• Providers should specifically detail areas of continued concern within the family and make
recommendations regarding whether that provider's service continues to be appropriate. Reports should
also document what barriers may be impeding progress.
• Providers should document any and all observed concerns regarding any child with whom the provider is
working. This should include concerns regarding physical, emotional, educational and behavioral well-
being of the child. When appropriate, providers should make recommendations regarding evaluations
and/or additional services that may address these concerns.
*Standardized reports will be provided and should be utilized by all agencies providing ongoing services to the
Department's families unless otherwise noted.
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CHILD PROTECTION AGREEMENT FOR SERVICES
BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES
AND GRIFFITH CENTERS FOR CHILDREN -CHINS UP CENTER
(:et wi. / lcffrr
This Agreement, made and entered into the 51 day of ' pj a 2009, by and between the Board of
Weld County Commissioners, sitting as the Board of uman Services, on behalf of the Weld County Department of
Human Services, hereinafter referred to as the "Department," and Griffith Centers for Children -Chins Up Center,
hereinafter referred to as "Contractor".
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 Core Services funding to the
Department for Lifeskills (Parenting Skills); and
NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows:
1. Term
This Agreement shall become effective on June 1, 2009, upon proper execution of this Agreement and shall
expire May 31, 2010, unless sooner terminated as provided herein.
2. Scope of Services
Services shall be provided by CONTRACTOR 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," of which are attached
hereto and incorporated herein by reference.
"Payment Schedule" shall establish the maximum reimbursement, which will be paid from
Core Services funding during the duration of this Agreement.
b. CONTRACTOR shall submit an itemized monthly bill to the Department for all costs incurred
and services provided pursuant to Exhibit A of this Agreement in accordance with criteria
established by the Department. CONTRACTOR shall submit all itemized monthly billings to
the Department by the 7th day of the month following the month the cost was incurred. If the
billing is not submitted within twenty-five (25) calendar days of the month following service, it
may result in forfeiture of payment.
I
c. Payments of costs incurred pursuant to this Agreement is expressly contingent upon the availability
of Core Services funding to the Department.
d. The Department 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.
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4. Financial Management
At all times from the effective date of this Contract until completion of this Contract, CONTRACTOR shall
comply with the administrative requirements, cost principles and other requirements set forth in the
Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds
expended under Core Service funding must conform to the Single Audit Act of 1984 and OMB Circular A-
133.
5. Payment Method
Unless otherwise provided in the Scope of Services and Payment Schedule:
a. CONTRACTOR shall provide proper monthly invoices and itemization of services performed for
costs incurred in the performance of the agreement.
b. The Department may withhold any payment if CONTRACTOR has failed to comply with the
Financial Management Requirements, program objectives, contractual terms, or reporting
requirements. In the event of a forfeiture of reimbursements, CONTRACTOR may appeal such
circumstance to the Director of Human Services, The decision of the Director of Human Services
shall be final.
6. Assurances
CONTRACTOR shall abide by all assurances as set forth in the attached Exhibit C, which is attached hereto
and incorporated herein by reference.
Compliance with Applicable Laws
At all times during the performance of this contract, CONTRACTOR 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. CONTRACTOR acknowledges that the following laws are included:
Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d-1 et. seq. and its implementing
regulation, 45 C.F.R. Part 80 et. seq.• and
Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 794, and
its implementing regulations, 45 C.F.R. Part 84; and
the Age Discrimination Act of 1975, 42 U.S.C. Sections 6101 et. seq. and
its implementation regulations, 45 C.F.R. Part 91; and
Title VII of the Civil Rights Act of 1964; and
the Age Discrimination in Employment Act of 1967; and
the Equal Pay Act of 1963; and
the Education Amendments of 1972; and
Immigration Reform and Control Act of 1986, P.L. 99-603;
42 C.F.R. Part 2
and all regulations applicable to these laws prohibiting discrimination because of race, color,
National origin, and sex, religion and handicap, including Acquired Immune Deficiency Syndrome (AIDS)
or AIDS related conditions, covered under Section 504 of the Rehabilitation Act of 1973, as amended, cited
above. If necessary, CONTRACTOR and the Department will resist in judicial proceedings any efforts to
obtain access to client records except as permitted by 42 CFR Part 2.
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Included is 45 C.F.R. Part 74 Appendix G 9, which requires that affirmative steps be taken to assure that
small and minority businesses are utilized, when possible, as sources of supplies, equipment, construction
and services. This assurance is given in consideration of and for the purpose of obtaining any and all
federal and/or state financial assistance.
Any person who feels that s/he has been discriminated against has the right to file a complaint either with
the Colorado Department of Human Services or with the U.S. Department of Health and Human Services,
Office for Civil Rights.
8. Compliance with Child and Family Services Review
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas;
Safety, Permanency and Well Being of families. For each outcome, data and performance indicators
measure each state's performance according to national standards and monitor progress over time.
Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance
services to families.
CONTRACTORS providing services to the Department's families and children must continually strive for
positive outcomes in the areas of safety, permanency and well being. Contractors providing services in
program areas identified by the Department are required to comply with a standard assessment and
reporting system set forth in Exhibit D which will address the aforementioned three areas.
9. Insurance
CONTRACTOR, shall procure, either personally or through its employer as applicable to the Contractor's
business, at its own expense, and maintain for the duration of the work, the following insurance coverage;
Weld County, Colorado, by and through the Board of County Commissioners of Weld County, its
employees and agents, shall be named as additional named insured on the insurance, where permissible by
the insurance provider.
a. Standard Workman's Compensation and Employer's Liability.
1. As required by state statute including occupational disease, covering all employees at
work site.
b. General Liability (PL & PD) (Minimum).
1. Combined single limit - $500,000 written on an occurrence basis.
2. Any aggregate limit will not be less than $1 million.
3. Provider must purchase additional insurance if claims reduce the annual aggregate below
$500,000.
4. State of Colorado to be named as additional insured on each comprehensive general
liability policy.
5. Certificate of insurance to be provided to Weld County and must be attached to the
contract.
6. Insurance shall include provisions preventing cancellation without 60 days prior notice
by certified mail to Weld County.
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c. Automobile Liability (Minimum) for any Contractor transporting children or any party to whom
Department services are being provided.
d. Additional coverage may be required in specific program areas. For any insurances that are
required by this contract, a completed Standard Certificate of Insurance Form shall be provided to
the Department by the Contractor prior to the start of any contract.
10. Certifications
CONTRACTOR 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. Copies of all necessary licenses shall be provided to the Department by the
Contractor prior to the start of any contract.
11. Training
Contractor shall attend a Court Testimony and Ethics Training to be paid for by the Department. The
Contractor may be required to attend additional training at the request of the Department. The cost of such
training will be paid for the Department. The Department will not compensate the Contractor for the time
spent attending the required trainings.
12. Monitoring and Evaluation
CONTRACTOR and the Department agree that monitoring and evaluation of the performance of this
Agreement shall be conducted by CONTRACTOR and the Department. The results of the monitoring and
evaluation shall be provided to the Board of Weld County Commissioners, the Department and
CONTRACTOR.
CONTRACTOR shall permit the Department, and any other duly authorized agent or governmental agency,
to monitor all activities conducted by CONTRACTOR 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.
13. Modification of Agreement
All modifications to this agreement shall be in writing and signed by both parties.
14. Remedies
The Director of Human Services or designee may exercise the following remedial actions should s/he find
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
CONTRACTOR. These remedial actions are as follows:
a. Withhold payment to 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 CONTRACTOR cannot be performed or if
performed would be of no value to the Department. Denial of the amount of payment shall be
reasonably related to the amount of work or deliverables lost to the Department;
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PY-09-10-CORE-0184
c. Incorrect payment to CONTRACTOR due to omission, error, fraud, and/or defalcation shall be
recovered from CONTRACTOR by deduction from subsequent payments under this Agreement or
other agreements between the Department and CONTRACTOR, or by the Department as a debt due
to the Department or otherwise as provided by law.
15. 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 the Department:
Gloria Romansik
Name
For CONTRACTOR:
Nicole Politis, M.A.
Name
16. Notice
Social Services Administrator
Title
Program Manager
Title
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: The Department
Judy A. Griego, Director
P.O. Box A
Greeley, CO 80632
(970) 352-1551
17. Litigation
To: CONTRACTOR
Nicole Politis, M.A., Program Manager
14142 Denver West Parkway, Suite 225
Lakewood, CO 80401
(303) 906-4909
CONTRACTOR shall promptly notify the Department in the event that CONTRACTOR learns of any
actual litigation in which it is a party defendant in a case that involves services provided under this
Agreement. 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, reorganization and/or foreclosure.
18. 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. CONTRACTOR reserves the right to suspend services to clients if
funding is no longer available.
19. 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 13 herein.
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IN WITNESS WHEREOF, the parties herr . . ve duly executed the Agreement as of the day, month, and year first
above written.
ATTEST:
By:
WELD CO
CLERK TO
2
Deputy Clerk '
RO DA
County orney
WELD COUNTY DEPARTMENT
OF HUMAN SERVICES
By:
CO
OF COUNTY
e .CVO MISSIONERS WELD
COUNTY, COL
y
Char William F. Garcia
06/17/2009
CONTRAC
BY
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A
LX Ca)
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PY-09-10-CORE-0184
EXHIBIT A
SCOPE OF SERVICES
1. CONTRACTOR will provide Lifeskills (Parenting Services/Skills) to families referred by the Department.
Target populations include:
• Parents or primary caregivers who need in -home parenting instruction and assistance with
household management and accessing community resources.
• Parents with children ages 0-17 years who are at risk of out -of -home placement.
• Parents with children ages 0-17 years who are placed out of the home with relatives or in foster
care.
• Children who are transitioning back home from out -of -home placement.
2. Services include an intensive home -based model with an emphasis on the child's developmental needs, and
a Parenting Skills Group
3. The goal of the intensive home -based program is to improve parenting skills, and increase safety and
stability in the home. Aspects of the program include:
• Services are flexible and individualized to each family, and are based on assessment of parent and
child strengths and needs.
• Each referred family is assigned a LSP specialist who is trained in and specializes in parenting,
child development, and life skills. The LSP assists parents/caregivers with basic parenting skills,
household management, budgeting, organizational skills, and other day-to-day issues that impede
the care and development of children in the home.
• All safety risks are addressed immediately by the LSP.
• The home -based model offers service delivery that overcomes bathers to service access and
services are provided in the environment in which issues most likely arise.
• Services are utilized to stabilize family functioning and address safety risks. This is done through
teaching families to work with community agencies, appropriate parenting skills, stress reduction,
problem -solving and increased communication skills.
• Services are available 24 hours per day, 7 days per week.
• Services include 3-6 hours per week in the referred families' home. Services can be increased as
needed.
• Appointment times are flexible and include evenings and weekends.
• Average length of services is 2 to 6 months.
• CONTRACTOR will coordinate and advocate with school systems, court and the Department.
• Follow up services are available for one year after discharge to aide in long-term success with pre -
approval from the Department.
4. The Parenting Skills Group is based on the Nurturing Parenting Program, and is an evidenced -based
program that focuses on non-violent parenting.
• The program emphasizes the development of empathy, self-worth, self-awareness, empowerment,
and discipline with dignity, as well as appropriate family roles and age -appropriate expectations
for children.
• The program is 10 weeks in duration and participants must attend 8 out of 10 weeks to successfully
complete the program.
• The group is open.
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• Levels of prevention within the program include:
i. Prevention Programs (Primary Prevention). This level includes pre -parent stage and
prenatal stage.
ii. Intervention Programs (Secondary Prevention). This level includes programs designed to
intervene to prevent further escalation of the early stages of maltreatment or for families
considered to be "at -risk".
iii. Treatment Programs (Tertiary Prevention). This level includes programs designed to
treat families identified by the Department for child abuse and/or neglect.
5. CONTRACTOR is sensitive to family ethnicity, culture, values and beliefs.
6. CONTRACTOR will participate in reviews of ongoing services as requested.
7. CONTRACTOR will submit monthly reports and billing for each active referral to the Core and Service
Contract Coordinator. Reports will be submitted via the Department's online system unless otherwise
directed by the Department.
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EXHIBIT B
PAYMENT SCHEDULE
1. Funding and Method of Payment
The Department agrees to reimburse CONTRACTOR in consideration for the work and services performed
from Core Services funding, not to exceed $15,000.00.
Expenses incurred by CONTRACTOR, in association with said project prior to the term of this agreement,
are not eligible Department expenditures and shall not be reimbursed by the Department.
Payment pursuant to this Contract, if Core Services funds, whether in whole or in part, is subject to and
contingent upon the continuing availability of said funds for the purposes hereof. In the event that said
funds, or any part thereof, become unavailable as determined by the Department, the Department may
immediately terminate this Contract or amend it accordingly.
2. Fees for Services
$36.00/Hour (Parenting Services)
$30.00/Hour/Family (Parenting Skills Group)
$45.00/Episode/Family (Parenting Skills Group, 1.5 Hours, Six Family Minimum)
Department referrals will not be sent to collections by Contractor for default of co-pay/fees. Services will
be performed regardless of client's refusal or inability to pay co -pay.
Contractor will collect any applicable sliding scale co -pays and credit the Department for any payments
received on the monthly billing statements.
3. Submittal of Vouchers
CONTRACTOR shall prepare and submit monthly the itemized voucher and certify that the services
authorized were provided on the date indicated and the charges made were pursuant to the terms and
conditions of Exhibit A.
a. All billings are to be submitted by the 7'5 day of the month following the month of service.
If the billing is not submitted within twenty-five (25) calendar days of the month
following service, it may result in forfeiture of payment.
b. Billings must be submitted with the following required forms: Authorization for
Contractual Services, Request for Reimbursement, Client Verification Form and monthly
report. The Authorization for Contractual Services and Client Verification Form must be
submitted with original signatures.
c. For monitored sobriety, proof of services rendered shall be a sign -in sheet with client
signatures or the test result.
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EXHIBIT C
ASSURANCES
1. CONTRACTOR 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 CONTRACTOR -contracted
CONTRACTOR or its employees, volunteers, or agents while performing duties as described in this
Agreement. CONTRACTOR shall indemnify, defend, and hold harmless Weld County, the Board of
County Commissioners of Weld County, its employees, volunteers, and agents. CONTRACTOR 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, CONTRACTOR shall provide the Department
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 created a
duty of care with respect to any persons not a party of this Agreement.
4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld, State
of Colorado, to expend funds not otherwise appropriated in each succeeding year.
5. If any section, subsection, paragraph, sentence, clause, or phrase of this Contract is for any reason held or
decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The
parties hereto declare that they would have entered into this Contract and each and every section,
subsection, paragraph, sentence, clause, and phrase thereof irrespective of the fact that any one or more
sections, subsections, paragraphs, sentences, clauses, or phrases might be declared to be unconstitutional or
invalid.
6. No officer, member or employee of Weld County and no member of their governing bodies shall have any
pecuniary interest, direct or indirect, in the approved Agreement or the proceeds thereof.
7. CONTRACTOR 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. CONTRACTOR 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
CONTRACTOR.
9. All such records, documents, communications, and other materials created pursuant or related to this
contract shall be maintained by CONTRACTOR, in a central location and shall be made available to Social
Services upon its request, for a period of seven (7) 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 seven (7) year period, or if audit findings
have not been resolved after a seven (7) period, the materials shall be retained until the resolution of the
audit finding.
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10. CONTRACTOR 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.
This Contract shall be binding upon the parties hereto, their successors, heirs, legal representatives, and
assigns. CONTRACTOR or the Department may not assign any of its rights or obligations hereunder
without the prior written consent of both parties.
12. CONTRACTOR certifies that federal appropriated funds have not been paid or will be paid, by or on behalf
of CONTRACTOR, 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. CONTRACTOR assures that it will fully comply with all other applicable federal and state laws.
CONTRACTOR understands that the source of funds to be used under this Contract is Core Services funds.
14. CONTRACTOR 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 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 12 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 the Department 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, CONTRACTOR 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, CONTRACTOR shall submit to the Department, 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 the
Department's termination, for cause, of its contract with CONTRACTOR.
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16. CONTRACTOR 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 CONTRACTOR shall be disclosed in a form identifiable with the applicant/recipient or a
minor's parent or guardian unless in accordance with CONTRACTOR written policies governing access to,
duplication and dissemination of, all such information. CONTRACTOR shall advise its employees, agents,
and subcontractor, if any, that they are subject to these confidentiality requirements. CONTRACTOR 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. CONTRACTOR shall have its
employees, agents, and subcontractors, if any, sign a written confidentiality agreement and shall provide a
copy of such agreement to the Department, if requested.
17. Proprietary information for the purposes of this contract is information relating to a party's research,
development, trade secrets, business affairs, internal operations and management procedures and those of its
customers, clients or affiliates, but does not include information (I) lawfully obtained from third parties, (2)
that which is in the public domain, or (3) that which is developed independently. Neither party shall use or
disclose directly or indirectly without prior written authorization any proprietary information concerning the
other party obtained as a result of this Contract. Any proprietary information removed from the State's site
by CONTRACTOR in the course of providing services under this Contract will be accorded at least the
same precautions as are employed by CONTRACTOR for similar information in the course of its own
business.
18. CONTRACTOR certifies it will abide by Colorado Revised Statue (C.R.S.) 26-6-104, requiring criminal
background record checks for all employees, contractors, and sub -contractors.
19. Contractor certifies that it shall comply with the provisions of Colorado Revised Statutes (C.R.S.) 8-17.5-
101, et seq. Contractor shall not knowingly employ or contract with an illegal alien to perform work under
this Contract or enter into a contract with a subcontractor that fails to certify to Contractor that the
subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this
Contract. Contractor represents, warrants, and agrees that it (a) has verified that it does not employ any
illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by
the Social Security Administration and Department of Homeland Security, and (b) otherwise will comply
with the requirements of C.R.S. 8-17.5-102(2)(b). Contractor shall comply with all reasonable requests
made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and
Employment. If Contractor fails to comply with any requirement of this provision or C.R.S. 8-17.5-101, et
seq., the Department may terminate this Contract for breach and Contractor shall be liable for actual and
consequential damages to the Department.
Except where exempted by federal law and except as provided in C.R.S. 24-76.5-103(3), if Contractor
receives federal or state funds under this Contract, Contractor must confirm that any individual natural
person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. 24-
76.5-103(4) if such individual applies for public benefits provided under this Contract. If Contractor
operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it (a) is a citizen of
the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall
produce one of the forms of identification required by C.R.S. 24-76.5-101, et seq., and (c) shall produce
one of the forms of identification required by C.R.S. 24-76.5-103 prior to the effective date of this Contract.
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EXHIBIT D
CHILD and FAMILY SERVICES REVIEWS (CFSR)
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas; Safety,
Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's
performance according to national standards and monitors progress over time. Following the review, a Performance
Improvement Program (PIP) will be implemented for the state to enhance services to families.
Additionally, the review will assess statewide, systemic factors to determine if the systems necessary to achieve
positive outcomes for families are in place.
All agencies that contract to provide service to families and children in Weld County must continually strive for
positive outcomes in the areas of safety, permanency and well-being for our youth. In order to insure continued
progress in this area, the Department is requiring providers to comply with a standard assessment and reporting
system which will address these three areas.*
The Department is requesting that provider reports include observations and recommendations regarding clients in a
way that specifically addresses the areas of safety, permanency and well-being. Below are the specific outcomes that
will be assessed by the CFSR in the areas of safety, permanency and well-being, followed by specific considerations
and tasks which must be addressed by the Department's contracted providers.
Safety Outcomes
CFSR Outcome Measures
Safety 1 Children are, first and foremost, protected from abuse and neglect.
Safety 2 Children are safely maintained in their homes whenever possible and appropriate.
Considerations for the Department's providers
• Providers should always consider the following definitions regarding child safety when assessing families.
o Children are considered safe when there are no present dangers or impending danger threats, or the
caregivers' protective capacities control existing threats.
o Children are considered unsafe when they are vulnerable to present or impending danger threats,
and caregivers are unable or unwilling to provide protection.
o Risk is the likelihood (chance, potential, prospect) for parenting behavior that is harmful and
destructive to a child's cognitive, social, emotional and/or physical development, and those with
parenting responsibility are unwilling or unable to behave differently.
• Monthly reports should continually document an assessment of risk and safety concerns and the
interventions that are being offered by the provider to ameliorate those concerns.
• Monthly reports should make recommendations regarding services and/or safety measures that the provider
believes should be implemented to insure safety of the child(ren).
• Providers must specifically document efforts to engage families in services and to control for safety.
Permanency Outcomes
CFSR Outcome Measures
Permanency 1 Children have permanency and stability in their living situations.
Permanency 2 The continuity of family relationships and connections is preserved for children.
Considerations for the Department's providers:
• Provider reports should always note the primary permanency goal for the child and document how
interventions are working toward achieving that goal.
• Provider reports must indicate progress toward achieving the permanency goal and should make specific
recommendations regarding how the continuation of the service may assist in achieving the goal.
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• Providers should continually provide recommendations about whether any out -of -home placement
continues to be appropriate and should make recommendations regarding when changes in this area should
be made, in the providers' opinion.
• Providers should continually assess family relationships (parent/child, sibling/sibling, extended
family/child, etc.) and should report any concerning relationship issues which may be a barrier to achieving
permanency. Providers should document ongoing efforts to resolve those issues and/or make
recommendations regarding additional services that may be required to address relationship issues.
• Providers must document specific time frames when recommending ongoing services and/or recommending
changes to services and/or placements.
Child and Family Well -Being Outcomes
CFSR Outcome Measures
Well Being 1 Families have enhanced capacity to provide for their children's needs.
Well Being 2 Children receive appropriate services to meet their educational needs.
Well Being 3 Children receive adequate services to meet their physical and mental health needs.
Considerations for the Department's providers:
• Providers must engage in ongoing assessments of the parents' capacity to appropriately care for their
children and whether or not the service being provided continues to be appropriate. This must be clearly
documented in monthly reports.
• Providers should specifically detail areas of continued concern within the family and make
recommendations regarding whether that provider's service continues to be appropriate. Reports should
also document what barriers may be impeding progress.
• Providers should document any and all observed concerns regarding any child with whom the provider is
working. This should include concerns regarding physical, emotional, educational and behavioral well-
being of the child. When appropriate, providers should make recommendations regarding evaluations
and/or additional services that may address these concerns.
*Standardized reports will be provided and should be utilized by all agencies providing ongoing services to the
Department's families unless otherwise noted.
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(let e . �.
CHILD PROTECTION AGREEMENT FOR SERVICES ,
BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES
AND GRIFFITH CENTERS FOR CHILDREN -CHINS UP CENTER
//: 19
el
This Agreement, made and entered into the day of ‘..c ,,i4 2009, by and between the Board of
Weld County Commissioners, sitting as the Board of Iuman Services, on behalf of the Weld County Department of
Human Services, hereinafter referred to as the "Department," and Griffith Centers for Children -Chins Up Center,
hereinafter referred to as "Contractor".
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 Core Services funding to the
Department for Mental Health Services; and
NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows:
1. Term
This Agreement shall become effective on June 1, 2009, upon proper execution of this Agreement and shall
expire May 31, 2010, unless sooner terminated as provided herein.
2. Scope of Services
Services shall be provided by CONTRACTOR 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," of which are attached
hereto and incorporated herein by reference.
"Payment Schedule" shall establish the maximum reimbursement, which will be paid from
Core Services funding during the duration of this Agreement.
b. CONTRACTOR shall submit an itemized monthly bill to the Department for all costs incurred
and services provided pursuant to Exhibit A of this Agreement in accordance with criteria
established by the Department. CONTRACTOR shall submit all itemized monthly billings to
the Department by the 7th day of the month following the month the cost was incurred. If the
billing is not submitted within twenty-five (25) calendar days of the month following service, it
may result in forfeiture of payment.
c. Payments of costs incurred pursuant to this Agreement is expressly contingent upon the availability
of Core Services funding to the Department.
d. The Department 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.
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4. Financial Management
At all times from the effective date of this Contract until completion of this Contract, CONTRACTOR shall
comply with the administrative requirements, cost principles and other requirements set forth in the
Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds
expended under Core Service funding must conform to the Single Audit Act of 1984 and OMB Circular A-
133.
5. Payment Method
Unless otherwise provided in the Scope of Services and Payment Schedule:
a. CONTRACTOR shall provide proper monthly invoices and itemization of services performed for
costs incurred in the performance of the agreement.
b. The Department may withhold any payment if CONTRACTOR has failed to comply with the
Financial Management Requirements, program objectives, contractual terms, or reporting
requirements. In the event of a forfeiture of reimbursements, CONTRACTOR may appeal such
circumstance to the Director of Human Services. The decision of the Director of Human Services
shall be final.
6. Assurances
CONTRACTOR shall abide by all assurances as set forth in the attached Exhibit C, which is attached hereto
and incorporated herein by reference.
7. Compliance with Applicable Laws
At all times during the performance of this contract, CONTRACTOR 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. CONTRACTOR acknowledges that the following laws are included:
Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d-1 et. seq. and its implementing
regulation, 45 C.F.R. Part 80 et. seq.; and
Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 794, and
its implementing regulations, 45 C.F.R. Part 84; and
the Age Discrimination Act of 1975, 42 U.S.C. Sections 6101 et. seq. and
its implementation regulations, 45 C.F.R. Part 91; and
Title VII of the Civil Rights Act of 1964; and
the Age Discrimination in Employment Act of 1967; and
the Equal Pay Act of 1963; and
the Education Amendments of 1972; and
Immigration Reform and Control Act of 1986, P.L. 99-603;
42 C.F.R. Part 2
and all regulations applicable to these laws prohibiting discrimination because of race, color,
National origin, and sex, religion and handicap, including Acquired Immune Deficiency Syndrome (AIDS)
or AIDS related conditions, covered under Section 504 of the Rehabilitation Act of 1973, as amended, cited
above. If necessary, CONTRACTOR and the Department will resist in judicial proceedings any efforts to
obtain access to client records except as permitted by 42 CFR Part 2.
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Included is 45 C.F.R. Part 74 Appendix G 9, which requires that affirmative steps be taken to assure that
small and minority businesses are utilized, when possible, as sources of supplies, equipment, construction
and services. This assurance is given in consideration of and for the purpose of obtaining any and all
federal and/or state financial assistance.
Any person who feels that s/he has been discriminated against has the right to file a complaint either with
the Colorado Department of Human Services or with the U.S. Department of Health and Human Services,
Office for Civil Rights.
8. Compliance with Child and Family Services Review
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas;
Safety, Permanency and Well Being of families. For each outcome, data and performance indicators
measure each state's performance according to national standards and monitor progress over time.
Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance
services to families.
CONTRACTORS providing services to the Department's families and children must continually strive for
positive outcomes in the areas of safety, permanency and well being. Contractors providing services in
program areas identified by the Department are required to comply with a standard assessment and
reporting system set forth in Exhibit D which will address the aforementioned three areas.
9. Insurance
CONTRACTOR, shall procure, either personally or through its employer as applicable to the Contractor's
business, at its own expense, and maintain for the duration of the work, the following insurance coverage;
Weld County, Colorado, by and through the Board of County Commissioners of Weld County, its
employees and agents, shall be named as additional named insured on the insurance, where permissible by
the insurance provider.
a. Standard Workman's Compensation and Employer's Liability.
1. As required by state statute including occupational disease, covering all employees at
work site.
b. General Liability (PL & PD) (Minimum).
1. Combined single limit - $500,000 written on an occurrence basis.
2. Any aggregate limit will not be less than $1 million.
3. Provider must purchase additional insurance if claims reduce the annual aggregate below
$500,000.
4. State of Colorado to be named as additional insured on each comprehensive general
liability policy.
5. Certificate of insurance to be provided to Weld County and must be attached to the
contract.
6. Insurance shall include provisions preventing cancellation without 60 days prior notice
by certified mail to Weld County.
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c. Automobile Liability (Minimum) for any Contractor transporting children or any party to whom
Department services are being provided.
d. Additional coverage may be required in specific program areas. For any insurances that are
required by this contract, a completed Standard Certificate of Insurance Form shall be provided to
the Department by the Contractor prior to the start of any contract.
10. Certifications
CONTRACTOR 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. Copies of all necessary licenses shall be provided to the Department by the
Contractor prior to the start of any contract.
11. Training
Contractor shall attend a Court Testimony and Ethics Training to be paid for by the Department. The
Contractor may be required to attend additional training at the request of the Department. The cost of such
training will be paid for the Department. The Department will not compensate the Contractor for the time
spent attending the required trainings.
12. Monitoring and Evaluation
CONTRACTOR and the Department agree that monitoring and evaluation of the performance of this
Agreement shall be conducted by CONTRACTOR and the Department. The results of the monitoring and
evaluation shall be provided to the Board of Weld County Commissioners, the Department and
CONTRACTOR.
CONTRACTOR shall permit the Department, and any other duly authorized agent or governmental agency,
to monitor all activities conducted by CONTRACTOR 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.
13. Modification of Agreement
All modifications to this agreement shall be in writing and signed by both parties.
14. Remedies
The Director of Human Services or designee may exercise the following remedial actions should s/he find
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
CONTRACTOR. These remedial actions are as follows:
a. Withhold payment to 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 CONTRACTOR cannot be performed or if
performed would be of no value to the Department. Denial of the amount of payment shall be
reasonably related to the amount of work or deliverables lost to the Department;
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c. Incorrect payment to CONTRACTOR due to omission, error, fraud, and/or defalcation shall be
recovered from CONTRACTOR by deduction from subsequent payments under this Agreement or
other agreements between the Department and CONTRACTOR, or by the Department as a debt due
to the Department or otherwise as provided by law.
15. 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 the Department:
Gloria Romansik
Name
For CONTRACTOR:
Nicole Politis, M.A.
Name
16. Notice
Social Services Administrator
Title
Program Manager
Title
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: The Department
Judy A. Griego, Director
P.O. Box A
Greeley, CO 80632
(970) 352-1551
17. Litigation
To: CONTRACTOR
Nicole Politis, M.A., Program Manager
14142 Denver West Parkway, Suite 225
Lakewood, CO 80401
(303) 906-4909
CONTRACTOR shall promptly notify the Department in the event that CONTRACTOR teams of any
actual litigation in which it is a party defendant in a case that involves services provided under this
Agreement. 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, reorganization and/or foreclosure.
18. 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. CONTRACTOR reserves the right to suspend services to clients if
funding is no longer available.
19. 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 13 herein.
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IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first
above written.
ATTEST:
By:
Deputy Clerk
APPRRV
rney
WELD COUNTY DEPARTMENT
OF HUMAN SERVICES
By:
ARD OF COUNTY
OMMISSIONERS WELD
OUNTY, COLORADO
By:
Chair William F. Garcia
06/17/2009
ontractor
CCSw
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EXHIBIT A
SCOPE OF SERVICES
1. CONTRACTOR will provide Mental Health Services to individuals and families (all ages) referred by the
Department.
2. Services include individual therapy, family therapy, Eye Movement Desensitization and Reprocessing
(EMDR) Therapy, and mental health assessment.
• IndividuaUFamily Therapy:
i. Therapy can occur in the office or a client's home/community.
ii. Can be utilized in conjunction with or as a follow up to in -home services.
iii. Therapy conducted by Master's level mental health professionals.
iv. Sessions are weekly, unless otherwise directed by the Department.
v. Pager access 24 hours a day, 7 days a week.
• Eye Movement Desensitization and Reprocessing (EMDR):
i. Short term therapy for post -traumatic stress, trauma, panic attacks, complicated grief,
dissociative disorder, phobias, anxiety, anger/violence issues, addictions, stress reduction
and other issues.
ii. Can be utilized alone or in conjunction with other therapies.
Length of treatment varies dependent upon severity of issue. Ten to twelve sessions is
recommended, however services can be completed in as little as 3-4 sessions.
• Mental Health Needs Assessment:
i. Pre-treatment assessment used to determine the mental health functioning of the referred
individual.
ii. Assessment is conducted by a licensed mental health professional in the office or at the
client's home.
iii. CONTRACTOR will provide a written report that details recommendations for immediate
interventions and/or goals.
iv. Assessment is completed in 1-2 one -hour sessions.
3. CONTRACTOR is sensitive to family ethnicity, culture, values and beliefs.
4. CONTRACTOR will participate in reviews of ongoing services as requested.
5. CONTRACTOR will submit monthly reports (with the exception of the Mental Health Needs Assessment)
and billing for each active referral to the Core and Service Contract Coordinator. Reports will be submitted
via the Department's online system unless otherwise directed by the Department.
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EXHIBIT B
PAYMENT SCHEDULE
1. Funding and Method of Payment
The Department agrees to reimburse CONTRACTOR in consideration for the work and services performed
from Core Services funding, not to exceed $15,000.00.
Expenses incurred by CONTRACTOR, in association with said project prior to the term of this agreement,
are not eligible Department expenditures and shall not be reimbursed by the Department.
Payment pursuant to this Contract, if Core Services funds, whether in whole or in part, is subject to and
contingent upon the continuing availability of said funds for the purposes hereof. In the event that said
funds, or any part thereof, become unavailable as determined by the Department, the Department may
immediately terminate this Contract or amend it accordingly.
2. Fees for Services
$150.00/Episode (Mental Health Assessment)
$52.00/Hour (Individual Therapy)
$56.00/Hour (Family Therapy)
$75.00/Hour (Eye Movement Desensitization and Reprocessing (EMDR) Therapy)
Department referrals will not be sent to collections by Contractor for default of co-pay/fees. Services will
be performed regardless of client's refusal or inability to pay co -pay.
Contractor will collect any applicable sliding scale co -pays and credit the Department for any payments
received on the monthly billing statements.
3. Submittal of Vouchers
CONTRACTOR shall prepare and submit monthly the itemized voucher and certify that the services
authorized were provided on the date indicated and the charges made were pursuant to the terms and
conditions of Exhibit A.
a. All billings are to be submitted by the 7th day of the month following the month of service.
If the billing is not submitted within twenty-five (25) calendar days of the month
following service, it may result in forfeiture of payment.
b. Billings must be submitted with the following required forms: Authorization for
Contractual Services, Request for Reimbursement, Client Verification Form and monthly
report. The Authorization for Contractual Services and Client Verification Form must be
submitted with original signatures.
c. For monitored sobriety, proof of services rendered shall be a sign -in sheet with client
signatures or the test result.
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EXHIBIT C
ASSURANCES
1. CONTRACTOR 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 CONTRACTOR -contracted
CONTRACTOR or its employees, volunteers, or agents while performing duties as described in this
Agreement. CONTRACTOR shall indemnify, defend, and hold harmless Weld County, the Board of
County Commissioners of Weld County, its employees, volunteers, and agents. CONTRACTOR 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, CONTRACTOR shall provide the Department
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 created a
duty of care with respect to any persons not a party of this Agreement.
4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld, State
of Colorado, to expend funds not otherwise appropriated in each succeeding year.
5. If any section, subsection, paragraph, sentence, clause, or phrase of this Contract is for any reason held or
decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The
parties hereto declare that they would have entered into this Contract and each and every section,
subsection, paragraph, sentence, clause, and phrase thereof irrespective of the fact that any one or more
sections, subsections, paragraphs, sentences, clauses, or phrases might be declared to be unconstitutional or
invalid.
6. No officer, member or employee of Weld County and no member of their governing bodies shall have any
pecuniary interest, direct or indirect, in the approved Agreement or the proceeds thereof.
7. CONTRACTOR 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. CONTRACTOR 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
CONTRACTOR.
9. All such records, documents, communications, and other materials created pursuant or related to this
contract shall be maintained by CONTRACTOR, in a central location and shall be made available to Social
Services upon its request, for a period of seven (7) 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 seven (7) year period, or if audit findings
have not been resolved after a seven (7) period, the materials shall be retained until the resolution of the
audit finding.
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10. CONTRACTOR assures that authorized local, federal, and state auditors and representatives shall, during
business hours, have access to inspect any copy records, and shall be allowed to monitor and review
through on -site visits, all contract activities, supported with funds under this Contract to ensure compliance
with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the
performance of the Agreement shall be conducted by appropriate funding sources. The results of the
monitoring and evaluation activities shall be provided to the appropriate and interested parties.
11. This Contract shall be binding upon the parties hereto, their successors, heirs, legal representatives, and
assigns. CONTRACTOR or the Department may not assign any of its rights or obligations hereunder
without the prior written consent of both parties.
12. CONTRACTOR certifies that federal appropriated funds have not been paid or will be paid, by or on behalf
of CONTRACTOR, 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. CONTRACTOR assures that it will fully comply with all other applicable federal and state laws.
CONTRACTOR understands that the source of funds to be used under this Contract is Core Services funds.
14. CONTRACTOR 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 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 12 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 the Department 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, CONTRACTOR 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, CONTRACTOR shall submit to the Department, 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 the
Department's termination, for cause, of its contract with CONTRACTOR.
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16. CONTRACTOR 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 CONTRACTOR shall be disclosed in a form identifiable with the applicant/recipient or a
minor's parent or guardian unless in accordance with CONTRACTOR written policies governing access to,
duplication and dissemination of, all such information. CONTRACTOR shall advise its employees, agents,
and subcontractor, if any, that they are subject to these confidentiality requirements. CONTRACTOR 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. CONTRACTOR shall have its
employees, agents, and subcontractors, if any, sign a written confidentiality agreement and shall provide a
copy of such agreement to the Department, if requested.
17. Proprietary information for the purposes of this contract is information relating to a party's research,
development, trade secrets, business affairs, internal operations and management procedures and those of its
customers, clients or affiliates, but does not include information (1) lawfully obtained from third parties, (2)
that which is in the public domain, or (3) that which is developed independently. Neither party shall use or
disclose directly or indirectly without prior written authorization any proprietary information concerning the
other party obtained as a result of this Contract. Any proprietary information removed from the State's site
by CONTRACTOR in the course of providing services under this Contract will be accorded at least the
same precautions as are employed by CONTRACTOR for similar information in the course of its own
business.
18. CONTRACTOR certifies it will abide by Colorado Revised Statue (C.R.S.) 26-6-104, requiring criminal
background record checks for all employees, contractors, and sub -contractors.
19. Contractor certifies that it shall comply with the provisions of Colorado Revised Statutes (C.R.S.) 8-17.5-
101, et seq. Contractor shall not knowingly employ or contract with an illegal alien to perform work under
this Contract or enter into a contract with a subcontractor that fails to certify to Contractor that the
subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this
Contract. Contractor represents, warrants, and agrees that it (a) has verified that it does not employ any
illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by
the Social Security Administration and Department of Homeland Security, and (b) otherwise will comply
with the requirements of C.R.S. 8-17.5-102(2)(b). Contractor shall comply with all reasonable requests
made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and
Employment. If Contractor fails to comply with any requirement of this provision or C.R.S. 8-17.5-101, et
seq., the Department may terminate this Contract for breach and Contractor shall be liable for actual and
consequential damages to the Department.
Except where exempted by federal law and except as provided in C.R.S. 24-76.5-103(3), if Contractor
receives federal or state funds under this Contract, Contractor must confirm that any individual natural
person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. 24-
76.5-103(4) if such individual applies for public benefits provided under this Contract. If Contractor
operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it (a) is a citizen of
the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall
produce one of the forms of identification required by C.R.S. 24-76.5-101, et seq., and (c) shall produce
one of the forms of identification required by C.R.S. 24-76.5-103 prior to the effective date of this Contract.
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EXHIBIT D
CHILD and FAMILY SERVICES REVIEWS (CFSR)
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas; Safety,
Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's
performance according to national standards and monitors progress over time. Following the review, a Performance
Improvement Program (PIP) will be implemented for the state to enhance services to families.
Additionally, the review will assess statewide, systemic factors to determine if the systems necessary to achieve
positive outcomes for families are in place.
All agencies that contract to provide service to families and children in Weld County must continually strive for
positive outcomes in the areas of safety, permanency and well-being for our youth. In order to insure continued
progress in this area, the Department is requiring providers to comply with a standard assessment and reporting
system which will address these three areas.*
The Department is requesting that provider reports include observations and recommendations regarding clients in a
way that specifically addresses the areas of safety, permanency and well-being. Below are the specific outcomes that
will be assessed by the CFSR in the areas of safety, permanency and well-being, followed by specific considerations
and tasks which must be addressed by the Department's contracted providers.
Safety Outcomes
CFSR Outcome Measures
Safety 1 Children are, first and foremost, protected from abuse and neglect.
Safety 2 Children are safely maintained in their homes whenever possible and appropriate.
Considerations for the Department's providers
• Providers should always consider the following definitions regarding child safety when assessing families.
o Children are considered safe when there are no present dangers or impending danger threats, or the
caregivers' protective capacities control existing threats.
o Children are considered unsafe when they are vulnerable to present or impending danger threats,
and caregivers are unable or unwilling to provide protection.
o Risk is the likelihood (chance, potential, prospect) for parenting behavior that is harmful and
destructive to a child's cognitive, social, emotional and/or physical development, and those with
parenting responsibility are unwilling or unable to behave differently.
• Monthly reports should continually document an assessment of risk and safety concerns and the
interventions that are being offered by the provider to ameliorate those concerns.
• Monthly reports should make recommendations regarding services and/or safety measures that the provider
believes should be implemented to insure safety of the child(ren).
• Providers must specifically document efforts to engage families in services and to control for safety.
Permanency Outcomes
CFSR Outcome Measures
Permanency 1 Children have permanency and stability in their living situations.
Permanency 2 The continuity of family relationships and connections is preserved for children.
Considerations for the Department's providers:
• Provider reports should always note the primary permanency goal for the child and document how
interventions are working toward achieving that goal.
• Provider reports must indicate progress toward achieving the permanency goal and should make specific
recommendations regarding how the continuation of the service may assist in achieving the goal.
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• Providers should continually provide recommendations about whether any out -of -home placement
continues to be appropriate and should make recommendations regarding when changes in this area should
be made, in the providers' opinion.
• Providers should continually assess family relationships (parent/child, sibling/sibling, extended
family/child, etc.) and should report any concerning relationship issues which may be a barrier to achieving
permanency. Providers should document ongoing efforts to resolve those issues and/or make
recommendations regarding additional services that may be required to address relationship issues.
• Providers must document specific time frames when recommending ongoing services and/or recommending
changes to services and/or placements.
Child and Family Well -Being Outcomes
CFSR Outcome Measures
Well Being 1 Families have enhanced capacity to provide for their children's needs.
Well Being 2 Children receive appropriate services to meet their educational needs.
Well Being 3 Children receive adequate services to meet their physical and mental health needs.
Considerations for the Department's providers:
• Providers must engage in ongoing assessments of the parents' capacity to appropriately care for their
children and whether or not the service being provided continues to be appropriate. This must be clearly
documented in monthly reports.
• Providers should specifically detail areas of continued concern within the family and make
recommendations regarding whether that provider's service continues to be appropriate. Reports should
also document what barriers may be impeding progress.
• Providers should document any and all observed concerns regarding any child with whom the provider is
working. This should include concerns regarding physical, emotional, educational and behavioral well-
being of the child. When appropriate, providers should make recommendations regarding evaluations
and/or additional services that may address these concerns.
*Standardized reports will be provided and should be utilized by all agencies providing ongoing services to the
Department's families unless otherwise noted.
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c`Lr t 5l'1
CHILD PROTECTION AGREEMENT FOR SERVICES ,...
BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES^"+r e
AND GRIFFITH CENTERS FOR CHILDREN -CHINS UP CENTER - /9" / 9
c!
This Agreement, made and entered into the day of -)t;,.iN 2009, by and between the Board of
Weld County Commissioners, sitting as the Board of Human Services, on behalf of the Weld County Department of
Human Services, hereinafter referred to as the "Department," and Griffith Centers for Children -Chins Up Center,
hereinafter referred to as "Contractor".
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 Core Services funding to the
Department for Sex Abuse Treatment (Sexual Abuse Intervention, Offense -Specific and Informed Supervision); and
NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows:
I. Term
This Agreement shall become effective on June 1, 2009, upon proper execution of this Agreement and shall
expire May 31, 2010, unless sooner terminated as provided herein.
2. Scope of Services
Services shall be provided by CONTRACTOR 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," of which are attached
hereto and incorporated herein by reference.
"Payment Schedule" shall establish the maximum reimbursement, which will be paid from
Core Services funding during the duration of this Agreement.
b. CONTRACTOR shall submit an itemized monthly bill to the Department for all costs incurred
and services provided pursuant to Exhibit A of this Agreement in accordance with criteria
established by the Department. CONTRACTOR shall submit all itemized monthly billings to
the Department by the 7`h day of the month following the month the cost was incurred. If the
billing is not submitted within twenty-five (25) calendar days of the month following service, it
may result in forfeiture of payment.
c. Payments of costs incurred pursuant to this Agreement is expressly contingent upon the availability
of Core Services funding to the Department.
d. The Department 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.
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4. Financial Management
At all times from the effective date of this Contract until completion of this Contract, CONTRACTOR shall
comply with the administrative requirements, cost principles and other requirements set forth in the
Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds
expended under Core Service funding must conform to the Single Audit Act of 1984 and OMB Circular A-
133.
5. Payment Method
Unless otherwise provided in the Scope of Services and Payment Schedule:
a. CONTRACTOR shall provide proper monthly invoices and itemization of services performed for
costs incurred in the performance of the agreement.
b. The Department may withhold any payment if CONTRACTOR has failed to comply with the
Financial Management Requirements, program objectives, contractual terms, or reporting
requirements. In the event of a forfeiture of reimbursements, CONTRACTOR may appeal such
circumstance to the Director of Human Services. The decision of the Director of Human Services
shall be final.
6. Assurances
CONTRACTOR shall abide by all assurances as set forth in the attached Exhibit C, which is attached hereto
and incorporated herein by reference.
7. Compliance with Applicable Laws
At all times during the performance of this contract, CONTRACTOR 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. CONTRACTOR acknowledges that the following laws are included:
Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d —1 et. seq. and its implementing
regulation, 45 C.F.R. Part 80 et. seq.; and
Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 794, and
its implementing regulations, 45 C.F.R. Part 84; and
the Age Discrimination Act of 1975, 42 U.S.C. Sections 6101 et. seq. and
its implementation regulations, 45 C.F.R. Part 91; and
Title VII of the Civil Rights Act of 1964; and
the Age Discrimination in Employment Act of 1967; and
the Equal Pay Act of 1963; and
the Education Amendments of 1972; and
Immigration Reform and Control Act of 1986, P.L. 99-603;
42 C.F.R. Part 2
and all regulations applicable to these laws prohibiting discrimination because of race, color,
National origin, and sex, religion and handicap, including Acquired Immune Deficiency Syndrome (AIDS)
or AIDS related conditions, covered under Section 504 of the Rehabilitation Act of 1973, as amended, cited
above. If necessary, CONTRACTOR and the Department will resist in judicial proceedings any efforts to
obtain access to client records except as permitted by 42 CFR Part 2.
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Included is 45 C.F.R. Part 74 Appendix G 9, which requires that affirmative steps be taken to assure that
small and minority businesses are utilized, when possible, as sources of supplies, equipment, construction
and services. This assurance is given in consideration of and for the purpose of obtaining any and all
federal and/or state financial assistance.
Any person who feels that s/he has been discriminated against has the right to file a complaint either with
the Colorado Department of Human Services or with the U.S. Department of Health and Human Services,
Office for Civil Rights.
8. Compliance with Child and Family Services Review
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas;
Safety, Permanency and Well Being of families. For each outcome, data and performance indicators
measure each state's performance according to national standards and monitor progress over time.
Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance
services to families.
CONTRACTORS providing services to the Department's families and children must continually strive for
positive outcomes in the areas of safety, permanency and well being. Contractors providing services in
program areas identified by the Department are required to comply with a standard assessment and
reporting system set forth in Exhibit D which will address the aforementioned three areas.
Insurance
CONTRACTOR, shall procure, either personally or through its employer as applicable to the Contractor's
business, at its own expense, and maintain for the duration of the work, the following insurance coverage;
Weld County, Colorado, by and through the Board of County Commissioners of Weld County, its
employees and agents, shall be named as additional named insured on the insurance, where permissible by
the insurance provider.
a. Standard Workman's Compensation and Employer's Liability.
1. As required by state statute including occupational disease, covering all employees at
work site.
b. General Liability (PL & PD) (Minimum).
I. Combined single limit - $500,000 written on an occurrence basis.
2. Any aggregate limit will not be less than $1 million.
3. Provider must purchase additional insurance if claims reduce the annual aggregate below
$500,000.
4. State of Colorado to be named as additional insured on each comprehensive general
liability policy.
5. Certificate of insurance to be provided to Weld County and must be attached to the
contract.
6. Insurance shall include provisions preventing cancellation without 60 days prior notice
by certified mail to Weld County.
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c. Automobile Liability (Minimum) for any Contractor transporting children or any party to whom
Department services are being provided.
d. Additional coverage may be required in specific program areas. For any insurances that are
required by this contract, a completed Standard Certificate of Insurance Form shall be provided to
the Department by the Contractor prior to the start of any contract.
10. Certifications
CONTRACTOR 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. Copies of all necessary licenses shall be provided to the Department by the
Contractor prior to the start of any contract.
11. Training
Contractor shall attend a Court Testimony and Ethics Training to be paid for by the Department. The
Contractor may be required to attend additional training at the request of the Department. The cost of such
training will be paid for the Department. The Department will not compensate the Contractor for the time
spent attending the required trainings.
12. Monitoring and Evaluation
CONTRACTOR and the Department agree that monitoring and evaluation of the performance of this
Agreement shall be conducted by CONTRACTOR and the Department. The results of the monitoring and
evaluation shall be provided to the Board of Weld County Commissioners, the Department and
CONTRACTOR.
CONTRACTOR shall permit the Department, and any other duly authorized agent or governmental agency,
to monitor all activities conducted by CONTRACTOR 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.
13. Modification of Agreement
All modifications to this agreement shall be in writing and signed by both parties.
14. Remedies
The Director of Human Services or designee may exercise the following remedial actions should s/he find
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
CONTRACTOR. These remedial actions are as follows:
a. Withhold payment to 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 CONTRACTOR cannot be performed or if
performed would be of no value to the Department. Denial of the amount of payment shall be
reasonably related to the amount of work or deliverables lost to the Department;
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PY-09-10-CORE-0186
c. Incorrect payment to CONTRACTOR due to omission, error, fraud, and/or defalcation shall be
recovered from CONTRACTOR by deduction from subsequent payments under this Agreement or
other agreements between the Department and CONTRACTOR, or by the Department as a debt due
to the Department or otherwise as provided by law.
15. 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 the Department:
Gloria Romansik
Name
For CONTRACTOR:
Nicole Politis, M.A.
Name
16. Notice
Social Services Administrator
Title
Program Manager
Title
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: The Department
Judy A. Griego, Director
P.O. Box A
Greeley, CO 80632
(970) 352-1551
17. Litigation
To: CONTRACTOR
Nicole Politis, M.A., Program Manager
14142 Denver West Parkway, Suite 225
Lakewood, CO 80401
(303) 906-4909
CONTRACTOR shall promptly notify the Department in the event that CONTRACTOR learns of any
actual litigation in which it is a party defendant in a case that involves services provided under this
Agreement. 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, reorganization and/or foreclosure.
18. 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. CONTRACTOR reserves the right to suspend services to clients if
funding is no longer available.
19. 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 13 herein.
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IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first
above written.
WELD COUNTY DEPARTMENT
OF HUMAN SERVICES
I
By:
Director
iuttv-
BOARD OF COUNTY
COMMISSIONERS WELD
COUNTY, CQLORApO
By:
CONTRAC
BY
ntractor
air William F. Garcia
06/17/2009
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EXHIBIT A
SCOPE OF SERVICES
1. CONTRACTOR will provide Sexual Abuse Treatment services to youth, ages 3-17, and their families as
referred by the Department.
2. Services include Sexual Abuse Intervention (SAI) and Informed Supervision Training.
• Sexual Abuse Intervention (SAI):
i. A comprehensive in -home and community intervention designed to ensure protection of
the victim, family, community, and alleged sexually acting out youth.
ii. Target populations include:
1. Families with youth who are demonstrating inappropriate sexual behavior.
2. Families with children ages 3-17.
3. Youth who may be at risk of out -of -home placement, or transitioning back home
from foster care, residential treatment, youth corrections or other placement.
4. Parents/caregivers who are willing to participate in the service and are
committed to monitoring the youth.
iii. SAI provides the following offense -specific services to the youth and family:
1. Sex Offender Risk Assessment
2. Intensive Home -Based Services and Safety Planning
3. Offensive Sexual Abuse Treatment with Polygraphs
4. Individual and Family Therapy
5. Informed Supervision
iv. Program is supervised by a licensed Sex Offender Management Board (SOMB) Juvenile
Full Operating Level Provider.
v. All in -home services are provided by SOMB Juvenile Associate Level Providers.
vi. Program staff serve as members of the multi -disciplinary team (MDT).
vii. The J -Soap II, a standardized community risk assessment tool, is utilized throughout the
intervention.
viii. Aspects of the program include:
1. Services are flexible and individualized to each family.
2. The home -based model offers service delivery that overcomes barriers to service
access and services are provided in the environment in which issues most likely
arise.
3. Services can be utilized at the initial onset of concerns or allegations of
inappropriate behavior.
4. Services are available 24 hours per day, 7 days per week.
5. Services include 5-15 hours per week in the referred families' home. Services
can be increased as needed.
6. Average length of services is 5-7 months.
7. Appointment times are flexible and include evenings and weekends.
8. CONTRACTOR will coordinate and advocate with school systems, court and
the Department.
• Informed Supervision Training:
i. Includes 2-3 hour of group or individual training for those responsible for supervising a
juvenile sex offender.
ii. Training covers the following topics:
1. Colorado State Standards for Juveniles Who Commit Sexual Offenses
2. Rationale of Informed Supervision
3. Role of the Multidisciplinary Team (MDT)
4. Cycles of Abuse
5. Patterns of Behavior
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6. Line -of -sight Supervision
7. Arranging for alternate supervision when primary caregiver is not available.
8. Safety Planning
3. CONTRACTOR is sensitive to family ethnicity, culture, values and beliefs.
4. CONTRACTOR will participate in reviews of ongoing services as requested.
5. CONTRACTOR will submit monthly reports and billing for each active referral to the Core and Service
Contract Coordinator. Reports will be submitted via the Department's online system unless otherwise
directed by the Department.
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EXHIBIT B
PAYMENT SCHEDULE
1. Funding and Method of Payment
The Department agrees to reimburse CONTRACTOR in consideration for the work and services performed
from Core Services funding, not to exceed $15,000.00.
Expenses incurred by CONTRACTOR, in association with said project prior to the term of this agreement,
are not eligible Department expenditures and shall not be reimbursed by the Department.
Payment pursuant to this Contract, if Core Services funds, whether in whole or in part, is subject to and
contingent upon the continuing availability of said funds for the purposes hereof. In the event that said
funds, or any part thereof, become unavailable as determined by the Department, the Department may
immediately terminate this Contract or amend it accordingly.
2. Fees for Services
$50.00/Hour/Person (Sexual Abuse Intervention (SAI))
$30.00/Hour/Person (Sex Offender Treatment Group)
$45.00/Episode/Person (Sex Offender Treatment Group, Six Member Minimum)
$30.00/Hour/Family (Informed Supervision Training -Group Format)
$60.00/Episode/Family (Informed Supervision Training -Group Format, Six Family Minimum)
$50.00/Hour/Person (Informed Supervision Training -Individual Format)
$100.00/Episode (Informed Supervision Training -Individual Format, Completed in One Session)
Department referrals will not be sent to collections by Contractor for default of co-pay/fees. Services will
be performed regardless of client's refusal or inability to pay co -pay.
Contractor will collect any applicable sliding scale co -pays and credit the Department for any payments
received on the monthly billing statements.
3. Submittal of Vouchers
CONTRACTOR shall prepare and submit monthly the itemized voucher and certify that the services
authorized were provided on the date indicated and the charges made were pursuant to the terms and
conditions of Exhibit A.
a. All billings are to be submitted by the 7' day of the month following the month of service.
If the billing is not submitted within twenty-five (25) calendar days of the month
following service, it may result in forfeiture of payment.
b. Billings must be submitted with the following required forms: Authorization for
Contractual Services, Request for Reimbursement, Client Verification Form and monthly
report. The Authorization for Contractual Services and Client Verification Form must be
submitted with original signatures.
c. For monitored sobriety, proof of services rendered shall be a sign -in sheet with client
signatures or the test result.
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EXHIBIT C
ASSURANCES
CONTRACTOR 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 CONTRACTOR -contracted
CONTRACTOR or its employees, volunteers, or agents while performing duties as described in this
Agreement. CONTRACTOR shall indemnify, defend, and hold harmless Weld County, the Board of
County Commissioners of Weld County, its employees, volunteers, and agents. CONTRACTOR 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, CONTRACTOR shall provide the Department
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 created a
duty of care with respect to any persons not a party of this Agreement.
4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld, State
of Colorado, to expend funds not otherwise appropriated in each succeeding year.
5. If any section, subsection, paragraph, sentence, clause, or phase 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. CONTRACTOR 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. CONTRACTOR 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
CONTRACTOR.
9. All such records, documents, communications, and other materials created pursuant or related to this
contract shall be maintained by CONTRACTOR, in a central location and shall be made available to Social
Services upon its request, for a period of seven (7) 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 seven (7) year period, or if audit findings
have not been resolved after a seven (7) period, the materials shall be retained until the resolution of the
audit finding.
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10. CONTRACTOR assures that authorized local, federal, and state auditors and representatives shall, during
business hours, have access to inspect any copy records, and shall be allowed to monitor and review
through on -site visits, all contract activities, supported with funds under this Contract to ensure compliance
with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the
performance of the Agreement shall be conducted by appropriate funding sources. The results of the
monitoring and evaluation activities shall be provided to the appropriate and interested parties.
11. This Contract shall be binding upon the parties hereto, their successors, heirs, legal representatives, and
assigns. CONTRACTOR or the Department may not assign any of its rights or obligations hereunder
without the prior written consent of both parties.
12. CONTRACTOR certifies that federal appropriated funds have not been paid or will be paid, by or on behalf
of CONTRACTOR, 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. CONTRACTOR assures that it will fully comply with all other applicable federal and state laws.
CONTRACTOR understands that the source of funds to be used under this Contract is Core Services funds.
14. CONTRACTOR 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 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 12 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 the Department 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, CONTRACTOR 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, CONTRACTOR shall submit to the Department, 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 the
Department's termination, for cause, of its contract with CONTRACTOR.
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16. CONTRACTOR 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 CONTRACTOR shall be disclosed in a form identifiable with the applicant/recipient or a
minor's parent or guardian unless in accordance with CONTRACTOR written policies governing access to,
duplication and dissemination of, all such information. CONTRACTOR shall advise its employees, agents,
and subcontractor, if any, that they are subject to these confidentiality requirements. CONTRACTOR 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. CONTRACTOR shall have its
employees, agents, and subcontractors, if any, sign a written confidentiality agreement and shall provide a
copy of such agreement to the Department, if requested.
17. Proprietary information for the purposes of this contract is information relating to a party's research,
development, trade secrets, business affairs, internal operations and management procedures and those of its
customers, clients or affiliates, but does not include information (1) lawfully obtained from third parties, (2)
that which is in the public domain, or (3) that which is developed independently. Neither party shall use or
disclose directly or indirectly without prior written authorization any proprietary information concerning the
other party obtained as a result of this Contract. Any proprietary information removed from the State's site
by CONTRACTOR in the course of providing services under this Contract will be accorded at least the
same precautions as are employed by CONTRACTOR for similar information in the course of its own
business.
18. CONTRACTOR certifies it will abide by Colorado Revised Statue (C.R.S.) 26-6-104, requiring criminal
background record checks for all employees, contractors, and sub -contractors.
19. Contractor certifies that it shall comply with the provisions of Colorado Revised Statutes (C.R.S.) 8-17.5-
101, et seq. Contractor shall not knowingly employ or contract with an illegal alien to perform work under
this Contract or enter into a contract with a subcontractor that fails to certify to Contractor that the
subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this
Contract. Contractor represents, warrants, and agrees that it (a) has verified that it does not employ any
illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by
the Social Security Administration and Department of Homeland Security, and (b) otherwise will comply
with the requirements of C.R.S. 8-17.5-102(2)(b). Contractor shall comply with all reasonable requests
made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and
Employment. If Contractor fails to comply with any requirement of this provision or C.R.S. 8-17.5-101, et
seq., the Department may terminate this Contract for breach and Contractor shall be liable for actual and
consequential damages to the Department.
Except where exempted by federal law and except as provided in C.R.S. 24-76.5-103(3), if Contractor
receives federal or state funds under this Contract, Contractor must confirm that any individual natural
person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. 24-
76.5-103(4) if such individual applies for public benefits provided under this Contract. If Contractor
operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it (a) is a citizen of
the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall
produce one of the forms of identification required by C.R.S. 24-76.5-101, et seq., and (c) shall produce
one of the forms of identification required by C.R.S. 24-76.5-103 prior to the effective date of this Contract.
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EXHIBIT D
CHILD and FAMILY SERVICES REVIEWS (CFSR)
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas; Safety,
Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's
performance according to national standards and monitors progress over time. Following the review, a Performance
Improvement Program (PIP) will be implemented for the state to enhance services to families.
Additionally, the review will assess statewide, systemic factors to determine if the systems necessary to achieve
positive outcomes for families are in place.
All agencies that contract to provide service to families and children in Weld County must continually strive for
positive outcomes in the areas of safety, permanency and well-being for our youth. In order to insure continued
progress in this area, the Department is requiring providers to comply with a standard assessment and reporting
system which will address these three areas.*
The Department is requesting that provider reports include observations and recommendations regarding clients in a
way that specifically addresses the areas of safety, permanency and well-being. Below are the specific outcomes that
will be assessed by the CFSR in the areas of safety, permanency and well-being, followed by specific considerations
and tasks which must be addressed by the Department's contracted providers.
Safety Outcomes
CFSR Outcome Measures
Safety 1 Children are, first and foremost, protected from abuse and neglect.
Safety 2 Children are safely maintained in their homes whenever possible and appropriate.
Considerations for the Department's providers
• Providers should always consider the following definitions regarding child safety when assessing families.
o Children are considered safe when there are no present dangers or impending danger threats, or the
caregivers' protective capacities control existing threats.
o Children are considered unsafe when they are vulnerable to present or impending danger threats,
and caregivers are unable or unwilling to provide protection.
o Risk is the likelihood (chance, potential, prospect) for parenting behavior that is harmful and
destructive to a child's cognitive, social, emotional and/or physical development, and those with
parenting responsibility are unwilling or unable to behave differently.
• Monthly reports should continually document an assessment of risk and safety concerns and the
interventions that are being offered by the provider to ameliorate those concerns.
• Monthly reports should make recommendations regarding services and/or safety measures that the provider
believes should be implemented to insure safety of the child(ren).
• Providers must specifically document efforts to engage families in services and to control for safety.
Permanency Outcomes
CFSR Outcome Measures
Permanency I Children have permanency and stability in their living situations.
Permanency 2 The continuity of family relationships and connections is preserved for children.
Considerations for the Department's providers:
• Provider reports should always note the primary permanency goal for the child and document how
interventions are working toward achieving that goal.
• Provider reports must indicate progress toward achieving the permanency goal and should make specific
recommendations regarding how the continuation of the service may assist in achieving the goal.
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• Providers should continually provide recommendations about whether any out -of -home placement
continues to be appropriate and should make recommendations regarding when changes in this area should
be made, in the providers' opinion.
• Providers should continually assess family relationships (parent/child, sibling/sibling, extended
family/child, etc.) and should report any concerning relationship issues which may be a barrier to achieving
permanency. Providers should document ongoing efforts to resolve those issues and/or make
recommendations regarding additional services that may be required to address relationship issues.
• Providers must document specific time frames when recommending ongoing services and/or recommending
changes to services and/or placements.
Child and Family Well -Being Outcomes
CFSR Outcome Measures
Well Being 1 Families have enhanced capacity to provide for their children's needs.
Well Being 2 Children receive appropriate services to meet their educational needs.
Well Being 3 Children receive adequate services to meet their physical and mental health needs.
Considerations for the Department's providers:
• Providers must engage in ongoing assessments of the parents' capacity to appropriately care for their
children and whether or not the service being provided continues to be appropriate. This must be clearly
documented in monthly reports.
• Providers should specifically detail areas of continued concern within the family and make
recommendations regarding whether that provider's service continues to be appropriate. Reports should
also document what barriers may be impeding progress.
• Providers should document any and all observed concerns regarding any child with whom the provider is
working. This should include concerns regarding physical, emotional, educational and behavioral well-
being of the child. When appropriate, providers should make recommendations regarding evaluations
and/or additional services that may address these concerns.
*Standardized reports will be provided and should be utilized by all agencies providing ongoing services to the
Department's families unless otherwise noted.
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CHILD PROTECTION AGREEMENT FOR SERVICES
BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES
AND MILESTONES COUNSELING SERVICES, LLC
el
This Agreement, made and entered into the day of vtly i- 2009, by and between the Board of
Weld County Commissioners, sitting as the Board of Human Services, on behalf of the Weld County Department of
Human Services, hereinafter referred to as the "Department," and Milestones Counseling Services, LLC, hereinafter
referred to as "Contractor".
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 Core Services funding to the
Department for Foster Parent Consultation; and
NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows:
1. Term
This Agreement shall become effective on June 1, 2009, upon proper execution of this Agreement and
shall expire May 31, 2010, unless sooner terminated as provided herein.
2. Scope of Services
Services shall be provided by CONTRACTOR 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," of which are attached
hereto and incorporated herein by reference.
"Payment Schedule" shall establish the maximum reimbursement, which will be paid from
Core Services funding during the duration of this Agreement.
b. CONTRACTOR shall submit an itemized monthly bill to the Department for all costs incurred
and services provided pursuant to Exhibit A of this Agreement in accordance with criteria
established by the Department. CONTRACTOR shall submit all itemized monthly billings to
the Department by the T" day of the month following the month the cost was incurred. If the
billing is not submitted within twenty-five (25) calendar days of the month following service, it
may result in forfeiture of payment.
c. Payments of costs incurred pursuant to this Agreement is expressly contingent upon the
availability of Core Services to the Department.
d. The Department 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.
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4. Financial Management
At all times from the effective date of this Contract until completion of this Contract, CONTRACTOR
shall comply with the administrative requirements, cost principles and other requirements set forth in the
Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds
expended under Core Service funding must conform to the Single Audit Act of 1984 and OMB Circular A
133.
5. Payment Method
Unless otherwise provided in the Scope of Services and Payment Schedule:
a. CONTRACTOR shall provide proper monthly invoices and itemization of services performed for
costs incurred in the performance of the agreement.
b. The Department may withhold any payment if CONTRACTOR has failed to comply with the
Financial Management Requirements, program objectives, contractual terms, or reporting
requirements. In the event of a forfeiture of reimbursements, CONTRACTOR may appeal such
circumstance to the Director of Human Services. The decision of the Director of Human Services
shall be final.
6. Assurances
CONTRACTOR shall abide by all assurances as set forth in the attached Exhibit C, which is attached hereto
and incorporated herein by reference.
7. Compliance with Applicable Laws
At all times during the performance of this contract, CONTRACTOR 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. CONTRACTOR acknowledges that the following laws are included:
Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d —1 et. seq. and its implementing
regulation, 45 C.F.R. Part 80 et. seq.; and
Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 794, and
its implementing regulations, 45 C.F.R. Part 84; and
the Age Discrimination Act of 1975, 42 U.S.C. Sections 6101 et. seq. and
its implementation regulations, 45 C.F.R. Part 91; and
Title VII of the Civil Rights Act of 1964; and
the Age Discrimination in Employment Act of 1967; and
the Equal Pay Act of 1963; and
the Education Amendments of 1972; and
Immigration Reform and Control Act of 1986, P.L. 99-603;
42 C.F.R. Part 2
and all regulations applicable to these laws prohibiting discrimination because of race, color,
National origin, and sex, religion and handicap, including Acquired Immune Deficiency Syndrome (AIDS)
or AIDS related conditions, covered under Section 504 of the Rehabilitation Act of 1973, as amended,
cited above. If necessary, CONTRACTOR and the Department will resist in judicial proceedings any
efforts to obtain access to client records except as permitted by 42 CFR Part 2.
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Included is 45 C.F.R. Part 74 Appendix G 9, which requires that affirmative steps be taken to assure that
small and minority businesses are utilized, when possible, as sources of supplies, equipment, construction
and services. This assurance is given in consideration of and for the purpose of obtaining any and all
federal and/or state financial assistance.
Any person who feels that s/he has been discriminated against has the right to file a complaint either with
the Colorado Department of Human Services or with the U.S. Department of Health and Human Services,
Office for Civil Rights.
8. Compliance with Child and Family Services Review
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas;
Safety, Permanency and Well Being of families. For each outcome, data and performance indicators
measure each state's performance according to national standards and monitor progress over time.
Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance
services to families.
CONTRACTORS providing services to the Department families and children must continually strive for
positive outcomes in the areas of safety, permanency and well being. Contractors providing services in
program areas identified by the Department are required to comply with a standard assessment and
reporting system set forth in Exhibit D which will address the aforementioned three areas.
9. Insurance
CONTRACTOR, shall procure, either personally or through its employer as applicable to the Contractor's
business, at its own expense, and maintain for the duration of the work, the following insurance coverage;
Weld County, Colorado, by and through the Board of County Commissioners of Weld County, its
employees and agents, shall be named as additional named insured on the insurance, where permissible by
the insurance provider.
a. Standard Workman's Compensation and Employer's Liability.
I. As required by state statute including occupational disease, covering all employees at
work site.
b. General Liability (PL & PD) (Minimum).
1. Combined single limit - $500,000 written on an occurrence basis.
2. Any aggregate limit will not be less than $1 million.
3. Provider must purchase additional insurance if claims reduce the annual aggregate below
$500,000.
4. State of Colorado to be named as additional insured on each comprehensive general
liability policy.
5. Certificate of insurance to be provided to Weld County and must be attached to the
contract.
6. Insurance shall include provisions preventing cancellation without 60 days prior notice
by certified mail to Weld County.
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c. Automobile Liability (Minimum) for any Contractor transporting children or any party to whom
Department services are being provided.
d. Additional coverage may be required in specific program areas. For any insurances that are
required by this contract, a completed Standard Certificate of Insurance Form shall be provided to
the Department by the Contractor prior to the start of any contract.
10. Certifications
CONTRACTOR 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. Copies of all necessary licenses shall be provided to the Department by the
Contractor prior to the start of any contract.
I. Training
Contractor shall attend a Court Testimony and Ethics Training to be paid for by the Department. The
Contractor may be required to attend additional training at the request of the Department. The cost of such
training will be paid for by the Department. The Department will not compensate the Contractor for the
time spent attending the required trainings.
12. Monitoring and Evaluation
CONTRACTOR and the Department agree that monitoring and evaluation of the performance of this
Agreement shall be conducted by CONTRACTOR and the Department. The results of the monitoring and
evaluation shall be provided to the Board of Weld County Commissioners, the Department and
CONTRACTOR.
CONTRACTOR shall permit the Department, and any other duly authorized agent or governmental
agency, to monitor all activities conducted by CONTRACTOR 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.
13. Modification of Agreement
All modifications to this agreement shall be in writing and signed by both parties.
14. Remedies
The Director of Human Services or designee may exercise the following remedial actions should s/he find
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
CONTRACTOR. These remedial actions are as follows:
a. Withhold payment to 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 CONTRACTOR cannot be performed or if
performed would be of no value to the Department. Denial of the amount of payment shall be
reasonably related to the amount of work or deliverables lost to the Department;
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PY-09- I 0 -CORE -0189
c. Incorrect payment to CONTRACTOR due to omission, error, fraud, and/or defalcation shall be
recovered from CONTRACTOR by deduction from subsequent payments under this Agreement or
other agreements between the Department and CONTRACTOR, or by the Department as a debt due to
the Department or otherwise as provided by law.
15. 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 the Department:
Gloria Romansik
Name
For CONTRACTOR:
Adelaida "Addle" Campbell
Name
16. Notice
Social Services Administrator
Title
Owner
Title
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: The Department
Judy A. Griego, Director
P.O. Box A
Greeley, CO 80632
(970) 352-1551
17. Litigation
To: CONTRACTOR
Adelaida "Addie" Campbell, Owner
904 49'' Avenue Court
Greeley, CO 80634
(970)301-5833
CONTRACTOR shall promptly notify the Department in the event that CONTRACTOR learns of any
actual litigation in which it is a party defendant in a case that involves services provided under this
Agreement. 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, reorganization and/or foreclosure.
18. 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. CONTRACTOR reserves the right to suspend services to clients if
funding is no longer available.
19. 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 13 herein.
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IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first
above wr
A
By:
APP
County A
WELD COUNTY
CLERK TO T1-IE BOARD
city CIer14� ��
WELD COUNTY DEPARTMENT
OF HUMAN SERVICES
By:
BOARD OF COUNTY
COMMISSIONERS WELD
COUNTY, COLO
Chair William F. Garcia
06/17/2009
CONTRACTOR: A
Contractor /Th eciuts y7.5c 67/ st L.
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PY-09-10-CORE-0189
EXHIBIT A
SCOPE OF SERVICES
1. CONTRACTOR will provide foster parent/child evaluation and consultation for children and youth
residing in Weld County foster homes as referred by the Department.
2. CONTRACTOR will work collaboratively with children, foster parents, caseworkers, foster care
coordinators and other service providers to identify and address issues, in a solution -focused manner that
could potentially disrupt placements.
3. CONTRACTOR will follow up with referred foster family within 48 hours of receiving referral and will
document efforts to engage foster family in referred services.
4. CONTRACTOR will provide services in three steps:
a. Step I —Engagement/Evaluation. CONTRACTOR will:
i. Meet with foster parent(s) of the referred child(ren)/youth to gather information
regarding their concerns and prior attempts to meet the needs of the child(ren)/youth.
ii. Administer the Parenting Relationship Questionnaire (PRQ). The PRQ will be used to
assess Relational Frustration (caregivers' level of stress or distress in parenting),
Parenting Confidence, Involvement, Discipline Practices and Communication of the
foster parent(s).
iii. Meet with the referred child(ren)/youth to gather information regarding their concerns
and perceived barriers to placement in the foster home.
b. Step 2 — Intervention. CONTRACTOR will:
i. Observe the foster child(ren)/youth and foster parent(s) for the purpose of gathering
information on parenting style, barriers to relationship formation between the referred
child(ren)/youth and the foster parent(s), possible issues and plans for intervention.
ii. Meet with the foster parent(s) to provide feedback and intervention strategies to improve
foster parent/child interaction.
c. Step 3 — Feedback. CONTRACTOR will:
i. Meet with foster child(ren)/youth and foster parent(s) following implementation of
interventions to assess progress. This will include observation of interaction with a
feedback session to highlight observed positive changes in the foster parent/child
interaction.
ii. Administer the PRQ to the foster parent(s) to assess changes made.
iii. Provide a written report to the Department regarding Evaluation, Intervention and
Feedback for referred child(ren)/youth. Intervention and Feedback will be reported on a
monthly basis for the duration of the referral.
5. CONTRACTOR will assess foster families abilities and capacity on an ongoing basis to appropriately care
for the foster children in their home and report this information on a monthly basis to the Department.
6. CONTRACTOR will identify in detail areas of continued concern and make recommendations to the
Department regarding continuation of foster parent consultation services and/or the need for additional
services.
7. CONTRACTOR will document in detail any and all observed or verbalized concerns regarding any child
whom the CONTRACTOR is working with under an active referral. Areas of concern may include, but
are not limited to, any physical, emotional, educational or behavioral issues. Areas of concern should be
reported immediately AND on the required monthly report.
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8. CONTRACTOR will submit reports on a monthly basis for each active referral. Reports will be submitted
per the online format required by the Department, unless otherwise directed by the Department.
9. CONTRACTOR will participate in team reviews of ongoing services as requested.
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EXHIBIT B
PAYMENT SCHEDULE
1. Funding and Method of Payment
The Department agrees to reimburse CONTRACTOR in consideration for the work and services
performed from Core Services funding, not to exceed $10,000.00.
Expenses incurred by CONTRACTOR, in association with said project prior to the term of this agreement,
are not eligible Department expenditures and shall not be reimbursed by the Department.
Payment pursuant to this Contract, if Core Services funds, whether in whole or in part, is subject to and
contingent upon the continuing availability of said funds for the purposes hereof. In the event that said
funds, or any part thereof, become unavailable as determined by the Department, the Department may
immediately terminate this Contract or amend it accordingly.
2. Fees for Services
$540.00 (Evaluation, Intervention and Feedback - 6 hours)
$90.00/Hour (Additional Follow Up after 6 hours)
Department referrals will not be sent to collections by Contractor for default of co-pay/fees. Services will
be performed regardless of client's refusal or inability to pay co -pay.
Contractor will collect any applicable sliding scale co -pays and credit the Department for any payments
received on the monthly billing statements.
3. Submittal of Vouchers
CONTRACTOR shall prepare and submit monthly the itemized voucher and certify that the services
authorized were provided on the date indicated and the charges made were pursuant to the terms and
conditions of Exhibit A.
a. All billings are to be submitted by the 7'" day of the month following the month of
service. If the billing is not submitted within twenty-five (25) calendar days of the month
following service, it may result in forfeiture of payment.
b. Billings must be submitted with the attached required forms, Authorization for
Contractual Services, Request for Reimbursement, Client Verification Form and monthly
report. The Authorization for Contractual Services and Client Verification Form must be
submitted with original signatures.
c. For monitored sobriety, proof of services rendered shall be a sign -in sheet with client
signatures or the test result.
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EXHIBIT C
ASSURANCES
I. CONTRACTOR 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 CONTRACTOR -
contracted CONTRACTOR or its employees, volunteers, or agents while performing duties as described in
this Agreement. CONTRACTOR shall indemnify, defend, and hold harmless Weld County, the Board of
County Commissioners of Weld County, its employees, volunteers, and agents. CONTRACTOR 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, CONTRACTOR shall provide the
Department 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 created a
duty of care with respect to any persons not a party of this Agreement.
4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld, State
of Colorado, to expend funds not otherwise appropriated in each succeeding year.
5. If any section, subsection, paragraph, sentence, clause, or phrase of this Contract is for any reason held or
decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The
parties hereto declare that they would have entered into this Contract and each and every section,
subsection, paragraph, sentence, clause, and phrase thereof irrespective of the fact that any one or more
sections, subsections, paragraphs, sentences, clauses, or phrases might be declared to be unconstitutional or
invalid.
6. No officer, member or employee of Weld County and no member of their governing bodies shall have any
pecuniary interest, direct or indirect, in the approved Agreement or the proceeds thereof.
7. CONTRACTOR 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. CONTRACTOR 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
CONTRACTOR.
9. All such records, documents, communications, and other materials created pursuant or related to this
contract shall be maintained by CONTRACTOR, in a central location and shall be made available to
Social Services upon its request, for a period of seven (7) 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 seven (7) year period, or if
audit findings have not been resolved after a seven (7) period, the materials shall be retained until the
resolution of the audit finding.
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10. CONTRACTOR 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.
1 I. This Contract shall be binding upon the parties hereto, their successors, heirs, legal representatives, and
assigns. CONTRACTOR or the Department may not assign any of its rights or obligations hereunder
without the prior written consent of both parties.
12. CONTRACTOR certifies that federal appropriated funds have not been paid or will be paid, by or on
behalf of CONTRACTOR, 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. CONTRACTOR assures that it will fully comply with all other applicable federal and state laws.
CONTRACTOR understands that the source of funds to be used under this Contract is Core Services
funds.
14. CONTRACTOR 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 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 12 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 the
Department 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,
CONTRACTOR 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, CONTRACTOR
shall submit to the Department, 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 the Department's termination, for cause, of its contract with
CONTRACTOR.
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16. CONTRACTOR 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 CONTRACTOR shall be disclosed in a form identifiable with the applicant/recipient or a
minor's parent or guardian unless in accordance with CONTRACTOR written policies governing access
to, duplication and dissemination of, all such information. CONTRACTOR shall advise its employees,
agents, and subcontractor, if any, that they are subject to these confidentiality requirements.
CONTRACTOR 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.
CONTRACTOR shall have its employees, agents, and subcontractors, if any, sign a written confidentiality
agreement and shall provide a copy of such agreement to the Department, if requested.
17. Proprietary information for the purposes of this contract is information relating to a party's research,
development, trade secrets, business affairs, internal operations and management procedures and those of
its customers, clients or affiliates, but does not include information (I) lawfully obtained from third parties,
(2) that which is in the public domain, or (3) that which is developed independently. Neither party
shall use or disclose directly or indirectly without prior written authorization any proprietary information
concerning the other party obtained as a result of this Contract. Any proprietary information removed from
the State's site by CONTRACTOR in the course of providing services under this Contract will be accorded
at least the same precautions as are employed by CONTRACTOR for similar information in the course of
its own business.
18. CONTRACTOR certifies it will abide by Colorado Revised Statue (C.R.S.) 26-6-104, requiring criminal
background record checks for all employees, contractors, and sub -contractors.
19. Contractor certifies that it shall comply with the provisions of Colorado Revised Statutes (C.R.S.) 8-17.5-
101, et seq. Contractor shall not knowingly employ or contract with an illegal alien to perform work under
this Contract or enter into a contract with a subcontractor that fails to certify to Contractor that the
subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this
Contract. Contractor represents, warrants, and agrees that it (a) has verified that it does not employ any
illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by
the Social Security Administration and Department of Homeland Security, and (b) otherwise will comply
with the requirements of C.R.S. 8-17.5-102(2)(b). Contractor shall comply with all reasonable requests
made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and
Employment. If Contractor fails to comply with any requirement of this provision or C.R.S. 8-17.5-101, et
seq., the Department may terminate this Contract for breach and Contractor shall be liable for actual and
consequential damages to the Department.
Except where exempted by federal law and except as provided in C.R.S. 24-76.5-103(3), if Contractor
receives federal or state funds under this Contract, Contractor must confirm that any individual natural
person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. 24-
76.5-103(4) if such individual applies for public benefits provided under this Contract. If Contractor
operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it (a) is a citizen of
the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall
produce one of the forms of identification required by C.R.S. 24-76.5-101, et seq., and (c) shall produce
one of the forms of identification required by C.R.S. 24-76.5-103 prior to the effective date of this
Contract.
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EXHIBIT D
CHILD and FAMILY SERVICES REVIEWS (CFSR)
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas; Safety,
Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's
performance according to national standards and monitors progress over time. Following the review, a Performance
Improvement Program (PIP) will be implemented for the state to enhance services to families.
Additionally, the review will assess statewide, systemic factors to determine if the systems necessary to achieve
positive outcomes for families are in place.
All agencies that contract to provide service to families and children in Weld County must continually strive for
positive outcomes in the areas of safety, permanency and well-being for our youth. In order to insure continued
progress in this area, the Department is requiring providers to comply with a standard assessment and reporting
system which will address these three areas.*
The Department is requesting that provider reports include observations and recommendations regarding clients in a
way that specifically addresses the areas of safety, permanency and well-being. Below are the specific outcomes
that will be assessed by the CFSR in the areas of safety, permanency and well-being, followed by specific
considerations and tasks which must be addressed by the Department contracted providers.
Safety Outcomes
CFSR Outcome Measures
Safety I Children are, first and foremost, protected from abuse and neglect.
Safety 2 Children are safely maintained in their homes whenever possible and appropriate.
Considerations for the Department's providers
Providers should always consider the following definitions regarding child safety when assessing families.
o Children are considered safe when there are no present dangers or impending danger threats, or
the caregivers' protective capacities control existing threats.
o Children are considered unsafe when they are vulnerable to present or impending danger threats,
and caregivers are unable or unwilling to provide protection.
o Risk is the likelihood (chance, potential, prospect) for parenting behavior that is harmful and
destructive to a child's cognitive, social, emotional and/or physical development, and those with
parenting responsibility are unwilling or unable to behave differently.
• Monthly reports should continually document an assessment of risk and safety concerns and the
interventions that are being offered by the provider to ameliorate those concerns.
• Monthly reports should make recommendations regarding services and/or safety measures that the provider
believes should be implemented to insure safety of the child(ren).
• Providers must specifically document efforts to engage families in services and to control for safety.
Permanency Outcomes
CFSR Outcome Measures
Permanency I Children have permanency and stability in their living situations.
Permanency 2 The continuity of family relationships and connections is preserved for children.
Considerations for the Department's providers:
• Provider reports should always note the primary permanency goal for the child and document how
interventions are working toward achieving that goal.
• Provider reports must indicate progress toward achieving the permanency goal and should make specific
recommendations regarding how the continuation of the service may assist in achieving the goal.
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Providers should continually provide recommendations about whether any out -of -home placement
continues to be appropriate and should make recommendations regarding when changes in this area should
be made, in the providers' opinion.
• Providers should continually assess family relationships (parent/child, sibling/sibling, extended
family/child, etc.) and should report any concerning relationship issues which may be a barrier to achieving
permanency. Providers should document ongoing efforts to resolve those issues and/or make
recommendations regarding additional services that may be required to address relationship issues.
Providers must document specific time frames when recommending ongoing services and/or
recommending changes to services and/or placements.
Child and Family Well -Being Outcomes
CFSR Outcome Measures
Well Being 1 Families have enhanced capacity to provide for their children's needs.
Well Being 2 Children receive appropriate services to meet their educational needs.
Well Being 3 Children receive adequate services to meet their physical and mental health needs.
Considerations for the Department's providers:
• Providers must engage in ongoing assessments of the parents' capacity to appropriately care for their
children and whether or not the service being provided continues to be appropriate. This must be clearly
documented in monthly reports.
• Providers should specifically detail areas of continued concern within the family and make
recommendations regarding whether that provider's service continues to be appropriate. Reports should
also document what barriers may be impeding progress.
• Providers should document any and all observed concerns regarding any child with whom the provider is
working. This should include concerns regarding physical, emotional, educational and behavioral well-
being of the child. When appropriate, providers should make recommendations regarding evaluations
and/or additional services that may address these concerns.
*Standardized reports will be provided and should be utilized by all agencies providing ongoing services to the
Department's families unless otherwise noted.
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CHILD PROTECTION AGREEMENT FOR SERVICES
BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES
AND MILESTONES COUNSELING SERVICES, LLC
teljetity
This Agreement, made and entered into the 4_day of 'Sum f 2009, by and between the Board of
Weld County Commissioners, sifting as the Board of Human Services, on behalf of the Weld County Department of
Human Services, hereinafter referred to as the "Department," and Milestones Counseling Services, LLC, hereinafter
referred to as "Contractor".
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 Administration
funding to the Department for Home Study Services; and
NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows:
I. Term
This Agreement shall become effective on June 1, 2009, upon proper execution of this Agreement and
shall expire May 31, 2010, unless sooner terminated as provided herein.
2. Scope of Services
Services shall be provided by CONTRACTOR 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," of which are attached
hereto and incorporated herein by reference.
"Payment Schedule" shall establish the maximum reimbursement, which will be paid from
Child Welfare Administration funding during the duration of this Agreement.
b. CONTRACTOR shall submit an itemized monthly bill to the Department for all costs incurred
and services provided pursuant to Exhibit A of this Agreement in accordance with criteria
established by the Department. CONTRACTOR shall submit all itemized monthly billings to
the Department by the 7th day of the month following the month the cost was incurred. If the
billing is not submitted within twenty-five (25) calendar days of the month following service, it
may result in forfeiture of payment.
c. Payments of costs incurred pursuant to this Agreement is expressly contingent upon the
availability of Child Welfare Administration to the Department.
d. The Department 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.
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PY-09-10-HS-0115
4. Financial Management
At all times from the effective date of this Contract until completion of this Contract, CONTRACTOR
shall comply with the administrative requirements, cost principles and other requirements set forth in the
Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds
expended under Core Service funding must conform to the Single Audit Act of 1984 and OMB Circular A
133.
5. Payment Method
Unless otherwise provided in the Scope of Services and Payment Schedule:
a. CONTRACTOR shall provide proper monthly invoices and itemization of services performed for
costs incurred in the performance of the agreement.
b. The Department may withhold any payment if CONTRACTOR has failed to comply with the
Financial Management Requirements, program objectives, contractual terms, or reporting
requirements. In the event of a forfeiture of reimbursements, CONTRACTOR may appeal such
circumstance to the Director of Human Services. The decision of the Director of Human Services
shall be final.
6. Assurances
CONTRACTOR shall abide by all assurances as set forth in the attached Exhibit C, which is attached hereto
and incorporated herein by reference.
7. Compliance with Applicable Laws
At all times during the performance of this contract, CONTRACTOR 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. CONTRACTOR acknowledges that the following laws are included:
Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d-1 et. seq. and its implementing
regulation, 45 C.F.R. Part 80 et. seq: and
Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 794, and
its implementing regulations, 45 C.F.R. Part 84; and
the Age Discrimination Act of 1975, 42 U.S.C. Sections 6101 et. seq. and
its implementation regulations, 45 C.F.R. Part 91; and
- Title VII of the Civil Rights Act of 1964; and
the Age Discrimination in Employment Act of 1967; and
the Equal Pay Act of 1963; and
the Education Amendments of 1972; and
- Immigration Reform and Control Act of 1986, P.L. 99-603;
42 C.F.R. Part 2
and all regulations applicable to these laws prohibiting discrimination because of race, color,
National origin, and sex, religion and handicap, including Acquired Immune Deficiency Syndrome (AIDS)
or AIDS related conditions, covered under Section 504 of the Rehabilitation Act of 1973, as amended,
cited above. If necessary, CONTRACTOR and the Department will resist in judicial proceedings any
efforts to obtain access to client records except as permitted by 42 CFR Part 2.
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Included is 45 C.F.R. Part 74 Appendix G 9, which requires that affirmative steps be taken to assure that
small and minority businesses are utilized, when possible, as sources of supplies, equipment, construction
and services. This assurance is given in consideration of and for the purpose of obtaining any and all
federal and/or state financial assistance.
Any person who feels that s/he has been discriminated against has the right to file a complaint either with
the Colorado Department of Human Services or with the U.S. Department of Health and Human Services,
Office for Civil Rights.
8. Compliance with Child and Family Services Review
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas;
Safety, Permanency and Well Being of families. For each outcome, data and performance indicators
measure each state's performance according to national standards and monitor progress over time.
Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance
services to families.
CONTRACTORS providing services to the Department families and children must continually strive for
positive outcomes in the areas of safety, permanency and well being. Contractors providing services in
program areas identified by the Department are required to comply with a standard assessment and
reporting system set forth in Exhibit D which will address the aforementioned three areas.
9. Insurance
CONTRACTOR, shall procure, either personally or through its employer as applicable to the Contractor's
business, at its own expense, and maintain for the duration of the work, the following insurance coverage;
Weld County, Colorado, by and through the Board of County Commissioners of Weld County, its
employees and agents, shall be named as additional named insured on the insurance, where permissible by
the insurance provider.
a. Standard Workman's Compensation and Employer's Liability.
1. As required by state statute including occupational disease, covering all employees at
work site.
b. General Liability (PL & PD) (Minimum).
1. Combined single limit - $500,000 written on an occurrence basis.
2. Any aggregate limit will not be less than $1 million.
3. Provider must purchase additional insurance if claims reduce the annual aggregate below
$500,000.
4. State of Colorado to be named as additional insured on each comprehensive general
liability policy.
5. Certificate of insurance to be provided to Weld County and must be attached to the
contract.
6. Insurance shall include provisions preventing cancellation without 60 days prior notice
by certified mail to Weld County.
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c. Automobile Liability (Minimum) for any Contractor transporting children or any party to whom
Department services are being provided.
d. Additional coverage may be required in specific program areas. For any insurances that are
required by this contract, a completed Standard Certificate of Insurance Form shall be provided to
the Department by the Contractor prior to the start of any contract.
10. Certifications
CONTRACTOR 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. Copies of all necessary licenses shall be provided to the Department by the
Contractor prior to the start of any contract.
11. Training
Contractor shall attend a Court Testimony and Ethics Training to be paid for by the Department. The
Contractor may be required to attend additional training at the request of the Department. The cost of such
training will be paid for by the Department. The Department will not compensate the Contractor for the
time spent attending the required trainings.
12. Monitoring and Evaluation
CONTRACTOR and the Department agree that monitoring and evaluation of the performance of this
Agreement shall be conducted by CONTRACTOR and the Department. The results of the monitoring and
evaluation shall be provided to the Board of Weld County Commissioners, the Department and
CONTRACTOR.
CONTRACTOR shall permit the Department, and any other duly authorized agent or governmental
agency, to monitor all activities conducted by CONTRACTOR 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.
13. Modification of Agreement
All modifications to this agreement shall be in writing and signed by both parties.
14. Remedies
The Director of Human Services or designee may exercise the following remedial actions should s/he find
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
CONTRACTOR. These remedial actions are as follows:
a. Withhold payment to 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 CONTRACTOR cannot be performed or if
performed would be of no value to the Department. Denial of the amount of payment shall be
reasonably related to the amount of work or deliverables lost to the Department;
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PY-09-10-HS-0115
c. Incorrect payment to CONTRACTOR due to omission, error, fraud, and/or defalcation shall be
recovered from CONTRACTOR by deduction from subsequent payments under this Agreement or
other agreements between the Department and CONTRACTOR, or by the Department as a debt due to
the Department or otherwise as provided by law.
15. 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 the Department:
Gloria Romansik
Name
For CONTRACTOR:
Adelaida "Addie" Campbell
Name
16. Notice
Social Services Administrator
Title
Owner
Title
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: The Department
Judy A. Griego, Director
P.O. Box A
Greeley, CO 80632
(970) 352-1551
17. Litigation
To: CONTRACTOR
Adelaida "Addie" Campbell, Owner
904 49th Avenue Court
Greeley, CO 80634
(970) 301-5833
CONTRACTOR shall promptly notify the Department in the event that CONTRACTOR learns of any
actual litigation in which it is a party defendant in a case that involves services provided under this
Agreement. 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, reorganization and/or foreclosure.
18. 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. CONTRACTOR reserves the right to suspend services to clients if
funding is no longer available.
19. 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 13 herein.
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PY-09-10-HS-0115
IN WITNESS WH i , parties hereto have duly executed the Agreement as of the day, month, and year first
above written.
ATTEST:
By:
GI) COUNTY
RRK TO THE BOARD
Deputy Clerk`
APPROVF AST
BY
WELD COUNTY DEPARTMENT
OF HUMANS RVICES
By:
BOARD OF COUNTY
COMMISSIONERS WELD
COUNTY, CQLODO
Chair William F. Garcia
06/17/2009
CONTRACTOR:
('t CULCU �(it, /�I �-(.'1 w4 di V1'ulicg91 %- 5
Contractor
6
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PY-09-10-HS-0115
EXHIBIT A
SCOPE OF SERVICES
1. CONTRACTOR will provide home study services for families referred by the Department.
2. CONTRACTOR will utilize the Structured Analysis Family Evaluation (SAFE) tool developed by the
Consortium of Children. CONTRACTOR is SAFE certified and on the State's approved home study
vendor list.
3. CONTRACTOR will conduct a minimum of three 2 -hour visits at the home study applicant's residence.
Visits will include physical contact and evaluation of each member living in the household.
4. CONTRACTOR will complete a Department of Motor Vehicle background check. All CBI, FBI and
LexisNexis background check information will be completed by the Department, unless otherwise directed
by the Department.
5. CONTRACTOR will submit a completed home study to the Department with their billing within 60 days
of receipt of the home study referral. A complete home study will include the study in SAFE format,
background check information, SAFE questionnaires completed by the applicants, references and all other
original documents submitted by the home study applicant.
6. CONTRACTOR will document in detail any and all observed or verbalized concerns regarding any
specific Weld County home. Areas of concern may include, but are not limited to, any physical,
emotional, educational or behavioral issues. Child abuse must be reported immediately per law.
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EXHIBIT B
PAYMENT SCHEDULE
I. Funding and Method of Payment
The Department agrees to reimburse CONTRACTOR in consideration for the work and services
performed from Child Welfare Administration funding, not to exceed $10,000.00.
Expenses incurred by CONTRACTOR, in association with said project prior to the term of this agreement,
are not eligible Department expenditures and shall not be reimbursed by the Department.
Payment pursuant to this Contract, if Child Welfare Administration funds, whether in whole or in part, is
subject to and contingent upon the continuing availability of said funds for the purposes hereof. In the
event that said funds, or any part thereof, become unavailable as determined by the Department, the
Department may immediately terminate this Contract or amend it accordingly.
2. Fees for Services
$950.00 (Full Home Study)
$250.00 (Each Additional Adult)
$550.00 (Updated Home Study)
$250.00 (Cancelled Home Study, 1-4 Hours of Service)
$ .30/Mile (Mileage - Referrals Outside Weld County)
$100.00/Hour (Court Testimony - 1 Hour Minimum)
Department referrals will not be sent to collections by Contractor for default of co-pay/fees. Services will
be performed regardless of client's refusal or inability to pay co -pay.
Contractor will collect any applicable sliding scale co -pays and credit the Department for any payments
received on the monthly billing statements.
3. Submittal of Vouchers
CONTRACTOR shall prepare and submit monthly the itemized voucher and certify that the services
authorized were provided on the date indicated and the charges made were pursuant to the terms and
conditions of Exhibit A.
a.
All billings are to be submitted by the 7s' day of the month following the month of
service. If the billing is not submitted within twenty-five (25) calendar days of the month
following service, it may result in forfeiture of payment.
b. Billings must be submitted with the attached required forms, Authorization for
Contractual Services, Request for Reimbursement, Client Verification Form and monthly
report. The Authorization for Contractual Services and Client Verification Form must be
submitted with original signatures.
c. For monitored sobriety, proof of services rendered shall be a sign -in sheet with client
signatures or the test result.
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EXHIBIT C
ASSURANCES
1. CONTRACTOR 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 CONTRACTOR -
contracted CONTRACTOR or its employees, volunteers, or agents while performing duties as described in
this Agreement. CONTRACTOR shall indemnify, defend, and hold harmless Weld County, the Board of
County Commissioners of Weld County, its employees, volunteers, and agents. CONTRACTOR 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, CONTRACTOR shall provide the
Department 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 created a
duty of care with respect to any persons not a party of this Agreement.
4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld, State
of Colorado, to expend funds not otherwise appropriated in each succeeding year.
5. If any section, subsection, paragraph, sentence, clause, or phrase of this Contract is for any reason held or
decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The
parties hereto declare that they would have entered into this Contract and each and every section,
subsection, paragraph, sentence, clause, and phrase thereof irrespective of the fact that any one or more
sections, subsections, paragraphs, sentences, clauses, or phrases might be declared to be unconstitutional or
invalid.
6. No officer, member or employee of Weld County and no member of their governing bodies shall have any
pecuniary interest, direct or indirect, in the approved Agreement or the proceeds thereof.
7. CONTRACTOR 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. CONTRACTOR 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
CONTRACTOR.
9. All such records, documents, communications, and other materials created pursuant or related to this
contract shall be maintained by CONTRACTOR, in a central location and shall be made available to
Social Services upon its request, for a period of seven (7) 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 seven (7) year period, or if
audit findings have not been resolved after a seven (7) period, the materials shall be retained until the
resolution of the audit finding.
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10. CONTRACTOR 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.
I I. This Contract shall be binding upon the parties hereto, their successors, heirs, legal representatives, and
assigns. CONTRACTOR or the Department may not assign any of its rights or obligations hereunder
without the prior written consent of both parties.
12. CONTRACTOR certifies that federal appropriated funds have not been paid or will be paid, by or on
behalf of CONTRACTOR, 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. CONTRACTOR assures that it will fully comply with all other applicable federal and state laws.
CONTRACTOR understands that the source of funds to be used under this Contract is
Child Welfare Administration funds.
14. CONTRACTOR 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 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 12 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 the
Department 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,
CONTRACTOR 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, CONTRACTOR
shall submit to the Department, 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 the Department's termination, for cause, of its contract with
CONTRACTOR.
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16. CONTRACTOR 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 CONTRACTOR shall be disclosed in a form identifiable with the applicant/recipient or a
minor's parent or guardian unless in accordance with CONTRACTOR written policies governing access
to, duplication and dissemination of, all such information. CONTRACTOR shall advise its employees,
agents, and subcontractor, if any, that they are subject to these confidentiality requirements.
CONTRACTOR 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.
CONTRACTOR shall have its employees, agents, and subcontractors, if any, sign a written confidentiality
agreement and shall provide a copy of such agreement to the Department, if requested.
17. Proprietary information for the purposes of this contract is information relating to a party's research,
development, trade secrets, business affairs, internal operations and management procedures and those of
its customers, clients or affiliates, but does not include information (1) lawfully obtained from third parties,
(2) that which is in the public domain, or (3) that which is developed independently. Neither party
shall use or disclose directly or indirectly without prior written authorization any proprietary information
concerning the other party obtained as a result of this Contract. Any proprietary information removed from
the State's site by CONTRACTOR in the course of providing services under this Contract will be accorded
at least the same precautions as are employed by CONTRACTOR for similar information in the course of
its own business.
18. CONTRACTOR certifies it will abide by Colorado Revised Statue (C.R.S.) 26-6-104, requiring criminal
background record checks for all employees, contractors, and sub -contractors.
19. Contractor certifies that it shall comply with the provisions of Colorado Revised Statutes (C.R.S.) 8-17.5-
101, et seq. Contractor shall not knowingly employ or contract with an illegal alien to perform work under
this Contract or enter into a contract with a subcontractor that fails to certify to Contractor that the
subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this
Contract. Contractor represents, warrants, and agrees that it (a) has verified that it does not employ any
illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by
the Social Security Administration and Department of Homeland Security, and (b) otherwise will comply
with the requirements of C.R.S. 8-17.5-102(2)(6). Contractor shall comply with all reasonable requests
made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and
Employment. If Contractor fails to comply with any requirement of this provision or C.R.S. 8-17.5-101, et
seq., the Department may terminate this Contract for breach and Contractor shall be liable for actual and
consequential damages to the Department.
Except where exempted by federal law and except as provided in C.R.S. 24-76.5-103(3), if Contractor
receives federal or state funds under this Contract, Contractor must confirm that any individual natural
person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. 24-
76.5-103(4) if such individual applies for public benefits provided under this Contract. If Contractor
operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it (a) is a citizen of
the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall
produce one of the forms of identification required by C.R.S. 24-76.5-101, et seq., and (c) shall produce
one of the forms of identification required by C.R.S. 24-76.5-103 prior to the effective date of this
Contract.
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EXHIBIT D
CHILD and FAMILY SERVICES REVIEWS (CFSR)
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas; Safety,
Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's
performance according to national standards and monitors progress over time. Following the review, a Performance
Improvement Program (PIP) will be implemented for the state to enhance services to families.
Additionally, the review will assess statewide, systemic factors to determine if the systems necessary to achieve
positive outcomes for families are in place.
All agencies that contract to provide service to families and children in Weld County must continually strive for
positive outcomes in the areas of safety, permanency and well-being for our youth. In order to insure continued
progress in this area, the Department is requiring providers to comply with a standard assessment and reporting
system which will address these three areas."
The Department is requesting that provider reports include observations and recommendations regarding clients in a
way that specifically addresses the areas of safety, permanency and well-being. Below are the specific outcomes
that will be assessed by the CFSR in the areas of safety, permanency and well-being, followed by specific
considerations and tasks which must be addressed by the Department contracted providers.
Safety Outcomes
CFSR Outcome Measures
Safety 1 Children are, first and foremost, protected from abuse and neglect.
Safety 2 Children are safely maintained in their homes whenever possible and appropriate.
Considerations for the Department's providers
Providers should always consider the following definitions regarding child safety when assessing families.
o Children are considered safe when there are no present dangers or impending danger threats, or
the caregivers' protective capacities control existing threats.
o Children are considered unsafe when they are vulnerable to present or impending danger threats,
and caregivers are unable or unwilling to provide protection.
o Risk is the likelihood (chance, potential, prospect) for parenting behavior that is harmful and
destructive to a child's cognitive, social, emotional and/or physical development, and those with
parenting responsibility are unwilling or unable to behave differently.
• Monthly reports should continually document an assessment of risk and safety concerns and the
interventions that are being offered by the provider to ameliorate those concerns.
• Monthly reports should make recommendations regarding services and/or safety measures that the provider
believes should be implemented to insure safety of the child(ren).
• Providers must specifically document efforts to engage families in services and to control for safety.
Permanency Outcomes
CFSR Outcome Measures
Permanency I Children have permanency and stability in their living situations.
Permanency 2 The continuity of family relationships and connections is preserved for children.
Considerations for the Department's providers:
• Provider reports should always note the primary permanency goal for the child and document how
interventions are working toward achieving that goal.
• Provider reports must indicate progress toward achieving the permanency goal and should make specific
recommendations regarding how the continuation of the service may assist in achieving the goal.
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Providers should continually provide recommendations about whether any out -of -home placement
continues to be appropriate and should make recommendations regarding when changes in this area should
be made, in the providers' opinion.
• Providers should continually assess family relationships (parent/child, sibling/sibling, extended
family/child, etc.) and should report any concerning relationship issues which may be a barrier to achieving
permanency. Providers should document ongoing efforts to resolve those issues and/or make
recommendations regarding additional services that may be required to address relationship issues.
• Providers must document specific time frames when recommending ongoing services and/or
recommending changes to services and/or placements.
Child and Family Well -Being Outcomes
CFSR Outcome Measures
Well Being 1 Families have enhanced capacity to provide for their children's needs.
Well Being 2 Children receive appropriate services to meet their educational needs.
Well Being 3 Children receive adequate services to meet their physical and mental health needs.
Considerations for the Department's providers:
• Providers must engage in ongoing assessments of the parents' capacity to appropriately care for their
children and whether or not the service being provided continues to be appropriate. This must be clearly
documented in monthly reports.
• Providers should specifically detail areas of continued concern within the family and make
recommendations regarding whether that provider's service continues to be appropriate. Reports should
also document what barriers may be impeding progress.
• Providers should document any and all observed concerns regarding any child with whom the provider is
working. This should include concerns regarding physical, emotional, educational and behavioral well-
being of the child. When appropriate, providers should make recommendations regarding evaluations
and/or additional services that may address these concerns.
*Standardized reports will be provided and should be utilized by all agencies providing ongoing services to the
Department's families unless otherwise noted.
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CHILD PROTECTION AGREEMENT FOR SERVICES
BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES
AND SAVIO HOUSE
Jt
This Agreement, made and entered into the l day of Sc,N L. 2009, by and between the Board of
Weld County Commissioners, sitting as the Board of Human Services, on behalf of the Weld County Department of
Human Services, hereinafter referred to as the "Department," and Savio House, hereinafter referred to as
"Contractor".
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 Core Services funding to the
Department for Home Based Services (Community -Based Services - Child Protection); and
NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows:
1. Term
This Agreement shall become effective on June 1, 2009, upon proper execution of this Agreement and
shall expire May 31, 2010, unless sooner terminated as provided herein.
2. Scope of Services
Services shall be provided by CONTRACTOR 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," of which are attached
hereto and incorporated herein by reference.
"Payment Schedule" shall establish the maximum reimbursement, which will be paid from
Core Services funding during the duration of this Agreement.
b. CONTRACTOR shall submit an itemized monthly bill to the Department for all costs incurred
and services provided pursuant to Exhibit A of this Agreement in accordance with criteria
established by the Department. CONTRACTOR shall submit all itemized monthly billings to
the Department by the 7`" day of the month following the month the cost was incurred. If the
billing is not submitted within twenty-five (25) calendar days of the month following service, it
may result in forfeiture of payment.
c. Payments of costs incurred pursuant to this Agreement is expressly contingent upon the
availability of Core Services to the Department.
d. The Department 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.
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4. Financial Management
At all times from the effective date of this Contract until completion of this Contract, CONTRACTOR
shall comply with the administrative requirements, cost principles and other requirements set forth in the
Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds
expended under Core Service funding must conform to the Single Audit Act of 1984 and OMB Circular A-
133.
5. Payment Method
Unless otherwise provided in the Scope of Services and Payment Schedule:
a. CONTRACTOR shall provide proper monthly invoices and itemization of services performed for
costs incurred in the performance of the agreement.
b. The Department may withhold any payment if CONTRACTOR has failed to comply with the
Financial Management Requirements, program objectives, contractual terms, or reporting
requirements. In the event of a forfeiture of reimbursements, CONTRACTOR may appeal such
circumstance to the Director of Human Services. The decision of the Director of Human Services
shall be final.
6. Assurances
CONTRACTOR shall abide by all assurances as set forth in the attached Exhibit C, which is attached hereto
and incorporated herein by reference.
7. Compliance with Applicable Laws
At all times during the performance of this contract, CONTRACTOR 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. CONTRACTOR acknowledges that the following laws are included:
Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d —1 et. seq. and its implementing
regulation, 45 C.F.R. Part 80 et. seq.; and
Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 794, and
its implementing regulations, 45 C.F.R. Part 84; and
the Age Discrimination Act of 1975, 42 U.S.C. Sections 6101 et. seq. and
its implementation regulations, 45 C.F.R. Part 91; and
Title VII of the Civil Rights Act of 1964; and
the Age Discrimination in Employment Act of 1967; and
the Equal Pay Act of 1963; and
the Education Amendments of 1972; and
Immigration Reform and Control Act of 1986, P.L. 99-603;
42 C.F.R. Part 2
and all regulations applicable to these laws prohibiting discrimination because of race, color,
National origin, and sex, religion and handicap, including Acquired Immune Deficiency Syndrome (AIDS)
or AIDS related conditions, covered under Section 504 of the Rehabilitation Act of 1973, as amended,
cited above. If necessary, CONTRACTOR and the Department will resist in judicial proceedings any
efforts to obtain access to client records except as permitted by 42 CFR Part 2.
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Included is 45 C.F.R. Part 74 Appendix G 9, which requires that affirmative steps be taken to assure that
small and minority businesses are utilized, when possible, as sources of supplies, equipment, construction
and services. This assurance is given in consideration of and for the purpose of obtaining any and all
federal and/or state financial assistance.
Any person who feels that s/he has been discriminated against has the right to file a complaint either with
the Colorado Department of Human Services or with the U.S. Department of Health and Human Services,
Office for Civil Rights.
8. Compliance with Child and Family Services Review
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas;
Safety, Permanency and Well Being of families. For each outcome, data and performance indicators
measure each state's performance according to national standards and monitor progress over time.
Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance
services to families.
CONTRACTORS providing services to the Department families and children must continually strive for
positive outcomes in the areas of safety, permanency and well being. Contractors providing services in
program areas identified by the Department are required to comply with a standard assessment and
reporting system set forth in Exhibit D which will address the aforementioned three areas.
Insurance
CONTRACTOR, shall procure, either personally or through its employer as applicable to the Contractor's
business, at its own expense, and maintain for the duration of the work, the following insurance coverage;
Weld County, Colorado, by and through the Board of County Commissioners of Weld County, its
employees and agents, shall be named as additional named insured on the insurance, where permissible by
the insurance provider.
a. Standard Workman's Compensation and Employer's Liability.
1. As required by state statute including occupational disease, covering all employees at
work site.
b. General Liability (PL & PD) (Minimum).
1. Combined single limit - $500,000 written on an occurrence basis.
2.
Any aggregate limit will not be less than $1 million.
3. Provider must purchase additional insurance if claims reduce the annual aggregate below
$500,000.
4. State of Colorado to be named as additional insured on each comprehensive general
liability policy.
5. Certificate of insurance to be provided to Weld County and must be attached to the
contract.
6. Insurance shall include provisions preventing cancellation without 60 days prior notice
by certified mail to Weld County.
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c. Automobile Liability (Minimum) for any Contractor transporting children or any party to whom
Department services are being provided.
d. Additional coverage may be required in specific program areas. For any insurances that are
required by this contract, a completed Standard Certificate of Insurance Form shall be provided to
the Department by the Contractor prior to the start of any contract.
10. Certifications
CONTRACTOR 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. Copies of all necessary licenses shall be provided to the Department by the
Contractor prior to the start of any contract.
11. Training
Contractor shall attend a Court Testimony and Ethics Training to be paid for by the Department. The
Contractor may be required to attend additional training at the request of the Department. The cost of such
training will be paid for by the Department. The Department will not compensate the Contractor for the
time spent attending the required trainings.
12. Monitoring and Evaluation
CONTRACTOR and the Department agree that monitoring and evaluation of the performance of this
Agreement shall be conducted by CONTRACTOR and the Department. The results of the monitoring and
evaluation shall be provided to the Board of Weld County Commissioners, the Department and
CONTRACTOR.
CONTRACTOR shall permit the Department, and any other duly authorized agent or governmental
agency, to monitor all activities conducted by CONTRACTOR 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.
13. Modification of Agreement
All modifications to this agreement shall be in writing and signed by both parties.
14. Remedies
The Director of Human Services or designee may exercise the following remedial actions should s/he find
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
CONTRACTOR. These remedial actions are as follows:
a. Withhold payment to 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 CONTRACTOR cannot be performed or if
performed would be of no value to the Department. Denial of the amount of payment shall be
reasonably related to the amount of work or deliverables lost to the Department;
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PY-09-10-CORE-0182
c. Incorrect payment to CONTRACTOR due to omission, error, fraud, and/or defalcation shall be
recovered from CONTRACTOR by deduction from subsequent payments under this Agreement or
other agreements between the Department and CONTRACTOR, or by the Department as a debt due to
the Department or otherwise as provided by law.
15. 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 the Department:
Gloria Romansik
Name
For CONTRACTOR:
David Bennett
Name
16. Notice
Social Services Administrator
Title
Director of Program Development
Title
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: The Department
Judy A. Griego, Director
P.O. Box A
Greeley, CO 80632
(970) 352-1551
17. Litigation
To: CONTRACTOR
David Bennett, Director of Program Development
325 King Street
Denver, CO 80219
j303)225-4202
CONTRACTOR shall promptly notify the Department in the event that CONTRACTOR learns of any
actual litigation in which it is a party defendant in a case that involves services provided under this
Agreement. 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, reorganization and/or foreclosure.
18. 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. CONTRACTOR reserves the right to suspend services to clients if
funding is no longer available.
19. 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 13 herein.
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IN WITNESS WHE
above written
F, the parties hereto have duly executed the Agreement as of the day, month, and year first
BOARD OF COUNTY
COMMISSIONERS WE
COUNTY, C
Lay:
WELD COUNTY DEPARTMENT
OF HUMAN SERVICES
By:
6
Chair William F. Garcia
Aix, 9 — /3rpc?
PY-09-10-CORE-0182
EXHIBIT A
SCOPE OF SERVICES
1. CONTRACTOR will provide family preservation or reunification services, through their Community
Based Services - Child Protection Division, to families with children age birth to 12 years, as referred by
the Department and who are in need of transitional services or family preservation services in order to
prevent recidivism or placement. Services will include:
a. Team Decision Making (TDM)—Family Group Conferences that involve extended family and kin.
b. Treatment Support Meetings — Family -centered, strength -based monthly staffing process to include
parents, extended family, CONTRACTOR, Department staff, GAL, and other involved professionals.
The process is anchored in the Colorado Assessment Continuum and the focus is on protective
concems that need to be resolved to eliminate the need for Department involvement. A work plan is
established with the team outlining specific goals to be accomplished, action steps, strengths, and time
frames for completion.
c. Therapeutic Supervised Visitation — CONTRACTOR will supervise visitation and work directly with
parents to improve parenting skills, eliminate safety concerns and reduce the time the child is in out -of -
home placement.
d. Parenting Skills Development — Referred families will receive both group and individual instruction
with an emphasis on alternatives to physical discipline, household management, consistent delivery of
rules, consequences and rewards; and knowledge of developmental milestones and nutrition.
2. Goals and Objectives:
a. Prevent child abuse and neglect by teaching parenting skills, eliminating safety concerns and reducing
risk factors;
b. Strengthen families so they may remain intact;
c. Strengthen the family unit with in -home, family dictated services.
3. It is the goal of services that upon completion, referred families will possess the skills necessary to:
a. Maintain their children in their home;
b. Eliminate the need for Department or agency involvement;
c. No longer abuse or neglect their children; and
d. Improve the overall family functioning.
4. CONTRACTOR will provide 6.5 hours of service per week/referral; 1.5 hours of administration and 5.0
hours of direct face-to-face service to the referred family.
5. CONTRACTOR will provide 24 -hour crisis intervention services to referred families.
6. CONTRACTOR will submit a report on a monthly basis for each active referral. Reports will be
submitted per the online format required by the Department, unless otherwise directed by the
Department.
7. CONTRACTOR will participate in team reviews of ongoing services as needed.
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EXHIBIT B
PAYMENT SCHEDULE
1. Funding and Method of Payment
The Department agrees to reimburse CONTRACTOR in consideration for the work and services
performed from Core Services funding, not to exceed $50,000.00.
Expenses incurred by CONTRACTOR, in association with said project prior to the term of this agreement,
are not eligible Department expenditures and shall not be reimbursed by the Department.
Payment pursuant to this Contract, if Core Services funds, whether in whole or in part, is subject to and
contingent upon the continuing availability of said funds for the purposes hereof In the event that said
funds, or any part thereof, become unavailable as determined by the Department, the Department may
immediately terminate this Contract or amend it accordingly.
2. Fees for Services
$1,600.00/Month (Pro -rated for any partial month of service)
Department referrals will not be sent to collections by Contractor for default of co-pay/fees. Services will
be performed regardless of client's refusal or inability to pay co -pay.
Contractor will collect any applicable sliding scale co -pays and credit the Department for any payments
received on the monthly billing statements.
3. Submittal of Vouchers
CONTRACTOR shall prepare and submit monthly the itemized voucher and certify that the services
authorized were provided on the date indicated and the charges made were pursuant to the terms and
conditions of Exhibit A.
a. All billings are to be submitted by the 7th day of the month following the month of
service. If the billing is not submitted within twenty-five (25) calendar days of the month
following service, it may result in forfeiture of payment.
b. Billings must be submitted with the attached required forms, Authorization for
Contractual Services, Request for Reimbursement, Client Verification Form and monthly
report. The Authorization for Contractual Services and Client Verification Form must be
submitted with original signatures.
c. For monitored sobriety, proof of services rendered shall be a sign -in sheet with client
signatures or the test result.
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EXHIBIT C
ASSURANCES
1. CONTRACTOR 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 CONTRACTOR -
contracted CONTRACTOR or its employees, volunteers, or agents while performing duties as described in
this Agreement. CONTRACTOR shall indemnify, defend, and hold harmless Weld County, the Board of
County Commissioners of Weld County, its employees, volunteers, and agents. CONTRACTOR 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, CONTRACTOR shall provide the
Department 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 created a
duty of care with respect to any persons not a party of this Agreement.
4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld, State
of Colorado, to expend funds not otherwise appropriated in each succeeding year.
5. If any section, subsection, paragraph, sentence, clause, or phrase of this Contract is for any reason held or
decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The
parties hereto declare that they would have entered into this Contract and each and every section,
subsection, paragraph, sentence, clause, and phrase thereof irrespective of the fact that any one or more
sections, subsections, paragraphs, sentences, clauses, or phrases might be declared to be unconstitutional or
invalid.
6. No officer, member or employee of Weld County and no member of their governing bodies shall have any
pecuniary interest, direct or indirect, in the approved Agreement or the proceeds thereof.
7. CONTRACTOR 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. CONTRACTOR 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
CONTRACTOR.
9. All such records, documents, communications, and other materials created pursuant or related to this
contract shall be maintained by CONTRACTOR, in a central location and shall be made available to
Social Services upon its request, for a period of seven (7) 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 seven (7) year period, or if
audit findings have not been resolved after a seven (7) period, the materials shall be retained until the
resolution of the audit finding.
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10. CONTRACTOR assures that authorized local, federal, and state auditors and representatives shall, during
business hours, have access to inspect any copy records, and shall be allowed to monitor and review
through on -site visits, all contract activities, supported with funds under this Contract to ensure compliance
with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the
performance of the Agreement shall be conducted by appropriate funding sources. The results of the
monitoring and evaluation activities shall be provided to the appropriate and interested parties.
11. This Contract shall be binding upon the parties hereto, their successors, heirs, legal representatives, and
assigns. CONTRACTOR or the Department may not assign any of its rights or obligations hereunder
without the prior written consent of both parties.
12. CONTRACTOR certifies that federal appropriated funds have not been paid or will be paid, by or on
behalf of CONTRACTOR, 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. CONTRACTOR assures that it will fully comply with all other applicable federal and state laws.
CONTRACTOR understands that the source of funds to be used under this Contract is Core Services
funds.
14. CONTRACTOR 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 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 12 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 the
Department 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,
CONTRACTOR shall not enter any third party relationship that gives the appearance of creating a conflict
of interest. Upon leaming of an existing appearance of a conflict of interest situation, CONTRACTOR
shall submit to the Department. 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 the Department's termination, for cause, of its contract with
CONTRACTOR.
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16. CONTRACTOR 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 CONTRACTOR shall be disclosed in a form identifiable with the applicant/recipient or a
minor's parent or guardian unless in accordance with CONTRACTOR written policies governing access
to, duplication and dissemination of, all such information. CONTRACTOR shall advise its employees,
agents, and subcontractor, if any, that they are subject to these confidentiality requirements.
CONTRACTOR 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.
CONTRACTOR shall have its employees, agents, and subcontractors, if any, sign a written confidentiality
agreement and shall provide a copy of such agreement to the Department, if requested.
17. Proprietary information for the purposes of this contract is information relating to a party's research,
development, trade secrets, business affairs, internal operations and management procedures and those of
its customers, clients or affiliates, but does not include information (1) lawfully obtained from third parties,
(2) that which is in the public domain, or (3) that which is developed independently. Neither party
shall use or disclose directly or indirectly without prior written authorization any proprietary information
concerning the other party obtained as a result of this Contract. Any proprietary information removed from
the State's site by CONTRACTOR in the course of providing services under this Contract will be accorded
at least the same precautions as are employed by CONTRACTOR for similar information in the course of
its own business.
18. CONTRACTOR certifies it will abide by Colorado Revised Statue (C.R.S.) 26-6-104, requiring criminal
background record checks for all employees, contractors, and sub -contractors.
19. Contractor certifies that it shall comply with the provisions of Colorado Revised Statutes (C.R.S.) 8-17.5-
101, et seq. Contractor shall not knowingly employ or contract with an illegal alien to perform work under
this Contract or enter into a contract with a subcontractor that fails to certify to Contractor that the
subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this
Contract. Contractor represents, warrants, and agrees that it (a) has verified that it does not employ any
illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by
the Social Security Administration and Department of Homeland Security, and (b) otherwise will comply
with the requirements of C.R.S. 8-17.5-102(2)(6). Contractor shall comply with all reasonable requests
made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and
Employment. If Contractor fails to comply with any requirement of this provision or C.R.S. 8-17.5-101, et
seq., the Department may terminate this Contract for breach and Contractor shall be liable for actual and
consequential damages to the Department.
Except where exempted by federal law and except as provided in C.R.S. 24-76.5-103(3), if Contractor
receives federal or state funds under this Contract, Contractor must confirm that any individual natural
person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. 24-
76.5-103(4) if such individual applies for public benefits provided under this Contract. If Contractor
operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it (a) is a citizen of
the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall
produce one of the forms of identification required by C.R.S. 24-76.5-101, et seq., and (c) shall produce
one of the forms of identification required by C.R.S. 24-76.5-103 prior to the effective date of this
Contract.
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EXHIBIT D
CHILD and FAMILY SERVICES REVIEWS (CFSR)
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas; Safety,
Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's
performance according to national standards and monitors progress over time. Following the review, a Performance
Improvement Program (PIP) will be implemented for the state to enhance services to families.
Additionally, the review will assess statewide, systemic factors to determine if the systems necessary to achieve
positive outcomes for families are in place.
All agencies that contract to provide service to families and children in Weld County must continually strive for
positive outcomes in the areas of safety, permanency and well-being for our youth. In order to insure continued
progress in this area, the Department is requiring providers to comply with a standard assessment and reporting
system which will address these three areas.*
The Department is requesting that provider reports include observations and recommendations regarding clients in a
way that specifically addresses the areas of safety, permanency and well-being. Below are the specific outcomes
that will be assessed by the CFSR in the areas of safety, permanency and well-being, followed by specific
considerations and tasks which must be addressed by the Department contracted providers.
Safety Outcomes
CFSR Outcome Measures
Safety 1 Children are, first and foremost, protected from abuse and neglect.
Safety 2 Children are safely maintained in their homes whenever possible and appropriate.
Considerations for the Department's providers
• Providers should always consider the following definitions regarding child safety when assessing families.
o Children are considered safe when there are no present dangers or impending danger threats, or
the caregivers' protective capacities control existing threats.
o Children are considered unsafe when they are vulnerable to present or impending danger threats,
and caregivers are unable or unwilling to provide protection.
o Risk is the likelihood (chance, potential, prospect) for parenting behavior that is harmful and
destructive to a child's cognitive, social, emotional and/or physical development, and those with
parenting responsibility are unwilling or unable to behave differently.
• Monthly reports should continually document an assessment of risk and safety concerns and the
interventions that are being offered by the provider to ameliorate those concems.
• Monthly reports should make recommendations regarding services and/or safety measures that the provider
believes should be implemented to insure safety of the child(ren).
• Providers must specifically document efforts to engage families in services and to control for safety.
Permanency Outcomes
CFSR Outcome Measures
Pei manency 1 Children have permanency and stability in their living situations.
Permanency 2 The continuity of family relationships and connections is preserved for children.
Considerations for the Department's providers:
Provider reports should always note the primary permanency goal for the child and document how
interventions are working toward achieving that goal.
• Provider reports must indicate progress toward achieving the permanency goal and should make specific
recommendations regarding how the continuation of the service may assist in achieving the goal.
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• Providers should continually provide recommendations about whether any out -of -home placement
continues to be appropriate and should make recommendations regarding when changes in this area should
be made, in the providers' opinion.
• Providers should continually assess family relationships (parent/child, sibling/sibling, extended
family/child, etc.) and should report any concerning relationship issues which may be a barrier to achieving
permanency. Providers should document ongoing efforts to resolve those issues and/or make
recommendations regarding additional services that may be required to address relationship issues.
• Providers must document specific time frames when recommending ongoing services and/or
recommending changes to services and/or placements.
Child and Family Well -Being Outcomes
CFSR Outcome Measures
Well Being 1 Families have enhanced capacity to provide for their children's needs.
Well Being 2 Children receive appropriate services to meet their educational needs.
Well Being 3 Children receive adequate services to meet their physical and mental health needs.
Considerations for the Department's providers:
• Providers must engage in ongoing assessments of the parents' capacity to appropriately care for their
children and whether or not the service being provided continues to be appropriate. This must be clearly
documented in monthly reports.
• Providers should specifically detail areas of continued concern within the family and make
recommendations regarding whether that provider's service continues to be appropriate. Reports should
also document what barriers may be impeding progress.
• Providers should document any and all observed concerns regarding any child with whom the provider is
working. This should include concerns regarding physical, emotional, educational and behavioral well-
being of the child. When appropriate, providers should make recommendations regarding evaluations
and/or additional services that may address these concerns.
*Standardized reports will be provided and should be utilized by all agencies providing ongoing services to the
Department's families unless otherwise noted.
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CHILD PROTECTION AGREEMENT FOR SERVICES
BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES
AND TURNING POINT CENTER FOR YOUTH AND FAMILY DEVELOPMENT, INC.
This Agreement, made and entered into the >1 day of SCtniC 2009, by and between the Board of
Weld County Commissioners, sitting as the Board ofHuman Services, on behalf of the Weld County Department of
Human Services, hereinafter referred to as the "Department," and Turning Point Center for Youth and Family
Development, Inc., hereinafter referred to as "Contractor".
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 Core Services funding to the
Department for Foster Parent Consultation; and
NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows:
1. Term
This Agreement shall become effective on June 1, 2009, upon proper execution of this Agreement and
shall expire May 31, 2010, unless sooner terminated as provided herein.
2. Scope of Services
Services shall be provided by CONTRACTOR 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," of which are attached
hereto and incorporated herein by reference.
"Payment Schedule" shall establish the maximum reimbursement, which will be paid from
Core Services funding during the duration of this Agreement.
b. CONTRACTOR shall submit an itemized monthly bill to the Department for all costs incurred
and services provided pursuant to Exhibit A of this Agreement in accordance with criteria
established by the Department. CONTRACTOR shall submit all itemized monthly billings to
the Department by the 715 day of the month following the month the cost was incurred. If the
billing is not submitted within twenty-five (25) calendar days of the month following service, it
may result in forfeiture of payment.
c. Payments of costs incurred pursuant to this Agreement is expressly contingent upon the
availability of Core Services to the Department.
d. The Department 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.
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4. Financial Management
At all times from the effective date of this Contract until completion of this Contract, CONTRACTOR
shall comply with the administrative requirements, cost principles and other requirements set forth in the
Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds
expended under Core Service funding must conform to the Single Audit Act of 1984 and OMB Circular A-
133.
5. Payment Method
Unless otherwise provided in the Scope of Services and Payment Schedule:
a. CONTRACTOR shall provide proper monthly invoices and itemization of services performed for
costs incurred in the performance of the agreement.
b. The Department may withhold any payment if CONTRACTOR has failed to comply with the
Financial Management Requirements, program objectives, contractual terms, or reporting
requirements. In the event of a forfeiture of reimbursements, CONTRACTOR may appeal such
circumstance to the Director of Human Services. The decision of the Director of Human Services
shall be final.
6. Assurances
CONTRACTOR shall abide by all assurances as set forth in the attached Exhibit C, which is attached hereto
and incorporated herein by reference.
7. Compliance with Applicable Laws
At all times during the performance of this contract, CONTRACTOR 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. CONTRACTOR acknowledges that the following laws are included:
Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d —1 et. seq. and its implementing
regulation, 45 C.F.R. Part 80 et. seq.; and
Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 794, and
its implementing regulations, 45 C.F.R. Part 84; and
the Age Discrimination Act of 1975, 42 U.S.C. Sections 6101 et. seq. and
its implementation regulations, 45 C.F.R. Part 91; and
Title VII of the Civil Rights Act of 1964; and
the Age Discrimination in Employment Act of 1967; and
the Equal Pay Act of 1963; and
the Education Amendments of 1972; and
Immigration Reform and Control Act of 1986, P.L. 99-603;
42 C.F.R. Part 2
and all regulations applicable to these laws prohibiting discrimination because of race, color,
National origin, and sex, religion and handicap, including Acquired Immune Deficiency Syndrome (AIDS)
or AIDS related conditions, covered under Section 504 of the Rehabilitation Act of 1973, as amended,
cited above. If necessary, CONTRACTOR and the Department will resist in judicial proceedings any
efforts to obtain access to client records except as permitted by 42 CFR Part 2.
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Included is 45 C.F.R. Part 74 Appendix G 9, which requires that affirmative steps be taken to assure that
small and minority businesses are utilized, when possible, as sources of supplies, equipment, construction
and services. This assurance is given in consideration of and for the purpose of obtaining any and all
federal and/or state financial assistance.
Any person who feels that s/he has been discriminated against has the right to file a complaint either with
the Colorado Department of Human Services or with the U.S. Department of Health and Human Services,
Office for Civil Rights.
8. Compliance with Child and Family Services Review
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas;
Safety, Permanency and Well Being of families. For each outcome, data and performance indicators
measure each state's performance according to national standards and monitor progress over time.
Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance
services to families.
CONTRACTORS providing services to the Department families and children must continually strive for
positive outcomes in the areas of safety, permanency and well being. Contractors providing services in
program areas identified by the Department are required to comply with a standard assessment and
reporting system set forth in Exhibit D which will address the aforementioned three areas.
9. Insurance
CONTRACTOR, shall procure, either personally or through its employer as applicable to the Contractor's
business, at its own expense, and maintain for the duration of the work, the following insurance coverage;
Weld County, Colorado, by and through the Board of County Commissioners of Weld County, its
employees and agents, shall be named as additional named insured on the insurance, where permissible by
the insurance provider.
a. Standard Workman's Compensation and Employer's Liability.
1. As required by state statute including occupational disease, covering all employees at
work site.
b. General Liability (PL & PD) (Minimum).
1. Combined single limit - $500,000 written on an occurrence basis.
2. Any aggregate limit will not be less than $1 million.
3. Provider must purchase additional insurance if claims reduce the annual aggregate below
$500,000.
4. State of Colorado to be named as additional insured on each comprehensive general
liability policy.
5. Certificate of insurance to be provided to Weld County and must be attached to the
contract.
6. Insurance shall include provisions preventing cancellation without 60 days prior notice
by certified mail to Weld County.
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c. Automobile Liability (Minimum) for any Contractor transporting children or any party to whom
Department services are being provided.
d. Additional coverage may be required in specific program areas. For any insurances that are
required by this contract, a completed Standard Certificate of Insurance Form shall be provided to
the Department by the Contractor prior to the start of any contract.
10. Certifications
CONTRACTOR 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. Copies of all necessary licenses shall be provided to the Department by the
Contractor prior to the start of any contract.
11. Training
Contractor shall attend a Court Testimony and Ethics Training to be paid for by the Department. The
Contractor may be required to attend additional training at the request of the Department. The cost of such
training will be paid for by the Department. The Department will not compensate the Contractor for the
time spent attending the required trainings.
12. Monitoring and Evaluation
CONTRACTOR and the Department agree that monitoring and evaluation of the performance of this
Agreement shall be conducted by CONTRACTOR and the Department. The results of the monitoring and
evaluation shall be provided to the Board of Weld County Commissioners, the Department and
CONTRACTOR.
CONTRACTOR shall permit the Department, and any other duly authorized agent or govemmental
agency, to monitor all activities conducted by CONTRACTOR 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.
13. Modification of Agreement
All modifications to this agreement shall be in writing and signed by both parties.
14. Remedies
The Director of Human Services or designee may exercise the following remedial actions should s/he find
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
CONTRACTOR. These remedial actions are as follows:
a. Withhold payment to 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 CONTRACTOR cannot be performed or if
performed would be of no value to the Department. Denial of the amount of payment shall be
reasonably related to the amount of work or deliverables lost to the Department;
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c. Incorrect payment to CONTRACTOR due to omission, error, fraud, and/or defalcation shall be
recovered from CONTRACTOR by deduction from subsequent payments under this Agreement or
other agreements between the Department and CONTRACTOR, or by the Department as a debt due to
the Department or otherwise as provided by law.
15. 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 the Department:
Gloria Romansik
Name
For CONTRACTOR:
Stephanie Brown
Name
16. Notice
Social Services Administrator
Title
Executive Director
Title
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: The Department
Judy A. Griego, Director
P.O. Box A
Greeley, CO 80632
(970) 352-1551
17. Litigation
To: CONTRACTOR
Stephanie Brown, Executive Director
1644 S. College Avenue
Fort Collins, CO 80525
(970)221-0999,x34
CONTRACTOR shall promptly notify the Department in the event that CONTRACTOR learns of any
actual litigation in which it is a party defendant in a case that involves services provided under this
Agreement. 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, reorganization and/or foreclosure.
18. 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. CONTRACTOR reserves the right to suspend services to clients if
funding is no longer available.
19. 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 13 herein.
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IN WITNESS W
above wri
ATT
EOF, the parties hereto have duly executed the Agreement as of the day, month, and year first
WELD COUN
CLERK PO TH
By:..
De ~`_-_'.,.,.'tom..
APPROVED AS TO F
Cou
WELD COUNTY DEPARTMENT
OF HUMAN SERVICES
i
By:
C -
Judy A. Griego, Director
BOARD OF COUNTY
COMMISSIONERS WELD
COUNTY, COLO
Chair William F. Garcia
06/17/2009
CONTRA R:
6
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EXHIBIT A
SCOPE OF SERVICES
1. CONTRACTOR will provide consultation services for foster children and youth residing in Weld
County foster homes. The goal of the program is to enhance and improve the quality of care being
provided to Weld County's children and youth.
2. CONTRACTOR will work collaboratively with children, foster parents, caseworkers, foster care
coordinators and other service providers to identify and address issues, in a solution -focused manner,
which could potentially disrupt placements.
3. Interventions will be clinical and/or psychoeducational in nature and will aim to target issues
including, but not limited to, the following:
a. Fine tune solutions: Solution -focused in working with challenging situations
b. Developmental appropriateness of expectations
c. Social skills education
d. Power struggles
e. Collaborative work with difficult teens
f. What to do when consequences don't work
g. De-escalation of anger
h. Facilitating structure/respect
Behavior modification
4. CONTRACTOR will provide on -call, crisis support for those homes with an active foster parent
consultation referral.
a. CONTRACTOR will respond to crises which arise within foster homes on a 24 hour per
day/7 day per week basis.
b. Crisis calls from foster parents will be returned within one (1) hour from the time the foster
parent contacts the provider.
5. CONTRACTOR will follow up with referred foster family within 48 hours of receiving a referral and will
document efforts to engage foster family in referred services.
6. CONTRACTOR will make recommendations to foster family following assessment of the child.
CONTRACTOR will document recommendations and follow through of foster family with regard to
recommendations.
7. CONTRACTOR will assess foster families abilities and capacity on an ongoing basis to appropriately care
for the foster children in their home and report this information on a monthly basis to the Department.
8. CONTRACTOR will identify in detail areas of continued concern and make recommendations to the
Department regarding continuation of foster parent consultation services and/or the need for additional
services.
9. CONTRACTOR will document in detail any and all observed or verbalized concerns regarding any child
whom the CONTRACTOR is working with under an active referral. Areas of concern may include, but
are not limited to, any physical, emotional, educational or behavioral issues. Areas of concern should be
reported immediately AND on the required monthly report.
10. CONTRACTOR will submit reports on a monthly basis for each active referral. Reports will be submitted
per the online format required by the Department.
11. CONTRACTOR will participate in monthly team reviews of ongoing services as needed.
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EXHIBIT B
PAYMENT SCHEDULE
1. Funding and Method of Payment
The Department agrees to reimburse CONTRACTOR in consideration for the work and services
performed from Core Services funding, not to exceed $35,000.00.
Expenses incurred by CONTRACTOR, in association with said project prior to the term of this agreement,
are not eligible Department expenditures and shall not be reimbursed by the Department.
Payment pursuant to this Contract, if Core Services funds, whether in whole or in part, is subject to and
contingent upon the continuing availability of said funds for the purposes hereof. In the event that said
funds, or any part thereof, become unavailable as determined by the Department, the Department may
immediately terminate this Contract or amend it accordingly.
2. Fees for Services
$82.00/Hour (Foster Parent Consultation - Greeley Metro Area, including Evans, LaSalle, Eaton and
Windsor)
$120.00/Hour (Foster Parent Consultation - Outside of Greeley Metro Area, including Lochbuie,
Frederick, and Hudson)
$40.00/Hour (24/7 Telephone Crisis Support, 15 -minute Increments)
$50.00/Hour (Court Testimony)
Department referrals will not be sent to collections by Contractor for default of co-pay/fees. Services will
be performed regardless of client's refusal or inability to pay co -pay.
Contractor will collect any applicable sliding scale co -pays and credit the Department for any payments
received on the monthly billing statements.
3. Submittal of Vouchers
CONTRACTOR shall prepare and submit monthly the itemized voucher and certify that the services
authorized were provided on the date indicated and the charges made were pursuant to the terms and
conditions of Exhibit A.
a. All billings are to be submitted by the 7'" day of the month following the month of
service. If the billing is not submitted within twenty-five (25) calendar days of the month
following service, it may result in forfeiture of payment.
b. Billings must be submitted with the attached required forms, Authorization for
Contractual Services, Request for Reimbursement, Client Verification Form and monthly
report. The Authorization for Contractual Services and Client Verification Form must be
submitted with original signatures.
c. For monitored sobriety, proof of services rendered shall be a sign -in sheet with client
signatures or the test result.
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EXHIBIT C
ASSURANCES
1. CONTRACTOR 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 CONTRACTOR -
contracted CONTRACTOR or its employees, volunteers, or agents while performing duties as described in
this Agreement. CONTRACTOR shall indemnify, defend, and hold harmless Weld County, the Board of
County Commissioners of Weld County, its employees, volunteers, and agents. CONTRACTOR 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, CONTRACTOR shall provide the
Department 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 created a
duty of care with respect to any persons not a party of this Agreement.
4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld, State
of Colorado, to expend funds not otherwise appropriated in each succeeding year.
5. If any section, subsection, paragraph, sentence, clause, or phrase of this Contract is for any reason held or
decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The
parties hereto declare that they would have entered into this Contract and each and every section,
subsection, paragraph, sentence, clause, and phrase thereof irrespective of the fact that any one or more
sections, subsections, paragraphs, sentences, clauses, or phrases might be declared to be unconstitutional or
invalid.
6. No officer, member or employee of Weld County and no member of their governing bodies shall have any
pecuniary interest, direct or indirect, in the approved Agreement or the proceeds thereof
7. CONTRACTOR 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. CONTRACTOR 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
CONTRACTOR.
9. All such records, documents, communications, and other materials created pursuant or related to this
contract shall be maintained by CONTRACTOR, in a central location and shall be made available to
Social Services upon its request, for a period of seven (7) 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 seven (7) year period, or if
audit findings have not been resolved after a seven (7) period, the materials shall be retained until the
resolution of the audit finding.
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10. CONTRACTOR assures that authorized local, federal, and state auditors and representatives shall, during
business hours, have access to inspect any copy records, and shall be allowed to monitor and review
through on -site visits, all contract activities, supported with funds under this Contract to ensure compliance
with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the
performance of the Agreement shall be conducted by appropriate funding sources. The results of the
monitoring and evaluation activities shall be provided to the appropriate and interested parties.
11. This Contract shall be binding upon the parties hereto, their successors, heirs, legal representatives, and
assigns. CONTRACTOR or the Department may not assign any of its rights or obligations hereunder
without the prior written consent of both parties.
12. CONTRACTOR certifies that federal appropriated funds have not been paid or will be paid, by or on
behalf of CONTRACTOR, 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. CONTRACTOR assures that it will fully comply with all other applicable federal and state laws.
CONTRACTOR understands that the source of funds to be used under this Contract is Core Services
funds.
14. CONTRACTOR 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 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 12 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 the
Department 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,
CONTRACTOR 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, CONTRACTOR
shall submit to the Department, 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 the Department's termination, for cause, of its contract with
CONTRACTOR.
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16. CONTRACTOR 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 CONTRACTOR shall be disclosed in a form identifiable with the applicant/recipient or a
minor's parent or guardian unless in accordance with CONTRACTOR written policies governing access
to, duplication and dissemination of, all such information. CONTRACTOR shall advise its employees,
agents, and subcontractor, if any, that they are subject to these confidentiality requirements.
CONTRACTOR 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.
CONTRACTOR shall have its employees, agents, and subcontractors, if any, sign a written confidentiality
agreement and shall provide a copy of such agreement to the Department, if requested.
17. Proprietary information for the purposes of this contract is information relating to a party's research,
development, trade secrets, business affairs, internal operations and management procedures and those of
its customers, clients or affiliates, but does not include information (1) lawfully obtained from third parties,
(2) that which is in the public domain, or (3) that which is developed independently. Neither party
shall use or disclose directly or indirectly without prior written authorization any proprietary information
concerning the other party obtained as a result of this Contract. Any proprietary information removed from
the State's site by CONTRACTOR in the course of providing services under this Contract will be accorded
at least the same precautions as are employed by CONTRACTOR for similar information in the course of
its own business.
18. CONTRACTOR certifies it will abide by Colorado Revised Statue (C.R.S.) 26-6-104, requiring criminal
background record checks for all employees, contractors, and sub -contractors.
19. Contractor certifies that it shall comply with the provisions of Colorado Revised Statutes (C.R.S.) 8-17.5-
101, et seq. Contractor shall not knowingly employ or contract with an illegal alien to perform work under
this Contract or enter into a contract with a subcontractor that fails to certify to Contractor that the
subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this
Contract. Contractor represents, warrants, and agrees that it (a) has verified that it does not employ any
illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by
the Social Security Administration and Department of Homeland Security, and (b) otherwise will comply
with the requirements of C.R.S. 8-17.5-102(2)(b). Contractor shall comply with all reasonable requests
made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and
Employment. If Contractor fails to comply with any requirement of this provision or C.R.S. 8-17.5-101, et
seq., the Department may terminate this Contract for breach and Contractor shall be liable for actual and
consequential damages to the Department.
Except where exempted by federal law and except as provided in C.R.S. 24-76.5-103(3), if Contractor
receives federal or state funds under this Contract, Contractor must confirm that any individual natural
person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. 24-
76.5-103(4) if such individual applies for public benefits provided under this Contract. If Contractor
operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it (a) is a citizen of
the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall
produce one of the forms of identification required by C.R.S. 24-76.5-101, et seq., and (c) shall produce
one of the forms of identification required by C.R.S. 24-76.5-103 prior to the effective date of this
Contract.
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EXHIBIT D
CHILD and FAMILY SERVICES REVIEWS (CFSR)
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas; Safety,
Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's
performance according to national standards and monitors progress over time. Following the review, a Performance
Improvement Program (PIP) will be implemented for the state to enhance services to families.
Additionally, the review will assess statewide, systemic factors to determine if the systems necessary to achieve
positive outcomes for families are in place.
All agencies that contract to provide service to families and children in Weld County must continually strive for
positive outcomes in the areas of safety, permanency and well-being for our youth. In order to insure continued
progress in this area, the Department is requiring providers to comply with a standard assessment and reporting
system which will address these three areas.*
The Department is requesting that provider reports include observations and recommendations regarding clients in a
way that specifically addresses the areas of safety, permanency and well-being. Below are the specific outcomes
that will be assessed by the CFSR in the areas of safety. permanency and well-being, followed by specific
considerations and tasks which must be addressed by the Department contracted providers.
Safety Outcomes
CFSR Outcome Measures
Safety 1 Children are, first and foremost, protected from abuse and neglect.
Safety 2 Children are safely maintained in their homes whenever possible and appropriate.
Considerations for the Department's providers
• Providers should always consider the following definitions regarding child safety when assessing families.
o Children are considered safe when there are no present dangers or impending danger threats, or
the caregivers' protective capacities control existing threats.
o Children are considered unsafe when they are vulnerable to present or impending danger threats,
and caregivers are unable or unwilling to provide protection.
o Risk is the likelihood (chance, potential, prospect) for parenting behavior that is harmful and
destructive to a child's cognitive, social, emotional and/or physical development, and those with
parenting responsibility are unwilling or unable to behave differently.
• Monthly reports should continually document an assessment of risk and safety concerns and the
interventions that are being offered by the provider to ameliorate those concerns.
• Monthly reports should make recommendations regarding services and/or safety measures that the provider
believes should be implemented to insure safety of the child(ren).
• Providers must specifically document efforts to engage families in services and to control for safety.
Permanency Outcomes
CFSR Outcome Measures
Permanency 1 Children have permanency and stability in their living situations.
Permanency 2 The continuity of family relationships and connections is preserved for children.
Considerations for the Department's providers:
• Provider reports should always note the primary permanency goal for the child and document how
interventions are working toward achieving that goal.
• Provider reports must indicate progress toward achieving the permanency goal and should make specific
recommendations regarding how the continuation of the service may assist in achieving the goal.
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• Providers should continually provide recommendations about whether any out -of -home placement
continues to be appropriate and should make recommendations regarding when changes in this area should
be made, in the providers' opinion.
Providers should continually assess family relationships (parent/child, sibling/sibling, extended
family/child, etc.) and should report any concerning relationship issues which may be a barrier to achieving
permanency. Providers should document ongoing efforts to resolve those issues and/or make
recommendations regarding additional services that may be required to address relationship issues.
• Providers must document specific time frames when recommending ongoing services and/or
recommending changes to services and/or placements.
Child and Family Well -Being Outcomes
CFSR Outcome Measures
Well Being 1 Families have enhanced capacity to provide for their children's needs.
Well Being 2 Children receive appropriate services to meet their educational needs.
Well Being 3 Children receive adequate services to meet their physical and mental health needs.
Considerations for the Department's providers:
• Providers must engage in ongoing assessments of the parents' capacity to appropriately care for their
children and whether or not the service being provided continues to be appropriate. This must be clearly
documented in monthly reports.
• Providers should specifically detail areas of continued concern within the family and make
recommendations regarding whether that provider's service continues to be appropriate. Reports should
also document what barriers may be impeding progress.
• Providers should document any and all observed concerns regarding any child with whom the provider is
working. This should include concerns regarding physical, emotional, educational and behavioral well-
being of the child. When appropriate, providers should make recommendations regarding evaluations
and/or additional services that may address these concerns.
*Standardized reports will be provided and should be utilized by all agencies providing ongoing services to the
Department's families unless otherwise noted.
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ea l/e5
cvnt-
ry
CHILD PROTECTION AGREEMENT FOR SERVICES
BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES
AND TURNING POINT CENTER FOR YOUTH AND FAMILY DEVELOPMENT, INC.
This Agreement, made and entered into the +I day of -416 f 2009, by and between the Board of
Weld County Commissioners, sitting as the Board of Human Services, on behalf of the Weld County Department of
Human Services, hereinafter referred to as the "Department," and Turning Point Center for Youth and Family
Development, Inc., hereinafter referred to as "Contractor".
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 Core Services funding to the
Department for Day Treatment; and
NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows:
1. Term
This Agreement shall become effective on June 1, 2009, upon proper execution of this Agreement and
shall expire May 31, 2010, unless sooner terminated as provided herein.
2. Scope of Services
Services shall be provided by CONTRACTOR 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," of which are attached
hereto and incorporated herein by reference.
"Payment Schedule" shall establish the maximum reimbursement, which will be paid from
Core Services funding during the duration of this Agreement.
b. CONTRACTOR shall submit an itemized monthly bill to the Department for all costs incurred
and services provided pursuant to Exhibit A of this Agreement in accordance with criteria
established by the Department. CONTRACTOR shall submit all itemized monthly billings to
the Department by the 7'h day of the month following the month the cost was incurred. If the
billing is not submitted within twenty-five (25) calendar days of the month following service, it
may result in forfeiture of payment.
c. Payments of costs incurred pursuant to this Agreement is expressly contingent upon the
availability of Core Services to the Department.
d. The Department 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.
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4. Financial Management
At all times from the effective date of this Contract until completion of this Contract, CONTRACTOR
shall comply with the administrative requirements, cost principles and other requirements set forth in the
Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds
expended under Core Service funding must conform to the Single Audit Act of 1984 and OMB Circular A-
133.
5. Payment Method
Unless otherwise provided in the Scope of Services and Payment Schedule:
a. CONTRACTOR shall provide proper monthly invoices and itemization of services performed for
costs incurred in the performance of the agreement.
b. The Department may withhold any payment if CONTRACTOR has failed to comply with the
Financial Management Requirements, program objectives, contractual terms, or reporting
requirements. In the event of a forfeiture of reimbursements, CONTRACTOR may appeal such
circumstance to the Director of Human Services. The decision of the Director of Human Services
shall be final.
6. Assurances
CONTRACTOR shall abide by all assurances as set forth in the attached Exhibit C, which is attached hereto
and incorporated herein by reference.
7. Compliance with Applicable Laws
At all times during the performance of this contract, CONTRACTOR 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. CONTRACTOR acknowledges that the following laws are included:
Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d-1 et. seq. and its implementing
regulation, 45 C.F.R. Part 80 et. seq.; and
Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 794, and
its implementing regulations, 45 C.F.R. Part 84; and
the Age Discrimination Act of 1975, 42 U.S.C. Sections 6101 et. seq. and
its implementation regulations, 45 C.P.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, CONTRACTOR and the Department will resist in judicial proceedings any
efforts to obtain access to client records except as permitted by 42 CFR Part 2.
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Included is 45 C.F.R. Part 74 Appendix G 9, which requires that affirmative steps be taken to assure that
small and minority businesses are utilized, when possible, as sources of supplies, equipment, construction
and services. This assurance is given in consideration of and for the purpose of obtaining any and all
federal and/or state financial assistance.
Any person who feels that s/he has been discriminated against has the right to file a complaint either with
the Colorado Department of Human Services or with the U.S. Department of Health and Human Services,
Office for Civil Rights.
8. Compliance with Child and Family Services Review
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas;
Safety, Permanency and Well Being of families. For each outcome, data and performance indicators
measure each state's performance according to national standards and monitor progress over time.
Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance
services to families.
CONTRACTORS providing services to the Department families and children must continually strive for
positive outcomes in the areas of safety, permanency and well being. Contractors providing services in
program areas identified by the Department are required to comply with a standard assessment and
reporting system set forth in Exhibit D which will address the aforementioned three areas.
9. Insurance
CONTRACTOR, shall procure, either personally or through its employer as applicable to the Contractor's
business, at its own expense, and maintain for the duration of the work, the following insurance coverage;
Weld County, Colorado, by and through the Board of County Commissioners of Weld County, its
employees and agents, shall be named as additional named insured on the insurance, where permissible by
the insurance provider.
a. Standard Workman's Compensation and Employer's Liability.
1. As required by state statute including occupational disease, covering all employees at
work site.
b. General Liability (PL & PD) (Minimum).
1. Combined single limit - $500,000 written on an occurrence basis.
2. Any aggregate limit will not be less than $1 million.
3. Provider must purchase additional insurance if claims reduce the annual aggregate below
$500,000.
4. State of Colorado to be named as additional insured on each comprehensive general
liability policy.
5. Certificate of insurance to be provided to Weld County and must be attached to the
contract.
6. Insurance shall include provisions preventing cancellation without 60 days prior notice
by certified mail to Weld County.
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c. Automobile Liability (Minimum) for any Contractor transporting children or any party to whom
Department services are being provided.
d. Additional coverage may be required in specific program areas. For any insurances that are
required by this contract, a completed Standard Certificate of Insurance Form shall be provided to
the Department by the Contractor prior to the start of any contract.
10. Certifications
CONTRACTOR 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. Copies of all necessary licenses shall be provided to the Department by the
Contractor prior to the start of any contract.
i L Training
Contractor shall attend a Court Testimony and Ethics Training to be paid for by the Department. The
Contractor may be required to attend additional training at the request of the Department. The cost of such
training will be paid for by the Department. The Department will not compensate the Contractor for the
time spent attending the required trainings.
12. Monitoring and Evaluation
CONTRACTOR and the Department agree that monitoring and evaluation of the performance of this
Agreement shall be conducted by CONTRACTOR and the Department. The results of the monitoring and
evaluation shall be provided to the Board of Weld County Commissioners, the Department and
CONTRACTOR.
CONTRACTOR shall permit the Department, and any other duly authorized agent or governmental
agency, to monitor all activities conducted by CONTRACTOR 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.
13. Modification of Agreement
All modifications to this agreement shall be in writing and signed by both parties.
14. Remedies
The Director of Human Services or designee may exercise the following remedial actions should s/he find
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
CONTRACTOR. These remedial actions are as follows:
a. Withhold payment to 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 CONTRACTOR cannot be performed or if
performed would be of no value to the Department. Denial of the amount of payment shall be
reasonably related to the amount of work or deliverables lost to the Department;
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c. Incorrect payment to CONTRACTOR due to omission, error, fraud, and/or defalcation shall be
recovered from CONTRACTOR by deduction from subsequent payments under this Agreement or
other agreements between the Department and CONTRACTOR, or by the Department as a debt due to
the Department or otherwise as provided by law.
15. 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 the Department:
Gloria Romansik
Name
For CONTRACTOR:
Stephanie Brown
Name
16. Notice
Social Services Administrator
Title
Executive Director
Title
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: The Department
Judy A. Griego, Director
P.O. Box A
Greeley, CO 80632
(970) 352-1551
17. Litigation
To: CONTRACTOR
Stephanie Brown, Executive Director
1644 South College Avenue
Fort Collins, CO 80525
(970)221-0999,x34
CONTRACTOR shall promptly notify the Department in the event that CONTRACTOR learns of any
actual litigation in which it is a party defendant in a case that involves services provided under this
Agreement. 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, reorganization and/or foreclosure.
18. 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. CONTRACTOR reserves the right to suspend services to clients if
funding is no longer available.
19. 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 13 herein.
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IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first
above writt-
ATTE
ELD CO]
Gr ci;ERj( TC
BOARD OF COUNTY
COMMISSIONERS WELD
COUNTY, COLODO
By: 110► r:_(i F.Q ti By:
Depu
APPRO E
a
Cour '-.mey
WELD COUNTY DEPARTMENT
OF HUMAN S RVICES
By:
Chair Wil
CONTRA
BY
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. Garcia
06/17/2009
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PY-09-10-CORE-0175
EXHIBIT A
SCOPE OF SERVICES
1. CONTRACTOR will provide comprehensive, highly structured day treatment services to female and male
youth, ages 12-18, as referred by the Department.
2. CONTRACTOR will provide day treatment services at 913 11th Avenue, Greeley, CO 80631, 8:30 a.m. to 4:30
p.m., Monday through Friday.
3. CONTRACTOR is licensed by the Colorado Department of Human Services State Child Care Licensing.
License number 1553624.
4. Services include, but are not limited to assessment/evaluation; psychiatric evaluation and medication
management if appropriate; six (6) seat hours of school; one (1) hour of therapeutic recreation per day; one
hour each per week of individual therapy, family and group therapy; two (2) groups sessions to include
substance abuse and skill building; minimum bi-monthly in -home family therapy; thirty (30) hours per week
education program approved by the Colorado Department of Education; year-round services; and
transportation to and from students' homes or a designated location.
5. Teacher/Student ratio is 1 to 10.
6. Admission criteria include:
a. Adolescents between the age of 12-18, male or female.
b. Youth must have a mental health diagnosis and/or substance abuse.
c. Youth must be expelled or at risk of being expelled from school.
d. Youth must have no sexual offense history.
e. Cognitive levels will be assessed on a case -by -case basis.
f. Lower level services are deemed inappropriate or have proved unsuccessful for the youth.
7. CONTRACTOR will provide individual, group and family therapy to all referred youth unless otherwise
directed by the Department.
8. Testing and psychiatric medication evaluations and appointments will be conducted as needed to aid in case
planning and ensure the appropriate treatment is utilized for the referred youth's maximum growth and benefit.
9. Services will be provided by Masters' level therapists.
10. CONTRACTOR will utilize a bilingual Spanish interpreter when needed.
11. Referred youth will receive services for approximately four (4) to six (6) months. Length of services is
dependent upon the referred youth's daily/weekly progress, individual/family needs and availability of
funding.
12. CONTRACTOR will submit monthly progress reports for each referred client. Reports will be submitted with
the monthly billing.
13. CONTRACTOR will participate in team reviews of ongoing services as needed.
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EXHIBIT B
PAYMENT SCHEDULE
Funding and Method of Payment
The Department agrees to reimburse CONTRACTOR in consideration for the work and services
performed from Core Services funding, not to exceed $50,000.00.
Expenses incurred by CONTRACTOR, in association with said project prior to the term of this agreement,
are not eligible Department expenditures and shall not be reimbursed by the Department.
Payment pursuant to this Contract, if Core Services funds, whether in whole or in part, is subject to and
contingent upon the continuing availability of said funds for the purposes hereof. In the event that said
funds, or any part thereof, become unavailable as determined by the Department, the Department may
immediately terminate this Contract or amend it accordingly.
2. Fees for Services
$85.00/Day (with In -home Family Therapy)
$75.00/Day (without In -home Family Therapy)
Department referrals will not be sent to collections by Contractor for default of co-pay/fees. Services will
be performed regardless of client's refusal or inability to pay co -pay.
Contractor will collect any applicable sliding scale co -pays and credit the Department for any payments
received on the monthly billing statements.
3. Submittal of Vouchers
CONTRACTOR shall prepare and submit monthly the itemized voucher and certify that the services
authorized were provided on the date indicated and the charges made were pursuant to the terms and
conditions of Exhibit A.
a. All billings are to be submitted by the 7'" day of the month following the month of
service. If the billing is not submitted within twenty-five (25) calendar days of the month
following service, it may result in forfeiture of payment.
b. Billings must be submitted with the attached required forms, Authorization for
Contractual Services, Request for Reimbursement, Client Verification Form and monthly
report. The Authorization for Contractual Services and Client Verification Form must be
submitted with original signatures.
c. For monitored sobriety, proof of services rendered shall be a sign -in sheet with client
signatures or the test result.
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EXHIBIT C
ASSURANCES
1. CONTRACTOR 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 CONTRACTOR -
contracted CONTRACTOR or its employees, volunteers, or agents while performing duties as described in
this Agreement. CONTRACTOR shall indemnify, defend, and hold harmless Weld County, the Board of
County Commissioners of Weld County, its employees, volunteers, and agents. CONTRACTOR 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, CONTRACTOR shall provide the
Department 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 created a
duty of care with respect to any persons not a party of this Agreement.
4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld, State
of Colorado, to expend funds not otherwise appropriated in each succeeding year.
5. If any section, subsection, paragraph, sentence, clause, or phrase of this Contract is for any reason held or
decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The
parties hereto declare that they would have entered into this Contract and each and every section,
subsection, paragraph, sentence, clause, and phrase thereof irrespective of the fact that any one or more
sections, subsections, paragraphs, sentences, clauses, or phrases might be declared to be unconstitutional or
invalid.
6. No officer, member or employee of Weld County and no member of their governing bodies shall have any
pecuniary interest, direct or indirect, in the approved Agreement or the proceeds thereof.
7. CONTRACTOR 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. CONTRACTOR 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
CONTRACTOR.
9. All such records, documents, communications, and other materials created pursuant or related to this
contract shall be maintained by CONTRACTOR, in a central location and shall be made available to
Social Services upon its request, for a period of seven (7) 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 seven (7) year period, or if
audit findings have not been resolved after a seven (7) period, the materials shall be retained until the
resolution of the audit finding.
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10. CONTRACTOR assures that authorized local, federal, and state auditors and representatives shall, during
business hours, have access to inspect any copy records, and shall be allowed to monitor and review
through on -site visits, all contract activities, supported with funds under this Contract to ensure compliance
with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the
performance of the Agreement shall be conducted by appropriate funding sources. The results of the
monitoring and evaluation activities shall be provided to the appropriate and interested parties.
11. This Contract shall be binding upon the parties hereto, their successors, heirs, legal representatives, and
assigns. CONTRACTOR or the Department may not assign any of its rights or obligations hereunder
without the prior written consent of both parties.
12. CONTRACTOR certifies that federal appropriated funds have not been paid or will be paid, by or on
behalf of CONTRACTOR, 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. CONTRACTOR assures that it will fully comply with all other applicable federal and state laws.
CONTRACTOR understands that the source of funds to be used under this Contract is Core Services
funds.
14. CONTRACTOR 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 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 12 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 the
Department 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,
CONTRACTOR 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, CONTRACTOR
shall submit to the Department, 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 the Department's termination, for cause, of its contract with
CONTRACTOR.
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16. CONTRACTOR 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 CONTRACTOR shall be disclosed in a form identifiable with the applicant/recipient or a
minor's parent or guardian unless in accordance with CONTRACTOR written policies governing access
to, duplication and dissemination of, all such information. CONTRACTOR shall advise its employees,
agents, and subcontractor, if any, that they are subject to these confidentiality requirements.
CONTRACTOR 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.
CONTRACTOR shall have its employees, agents, and subcontractors, if any, sign a written confidentiality
agreement and shall provide a copy of such agreement to the Department, if requested.
17. Proprietary information for the purposes of this contract is information relating to a party's research,
development, trade secrets, business affairs, internal operations and management procedures and those of
its customers, clients or affiliates, but does not include information (1) lawfully obtained from third parties,
(2) that which is in the public domain, or (3) that which is developed independently. Neither party
shall use or disclose directly or indirectly without prior written authorization any proprietary information
concerning the other party obtained as a result of this Contract. Any proprietary information removed from
the State's site by CONTRACTOR in the course of providing services under this Contract will be accorded
at least the same precautions as are employed by CONTRACTOR for similar information in the course of
its own business.
18. CONTRACTOR certifies it will abide by Colorado Revised Statue (C.R.S.) 26-6-104, requiring criminal
background record checks for all employees, contractors, and sub -contractors.
19. Contractor certifies that it shall comply with the provisions of Colorado Revised Statutes (C.R.S.) 8-17.5-
101, et seq. Contractor shall not knowingly employ or contract with an illegal alien to perform work under
this Contract or enter into a contract with a subcontractor that fails to certify to Contractor that the
subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this
Contract. Contractor represents, warrants, and agrees that it (a) has verified that it does not employ any
illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by
the Social Security Administration and Department of Homeland Security, and (b) otherwise will comply
with the requirements of C.R.S. 8-17.5-102(2)(6). Contractor shall comply with all reasonable requests
made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and
Employment. If Contractor fails to comply with any requirement of this provision or C.R.S. 8-17.5-101, et
seq., the Department may terminate this Contract for breach and Contractor shall be liable for actual and
consequential damages to the Department.
Except where exempted by federal law and except as provided in C.R.S. 24-76.5-103(3), if Contractor
receives federal or state funds under this Contract, Contractor must confirm that any individual natural
person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. 24-
76.5-103(4) if such individual applies for public benefits provided under this Contract. If Contractor
operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it (a) is a citizen of
the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall
produce one of the forms of identification required by C.R.S. 24-76.5-101, et seq., and (c) shall produce
one of the forms of identification required by C.R.S. 24-76.5-103 prior to the effective date of this
Contract.
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EXHIBIT D
CHILD and FAMILY SERVICES REVIEWS (CFSR)
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas; Safety,
Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's
performance according to national standards and monitors progress over time. Following the review, a Performance
Improvement Program (PIP) will be implemented for the state to enhance services to families.
Additionally, the review will assess statewide, systemic factors to determine if the systems necessary to achieve
positive outcomes for families are in place.
All agencies that contract to provide service to families and children in Weld County must continually strive for
positive outcomes in the areas of safety, permanency and well-being for our youth. In order to insure continued
progress in this area, the Department is requiring providers to comply with a standard assessment and reporting
system which will address these three areas.*
The Department is requesting that provider reports include observations and recommendations regarding clients in a
way that specifically addresses the areas of safety, permanency and well-being. Below are the specific outcomes
that will be assessed by the CFSR in the areas of safety, permanency and well-being, followed by specific
considerations and tasks which must be addressed by the Department contracted providers.
Safety Outcomes
CFSR Outcome Measures
Safety I Children are, first and foremost, protected from abuse and neglect.
Safety 2 Children are safely maintained in their homes whenever possible and appropriate.
Considerations for the Department's providers
• Providers should always consider the following definitions regarding child safety when assessing families.
o Children are considered safe when there are no present dangers or impending danger threats, or
the caregivers' protective capacities control existing threats.
o Children are considered unsafe when they are vulnerable to present or impending danger threats,
and caregivers are unable or unwilling to provide protection.
o Risk is the likelihood (chance, potential, prospect) for parenting behavior that is harmful and
destructive to a child's cognitive, social, emotional and/or physical development, and those with
parenting responsibility are unwilling or unable to behave differently.
• Monthly reports should continually document an assessment of risk and safety concerns and the
interventions that are being offered by the provider to ameliorate those concerns.
• Monthly reports should make recommendations regarding services and/or safety measures that the provider
believes should be implemented to insure safety of the child(ren).
• Providers must specifically document efforts to engage families in services and to control for safety.
Permanency Outcomes
CFSR Outcome Measures
Permanency 1 Children have permanency and stability in their living situations.
Permanency 2 The continuity of family relationships and connections is preserved for children.
Considerations for the Department's providers:
• Provider reports should always note the primary permanency goal for the child and document how
interventions are working toward achieving that goal.
Provider reports must indicate progress toward achieving the permanency goal and should make specific
recommendations regarding how the continuation of the service may assist in achieving the goal.
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Providers should continually provide recommendations about whether any out -of -home placement
continues to be appropriate and should make recommendations regarding when changes in this area should
be made, in the providers' opinion.
• Providers should continually assess family relationships (parent/child, sibling/sibling, extended
family/child, etc.) and should report any concerning relationship issues which may be a barrier to achieving
permanency. Providers should document ongoing efforts to resolve those issues and/or make
recommendations regarding additional services that may be required to address relationship issues.
Providers must document specific time frames when recommending ongoing services and/or
recommending changes to services and/or placements.
Child and Family Well -Being Outcomes
CFSR Outcome Measures
Well Being 1 Families have enhanced capacity to provide for their children's needs.
Well Being 2 Children receive appropriate services to meet their educational needs.
Well Being 3 Children receive adequate services to meet their physical and mental health needs.
Considerations for the Department's providers:
• Providers must engage in ongoing assessments of the parents' capacity to appropriately care for their
children and whether or not the service being provided continues to be appropriate. This must be clearly
documented in monthly reports.
• Providers should specifically detail areas of continued concern within the family and make
recommendations regarding whether that provider's service continues to be appropriate. Reports should
also document what barriers may be impeding progress.
• Providers should document any and all observed concerns regarding any child with whom the provider is
working. This should include concerns regarding physical, emotional, educational and behavioral well-
being of the child. When appropriate, providers should make recommendations regarding evaluations
and/or additional services that may address these concerns.
*Standardized reports will be provided and should be utilized by all agencies providing ongoing services to the
Department's families unless otherwise noted.
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CHILD PROTECTION AGREEMENT FOR SERVICES
BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES
AND TURNING POINT CENTER FOR YOUTH AND FAMILY DEVELOPMENT, INC.
This Agreement, made and entered into the +CA day of - S::IJ (= 2009, by and between the Board of
Weld County Commissioners, sitting as the Board of Human Services, on behalf of the Weld County Department of
Human Services, hereinafter referred to as the "Department," and Turning Point Center for Youth and Family
Development, Inc., hereinafter referred to as "Contractor".
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 Administration
funding to the Department for Group Home Therapy; and
NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows:
1. Term
This Agreement shall become effective on June 1, 2009, upon proper execution of this Agreement and
shall expire May 31, 2010, unless sooner terminated as provided herein.
2. Scope of Services
Services shall be provided by CONTRACTOR 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.
Payment
a. Payment shall be made on the basis of Exhibit B, "Payment Schedule," of which are attached
hereto and incorporated herein by reference.
"Payment Schedule" shall establish the maximum reimbursement, which will be paid from
Child Welfare Administration funding during the duration of this Agreement.
b. CONTRACTOR shall submit an itemized monthly bill to the Department for all costs incurred
and services provided pursuant to Exhibit A of this Agreement in accordance with criteria
established by the Department. CONTRACTOR shall submit all itemized monthly billings to
the Department by the T" day of the month following the month the cost was incurred. If the
billing is not submitted within twenty-five (25) calendar days of the month following service, it
may result in forfeiture of payment.
c. Payments of costs incurred pursuant to this Agreement is expressly contingent upon the
availability of Child Welfare Administration to the Department.
d. The Department 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.
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4. Financial Management
At all times from the effective date of this Contract until completion of this Contract, CONTRACTOR
shall comply with the administrative requirements, cost principles and other requirements set forth in the
Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds
expended under Core Service funding must conform to the Single Audit Act of 1984 and OMB Circular A-
133.
5. Payment Method
Unless otherwise provided in the Scope of Services and Payment Schedule:
a. CONTRACTOR shall provide proper monthly invoices and itemization of services performed for
costs incurred in the performance of the agreement.
b. The Department may withhold any payment if CONTRACTOR has failed to comply with the
Financial Management Requirements, program objectives, contractual terms, or reporting
requirements. In the event of a forfeiture of reimbursements, CONTRACTOR may appeal such
circumstance to the Director of Human Services. The decision of the Director of Human Services
shall be final.
6. Assurances
CONTRACTOR shall abide by all assurances as set forth in the attached Exhibit C, which is attached hereto
and incorporated herein by reference.
7. Compliance with Applicable Laws
At all times during the performance of this contract. CONTRACTOR 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. CONTRACTOR acknowledges that the following laws are included:
Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d —1 et. seq. and its implementing
regulation, 45 C.F.R. Part 80 et. seq.; and
Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 794, and
its implementing regulations, 45 C.F.R. Part 84; and
the Age Discrimination Act of 1975, 42 U.S.C. Sections 6101 et. seq. and
its implementation regulations, 45 C.F.R. Part 91; and
Title VII of the Civil Rights Act of 1964; and
the Age Discrimination in Employment Act of 1967; and
the Equal Pay Act of 1963; and
the Education Amendments of 1972; and
Immigration Reform and Control Act of 1986, P.L. 99-603;
42 C.F.R. Part 2
and all regulations applicable to these laws prohibiting discrimination because of race, color,
National origin, and sex, religion and handicap, including Acquired Immune Deficiency Syndrome (AIDS)
or AIDS related conditions, covered under Section 504 of the Rehabilitation Act of 1973, as amended,
cited above. If necessary. CONTRACTOR and the Department will resist in judicial proceedings any
efforts to obtain access to client records except as permitted by 42 CFR Part 2.
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Included is 45 C.F.R. Part 74 Appendix G 9, which requires that affirmative steps be taken to assure that
small and minority businesses are utilized, when possible, as sources of supplies, equipment, construction
and services. This assurance is given in consideration of and for the purpose of obtaining any and all
federal and/or state financial assistance.
Any person who feels that s/he has been discriminated against has the right to file a complaint either with
the Colorado Department of Human Services or with the U.S. Department of Health and Human Services,
Office for Civil Rights.
8. Compliance with Child and Family Services Review
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas;
Safety, Permanency and Well Being of families. For each outcome, data and performance indicators
measure each state's performance according to national standards and monitor progress over time.
Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance
services to families.
CONTRACTORS providing services to the Department families and children must continually strive for
positive outcomes in the areas of safety, permanency and well being. Contractors providing services in
program areas identified by the Department are required to comply with a standard assessment and
reporting system set forth in Exhibit D which will address the aforementioned three areas.
9. Insurance
CONTRACTOR, shall procure, either personally or through its employer as applicable to the Contractor's
business, at its own expense, and maintain for the duration of the work, the following insurance coverage;
Weld County, Colorado, by and through the Board of County Commissioners of Weld County, its
employees and agents, shall be named as additional named insured on the insurance, where permissible by
the insurance provider.
a. Standard Workman's Compensation and Employer's Liability.
1. As required by state statute including occupational disease, covering all employees at
work site.
b. General Liability (PL & PD) (Minimum).
1. Combined single limit - $500,000 written on an occurrence basis.
2. Any aggregate limit will not be less than $1 million.
Provider must purchase additional insurance if claims reduce the annual aggregate below
$500,000.
4. State of Colorado to be named as additional insured on each comprehensive general
liability policy.
5. Certificate of insurance to be provided to Weld County and must be attached to the
contract.
6. Insurance shall include provisions preventing cancellation without 60 days prior notice
by certified mail to Weld County.
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c. Automobile Liability (Minimum) for any Contractor transporting children or any party to whom
Department services are being provided.
d. Additional coverage may be required in specific program areas. For any insurances that are
required by this contract, a completed Standard Certificate of Insurance Form shall be provided to
the Department by the Contractor prior to the start of any contract.
10. Certifications
CONTRACTOR 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. Copies of all necessary licenses shall be provided to the Department by the
Contractor prior to the start of any contract.
11. Training
Contractor shall attend a Court Testimony and Ethics Training to be paid for by the Department. The
Contractor may be required to attend additional training at the request of the Department. The cost of such
training will be paid for by the Department. The Department will not compensate the Contractor for the
time spent attending the required trainings.
12. Monitoring and Evaluation
CONTRACTOR and the Department agree that monitoring and evaluation of the performance of this
Agreement shall be conducted by CONTRACTOR and the Department. The results of the monitoring and
evaluation shall be provided to the Board of Weld County Commissioners, the Department and
CONTRACTOR.
CONTRACTOR shall permit the Department, and any other duly authorized agent or governmental
agency, to monitor all activities conducted by CONTRACTOR 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.
13. Modification of Agreement
All modifications to this agreement shall be in writing and signed by both parties.
14. Remedies
The Director of Human Services or designee may exercise the following remedial actions should s/he find
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
CONTRACTOR. These remedial actions are as follows:
a. Withhold payment to 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 CONTRACTOR cannot be performed or if
performed would be of no value to the Department. Denial of the amount of payment shall be
reasonably related to the amount of work or deliverables lost to the Department;
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c. Incorrect payment to CONTRACTOR due to omission, error, fraud, and/or defalcation shall be
recovered from CONTRACTOR by deduction from subsequent payments under this Agreement or
other agreements between the Department and CONTRACTOR, or by the Department as a debt due to
the Department or otherwise as provided by law.
15. 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 the Department:
Gloria Romansik
Name
For CONTRACTOR:
Stephanie Brown
Name
16. Notice
Social Services Administrator
Title
Executive Director
Title
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: The Department
Judy A. Griego, Director
P.O. Box A
Greeley, CO 80632
(970) 352-1551
17. Litigation
To: CONTRACTOR
Stephanie Brown, Executive Director
1644 S. College Avenue
Fort Collins, CO 80525
(970) 221-0999, x34
CONTRACTOR shall promptly notify the Department in the event that CONTRACTOR learns of any
actual litigation in which it is a party defendant in a case that involves services provided under this
Agreement. 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, reorganization and/or foreclosure.
18. 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. CONTRACTOR reserves the right to suspend services to clients if
funding is no longer available.
19. 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 13 herein.
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IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first
above written.
WELD COUNTY DEPARTMENT
OF HUMAN RVICES
By:
Jus .Griego,!lirector
114
BOARD OF COUNTY
COMMISSIONERS WELD
COUNTY, COL QRA
Chair William F. Garcia
06/17/2009
CONTRAC
BY
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EXHIBIT A
SCOPE OF SERVICES
I. CONTRACTOR will provide group therapy and emergency services to the five (5) group homes certified
and managed by the Department, as follows:
a. Group Therapy — CONTRACTOR will provide group therapy in each group home one (1) time
per week for 1.5 — 2 hours. Issues addressed in each session will include family dynamics,
conflict resolution, power and control, coping and communication, and/or any other topics
necessary to create a stable and therapeutic environment in the group home. CONTRACTOR will
work closely with foster parents and the Department's group home coordinator to insure that
groups are clinically appropriate to address issues in the homes while meeting the clinical needs of
individual youth.
b. Emergency Services — CONTRACTOR will provide emergency services for the Department's
five (5) group homes when necessary to help ameliorate difficult situations in the homes which
may include safety issues and the risk of disrupted placement.
CONTRACTOR will be available by pager 24 hours per day, seven (7) days per week, to accept
calls from group home parents and Department staff when emergencies arise. When paged, the
CONTRACTOR will respond by phone within 20 minutes and will attempt to assist the group
home parent and the youth to resolve whatever emergency conflict has arisen and mitigate the
problem. This can include facilitating appropriate communication, mediation and safety planning.
At such times that the CONTRACTOR determines that there is an imminent safety risk or risk of
imminent placement disruption, the CONTRACTOR will make a face-to-face visit to the group
home within four (4) hours of the original call. Incidents which require a face-to-face visit
include but are not limited to:
I. A situation wherein a group home parent is requesting emergency removal of a child/youth
from the home.
2. Significant conflict in the group home involving destruction of property and/or the threat of
violence.
3. Drug and/or alcohol abuse by a child/youth in the home.
4. Allegations of abuse and/or neglect in the group home.
5. Any incident necessitating law enforcement and/or the Department's emergency duty
response.
6. A situation in which the group home parent requests an emergency visit by the clinician to
stabilize the situation.
At such times, the CONTRACTOR will assess the situation and make recommendations to the
group home parent, group home coordinator, emergency duty worker, caseworker, etc., to insure
that steps are taken to ameliorate the situation and/or insure the safety of the residents and parents
in the group home.
2. Services will be offered by Master -level therapists with ongoing clinical supervision provided by the
program director.
3. The goal of this program is to provide services to both group home parents and the children for whom they
are caring for in order to increase children's coping skills and reduce maladaptive behaviors. Additionally,
ongoing case management and emergency services will be provided to group homes in order to both reduce
placement disruptions and the length of stay of children in group homes.
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4. CONTRACTOR is dedicated to providing quality care while gathering qualitative and quantitative data
about the treatment they provide. The Department will utilize this data directly in supervision to enhance
the quality of care provided in group homes.
5. CONTRACTOR will participate in one (1) staffing per month, per group home, with the group home
parent and the Department's group home coordinator to discuss issues in the group home and the progress
of the youth residing in the home. The staffing will be coordinated by the group home coordinator and will
be 1.5-2 hours in duration.
6. CONTRACTOR will attend court facilitations, staffings, mediations, team decision making meetings and
other meetings when scheduled. If the therapist is unable to attend one of these scheduled meetings in a
case, the therapist will provide a written report regarding the youth who is the subject of the meeting which
will include a report of the youth's progress in the home and any recommendations.
7. CONTRACTOR will provide one report per group home, per month, to the Department. The report will
note the date and content of each contact (phone or face-to-face) with the group home members during the
month. Reports will include documentation of issues addressed in each group therapy session and an
overview of the home's environment and dynamics during the month. Reports also will include
recommendations regarding the needs of the youth in the home as well as possible training or interventions
that may assist the group home parent in caring for the Department's youth. Monthly reports shall be
submitted with each month's billing. Billing will not be processed unless the reports are received.
8. CONTRACTOR will testify at no additional cost to the Department.
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EXHIBIT B
PAYMENT SCHEDULE
Funding and Method of Payment
The Department agrees to reimburse CONTRACTOR in consideration for the work and services
performed from Child Welfare Administration funding, not to exceed $54,000.00.
Expenses incurred by CONTRACTOR, in association with said project prior to the term of this agreement,
are not eligible Department expenditures and shall not be reimbursed by the Department.
Payment pursuant to this Contract, if Child Welfare Administration funds, whether in whole or in part, is
subject to and contingent upon the continuing availability of said funds for the purposes hereof. In the
event that said funds, or any part thereof, become unavailable as determined by the Department, the
Department may immediately terminate this Contract or amend it accordingly.
2. Fees for Services
$4,500.00/Month (All inclusive rate for five (5) group homes)
Department referrals will not be sent to collections by Contractor for default of co-pay/fees. Services will
be performed regardless of client's refusal or inability to pay co -pay.
Contractor will collect any applicable sliding scale co -pays and credit the Department for any payments
received on the monthly billing statements.
3. Submittal of Vouchers
CONTRACTOR shall prepare and submit monthly the itemized voucher and certify that the services
authorized were provided on the date indicated and the charges made were pursuant to the terms and
conditions of Exhibit A.
a. All billings are to be submitted by the 7'h day of the month following the month of
service. If the billing is not submitted within twenty-five (25) calendar days of the month
following service, it may result in forfeiture of payment.
b. Billings must be submitted with the attached required forms, Authorization for
Contractual Services, Request for Reimbursement, Client Verification Form and monthly
report. The Authorization for Contractual Services and Client Verification Form must be
submitted with original signatures.
c. For monitored sobriety, proof of services rendered shall be a sign -in sheet with client
signatures or the test result.
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EXHIBIT C
ASSURANCES
1. CONTRACTOR 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 CONTRACTOR -
contracted CONTRACTOR or its employees, volunteers, or agents while performing duties as described in
this Agreement. CONTRACTOR shall indemnify, defend, and hold harmless Weld County, the Board of
County Commissioners of Weld County, its employees, volunteers, and agents. CONTRACTOR 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, CONTRACTOR shall provide the
Department 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 created a
duty of care with respect to any persons not a party of this Agreement.
4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld, State
of Colorado, to expend funds not otherwise appropriated in each succeeding year.
5. If any section, subsection, paragraph, sentence, clause, or phrase of this Contract is for any reason held or
decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The
parties hereto declare that they would have entered into this Contract and each and every section,
subsection, paragraph, sentence, clause, and phrase thereof irrespective of the fact that any one or more
sections, subsections, paragraphs, sentences, clauses, or phrases might be declared to be unconstitutional or
invalid.
6. No officer, member or employee of Weld County and no member of their governing bodies shall have any
pecuniary interest, direct or indirect, in the approved Agreement or the proceeds thereof.
7. CONTRACTOR 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. CONTRACTOR 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
CONTRACTOR.
9. All such records, documents, communications, and other materials created pursuant or related to this
contract shall be maintained by CONTRACTOR, in a central location and shall be made available to
Social Services upon its request, for a period of seven (7) 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 seven (7) year period, or if
audit findings have not been resolved after a seven (7) period, the materials shall be retained until the
resolution of the audit finding.
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10. CONTRACTOR 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.
I I. This Contract shall be binding upon the parties hereto, their successors, heirs, legal representatives, and
assigns. CONTRACTOR or the Department may not assign any of its rights or obligations hereunder
without the prior written consent of both parties.
12. CONTRACTOR certifies that federal appropriated funds have not been paid or will be paid, by or on
behalf of CONTRACTOR, 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. CONTRACTOR assures that it will fully comply with all other applicable federal and state laws.
CONTRACTOR understands that the source of funds to be used under this Contract is
Child Welfare Administration funds.
14. CONTRACTOR 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 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 12 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 the
Department 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,
CONTRACTOR 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, CONTRACTOR
shall submit to the Department, 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 the Department's termination, for cause, of its contract with
CONTRACTOR.
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16. CONTRACTOR 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 CONTRACTOR shall be disclosed in a form identifiable with the applicant/recipient or a
minor's parent or guardian unless in accordance with CONTRACTOR written policies governing access
to, duplication and dissemination of, all such information. CONTRACTOR shall advise its employees,
agents, and subcontractor, if any, that they are subject to these confidentiality requirements.
CONTRACTOR 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.
CONTRACTOR shall have its employees, agents, and subcontractors, if any, sign a written confidentiality
agreement and shall provide a copy of such agreement to the Department, if requested.
17. Proprietary information for the purposes of this contract is information relating to a party's research,
development, trade secrets, business affairs, internal operations and management procedures and those of
its customers, clients or affiliates, but does not include information (I) lawfully obtained from third parties,
(2) that which is in the public domain, or (3) that which is developed independently. Neither party
shall use or disclose directly or indirectly without prior written authorization any proprietary information
concerning the other party obtained as a result of this Contract. Any proprietary information removed from
the State's site by CONTRACTOR in the course of providing services under this Contract will be accorded
at least the same precautions as are employed by CONTRACTOR for similar information in the course of
its own business.
18. CONTRACTOR certifies it will abide by Colorado Revised Statue (C.R.S.) 26-6-104, requiring criminal
background record checks for all employees, contractors, and sub -contractors.
19. Contractor certifies that it shall comply with the provisions of Colorado Revised Statutes (C.R.S.) 8-17.5-
101, et seq. Contractor shall not knowingly employ or contract with an illegal alien to perform work under
this Contract or enter into a contract with a subcontractor that fails to certify to Contractor that the
subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this
Contract. Contractor represents, warrants, and agrees that it (a) has verified that it does not employ any
illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by
the Social Security Administration and Department of Homeland Security, and (b) otherwise will comply
with the requirements of C.R.S. 8-17.5-102(2)(6). Contractor shall comply with all reasonable requests
made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and
Employment. If Contractor fails to comply with any requirement of this provision or C.R.S. 8-17.5-101, et
seq., the Department may terminate this Contract for breach and Contractor shall be liable for actual and
consequential damages to the Department.
Except where exempted by federal law and except as provided in C.R.S. 24-76.5-103(3), if Contractor
receives federal or state funds under this Contract, Contractor must confirm that any individual natural
person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. 24-
76.5-103(4) if such individual applies for public benefits provided under this Contract. If Contractor
operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it (a) is a citizen of
the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall
produce one of the forms of identification required by C.R.S. 24-76.5-101, et seq., and (c) shall produce
one of the forms of identification required by C.R.S. 24-76.5-103 prior to the effective date of this
Contract.
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EXHIBIT D
CHILD and FAMILY SERVICES REVIEWS (CFSR)
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas; Safety,
Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's
performance according to national standards and monitors progress over time. Following the review, a Performance
Improvement Program (PIP) will be implemented for the state to enhance services to families.
Additionally, the review will assess statewide, systemic factors to determine if the systems necessary to achieve
positive outcomes for families are in place.
All agencies that contract to provide service to families and children in Weld County must continually strive for
positive outcomes in the areas of safety, permanency and well-being for our youth. In order to insure continued
progress in this area, the Department is requiring providers to comply with a standard assessment and reporting
system which will address these three areas.*
The Department is requesting that provider reports include observations and recommendations regarding clients in a
way that specifically addresses the areas of safety, permanency and well-being. Below are the specific outcomes
that will be assessed by the CFSR in the areas of safety, permanency and well-being, followed by specific
considerations and tasks which must be addressed by the Department contracted providers.
Safety Outcomes
CFSR Outcome Measures
Safety 1 Children are, first and foremost, protected from abuse and neglect.
Safety 2 Children are safely maintained in their homes whenever possible and appropriate.
Considerations for the Department's providers
• Providers should always consider the following definitions regarding child safety when assessing families.
o Children are considered safe when there are no present dangers or impending danger threats, or
the caregivers' protective capacities control existing threats.
o Children are considered unsafe when they are vulnerable to present or impending danger threats,
and caregivers are unable or unwilling to provide protection.
o Risk is the likelihood (chance, potential, prospect) for parenting behavior that is harmful and
destructive to a child's cognitive, social, emotional and/or physical development, and those with
parenting responsibility are unwilling or unable to behave differently.
• Monthly reports should continually document an assessment of risk and safety concerns and the
interventions that are being offered by the provider to ameliorate those concerns.
• Monthly reports should make recommendations regarding services and/or safety measures that the provider
believes should be implemented to insure safety of the child(ren).
• Providers must specifically document efforts to engage families in services and to control for safety.
Permanency Outcomes
CFSR Outcome Measures
Permanency 1 Children have permanency and stability in their living situations.
Permanency 2 The continuity of family relationships and connections is preserved for children.
Considerations for the Department's providers:
Provider reports should always note the primary permanency goal for the child and document how
interventions are working toward achieving that goal.
• Provider reports must indicate progress toward achieving the permanency goal and should make specific
recommendations regarding how the continuation of the service may assist in achieving the goal.
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• Providers should continually provide recommendations about whether any out -of -home placement
continues to be appropriate and should make recommendations regarding when changes in this area should
be made, in the providers' opinion.
Providers should continually assess family relationships (parent/child, sibling/sibling, extended
family/child, etc.) and should report any concerning relationship issues which may be a barrier to achieving
permanency. Providers should document ongoing efforts to resolve those issues and/or make
recommendations regarding additional services that may be required to address relationship issues.
• Providers must document specific time frames when recommending ongoing services and/or
recommending changes to services and/or placements.
Child and Family Well -Being Outcomes
CFSR Outcome Measures
Well Being I Families have enhanced capacity to provide for their children's needs.
Well Being 2 Children receive appropriate services to meet their educational needs.
Well Being 3 Children receive adequate services to meet their physical and mental health needs.
Considerations for the Department's providers:
• Providers must engage in ongoing assessments of the parents' capacity to appropriately care for their
children and whether or not the service being provided continues to be appropriate. This must be clearly
documented in monthly reports.
• Providers should specifically detail areas of continued concern within the family and make
recommendations regarding whether that provider's service continues to be appropriate. Reports should
also document what barriers may be impeding progress.
• Providers should document any and all observed concerns regarding any child with whom the provider is
working. This should include concerns regarding physical, emotional, educational and behavioral well-
being of the child. When appropriate, providers should make recommendations regarding evaluations
and/or additional services that may address these concerns.
*Standardized reports will be provided and should be utilized by all agencies providing ongoing services to the
Department's families unless otherwise noted.
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Calte'q110
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Pt,
CHILD PROTECTION AGREEMENT FOR SERVICES
BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES
AND TURNING POINT CENTER FOR YOUTH AND FAMILY DEVELOPMENT, INC.
This Agreement, made and entered into the 1 " day of i;ti F 2009, by and between the Board of
Weld County Commissioners, sitting as the Board of Human Services, on behalf of the Weld County Department of
Human Services, hereinafter referred to as the "Department," and Turning Point Center for Youth and Family
Development, Inc., hereinafter referred to as "Contractor".
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 Core Services funding to the
Department for Home -Based Services (Option B); and
NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows:
1. Term
This Agreement shall become effective on June 1, 2009, upon proper execution of this Agreement and
shall expire May 31, 2010, unless sooner terminated as provided herein.
2. Scope of Services
Services shall be provided by CONTRACTOR 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," of which are attached
hereto and incorporated herein by reference.
"Payment Schedule" shall establish the maximum reimbursement, which will be paid from
Core Services funding during the duration of this Agreement.
b. CONTRACTOR shall submit an itemized monthly bill to the Department for all costs incurred
and services provided pursuant to Exhibit A of this Agreement in accordance with criteria
established by the Department. CONTRACTOR shall submit all itemized monthly billings to
the Department by the 7'h day of the month following the month the cost was incurred. If the
billing is not submitted within twenty-five (25) calendar days of the month following service, it
may result in forfeiture of payment.
c. Payments of costs incurred pursuant to this Agreement is expressly contingent upon the
availability of Core Services to the Department.
d. The Department 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.
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PY-09-10-CORE-0153
4. Financial Management
At all times from the effective date of this Contract until completion of this Contract, CONTRACTOR
shall comply with the administrative requirements, cost principles and other requirements set forth in the
Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds
expended under Core Service funding must conform to the Single Audit Act of 1984 and OMB Circular A-
133.
5. Payment Method
Unless otherwise provided in the Scope of Services and Payment Schedule:
a. CONTRACTOR shall provide proper monthly invoices and itemization of services performed for
costs incurred in the performance of the agreement.
b. The Department may withhold any payment if CONTRACTOR has failed to comply with the
Financial Management Requirements, program objectives, contractual terms, or reporting
requirements. In the event of a forfeiture of reimbursements, CONTRACTOR may appeal such
circumstance to the Director of Human Services. The decision of the Director of Human Services
shall be final.
6. Assurances
CONTRACTOR shall abide by all assurances as set forth in the attached Exhibit C, which is attached hereto
and incorporated herein by reference.
7. Compliance with Applicable Laws
At all times during the performance of this contract, CONTRACTOR 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. CONTRACTOR acknowledges that the following laws are included:
Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d-1 et. seq. and its implementing
regulation, 45 C.F.R. Part 80 et. seq.; and
Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 794, and
its implementing regulations, 45 C.F.R. Part 84; and
the Age Discrimination Act of 1975, 42 U.S.C. Sections 6101 et. seq. and
its implementation regulations, 45 C.F.R. Part 91; and
Title VII of the Civil Rights Act of 1964; and
the Age Discrimination in Employment Act of 1967; and
the Equal Pay Act of 1963; and
the Education Amendments of 1972; and
Immigration Reform and Control Act of 1986, P.L. 99-603;
42 C.F.R. Part 2
and all regulations applicable to these laws prohibiting discrimination because of race, color,
National origin, and sex, religion and handicap, including Acquired Immune Deficiency Syndrome (AIDS)
or AIDS related conditions, covered under Section 504 of the Rehabilitation Act of 1973, as amended,
cited above. If necessary, CONTRACTOR and the Department will resist in judicial proceedings any
efforts to obtain access to client records except as permitted by 42 CFR Part 2.
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Included is 45 C.F.R. Part 74 Appendix G 9, which requires that affirmative steps be taken to assure that
small and minority businesses are utilized, when possible, as sources of supplies, equipment, construction
and services. This assurance is given in consideration of and for the purpose of obtaining any and all
federal and/or state financial assistance.
Any person who feels that s/he has been discriminated against has the right to file a complaint either with
the Colorado Department of Human Services or with the U.S. Department of Health and Human Services,
Office for Civil Rights.
8. Compliance with Child and Family Services Review
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas;
Safety, Permanency and Well Being of families. For each outcome, data and performance indicators
measure each state's performance according to national standards and monitor progress over time.
Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance
services to families.
CONTRACTORS providing services to the Department families and children must continually strive for
positive outcomes in the areas of safety, permanency and well being. Contractors providing services in
program areas identified by the Department are required to comply with a standard assessment and
reporting system set forth in Exhibit D which will address the aforementioned three areas.
9. Insurance
CONTRACTOR, shall procure, either personally or through its employer as applicable to the Contractor's
business, at its own expense, and maintain for the duration of the work, the following insurance coverage;
Weld County, Colorado, by and through the Board of County Commissioners of Weld County, its
employees and agents, shall be named as additional named insured on the insurance, where permissible by
the insurance provider.
a. Standard Workman's Compensation and Employer's Liability.
1. As required by state statute including occupational disease, covering all employees at
work site.
b. General Liability (PL & PD) (Minimum).
1. Combined single limit - $500,000 written on an occurrence basis.
2. Any aggregate limit will not be less than $1 million.
3. Provider must purchase additional insurance if claims reduce the annual aggregate below
$500,000.
4. State of Colorado to be named as additional insured on each comprehensive general
liability policy.
5. Certificate of insurance to be provided to Weld County and must be attached to the
contract.
6. Insurance shall include provisions preventing cancellation without 60 days prior notice
by certified mail to Weld County.
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c. Automobile Liability (Minimum) for any Contractor transporting children or any party to whom
Department services are being provided.
d. Additional coverage may be required in specific program areas. For any insurances that are
required by this contract, a completed Standard Certificate of Insurance Form shall be provided to
the Department by the Contractor prior to the start of any contract.
10. Certifications
CONTRACTOR 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. Copies of all necessary licenses shall be provided to the Department by the
Contractor prior to the start of any contract.
11. Training
Contractor shall attend a Court Testimony and Ethics Training to be paid for by the Department. The
Contractor may be required to attend additional training at the request of the Department. The cost of such
training will be paid for by the Department. The Department will not compensate the Contractor for the
time spent attending the required trainings.
12. Monitoring and Evaluation
CONTRACTOR and the Department agree that monitoring and evaluation of the performance of this
Agreement shall be conducted by CONTRACTOR and the Department. The results of the monitoring and
evaluation shall be provided to the Board of Weld County Commissioners, the Department and
CONTRACTOR.
CONTRACTOR shall permit the Department, and any other duly authorized agent or governmental
agency, to monitor all activities conducted by CONTRACTOR 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.
13. Modification of Agreement
All modifications to this agreement shall be in writing and signed by both parties.
14. Remedies
The Director of Human Services or designee may exercise the following remedial actions should s/he find
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
CONTRACTOR. These remedial actions are as follows:
a. Withhold payment to 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 CONTRACTOR cannot be performed or if
performed would be of no value to the Department. Denial of the amount of payment shall be
reasonably related to the amount of work or deliverables lost to the Department;
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c. Incorrect payment to CONTRACTOR due to omission, error, fraud, and/or defalcation shall be
recovered from CONTRACTOR by deduction from subsequent payments under this Agreement or
other agreements between the Department and CONTRACTOR, or by the Department as a debt due to
the Department or otherwise as provided by law.
15. 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 the Department:
Gloria Romansik
Name
For CONTRACTOR:
Stephanie Brown
Name
16. Notice
Social Services Administrator
Title
Executive Director
Title
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: The Department
Judy A. Griego, Director
P.O. Box A
Greeley, CO 80632
(970) 352-1551
17. Litigation
To: CONTRACTOR
Stephanie Brown, Executive Director
1644 S. College Avenue
Fort Collins, CO 80525
(970)221-0999,x34
CONTRACTOR shall promptly notify the Department in the event that CONTRACTOR learns of any
actual litigation in which it is a party defendant in a case that involves services provided under this
Agreement. 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, reorganization and/or foreclosure.
18. 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. CONTRACTOR reserves the right to suspend services to clients if
funding is no longer available.
19. 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 13 herein.
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IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first
above written......--C7e T�
I'�
By:
APP
Cou ,Fr omey
WELD COUNTY DEPARTMENT
OF HUMAN ERVICES
By:
BOARD OF COUNTY
COMMISSIONERS WELD
COUNTY, COLODO
By:
Chair William
CONTRACT
BY
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06/17/2009
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PY-09-10-CORE-0153
EXHIBIT A
SCOPE OF SERVICES
1. CONTRACTOR will provide home -based services to individuals and families in Weld County
referred by the Department.
2. Services will include interventions that combine strength based, solution focused, family systems and
cognitive behavioral to promote pro -social behaviors and increase functional behavior.
3. CONTRACTOR will follow up with referred individual or family within 48 hours of receiving a
referral and will document efforts to engage foster family in referred services.
4. CONTRACTOR will identify in detail areas of continued concern and make recommendations to the
Department regarding continuation of services and/or the need for additional services.
5. CONTRACTOR will document in detail any and all observed or verbalized concerns regarding any
child whom the CONTRACTOR is working with under an active referral. Areas of concern may
include, but are not limited to, any physical, emotional, educational or behavioral issues. Areas of
concern should be reported immediately AND on the required monthly report.
6. CONTRACTOR will submit reports on a monthly basis for each active referral. Reports will be
submitted per the online format required by the Department.
7. CONTRACTOR will participate in monthly team reviews of ongoing services as needed.
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EXHIBIT B
PAYMENT SCHEDULE
1. Funding and Method of Payment
The Department agrees to reimburse CONTRACTOR in consideration for the work and services
performed from Core Services funding, not to exceed $10,000.00.
Expenses incurred by CONTRACTOR, in association with said project prior to the term of this agreement,
are not eligible Department expenditures and shall not be reimbursed by the Department.
Payment pursuant to this Contract, if Core Services funds, whether in whole or in part, is subject to and
contingent upon the continuing availability of said funds for the purposes hereof. In the event that said
funds, or any part thereof, become unavailable as determined by the Department, the Department may
immediately terminate this Contract or amend it accordingly.
2
Fees for Services
$82.00/Hour (Option B - Greeley Metro Area, including Evans, LaSalle, Eaton and Windsor)
$120.00/Hour (Option B - Outside of Greeley Metro Area, including Lochbuie, Frederick, and Hudson)
Department referrals will not be sent to collections by Contractor for default of co-pay/fees. Services will
be performed regardless of client's refusal or inability to pay co -pay.
Contractor will collect any applicable sliding scale co -pays and credit the Department for any payments
received on the monthly billing statements.
3. Submittal of Vouchers
CONTRACTOR shall prepare and submit monthly the itemized voucher and certify that the services
authorized were provided on the date indicated and the charges made were pursuant to the terms and
conditions of Exhibit A.
a. All billings are to be submitted by the 7th day of the month following the month of
service. If the billing is not submitted within twenty-five (25) calendar days of the month
following service, it may result in forfeiture of payment.
b. Billings must be submitted with the attached required forms, Authorization for
Contractual Services, Request for Reimbursement, Client Verification Form and monthly
report. The Authorization for Contractual Services and Client Verification Form must be
submitted with original signatures.
c. For monitored sobriety, proof of services rendered shall be a sign -in sheet with client
signatures or the test result.
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EXHIBIT C
ASSURANCES
1. CONTRACTOR 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 CONTRACTOR -
contracted CONTRACTOR or its employees, volunteers, or agents while performing duties as described in
this Agreement. CONTRACTOR shall indemnify, defend, and hold harmless Weld County, the Board of
County Commissioners of Weld County, its employees, volunteers, and agents. CONTRACTOR 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, CONTRACTOR shall provide the
Department 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 created a
duty of care with respect to any persons not a party of this Agreement.
4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld, State
of Colorado, to expend funds not otherwise appropriated in each succeeding year.
5. If any section, subsection, paragraph, sentence, clause, or phrase of this Contract is for any reason held or
decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The
parties hereto declare that they would have entered into this Contract and each and every section,
subsection, paragraph, sentence, clause, and phrase thereof irrespective of the fact that any one or more
sections, subsections, paragraphs, sentences, clauses, or phrases might be declared to be unconstitutional or
invalid.
6. No officer, member or employee of Weld County and no member of their governing bodies shall have any
pecuniary interest, direct or indirect, in the approved Agreement or the proceeds thereof.
7. CONTRACTOR 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. CONTRACTOR 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
CONTRACTOR.
9. All such records, documents, communications, and other materials created pursuant or related to this
contract shall be maintained by CONTRACTOR, in a central location and shall be made available to
Social Services upon its request, for a period of seven (7) 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 seven (7) year period, or if
audit findings have not been resolved after a seven (7) period, the materials shall be retained until the
resolution of the audit finding.
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10. CONTRACTOR assures that authorized local, federal, and state auditors and representatives shall, during
business hours, have access to inspect any copy records, and shall be allowed to monitor and review
through on -site visits, all contract activities, supported with funds under this Contract to ensure compliance
with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the
performance of the Agreement shall be conducted by appropriate funding sources. The results of the
monitoring and evaluation activities shall be provided to the appropriate and interested parties.
11. This Contract shall be binding upon the parties hereto, their successors, heirs, legal representatives, and
assigns. CONTRACTOR or the Department may not assign any of its rights or obligations hereunder
without the prior written consent of both parties.
12. CONTRACTOR certifies that federal appropriated funds have not been paid or will be paid, by or on
behalf of CONTRACTOR, 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. CONTRACTOR assures that it will fully comply with all other applicable federal and state laws.
CONTRACTOR understands that the source of funds to be used under this Contract is Core Services
funds.
14. CONTRACTOR 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 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 12 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 the
Department 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,
CONTRACTOR 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, CONTRACTOR
shall submit to the Department, 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 the Department's termination, for cause, of its contract with
CONTRACTOR.
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16. CONTRACTOR 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 CONTRACTOR shall be disclosed in a form identifiable with the applicant/recipient or a
minor's parent or guardian unless in accordance with CONTRACTOR written policies governing access
to, duplication and dissemination of, all such information. CONTRACTOR shall advise its employees,
agents, and subcontractor, if any, that they are subject to these confidentiality requirements.
CONTRACTOR 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.
CONTRACTOR shall have its employees, agents, and subcontractors, if any, sign a written confidentiality
agreement and shall provide a copy of such agreement to the Department, if requested.
17. Proprietary information for the purposes of this contract is information relating to a party's research,
development, trade secrets, business affairs, internal operations and management procedures and those of
its customers, clients or affiliates, but does not include information (1) lawfully obtained from third parties,
(2) that which is in the public domain, or (3) that which is developed independently. Neither party
shall use or disclose directly or indirectly without prior written authorization any proprietary information
concerning the other party obtained as a result of this Contract. Any proprietary information removed from
the State's site by CONTRACTOR in the course of providing services under this Contract will be accorded
at least the same precautions as are employed by CONTRACTOR for similar information in the course of
its own business.
18. CONTRACTOR certifies it will abide by Colorado Revised Statue (C.R.S.) 26-6-104, requiring criminal
background record checks for all employees, contractors, and sub -contractors.
19. Contractor certifies that it shall comply with the provisions of Colorado Revised Statutes (C.R.S.) 8-17.5-
101, et seq. Contractor shall not knowingly employ or contract with an illegal alien to perform work under
this Contract or enter into a contract with a subcontractor that fails to certify to Contractor that the
subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this
Contract. Contractor represents, warrants, and agrees that it (a) has verified that it does not employ any
illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by
the Social Security Administration and Department of Homeland Security, and (b) otherwise will comply
with the requirements of C.R.S. 8-17.5-102(2)(b). Contractor shall comply with all reasonable requests
made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and
Employment. If Contractor fails to comply with any requirement of this provision or C.R.S. 8-17.5-101, et
seq., the Department may terminate this Contract for breach and Contractor shall be liable for actual and
consequential damages to the Department.
Except where exempted by federal law and except as provided in C.R.S. 24-76.5-103(3), if Contractor
receives federal or state funds under this Contract, Contractor must confirm that any individual natural
person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. 24-
76.5-103(4) if such individual applies for public benefits provided under this Contract. If Contractor
operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it (a) is a citizen of
the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall
produce one of the forms of identification required by C.R.S. 24-76.5-101, et seq., and (c) shall produce
one of the forms of identification required by C.R.S. 24-76.5-103 prior to the effective date of this
Contract.
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EXHIBIT D
CHILD and FAMILY SERVICES REVIEWS (CFSR)
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas; Safety,
Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's
performance according to national standards and monitors progress over time. Following the review, a Performance
Improvement Program (PIP) will be implemented for the state to enhance services to families.
Additionally, the review will assess statewide, systemic factors to determine if the systems necessary to achieve
positive outcomes for families are in place.
All agencies that contract to provide service to families and children in Weld County must continually strive for
positive outcomes in the areas of safety, permanency and well-being for our youth. In order to insure continued
progress in this area, the Department is requiring providers to comply with a standard assessment and reporting
system which will address these three areas.*
The Department is requesting that provider reports include observations and recommendations regarding clients in a
way that specifically addresses the areas of safety, permanency and well-being. Below are the specific outcomes
that will be assessed by the CFSR in the areas of safety, permanency and well-being, followed by specific
considerations and tasks which must be addressed by the Department contracted providers.
Safety Outcomes
CFSR Outcome Measures
Safety 1 Children are, first and foremost, protected from abuse and neglect.
Safety 2 Children are safely maintained in their homes whenever possible and appropriate.
Considerations for the Department's providers
Providers should always consider the following definitions regarding child safety when assessing families.
o Children are considered safe when there are no present dangers or impending danger threats, or
the caregivers' protective capacities control existing threats.
o Children are considered unsafe when they are vulnerable to present or impending danger threats,
and caregivers are unable or unwilling to provide protection.
o Risk is the likelihood (chance, potential, prospect) for parenting behavior that is harmful and
destructive to a child's cognitive, social, emotional and/or physical development, and those with
parenting responsibility are unwilling or unable to behave differently.
• Monthly reports should continually document an assessment of risk and safety concerns and the
interventions that are being offered by the provider to ameliorate those concerns.
• Monthly reports should make recommendations regarding services and/or safety measures that the provider
believes should be implemented to insure safety of the child(ren).
• Providers must specifically document efforts to engage families in services and to control for safety.
Permanency Outcomes
CFSR Outcome Measures
Permanency 1 Children have permanency and stability in their living situations.
Permanency 2 The continuity of family relationships and connections is preserved for children.
Considerations for the Department's providers:
• Provider reports should always note the primary permanency goal for the child and document how
interventions are working toward achieving that goal.
• Provider reports must indicate progress toward achieving the permanency goal and should make specific
recommendations regarding how the continuation of the service may assist in achieving the goal.
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• Providers should continually provide recommendations about whether any out -of -home placement
continues to be appropriate and should make recommendations regarding when changes in this area should
be made, in the providers' opinion.
• Providers should continually assess family relationships (parent/child, sibling/sibling, extended
family/child, etc.) and should report any concerning relationship issues which may be a barrier to achieving
permanency. Providers should document ongoing efforts to resolve those issues and/or make
recommendations regarding additional services that may be required to address relationship issues.
• Providers must document specific time frames when recommending ongoing services and/or
recommending changes to services and/or placements.
Child and Family Well -Being Outcomes
CFSR Outcome Measures
Well Being 1 Families have enhanced capacity to provide for their children's needs.
Well Being 2 Children receive appropriate services to meet their educational needs.
Well Being 3 Children receive adequate services to meet their physical and mental health needs.
Considerations for the Department's providers:
• Providers must engage in ongoing assessments of the parents' capacity to appropriately care for their
children and whether or not the service being provided continues to be appropriate. This must be clearly
documented in monthly reports.
• Providers should specifically detail areas of continued concern within the family and make
recommendations regarding whether that provider's service continues to be appropriate. Reports should
also document what barriers may be impeding progress.
• Providers should document any and all observed concerns regarding any child with whom the provider is
working. This should include concerns regarding physical, emotional, educational and behavioral well-
being of the child. When appropriate, providers should make recommendations regarding evaluations
and/or additional services that may address these concerns.
*Standardized reports will be provided and should be utilized by all agencies providing ongoing services to the
Department's families unless otherwise noted.
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CHILD PROTECTION AGREEMENT FOR SERVICES
BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES
AND TURNING POINT CENTER FOR YOUTH AND FAMILY DEVELOPMENT, INC.
This Agreement, made and entered into the � - day of ]e+ 2009, by and between the Board of
Weld County Commissioners, sitting as the Board of uman Services, on behalf of the Weld County Department of
Human Services, hereinafter referred to as the "Department," and Turning Point Center for Youth and Family
Development, Inc., hereinafter referred to as "Contractor".
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 Core Services funding to the
Department for Mental Health Services; and
NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows:
1. Term
This Agreement shall become effective on June I, 2009, upon proper execution of this Agreement and
shall expire May 31, 2010, unless sooner terminated as provided herein.
2. Scope of Services
Services shall be provided by CONTRACTOR 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," of which are attached
hereto and incorporated herein by reference.
"Payment Schedule" shall establish the maximum reimbursement, which will be paid from
Core Services funding during the duration of this Agreement.
b. CONTRACTOR shall submit an itemized monthly bill to the Department for all costs incurred
and services provided pursuant to Exhibit A of this Agreement in accordance with criteria
established by the Department. CONTRACTOR shall submit all itemized monthly billings to
the Department by the 7'h day of the month following the month the cost was incurred. If the
billing is not submitted within twenty-five (25) calendar days of the month following service, it
may result in forfeiture of payment.
c. Payments of costs incurred pursuant to this Agreement is expressly contingent upon the
availability of Core Services to the Department.
d. The Department 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.
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4. Financial Management
At all times from the effective date of this Contract until completion of this Contract, CONTRACTOR
shall comply with the administrative requirements, cost principles and other requirements set forth in the
Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds
expended under Core Service funding must conform to the Single Audit Act of 1984 and OMB Circular A-
133.
5. Payment Method
Unless otherwise provided in the Scope of Services and Payment Schedule:
a. CONTRACTOR shall provide proper monthly invoices and itemization of services performed for
costs incurred in the performance of the agreement.
b. The Department may withhold any payment if CONTRACTOR has failed to comply with the
Financial Management Requirements, program objectives, contractual terms, or reporting
requirements. In the event of a forfeiture of reimbursements, CONTRACTOR may appeal such
circumstance to the Director of Human Services. The decision of the Director of Human Services
shall be final.
6. Assurances
CONTRACTOR shall abide by all assurances as set forth in the attached Exhibit C, which is attached hereto
and incorporated herein by reference.
7. Compliance with Applicable Laws
At all times during the performance of this contract, CONTRACTOR 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. CONTRACTOR acknowledges that the following laws are included:
Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d-1 et. seq. and its implementing
regulation, 45 C.F.R. Part 80 et. seq.; and
Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 794, and
its implementing regulations, 45 C.F.R. Part 84; and
the Age Discrimination Act of 1975, 42 U.S.C. Sections 6101 et. seq. and
its implementation regulations, 45 C.F.R. Part 91; and
Title VII of the Civil Rights Act of 1964; and
the Age Discrimination in Employment Act of 1967; and
the Equal Pay Act of 1963; and
the Education Amendments of 1972; and
Immigration Reform and Control Act of 1986, P.L. 99-603;
42 C.F.R. Part 2
and all regulations applicable to these laws prohibiting discrimination because of race, color,
National origin, and sex, religion and handicap, including Acquired Immune Deficiency Syndrome (AIDS)
or AIDS related conditions, covered under Section 504 of the Rehabilitation Act of 1973, as amended,
cited above. If necessary, CONTRACTOR and the Department will resist in judicial proceedings any
efforts to obtain access to client records except as permitted by 42 CFR Part 2.
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Included is 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.
R. Compliance with Child and Family Services Review
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas;
Safety, Permanency and Well Being of families. For each outcome, data and performance indicators
measure each state's performance according to national standards and monitor progress over time.
Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance
services to families.
CONTRACTORS providing services to the Department families and children must continually strive for
positive outcomes in the areas of safety, permanency and well being. Contractors providing services in
program areas identified by the Department are required to comply with a standard assessment and
reporting system set forth in Exhibit D which will address the aforementioned three areas.
9. Insurance
CONTRACTOR, shall procure, either personally or through its employer as applicable to the Contractor's
business, at its own expense, and maintain for the duration of the work, the following insurance coverage;
Weld County, Colorado, by and through the Board of County Commissioners of Weld County, its
employees and agents, shall be named as additional named insured on the insurance, where permissible by
the insurance provider.
a. Standard Workman's Compensation and Employer's Liability.
1. As required by state statute including occupational disease, covering all employees at
work site.
b. General Liability (PL & PD) (Minimum).
1. Combined single limit - $500,000 written on an occurrence basis.
2. Any aggregate limit will not be less than $1 million.
3. Provider must purchase additional insurance if claims reduce the annual aggregate below
$500,000.
4. State of Colorado to be named as additional insured on each comprehensive general
liability policy.
5. Certificate of insurance to be provided to Weld County and must be attached to the
contract.
6. Insurance shall include provisions preventing cancellation without 60 days prior notice
by certified mail to Weld County.
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c. Automobile Liability (Minimum) for any Contractor transporting children or any party to whom
Department services are being provided.
d. Additional coverage may be required in specific program areas. For any insurances that are
required by this contract, a completed Standard Certificate of Insurance Form shall be provided to
the Department by the Contractor prior to the start of any contract.
10. Certifications
CONTRACTOR 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. Copies of all necessary licenses shall be provided to the Department by the
Contractor prior to the start of any contract.
11. Training
Contractor shall attend a Court Testimony and Ethics Training to be paid for by the Department. The
Contractor may be required to attend additional training at the request of the Department. The cost of such
training will be paid for by the Department. The Department will not compensate the Contractor for the
time spent attending the required trainings.
12. Monitoring and Evaluation
CONTRACTOR and the Department agree that monitoring and evaluation of the performance of this
Agreement shall be conducted by CONTRACTOR and the Department. The results of the monitoring and
evaluation shall be provided to the Board of Weld County Commissioners, the Department and
CONTRACTOR.
CONTRACTOR shall permit the Department, and any other duly authorized agent or governmental
agency, to monitor all activities conducted by CONTRACTOR 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.
13. Modification of Agreement
All modifications to this agreement shall be in writing and signed by both parties.
14. Remedies
The Director of Human Services or designee may exercise the following remedial actions should s/he find
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
CONTRACTOR. These remedial actions are as follows:
a. Withhold payment to 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 CONTRACTOR cannot be performed or if
performed would be of no value to the Department. Denial of the amount of payment shall be
reasonably related to the amount of work or deliverables lost to the Department;
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c. Incorrect payment to CONTRACTOR due to omission, error, fraud, and/or defalcation shall be
recovered from CONTRACTOR by deduction from subsequent payments under this Agreement or
other agreements between the Department and CONTRACTOR, or by the Department as a debt due to
the Department or otherwise as provided by law.
15. 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 the Department:
Gloria Romansik
Name
For CONTRACTOR:
Stephanie Brown
Name
16. Notice
Social Services Administrator
Title
Executive Director
Title
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: The Department
Judy A. Griego, Director
P.O. Box A
Greeley, CO 80632
(970)352-1551
17. Litigation
To: CONTRACTOR
Stephanie Brown, Executive Director
1644 S. College Avenue
Fort Collins, CO 80525
(970) 221-0999, x34
CONTRACTOR shall promptly notify the Department in the event that CONTRACTOR learns of any
actual litigation in which it is a party defendant in a case that involves services provided under this
Agreement. 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, reorganization and/or foreclosure.
18. 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. CONTRACTOR reserves the right to suspend services to clients if
funding is no longer available.
19. 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 13 herein.
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IN WITNESS HEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first
above
BOARD OF COUNTY
COMMISSIONERS WELD
COUNTY, CQLOl DO
Chair
CONTRAC
BY
WELD COUNTY DEPARTMENT
OF HUMAN ERVICES ;
By:
6
William F. Garcia
06/17/2009
Co - a�L•r
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PY-09-10-CORE-0145
EXHIBIT A
SCOPE OF SERVICES
CONTRACTOR will provide mental health services to individuals and families in Weld County
referred by the Department. Services include individual and family therapy.
2. CONTRACTOR will follow up with referred individual or family within 48 hours of receiving a
referral and will document efforts to engage client in referred services.
3. CONTRACTOR will identify in detail areas of continued concern and make recommendations to the
Department regarding continuation of services and/or the need for additional services.
4. CONTRACTOR will document in detail any and all observed or verbalized concerns regarding any
child whom the CONTRACTOR is working with under an active referral. Areas of concern may
include, but are not limited to, any physical, emotional, educational or behavioral issues. Areas of
concern should be reported immediately AND on the required monthly report.
5. CONTRACTOR will submit reports on a monthly basis for each active referral. Reports will be
submitted per the online format required by the Department.
6. CONTRACTOR will participate in monthly team reviews of ongoing services as needed.
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EXHIBIT B
PAYMENT SCHEDULE
1. Funding and Method of Payment
The Department agrees to reimburse CONTRACTOR in consideration for the work and services
performed from Core Services funding, not to exceed $10,000.00.
Expenses incurred by CONTRACTOR, in association with said project prior to the term of this agreement,
are not eligible Department expenditures and shall not be reimbursed by the Department.
Payment pursuant to this Contract, if Core Services funds, whether in whole or in part, is subject to and
contingent upon the continuing availability of said funds for the purposes hereof. In the event that said
funds, or any part thereof, become unavailable as determined by the Department, the Department may
immediately terminate this Contract or amend it accordingly.
2. Fees for Services
$82.00/Hour (Individual/Family Therapy, Staffings - Greeley Metro Area, including Evans, LaSalle, Eaton
and Windsor)
$120.00/Hour (Individual/Family Therapy, Staffings - Outside of Greeley Metro Area, including Lochbuie,
Frederick, and Hudson)
Department referrals will not be sent to collections by Contractor for default of co-pay/fees. Services will
be performed regardless of client's refusal or inability to pay co -pay.
Contractor will collect any applicable sliding scale co -pays and credit the Department for any payments
received on the monthly billing statements.
3. Submittal of Vouchers
CONTRACTOR shall prepare and submit monthly the itemized voucher and certify that the services
authorized were provided on the date indicated and the charges made were pursuant to the terms and
conditions of Exhibit A.
a. All billings are to be submitted by the 7'h day of the month following the month of
service. If the billing is not submitted within twenty-five (25) calendar days of the month
following service, it may result in forfeiture of payment.
b. Billings must be submitted with the attached required forms, Authorization for
Contractual Services, Request for Reimbursement, Client Verification Form and monthly
report. The Authorization for Contractual Services and Client Verification Form must be
submitted with original signatures.
c. For monitored sobriety, proof of services rendered shall be a sign -in sheet with client
signatures or the test result.
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EXHIBIT C
ASSURANCES
1. CONTRACTOR 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 CONTRACTOR -
contracted CONTRACTOR or its employees, volunteers, or agents while performing duties as described in
this Agreement. CONTRACTOR shall indemnify, defend, and hold harmless Weld County, the Board of
County Commissioners of Weld County, its employees, volunteers, and agents. CONTRACTOR 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, CONTRACTOR shall provide the
Department 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 created a
duty of care with respect to any persons not a party of this Agreement.
4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld, State
of Colorado, to expend funds not otherwise appropriated in each succeeding year.
5. If any section, subsection, paragraph, sentence, clause, or phrase of this Contract is for any reason held or
decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The
parties hereto declare that they would have entered into this Contract and each and every section,
subsection, paragraph, sentence, clause, and phrase thereof irrespective of the fact that any one or more
sections, subsections, paragraphs, sentences, clauses, or phrases might be declared to be unconstitutional or
invalid.
6. No officer, member or employee of Weld County and no member of their governing bodies shall have any
pecuniary interest, direct or indirect, in the approved Agreement or the proceeds thereof.
7. CONTRACTOR 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. CONTRACTOR 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
CONTRACTOR.
9. All such records, documents, communications, and other materials created pursuant or related to this
contract shall be maintained by CONTRACTOR, in a central location and shall be made available to
Social Services upon its request, for a period of seven (7) 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 seven (7) year period, or if
audit findings have not been resolved after a seven (7) period, the materials shall be retained until the
resolution of the audit finding.
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10. CONTRACTOR assures that authorized local, federal, and state auditors and representatives shall, during
business hours, have access to inspect any copy records, and shall be allowed to monitor and review
through on -site visits, all contract activities, supported with funds under this Contract to ensure compliance
with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the
performance of the Agreement shall be conducted by appropriate funding sources. The results of the
monitoring and evaluation activities shall be provided to the appropriate and interested parties.
11. This Contract shall be binding upon the parties hereto, their successors, heirs, legal representatives, and
assigns. CONTRACTOR or the Department may not assign any of its rights or obligations hereunder
without the prior written consent of both parties.
12. CONTRACTOR certifies that federal appropriated funds have not been paid or will be paid, by or on
behalf of CONTRACTOR, 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. CONTRACTOR assures that it will fully comply with all other applicable federal and state laws.
CONTRACTOR understands that the source of funds to be used under this Contract is Core Services
funds.
14. CONTRACTOR 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 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 12 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 the
Department 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,
CONTRACTOR 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, CONTRACTOR
shall submit to the Department, 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 the Department's termination, for cause, of its contract with
CONTRACTOR.
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16. CONTRACTOR 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 CONTRACTOR shall be disclosed in a form identifiable with the applicant/recipient or a
minor's parent or guardian unless in accordance with CONTRACTOR written policies governing access
to, duplication and dissemination of, all such information. CONTRACTOR shall advise its employees,
agents, and subcontractor, if any, that they are subject to these confidentiality requirements.
CONTRACTOR 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.
CONTRACTOR shall have its employees, agents, and subcontractors, if any, sign a written confidentiality
agreement and shall provide a copy of such agreement to the Department, if requested.
17. Proprietary information for the purposes of this contract is information relating to a party's research,
development, trade secrets, business affairs, internal operations and management procedures and those of
its customers, clients or affiliates, but does not include information (1) lawfully obtained from third parties,
(2) that which is in the public domain, or (3) that which is developed independently. Neither party
shall use or disclose directly or indirectly without prior written authorization any proprietary information
concerning the other party obtained as a result of this Contract. Any proprietary information removed from
the State's site by CONTRACTOR in the course of providing services under this Contract will be accorded
at least the same precautions as are employed by CONTRACTOR for similar information in the course of
its own business.
18. CONTRACTOR certifies it will abide by Colorado Revised Statue (C.R.S.) 26-6-104, requiring criminal
background record checks for all employees, contractors, and sub -contractors.
19. Contractor certifies that it shall comply with the provisions of Colorado Revised Statutes (C.R.S.) 8-17.5-
101, et seq. Contractor shall not knowingly employ or contract with an illegal alien to perform work under
this Contract or enter into a contract with a subcontractor that fails to certify to Contractor that the
subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this
Contract. Contractor represents, warrants, and agrees that it (a) has verified that it does not employ any
illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by
the Social Security Administration and Department of Homeland Security, and (b) otherwise will comply
with the requirements of C.R.S. 8-17.5-102(2)(b). Contractor shall comply with all reasonable requests
made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and
Employment. If Contractor fails to comply with any requirement of this provision or C.R.S. 8-17.5-101, et
seq., the Department may terminate this Contract for breach and Contractor shall be liable for actual and
consequential damages to the Department.
Except where exempted by federal law and except as provided in C.R.S. 24-76.5-103(3), if Contractor
receives federal or state funds under this Contract, Contractor must confirm that any individual natural
person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. 24-
76.5-103(4) if such individual applies for public benefits provided under this Contract. If Contractor
operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it (a) is a citizen of
the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall
produce one of the forms of identification required by C.R.S. 24-76.5-101, et seq., and (c) shall produce
one of the forms of identification required by C.R.S. 24-76.5-103 prior to the effective date of this
Contract.
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EXHIBIT D
CHILD and FAMILY SERVICES REVIEWS (CFSR)
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas; Safety,
Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's
performance according to national standards and monitors progress over time. Following the review, a Performance
Improvement Program (PIP) will be implemented for the state to enhance services to families.
Additionally, the review will assess statewide, systemic factors to determine if the systems necessary to achieve
positive outcomes for families are in place.
All agencies that contract to provide service to families and children in Weld County must continually strive for
positive outcomes in the areas of safety, permanency and well-being for our youth. In order to insure continued
progress in this area, the Department is requiring providers to comply with a standard assessment and reporting
system which will address these three areas.*
The Department is requesting that provider reports include observations and recommendations regarding clients in a
way that specifically addresses the areas of safety, permanency and well-being. Below are the specific outcomes
that will be assessed by the CFSR in the areas of safety, permanency and well-being, followed by specific
considerations and tasks which must be addressed by the Department contracted providers.
Safety Outcomes
CFSR Outcome Measures
Safety 1 Children are, first and foremost, protected from abuse and neglect.
Safety 2 Children are safely maintained in their homes whenever possible and appropriate.
Considerations for the Department's providers
• Providers should always consider the following definitions regarding child safety when assessing families.
o Children are considered safe when there are no present dangers or impending danger threats, or
the caregivers' protective capacities control existing threats.
o Children are considered unsafe when they are vulnerable to present or impending danger threats,
and caregivers are unable or unwilling to provide protection.
o Risk is the likelihood (chance, potential, prospect) for parenting behavior that is harmful and
destructive to a child's cognitive, social, emotional and/or physical development, and those with
parenting responsibility are unwilling or unable to behave differently.
• Monthly reports should continually document an assessment of risk and safety concerns and the
interventions that are being offered by the provider to ameliorate those concerns.
• Monthly reports should make recommendations regarding services and/or safety measures that the provider
believes should be implemented to insure safety of the child(ren).
• Providers must specifically document efforts to engage families in services and to control for safety.
Permanency Outcomes
CFSR Outcome Measures
Permanency 1 Children have permanency and stability in their living situations.
Permanency 2 The continuity of family relationships and connections is preserved for children.
Considerations for the Department's providers:
• Provider reports should always note the primary permanency goal for the child and document how
interventions are working toward achieving that goal.
• Provider reports must indicate progress toward achieving the permanency goal and should make specific
recommendations regarding how the continuation of the service may assist in achieving the goal.
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• Providers should continually provide recommendations about whether any out -of -home placement
continues to be appropriate and should make recommendations regarding when changes in this area should
be made, in the providers' opinion.
• Providers should continually assess family relationships (parent/child, sibling/sibling, extended
family/child, etc.) and should report any concerning relationship issues which may be a barrier to achieving
permanency. Providers should document ongoing efforts to resolve those issues and/or make
recommendations regarding additional services that may be required to address relationship issues.
• Providers must document specific time frames when recommending ongoing services and/or
recommending changes to services and/or placements.
Child and Family Well -Being Outcomes
CFSR Outcome Measures
Well Being 1 Families have enhanced capacity to provide for their children's needs.
Well Being 2 Children receive appropriate services to meet their educational needs.
Well Being 3 Children receive adequate services to meet their physical and mental health needs.
Considerations for the Department's providers:
• Providers must engage in ongoing assessments of the parents' capacity to appropriately care for their
children and whether or not the service being provided continues to be appropriate. This must be clearly
documented in monthly reports.
• Providers should specifically detail areas of continued concern within the family and make
recommendations regarding whether that provider's service continues to be appropriate. Reports should
also document what barriers may be impeding progress.
• Providers should document any and all observed concerns regarding any child with whom the provider is
working. This should include concerns regarding physical, emotional, educational and behavioral well-
being of the child. When appropriate, providers should make recommendations regarding evaluations
and/or additional services that may address these concerns.
"Standardized reports will be provided and should be utilized by all agencies providing ongoing services to the
Department's families unless otherwise noted.
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CHILD PROTECTION AGREEMENT FOR SERVICES
BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES
AND VICTOR H. CORDERO, PSY.D., P.C.
This Agreement, made and entered into the 1 day of 7i„„i e 2009. by and between the Board of
Weld County Commissioners, sitting as the Board of Human Services, on behalf of the Weld County Department of
I Inman Services, hereinafter referred to as the `Department,' and Victor H. Cordero, PsvD., P.C., hereinafter
referred to as `Contractor
WITNISSETH
WIIEREAS, required approval, clearance, and coordination have been accomplished from and with
appropriate agencies: and
WHEREAS, the Colorado Department of I hmran Services has provided Core Services funding to the
Department for Mental Health Services, and
NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows:
1. Term
This Agreement shall become effective on June 1, 2009, upon proper execution of this Agreement and
shall expire May 31, 2010, unless sooner terminated as provided herein.
2. Scope of Services
Services shall be provided by CONTRACTOR 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.
Payment
a. Payment shall be made on the basis of Exhibit H, "Payment Schedule." of which are attached
hereto and incorporated herein by reference.
"Payment Schedule" shall establish the maximum reimbursement, which will be paid from
Core Services funding during the duration of this Agreement.
b. CONTRACTOR shall submit an itemized monthly bill to the Department for all costs incurred
and services provided pursuant to Exhibit A of this Agreement in accordance with criteria
established by the Department. CONTRACTOR shall submit all itemized monthly billings to
the Department by the 7th day of the month following the month the cost was incurred. If the
billing is not submitted within twenty-five (25) calendar days of the month following service, it
may result in forfeiture of payment.
c. Payments of costs incurred pursuant to this Agreement is expressly contingent upon the
availability of Core Services to the Department.
d. The Department shall not he billed for, and reimbursement shall not he 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.
a'nni_/Scia'
PY-09-10-CORE-0136
4. Financial Management
At all times from the effective date of this Contract until completion of this Contract, CONTRACTOR
shall
comply with the administrative requirements, cost principles and other requirements set forth in the
Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds
expended under Core Service funding must conform to the Single Audit Act of 1984 and OMB Circular A-
133.
5. Payment Method
Unless otherwise provided in the Scope of Services and Payment Schedule:
a. CONTRACTOR shall provide proper monthly invoices and itemization of services performed for
costs incurred in the performance of the agreement.
h. The Department may withhold any payment if CONTRACTOR has failed to comply with the
Financial Management Requirements, program objectives, contractual terms, or reporting
requirements. In the event of a forfeiture of reimbursements, CONTRACTOR may appeal such
circumstance to the Director of I luman Services. The decision of the Director of Human Services
shall be final.
Assurances
CONTRACTOR shall abide by all assurances as set forth in the attached Exhibit C, which is attached hereto
and incorporated herein by reference.
7. Compliance with Applicable Laws
At all times during the performance of this contract, CONTRACTOR 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 he established which
relate to the Contract. CONTRACTOR acknowledges that the following laws are included:
Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d-1 et seq. and its implementing
regulation, 45 C.F.R. Part SO et. seq.; and
Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 794, and
its implementing regulations, 45 C.F.R. Part 84; and
the Age Discrimination Act of 1975, 42 U.S.C. Sections 6101 et seq. and
its implementation regulations, 45 Cl' 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, CONTRACTOR and the Department will resist in judicial proceedings any
efforts to obtain access to client records except as permitted by 42 CFR Part 2.
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PY-09-10-CORE-0136
Included is 45 C.F.R. Part 74 Appendix G 9, which requires that affirmative steps be taken to assure that
small and minority businesses are utilized, when possible, as sources of supplies, equipment, construction
and services. This assurance is given in consideration of and for the purpose of obtaining any and all
federal and/or state financial assistance.
Any person who feels that s/he has been discriminated against has the right to file a complaint either with
the Colorado Department of Human Services or with the U.S. Department of Health and Human Services,
Office for Civil Rights.
8. Compliance with Child and Family Services Review
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas;
Safety, Permanency and Well Being of families. For each outcome, data and performance indicators
measure each state's performance according to national standards and monitor progress over time.
Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance
services to families.
CONTRACTORS providing services to the Department families and children must continually strive for
positive outcomes in the areas of safety, permanency and well being. Contractors providing services in
program areas identified by the Department are required to comply with a standard assessment and
reporting system set forth in Exhibit D which will address the aforementioned three areas.
9. Insurance
CONTRACTOR, shall procure, either personally or through its employer as applicable to the Contractor's
business, at its own expense, and maintain for the duration of the work, the following insurance coverage,
Weld County, Colorado, by and through the Board of County Commissioners of Weld County, its
employees and agents, shall be named as additional named insured on the insurance, where permissible by
the insurance provider.
Standard Workman's Compensation and Employer's Liability.
1. As required by state statute including occupational disease, covering all employees at
work site.
h. General liability (PL & PD) (Minimum).
1. Combined single limit - $500,000 written on an occurrence basis.
2. Any aggregate limit will not be less than $1 million.
3. Provider must purchase additional insurance if claims reduce the annual aggregate below
$500,000.
4. State of Colorado to be named as additional insured on each comprehensive general
liability policy.
Certificate of insurance to be provided to Weld County and must be attached to the
contract.
6. Insurance shall include provisions preventing cancellation without 60 days prior notice
by certified mail to Weld County.
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PY-09-1 U -CORE -(1136
c. Automobile Liability (Minimum) for any Contractor transporting children or any party to whom
Department services are being provided.
d. Additional coverage may be required in specific program areas. For any insurances that are
required by this contract, a completed Standard Certificate of Insurance Form shall he provided to
the Department by the Contractor prior to the start of any contract.
10. Certifications
CONTRACTOR 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. Copies of all necessary licenses shall be provided to the Department by the
Contractor prior to the start of any contract
11. Training
Contractor shall attend a Court Testimony and Ethics Training to be paid for by the Department. The
Contractor may be required to attend additional training at the request of the Department. The cost of such
training will be paid for by the Department. The Department will not compensate the Contractor for the
time spent attending the required trainings.
12. Monitoring and Evaluation
CONTRACTOR and the Department agree that monitoring and evaluation of the performance of this
Agreement shall be conducted by CONTRACTOR and the Department The results of the monitoring and
evaluation shall be provided to the Board of Weld County Commissioners, the Department and
CONTRACTOR.
CONTRACTOR shall permit the Department, and any other duly authorized agent or governmental
agency, to monitor all activities conducted by CONTRACTOR 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.
13. Modification of Agreement
All modifications to this agreement shall be in writing and signed by both parties.
14. Remedies
The Director of I Iuman Services or designee may exercise the following remedial actions should s/he find
CONTRACTOR substantially failed to satisfy the scope of work found in this Agreement. Substantial
failure to satisfy the scope of work shall he defined to mean incorrect or improper activities or inaction by
CONTRACTOR. These remedial actions are as follows:
a. Withhold payment to 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 CONTRACTOR cannot be performed or if
perforated would be of no value to the Department. Denial of the amount of payment shall be
reasonably related to the amount of work or deliverables lost to the Department;
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PY-09-10-CORE-0136
e. Incorrect payment to CONTRACTOR due to omission, error, fraud, and/or defalcation shall be
recovered from CONTRACTOR by deduction from subsequent payments under this Agreement or
other agreements between the Department and CONTRACTOR, or by the Department as a debt due to
the Department or otherwise as provided by law.
15. 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 the Department:
Gloria Romansik
Name
For CONTRACTOR:
Victor II. Cordero, Psy.D.
Name
16_ Notice
Social Services Administrator
Title
Owner
Title
All notices required to be given by the parties hereunder shall be given by certified or registered mail to the
individuals at the addresses set forth below. Either party may from time to time designate in writing a
substitute person(s) or address to whom such notices shall he sent:
To: The Department
Judy A. Griego, Director
P.O. Box A
Greeley, CO 80632
(970)352-1551
17. Litigation
'lo: CONTRACTOR
Victor H. Cordero, Psy.D.
2870 N. Speer Boulevard. Unit 240
Denver, CO 80211
(303) 455-9480
CONTRACTOR shall promptly notify the Department in the event that CONTRACTOR learns of any
actual litigation in which it is a party defendant in a case that involves services provided under this
Agreement. 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 documents) to the I luman Services Director. 'The term 'litigation includes an assignment
for the benefit of creditors, and filings in bankruptcy, reorganization and/or foreclosure.
18. Termination
This Agreement may be terminated at any time by either party given thirty (30) days written notice and is
subjeet to the availability of funding. CONTRACTOR reserves the right to suspend services to clients if
finding is no longer available.
19. 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 13 herein.
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1'Y-09- I 0 -CORE -0136
IN WITNESS WI II FREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first
above with.
WELD COUNTY DIEPARTMENI
OF HUMAN SERVICES
BOARD OF COUNTY
COMMISSIONERS WEIR
COUNTY, COLOR
Chair William 'F. Garcia
06/17/2009
CONTRACTOR
6
at\ \-‘,CoutaAr?-5A
Contractor
PY-09-10-CORE-0136
EXHIBIT A
SCOPE OF SERVICES
. CONTRACTOR will provide Mental Health Services to individuals, couples and/or families in Weld
County referred by the Department. Services include the following:
a- Psychological Evaluations —Evaluations include a comprehensive evaluation of the client utilizing
various assessment tools including standardized, objective, projective and otherwise nomted
instructions, as well as questionnaires, mental status examination and clinical interview. Testing
and screening may include, but arc not limited to, any of the following instruments; Wechsler
Intelligence Scale -III or subtests, Universal Nonverbal Intelligence Test, other tests of
cognitive/intellectual ability. Wechsler Abbreviated Scale of Intelligence, various informal
cognitive/neuropsychological tasks, Minnesota Multiphasic Personality Inventory -II (MMPI-H),
Personality Assessment Inventory (PAD, Millon Clinical Multiaxial Inventory -Ill (MCMI-Ill),
Millon Adolescent Clinical Inventory (MALT), Parenting Stress Index, Child Abuse Potential
Inventory, Beck Scales of Depression and Anxiety, State trait Anger Expression Inventory,
Trauma Symptom Checklist for Children, and other screening/testing assessments.
Face-to-face interview and testing time will range from five (5) to seven (7) hours, plus scoring,
interpretation, collateral contacts and report generation.
b. Interactional Evaluations —Evaluation of parent -child dynamics, family dynamics, capacity to
parent and overall parent ability as determined by, but not limited to, in -person observation of the
parent or family during visitation with the children, interview with the parent, parenting related
questionnaires and collateral contacts_
These evaluations can occur at scheduled visitation time at supervising agencies, the evaluator's
office, or in the client's home.
c. Mental I Iealth Evaluation — Specific evaluation utilized to assess for the presence of specific
mental, emotional, behavioral or psychological process. It is not a comprehensive evaluation of
personality, global functioning or intellectual capacity. Assessment is completed utilizing
screening instruments, symptom checklists, formal mental status examination, and clinical
interview, as well as psychological evaluation tools as appropriate.
Face-to-face interview and testing will range from three (3) to five (5) hours, plus scoring,
collateral contacts and report generation.
d. Individual, Couples and Family Counseling — Services to assist in identifying harriers to
appropriate parenting. Interventions are designed to improve safety of children in the home, assist
in stabilizing the home environment and adult/caregiver behaviors, and intervene in order to affect
more positive, healthy family dynamics and functioning.
2. Services will be provided by Victor II_ Gorden), Psy.D.
3. CONTRACTOR is bi-lingual (Spanish/English).
4. CONTRACTOR will submit a report on a monthly basis for each active ongoing referral. Reports will be
submitted per the online format required by the Department. For evaluation services, the CONTRACTOR
will submit a portion of the evaluation, and submit a full, original copy to the referring caseworker.
5. CONTRACTOR will participate in team reviews of ongoing services as needed.
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EXHIBIT B
PAYMENT SCHEDULE
1. Funding and Method of Payment
The Department agrees to reimburse CONTRACTOR in consideration for the work and services
performed from Core Services funding, not to exceed $25,000.00.
Expenses incurred by CONTRACTOR, in association with said project prior to the term of this agreement,
are not eligible Department expenditures and shall not be reimbursed by the Department
Payment pursuant to this Contract, if Core Services funds, whether in whole or in part, is subject to and
contingent upon the continuing availability of said funds for the purposes hereof. In the event that said
funds, or any part thereof, become unavailable as determined by the Department, the Department may
immediately terminate this Contract or amend it accordingly.
2. Fees for Services
$1,200.00/Episode (Psychological Evaluation)
$1,200.00/Episode (Interactional Evaluation - Regardless of number of participants if one report is
produced.)
$700.00/Episode (Mental Health Evaluation)
$10200/hour (Individual, Couples and Family Counseling - Face -to -Face Contact)
$100.00/Hour (Court Facilitation, Staffing and Testimony)
Department referrals will not be sent to collections by Contractor for default of co-pay/fees. Services will
be performed regardless of client's refusal or inability to pay co -pay.
Contractor will collect any applicable sliding scale co -pays and credit the Department for any payments
received on the monthly billing statements.
Submittal of Vouchers
CONTRACTOR shall prepare and submit monthly the itemized voucher and certify that the services
authorized were provided on the date indicated and the charges made were pursuant to the terms and
conditions of Exhibit A.
a. All billings are to be submitted by the 7th day of the month following the month of
service. If the billing is not submitted within twenty-five (25) calendar days of the month
following service, it may result in forfeiture of payment.
b. Billings must he submitted with the attached required fonns, Authorization for
Contractual Services, Request for Reimbursement, Client Verification Form and monthly
report. The Authorization for Contractual Services and Client Verification Form must be
submitted with original signatures.
c. For monitored sobriety, proof of services rendered shall be a sign -in sheet with client
signatures or the test result.
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PY-09-10-CORE-0136
EXHIBIT C
ASSURANCES
CONTRACTOR 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 CONTRACTOR -
contracted CONTRACTOR or its employees, volunteers, or agents while performing duties as described in
this Agreement. CONTRACTOR shall indemnify, defend, and hold harmless Weld County, the Board of
County Commissioners of Weld County, its employees, volutteets, and agents. CONTRACTOR 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, CONTRACTOR shall provide the
Department 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 created a
duty of care with respect to any persons not a party of this Agreement.
4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld, State
of Colorado, to expend funds not otherwise appropriated in each succeeding year.
5. If any section, subsection, paragraph, sentence, clause, or phrase of this Contract is tiff any reason held or
decided to he unconstitutional, such decision shall not affect the validity of the remaining portions. The
parties hereto declare that they would have entered into this Contract and each and every section,
subsection, paragraph, sentence, clause, and phrase thereof irrespective of the fact that any one or more
sections, subsections, paragraphs, sentences, clauses, or phrases might he 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, director indirect, in the approved Agreement or the proceeds thereof.
7. CONTRACTOR 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,
he denied the benefits of, or be otherwise subjected to discrimination under this approved Contract.
S. CONTRACTOR 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
CONTRACTOR.
9. All such records, documents, communications, and other materials created pursuant or related to this
contract shall be maintained by CONTRACTOR, in a central location and shall be made available to
Social Services upon its request, for a period of seven (7) 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 seven (7) year period, or if
audit findings have not been resolved after a seven (7) period, the materials shall he retained until the
resolution of the audit finding.
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PY-09-I 0 -CORE -0136
10. CONTRACTOR assures that authorized local, federal, and state auditors and representatives shall, during
business hours, have access to inspect any copy records, and shall be allowed to monitor and review
through on -site visits, all contract activities, supported with funds under this Contract to ensure compliance
with the terms of this Agreement Contracting parties agree that monitoring and evaluation of the
performance of the Agreement shall be conducted by appropriate funding sources. The results of the
monitoring and evaluation activities shall be provided to the appropriate and interested parties.
11. This Contract shall be binding upon the parties hereto, their successors, heirs, legal representatives, and
assigns. CONTRACTOR or the Department may not assign any of its rights or obligations hereunder
without the prior written consent of both parties.
12. CONTRACTOR certifies that federal appropriated funds have not been paid or will be paid, by or on
behalf of CONTRACTOR, to any person for influencing or attempting to influence an officer or employee
of all 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. CONTRACTOR assures that it will fully comply with all other applicable federal and state laws.
CONTRACTOR understands that the source of funds to be used under this Contract is Core Services
funds.
14. CONTRACTOR 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. I hive not, within a three-year period 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 perfonning 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 12 of
this certification, and
d. I lave not, within a three-year period preceding this Contract, had one or more public transactions
(federal, state, and local) terminated for cause or default.
IS. The Appearance of Conflict of Interest applies to the relationship of a CONTRACTOR with the
Department 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,
CONTRACTOR 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, CONTRACTOR
shall submit to the Department, 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 the Departments termination, for cause, of its contract with
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PY-09-10-CORK: 0136
CONTRACTOR.
16. CONTRACTOR 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 CONTRACTOR shall he disclosed in a ti>mm identifiable with the applicant/recipient or a
minor's parent or guardian unless in accordance with CONTRACTOR written policies governing access
to, duplication and dissemination of, all such information. CONTRACTOR shall advise its employees,
agents, and subcontractor, if any, that they are subject to these confidentiality requirements.
CONTRACTOR 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 pennitted.
CONTRACTOR shall have its employees, agents, and subcontractors, if any, sign a written confidentiality
agreement and shall provide a copy of such agreement to the Department, if requested.
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 inforniation removed from
the State's site by CONTRACTOR in the course of providing services under this Contract will he accorded
at least the same precautions as are employed by CONTRACTOR for similar information in the course of
its own business.
18. CONTRACTOR certifies it will abide by Colorado Revised Statue (C.R.S.) 26-6-104, requiring criminal
background record checks for all employees, contractors, and sub -contractors.
19. Contractor certifies that it shall comply with the provisions of Colorado Revised Statutes (C.R.S.) 8-17.5-
101, et seq. Contractor shall not knowingly employ or contract with an illegal alien to perform work under
this Contract or enter into a contract with a subcontractor that fails to certify to Contractor that the
subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this
Contract. Contractor represents, warrants, and agrees that it (a) has verified that it does not employ any
illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by
the Social Security Administration and Department of I lomeland Security, and (b) otherwise will comply
with the requirements of C.R.S. 8-175-102(2)(b). Contractor shall comply with all reasonable requests
made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and
Employment. If Contractor fails to comply with any requirement of this provision or C.K.S. 8-17.5-101, et
seq., the Department may terminate this Contract for breach and Contractor shall he liable for actual and
consequential damages to the Department.
Except where exempted by federal law and except as provided in C.R.S. 24-76.5-103(3), if Contractor
receives federal or state funds under this Contract, Contractor must confirm that any individual natural
person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. 24-
76.5-103(4) if such individual applies for public benefits provided under this Contract. If Contractor
operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it (a) is a citizen of
the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall
produce one of the forms of identification required by C.R.S. 24-76.5-101, et seq., and (c) shall produce
one of the forms of identification required by C.R.S. 24-765-103 prior to the effective date of this
Contract.
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PY-09-10-CORE-0136
EXHIBIT D
CHILD and FAMILY SERVICES REVIEWS (CFSR)
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas: Safety,
Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's
performance according to national standards and monitors progress over time. Following the review, a Performance
Improvement Program (PIP) will be implemented for the state to enhance services to families.
Additionally, the review will assess statewide, systemic factors to determine if the systems necessary to achieve
positive outcomes for families are in place.
All agencies that contract to provide service to families and children in Weld County must continually strive for
positive outcomes in the areas of safety, permanency and well-being for our youth. In order to insure continued
progress in this area, the Department is requiring providers to comply with a standard assessment and reporting
system which will address these three areas.*
'fhe Department is requesting that provider reports include observations and recommendations regarding clients in a
way that specifically addresses the areas of safety, permanency and well-being. Below are the specific outcomes
that will he assessed by the CFSR in the areas of safety, permanency and well-being, followed by specific
considerations and tasks which must be addressed by the Department contracted providers.
Safety Outcomes
CFSR Outcome Measures
Safety 1 Children are, first and foremost, protected from abuse and neglect.
Safety 2 Children are safely maintained in their homes whenever possible and appropriate.
Considerations for the Department's providers
Providers should always consider the following definitions regarding child safety when assessing families.
o Children are considered safe when there are no present dangers or impending danger threats, or
the caregivers' protective capacities control existing threats.
o Children are considered unsafe when they are vulnerable to present or impending danger threats,
and caregivers are unable or unwilling to provide protection.
o Risk is the likelihood (chance, potential, prospect) for parenting behavior that is harmful and
destructive to a child's cognitive, social, emotional and/or physical development, and those with
parenting responsibility are unwilling or unable to behave differently.
• Monthly reports should continually document an assessment of risk and safety concerns and the
interventions that are being offered by the provider to ameliorate those concerns.
• Monthly reports should make recommendations regarding services and/or safety measures that the provider
believes should be implemented to insure safety of the childtren).
• Providers must specifically document efforts to engage families in services and to control for safety.
Permanency Outcomes
CFSR Outcome Measures
Permanency 1 Children have permanency and stability in their living situations.
Permanency 2 The continuity of family relationships and connections is preserved for children.
Considerations for the Department's providers:
• Provider reports should always note the primary permanency goal for the child and document how
interventions are working toward achieving that goal.
• Provider reports must indicate progress toward achieving the permanency goal and should make specific
recommendations regarding how the continuation of the service may assist in achieving the goal.
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PY-09-10-CORD: 01 36
• Providers should continually provide recommendations about whether any out -of -home placement
continues to be appropriate and should make recommendations regarding when changes in this area should
be made, in the providers' opinion.
• Providers should continually assess family relationships (parent/child, sibling/sibling, extended
family/child, etc.) and should report any concerning relationship issues which may be a barrier to achieving
permanency. Providers should document ongoing efforts to resolve those issues and/or make
recommendations regarding additional services that may be required to address relationship issues.
• Providers must document specific true frames when recommending ongoing services and/or
recommending changes to services and/or placements.
Child and Family Well -Being Outcomes
CFSR Outcome Measures
Well Being I Families have enhanced capacity to provide for their children's needs.
Well Being 2 Children receive appropriate services to meet their educational needs.
Well Being 3 Children receive adequate services to meet their physical and mental health needs.
Considerations for the Department's providers:
• Providers must engage in ongoing assessments of the parents' capacity to appropriately care for their
children and whether or not the service being provided continues to be appropriate_ This must he clearly
documented in monthly reports.
• Providers should specifically detail areas of continued concern within the family and make
recommendations regarding whether that provider's service continues to be appropriate. Reports should
also document what barriers may he impeding progress.
• Providers should document any and all observed concerns regarding any child with whom the provider is
working- This should include concerns regarding physical, emotional, educational and behavioral well-
being of the child When appropriate, providers should make recommendations regarding evaluations
and/or additional services that may address these concerns.
*Standardized reports will be provided and should be utilized by all agencies providing ongoing services to the
Department's families unless otherwise noted
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PY-09- I 0 -CORE -0159
CHILD PROTECTION AGREEMENT FOR SERVICES
BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES
AND VICTOR H. CORDERO, PSY.D., P.C.
�+
This Agreement, made and entered into the day of Thr; /kJ 2009, by and between the Board of
Weld County Commissioners, sitting as the Board of luman Services, on behalf of the Weld County Department of
Human Services, hereinafter referred to as the "Department," and Victor H. Cordero, Psy l)., P.C., hereinafter
referred to as "Contractor".
WITNESSFIll
WI IEREAS, required approval, clearance, and coordination have been accomplished from and with
appropriate agencies: and
WIIEREAS, the Colorado Department of 'Inman Services has provided Core Services funding to the
Department for Sex Abuse Treatment (Informed Supervision): and
NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows:
Tenn
This Agreement shall become effective on June 1, 2009, upon proper execution of this Agreement and
shall expire May 31, 2010, unless sooner terminated as provided herein.
2. Scope of Services
Services shall he provided by CONTRACTOR 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.
Payment
Payment shall be made on the basis of Exhibit B,'Payment Schedule,` of which are attached
hereto and incorporated herein by reference.
"Payment Schedule" shall establish the maximum reimbursement, which will be paid from
Core Services funding during the duration of this Agreement.
b. CONTRACTOR shall submit an itemized monthly bill to the Department for all costs incurred
and services provided pursuant to Exhibit A of this Agreement in accordance with criteria
established by the Department. CONTRACTOR shall submit all itemized monthly billings to
the Department by the 75 day of the month following the month the cost was incurred. If the
billing is not submitted within twenty-five (25) calendar days of the month following service, it
may result in forfeiture of payment.
c. Payments of costs incurred pursuant to this Agreement is expressly contingent upon the
availability of Core Services to the Department.
d. The Department shall not be billed for, and reimbursement shall not be made for tune 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.
1
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PY-09-10-CORE-0159
4. Financial Management
At all times from the effective date of this Contract until completion of this Contract, CONTRACTOR
shall
comply with the administrative requirements, cost principles and other requirements set forth in the
Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds
expended under Core Service funding must conform to the Single Audit Act of 1984 and OMB Circular A-
133.
5. Payment Method
Unless otherwise provided in the Scope of Services and Payment Schedule:
a. CONTRACTOR shall provide proper monthly invoices and itemization of services performed for
costs incurred in the performance of the agreement.
The Department may withhold any payment if CONTRACTOR has failed to comply with the
Financial Management Requirements, program objectives, contractual terms, or reporting
requirements. In the event of a forfeiture of reimbursements, CONTRACTOR may appeal such
circumstance to the Director of Human Services. The decision of the Director of Human Services
shall he final.
6. Assurances
CONTRACTOR shall abide by all assurances as set forth m the attached Exhibit C, which is attached hereto
and incorporated herein by reference.
7. Compliance with Applicable Laws
At all times during the performance of this contract, CONTRACTOR 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. CONTRACTOR acknowledges that the following laws are included:
Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d-1 et seq. and its implementing
regulation, 45 C.F.R. Part 80 et seq.; and
Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 794, and
its implementing regulations, 45 C.E.R. Part 84; and
the Age Discrimination Act of 1975, 42 U.S.C. Sections 6101 et seq. and
its implementation regulations, 45 C.F.R. Part 91; and
Title VII of the Civil Rights Act of 1964; and
the Age Discrimination in Employment Act of 1967, and
the Equal Pay Act of 1963; and
the Education Amendments of 1972; and
- Immigration Reform and Control Act of 1986, P.L. 99-603;
42 C.F.R. Part 2
and all regulations applicable to these laws prohibiting discrimination because of race, color,
National origin, and sex, religion and handicap, including Acquired Immune Deficiency Syndrome (AIDS)
or AIDS related conditions, covered under Section 504 of the Rehabilitation Act of 1973, as amended,
cited above. If necessary, CONTRACTOR and the Department will resist in judicial proceedings any
efforts to obtain access to client records except as permitted by 42 CFR Part 2.
2
PY-09-10-CORE-0159
Included is 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.
Compliance with Child and Family Services Review
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas;
Safety, Permanency and Well Being of families. For each outcome, data and performance indicators
measure each state's performance according to national standards and monitor progress over time.
Following the review, a Program improvement Plan (PIP) will he implemented for the state to enhance
services to families.
CONTRACTORS providing services to the Department families and children must continually strive for
positive outcomes in the areas of safety, permanency and well being. Contractors providing services in
program areas identified by the Department arc required to comply with a standard assessment and
reporting system set forth in Exhibit D which will address the aforementioned three areas.
9. Insurance
CONTRACTOR, shall procure, either personally or through its employer as applicable to the Contractor's
business, at its own expense, and maintain for the duration of the work, the following insurance coverage;
Weld County, Colorado, by and through the Board of County Commissioners of Weld County, its
employees and agents, shall be named as additional named insured on the insurance, where permissible by
the insurance provider.
a. Standard Workman's Compensation and Employer's Liability.
As required by state statute including occupational disease, covering all employees at
work site.
b. General Liability (PL & PD) (Minimum).
. Combined single limit - $500,000 written on an occurrence basis.
2. Any aggregate limit will not be less than $ 1 million.
3. Provider must purchase additional insurance if claims reduce the annual aggregate below
$500,000.
4. State of Colorado to be named as additional insured on each comprehensive general
liability policy.
5. Certificate of insurance to be provided to Weld County and must be attached to the
contract.
6. Insurance shall include provisions preventing cancellation without 60 days prior notice
by certified mail to Weld County.
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PY-09- I 0 -CORE -0159
c. Automobile Liability (Minimum) for any Contractor transporting children or any party to whom
Department services are being provided.
d_ Additional coverage may be required in specific program areas. For any insurances that are
required by this contract, a completed Standard Certificate of Insurance Form shall he provided to
the Department by the Contractor prior to the start of any contract.
10. Certifications
CONTRACTOR 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. Copies of all necessary licenses shall be provided to the Department by the
Contractor prior to the start of any contract.
II. Training
Contractor shall attend a Court Testimony and Ethics Training to be paid for by the Department. The
Contractor may be required to attend additional training at the request of the Department. The cost of such
training will be paid for by the Department. 'the Department will not compensate the Contractor for the
time spent attending the required trainings.
12. Monitoring and Evaluation
CONTRACTOR and the Department agree that monitoring and evaluation of the perfonnance of this
Agreement shall be conducted by CONTRACTOR and the Department. The results of the monitoring and
evaluation shall be provided to the Board of Weld County Commissioners, the Department and
CONTRACTOR.
CONTRACTOR shall permit the Department, and any other duly authorized agent or governmental
agency, to monitor all activities conducted by CONTRACTOR 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.
13. Modification of Agreement
All modifications to this agreement shall be in writing and signed by both parties.
14. Remedies
The Director of Human Services or designee may exercise the following remedial actions should s/he find
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
CONTRACTOR. These remedial actions arc as follows:
a. Withhold payment to CONTRACTOR until the necessary services or corrections in perlbnnance arc
satisfactorily completed',
h. Deny payment or recover reimbursement for those services or deliverables, which have not been
performed and which due to circumstances caused by CONTRACTOR cannot be performed or if
performed would be of no value to the Department. Denial of the amount of payment shall be
reasonably related to the amount of work or deliverables lost to the Department
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PY-09-10-CORE-0159
c. Incorrect payment to CONTRACTOR due to omission, error, fraud, and/or defalcation shall be
recovered from CONTRACTOR by deduction from subsequent payments under this Agreement or
other agreements between the Department and CONTRACTOR, or by the Department as a debt due to
the Department or otherwise as provided by law.
15. 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 the Department:
Gloria Romansik
Name
For CONTRACTOR:
Victor H. Cordero. Psv.D.
Name
16. Notice
Social Services Administrator
Title
Owner
Title
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: The Department
Judy A. Griego, Director
P.O. )3ox A
Greeley, CO 80632
(970)352-1551
17. Litigation
To: CONTRACTOR
Victor 11. Cordero, Psv.D.
2870 N. Speer Boulevard, Unit 240
Denver, CO 80211
(303) 455-9480
CONTRACTOR shall promptly notify the Department in the event that CONTRACTOR learns of any
actual litigation in which it is a party defendant in a case that involves services provided under this
Agreement. 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 documents) to the human Services Director_ The temm 'litigation' includes an assignment
for the benefit of creditors, and filings in bankruptcy, reorganization and/or foreclosure.
18_ 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. CONTRACTOR reserves the right to suspend services to clients if
funding is no longer available.
18. 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 he changed or modified except as stated in
Paragraph 13 herein.
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PY-09- 0 -CORE -0159
IN WITNES.
above
13v:
APP
Depute ( eiR ✓
Cow7/Yttorne}
REOF, the parties hereto have duly executed the Agreement as of the day, month, and year first
FY BOARD OF COUNTY
IE BOARD COMMISSIONERS WELD
4 COUNTY, COLORA
✓ �XY .,A.� 64 G�13v:
Chair William F. Garcia
WELD COUNTY DEPARTMENT
OF HUMAN SERVICES
CONTRA TOR:
BY
Contractor
06/17/2009
ADO% - /3b''8
PY-09-10-CORE; 0li9
EXHIBIT A
SCOPE OF SERVICES
I. CONTRACTOR will provide informed Supervision services to non -offending parents in Weld County as
referred by the Department.
2. CONTRACTOR will provide non -offending parents with a tune limited, psycho -educational understanding
of perpetrator dynamics, victim dynamics, impact of abuse on victims, and assist non -offending parents in
the development of a safety plan and safety mentality within the home to minimize potential for future
abuse of children.
3. Services will be provided in eight (8) to 12 sessions (hours).
4. Services will be provided by Victor H. Cordero, Psy.D.
5. CONTRACTOR is bilingual (Spanish/English).
6. CONTRACTOR will submit a report detailing the outcome of ongoing services per the online format
required by the Department.
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PY-09-10-CORE-0159
EXHIBIT B
PAYMENT SCHEDULE
Funding and Method of Payment
The Department agrees to reimburse CONTRACTOR in consideration for the work and services
performed from Core Services funding, not to exceed $5,000.00.
Expenses incurred by CONTRACTOR, in association with said project prior to the term of this agreement,
are not eligible Department expenditures and shall not he reimbursed by the Department.
Payment pursuant to this Contract, if Core Services funds, whether in whole or in part, is subject to and
contingent upon the continuing availability of said funds for the purposes hereof In the event that said
funds, or any part thereof, become unavailable as determined by the Department, the Department may
inunediately terminate this Contract or amend it accordingly.
2. Fees for Services
$60.00/Hour (Informed Supervision for Non -offending Parent)
Department referrals will not be sent to collections by Contractor for default of co-pay/fees. Services will
be performed regardless of clients refusal or inability to pay co -pay.
Contractor will collect any applicable sliding scale co -pays and credit the Department for any payments
received on the monthly billing statements.
Submittal of Vouchers
CONTRACTOR shall prepare and submit monthly the itemized voucher and certify that the services
authorized were provided on the date indicated and the charges made were pursuant to the terms and
conditions of Exhibit A.
a. All billings are to he submitted by the 70t day of the month following the month of
service. If the billing is not submitted within twenty-five (25) calendar days of the month
following service, it may result in forfeiture of payment.
h. Billings must be submitted with the attached required forms, Authorization for
Contractual Services, Request for Reimbursement, Client Verification Form and monthly
report. The Authorization for Contractual Services and Client Verification Form must he
submitted with original signatures.
c. For monitored sobriety, proof of services rendered shall be a sign -in sheet with client
signatures or the test result.
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EXHIBIT C
ASSURANCES
CONTRACTOR 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 CONTRACTOR -
contracted CONTRACTOR or its employees, volunteers, or agents while performing duties as described in
this Agreement. CONTRACTOR shall indemnify, defend, and hold harmless Weld County, the Board of
County Commissioners of Weld County, its employees, volunteers, and agents. CONTRACTOR 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, CONTRACTOR shall provide the
Department with the acceptable evidence that such coverage is in effect.
3. No portion of this Contract shall he deemed to constitute a waiver of any immunities the parties or their
officers or employees may possess, not shall any portion of this Agreement he deemed to have created a
duty of care with respect to any persons not a party of this Agreement.
4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld, State
of Colorado, to expend funds not otherwise appropriated in each succeeding year.
5. If any section, subsection, paragraph, sentence, clause, or phrase of this Contract is for any reason held or
decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The
parties hereto declare that they would have entered into this Contract and each and every section,
subsection, paragraph, sentence, clause, and phrase thereof irrespective of the fact that any one or more
sections, subsections, paragraphs, sentences, clauses, or phrases might he 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. CONTRACTOR 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,
he denied the benefits of, or be otherwise subjected to discrimination under this approved Contract.
8. CONTRACTOR 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
CONTRACTOR.
9. All such records, documents, communications, and other materials created pursuant or related to this
contract shall be maintained by CONTRACTOR, in a central location and shall be made available to
Social Services upon its request, for a period of seven (7) 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 seven (7) year period, or if
audit findings have not been resolved after a seven (7) period, the materials shall be retained until the
resolution of the audit finding.
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10. CONTRACTOR 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.
This Contract shall he binding upon the parties hereto, their successors, heirs, legal representatives, and
assigns. CONTRACTOR or the Department may not assign any of its rights or obligations hereunder
without the prior written consent of both parties.
12. CONTRACTOR certifies that federal appropriated funds have not been paid or will be paid, by or on
behalf of CONTRACTOR, 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. CONTRACTOR assures that it will fully comply with all other applicable federal and state laws.
CONTRACTOR understands that the source of funds to be used under this Contract is Core Services
funds.
14 CONTRACTOR 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. (lave not, within a three-year period 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:
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 12 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 the
Department 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 tenn of the Contract,
CONTRACTOR 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, CONTRACTOR
shall submit to the Department, 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 the Department's termination, for cause, of its contract with
CONTRACTOR.
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16. CONTRACTOR 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 CONTRACTOR shall be disclosed in a form identifiable with the applicant/recipient or a
minor's parent or guardian unless in accordance with CONTRACTOR written policies governing access
to, duplication and dissemination of, all such information CONTRACTOR shall advise its employees,
agents, and subcontractor, if any, that they are subject to these confidentiality requirements.
CONTRACTOR 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.
CONTRACTOR shall have its employees, agents, and subcontractors, if any, sign a written confidentiality
agreement and shall provide a copy of such agreement to the Department, if requested.
17. Proprietary information for the purposes of this contract is information relating to a party's research,
development, trade secrets, business affairs, internal operations and management procedures and those of
its customers, clients or affiliates, but does not include information (1) lawfully obtained from third parties,
(2) that which is in the public domain, or (3) that which is developed independently. Neither party
shall use or disclose directly or indirectly without prior written authorization any proprietary information
concerning the other party obtained as a result of this Contract. Any proprietary information removed from
the State's site by CONTRACTOR in the course of providing services under this Contract will be accorded
at least the same precautions as are employed by CONTRACTOR for similar information in the course of
its own business.
l8. CONTRACTOR certifies it will abide by Colorado Revised Statue (C.R.S.) 26-6-104, requiring criminal
background record checks for all employees, contractors, and sub -contractors.
19. Contractor certifies that it shall comply with the provisions of Colorado Revised Statutes (C.R.S_) 8-17.5-
101, et seq. Contractor shall not knowingly employ or contract with an illegal alien to perform work trader
this Contract or enter into a contract with a subcontractor that fails to certify to Contractor that the
subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this
Contract. Contractor represents, warrants, and agrees that it (a) has verified that it does not employ any
illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by
the Social Security Administration and Department of I lomeland Security, and (b) otherwise will comply
with the requirements of C.R.S. 8-I 7.5-102(2)(b). Contractor shall comply with all reasonable requests
made in the course of an investigation under C R.S. 8-17.5-102 by the Colorado Department of Labor and
Employment. If Contractor fails to comply with any requirement of this provision or C.R.S. 8-17.5-101, et
seq., the Department may terminate this Contract for breach and Contractor shall be liable for actual and
consequential damages to the Department.
Except where exempted by federal law and except as provided in C.R.S. 24-76.5-103(3), if Contractor
receives federal or state funds under this Contract, Contractor must confirm that any individual natural
person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. 24-
76.5-103(4) if such individual applies for public benefits provided under this Contract. If Contractor
operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it (a) is a citizen of
the United States or is othenvise lawfully present in the United States pursuant to federal law, (h) shall
produce one of the forms of identification required by C.R.S. 24-76.5-101, et seq., and (c) shall produce
one of the forms of identification required by C.R.S. 24-76.5-103 prior to the effective date of this
Contract.
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EXHIBIT D
CHILD and FAMILY SERVICES REVIEWS (CFSR)
The Child and Family Services Reviews (CFSR) examines child welfare service outcomes in three areas; Safety,
Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's
performance according to national standards and monitors progress over time. Following the review, a Performance
Improvement Program (I'll') will he implemented for the state to enhance services to families_
Additionally, the review will assess statewide, systemic factors to determine if the systems necessary to achieve
positive outcomes for families are in place.
All agencies that contract to provide service to families and children in Weld County must continually strive for
positive outcomes in the areas of safety, permanency and well-being for our youth_ In order to insure continued
progress in this area, the Department is requiring providers to comply with a standard assessment and reporting
system which will address these three areas.*
The Department is requesting that provider reports include observations and recommendations regarding clients in a
way that specifically addresses the areas of safety, permanency and well-being. Below are the specific outcomes
that will be assessed by the CFSR in the areas of safety, permanency and well-being, followed by specific
considerations and tasks which must be addressed by the Department contracted providers.
Safety Outcomes
CFSR Outcome Measures
Safety 1 Children are, first and foremost, protected from abuse and neglect.
Safety 2 Children are safely maintained in their homes whenever possible and appropriate_
Considerations for the Department's providers
• Providers should always consider the following definitions regarding child safety when assessing families.
o Children are considered safe when there are no present dangers or impending danger threats, or
the caregivers' protective capacities control existing threats.
o Children arc considered unsafe when they are vulnerable to present or impending danger threats,
and caregivers are unable or unwilling to provide protection.
o Risk is the likelihood (chance, potential, prospect) for parenting behavior that is harmful and
destructive to a child's cognitive, social, emotional and/or physical development, and those with
parenting responsibility are unwilling or unable to behave differently.
• Monthly reports should continually document an assessment of risk and safety concerns and the
interventions that are being offered by the provider to ameliorate those concerns.
• Monthly reports should make recommendations regarding services and/or safety measures that the provider
believes should he implemented to insure safety of the child(ren).
• Providers must specifically document efforts to engage families in services and to control for safety.
Permanency Outcomes
CFSR Outcome Measures
Permanency I Children have pennanency and stability in their living situations.
Permanency 2 The continuity of family relationships and connections is preserved for children_
Considerations for the Department's providers:
• Provider reports should always note the primary permanency goal for the child and document how
interventions are working toward achieving that goal.
Provider reports must indicate progress toward achieving the permanency goal and should make specific
recommendations regarding how the continuation of the service may assist in achieving the goal.
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• Providers should continually provide recommendations about whether any out -of -home placement
continues to be appropriate and should make recommendations regarding when changes in this area should
be made, in the providers' opinion.
• Providers should continually assess family relationships (parent/child, sibling/sibling, extended
family/child, etc.) and should report any concerning relationship issues which may be a barrier to achieving
pennanency. Providers should document ongoing efforts to resolve those issues and/or make
recommendations regarding additional services that may be required to address relationship issues.
• Providers must document specific time frames when recommending ongoing services and/or
recommending changes to services and/or placements.
Child and Family Well -Being Outcomes
CFSR Outcome Measures
Well Being I Families have enhanced capacity to provide for their children's needs.
Well Being 2 Children receive appropriate services to meet their educational needs.
Well Being 3 Children receive adequate services to meet their physical and mental health needs.
Considerations for the Department's providers:
• Providers must engage in ongoing assessments of the parents' capacity to appropriately care for their
children and whether or not the service being provided continues to be appropriate. This must be clearly
documented in monthly reports.
• Providers should specifically detail areas of continued concern within the family and make
recommendations regarding whether that provider's service continues to he appropriate. Reports should
also document what barriers may be impeding progress.
• Providers should document any and all observed concerns regarding any child with whom the provider is
working. This should include concerns regarding physical, emotional, educational and behavioral well-
being of the child. When appropriate, providers should make recommendations regarding evaluations
and/or additional services that may address these concerns.
* Standardized reports will be provided and should he utilized by all agencies providing ongoing services to the
Department's families unless otherwise noted.
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