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Home My WebLink About20082168.tiff a DEPARTMENT OF HUMAN SERVICES P.O. BOX A GREELEY, CO. 80632 Website:www.co.weld.co.us Administration and Public Assistance(970)352-1551 Child Support(970)352-6933 ik COLORADO MEMORANDUM TO: Judy Griego — Director FROM: Lesley Cobb - Child Welfare Rate Negotiator DATE: July 29, 2008 SUBJECT: Weld Addendum to the Agreements to Purchase Out-of-home Placement Services (SS-23A) Attached please find the Weld Addendum to the Agreements to Purchase Out-of-home Placement Services (SS-23A) for the following providers: 2008-2009 CONTRACTS FOR TRCCF SERVICES RCCF TRCCF FACILITY FACILITY FACILITY CITY STATE DAILY DAILY FACILITY NAME ID ADDRESS ZIP RATE RATE Courthouse Inc/Daybreak 3640 W 1 - Princeton 46050 Princeton Ave Denver CO 80236-2333 $180.75 $180.75 Courthouse Inc/Marilee 3864 W 2 Center 45724 Princeton Ct Denver CO 80236 $180.75 $180.75 8405 Church 3 Devereux Cleo Wallace 39794 Ranch Blvd Westminster, CO 80021 $180.75 $180.75 El Pueblo Boys' and Girls' One El Pueblo 4 Ranch 45146 Ranch Way Pueblo CO 81006 $180.75 $180.75 15001 E Oxford 5 Excelsior Youth Centers 45243 Ave Aurora CO 80014 $180.75 $180.75 Flatirons Behavioral/Centennial 2255 S 88th 6 Peaks 1520898 Street Louisville CO 80027 $161.66 $161.66 7 Jefferson Hills Aurora 12284 1290 S Patomac Aurora CO 80012 $176.08 $176.08 /vie CO2? r%,f rtA 2008-2168 RCCF TRCCF FACILITY FACILITY FACILITY CITY STATE DAILY DAILY FACILITY NAME ID ADDRESS ZIP RATE RATE 8 Jefferson Hills Lakewood 88459 421 Zang St Lakewood CO 80228 $171.30 $171.30 9 Kidz Ark In Sterling 34340 17282 CR 32 Sterling CO 80751 $180.75 $180.75 Kidz Ark New Raymer 10 Ranch 34341 44132 WCR 129 New Raymer CO 80742 $180.75 $180.75 Lost and Found Inc. 7695 W 59th 11 Arvada 1529554 Ave Arvada CO 80004 $167.93 $167.93 Lost and Found Inc. 9189 S Turkey 12 Morrison 49489 Creek Rd Morrison CO 80465 $167.93 $167.93 13 Mount St. Vincent Home 45174 4159 Lowell Blvd Denver, CO 80211 $180.75 $180.75 Mountain Star Center(At 4177 S Knox Ct 14 Ft. Logan) 13363 - Fl Denver CO 80236 $180.75 $180.75 204 West RFY Inc./Grismore County Road 10- 15 Treatment Center 1530130 E Berthoud CO 80513 $163.87 $163.87 RFY Inc./Prairie View 8233 East 16 Treatment Center 1530128 County Road 18 Loveland CO 80537 $163.87 $163.87 RFY Inc./Wilderness 1435 South 17 Treatment Center 1530131 County Road 17 Berthoud CO 80513 $163.87 $163.87 18 Savio House 48170 325 King St Denver CO 80219 $180.75 $180.75 4821 S Bannock 19 Third Way Center 1507881 St Englewood CO 80010 $179.24 $179.24 Third Way Center- 20 Lincoln 77810 1133 Lincoln Denver CO 80203 $179.24 $179.24 9100 E Lowry 21 Third Way Center- Lowry 1547437 Blvd Denver CO 80230 $175.71 $175.71 Third Way Center- 22 Pontiac 65346 1735 Pontiac St Denver CO 80220 $179.24 $179.24 23 Third Way Center-York 49487 1295 York St Denver CO 80206 $179.24 $179.24 614 S Mathews 24 Turning Point- Mathews 45179 St Fort Collins CO 80521 $178.02 $178.02 25 Turning Point-Shields 100441 801 S Shields St Fort Collins CO 80524 $178.02 $178.02 5924 Highway 26 Youth Track Jeffco 11724 285 Morrison CO 80465 $129.23 $129.23 Youthtrack San Luis 27 Valley 11725 1317 17 St. #8 Alamosa CO 81101 $141.50 $141.50 These contracts have been presented for consent approval to the Board of County Commissioners however; I am requesting your signature along with the Boards to complete these contracts for the FY 2008-2009. If you have any questions please call me at Ext. 6441. WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Courthouse Inc. and Weld County Department of Human Services for the period from July 1, 2008 through June 30, 2009. The following provisions, made this // day of/4141/O" , 2008, are added to the referenced Agreement. Except as modified hereby, all terms of the Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#45724, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$180.75 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$180.75 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis,based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing (3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum &Ctaf �?/ E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Human Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 12. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. 13. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 14. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 15. Add Paragraph 9 to Section VI. The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: A. Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed; B. Deny payment or recover reimbursement for those services or deliverables which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Human Services and the Contractor, or by Human Services as a debt to Human Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 16. Add Paragraph 10 to Section VI. The contractor shall promptly notify Human Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Human Services' Director. The term "litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: ia" "adiaAa( Weld C to the Board // { I\ WELD COUNTY BOARD OF r } HUMAN SERVICES, ON BEHALF i i OF THE WELD COUNTY s," 1 DEPARTMENT OF HUMAN 7 SERVICES -12-4? By: 1G Il By: 1-,'t 4-G>.- - Deputy CI to the Board Chair Signature William H. Jerke AUG 1 1 2008 CONTRACTOR Courthouse Inc. 333 W Hampden Ave, Suite 305 Englewood, CO 80111-2333 BY: 74///2�)d- e_ Li WELD COUNTY DEPARTMENT OF HUMAN SERVICES t, , 7 j C ,„ 4 By: L., nLA \Aut Director 4 Weld County SS-23A Addendum 7n/7A'_ 6? 1 Zoicc Exhibit A Beacon Youth and Family Center Weld County Department of Social Services Scope of Service Beacon Center operates two residential treatment facilities for female adolescents and one residential treatment facility for male adolescents. Our buildings are leased from the State of Colorado and are located on the campus of the Colorado Mental Health Institute at Ft. Logan. The Daybreak Programs described in this scope of services are licensed jointly as both a TRCCF (License #46050) and as an RCCF. The Marilee Center is licensed as both a TRCCF (License #45724) and as an RCCF. We are in full compliance with the rules and regulations that govern TRCCFs and RCCFs. Daybreak Girls' Home is located at 3804 W. Princeton Circle, Denver, Colorado 80236 and Daybreak-Princeton Girls' Home is located at 3640 W. Princeton Circle, Denver, Colorado 80236. The Marilee Center is located at 3874 W. Princeton Circle, Denver, Colorado 80236. Daybreak-Princeton and Marilee are mixed long-term, short-term facilities. These three residential facilities each are licensed for 18 beds, for a total capacity of 54 beds. Each facility is also licensed by the Colorado Alcohol and Drug Abuse Division (ADAD) to provide outpatient treatment services. We are not a locked facility but do have exterior doors alarmed to signal egress. Staff is trained in safety and security protocols appropriate to our type of facility. We operate under DYC Policy 8.1 standards for fire and emergency procedures. Treatment planning/Case management: Within Beacon Center's TRCCF facilities, a staffing will be held with the assigned therapists, Client Manager, client, education staff, personal counselor and parent, as available, within 14 days from the clients' entrance date. During the first 14 days, multiple assessments will be done with the client to help identify strengths, weaknesses, substance abuse patterns and level of involvement, medication concerns, educational learning styles and grade level of functioning, life skills proficiency, talents, legal concerns, family history, client's personal history, recreation preferences, religious and cultural preferences, and the client's current concerns and issues. This information will be gathered and presented within a Mental Health/Diagnostic Evaluation report at the staffing. The 14 day staffing incorporates the development of the client's Individualized Treatment Plan (ITP), developed by our clinicians, family/guardian members, and client manager in conjunction with the Discrete Case Plan. The treatment plan is reviewed in monthly staffings with the Client Manager, client, and parents/guardians. Updates and or changes are discussed during this staffing session. We provide case management to meet the requirements of the client's individualized level of care and their family. As clients begin the transition process, treatment planning and case management reflect the individual client's needs. Family Services: Beacon Center Residential facilities (TRCCF) currently utilize the family systems approach, DBT skills, and Motivational Interviewing skills with the desire to incorporate Functional Family Therapy skills to help the families focus on rebuilding relationships, improving communication, and learning, as a family, how to solve problems together. The frequency of family therapy depends on the individual family, the parents' work schedules, discharge plan, and the assessed level of care. Family therapy is held a minimum of twice a month with phone sessions when family members Exhibit A are located a substantial distance from the facilities. Family therapy is provided by clinically licensed professionals. Therapists are scheduled on a seven-day rotation in order to enhance their availability for families. The family is involved with all phases of treatment, including transition planning. Resources are made available to clients and their families through our Community Home-Based Services Program. In addition, the family can be referred to community support systems. Drug/Alcohol Program Services: The Drug and Alcohol Treatment Program at Beacon Center is centered on a philosophy that helps residents examine their actions and take responsibility for making positive changes in their alcohol and drug abuse habits. This is accomplished by thoroughly assessing the resident's alcohol and drug abuse history and its impact on their lives and the lives of people close to them. Standardized Substance Uses Survey (SUS), the Adolescent Self Assessment Profile II (ASAPII), Substance Abuse Subtle Screenings Inventory (SASSI A2, for adolescents), and the Socrates 7D Personal Drug Use Questionnaire as part of the overall extensive assessment process. We provide culturally responsive support and education related to substance abuse. In addition, we provide gender specific activities that enable the residents to process and understand the reasons they use substances, how substance abuse has interfered with their future goals, alternatives to substance use, and methods for establishing their own long term recovery programs. Residents who have substance abuse issues are expected to participate in this program and are asked to commit to an abstinent lifestyle. All residents participate in a random urinalysis/breathalyzer testing program. They work closely with their therapist to develop and maintain an individualized relapse prevention plan. This plan is strength-based and success- oriented. We have ADAD licensing, number 1374-00, for Level I DUI Education, Level II DUI Education and Therapy, and Treatment Program Specific to Minors. We provide clients up to eight hours per week of drug and alcohol intervention/services as defined by ADAD to meet level of care standards for transitional residential/outpatient treatment. Our services include specialized therapy adjusted for other levels of care and based on the client's individual needs. Drug and alcohol issues are addressed in group, individual and family sessions, and as part of the curriculum in the school. The curriculum currently in place in the school, "Health Smart" is taught by a licensed teacher for one hour per school day. The curriculum is ADAD approved for D&A education groups. We offer three different drug and alcohol treatment groups using evidence based curriculums. Groups are facilitated by licensed and/or Certified Addiction Counselor (CAC) II/III staff. Beacon Center currently employees four CACIII clinicians, three employees with CAC III pending (one of whom is CACII), and five staff in the process of training for CAC. As an agency we are committed to promote professional growth, and we provide financial assistance for CAC training. Our services include an emphasis on supporting clients while transitioning back into the community. We introduce clients to self help groups such as Alcoholics Anonymous and Narcotics Anonymous, as well as other sources of support in the community. We guide and assist clients while they are establishing their future support system and their relapse prevention plan. Exhibit A Our Drug and Alcohol Services Coordinator oversees the drug and alcohol treatment program, provides supervision and training to staff members, facilitates group and individual therapy and relapse intervention therapy. Beacon Center is committed to providing all residents with current information and education about the risks of HIV and other infectious diseases, and the availability of testing centers if they feel they are at risk for having contracted HIV/infectious disease. Mental Health Services: Beacon Center clinicians are licensed as Licensed Clinical Social Workers (LCSW), Licensed Professional Counselors (LPC), and/or Licensed Marriage and Family Therapists (LMFT). Evidence based theories used consist of Cognitive Behavioral Therapy, Motivational Enhancement Therapy, Dialectic Behavioral Therapy and Systems Therapy. These evidence based clinical approaches address co- occurring diagnoses. Clients receive weekly individual therapy, family therapy and group therapy. The frequency and intensity of mental health services are appropriate to the client's level of care and are determined by previous assessments and on-going case management. Group treatment is prescriptive and covers a variety of mental health issues. Groups meet once a week. A contracted psychiatrist provides medication evaluations and medication monitoring on a weekly basis. A contracted clinical psychologist provides psychological evaluations for those clients who have not had one in the last two years, or as needed on an individual case basis. Our therapeutic milieu is supervised by a licensed clinician and incorporates interventions designed to promote resident success and pro-social development. Treatment Coordinators and therapists provide clinical direction daily to milieu counselors. Behavioral and clinical interventions are coordinated to promote individualized, age appropriate, strength based and gender specific skill development. The services provided meet the TRCCF standards of Level B Care, but can be adjusted to meet Level A or Level C Care when appropriate. Level B Care identifies one family session, one individual session, and three groups per week. Every client's service plan is reviewed monthly by a multi-disciplinary team to insure that treatment is effective. Medical Services: There is a medical clinic at the Daybreak facility and all residents receive in-house attention at that location. A consulting physician, Dr. Ron Eager, who comes to the facility one or two times per week, provides medical services. He is responsible for doing the initial physical exam within 72 hours, as well as providing routine medical care, and makes any necessary arrangement for further care. Additionally, two Nurse Practitioners from Rocky Mountain Youth Pediatrics visit one time per week each to provide medical care to residents (under the supervision of Dr. Eager). A dental exam is scheduled within 30 days at Midtown Dental (Dr. Tsumara), Comfort Dental, or Santa Fe Oral Surgery (Dr Sedhom). Eye exams are scheduled within 30 days with Dr. Hansen, Optometrist. The Treatment Coordinator completes Medicaid eligibility forms within five days of the client's admission to the Daybreak Programs. For those clients who have other insurance coverage, we secure the necessary information from the parents and begin the process of working with their medical providers. Drs. Eager, Tsumara, Sedhom, and Hansen are all licensed professionals in the State of Colorado. Exhibit A Medical emergencies are handled through the Porter and Swedish hospitals' emergency rooms. Follow-up care is done through Rocky Mountain Pediatrics clinic on Dr. Eager's referrals. Prescriptions are filled through Midtown Pharmacy and are delivered daily, as needed. Prescriptions may also be filled at a nearby King Soopers or Walgreen's pharmacy. All medical, dental, and eye appointments are documented on a medical tracking sheet and an interval exam form is completed by the doctor for the client's file. Prescription medications for the residents are stored in a double locked cabinet in the administrative office, which also is always locked unless staff is present. Staff is required to complete Qualified Medication Administration Person (QMAP) training as approved by the State of Colorado Department of Public Health and Environment. Staff is further trained in-house to follow a strict regimen in storing, dispensing, and disposing of medication. This activity is closely monitored and medication-dispensing reports (including addressing errors) are presented monthly to the agency's Continuing Quality Improvement Committee. Treatment Services: Placement in the Beacon Center Residential Programs is viewed as a continuum of care for our clients. Clinical reports from previous placements, discrete case plans, the CJRA, and input from the Case Manager, client, and family members or guardians as well as the Beacon Center clinical assessments are all integrated to form the CTP (Client Treatment Plan). This plan is created for each individual client and family using additional criteria of age, diagnosis, circumstances, strengths and any special needs. The frequency of treatment service is indicated in the CTP. Individual therapy is provided by clinically licensed therapists who are trained in a variety of treatment modalities, such as Motivational Enhancement Therapy, Dialectic Behavioral Therapy, Cognitive-Behavioral Therapy, and Systems Therapy. Clinically Licensed therapists utilize a Family System's Approach in providing family therapy. Group treatment is prescriptive and topic specific, based on the needs of the client and the milieu. Group therapy is provided by clinically licensed therapists, CACII or CACIII counselors, and bachelor's level counselors. The services provided meet the TRCCF standards of Level B Care, but can be adjusted to meet Level A or Level C Care when appropriate. Level B Care identifies 1 Family /week, 1 Individual/week, and 3 groups per week. Educational Services: Beacon Center's Educational Program is approved by the Colorado Department of Education, meeting both Denver Public School curriculum guidelines as well as Colorado State standards. This level of recognition allows our students to obtain transferable credit when discharged. A transitional conference with the accepting school provides information about the student to ensure that there is a continuity of care and continued positive gains. The school serves the educational needs of students in the Residential Treatment programs as well as the Day Students who enroll because of struggles in the public school system. Beacon Center's Educational Program is a co-ed environment and serves the educational needs of students in the Residential Treatment programs as well as the Day Students who enroll because of struggles in the public school system. The school's program addresses the therapeutic needs of students in a variety of ways. All the Exhibit A education staff receives special training in working therapeutically with the students. A weekly class addressing substance use, abuse and prevention is taught along with a weekly Independent Living Skills class for clients 15 years and younger. For the clients who are 16 years and older, a licensed therapist teaches an independent living class to support these youth who require a more intensive level of skills in this area. Conflict Resolution skills, Restorative Justice, Social Skills, and Anger Management classes are taught throughout the school year. The curriculum is designed to ensure students are working towards grade advancement, earning high school credits or passing their GED. We provide students who are pursuing a GED with specific class instructors and support for these clients as they prepare for the examinations. Clients take pre-tests that identify difficult areas and the teacher works with them individually in these areas. Instruction is delivered in a variety of ways, including whole class, small groups and individuals. Lessons are designed to address individual needs and learning styles. Art and recreation classes are part of the curriculum. Based on availability, and the appropriateness to meeting an individual student's needs, off-grounds, public school setting is a possibility. Vocational training is available through various alternative educational settings within the community. Our education program strives to meet the needs of the individual student as well as focusing on their strengths. Some students do not enter the school program with a Special Education Individualized Education Plan (IEP). We assess all students' level of academic functioning using standardized tests. These results provide important information to aid in the development of instructional strategies for a personalized learning plan (PLP). Our education staff provides the highest standards of instructional strategies for teaching troubled adolescents. Education staff consists of four licensed teachers, three teachers aides, and an Education Director. Licensing documents for all are attached. Denver Public Schools provide a Special Education teacher to our school, who is not our employee and therefore is not listed on our staffing. Administrative and support functions are covered by other Beacon Center staff not specifically assigned to the school. Residential and community staff, including Program Directors, Treatment Coordinators, counselors, therapists, the Drug/Alcohol Coordinator, and the Independent Living therapist, interact on a daily basis with school staff and students to assure that education programs are well coordinated and therapeutically appropriate for each student. Exhibit A Beacon Youth and Family Center Weld County Department of Social Services Daily Rate for Service Beacon Center's rate for TRCCF service for fiscal year 2008/09 is $180.22 per day. This is based on the $178.08 rate for FY 2007/08 plus 1.2%, which is the amount of increase we have been informed to expect. This rate does not reflect fee-for-service clinical treatment billable through Medicaid. WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Courthouse Inc. and Weld County Department of Human Services for the period from July 1, 2008 through June 30, 2009. a The following provisions, made this //—day of ,41/9y574, 2008, are added to the referenced Agreement. Except as modified hereby, all terms of the Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#46050, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$180.75 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$180.75 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff,parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing (3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum &a'8•,ii/G4 E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include,but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Human Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery,bribery, falsification or destruction of records,making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 12. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. 13. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 14. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 15. Add Paragraph 9 to Section VI. The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: A. Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed; B. Deny payment or recover reimbursement for those services or deliverables which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Human Services and the Contractor, or by Human Services as a debt to Human Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 16. Add Paragraph 10 to Section VI. The contractor shall promptly notify Human Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Human Services' Director. The term "litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: M_____""_'( Weld Co he Board /i� /�.. WELD COUNTY BOARD OF I I HUMAN SERVICES, ON BEHALF OF THE WELD COUNTY 8 - / ✓;"� DEPARTMENT OF HUMAN > J SERVICES By: %LC1Gait.., ate By: Deputy Cle to the Board Chair Signature William H. Jerke AUG 1 1 2008 CONTRACTOR Courthouse Inc. 333 W Hampden Ave, Suite 305 Englewood, CO 80110-2333 By WELD COUNTY DEPARTMENT OF HUMAN SERVICES By: 'rector • 4 Weld County SS-23A Addendum 0a9er- air Exhibit A Beacon Youth and Family Center Weld County Department of Social Services Scope of Service Beacon Center operates two residential treatment facilities for female adolescents and one residential treatment facility for male adolescents. Our buildings are leased from the State of Colorado and are located on the campus of the Colorado Mental Health Institute at Ft. Logan. The Daybreak Programs described in this scope of services are licensed jointly as both a TRCCF (License #46050) and as an RCCF. The Marilee Center is licensed as both a TRCCF (License #45724) and as an RCCF. We are in full compliance with the rules and regulations that govern TRCCFs and RCCFs. Daybreak Girls' Home is located at 3804 W. Princeton Circle, Denver, Colorado 80236 and Daybreak-Princeton Girls' Home is located at 3640 W. Princeton Circle, Denver, Colorado 80236. The Marilee Center is located at 3874 W. Princeton Circle, Denver, Colorado 80236. Daybreak-Princeton and Marilee are mixed long-term, short-term facilities. These three residential facilities each are licensed for 18 beds, for a total capacity of 54 beds. Each facility is also licensed by the Colorado Alcohol and Drug Abuse Division (ADAD) to provide outpatient treatment services. We are not a locked facility but do have exterior doors alarmed to signal egress. Staff is trained in safety and security protocols appropriate to our type of facility. We operate under DYC Policy 8.1 standards for fire and emergency procedures. Treatment planning/Case management: Within Beacon Center's TRCCF facilities, a staffing will be held with the assigned therapists, Client Manager, client, education staff, personal counselor and parent, as available, within 14 days from the clients' entrance date. During the first 14 days, multiple assessments will be done with the client to help identify strengths, weaknesses, substance abuse patterns and level of involvement, medication concerns, educational learning styles and grade level of functioning, life skills proficiency, talents, legal concerns, family history, client's personal history, recreation preferences, religious and cultural preferences, and the client's current concerns and issues. This information will be gathered and presented within a Mental Health/Diagnostic Evaluation report at the staffing. The 14 day staffing incorporates the development of the client's Individualized Treatment Plan (ITP), developed by our clinicians, family/guardian members, and client manager in conjunction with the Discrete Case Plan. The treatment plan is reviewed in monthly staffings with the Client Manager, client, and parents/guardians. Updates and or changes are discussed during this staffing session. We provide case management to meet the requirements of the client's individualized level of care and their family. As clients begin the transition process, treatment planning and case management reflect the individual client's needs. Family Services: Beacon Center Residential facilities (TRCCF) currently utilize the family systems approach, DBT skills, and Motivational Interviewing skills with the desire to incorporate Functional Family Therapy skills to help the families focus on rebuilding relationships, improving communication, and learning, as a family, how to solve problems together. The frequency of family therapy depends on the individual family, the parents' work schedules, discharge plan, and the assessed level of care. Family therapy is held a minimum of twice a month with phone sessions when family members Exhibit A are located a substantial distance from the facilities. Family therapy is provided by clinically licensed professionals. Therapists are scheduled on a seven-day rotation in order to enhance their availability for families. The family is involved with all phases of treatment, including transition planning. Resources are made available to clients and their families through our Community Home-Based Services Program. In addition, the family can be referred to community support systems. Drug/Alcohol Program Services: The Drug and Alcohol Treatment Program at Beacon Center is centered on a philosophy that helps residents examine their actions and take responsibility for making positive changes in their alcohol and drug abuse habits. This is accomplished by thoroughly assessing the resident's alcohol and drug abuse history and its impact on their lives and the lives of people close to them. Standardized Substance Uses Survey (SUS), the Adolescent Self Assessment Profile II (ASAPII), Substance Abuse Subtle Screenings Inventory (SASSI A2, for adolescents), and the Socrates 7D Personal Drug Use Questionnaire as part of the overall extensive assessment process. We provide culturally responsive support and education related to substance abuse. In addition, we provide gender specific activities that enable the residents to process and understand the reasons they use substances, how substance abuse has interfered with their future goals, alternatives to substance use, and methods for establishing their own long term recovery programs. Residents who have substance abuse issues are expected to participate in this program and are asked to commit to an abstinent lifestyle. All residents participate in a random urinalysis/breathalyzer testing program. They work closely with their therapist to develop and maintain an individualized relapse prevention plan. This plan is strength-based and success- oriented. We have ADAD licensing, number 1374-00, for Level I DUI Education, Level II DUI Education and Therapy, and Treatment Program Specific to Minors. We provide clients up to eight hours per week of drug and alcohol intervention/services as defined by ADAD to meet level of care standards for transitional residential/outpatient treatment. Our services include specialized therapy adjusted for other levels of care and based on the client's individual needs. Drug and alcohol issues are addressed in group, individual and family sessions, and as part of the curriculum in the school. The curriculum currently in place in the school, "Health Smart" is taught by a licensed teacher for one hour per school day. The curriculum is ADAD approved for D&A education groups. We offer three different drug and alcohol treatment groups using evidence based curriculums. Groups are facilitated by licensed and/or Certified Addiction Counselor (CAC) II/III staff. Beacon Center currently employees four CACIII clinicians, three employees with CAC III pending (one of whom is CACII), and five staff in the process of training for CAC. As an agency we are committed to promote professional growth, and we provide financial assistance for CAC training. Our services include an emphasis on supporting clients while transitioning back into the community. We introduce clients to self help groups such as Alcoholics Anonymous and Narcotics Anonymous, as well as other sources of support in the community. We guide and assist clients while they are establishing their future support system and their relapse prevention plan. Exhibit A Our Drug and Alcohol Services Coordinator oversees the drug and alcohol treatment program, provides supervision and training to staff members, facilitates group and individual therapy and relapse intervention therapy. Beacon Center is committed to providing all residents with current information and education about the risks of HIV and other infectious diseases, and the availability of testing centers if they feel they are at risk for having contracted HIV/infectious disease. Mental Health Services: Beacon Center clinicians are licensed as Licensed Clinical Social Workers (LCSW), Licensed Professional Counselors (LPC), and/or Licensed Marriage and Family Therapists (LMFT). Evidence based theories used consist of Cognitive Behavioral Therapy, Motivational Enhancement Therapy, Dialectic Behavioral Therapy and Systems Therapy. These evidence based clinical approaches address co- occurring diagnoses. Clients receive weekly individual therapy, family therapy and group therapy. The frequency and intensity of mental health services are appropriate to the client's level of care and are determined by previous assessments and on-going case management. Group treatment is prescriptive and covers a variety of mental health issues. Groups meet once a week. A contracted psychiatrist provides medication evaluations and medication monitoring on a weekly basis. A contracted clinical psychologist provides psychological evaluations for those clients who have not had one in the last two years, or as needed on an individual case basis. Our therapeutic milieu is supervised by a licensed clinician and incorporates interventions designed to promote resident success and pro-social development. Treatment Coordinators and therapists provide clinical direction daily to milieu counselors. Behavioral and clinical interventions are coordinated to promote individualized, age appropriate, strength based and gender specific skill development. The services provided meet the TRCCF standards of Level B Care, but can be adjusted to meet Level A or Level C Care when appropriate. Level B Care identifies one family session, one individual session, and three groups per week. Every client's service plan is reviewed monthly by a multi-disciplinary team to insure that treatment is effective. Medical Services: There is a medical clinic at the Daybreak facility and all residents receive in-house attention at that location. A consulting physician, Dr. Ron Eager, who comes to the facility one or two times per week, provides medical services. He is responsible for doing the initial physical exam within 72 hours, as well as providing routine medical care, and makes any necessary arrangement for further care. Additionally, two Nurse Practitioners from Rocky Mountain Youth Pediatrics visit one time per week each to provide medical care to residents (under the supervision of Dr. Eager). A dental exam is scheduled within 30 days at Midtown Dental (Dr. Tsumara), Comfort Dental, or Santa Fe Oral Surgery (Dr Sedhom). Eye exams are scheduled within 30 days with Dr. Hansen, Optometrist. The Treatment Coordinator completes Medicaid eligibility forms within five days of the client's admission to the Daybreak Programs. For those clients who have other insurance coverage, we secure the necessary information from the parents and begin the process of working with their medical providers. Drs. Eager, Tsumara, Sedhom, and Hansen are all licensed professionals in the State of Colorado. Exhibit A Medical emergencies are handled through the Porter and Swedish hospitals' emergency rooms. Follow-up care is done through Rocky Mountain Pediatrics clinic on Dr. Eager's referrals. Prescriptions are filled through Midtown Pharmacy and are delivered daily, as needed. Prescriptions may also be filled at a nearby King Soopers or Walgreen's pharmacy. All medical, dental, and eye appointments are documented on a medical tracking sheet and an interval exam form is completed by the doctor for the client's file. Prescription medications for the residents are stored in a double locked cabinet in the administrative office, which also is always locked unless staff is present. Staff is required to complete Qualified Medication Administration Person (QMAP) training as approved by the State of Colorado Department of Public Health and Environment. Staff is further trained in-house to follow a strict regimen in storing, dispensing, and disposing of medication. This activity is closely monitored and medication-dispensing reports (including addressing errors) are presented monthly to the agency's Continuing Quality Improvement Committee. Treatment Services: Placement in the Beacon Center Residential Programs is viewed as a continuum of care for our clients. Clinical reports from previous placements, discrete case plans, the CJRA, and input from the Case Manager, client, and family members or guardians as well as the Beacon Center clinical assessments are all integrated to form the CTP (Client Treatment Plan). This plan is created for each individual client and family using additional criteria of age, diagnosis, circumstances, strengths and any special needs. The frequency of treatment service is indicated in the CTP. Individual therapy is provided by clinically licensed therapists who are trained in a variety of treatment modalities, such as Motivational Enhancement Therapy, Dialectic Behavioral Therapy, Cognitive-Behavioral Therapy, and Systems Therapy. Clinically Licensed therapists utilize a Family System's Approach in providing family therapy. Group treatment is prescriptive and topic specific, based on the needs of the client and the milieu. Group therapy is provided by clinically licensed therapists, CACII or CACIII counselors, and bachelor's level counselors. The services provided meet the TRCCF standards of Level B Care, but can be adjusted to meet Level A or Level C Care when appropriate. Level B Care identifies 1 Family /week, 1 Individual/week, and 3 groups per week. Educational Services: Beacon Center's Educational Program is approved by the Colorado Department of Education, meeting both Denver Public School curriculum guidelines as well as Colorado State standards. This level of recognition allows our students to obtain transferable credit when discharged. A transitional conference with the accepting school provides information about the student to ensure that there is a continuity of care and continued positive gains. The school serves the educational needs of students in the Residential Treatment programs as well as the Day Students who enroll because of struggles in the public school system. Beacon Center's Educational Program is a co-ed environment and serves the educational needs of students in the Residential Treatment programs as well as the Day Students who enroll because of struggles in the public school system. The school's program addresses the therapeutic needs of students in a variety of ways. All the Exhibit A education staff receives special training in working therapeutically with the students. A weekly class addressing substance use, abuse and prevention is taught along with a weekly Independent Living Skills class for clients 15 years and younger. For the clients who are 16 years and older, a licensed therapist teaches an independent living class to support these youth who require a more intensive level of skills in this area. Conflict Resolution skills, Restorative Justice, Social Skills, and Anger Management classes are taught throughout the school year. The curriculum is designed to ensure students are working towards grade advancement, earning high school credits or passing their GED. We provide students who are pursuing a GED with specific class instructors and support for these clients as they prepare for the examinations. Clients take pre-tests that identify difficult areas and the teacher works with them individually in these areas. Instruction is delivered in a variety of ways, including whole class, small groups and individuals. Lessons are designed to address individual needs and learning styles. Art and recreation classes are part of the curriculum. Based on availability, and the appropriateness to meeting an individual student's needs, off-grounds, public school setting is a possibility. Vocational training is available through various alternative educational settings within the community. Our education program strives to meet the needs of the individual student as well as focusing on their strengths. Some students do not enter the school program with a Special Education Individualized Education Plan (IEP). We assess all students' level of academic functioning using standardized tests. These results provide important information to aid in the development of instructional strategies for a personalized learning plan (PLP). Our education staff provides the highest standards of instructional strategies for teaching troubled adolescents. Education staff consists of four licensed teachers, three teachers aides, and an Education Director. Licensing documents for all are attached. Denver Public Schools provide a Special Education teacher to our school, who is not our employee and therefore is not listed on our staffing. Administrative and support functions are covered by other Beacon Center staff not specifically assigned to the school. Residential and community staff, including Program Directors, Treatment Coordinators, counselors, therapists, the Drug/Alcohol Coordinator, and the Independent Living therapist, interact on a daily basis with school staff and students to assure that education programs are well coordinated and therapeutically appropriate for each student. Exhibit A Beacon Youth and Family Center Weld County Department of Social Services Daily Rate for Service Beacon Center's rate for TRCCF service for fiscal year 2008/09 is $180.22 per day. This is based on the $178.08 rate for FY 2007/08 plus 1.2%, which is the amount of increase we have been informed to expect. This rate does not reflect fee-for-service clinical treatment billable through Medicaid. WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Devereux Cleo Wallace and Weld County Department of Human Services for the period from July 1, 2008 through June 30, 2009. The following provisions, made this // day of41/0k5/1 , 2008, are added to the referenced Agreement. Except as modified hereby, all terms of the Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#39794, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$180.75 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$180.75 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing (3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); ] Weld County SS-23A Addendum /LC? E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Human Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 12. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. 13. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 14. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 15. Add Paragraph 9 to Section VI. The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: A. Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed; B. Deny payment or recover reimbursement for those services or deliverables which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Human Services and the Contractor, or by Human Services as a debt to Human Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 16. Add Paragraph 10 to Section VI. The contractor shall promptly notify Human Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Human Services' Director. The term "litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: go#14024* Weld Count he Board N WELD COUNTY BOARD OF HUMAN SERVICES, ON BEHALF OF THE WELD COUNTY DEPARTMENT OF HUMAN tib SERVICES By: By: GL,Sc 1/ Deputy Cl to the Board Chair Signature William H. Jerke AUG 1 1 2008 CONTRACTOR Devereux Cleo Wallace 8405 Church Ranch Blvd Westminster, CO 80021 By: LA_ WELD COUNTY DEPARTMENT OF HUMAN SERVICES By: dA, D rector 4 Weld County SS-23A Addendum aonf--a/6i WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between El Pueblo Boys' and Girls' Ranch and Weld County Department of Human Services for the period from July 1, 2008 through June 30, 2009. The following provisions, made this /1 —day ay of Altiva3,/, 2008, are added to the referenced Agreement. Except as modified hereby, all terms of the Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#45146, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$180.75 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$180.75 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); t Weld County SS-23A Addendum OMIT- /tvv E. Other/miscellaneous items considered usual in the care and supervision of the child, include,but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number (970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Human Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal depaitiuent or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery,bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 12. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. 13. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 14. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 15. Add Paragraph 9 to Section VI. The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: A. Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed; B. Deny payment or recover reimbursement for those services or deliverables which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Human Services and the Contractor, or by Human Services as a debt to Human Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 16. Add Paragraph 10 to Section VI. The contractor shall promptly notify Human Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five(5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Human Services' Director. The term "litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: 441/14/1444 Weld County Cl }y oard WELD COUNTY BOARD OF ` .` =� HUMAN SERVICES, ON BEHALF OF THE WELD COUNTY DEPARTMENT OF HUMAN s� SERVICES BY: 42--4--4 //del -61-64, By: Deputy Cl to the Board Chair Signature William H. Jerke AUG 1 1 2008 CONTRACTOR El Pueblo Boys' and Girls' Ranch One El Pueblo Ranch Way Pueblo, CO 81006cuxc,� By: ( ��1�.4e. WELD COUNTY DEPARTMENT OF HUMAN SERVICES By: l irector 4 Weld County SS-23A Addendum � tX1t27 P— o?/&'t EXHIBIT A CONFIDENTIAL FOR PROFESSIONAL USE ONLY DO NOT FORWARD OR DUPLICATE TO OTHER AGENCIES OR INDIVIDUALS Population Served ( El Pueblo serves boys and girls ages 10— 18 without regard to race, color, creed, national origin, f sex, sexual orientation, religion, age, disability or other legally protected status in admission to, access to, or operations of its programs, services or activities. All youth served at El Pueblo have a psychiatric disorder as described in DSM IV. Male clients may also be classified as sex offenders, have severe cognitive behavioral disorders, substance abuse issues, or cognitive delays. Female clients may also have cognitive behavioral disorders and/or substance abuse issues. The boys are served through the following programs: CHANGE Commitment, Honor, Achievement and New Growth Experiences OSTAY Offense Specific Treatment of Aggressive Youth STRIVE Strength, Teamwork, Respect, Independence, and Vision for Excellence The girls are served through the SPIRIT (Self, Pride, Integrity, Resiliency and Independence Training) Program. Both boys and girls with substance use/abuse issues are served through the Substance Education and Addiction Recovery (SEAR) Program Residents accepted to El Pueblo exhibit behaviors that indicate that they cannot be adequately or safely treated in a less restrictive setting. Referred residents typically present with issues of lying,; stealing; running away; substance abuse; school expulsion; sexual promiscuity; fire setting; history of being abused or neglected and inability to function in school, home, or foster care. The typical resident has failed in outpatient treatment and foster care. Typical diagnosis would be Post Traumatic Stress Disorder; Oppositional Defiant Disorder, Mood Disorders, Bipolar Disorder; Attention —Deficit Hyperactivity Disorder; Substance Abuse or Dependence; Cyclothymic Disorder;Dysthymic Disorder; other Depressive Disorders, and Anxiety Disorders. Staff Ratio Staff ratios are as follows: • Therapeutic Cottages 1:6 • Reflection Centers 1:4 • Donegan Hall 1:6 • Transition Houses 1:10 • STRIVE Cottages 1:3 • STRIVE II 1:4 ©2007, El Pueblo...an Adolescent Treatment Community Pueblo, CO. 3 Rev. 3/1/08 tw CONFIDENTIAL FOR PROFESSIONAL USE ONLY DO NOT FORWARD OR DUPLICATE TO OTHER AGENCIES OR INDIVIDUALS Admission Criteria El Pueblo accepts Boys and Girls that meet the following Admission Criteria • Must be between the ages of 10— 18 years • Must have no active psychosis. • Must have an IQ sufficient for comprehension of treatment material (functioning of 70 or above), and reading and writing skills of at least third grade level. o For children with an IQ lower than 70, please refer to the PROGRAM ENHANCEMENTS — STRIVE PROGRAM for specific program admission criteria. • Must be willing to participate in treatment. • Must meet DSM IV medical necessity criteria for residential treatment center placement. o Must have a psychiatric disorder as described in DSM IV. o The adolescent is being treated in the most appropriate and least restrictive setting. o The severity of illness must make it impossible to manage the treatment in a normal home environment or in an alternate living situation such as a group home, foster care placement, etc. o One or more of the following Severity of Illness Criteria must be met. • Impaired ability to maintain/sustain adequate functioning in three of the major life areas (school, social, family, and psychosocial) • Significant risk of harm to self and/or others such as substance abuse, aggression, or self-abusive behavior. • Demonstrated inability to be managed in a less restrictive setting. • Inability to cope with stressors without victimizing self or others. o The parent/guardian/family member or custodian accepts responsibility for participating in the treatment program and/or permanency planning. o Planned treatment services can reasonably be expected to improve the adolescent's conditions. Potential exclusion criteria • Requiring a locked facility — El Pueblo...an Adolescent Treatment Community is not a locked facility. • Acute Level of Violence — If a youth presents a level of violence that is considered unmanageable at this level. For example a youth who is being charged for murder or major assaults against staff and/or peers. The Director of Clinical Services evaluates the behavior of each youth on a case-by-case basis. • Acute Inpatient Medical / Surgical Care — A youth who may have a medical condition that may require intense medical care • Refusal to Contract for Safety — A youth who is actively suicidal or homicidal and refuses to contract for safety. The Director of Clinical Services will also evaluate the I behavior of a youth who has or may have recently tried to commit suicide. ©2007, El Pueblo...an Adolescent Treatment Community 4 Pueblo, CO. Rev. 3/1/08 tw r , I CONFIDENTIAL ti�H I'HOC LSSIONAL USE ONLY Nu NOI 1 ORWARD OR DUPLICATE TO UIIII R M:it NCIES OR INDIVIDUALS I Referral Process I, Contact Admissions Department at 719-404-1107 to ascertain bed availability and potential length of wait for an opening. 2, A referral packet will be required which consists of the following: * A Psychological Evaluation completed within the past three years (must provide I.Q. and diagnosis). • Documentation of current problems, that bring about the need for placement and current medications. • Family and Social History, to include previous treatment and/or placements, and resident and family response to treatment. • A police report, investigation or interview, polygraph results, and other documents will he requested if the youth is accepted to assist in breaking through the denial of the problems. I. Clinical Director and Admissions Officer will review the material to conduct a preliminary assessment of presenting problems in social, physical health, mental health, psychological concerns, physical and/or sexual abuse, and any concerns about assaultive or destructive behavior. The youth's motivation and ability to benefit from the treatment program are also assessed. If it is determined that El Pueblo is the least restrictive setting and appropriate to meet the youth's needs, the Admissions Officer will contact the referring person and inform them of the youth's acceptance or non-acceptance into the program within 48 hours of receipt of the additional referral information. Possible admission dates will be identified at that time. The Admissions Officer will mail admission consents and releases required for intake to the parent(s)of the youth to facilitate a smooth intake process. 4. Copies of the youth's birth certificate, social security card, immunization record and record of last school attended will be required prior to actual admission. 'I'rcatment Approach the El Pueblo Boys' & Girls'Ranch Performance Program for Youth© is based on a Positive Cognitive Behavioral approach to deal with the biological, psychological, intellectual, spiritual, and social needs of the children placed in our care. The staff use a psychotherapeutic approach Io help promote positive change in the boys and girls, to help alleviate emotional distress, and to address a myriad of psycho/social/behavioral issues. our Rehabilitative Services Teams identify and treat difficulties arising from a child's irrational thinking, misperceptions, dysfunctional thoughts, and faulty learning. Therapy is conducted individually with the youth, and collectively with their families. Pueblo...an Adolescent Treatment Community 5 l'iFAIri ('(1 Mel, 1 t 1114 fir CONFIDENTIAL FOR PROFESSIONAL USE ONLY DO NOT FORWARD OR DUPLICATE TO OTHER AGENCIES OR INDIVIDUALS A holistic approach to treatment is sought with a consistent message being delivered throughout the various components of the program — clinical, milieu, education, and recreation and leisure. The El Pueblo Boys' & Girls' Ranch Performance Program for Youth© incorporates — structure, discipline, consistency, safety, and positive reinforcement. Our goal is to restructure the child's thoughts, perceptions, and beliefs. Such restructuring facilitates behavioral and emotional change. During therapy and daily milieu, coping skills and abilities are assessed and further developed. The El Pueblo Boys' and & Girls' Ranch Performance Program for Youth© consists of five performance standards: Performance Standard I: Orientation & Evaluation Getting to Know Self/Getting to Know the Rules of El Pueblo Performance Standard II: Skill Development Improving Self Performance Standard III: Self Development Enhancing Self-Esteem & Self Worth Performance Standard IV: Social Application Applying Learned Skills Performance Standard V: Leadership Choosing Service over Self Interest Treatment Review Rehabilitative Services Team Rehabilitation teams consist of the therapist, recreation staff, milieu staff, nursing, and education personnel. The rehabilitation team meets every week. Individual residents are reviewed to ensure collaboration and coordination of services. Residents who are eligible for Performance Standard advancement come before the rehabilitation team for an oral exam and review of accomplishments. Advancement to the next Performance Standard is determined by this team. Residents who are exhibiting significant behavioral problems are also required to come before this team to address the problematic behaviors. Individual plans or contracts to help the resident with behavioral improvement are developed in the rehabilitation team meeting. In addition, privilege requests are reviewed for team approval. The rehabilitation team makes recommendations for discharge. Provisions of Care Clinical Services Treatment is individualized based on the child's needs. Clinical Services are administered by Master's level therapists who have credentials as L.P.C.'s, C.A.C. III's, L.A.C, M.S.W., and ©2007, El Pueblo...an Adolescent Treatment Community 6 Pueblo, CO. Rev. 3/1/08 tw 4 CONFIDENTIAL FOR PROFESSIONAL USE ONLY DO NOT FORWARD OR DUPLICATE TO OTHER AGENCIES OR INDIVIDUALS A.T.R. Several of El Pueblo's therapists have training in Dialectic Behavior Therapy (DBT) and Eye Movement Desensitization Replacement Therapy (EMDR). With this specialized training, treatment can more effectively address self-harm behavior, trauma, victimization and sexually reactive problems, sexual compulsivity, and sexual abuse behavior. Individual Therapy Individual therapy is provided by Master's level, licensed therapists who build on the child's strengths, are goal oriented, and individualize treatment based upon the individual presenting problems and ability to participate in treatment. Themes in individual therapy are derived from the Individual Comprehensive Service Plan and are focused on building skills, self awareness, and resolution of conflicts around historical events and current problems with functioning in the community. The frequency of individual therapy is determined by the resident's Individualized Comprehensive Service Plan. Typically individual therapy takes place once a week when the resident is in early stages of treatment and may be increased or decreased as needed. Family Therapy Family therapy will be scheduled as soon as the resident has stabilized; usually within 7 to 10 days of admission. Family sessions will be conducted from one time per week to one time per month depending upon parent's ability to come to El Pueblo. Telephone conference calls may be used for residents whose parents live a significant distance from the facility. As the resident approaches the last three months of his treatment at El Pueblo, parents will be asked to participate in family therapy on a more frequent basis. Group Therapy Residents are assigned to specific groups based upon the treatment needs. A variety of topics are offered on a rotating basis. Groups offered include, but are not limited to the following. Anger Management, Thinking for a Change, Survivors, DBT, Healthy Sexuality, Self Esteem, Guided Imagery, Boys to Men, Child of Addicts, Social Skills, Stress Management, and Substance Abuse treatment. Psychiatric Services El Pueblo has a half-time psychiatrist who provides case supervision and medication management services. Interdisciplinary staffings are held on a monthly basis with the on-staff psychiatrist. ©2007, El Pueblo...anAdolescent Treatment Community 7 Pueblo, CO Rev. 3/1/08 tw CONFIDENTIAL FOR PROFESSIONAL USE ONLY DO NOT FORWARD OR DUPLICATE TO OTHER AGENCIES OR INDIVIDUALS Medical Services All residents at El Pueblo are provided medical services. A physical examination is scheduled at Pueblo Community Health Center (PCHC) after admission unless a physical examination has been completed within 30 days. All residents are registered at PCHC. Request for medical/health services or information are forwarded to the nursing department via a Medical Needs Screening Sheet, which is responded to by the nursing department. Requests for immediate medical services are sent to the medical/nursing department for prompt responses. New residents are also scheduled for dental services at Takaki Dental or at their private dentist if appropriate. Eye examinations are done at Abba eye care, who provide glasses for residents. All medication administered to El Pueblo residents is ordered by the onsite psychiatrist. Medication coming in with residents is continued until seen by the onsite psychiatrist. Medication consents are obtained from family/guardian or caseworker prior to administration. Medication teaching is done by the psychiatrist and nursing staff at El Pueblo. Medications are obtained from a local pharmacy and refilled as necessary. Medication is administered by licensed nursing staff and by qualified medication administrators who pass a State of Colorado class and test. Medication administration is monitored by the Milieu Director and by the Nursing Department. Medications for medical conditions are ordered by Pueblo Community Health Center (PCHC) or by area health providers. They are dispensed by the local pharmacy or by Walgreen's pharmacies after hours. All medications administered are recorded on agency approved medication administration sheets. Prescription Not Required (PRN) medications are recorded on PRN sheets which indicate the condition for which the medication is given and the resident's response to the medication. Controlled drugs are counted each shift and documented on a control drug sheet when administered. When residents are transferred from one cottage to another, medications are counted and a medication transfer sheet is attached to the medication and sent to the receiving cottage. When residents are not Medicaid-eligible, services are arranged utilizing private insurance carriers. Milieu Services Residents benefit from 24 hour structured milieu services. The milieu program provides repetitive learning scenarios with immediate rewards of increased levels of freedom and privileges. The Performance Standards also offers a resident immediate feedback, and a chance for processing. Natural consequences occur when a resident does not comply with the daily schedule. The Performance Standards Program is also used as a tool to monitor the general health of the milieu. Residents must meet the requirements of each Performance Standard as to daily behaviors, learning, therapeutic components, and academic and recreation criteria to be eligible to advance to the next Performance Standard. C 2007, El Pueblo...an Adolescent Treatment Community 8 Pueblo, CO Rev, 3/1/08 tw CONFIDENTIAL FOR PROFESSIONAL USE ONLY DO NOT FORWARD OR DUPLICATE TO OTHER AGENCIES OR INDIVIDUALS p 'i Crisis Intervention All staff members are trained in crisis intervention techniques. El Pueblo emphasizes using crises as opportunities for learning. Residents are taught to recognize their "triggers" and to learn to intervene in their cycle of dysfunctional behavior in response to these triggers, thereby acquiring new skills for effective daily living. Social Skills Training Youth Service Workers provide ongoing social skills training. Recreation and Leisure Therapy El Pueblo takes a holistic approach to healing each child. The recreation and leisure therapy component exposes the boys and girls to healthy lifestyle choices, community service involvement, and allows the kids to explore a variety of activities to learn how to make personal choices about their likes and dislikes. Some of the activities include: 4-H, the miniature horse program, student council, team and individual sports, and Girl Scouts. The kids learn how to engage in positive outlets for energy and anger release. There are regularly scheduled recreational events as well as special events. Residents will have organized staff directed and supervised recreation activities for at least one hour a day. Part of the recreation schedule will include three hours per week of instruction from a recreation specialist who is under the supervision of a Certified Therapeutic Recreation Specialist. El Pueblo provides two distinct recreational programs; a stimulation/skill building program and a support/maintenance program. Both programs are designed to promote the independence and self-care capabilities of the residents. Each resident is placed in one of the following programs based on information collected through a recreational needs assessment process. The stimulation/skill building program is designed to service the residents in the STRIVE Program. Recreation specialists conduct group activities that are designed to address teamwork, trust, behavior, motor functioning, intellectual functioning, perceptual skills and community reintegration. The support/maintenance program serves the general population who need continued support to prevent regression and teach healthy lifestyles. Recreation specialists conduct group activities that are therapeutically designed to address teamwork and trust. At the µt3.. end of each activity, the specialists process with the residents to assist them in gaining an t4 7, El Pueblo...an Adolescent Treatment Community 9 Co. ''`J!1/08 tw CONFIDENTIAL FOR PROFESSIONAL USE ONLY DO NOT FORWARD OR DUPLICATE TO OTHER AGENCIES OR INDIVIDUALS understanding of their interactions with others. In addition, residents will have one hour a day of physical fitness exercises with large muscle activity. The key difference between the stimulation/skills building program and the support/maintenance program, are the special staff-directed interventions and activities to meet individual goals. Education Services El Pueblo...an Adolescent Treatment Community operates the El Pueblo School, (approved as an alternative school by the Colorado Department of Education), an on-site school that ensures continuous learning for every child. Residents receive 6 hours of educational programming daily, Monday through Friday and work at their own level and pace in an individualized instruction program. Residents have social/behavioral and instructional needs that must be addressed in the educational setting. Residents are scheduled for classes according to both social/behavioral interventions and instructional needs. Record review, testing, classroom observation and assessment determine instructional needs. Residents earn education credits that can be transferred to the next school district in which the child may reside. In addition to academic instruction, educational programming includes physical education, and basic life skills. Teachers are State of Colorado certified teachers. Paraprofessionals provide teacher aide services and individual tutoring to students. Teamwork is emphasized with both the teachers and youth service workers. Collaboration and cooperation is foundational to educational services. ©2007, El Pueblo...an Adolescent Treatment Community 10 Pueblo, CO. Rev. 3/1/08 tw ' El Pueblo...an Adolescent Treatment Community Menu of Services CONFIDENTIAL FOR PROFESSIONAL USE ONLY DO NOT FORWARD OR DUPLICATE TO I El Pueblo Ranch Way OTHER AGENCIES OR INDIVIDUALS Pueblo,CO 81006 CV6 (719)544-7496 ga unpin t „ fax(719)544-7705 lgteht www.elpueblokids.org Menu of Services Basic Milieu Service Package Complimented with Clinical Services prescribed by the State of Colorado in accordance with the Colorado Department of Human Services Staff Manual, Rules for Child Care Facilities, Volume VII County DHS Medicaid Billable — DSM IV Diagnosis Non billable Medicaid Fee for Service Therapeutic Services Individual Therapy- 1 time per week Group Therapy- 3 times per week Basic TRCCF Services Family Therapy - 1 time per week ©2007, El Pueblo...an Adolescent Treatment Community Pueblo, CO. Rev. 3/1/08 tw El Pueblo...an Adolescent Treatment Community Menu of Services CONFIDENTIAL FOR PROFESSIONAL USE ONLY DO NOT FORWARD OR DUPLICATE TO 1 El Pueblo Ranch Way OTHER AGENCIES OR INDIVIDUALS Pueblo,CO 81006 d _ (719)544-7496 *Stift rt�merntommmx Fax(719)544-7705 www.elpueblokids.org Menu of Services Enhanced Milieu Service Package Complimented with enhanced Clinical Services for those children with a DSM IV Diagnosis, in need of Offense Specific Treatment. Medicaid Billable— DSM IV Diagnosis County DHS Fee for Service Non billable Medicaid Therapeutic Services Individual Therapy -2 times per month Group Therapy - I time per week Basic TRCCF Services Family Therapy - I time per month PLUS Enhanced Services: SEX OFFENDER TREATMENT Individual Therapy/Offense Specific — 2 times per month Group Therapy/Offense Specific - 2 times per week -Additional therapist** Family Therapy/Offense Specific —1 time per month **There are 3 groups that take place each week. In complying with best practice, there is I male and I female who are both SOMB approved providers, highly qualified and credentialed therapists who co- facilitate the groups. Private bedrooms/Electronic Monitoring 1 time Initial Assessment Risk Assessment every six months Polygraphs (initial testing only) Clarification Sessions Informed Supervision for all staff Informed Supervision for Parents ©2007, El Pueblo...an Adolescent Treatment Community Pueblo, CO. Rev. 3/1/08 tw 4 El Pueblo...an Adolescent Treatment Community CONFIDENTIAL Plan of Service FOR PROFESSIONAL USE ONLY DO NOT FORWARD OR DUPLICATE TO OTHER AGENCIES OR INDIVIDUALS 1 El Pueblo Ranch Way Pueblo,CO 81006 <V� (719)544-7496 fax(719)544-7705 www.elpueblokids.org I Menu of Services Enhanced Milieu Service Package Complimented with Independent Living and Vocational Skills for those young adults with a DSM IV Diagnosis, in need of Special Services. (IQ Less than 70) DHS County Medicaid Billable — DSM IV Diagnosis g Non billable Medicaid Fee for Service Plus Enhanced Services Therapeutic Services Basic RCCF Services (with Case Management) PLUS Enhanced Services DUAL DIAGNOSIS Staff Ratio of 1:4 Specifically trained direct care staff Daily Therapeutic Milieu Groups Specialized Recreational services Specialized CareerNocational Skills Opportunities Independent Living Cottages Educational Services— er IEP ©2007, El Pueblo...an Adolescent Treatment Community Pueblo, CO. Rev. 3/1/08 tw I I El Pueblo...an Adolescent Treatment Community Plan of Service CONFIDENTIAL I FOR PROFESSIONAL USE ONLY DO NOT FORWARD OR DUPLICATE TO OTHER AGENCIES OR INDIVIDUALS I I Menu of Services I Basic Milieu Service Package Complimented with Clinical Services prescribed by the State of Colorado in accordance with the Colorado Department of Human Services Staff Manual, Rules for Child Care Facilities, Volume VII, in need of Transition and Independent Living Services. County DHS Medicaid Billable— DSM IV Diagnosis Non billable Medicaid Fee for Service Therapeutic Services Individual Therapy - 2 times per month TRANSITION & Group Therapy - 1 time per week INDEPENDENT LIVING SERVICES Family Therapy - I times per month As Described in Transition & Independent Living Services Section I I ©2007, El Pueblo...an Adolescent Treatment Community Pueblo, CO. Rev. 3/1/08 tw I ' El Pueblo...an Adolescent Treatment Community Menu of Services CONFIDENTIAL FOR PROFESSIONAL USE ONLY DO NOT FORWARD OR DUPLICATE TO 1 El Pueblo Ranch Way AGENCIES OR INDIVIDUALS y L Pueblo, CO 81006 (719) 544-7496 :aaAtam,mmtremrwmr ' fax(719)544-7705 www.elpueblokids.org I 1 Menu of Services Enhanced Clinical Services for those children with a DSM IV Diagnosis, in need of Substance Abuse Treatment. Medicaid Billable — DSM IV Diagnosis County DHS Fee for Service Non billable Medicaid Therapeutic Services Individual Therapy - 2 times per month Group Therapy - I times per week Basic TRCCF Services Family Therapy - I time per month PLUS Enhanced Services: DRUG & ALCOHOL TREATMENT I time initial assessment Individual Therapy— 1 time per week Group Therapy—2 times per week AA Meetings I time per week with Group Processing Related Educational Activity— 1 hour per week UA 2 times per month (minimum) ©2007, El Pueblo...an Adolescent Treatment Community Pueblo, CO. Rev. 3/1/08 tw El Pueblo...an Adolescent Treatment Community Menu of Services CONFIDENTIAL FOR PROFESSIONAL USE ONLY DO NOT FORWARD OR DUPLICATE TO 1 El Pueblo Ranch Way OTHER AGENCIES OR INDIVIDUALS Pueblo, CO 81006 tVW (719) 544-7496 u. „„a � � fax (719)544-7705 www.elpueblokids.org Menu of Services Enhanced Milieu Service Package Complimented with Clinical Services for those children with a DSM IV Diagnosis, in need of Intensive Treatment in the Reflection Center. (For Children with Repeated Incidents of Crisis) Medicaid Billable — DSM IV Diagnosis County DHS Fee for Service Non billable Medicaid Therapeutic Services Individual Therapy- I time per week Basic TRCCF Services Group Therapy- 3 times per week Family Therapy - I times per week _ PLUS Enhanced Services: INTENSIVE THERAPEUTIC TREATMENT Staff Ration of 1:4 Private bedrooms/Electronic Monitoring Individualized Crisis Management Plan Enhanced Therapeutic Milieu • Brief daily (non-Medicaid) individual and group sessions facilitated by BA level, specifically trained direct care staff Specialty trained Direct Care Staff ©2007, El Pueblo...an Adolescent Treatment Community Pueblo, CO. Rev. 3/1/08 tw El Pueblo...an Adolescent Treatment Community ' Plan of Service CONFIDENTIAL FOR PROFESSIONAL USE ONLY DO NOT FORWARD OR DUPLICATE TO 1 El Pueblo Ranch Way OTHER AGENCIES OR INDIVIDUALS Pueblo, CO 81006 C6lo (719) 544-7496 fax(719)544-7705 AclosettemlYeaimem www.elpueblokids.org Menu of Services Enhanced Milieu Service Package Complimented with Clinical Services for those children with a DSM IV Diagnosis, in need of Special Services. (IQ Less than 70) County DHS Medicaid Billable— DSM IV Diagnosis Non billable Medicaid Fee for Service Plus Enhanced Services Therapeutic Services Individual Therapy— 1 time per week Group Therapy - 3 times per week Basic TRCCF Services Family Therapy - 1 time per week PLUS Enhanced Services DUAL DIAGNOSIS Staff Ratio of 1:3 Specifically trained direct care staff Specialized recreational services Specialized Career/Vocational Skills Exploration Facilitate specific activities directed by occupational therapist Self contained cottage/classroom ©2007, El Pueblo...anAdolescent Treatment Community Pueblo, CO. Rev. 3/1/08 tw WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Excelsior Youth Centers and Weld County Department of Human Services for the period from July 1, 2008 through June 30, 2009. The following provisions, made this 1/day of Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#45243, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$180.75 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$180.75 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing (3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum rOCAF cQJ/' E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Human Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery,bribery, falsification or destruction of records,making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 12. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. 13. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 14. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 15. Add Paragraph 9 to Section VI. The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: A. Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed; B. Deny payment or recover reimbursement for those services or deliverables which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Human Services and the Contractor, or by Human Services as a debt to Human Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 16. Add Paragraph 10 to Section VI. The contractor shall promptly notify Human Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Human Services' Director. The term"litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: atitil�"v"u%`r �( Weld Cou he Board "'- �. WELD COUNTY BOARD OF HUMAN SERVICES, ON BEHALF OF THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES "-----1_, �� By: /. 42914 � +o-[-('-�TiCe, By: 1-,;�`. Deputy Clem Board Chair Signature William H. Jerke AUG 1 1 2008 CONTRACTOR Excelsior Youth Centers 15001 E. Oxford Ave Aurora, CO 80014 By: eti4cy, (7, -e+ - Q ; WELD COUNTY DEPARTMENT OF HUMAN SERVICES By: 40110 (tiLLA 3 D' ector 4 Weld County SS-23A Addendum P EXHIBIT A Excelsior ! ! Excelsior Youth Centers,Inc. 15001 E.Oxford Avenue/Aurora,Colorado 80014/(303) 693-1550/Fax(303)693-8309 PROGRAM DESCRIPTION I . GENERAL DESCRIPTION A. Excelsior Youth Centers, Inc . , 15001 East Oxford Avenue, Aurora, Colorado, 80014 - 303-693-1550, a Colorado Non-Profit Corporation. B. Licensed capacity - 176/Average capacity - 169 C. • General Overview - Excelsior. Youth Center offers therapeutic residential and day treatment for adolescent females with emotional and behavioral disturbances . A full curriculum, North Central Association accredited Junior-Senior, High School is located on the campus . The Excelsior program emphasizes four primary program components : formal therapy, recreation, daily living skills, and education. D. Clients served - Excelsior Youth Center has been at near full capacity for many years . The average length of stay is fifteen months . In a one year span of time the program will have served approximately 240 clients . II . POPULATION SERVED A. Sex - female B . Age Range - 11 - 21 years C. General Characteristics - psychiatrically and behaviorally disturbed girls between the ages of 11 aryt1 21 years . III . INTAKE CRITERIA AND ADMISSION PROCEDURES A. Excelsior accepts adolescent girls with a broad range of emotional and behavioral problems in their backgrounds . Included among the problems are depression, withdrawal, chronic runaway, substance abuse, delinquency and pre-delinquency, self-abuse, assaultive and aggressive behavior, prostitution, sexual promiscuity, inability to function within the family, inability to function in the public school classroom;• etc. °(`nla Liro/lnr. n.rnr OG v..nrn ♦.- ..-.. u, Page 2 Program Description B. Excelsior accepts adolescent girls with a broad range of emotional and behavioral problems and levels of functioning . Referrals considered appropriate for placement will meet the following criteria : • intellectually functioning above a mildly retarded level • potential to behave appropriately and safely within the treatment milieu • potential for insight and understanding • not pregnant , with exceptions determined by Executive Director assaultive or self destructive behaviors that- are manageable • not able to function in a program with a lower level of services or less restrictive setting Requirements for admission are clearly communicated to referral sources and, when appropriate, to the prospective client' s family. They are given enough information about the care or services to make a knowledgeable decision about whether to make the placement . Insurance coverage and managed care arrangements are explained as part of the referral and admissions process when applicable . Insurance and managed care utilization reviewers as well as case management professionals may contribute to clinical decisions . A comprehensive overview of background materials and other information from the referring agency would be considered prior to excluding any child referred. C. Excelsior prides itself on ed refer al process . It is our policy that a decision regarding referral be given to the referring agencies within 48 hours of receipt of background materials . Admission times vary throughout the year depending on length of waiting list and turnover factor. We do not discriminate in any way as to the routing a referral must take . It can be through an agency, 'insurance company or a private individual . tatlt Admissionon can s completed by phone or referal leter o our Director. Page 3 Program Description IV. SOCIAL AND REHABILITATIVE SERVICES A. Treatment Modalities - in addition to a philosophic base that is implemented through a Phase/Level system, Excelsior uses individual psychotherapy, group therapy, and family therapy as its primary treatment modalities . Attention is also given to recreational therapy, milieu therapy, spiritual counseling and cultural diversity. In addition to the formal therapies, Excelsior uses a multiplicity of therapeutic tools that are determined by a client ' s individual treatment need. B. Therapists are responsible for the delivery of casework services to each client enrolled. These services are planned and documented in the client ' s initial Master Treatment Plan and updated quarterly by her treatment team. C. Professional Services - psychiatric and psychological services are available on an as needed basis . A psychiatric screening is completed on each newly entering client when indicated and a battery of psychological testing may be completed if a need is indicated. Excelsior contracts with a local community physician who is responsible for supervision of our staff, nurses, medical records, etc . Other specialists in the medical community are available for services to our clientele . D. Use of Community Resources - Recreational facilities and programs of the entire metropolitan Denver area in addition to the Rocky Mountain region are available to Excelsior clients . Excelsior is associated with Artreach, a Denver based community service organization which provides our clients with a vast array of sporting events, art exhibits, etc . Mountain outings , field -trips and other off-campus activities are scheduled s utilized in the school year. are interns other resources utilizedcommunity various colleges and universities, AA/NA, Gang Rescue and Support Program (GRASP) , equestrian therapy and many animal shelters and various agencies used for community volunteer projects . E . Recreation - Excelsior' s Recreational Therapist coordinates all campus recreational activities and supervises the "Special Friends" program by interviewing, screening and selecting individuals or families who wish to act as resources and friends to • Page 4 Program Description our clients . In addition, each cottage treatment team has a recreation staff member who is on duty on weekends to assist in implementation of recreational plans . V. TREATMENT GOALS AND TIME FRAMES A. Objectives - Excelsior' s desire is that each of it ' s clients achieve a level of functioning that would be considered optimal in light of her capacities . Therapy is done within framework of reality therapy principles which stresses individual responsibility for one ' s own actions . It is hoped that graduates of this program ' will be better able to manage their behavior-- and effectively function within their communities. Also, within this course of accelerated rehabilitation, our objective is to have assisted individual clients with their interpersonal psychotherapeutic issues. In that our focus is a "total child" focus our aim is for each client to grow, develop, and mature within a healthy, wholesome milieu during her stay at Excelsior. B . Treatment Planning Process - the formulation of Master Treatment Plans and implementation of same are the responsibility of the Treatment and Team Coordinator, therapist, direct care counselors, and Recreation Counselor. One teacher from the school also participates as a liaison between the school and cottage counseling staff. Consultation as to Treatment Plans is, available from a staff psychiatrist, psychologist, and nurse practitioner. Treatment team meetings are held for one and one-half hours , four times weekly, as well as one four hour meeting per month, and one all day team meeting every six months . Decisions as to a recommended promotion within the Phase Program for a student, as well as assignments to specialized therapy groups are also made in this meeting. Quarterly Treatment Plan Reviews are held every 90 days and address objectives, justification for treatment, Individual Transition Plan, family involvement, and disposition. Long range plans , such as tentative discharge dates, and future goals are another element in Treatment Plan designs . Treatment Plan decisions are generally made by consensus within the treatment team, with final authority and responsibility resting with the Treatment and Team. Coordinator. Page 5 Program Description C . Projected Length of Treatment - 6 to 18 months (average length of stay - 15 months) . D. Outcome Goals - it is projected that during their stay clients will have experienced a thorough course of individual therapy focused at their personal and family issues, participation in between two and four therapy groups each of which is focused on a pathology common to individuals assigned to that particular group, and involvement in family therapy, whenever appropriate, and in conjunction with the Family Service Plan aimed at resolution of issues creating dysfunction. Accelerated academic achievement is desired in that the student is enrolled in a year-round school program. ' Additionally, aside from the formal therapy- and academic program, the student will have participated in various forms of healthy wholesome recreational pursuits . VI . EDUCATIONAL AND VOCATIONAL SERVICES A. Agency Provided Educational Components - Excelsior has a fully approved year-round Junior/Senior High School on its main campus . The school program is North Central Association accredited, and Colorado Department of Education accredited. In addition to the regular academic program, Excelsior has a Colorado Licensed Cosmetology School and vocational Food Services, Office Procedure Program, and bicycle mechanics program on- grounds . Within the school component , individual educational testing as well as psychological testing, remedial classes, tutoring, and educational and vocational counseling are offered. School offers an array of on-campus extracurricular activities, including interschool basketball and volleyball , school newspaper and social events . A nearby recreation facility provides a swimming pool . The school has membership in the Colorado High School Activities Association and participates in sporting events with public school leagues . B . Use of Community Schools - When appropriate, toward the end of a client ' s course of treatment, she may yatt of attend local public school classes . Generally the purpose P this transfer is to assist the student in transition to the community. Excelsior is fortunate to have an excellent relationship with the local school district . Page 6 Program Description All facilities and resources of said district are available to our clients on request . ecial Education C . Special Education Components - SP classrooms and teachers are incorporated into the school setting . This program is funded as a component of Excelsior' s educational program. D. Tutoring - Individual tutoring is available to clients on an as needed basis throughout the school day. In addition, tutoring and academics is attended to in the cottage setting and evening tutorial sessions in the school . E. Skills Training - Training in daily living skills is an important element of the Excelsior Phase Program. Each ' student is monitored and counseled daily regarding her hygiene, care of her environment, and ability to relate effectively to peers and adults . In addition, the school program includes courses in home economics, child care, sexuality, business skills, etc . Training for other specific skills can be tailored according to the client ' s individual need. F . Sex and Drug Education - Certain therapy groups are specifically focused on issues such as sexuality and substance abuse . In addition, resources are brought to the academic setting where a didactic approach is utilized to address these issues . Classes such as Womanhood, Health and Human Body and Exploring Self cover the topics extensively. VII . MEDICAL SERVICES A. As indicated above, Excelsior has a contract with a local physician who is responsible for the supervision of registered nurses, licensed practical ' nurses and medical assistants, and our medical records department . This individual also completes medical examinations on all clients . She\he refers to other medical specialists in the community with whom Excelsior maintains a relationship. Dental care is provided by community dentists pending insurance coverage . Excelsior' s staff psychiatrists complete a psychiatric screening on all new entering clients . Vision and auditory screenings are completed on all new clients and updated as needed. Page 7 Program Description B . Excelsior' s nurses are responsible for supervising and administering medications, day to day medical decision making under the supervision of Excelsior ' s physician, client health education and conducting inservice training in health care for professional staff. VIII . RELIGIOUS RESOURCES A. Excelsior employs on a part-time basis a Religious Activities Coordinator. This individual is responsible to acquaint clients with religious philosophies and oversee various religious activities that occur both on and off campus . B. ' The Religious Activities Coordinator provides contacts with community religious resources and maintains an on going spiritual counselor relationship with clients who wish to participate . A weekly (Sunday) non- denominational religious service ' is provided. Attendance at this service is non-compulsory. IX. DISCHARGE POLICY AND AFTERCARE A. In concert with the placing agency, decisions regarding discharge are made by the treatment team. Discharge is an agenda item addressed in the monthly Treatment Plan review process . Ideally the student will have completed four phases of our Phase Program prior to discharge. This program of growth development and maturation, can be applied to students according to their individual capacities . The client ' s ability to function within the family or in an alternative setting and in the public school setting or preparing for emancipation and independent living are also criteria considered prior to discharge . B . Excelsior approaches aftercare services on an as needed basis . Typically, close communication is maintained with client immediately following discharge from the program. This communication involves visits to the Center, correspondence, and telephone contacts . All previous clients are invited to attend a weekly Aftercare Support Group held throughout the year. Also, these 'girls are welcome to return for short durations of stay at Excelsior at any time . A full time Aftercare Case Manager helps prepare clients for discharge and follows up on clients who need help within the community. Page 8 Program Description X. STAFF DEVELOPMENT A. An on going staff development program is incorporated under the supervision of the Treatment Director and Quality Improvement Coordinator. All new employees are required to attend a week long Orientation Program, which includes Program history, philosophy, procedures, Crisis Intervention and First Aid Training, conducted by various administrative and supervisory staff . The Program Director coordinates inservice training sessions for treatment staff on a monthly basis . The Excelsior High School Principal is responsible to ' implement a regular inservice. training program- for teachers . B . Consultants are utilized in special staffings for individual girls as well as assisting treatment teams in team functioning and team dynamics . , C. Excelsior makes extensive use of local workshops and seminars to assist staff in upgrading professional skills . Staff members frequently are enrolled in local college and university programs seeking advanced degrees . XI . REPORTING PROCEDURES A. Within ten days of intake, the initial treatment staffing will occur and the Master Treatment Plan developed:, The referring agency will receive the Initial Treatment Plan and thereafter monthly Treatment Plan Reviews detailing the client ' s movement through the program, achievement in school , and progress towards treatment goals/objectives . Treatment Plan revisions, Quarterly Staffings, and Discharge Plans are sent to. agencies as well . The final monthly Treatment Plan Review also includes a Discharge Summary. XII . CONTRACT MONITORING A. A weekly meeting of various administrative and supervisory personnel sits as a program evaluation committee . This is an open agenda forum and input relative to any issues are addressed. Page 9 Program Description B . A Quality Improvement Program is implemented by regular meetings of the following committees, including but not limited to: Quality of Care, Admission Records and Research, Staff Development, Risk Management, Medical Issues, Administrative Meetings and Quality Improvement . C. Program reviews by referral agencies are conducted on numerous occasions . Close communication and collaboration with referral sources, relative to individual students, has been our experience . Revised 6/19/00 Excelsior "Over 30 years of service to youth" Excelsior Youth Centers,Inc. 15001 E.Oxford Avenue/Aurora,Colorado 80014/(303)693-1550/Fax(303)693-8309/www.excelsioryc.org Daily rate of services: We have not received an official notification of the new rate for the 2008-2009 fiscal year. Our Director of Finance was told we should get around a 1.5 percent increase added to our current rate of$178.08 per day. Once we have received that notification, I will send that to you. Our Day Treatment rate is $1,617.00 per month or $53.16 per day. Menu of Services: Substance Abuse Group—4 groups per month at $20.00 per group. Non-Special Ed. Students excess cost - $36.68/per day— school days only (clients who are not special education when they enter our facility or do not have a current IEP) Council on Accreditation of Service for Families and Children, Inc. WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Flatirons Behavioral Health Hospital, Corp. and Weld County Department of Human Services for the period from July 1, 2008 through June 30, 2009. TiL ,,yy The following provisions, made this //day of rhtgV5 f, 2008, are added to the referenced Agreement. Except as modified hereby, all terms of t Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#1520898, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$161.66 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$161.66 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child(30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum E. Other/miscellaneous items considered usual in the care and supervision of the child, include,but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Human Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public(federal, state, or local)transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery,bribery, falsification or destruction of records,making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 12. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. 13. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 14. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 15. Add Paragraph 9 to Section VI. The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: A. Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed; B. Deny payment or recover reimbursement for those services or deliverables which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Human Services and the Contractor, or by Human Services as a debt to Human Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 16. Add Paragraph 10 to Section VI. The contractor shall promptly notify Human Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Human Services' Director. The term "litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. // // 1 l ATTEST: Weld, ounty elk to the Board h . 1 : 1 WELD COUNTY BOARD OF is, C 1 HUMAN SERVICES, ON BEHALF oe OF THE WELD COUNTY k.,;::? DEPARTMENT OF HUMAN /o% �`C� SERVICES /J By: r ,C4_, By: ,vii-, Deputy Cler " o the Board Chair Signature William H. Jerke AUG 1 1 2008 CONTRACTOR Flatirons Behavioral Health Hospital, Corp. 2255 S 88th Street Louisville 800 7 By: e. WELD COUNTY DEPARTMENT OF HUMAN SERVICES By: AA Ct. erector v 4 Weld County SS-23A Addendum aa'a ai6F Exhibit A Program: TRCCF, Centennial Peaks Hospital, Flatirons Behavioral Health Corporation 1. Scope of Service: `y 16 bed capacity • 12-18 years old • Males and female • Primary Mental Health diagnosis, Chemical Dependency issues and family disruption • Average length of stay is 90days Services: • 1:1 individual therapy • Group therapy • Family therapy • CDE approved school • Chemical Dependency groups • Life Skills groups Staff: • Program Director • Medical Director, MD • Program Coordinator • Two (2) licensed clinical therapist • Licensed teacher • Para professional • Mental Health Councilors • RN for all medications 2. Dailey rate: State published rate 3. Menu of services: N/A If you have any further questions please contact Jeffrey Farmelo at 303-666- 2037 or by e-mail at jfarmelo(a,centennialpeaks.orq. • WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic ResidentialthW care Facility Services and Residential Child Care FacilityServices (thei y "Agreement") between Jefferson Hills and Weld County Department of lb 0' Human Services for the period from July 1, 2008 through June 30, 2009. The following provisions, made this 1/day of 4U9a5f , 2008, are added to the referenced Agreement. Except as modified hereby, all terms of the Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#12284, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$176.08 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$176.08 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); ] Weld County SS-23A Addendum p &mod - cQJ6'6 E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include,but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Human Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 12. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. 13. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 14. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 15. Add Paragraph 9 to Section VI. The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: A. Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed; B. Deny payment or recover reimbursement for those services or deliverables which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Human Services and the Contractor, or by Human Services as a debt to Human Services or otherwise as provided by law. 3 Weld County SS-23A Addendum • 16: Add Paragraph 10 to Section VI. The contractor shall promptly notify Human Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Human Services' Director. The term "litigation"includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: ," '"""ada Weld Coc aat55to the Board WELD COUNTY BOARD OF 4s, (1.-!41"\\...-- c HUMAN SERVICES, ON BEHALF \ OF THE WELD COUNTY �.� itc., ,")/ DEPARTMENT OF HUMAN " SERVICES w. By: LL 4l/ , i. r 1 . ., 4 By: `Le%4G-Z7c Deputy Cl:. to the Board Chair Signature CONTRACTOR Jefferson Hills 421 Zang St Lakewood, CO 80228 By: WELD COUNTY DEPARTMENT k�c G` Cc"` �t �P OF HUMAN SERVICES 1 By: irector I 4 Weld County SS-23A Addendum �e�tn / /, 0,9e'0 _' 02ie6 WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Jefferson Hills and Weld County Department of Human Services for the period from July 1, 2008 through June 30, 2009. The following provisions, made this // day of AIVUst , 2008, are added to the referenced Agreement. Except as modified hereby, all terms of the Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#88459, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$171.30 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$171.30 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates maybe negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing,personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); Weld County SS-23A Addendum 960J'- o?/Gx • E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County,prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Human Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 12. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. 13. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 14. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 15. Add Paragraph 9 to Section VI. The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: A. Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed; B. Deny payment or recover reimbursement for those services or deliverables which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Human Services and the Contractor, or by Human Services as a debt to Human Services or otherwise as provided by law. 3 Weld County SS-23A Addendum i 16. Add Paragraph 10 to Section VI. The contractor shall promptly notify Human Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Human Services' Director. The term "litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. Medi ATTEST: LU - Weld C leitTv,te< Board sC "�' 9 �,� WELD COUNTY BOARD OF I ' HUMAN SERVICES, ON BEHALF _< J� OF THE WELD COUNTY O { i DEPARTMENT OF HUMAN U y ? v./ SERVICES By: / By: dt" c <1-G✓ Deputy Cl to the Board Chair Signature William H. Jerke AUG 1 1 2000 CONTRACTOR Jefferson Hills 421 Zang St Lakewood, CO 80228 r By: WELD COUNTY DEPARTMENT OF HUMAN SERVICES By: A j VwaiC Director L ' 4 Weld County SS-23A Addendum a40(f— a/6fl 4 WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Kids Ark and Weld County Department of Human Services for the period from July 1, 2008 through June 30, 2009. The following provisions, made this /J -day of /49915f , 2008, are added to the referenced Agreement. Except as modified hereby, all terms of the Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#34340, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$180.75 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$180.75 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates maybe negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household famishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); Weld County SS-23A Addendum a7 6 E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Human Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 12. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. 13. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 14. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 15. Add Paragraph 9 to Section VI. The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: A. Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed; B. Deny payment or recover reimbursement for those services or deliverables which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Human Services and the Contractor, or by Human Services as a debt to Human Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 16. Add Paragraph 10 to Section VI. The contractor shall promptly notify Human Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Human Services' Director. The term "litigation"includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: /a ��'v"'_% Weld Cou the Board ' � WELD COUNTY BOARD OF �` HUMAN SERVICES, ON BEHALF • r OF THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES By: / i / (# /�• By: Deputy Cle o the Board Chair Signature William H. Jerke AUG 1 1 2008 CONTRACTOR Kids Ark PO Box 1725 Sterlin , CO 80751 n By: WELD COUNTY DEPARTMENT OF HUMAN SERVICES By: irector 4 Weld County SS-23A Addendum doted'-G/4 WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Kids Ark and Weld County Department of Human Services for the period from July 1, 2008 through June 30,2009. The following provisions, made this /1 day of /41/9e5/, 2008, are added to the referenced Agreement. Except as modified hereby, all terms of the Agreement remain unchanged. County agrees to purchase and Contractor, identified as Provider ID#34341, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$180.75 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$180.75 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing (3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum &aW - ai E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Human Services to shorten the duration of placement. 9. Add Paragraph 14 to Section W. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section W. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 12. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. 13. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 14. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 15. Add Paragraph 9 to Section VI. The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: A. Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed; B. Deny payment or recover reimbursement for those services or deliverables which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Human Services and the Contractor, or by Human Services as a debt to Human Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 16. Add Paragraph 10 to Section VI. The contractor shall promptly notify Human Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five(5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Human Services' Director. The term "litigation"includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: 1444111 Weld Coytn£y C erk'tib<e Board s T ` + WELD COUNTY BOARD OF HUMAN SERVICES, ON BEHALF ,.( - r+ ` i OF THE WELD COUNTY (� Vi? _11/4, DEPARTMENT OF HUMAN I SERVICES By: bi - By: "T-'l`, ew Deputy Cl to the Board Chair Signature William H. Jerke AUG 1 1 200& CONTRACTOR Kids Ark PO Box 1725 Sterling, CO 80751,\ By: /I - WELD COUNTY DEPARTMENT OF HUMAN SERVICES By: d1 Vl 617-11; DD�rector J 4 Weld County SS-23A Addendum 0 aor 02 J ,80 WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Lost and Found Inc. and Weld County Department of Human Services for the period from July 1, 2008 through June 30, 2009. The following provisions, made this // day of G/olLSf , 2008, are added to the referenced Agreement. Except as modified hereby, all terms of tie Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#49489, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$167.93 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$167.93 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis,based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing (3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum c2voj'- ai&8 E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include,but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Human Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery,bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 12. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. 13. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 14. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 15. Add Paragraph 9 to Section VI. The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: A. Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed; B. Deny payment or recover reimbursement for those services or deliverables which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Human Services and the Contractor, or by Human Services as a debt to Human Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 16. Add Paragraph 10 to Section VI. The contractor shall promptly notify Human Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Human Services' Director. The term "litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: MA/ILL Weld C iflyTb rk t,o the Board WELD COUNTY BOARD OF is<, HUMAN SERVICES, ON BEHALF J j OF THE WELD COUNTY ‘2_, {AC? A DEPARTMENT OF HUMAN SERVICES i By: By: Deputy Clerk the Board Chair Signature William H. Jcrke AUG 1 1 ad CONTRACTOR Lost and Found Inc. 6700 W 44th Ave Wheat Ridge, CO 80033 BYE • --Cry �r�ra-� WELD COUNTY DEPARTMENT OF HUMAN SERVICES By: Jt j 1 r / irector ( (t) 4 Weld County SS-23A Addendum i(enS WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Lost and Found Inc. and Weld County Department of Human Services for the period from July 1, 2008 through June 30, 2009. The following provisions, made this // —day ay of /-2 5 , 2008, are added to the referenced Agreement. Except as modified hereby, all terms of tement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#1529554, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$167.93 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$167.93 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include,but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household famishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Human Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local)transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 12. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. 13. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 14. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 15. Add Paragraph 9 to Section VI. The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: A. Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed; B. Deny payment or recover reimbursement for those services or deliverables which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Human Services and the Contractor, or by Human Services as a debt to Human Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 16. Add Paragraph 10 to Section VI. The contractor shall promptly notify Human Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Human Services' Director. The term "litigation"includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: ate � 't/" W Clerk to the Board WELD COUNTY BOARD OF s d i -� � HUMAN SERVICES, ON BEHALF tr;it(` OF THE WELD COUNTY - DEPARTMENT OF HUMAN d� SERVICES ti By: 7 ' � By: "1ti:7L!- r Deputy Cle to the Board Chair Signature William H. Jerke AUG 1 1 2008 CONTRACTOR Lost and Found Inc. 6700 W 44th Ave Wheat Ridge, CO 80033 I) WELD COUNTY DEPARTMENT OF HUMAN SERVICES By: irector 1 4 Weld County SS-23A Addendum awe'- &/e WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Mount St. Vincent Home and Weld County Department of Human Services for the period from July 1, 2008 through June 30, 2009. a The following provisions, made this // 'day of Wk ;5/ , 2008, are added to the referenced Agreement. Except as modified hereby, all terms of the Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#45174, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$180.75 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$180.75 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limitede: Food, shelter, clothing, personal needs and allowance, administration, administrative 1Z- overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens,—' independent living training, mentor/advocate, supervised visitation and all other serviggs as outlined in the Contractor's scope of service attached as Exhibit A or the Child N Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: 6' A. Food, including meals and snacks (25%); B. Clothing (3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum cQap — C- / C E. Other/miscellaneous items considered usual in the care and supervision of the child, include,but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Human Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public(federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 12. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. 13. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 14. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 15. Add Paragraph 9 to Section VI. The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: A. Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed; B. Deny payment or recover reimbursement for those services or deliverables which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Human Services and the Contractor, or by Human Services as a debt to Human Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 16. Add Paragraph 10 to Section VI. The contractor shall promptly notify Human Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Human Services' Director. The term"litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: ia"ilid Weld Co rk to the Board ,J WELD COUNTY BOARD OF c"'�' ��' Yi HUMAN SERVICES, ON BEHALF OF THE WELD COUNTY �r � �, DEPARTMENT OF HUMAN t SERVICES By 4291.(. 114-4/0__ By: �`,I�,_.e Deputy Che Board Chair Signature William H. Jerke AUG 1 1 2008 CONTRACTOR Mount St. Vincent Home 4159 Lowell Blvd Denver, CO 80211 By:,. 'i( MN ,�j'�.,,�, Jve, t e'l WELD COUNTY DEPARTMENT J OF HUMAN SERVICES 1 By: U-0 0 r irector 4 Weld County SS-23A Addendum .-VAA P_ ,-V it 2 WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Mountain Star Center and Weld County Department of Human Services for the period from July 1, 2008 through June 30, 2009. The following provisions, made this /7 day of 31] y , 2008, are added to the referenced Agreement. Except as modified hereby, all terms of the Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#13363, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$180.75 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$180.75 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include,but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing (3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); Weld County SS-23A Addendum E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include,but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Human Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section W. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum . C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 12. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. 13. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 14. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 15. Add Paragraph 9 to Section VI. The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: A. Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed; B. Deny payment or recover reimbursement for those services or deliverables which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Human Services and the Contractor, or by Human Services as a debt to Human Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 16. Add Paragraph 10 to Section VI. The contractor shall promptly notify Human Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Human Services' Director. The term"litigation"includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: 144#/ v"_____ Weld C ' 1 e Board N\i �� v �f" ` \ WELD COUNTY BOARD OF ic., I_( ,t- ^'Ili; ` HUMAN SERVICES, ON BEHALF A' OF THE WELD COUNTY �� r &g� DEPARTMENT OF HUMAN ::4-11 1 RI CY: SERVICES \9 By: 7 9 %. By: ie-(.._i Deputy Cle ' o the Board Chair Signature William H. Jerke AUG 1 1 2008 CONTRACTOR Mountain Star Center 3520 W Oxford Ave Denver, CO 80236 �--�; By. ". WELD COUNTY DEPARTMENT OF HUMAN SERVICES By: % l�'� irector 1 4 Weld County SS-23A Addendum WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Reflections For Youth, Inc. and Weld County Department of Human Services for the period from July 1, 2008 through June 30, 2009. The following provisions, made this //-day of 4/T,Cj/,f,5i, 2008, are added to the referenced Agreement. Except as modified hereby, all terms of fife Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#1530128, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$163.87 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$163.87 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum // ri��- cQ/t E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Human Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery,bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 12. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. 13. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 14. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 15. Add Paragraph 9 to Section VI. The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: A. Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed; B. Deny payment or recover reimbursement for those services or deliverables which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Human Services and the Contractor, or by Human Services as a debt to Human Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 16. Add Paragraph 10 to Section VI. The contractor shall promptly notify Human Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five(5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Human Services' Director. The term "litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: iiad Weld k to the Board \ WELD COUNTY BOARD OF HUMAN SERVICES, ON BEHALF IL "� "' OF THE WELD COUNTY '° ` DEPARTMENT OF HUMAN , . x \ SERVICES By: L/ / y4 t'�_: ./ -lib By: '1-,'ii- i-., Deputy Cl= to the Board Chair Signature William H. Jerke AUG 1 1 2006 CONTRACTOR Reflections For Youth, Inc. PO Box 1860 Berthoud CO 80513 By: I WELD COUNTY DEPARTMENT OF HUMAN SERVICES By: JJlA� ector ,, 4 Weld County SS-23A Addendum a cog?-a/f, Exhibit A Reflections for Youth, Inc. "Discovering the Power of Positive Choice" P.O. Box 1860 Berthoud, CO 80513 (970) 344-1380 (p) (970) 344-1394 (0 05-27-08 (1) Scope of Service: An agreement was reached between Weld County DSS and Reflections for Youth, Inc. for the purchase of four guaranteed beds during the fiscal year July 1, 2007—June 30, 2008. Reflections for Youth is interested in continuing with the agreement and if it is an option, could increase the guaranteed bed number to six (6) youth. Base on information from the 11 months of the current fiscal year, Weld County DSS has averaged six youth (actually 5.7) in placement. It is understood that the initial emphasis was on placements for females but can be used for males as well. It is further understood that Weld County DSS can place additional youth in placement at Reflections under the existing placement contract, provided that space is available at the time of the referral. B. Scope of Service Prairie View: RFY Prairie View TRCCF program is open to any male youth requiring a well structured community-based program, consistent supervision, therapeutic/mental health services, and extra support educationally. An I.E.P. is preferred but not required. Youth who are dependent, neglected, abused or delinquent are considered for admission. Typically such youth will demonstrate behavioral and emotional difficulties and have a history that involves one or more of the following: family conflict/dysfunction, physical abuse, sexual abuse, running away, substance abuse, sexual acting out, oppositional/conduct difficulties, self-defeating behaviors/activities, delinquent acts and adjudications and learning disorders. Reflections employs a contracted child psychiatrist and accepts youth currently taking and/or in need of psychotropic medications. All medication evaluation and management appointments are billed directly to Medicaid. Reflections will not reject any referral solely on the basis of the youth's psychiatric/emotional history, placement history, committed delinquent acts and/or adjudications and/or running behavior. Youth with an extensive history of aggression to self and/or others and requiring repeated restraint for the protection of self and others, as well as adjudicated sexual offenders will be assessed on a case-by-case basis. Reflections will work with sex offenders and all staff are certified in Informed Supervision and Therapeutic Care for Juveniles that Sexually Offend. Reflections for Youth, Inc. contracts with two separate agencies that work to provide SOMB approved sex offender support and employs a licensed therapist that provides Informed Supervision and Therapeutic Care training to all staff and families of youth placed in our facility. Reflections for Youth, Inc. also employs a master's level LCSW therapist that has completed the six-day Kempe Center, SOMB approved training as a necessary step in becoming a SOMB fully operating offender therapist. Exhibit A Youth with full-scale IQ below 70 and youth requiring routine emergency medical assistance (diabetic, seizure disorders, etc) will also be assessed on a case-by-case basis. Actively suicidal or homicidal youth will not be accepted until the criteria for 27-10 is no longer being met. Reflections maintains the right, after screening and appropriate professional discussions, to the deny acceptance of a referral with either or both of the described issues. Minimum ratios of 4:1 are maintained at all awake times during all awake non-school hours. During the weekday hours of approximately 8:00am to 6:00 p.m. the 4:1 ratio is enhanced with the presence of House Managers and Therapists on site. On-call support is available at ALL times. The ratio is 8:1 for overnight awake shift at the Prairie View Treatment Facility. Roles for each staff are as follows. The House Manager is responsible for the supervision of all staff and insuring the program is following the state and placing agency guidelines and the mission and treatment philosophy of Reflections for Youth, Inc. The House Manager is charged with the authority to implement, evaluate, and ensure consistent application of policy and procedure within the group home/treatment center. Of highest priority is safety of the residents. The House Manager is responsible for the curb appeal, interior cleanliness, maintenance, and overall appearance of the home and property. In addition the House Manger is responsible for the overall quality and effectiveness of the treatment milieu. In addition to working direct care with the residents in place of any Child Care Worker position. The Associate House Manager is responsible to cooperate with the House Manager and ensure a safe, nurturing environment for residents, as well as providing direct milieu counseling support. Further, the AHM must be able to step-in and continue with the consistence application of polices and procedures as well as state regulations should the HM be absent, and/or for any absent Child Care Worker. The Special Education Teacher is the primary staff responsible for classroom instruction as well as assistance to the Educational Director regarding the student testing, IEP process, and student transcripts. The Teachers Assistant/Day Counselor is responsible for assisting the Special Ed. Teacher with classroom instruction and management and also to be available for transportation and at times of planned interventions or crisis to supervise youth that are not involved in the school program due to behavior problems, illness, outside appointments or other approved reasons. The Child Care Worker/Milieu Counselor is responsible to assist with daily scheduling and routines; to provide encouragement and motivation; to facilitate personal development and maturation by modeling behavior, appropriate social skills, restorative justice in the milieu and problem solving skills; and to implement behavior management and modification techniques, including a phase system as warranted. The Overnight Exhibit A Child Care Workers has the same responsibilities and additionally needs to check on the residents every 15 minutes and document accordingly to ensure safety. Therapists have responsibility to provide individual, conjoint family and group therapy to the residents assigned by the Clinical Directors as a "case load". They assess, write and document monthly treatment plans and therapy notes. They maintain contact with the caseworkers, probation officers, and GAL's, and provide family support during non-therapy times as needed. They have regular bi-weekly consultation with residential staff support meetings and are available as needed. Therapists are available for crisis intervention within the milieu. Therapists complete after-care agreements with residents and their families. They oversee discharge planning with external systems and complete discharge summaries. They are responsible for all required documentation and record keeping. They maintain their licensure as LCSW, LMFT or LPC and actively seek educational opportunities and offer Medicaid eligible individual, family and group therapies to all TRCCF youth in placement. ALL therapists providing services for Reflections for Youth, Inc. are fully licensed. Although Reflections is not a fully integrated DBT program/milieu yet, a great deal of emphasis has been placed in the last year with additional trainings and supports scheduled in the next year to move in that direction. All program staff that support the program at each of the facilities but are not directly assigned to any one facility are as follows; Executive Director, Educational Director, Treatment Coordinator, Medical Services Coordinator and Client Services Coordinator. The Executive Director is responsible for the supervision of the daily operation of the program at Reflections for Youth, Inc. The Executive Director is held accountable for census, IEP status, staffing patterns, resident and employee record keeping, treatment plans for clients, and operating budget compliance. In addition, it is the responsibility of the Executive Director to maintain a professional operation while constantly seeking to improve services and operational systems. Reflections' Executive Director is also a Licensed Professional Counselor and is available for TRCCF level Medicaid services that include individual therapy sessions conjoint family therapy sessions and group therapy sessions. The Educational Director is the leader of the educational team. The Educational Director is responsible for curriculum, teacher quality, and the maintenance of an excellent learning environment. In addition, the Educational Director is charged with the authority to implement, evaluate, and insure consistent application of corporate policy and procedure. The Educational Director also attends a majority of all twice monthly treatments planning sessions and staffings. The Treatment Coordinator is a licensed LCSW and oversees the non-Medicaid billable mental health services offered in the program. These include attending facility specific meetings and treatment team meetings to ensure that milieu-based counseling and support is occurring regularly and that all Family Service Plans and Discrete Case Plans are being followed and implemented. It also includes attending monthly staffings to monitor overall progress and to evaluate and change the Reflections Treatment Plan as needed for the benefit of the client and with the approval of the treatment team. The Treatment Coordinator gathers information from the Client Services Coordinator and other collaterals to complete the Initial Treatment Plan as soon as possible after intake but no later that 14 Exhibit A days after intake. The Medical Coordinator is responsible for ensuring that all policies and procedures that are related to the medical program at Reflections for Youth, Inc. are in compliance with licensing and are being followed at all times. This includes ensuring that initial physical, dental and vision appointments are scheduled timely and that all medication prescriptions are filled and kept in order. The Medical Coordinator conducts weekly audits of medical charts and coordinates with the House Manager of each facility to meet the needs of the youth in care. She also schedules all medication/psychiatric evaluation appointments and provides information to our Child Psychiatrist from counseling staff, therapists, managers, parents and placement workers so that he may serve the needs of the youth with all of the information available. The Client Services Coordinator has responsibilities in the areas of intake, drug and alcohol education and support services, including initial screening and testing for youth in need of drug and alcohol services, and within the Family:Family program at Reflections providing in-home services to the youth and family while the youth is still in placement at Reflections. Based on information provided to the state of Colorado Department of Human Services in the completion of our cost reports for the time periods July 1, 2006—June 30, 2007, our average length of stay was 116 days. Reflections has worked hard to provide extensive transition services and planning and offers continuing support services through our core service home-based option B, Lifeksills and Day Treatment programs to enable youths to step-down sooner with continuing support. In addition, while a youth is still in TRCCF level placement, our family:family program is offered as a home-based service for family support and planning prior to the youth returning home. This is a program in addition to the Medicaid-billed therapeutic services offered to the family and was specifically put into place to reduce length of stays as possible and to promote a positive continuum of care. Reflections for Youth, Inc. operates a state-certified, centralized special education/regular education school. With a student-to-teacher ratio of no more than 5:1, and a year-round school offering three full semesters of education, students have the opportunity to get closer to or achieve the credits necessary for grade level education. A state curriculum of academics is presented with the goal for each youth to eventually transfer back to the public school system or to graduate from Reflections Academy. Reflections Academy employs a master's level, certified school administrator, state- certified special education teachers and qualified associate teachers. Reflections Academy assures a continuity of care for each of the youth in residential treatment by providing education experiences which remediate, maintain and improve academic, intellectual and social functioning. Educational experiences include occupational and recreational classes and opportunities as well as academic and remedial classes. Reflections for Youth, Inc. maintains a professional working relationship with Colorado Department of Education's Special Services Unit. Reflections operates a centralized school for its residential students and day treatment students, including female youth in the girl's adolescent residential program. The school must comply with CDE's teacher and administrator licensing requirements, state and national curriculum standards, the administration of CSAP testing each calendar year, October 1 and December counting Exhibit A reports, Title I compliance, No Child Left Behind, Special Education Law (IDEA) and FAPE (Free and Public Education). Reflections for Youth's educational program consists of a minimum of 6.5 hours of school daily and is offered year round. Students do not attend on regularly scheduled holidays and teacher workdays throughout the year. Upon entering the program, teachers and educational staff use a variety of formal and informal measures to assess student growth and achievement on a regular basis. When a student enters without an I.E.P. or if further testing is appropriate, a wide range achievement test is administered and scores are used for making education placement decisions. At the time of intake into the educational program, requests are immediately made for past school records, including a current I.E.P. if applicable and the student's home school is notified of the placement. The I.E.P. is reviewed for compliance and used as-is if appropriate. If the I.E.P. is out of compliance, an annual or triennial review will be scheduled in cooperation with the student's district of residence. Reflections for Youth teachers are state certified Special Education Generalists. All teachers are either master's level educators or are working towards their master's degree in special education and teacher preparation (Temporary Teacher Equivalency credentialed). Classroom paraprofessionals have at least a bachelor's level education and are state substitute certified. RFY also employs a Title I Reading Specialist on a yearly basis to meet the needs of students struggling with reading and mathematics. Reflections for Youth's educational program is overseen by a master's level Special Education Director and RFY employs licensed therapists only. (2) Daily Rate for Service: Reflections for Youth, Inc. daily rate for service will be the anchor rates that the state has established for the Grismore TRCCF facility. The rate for fiscal year 2007/2008 was $161.44 per day. It is unknown at this time what the rate for fiscal year 2008/2009 will be but our actual costs based on the cost report due April 30, 2008 were $173.35 per day. This rate does not reflect the fee-for-service piece that is billable directly to Medicaid. (3) Menu of Services: Additional fees that were paid last year and once again asked for this year include drug and alcohol services, if needed based on history, initial testing and CCAR and beyond education and for specific offender service treatments. An additional $9.75 per day is requested if drug and alcohol services, beyond education, are needed. This can be a negotiated rate depending upon level of service that is needed. Reflections is in the process of becoming ADAD certified and is expecting certification by October 2008. What follows is an entire description of the drug and alcohol program offered at Reflections for Youth, Inc. Exhibit A The Drug and Alcohol program is a divided into educational and treatment service components and is heavily based in the skills and skillsets of DBT. The therapeutic and treatment portion is named the Substance Abuse and Dependency Program. Clients in the Substance Abuse and Dependency Program also receive the services offered in the Drug and Alcohol educational program. In this way Reflections for Youth, Inc. offers Education program, Comprehensive prevention program, Intervention program and Treatment level program. The mission of Reflections for Youth, Inc. Drug and Alcohol Program is to provide education and access to prevention services to every youth in the community based residential and day treatment programs. These services are provided through weekly educational/support and therapy groups. Educational groups are facilitated by a CAC I or Milieu Counselor. Educational services are initiated at intake as students are immediately enrolled in a once weekly class. (Educational Program) Prevention services and support/therapy groups are conducted by CAC, CACIII or licensed therapists. Access to these services is determined by the administration of an assessment tool (SASSI), DSM IV diagnosis, interviews with the client, family and Case Worker, and a history/documentation review. These initial assessments are conducted by a CAC level staff member. Once the assessment procedures are completed a licensed therapist recommends that the resident either participate in only the educational portion of the Drug and Alcohol Program or the Substance Abuse and Dependency Program. Random UA screenings are provided by Reflections for Youth as part of the residential program. In most circumstances youth classified as experimental users will be eligible to participate in the weekly coping skills group. This group includes the skills portion of the DBT model and incorporates educational and prevention components, such as safety planning, cognitive distortions and further education not included in the educational services. This group is facilitated by a licensed therapist and/or CAC level counselor. The decision for this level of program involvement will be made by the Reflections clinical team, Substance Abuse and Dependency Program staff and the Client Manager. (Comprehensive prevention program and Intervention Program) Anyone deemed as "dependent" on the SASSI Assessment is required to attend AA or NA meetings in their home environment while on home passes, and get a sponsor. They must have a 12 step attendance form signed and have sponsor make contact with the facility to speak with the House Manager of Client Services Coordinator. For youth involved in need of the Comprehensive prevention and Intervention program, recommendations may be made and requirements put in place for the youth(s) to attend AA or NA in the community while in placement in addition to during times of home visits. The mission of Reflections for Youth's Substance Abuse and Dependency Program is for each participant to understand the power of a sober life by developing coping strategies independent of substances, developing healthful ways to think about the world and themselves, identifying and addressing any underlying causes to the dependent behavior, and by creating personal situations that sustain abstinence and a healthy lifestyle. The additional services provided above the educational and coping skills Exhibit A component are weekly therapy group; every third week art therapy group conducted by a CAC III, access to individual support sessions with CAC level counselor, and focused cognitive behavioral assignments for individual and family therapy. The therapeutic assignments assist the individual to identify their cycle of abuse (triggers, cognitive distortions and unhealthy coping strategies), the underlying causes of their abuse/dependency, the specific belief systems that create their cycle of abuse/dependency, and the provocation of thinking about their future in planning for a life of abstinence from drugs and alcohol. The therapy group is structured to protect the safety of its members by requiring that the 1st cognitive behavioral therapy assignment is completed and that all members have respectfully put effort into and participated in the educational and coping skills group. Additionally, students are required to have reports from staff and their therapist that indicate they practice and use the coping skills discussed in the group. These requirements help create a safe group where participants are able to talk openly about their underlying causes and provide support or feedback regarding their belief systems that are not conducive to sobriety. All members of the program generate safety plans prior to passes and members of the abuse and dependency program must complete their relapse prevention plan to successfully complete the program. (Treatment level program). Because the Substance abuse and dependency program is tied to the residential program, therapeutic, educational and milieu services are provide conjointly. Substance abuse program members have milieu goals that focus on their substance use in addition to any other behavioral or emotional concerns. In the event an offender youth is placed by Weld County DSS, Weld County DSS would have an option of contracting with the S.O. provider directly for all services, including polygraphs and other services required as part of the SO treatment and pay directly to the provider or could contract with Reflections at a cost of$31.40 per day and Reflections would pay all provider costs for therapy, attending staffings, court, etc., including polygraphers, and any additional staff or services involved. WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Reflections For Youth, Inc. and Weld County Department of Human Services for the period from July 1, 2008 through June 30, 2009. The following provisions, made this //—day ay of / , 2008, are added to the referenced Agreement. Except as modified hereby, all terms of tement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#1530130, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$163.87 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$163.87 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum rnm,P— .O 11,K E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Human Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 12. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. 13. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 14. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 15. Add Paragraph 9 to Section VI. The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: A. Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed; B. Deny payment or recover reimbursement for those services or deliverables which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Human Services and the Contractor, or by Human Services as a debt to Human Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 16. Add Paragraph 10 to Section VI. The contractor shall promptly notify Human Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Human Services' Director. The term "litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: Liell-aizAh Weld C o the Board r4a° l'ks WELD COUNTY BOARD OF HUMAN SERVICES, ON BEHALF MI4 ' - OF THE WELD COUNTY % DEPARTMENT OF HUMAN SERVICES By By: 4- Deputy cyyrk to1he Board Chair Signature William H. Jerke AUG 1 1 2008 CONTRACTOR Reflections For Youth, Inc. PO Box 1860 Berthoud CO 80513 1 By. ,(4 _\ ifV -h l ,or WELD COUNTY DEPARTMENT OF HUMAN SERVICES a By: c"� Di)ctor 4 Weld County SS-23A Addendum ‘-‘96/_T-- 9/(c Exhibit A Reflections for Youth, Inc. "Discovering the Power of Positive Choice" P.O. Box 1860 Berthoud, CO 80513 (970) 344-1380 (p) (970) 344-1394 (f) 05-27-08 (1) Scope of Service: An agreement was reached between Weld County DSS and Reflections for Youth, Inc. for the purchase of four guaranteed beds during the fiscal year July 1, 2007—June 30, 2008. Reflections for Youth is interested in continuing with the agreement and if it is an option, could increase the guaranteed bed number to six (6) youth. Base on information from the 11 months of the current fiscal year, Weld County DSS has averaged six youth (actually 5.7) in placement. It is understood that the initial emphasis was on placements for females but can be used for males as well. It is further understood that Weld County DSS can place additional youth in placement at Reflections under the existing placement contract, provided that space is available at the time of the referral. A. Scope of Service Grismore: RFY Grismore TRCCF program is open to any male youth requiring a well structured community-based program, consistent supervision, therapeutic/mental health services, and extra support educationally. An I.E.P. is preferred but not required. Youth who are dependent, neglected, abused or delinquent are considered for admission. Typically such youth will demonstrate behavioral and emotional difficulties and have a history that involves one or more of the following: family conflict/dysfunction, physical abuse, sexual abuse, running away, substance abuse, sexual acting out, oppositional/conduct difficulties, self-defeating behaviors/activities, delinquent acts and adjudications and learning disorders. Reflections employs a contracted child psychiatrist and accepts youth currently taking and/or in need of psychotropic medications. All medication evaluation and management appointments are billed directly to Medicaid. Reflections will not reject any referral solely on the basis of the youth's psychiatric/emotional history, placement history, committed delinquent acts and/or adjudications and/or running behavior. Youth with an extensive history of aggression to self and/or others and requiring repeated restraint for the protection of self and others, as well as adjudicated sexual offenders will be assessed on a case-by-case basis. Reflections will work with sex offenders and all staff are certified in Informed Supervision and Therapeutic Care for Juveniles that Sexually Offend. Reflections for Youth, Inc. contracts with two separate agencies that work to provide SOMB approved sex offender support and employs a licensed therapist that provides Informed Supervision and Therapeutic Care training to all staff and families of youth placed in our facility. Reflections for Youth, Inc. also employs a master's level LCSW therapist that has completed the six-day Kempe Center, SOMB approved training as a necessary step in becoming a SOMB fully operating offender therapist. Exhibit A Youth with full-scale IQ below 70 and youth requiring routine emergency medical assistance(diabetic, seizure disorders, etc) will also be assessed on a case-by-case basis. Actively suicidal or homicidal youth will not be accepted until the criteria for 27-10 is no longer being met. Reflections maintains the right, after screening and appropriate professional discussions, to the deny acceptance of a referral with either or both of the described issues. Minimum ratios of 4:1 are maintained at all awake times during all awake non-school hours. During the weekday hours of approximately 8:00am to 6:00 p.m. the 4:1 ratio is enhanced with the presence of House Managers and Therapists on site. On-call support is available at ALL times. The ratio is 10:1 for overnight awake shift at the Grismore Treatment Facility. Roles for each staff are as follows. The House Manager is responsible for the supervision of all staff and insuring the program is following the state and placing agency guidelines and the mission and treatment philosophy of Reflections for Youth, Inc. The House Manager is charged with the authority to implement, evaluate, and ensure consistent application of policy and procedure within the group home/treatment center. Of highest priority is safety of the residents. The House Manager is responsible for the curb appeal, interior cleanliness, maintenance, and overall appearance of the home and property. In addition the House Manger is responsible for the overall quality and effectiveness of the treatment milieu. In addition to working direct care with the residents in place of any Child Care Worker position. The Associate House Manager is responsible to cooperate with the House Manager and ensure a safe, nurturing environment for residents, as well as providing direct milieu counseling support. Further, the AHM must be able to step-in and continue with the consistence application of polices and procedures as well as state regulations should the HM be absent, and/or for any absent Child Care Worker. The Special Education Teacher is the primary staff responsible for classroom instruction as well as assistance to the Educational Director regarding the student testing, IEP process, and student transcripts. The Teachers Assistant/Day Counselor is responsible for assisting the Special Ed. Teacher with classroom instruction and management and also to be available for transportation and at times of planned interventions or crisis to supervise youth that are not involved in the school program due to behavior problems, illness, outside appointments or other approved reasons. The Child Care Worker/Milieu Counselor is responsible to assist with daily scheduling and routines; to provide encouragement and motivation; to facilitate personal development and maturation by modeling behavior, appropriate social skills, restorative justice in the milieu and problem solving skills; and to implement behavior management and modification techniques, including a phase system as warranted. The Overnight Exhibit A Child Care Workers has the same responsibilities and additionally needs to check on the residents every 15 minutes and document accordingly to ensure safety. Therapists have responsibility to provide individual and family therapy to the residents assigned by the Clinical Directors as a"case load". They assess, write and document monthly treatment plans and therapy notes. They maintain contact with the caseworkers, probation officers, and GAL's, and provide family support during non- therapy times as needed. They have regular bi-weekly consultation with residential staff support meetings and are available as needed. Therapists are available for crisis intervention within the milieu. Therapists complete after-care agreements with residents and their families. They oversee discharge planning with external systems and complete discharge summaries. They are responsible for all required documentation and record keeping. They maintain their licensure as LCSW, LMFT or LPC and actively seek educational opportunities and offer Medicaid eligible individual, family and group therapies to all TRCCF youth in placement. ALL therapists providing services for Reflections for Youth, Inc. are fully licensed. Although Reflections is not a fully integrated DBT program/milieu yet, a great deal of emphasis has been placed in the last year with additional trainings and supports scheduled in the next year to move in that direction. All program staff that support the program at each of the facilities but are not directly assigned to any one facility are as follows; Executive Director, Educational Director, Treatment Coordinator, Medical Services Coordinator and Client Services Coordinator. The Executive Director is responsible for the supervision of the daily operation of the program at Reflections for Youth, Inc. The Executive Director is held accountable for census, IEP status, staffing patterns, resident and employee record keeping, treatment plans for clients, and operating budget compliance. In addition, it is the responsibility of the Executive Director to maintain a professional operation while constantly seeking to improve services and operational systems. Reflections' Executive Director is also a Licensed Professional Counselor and is available for TRCCF level Medicaid services that include individual therapy sessions conjoint family therapy sessions and group therapy sessions. The Educational Director is the leader of the educational team. The Educational Director is responsible for curriculum, teacher quality, and the maintenance of an excellent learning environment. In addition, the Educational Director is charged with the authority to implement, evaluate, and insure consistent application of corporate policy and procedure. The Educational Director also attends a majority of all twice monthly treatments planning sessions and staffings. The Treatment Coordinator is a licensed LCSW and oversees the non-Medicaid billable mental health services offered in the program. These include attending facility specific meetings and treatment team meetings to ensure that milieu-based counseling and support is occurring regularly and that all Family Service Plans and Discrete Case Plans are being followed and implemented. It also includes attending monthly staffings to monitor overall progress and to evaluate and change the Reflections Treatment Plan as needed for the benefit of the client and with the approval of the treatment team. The Treatment Coordinator gathers information from the Client Services Coordinator and other collaterals to Exhibit A complete the Initial Treatment Plan as soon as possible after intake but no later that 14 days after intake. The Medical Coordinator is responsible for ensuring that all policies and procedures that are related to the medical program at Reflections for Youth, Inc. are in compliance with licensing and are being followed at all times. This includes ensuring that initial physical, dental and vision appointments are scheduled timely and that all medication prescriptions are filled and kept in order. The Medical Coordinator conducts weekly audits of medical charts and coordinates with the House Manager of each facility to meet the needs of the youth in care. She also schedules all medication/psychiatric evaluation appointments and provides information to our Child Psychiatrist from counseling staff, therapists, managers,parents and placement workers so that he may serve the needs of the youth with all of the information available. The Client Services Coordinator has responsibilities in the areas of intake, drug and alcohol education and support services, including initial screening and testing for youth in need of drug and alcohol services, and within the Family:Family program at Reflections providing in-home services to the youth and family while the youth is still in placement at Reflections. Based on information provided to the state of Colorado Department of Human Services in the completion of our cost reports for the time periods July 1, 2006 —June 30, 2007, our average length of stay was 116 days. Reflections has worked hard to provide extensive transition services and planning and offers continuing support services through our core service home-based option B, Lifeksills and Day Treatment programs to enable youths to step-down sooner with continuing support. In addition, while a youth is still in TRCCF level placement, our family:family program is offered as a home-based service for family support and planning prior to the youth returning home. This is a program in addition to the Medicaid-billed therapeutic services offered to the family and was specifically put into place to reduce length of stays as possible and to promote a positive continuum of care. Reflections for Youth, Inc. operates a state-certified, centralized special education/regular education school. With a student-to-teacher ratio of no more than 5:1, and a year-round school offering three full semesters of education, students have the opportunity to get closer to or achieve the credits necessary for grade level education. A state curriculum of academics is presented with the goal for each youth to eventually transfer back to the public school system or to graduate from Reflections Academy. Reflections Academy employs a master's level, certified school administrator, state- certified special education teachers and qualified associate teachers. Reflections Academy assures a continuity of care for each of the youth in residential treatment by providing education experiences which remediate, maintain and improve academic, intellectual and social functioning. Educational experiences include occupational and recreational classes and opportunities as well as academic and remedial classes. Reflections for Youth, Inc. maintains a professional working relationship with Colorado Department of Education's Special Services Unit. Reflections operates a centralized school for its residential students and day treatment students, including female youth in the girl's adolescent residential program. The school must comply with CDE's teacher and administrator licensing requirements, state and national curriculum standards, Exhibit A the administration of CSAP testing each calendar year, October 1 and December counting reports, Title I compliance,No Child Left Behind, Special Education Law (IDEA) and FAPE (Free and Public Education). Reflections for Youth's educational program consists of a minimum of 6.5 hours of school daily and is offered year round. Students do not attend on regularly scheduled holidays and teacher workdays throughout the year. Upon entering the program, teachers and educational staff use a variety of formal and informal measures to assess student growth and achievement on a regular basis. When a student enters without an I.E.P. or if further testing is appropriate, a wide range achievement test is administered and scores are used for making education placement decisions. At the time of intake into the educational program, requests are immediately made for past school records, including a current I.E.P. if applicable and the student's home school is notified of the placement. The I.E.P. is reviewed for compliance and used as-is if appropriate. If the I.E.P. is out of compliance, an annual or triennial review will be scheduled in cooperation with the student's district of residence. Reflections for Youth teachers are state certified Special Education Generalists. All teachers are either master's level educators or are working towards their master's degree in special education and teacher preparation (Temporary Teacher Equivalency credentialed). Classroom paraprofessionals have at least a bachelor's level education and are state substitute certified. RFY also employs a Title I Reading Specialist on a yearly basis to meet the needs of students struggling with reading and mathematics. Reflections for Youth's educational program is overseen by a master's level Special Education Director and RFY employs licensed therapists only. (2) Daily Rate for Service: Reflections for Youth, Inc. daily rate for service will be the anchor rates that the state has established for the Grismore TRCCF facility. The rate for fiscal year 2007/2008 was $161.44 per day. It is unknown at this time what the rate for fiscal year 2008/2009 will be but our actual costs based on the cost report due April 30, 2008 were $173.35 per day. This rate does not reflect the fee-for-service piece that is billable directly to Medicaid. (3) Menu of Services: Additional fees that were paid last year and once again asked for this year include drug and alcohol services, if needed based on history, initial testing and CCAR and beyond education and for specific offender service treatments. An additional $9.75 per day is requested if drug and alcohol services, beyond education, are needed. This can be a negotiated rate depending upon level of service that is needed. Reflections is in the process of becoming ADAD certified and is expecting certification by October 2008. Exhibit A • What follows is an entire description of the drug and alcohol program offered at Reflections for Youth, Inc. The Drug and Alcohol program is a divided into educational and treatment service components and is heavily based in the skills and skillsets of DBT. The therapeutic and treatment portion is named the Substance Abuse and Dependency Program. Clients in the Substance Abuse and Dependency Program also receive the services offered in the Drug and Alcohol educational program. In this way Reflections for Youth, Inc. offers Education program, Comprehensive prevention program, Intervention program and Treatment level program. The mission of Reflections for Youth, Inc. Drug and Alcohol Program is to provide education and access to prevention services to every youth in the community based residential and day treatment programs. These services are provided through weekly educational/support and therapy groups. Educational groups are facilitated by a CAC I or Milieu Counselor. Educational services are initiated at intake as students are immediately enrolled in a once weekly class. (Educational Program) Prevention services and support/therapy groups are conducted by CAC, CACIII or licensed therapists. Access to these services is determined by the administration of an assessment tool (SASSI), DSM IV diagnosis, interviews with the client, family and Case Worker, and a history/documentation review. These initial assessments are conducted by a CAC level staff member. Once the assessment procedures are completed a licensed therapist recommends that the resident either participate in only the educational portion of the Drug and Alcohol Program or the Substance Abuse and Dependency Program. Random UA screenings are provided by Reflections for Youth as part of the residential program. In most circumstances youth classified as experimental users will be eligible to participate in the weekly coping skills group. This group includes the skills portion of the DBT model and incorporates educational and prevention components, such as safety planning, cognitive distortions and further education not included in the educational services. This group is facilitated by a licensed therapist and/or CAC II level counselor. The decision for this level of program involvement will be made by the Reflections clinical team, Substance Abuse and Dependency Program staff and the Client Manager. (Comprehensive prevention program and Intervention Program) Anyone deemed as "dependent" on the SASSI Assessment is required to attend AA or NA meetings in their home environment while on home passes, and get a sponsor. They must have a 12 step attendance form signed and have sponsor make contact with the facility to speak with the House Manager of Client Services Coordinator. For youth involved in need of the Comprehensive prevention and Intervention program, recommendations may be made and requirements put in place for the youth(s) to attend AA or NA in the community while in placement in addition to during times of home visits. The mission of Reflections for Youth's Substance Abuse and Dependency Program is for each participant to understand the power of a sober life by developing coping strategies independent of substances, developing healthful ways to think about the world and themselves, identifying and addressing any underlying causes to the dependent Exhibit A behavior, and by creating personal situations that sustain abstinence and a healthy lifestyle. The additional services provided above the educational and coping skills component are weekly therapy group; every third week art therapy group conducted by a CAC III, access to individual support sessions with CAC level counselor, and focused cognitive behavioral assignments for individual and family therapy. The therapeutic assignments assist the individual to identify their cycle of abuse (triggers, cognitive distortions and unhealthy coping strategies), the underlying causes of their abuse/dependency, the specific belief systems that create their cycle of abuse/dependency, and the provocation of thinking about their future in planning for a life of abstinence from drugs and alcohol. The therapy group is structured to protect the safety of its members by requiring that the Pt cognitive behavioral therapy assignment is completed and that all members have respectfully put effort into and participated in the educational and coping skills group. Additionally, students are required to have reports from staff and their therapist that indicate they practice and use the coping skills discussed in the group. These requirements help create a safe group where participants are able to talk openly about their underlying causes and provide support or feedback regarding their belief systems that are not conducive to sobriety. All members of the program generate safety plans prior to passes and members of the abuse and dependency program must complete their relapse prevention plan to successfully complete the program. (Treatment level program). Because the Substance abuse and dependency program is tied to the residential program, therapeutic, educational and milieu services are provide conjointly. Substance abuse program members have milieu goals that focus on their substance use in addition to any other behavioral or emotional concerns. In the event an offender youth is placed by Weld County DSS, Weld County DSS would have an option of contracting with the S.O. provider directly for all services, including polygraphs and other services required as part of the SO treatment and pay directly to the provider or could contract with Reflections at a cost of$31.40 per day and Reflections would pay all provider costs for therapy, attending staffings, court, etc., including polygraphers, and any additional staff or services involved. • WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Reflections For Youth and Weld County Department of Human Services for the period from July 1, 2008 through June 30, 2009. ZX The following provisions, made this f/day of ,4( ,/c!2008, are added to the referenced Agreement. Except as modified hereby, all terms of the Agreement remain unchanged. 1. County and Contractor, identified as Provider ID#1530131, agrees as follows: A. Contractor will provide four(4) guaranteed Therapeutic Residential Child Care Facility (TRCCF)beds, located at 1435 South County Road 17, Berthoud, CO, 80513, for the exclusive use of the County. County agrees to pay$163.87 per day for each guaranteed bed that is not filled by a County youth. B. Contractor will provide Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$163.87 per day for children placed within the Therapeutic Residential Child Care Facility. C. Contractor will provide Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$163.87 per day for children placed within the Residential Child Care Facility. RCCF placements may be considered as guarantee beds on a case by case basis. D. Contractor will give County youth priority placement at other facilities operated by Contractor. E. Additional services not covered by Medicaid or considered within the above rate may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments, excluding guaranteed beds, are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: 1 Weld County SS-23A Addendum an- (->2/6Ci A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Human Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. 2 Weld County SS-23A Addendum B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 11. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. 12. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 13. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 14. Add Paragraph 9 to Section VI. The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: A. Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed; B. Deny payment or recover reimbursement for those services or deliverables which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; 3 Weld County SS-23A Addendum C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Human Services and the Contractor, or by Human Services as a debt to Human Services or otherwise as provided by law. 15. Add Paragraph 10 to Section VI. The contractor shall promptly notify Human Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Human Services' Director. The term "litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: �_ /____� _ Weld, d i37Cle o the Board i �� 7 WELD COUNTY BOARD OF ! Y ' p to .\ -, -- HUMAN SERVICES, ON BEHALF e, / —1--- U OF THE WELD COUNTY DEPARTMENT OF HUMAN a SERVICES tip_ By: / '71/ e k By: $1-„,,j.,-/„., Deputy Cl rk to the Board Chair Signature William H. Jerke AUG 1 1 2008 CONTRACTOR Reflections For Youth, Inc. PO Box 1860 Berthoud CO 80513 By. id WELD COUNTY DEPARTMENT OF HUMAN SERVICES By: jLA (L ok,„"_,, DiI for 4 Weld County SS-23A Addendum p Exhibit A Reflections for Youth, Inc. "Discovering the Power of Positive Choice" P.O. Box 1860 Berthoud, CO 80513 (970) 344-1380 (p) (970) 344-1394 (f) 05-27-08 (1) Scope of Service: An agreement was reached between Weld County DSS and Reflections for Youth, Inc. for the purchase of four guaranteed beds during the fiscal year July 1, 2007 —June 30, 2008. Reflections for Youth is interested in continuing with the agreement and if it is an option, could increase the guaranteed bed number to six (6) youth. Base on information from the 11 months of the current fiscal year, Weld County DSS has averaged six youth (actually 5.7) in placement. It is understood that the initial emphasis was on placements for females but can be used for males as well. It is further understood that Weld County DSS can place additional youth in placement at Reflections under the existing placement contract, provided that space is available at the time of the referral. C. Scope of Service Wilderness: RFY Wilderness TRCCF program is open to any female youth requiring a well structured community-based program, consistent supervision, therapeutic/mental health services, and extra support educationally. An I.E.P. is preferred but not required. Youth who are dependent, neglected, abused or delinquent are considered for admission. Typically such youth will demonstrate behavioral and emotional difficulties and have a history that involves one or more of the following: family conflict/dysfunction, physical abuse, sexual abuse, running away, substance abuse, sexual acting out, oppositional/conduct difficulties, self-defeating behaviors/activities, delinquent acts and adjudications and learning disorders. Reflections employs a contracted child psychiatrist and accepts youth currently taking and/or in need of psychotropic medications. All medication evaluation and management appointments are billed directly to Medicaid. Reflections will not reject any referral solely on the basis of the youth's psychiatric/emotional history, placement history, committed delinquent acts and/or adjudications and/or running behavior. Youth with an extensive history of aggression to self and/or others and requiring repeated restraint for the protection of self and others, as well as adjudicated sexual offenders will be assessed on a case-by-case basis. Reflections will work with sex offenders and all staff are certified in Informed Supervision and Therapeutic Care for Juveniles that Sexually Offend. Reflections for Youth, Inc. contracts with two separate agencies that work to provide SOMB approved sex offender support and employs a licensed therapist that provides Informed Supervision and Therapeutic Care training to all staff and families of youth placed in our facility. Reflections for Youth, Inc. also employs a master's level therapist that has completed the six-day Kempe Center, SOMB approved training as a necessary step in becoming a SOMB fully operating offender therapist. Exhibit A Youth with full-scale IQ below 70 and youth requiring routine emergency medical assistance(diabetic, seizure disorders, etc) will also be assessed on a case-by-case basis. Actively suicidal or homicidal youth will not be accepted until the criteria for 27-10 is no longer being met. Reflections maintains the right, after screening and appropriate professional discussions, to the deny acceptance of a referral with either or both of the described issues. Reflections Wilderness offers a 17 session Teen Life Skills Health Education Program curriculum to all female youth in the residential program. The curriculum is designed so that new youth can enter the curriculum at anytime and continue through the completion of the curriculum. The curriculum is as follows: • Our bodies, Ourselves • Reproduction 101 • Hormones 101 • What's Happened to My Self-Esteem? • What Do I Value? • Choices and Conscious Decisions—Intentionality • How Can I Be Assertive Without Being Aggressive? • Sexuality • Contraception • Sexually Transmitted Diseases • Are You or Are Not You My Friend? • Dating Violence • Sexual Exploitation • Free to Be, You and Me • Identifying and Understanding Eating Disorders • Women's History is Now My History • Journaling My Story. It is Important! Reflections believes it is important to offer gender specific programming because albeit some of the issues facing adolescents today are similar, most research agrees that females in our society face a certain specific set of issues, different from those of adolescent males. Some of the issues discussed and processed in the curriculum may even be the same issues but within the gender specific programming they are looked at in a different way and from the female adolescent perspective Minimum ratios of 4:1 are maintained at all awake times during all awake non-school hours. During the weekday hours of approximately 8:00am to 6:00 p.m. the 4:1 ratio is enhanced with the presence of House Managers and Therapists on site. On-call support is available at ALL times. The ratio is 8:1 for overnight awake shifts at the Wilderness Treatment Facility. Roles for each staff are as follows. The House Manager is responsible for the supervision of all staff and insuring the program is following the state and placing agency Exhibit A guidelines and the mission and treatment philosophy of Reflections for Youth, Inc. The House Manager is charged with the authority to implement, evaluate, and ensure consistent application of policy and procedure within the group home/treatment center. Of highest priority is safety of the residents. The House Manager is responsible for the curb appeal, interior cleanliness, maintenance, and overall appearance of the home and property. In addition the House Manger is responsible for the overall quality and effectiveness of the treatment milieu. In addition to working direct care with the residents in place of any Child Care Worker position. The Associate House Manager is responsible to cooperate with the House Manager and ensure a safe, nurturing environment for residents, as well as providing direct milieu counseling support. Further, the AHM must be able to step-in and continue with the consistence application of polices and procedures as well as state regulations should the HM be absent, and/or for any absent Child Care Worker. The Special Education Teacher is the primary staff responsible for classroom instruction as well as assistance to the Educational Director regarding the student testing, IEP process, and student transcripts. The Teachers Assistant/Day Counselor is responsible for assisting the Special Ed. Teacher with classroom instruction and management and also to be available for transportation and at times of planned interventions or crisis to supervise youth that are not involved in the school program due to behavior problems, illness, outside appointments or other approved reasons. The Child Care Worker/Milieu Counselor is responsible to assist with daily scheduling and routines; to provide encouragement and motivation; to facilitate personal development and maturation by modeling behavior, appropriate social skills, restorative justice in the milieu and problem solving skills; and to implement behavior management and modification techniques, including a phase system as warranted. The Overnight Child Care Workers has the same responsibilities and additionally needs to check on the residents every 15 minutes and document accordingly to ensure safety. Therapists have responsibility to provide individual and family therapy to the residents assigned by the Clinical Directors as a"case load". They assess, write and document monthly treatment plans and therapy notes. They maintain contact with the caseworkers, probation officers, and GAL's, and provide family support during non- therapy times as needed. They have regular bi-weekly consultation with residential staff support meetings and are available as needed. Therapists are available for crisis intervention within the milieu. Therapists complete after-care agreements with residents and their families. They oversee discharge planning with external systems and complete discharge summaries. They are responsible for all required documentation and record keeping. They maintain their licensure as LCSW, LMFT or LPC and actively seek educational opportunities and offer Medicaid eligible individual, family and group therapies to all TRCCF youth in placement. ALL therapists employed by Reflections for Youth, Inc are fully licensed. Although Reflections is not a fully integrated DBT Exhibit A program/milieu yet, a great deal of emphasis has been placed in the last year with additional trainings and supports scheduled in the next year to move in that direction. All program staff that support the program at each of the facilities but are not directly assigned to any one facility are as follows; Executive Director, Educational Director, Treatment Coordinator, Medical Services Coordinator and Client Services Coordinator. The Executive Director is responsible for the supervision of the daily operation of the program at Reflections for Youth, Inc. The Executive Director is held accountable for census, IEP status, staffing patterns, resident and employee record keeping, treatment plans for clients, and operating budget compliance. In addition, it is the responsibility of the Executive Director to maintain a professional operation while constantly seeking to improve services and operational systems. Reflections' Executive Director is also a Licensed Professional Counselor and is available for TRCCF level Medicaid services that include individual therapy sessions conjoint family therapy sessions and group therapy sessions. The Educational Director is the leader of the educational team. The Educational Director is responsible for curriculum, teacher quality, and the maintenance of an excellent learning environment. In addition, the Educational Director is charged with the authority to implement, evaluate, and insure consistent application of corporate policy and procedure. The Educational Director also attends a majority of all twice monthly treatments planning sessions and staffings. The Treatment Coordinator is a licensed LCSW and oversees the non-Medicaid billable mental health services offered in the program. These include attending facility specific meetings and treatment team meetings to ensure that milieu-based counseling and support is occurring regularly and that all Family Service Plans and Discrete Case Plans are being followed and implemented. It also includes attending monthly staffings to monitor overall progress and to evaluate and change the Reflections Treatment Plan as needed for the benefit of the client and with the approval of the treatment team. The Treatment Coordinator gathers information from the Client Services Coordinator and other collaterals to complete the Initial Treatment Plan as soon as possible after intake but no later that 14 days after intake. The Medical Coordinator is responsible for ensuring that all policies and procedures that are related to the medical program at Reflections for Youth, Inc. are in compliance with licensing and are being followed at all times. This includes ensuring that initial physical, dental and vision appointments are scheduled timely and that all medication prescriptions are filled and kept in order. The Medical Coordinator conducts weekly audits of medical charts and coordinates with the House Manager of each facility to meet the needs of the youth in care. She also schedules all medication/psychiatric evaluation appointments and provides information to our Child Psychiatrist from counseling staff, therapists, managers, parents and placement workers so that he may serve the needs of the youth with all of the information available. The Client Services Coordinator has responsibilities in the areas of intake, drug and alcohol education and support services, including initial screening and testing for youth in need of drug and alcohol services, and within the Family:Family program at Reflections providing in-home services to the youth and family while the youth is still in placement at Reflections. Exhibit A Based on information provided to the state of Colorado Department of Human Services in the completion of our cost reports for the time periods July 1, 2006—June 30, 2007, our average length of stay was 116 days. Reflections has worked hard to provide extensive transition services and planning and offers continuing support services through our core service home-based option B, Lifeksills and Day Treatment programs to enable youths to step-down sooner with continuing support. In addition, while a youth is still in TRCCF level placement, our family:family program is offered as a home-based service for family support and planning prior to the youth returning home. This is a program in addition to the Medicaid-billed therapeutic services offered to the family and was specifically put into place to reduce length of stays as possible and to promote a positive continuum of care. Reflections for Youth, Inc. operates a state-certified, centralized special education/regular education school. With a student-to-teacher ratio of no more than 5:1, and a year-round school offering three full semesters of education, students have the opportunity to get closer to or achieve the credits necessary for grade level education. A state curriculum of academics is presented with the goal for each youth to eventually transfer back to the public school system or to graduate from Reflections Academy. Reflections Academy employs a master's level, certified school administrator, state- certified special education teachers and qualified associate teachers. Reflections Academy assures a continuity of care for each of the youth in residential treatment by providing education experiences which remediate, maintain and improve academic, intellectual and social functioning. Educational experiences include occupational and recreational classes and opportunities as well as academic and remedial classes. Reflections for Youth, Inc. maintains a professional working relationship with Colorado Department of Education's Special Services Unit. Reflections operates a centralized school for its residential students and day treatment students, including female youth in the girl's adolescent residential program. The school must comply with CDE's teacher and administrator licensing requirements, state and national curriculum standards, the administration of CSAP testing each calendar year, October 1 and December counting reports, Title I compliance, No Child Left Behind, Special Education Law (IDEA) and FAPE (Free and Public Education). Reflections for Youth's educational program consists of a minimum of 6.5 hours of school daily and is offered year round. Students do not attend on regularly scheduled holidays and teacher workdays throughout the year. Upon entering the program, teachers and educational staff use a variety of formal and informal measures to assess student growth and achievement on a regular basis. When a student enters without an I.E.P. or if further testing is appropriate, a wide range achievement test is administered and scores are used for making education placement decisions. At the time of intake into the educational program, requests are immediately made for past school records, including a current I.E.P. if applicable and the student's home school is notified of the placement. The I.E.P. is reviewed for compliance and used as-is if appropriate. If the I.E.P. is out of Exhibit A compliance, an annual or triennial review will be scheduled in cooperation with the student's district of residence. Reflections for Youth teachers are state certified Special Education Generalists. All teachers are either master's level educators or are working towards their master's degree in special education and teacher preparation (Temporary Teacher Equivalency credentialed). Classroom paraprofessionals have at least a bachelor's level education and are state substitute certified. RFY also employs a Title I Reading Specialist on a yearly basis to meet the needs of students struggling with reading and mathematics. Reflections for Youth's educational program is overseen by a master's level Special Education Director and RFY employs licensed therapists only. (2) Daily Rate for Service: Reflections for Youth, Inc. daily rate for service will be the anchor rates that the state has established for the Grismore TRCCF facility. The rate for fiscal year 2007/2008 was $161.44 per day. It is unknown at this time what the rate for fiscal year 2008/2009 will be but our actual costs based on the cost report due April 30, 2008 were $173.35 per day. This rate does not reflect the fee-for-service piece that is billable directly to Medicaid. (3) Menu of Services: Additional fees that were paid last year and once again asked for this year include drug and alcohol services, if needed based on history, initial testing and CCAR and beyond education and for specific offender service treatments. An additional $9.75 per day is requested if drug and alcohol services, beyond education, are needed. This can be a negotiated rate depending upon level of service that is needed. Reflections is in the process of becoming ADAD certified and is expecting certification by October 2008. What follows is an entire description of the drug and alcohol program offered at Reflections for Youth, Inc. The Drug and Alcohol program is a divided into educational and treatment service components and is heavily based in the skills and skillsets of DBT. The therapeutic and treatment portion is named the Substance Abuse and Dependency Program. Clients in the Substance Abuse and Dependency Program also receive the services offered in the Drug and Alcohol educational program. In this way Reflections for Youth, Inc. offers Education program, Comprehensive prevention program, Intervention program and Treatment level program. The mission of Reflections for Youth, Inc. Drug and Alcohol Program is to provide education and access to prevention services to every youth in the community based Exhibit A residential and day treatment programs. These services are provided through weekly educational/support and therapy groups. Educational groups are facilitated by a CAC I or Milieu Counselor. Educational services are initiated at intake as students are immediately enrolled in a once weekly class. (Educational Program) Prevention services and support/therapy groups are conducted by CAC, CACIII or licensed therapists. Access to these services is determined by the administration of an assessment tool (SASSI), DSM IV diagnosis, interviews with the client, family and Case Worker, and a history/documentation review. These initial assessments are conducted by a CAC level staff member. Once the assessment procedures are completed a licensed therapist recommends that the resident either participate in only the educational portion of the Drug and Alcohol Program or the Substance Abuse and Dependency Program. Random UA screenings are provided by Reflections for Youth as part of the residential program. In most circumstances youth classified as experimental users will be eligible to participate in the weekly coping skills group. This group includes the skills portion of the DBT model and incorporates educational and prevention components, such as safety planning, cognitive distortions and further education not included in the educational services. This group is facilitated by a licensed therapist and/or CAC level counselor. The decision for this level of program involvement will be made by the Reflections clinical team, Substance Abuse and Dependency Program staff and the Client Manager. (Comprehensive prevention program and Intervention Program) Anyone deemed as "dependent" on the SASSI Assessment is required to attend AA or NA meetings in their home environment while on home passes, and get a sponsor. They must have a 12 step attendance form signed and have sponsor make contact with the facility to speak with the House Manager of Client Services Coordinator. For youth involved in need of the Comprehensive prevention and Intervention program, recommendations may be made and requirements put in place for the youth(s) to attend AA or NA in the community while in placement in addition to during times of home visits. The mission of Reflections for Youth's Substance Abuse and Dependency Program is for each participant to understand the power of a sober life by developing coping strategies independent of substances, developing healthful ways to think about the world and themselves, identifying and addressing any underlying causes to the dependent behavior, and by creating personal situations that sustain abstinence and a healthy lifestyle. The additional services provided above the educational and coping skills component are weekly therapy group; every third week art therapy group conducted by a CAC III, access to individual support sessions with CAC II level counselor, and focused cognitive behavioral assignments for individual and family therapy. The therapeutic assignments assist the individual to identify their cycle of abuse (triggers, cognitive distortions and unhealthy coping strategies), the underlying causes of their abuse/dependency, the specific belief systems that create their cycle of abuse/dependency, and the provocation of thinking about their future in planning for a life of abstinence from drugs and alcohol. For youth that are referred to the program and in need of drug and alcohol services beyond education, there is an additional daily rate charge of$9.75/day. Exhibit A The therapy group is structured to protect the safety of its members by requiring that the 1st cognitive behavioral therapy assignment is completed and that all members have respectfully put effort into and participated in the educational and coping skills group. Additionally, students are required to have reports from staff and their therapist that indicate they practice and use the coping skills discussed in the group. These requirements help create a safe group where participants are able to talk openly about their underlying causes and provide support or feedback regarding their belief systems that are not conducive to sobriety. All members of the program generate safety plans prior to passes and members of the abuse and dependency program must complete their relapse prevention plan to successfully complete the program. (Treatment level program). Because the Substance abuse and dependency program is tied to the residential program, therapeutic, educational and milieu services are provide conjointly. Substance abuse program members have milieu goals that focus on their substance use in addition to any other behavioral or emotional concerns. In the event an offender youth is placed by Weld County DSS, Weld County DSS would have an option of contracting with the S.O. provider directly for all services, including polygraphs and other services required as part of the SO treatment and pay directly to the provider or could contract with Reflections at a cost of$31.40 per day and Reflections would pay all provider costs for therapy, attending staffings, court, etc., including polygraphers, and any additional staff or services involved. WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Savio House and Weld County Department of Human Services for the period from July 1,2008 through June 30, 2009. The following provisions, made this g— ay of,�4zf 2008, are added to the referenced Agreement. Except as modified hereby, all terms of e Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#48170, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$180.75 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$180.75 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum a —ai6R E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include,but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number (970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Human Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 12. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. 13. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 14. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 15. Add Paragraph 9 to Section VI. The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: A. Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed; B. Deny payment or recover reimbursement for those services or deliverables which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Human Services and the Contractor, or by Human Services as a debt to Human Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 16. Add Paragraph 10 to Section VI. The contractor shall promptly notify Human Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five(5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Human Services' Director. The term "litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written.aidATTEST: Ia di Weld Co o the Board N b` WELD COUNTY BOARD OF j HUMAN SERVICES, ON BEHALF sF, OF THE WELD COUNTY !" DEPARTMENT OF HUMAN � SERVICES 4 _.,0.`r, (, By: f By: '1-r--c( L--!-✓x Deputy C c to t e Board Chair Signature William H. Jerke AUG 1 1 2008 CONTRACTOR Savio House 325 King St Denver, CO 80219 By://i4/‘' WELD COUNTY DEPARTMENT OF HUMAN SERVICES By: 1, ILCicifL 1juni irector 4 Weld County SS-23A Addendum &M2- v?/laS Exhibit A SAVIO HOUSE RESIDENTIAL TREATMENT CENTER PROGRAM DESCRIPTION INTRODUCTION The Savio House residential program serves twenty-seven male adolescents, ten to eighteen years old, who are classified as emotionally and behaviorally disturbed. Savio's RTC provides a comprehensive, structured and integrative program which includes individual and group treatment, family therapy, seamless therapeutic services, educational programming, recreational activities, and other planned activities appropriate to the age, behavior levels and emotional readiness of the residents. Program goals are to quickly address the presenting problems and to reintegrate the adolescent into his home and public school or emancipate him to independent living. Clients are assigned to Savio by local juvenile courts and public social service agencies. Savio clients are court ordered into placement as dependent and neglected and/or delinquent. The program services described here can be delivered in either a short or long term mode depending on the needs of the individual client and family. Family pathology and wishes, the juvenile court mandate, the objectives of the referral source and progress towards identified treatment goals dictate length of service. ADMISSIONS Behavioral and family characteristics of clients served in the Savio residential program are: • Emotional, thought, attitudinal, and educational impairments; • Drug and alcohol abuse; • Poor or non-existent school attendance; • Delinquent acts such as auto theft, breaking and entering, assaults, property damage, stealing/shoplifting, and repeated police contacts; • Sexual acting-out; • Victimization of others; • Fire-setting (depending on severity); • Enuresis/Encopresis; • Lack of impulse control; • Runaway behavior; • Intellectual and/or neurological handicap (minor); • Withdrawn and self-destructive; • Suicide gestures/attempts; • Abandonment by parents; • Minimizes negative behavior; • Hostile to authority; • Long-term neglect by family; and, • Compulsive lying. Referrals are made to the Savio Residential Treatment Coordinator and are followed by an assessment interview as a placement opening is nearing. In preparation of this meeting, referral sources are asked to provide as much of the following materials as is available: • A current social history; • Delinquent, probation, and court records; • Psychological/Psychosexual and psychiatric evaluations; • Education records including recent testing and individual education plans; and, • Any other document providing background history. Referral sources are notified within 24 hours regarding acceptance and the planned time of admission. During this first interview an initial Case Service Plan is established with input from all involved parties. Upon intake the new student meets with selected staff and senior students to: • Complete admissions reports and to be entered into the client database; • Define client and staff responsibilities; • Do preliminary medical screening with an appointment for medical care within 10 days and dental services within 30 days; • Inventory of belongings; • Explain non-prescription and prescription drug policy; • Receive grievance procedure, damage policy, student's rights, personal hygiene and room checklists and Positive Peer Culture problem-solving list; • Receive bedding and personal hygiene supplies; • Review Boys' Rule Book with student; • View the dormitory, facilities, fire alarm, and exits; and, • Be introduced to the dormitory and peer therapy group. FAMILY INVOLVEMENT The Residential Program utilizes a family focused, strengths-based approach to treatment planning, implementation and evaluation. Family involvement is considered key to successful treatment outcomes, as family reunification is the primary goal for the majority of the residents. Savio is a family friendly agency and as much family involvement as possible is encouraged. The adolescent's family members are involved in all phases of treatment and are encouraged to share their knowledge and experiences with staff to better serve the youth in the program. Family members attend pre-placement and intake interviews and are given a Parent Handbook which describes the program in detail. The assigned Therapist makes immediate contact with the family and schedules weekly family therapy sessions, often occurring within 24 hours of intake into the program. Savio does not serve adolescents without parental consent. The only exception to this would be in a situation where parental rights have been terminated. In such cases, Savio would obtain consent from social services or other legal guardian. Savio RTC Program Description, Page 2 Family therapy is done weekly with a minimum of every other session in the home and may occur in the evenings and on weekends as well as during the weekday. Therapy is implemented using a systems approach meaning that the family's needs are addressed in addition to the adolescent's problem areas or deficiencies. Services are provided in a professional and respectful manner that encourages a sense of trust and teamwork. When a resident has been accepted from a location not in geographic proximity to Savio because of specialized needs not available closer to home, Savio makes significant efforts to involve the family in treatment and maintain family ties. This may be done through arrangements which compensate for the distance (such as traveling to the home or assisting the family with travel arrangements), and/or coordinating and arranging for all needed family services in the family's community. Parents are invited and encouraged to attend all clinical and educational staffings and to have input into treatment implementation. Families are encouraged to visit Savio often in order to become acquainted and feel comfortable with the facility, treatment program and staff. Family focused activities, such as the bi-annual Open House and weekly parenting groups, are held at Savio to encourage family involvement and support. There are two parenting groups facilitated by Savio House staff. Partners in Parenting is a sixteen week parenting group focused on improving parenting skills related to discipline and communication. The second parenting group is the Caretaker of Offender group. The Caretaker of Offender group is focused on offense-specific related concepts and the treatment of sexual abuse. Any family in need receives donations (holiday meals, food items, cleaning products, paper products) and assistance with community resources in order to obtain the items independently in the future. Finally, family members are given the opportunity to evaluate the program, the staff and the services they have received through Parent Satisfaction Surveys which are administered twice yearly. EXTENDED HOME PASSES AND CHECK-OUTS Because Savio House considers healthy functioning within the family a primary goal, residents who are able to utilize skills to remain safe in the community often times spend the entire or a portion of the weekends at their home. During this time, the family is given assignments or asked to focus on using the skills being developed in family meetings. For example, parents are challenged to set rules and follow through with consequences in the home if/when rules are violated. Family members are encouraged to access community resources to spend time together in prosocial activities. Problems that may arise during home passes, are the topic of family therapy the following week. The family is empowered to solve problems using their strengths and newly developing skills. In addition, residents are given the opportunity to practice more appropriate behaviors at home and in the community, with extended home passes and community check-outs. Savio RTC Program Description, Page 3 FAMILY GROUP CONFERENCING Savio's philosophy is that transition planning begins at the point of admission to Savio and that constant efforts are directed toward a time-limited, successful discharge from the program. Staff join with families in the intervention and treatment process and use a strengths-based approach when addressing family issues. At various times throughout involvement with the program, staff and the family may decide to schedule a family group conference to have the family discuss and resolve a problem or issue, make decisions regarding long term living arrangements or discuss treatment planning. Although meetings can be held at any time, opportune situations may include resolving a family crisis, encouraging involvement from extended family, and developing safety and transition plans. The meeting is to be cooperative in nature and shall utilize the strengths and decision making abilities of the family members rather than allowing the meeting to be facilitated as a therapy session or staffing. The meetings may also illicit community support, as supportive community members may also participate in family group conferencing. Prior to the meeting, an agenda and an outcome goal are developed and shared with all meeting participants. Family members are asked to follow the agenda and to determine as a team how to resolve the specified issues. After the meeting, the notes are finalized and distributed to involved parties and become a formal plan of action. TREATMENT PLANNING A preliminary Case Service Plan is created at the initial intake interview prior to placement with input from the referral representatives, family and client. This permits the adolescent and staff to implement the treatment program the moment the client enters Savio. A comprehensive plan is developed ten days after admission with direction from the Savio multi-disciplinary staffing team. A monthly review and revision are accomplished by the same teams with client and family participation. Those clients referred for service on an involuntary basis participate in the formulation and review of the service plan to the extent that they are able. This concerted effort maintains focus and makes the placement much more efficient. Clients or parents who are not able to participate fully in the treatment planning are informed in advance about the benefits and risks of, and alternatives to, planned treatment to be administered by Savio. A detailed discharge plan with objectives for follow-up care and identification of responsibilities is completed as the adolescent departs the facility. All documents are written in a goals and objective format which define the desired outcome, steps to be taken and means to determine the degree of accomplishment. Copies of case service plans, reviews and discharges are distributed to all approved groups. Treatment planning is a comprehensive effort with input from all sectors of the agency. Psychiatric and psychological consultants give input from their assessments, social workers note family and client status from their weekly home visitations, educational staff describe school progress and counselors detail student interactions in the therapeutic environment. Family members are considered critical participants in treatment planning, when possible. Treatment planning will cover the following areas: • Health care Savio RTC Program Description, Page 4 • Education • Mental health status • Personal/social development • Family relationships • Vocational training • Recreation • Life skills development Treatment planning also regularly evaluates the effectiveness of the treatment, whether the client is benefiting and a review of more or less restrictive treatment alternatives. It is the goal of Savio to use the least restrictive treatment alternative that is most appropriate for the specific needs of the client. All contributing professionals document their findings for case service plans and counselors use the Savio Computer Assisted Treatment Program in addition to written charting. The counselors' computer allows them to track each day's progress and to provide daily, weekly, monthly, and end of placement summaries for case planning. All efforts are directed at a focused, goal- oriented, realistic, time-limited, and successful placement. Savio recognizes the client's right to refuse any treatment or medication, unless those rights have been limited by law or court order, and Savio informs clients of the consequences of such refusal. It should be noted that "treatment" is not meant to include those group and individual, social, educational or counseling activities that are a routine part of the overall program, but rather a specific or unusual intervention, form of therapy or medication. Invitations to staffings are provided to: • L.S.C.W. Program Coordinator and Social Worker • Consulting Psychologist • B.A. level Counselors • Educational staff • Recreation Coordinator • Family members • Client • Guardian ad litem • Referral representatives • Probation Officer The Consulting Psychologist, who is present at all staffings, will review the client information and participate in the staffing. The Consulting Psychologist will provide a diagnosis according to the current Diagnostic and Statistical Manual of Mental Disorder of the American Psychiatric Association. Savio RTC Program Description, Page 5 TREATMENT PROCESS PROGRAM PHILOSOPHIES Cognitive Behavioral Therapy. There are several schools of cognitive-behavioral therapy (Spiegler & Guevremont, 1993). Fundamentally, cognitive-behavioral therapy seeks to change the cognitions, attitudes, values and expectations that maintain anti-social behavior. Problem- solving, reasoning, self-control, and self-instruction are techniques that are frequently utilized. A major tenet of cognitive-behavioral therapy is that therapeutic relationships involve empathy, openness and understanding in order for interventions to be effective. A second tenet is that thinking is a basic determinant of behavior for all people. Thinking consists of what a juvenile says to himself, and it is this inner dialogue, rather than unconscious forces, that is the key to understanding behavior. A third major tenet is that the past is important only in identifying those origins of faulty thinking. It is the present faulty thinking, not the past, which motivates behavior. Finally, in order to make constructive changes, the adolescent must realize that his misconceptions may produce or contribute to many of his problems, and he must assume responsibility for modifying these misconceptions. Once an adolescent accepts the proposition that thoughts and beliefs medicate his emotional reactions, it is important to help him examine his personal thoughts that pertain to his difficulties and to identify specific situations that engender dysfunctional cognitions. For example, an adolescent who has difficulties controlling anger, may identify that certain situations frequently trigger an angry response. As adolescents gain awareness of their dysfunctional thoughts and beliefs, they generally welcome efforts to learn new coping patterns. These coping strategies consist of employing self-statements that are both realistic and effective in eliminating negative emotional reactions and self-defeating behaviors (Hepworth, Rooney and Larsen, 1997). Aggressive Replacement Training (ART) by Goldstein and Glick compliments the cognitive- behavioral approach. The ART model assumes that delinquency arises from multiple factors, including poor social-cognitive skills, deficiencies controlling anger and primitive moral reasoning. ART responds to these core issues using three key coordinated interventions. Structured learning focuses on enhancing prosocial learning and consists of modeling, rehearsing, performance feedback and transferring the use of newly learned behaviors into the real world. Anger Control Training teaches youth to reduce, manage and control anger and aggression by training youth to respond to provocation with a chain of well thought out and prosocial responses. Moral education focuses on choices. After learning to respond to the world prosocially and establishing the skills to diminish impulsive anger responses, the adolescent must choose to use these skills. As such, Kohlberg (1969, 1973) has demonstrated that exposing youth to moral dilemmas in a group context that includes youth reasoning at differing levels of moral thinking brings about cognitive conflict. The resolution of such conflict will frequently advance a youth's moral reasoning to that of the higher level peers in the group, thereby increasing the likelihood that the adolescent will choose to use his new skills in the real world. Reality Therapy by William Glasser continues the theme of personal responsibility by stating the adolescent must take charge of his actions and no matter what the situation he has choices. The youth are taught decisions must be the most appropriate for a variety of situations and must take into account that the world cannot be controlled and life is not always fair. Do not dwell on and become depressed by these factors but accept them as facts of life and move forward. The Savio RTC Program Description, Page 6 youth may say he is here because of poor and ineffective parents. This may be an unfortunate truth but at Savio he will be encouraged to modify his thinking and improve his coping skills to put his past in perspective and behind himself, and then move forward to a more positive life for himself and his own future family. Seeking independence and control are major issues for adolescents. Savio also utilizes concepts related to Positive Peer Culture (PPC) in the therapeutic environment. PPC advocates the important value of peers helping peers to modify their behavior. Adolescence is a time of separating from and seeking independence of family, authority figures and adults. Adolescents begin to depend on their peers. What better than a treatment approach for adolescents where peers help peers. In the group process, adolescents who help others help themselves. A key philosophy that supports the aforementioned perspectives and is a foundation to the Savio therapeutic environment is Replication of Society (ROS). This rule of thumb permeates the program and can be seen throughout the Boys' Rule Book and Staff Manual. To replicate society means to operate the Savio residential program in the same manner as society. It is to make Savio a duplicate micro-system, which holds its members responsible for their behavior and does not encapsulate the client in a protective cocoon, free from responsibilities and decisions. It provides opportunities for youth to utilize new ways of thinking and responding that are learned using the cognitive-behavioral approach and Aggressive Replacement Training. While residing at Savio, students are expected to assume responsibility for their actions as they should while residing and home and in society. When a student breaks a rule or fails to meet a responsibility, he and any other related party will receive a consequence. The aim is to teach the youth that all actions have implications and an individual's behavior may have a negative impact on friends, family and individuals who were not involved in the original activity. Should a husband/father drive while intoxicated, have an accident, not only will he feel the implications but so will his passengers, the other driver and all family members not present. To teach and repeatedly reinforce this concept group consequences are regularly given which involve the youth and his peer group. The ROS policy, through behavior modification, repetitions of being confronted by one's peers, trains the adolescent to think before he acts and tries to create a negative, uncomfortable state of being when anticipating any action. This momentary halt and physical discomfort will reinforce the desire to not commit delinquent or anti-social behaviors. All of the overriding program philosophies also govern recreational services, communications and other Savio components. The Savio student is taken on recreational activities that will be available to him when he retums to the community. All communication between staff and students is to be straight forward and without professional or therapeutic jargon. When a student prepares to graduate, rules, procedures, and expectations in the community will be similar to what he experienced in Savio. This will strengthen the transition and the potential for success in the student's life. Savio RTC Program Description, Page 7 PROGRAM ORIENTATION Students, during the first day, begin to learn the program and what their responsibilities will be. The peer group, the basis of all treatment efforts, takes a lead role in this process. A fellow peer (s) is assigned to the new student for discussion and support. Before fully entering the environment the client reads the Boys' Rule Book with staff and student assistance. When completed, the adolescent must sign that they have read and understand the Boys' Rule Book, a first step in accountability and responsibility. THERAPEUTIC ENVIRONMENT A therapeutic environment (TE) is one which teaches, confronts, modifies, redirects, and commends student behavior. The TE brings together all aspects of the Savio program to address in daily living and clients' problems. In such a living community all behaviors, day and night, are addressed in a therapeutic manner so as to assist the student to learn new methods of interacting. The therapeutic environment is a continuum of cognitive behavioral interventions which attempt to alter thinking and behavior. This array of activities stretch from the passing confrontation in the hallway to the scheduled peer therapy groups. When peers are given consequences for a negative behavior, they are assisted in evaluating both the feelings and thoughts that occurred just prior to the incident. The student will find himself receiving a minimum of four positive interactions for each confrontation for a negative behavior. Peer therapy groups will happen throughout the week on both a scheduled and spontaneous basis. Positive programming is the primary means to control or replace nonproductive and/or negative behaviors. All interventions are based on positive techniques and are applied in a caring and humane manner. For many adolescents the therapeutic environment is an educational event. They will learn to develop structure to their lives, when to rise and when to rest, the need for daily personal hygiene, the need to moderate life's experiences, how to respect self and others, concern and commitment to the community and how to direct their own lives in a constructive manner. They will evolve a sense of self with a core set of values that will be governed by the belief of doing for no other reason than it is the right thing to do. Accompanying this set of values will be the inner satisfaction associated with self-actualization and knowing he is operating on the higher level of human functioning. The therapeutic environment builds a base of immediate, easily successful steps for the student from which to solve more complex issues. The new student first learns that each morning he will be expected to pass a personal hygiene check, a room cleanliness check, and a community chore. Staff will focus on the peer's willingness and ability to follow the daily schedule and to meet the minimum requirements it entails. When these basic tasks are mastered, students are given new challenges involving responsibilities for others and to the community. Concurrently, students are expected to role model new interpersonal skills leamed in peer group therapy and to move into a status where they are addressing their issues through independent thought and self-assessment. As students develop insight, maturity, and move up the pyramid of growth, the expectation is that they will evolve from a singular self-centered view of life to an altruistic vision. Savio RTC Program Description, Page 8 TREATMENT GROUPS New students are initially assigned to shadow a group member to learn: • The rules and structure of Savio; • How the therapeutic groups operate; • What will be expected of them; • The importance of peer group relations; • How to take charge of the groups; and, • To insure a positive therapeutic experience even though they must confront negative behaviors. Adolescents are assigned a treatment group based upon their presenting problem. There are three treatment groups; sexual abuse intervention (group A), substance abuse intervention (group B) and general delinquency(group C). TREATMENT TRACKS Sexual Abuse Intervention The Sexual Abuse Intervention (SAI) group is specifically designed for students experiencing problems of sexual perpetration and sexual abuse in order to prevent further abusive acts. The group utilizes an offense-specific curriculum and focuses on understanding the abuse cycle, accepting responsibility for sexually problematic behavior, teaching how to modify cognitive thinking processes and thinking errors, aversion and behavior modification techniques, victim empathy, socialization and relapse prevention. Family members are asked to participate and attend a weekly Caretaker of Offender group so they may learn the same concepts presented to their children. Relapse prevention and compliance with safety contracting is monitored through use of history and maintenance polygraph evaluations. Drug and Alcohol Treatment Services The Drug and Alcohol Treatment services (DAT) is designed to provide the level and type of intervention required by clients with problems related to substance abuse. Students participate in treatment groups which focus on prevention, treatment, intervention and relapse prevention. The drug and alcohol services are facilitated by certified counselors and adhere to the Standards and Regulations for Alcohol and Drug Abuse Treatment. Family members are empowered to address the adolescent's drug usage and to assist in the treatment process. Relapse prevention is stressed through use of random urinalysis screening and treatment which includes problem-solving, role playing, and abstinence planning. General Delinquency Intervention The General Delinquency Intervention program is designed to address the youth's delinquent behavior and anti-social attitudes. The group curriculum includes victim empathy, responsibility, changing distorted thinking, problem-solving, decision-making, family functioning and relapse prevention. The group focuses on understanding the impact of delinquent behavior on the community. The group also focuses on concepts related to restorative justice. The family is asked to participate and learn the concepts presented in the group. They are asked to hold their children accountable for their behavior with consistent limits and follow through. Savio RTC Program Description, Page 9 The personality characteristics of each group member are assessed. Residents generally demonstrate two personality types. Those who tend to be predominantly present characteristics of passivity, uncomfortable with anger, poor self-concept, accepts too much blame, repression, intellectualization, overly trusting, dependent and preoccupied with failure are considered expressive. Clients who are pessimistic, independent, suspicious, paranoid, aggressive and arrogant, deny feelings, turn all feelings to anger, project blame to others, avoid relationships, deny and minimize their negative behaviors and responsibilities and who generally fall into the classification of conduct disordered are considered instrumental. Residents of differing personality types may enter the same group. Peer therapy groups meet daily, except Saturday and Sunday, for 90 minute sessions based on Clinical Pathways and the specialized group curriculum, There are two specialized groups that occur on Monday and Friday. These groups are facilitated by a Mater's level therapist and are based on curriculum specific to each group. The Tuesday, Wednesday and Thursday group sessions are facilitated by the Residential Group leaders specifically assigned to work with each group. These sessions are based on the Clinical Pathways curriculum and include units such as anger management, interpersonal skills and managing depression. The Clinical Pathways curriculum is a general curriculum and is presented to each group, whereas the specialized group curriculums differ. The therapists and group counselors who work with the same treatment group are considered a "treatment team", and meet weekly to discuss group process and interventions. All group leaders, therapists and counselors, work to instill cohesiveness, a trusting atmosphere and confidentiality within the group. FAMILY GROUPS One of the five scheduled peer therapy groups is for weekly goal setting and review and is referred to as family group. These groups are a means for the peer to review, evaluate and establish individual goals. Family groups are critical to the successful placement and graduation of Savio students as these groups permit the peers on a weekly basis to review both short-term (weekly) and long-term treatment goals. During family group, the youth participate in team building activities, focused on improving their ability to function within the larger community. Family groups also provide the opportunity for the presentation of educational information on topics such as, substance use, sexuality and domestic violence. The group may also present and resolve conflicts that may occur between group members or within the milieu. Group members are encouraged to discuss issues of concern and create plans, with support of fellow group members, to address issues appropriately. For example, two roommates may discuss issues that are occurring in the room and create a plan to live together without conflict using the help of their peers. SPONTANEOUS HOUSE/GROUP MEETINGS When a student is escalating or is not responding to staff and peers' confrontations/redirections, a spontaneous peer group meeting or a house meeting is called. These meetings have the purpose of crisis intervention and are effective in stabilizing the child in crisis and halting his negative behavior. In addition, group meetings and house meetings develop group cohesiveness and a sense of caring for each other; joint and immediate problem-solving; universality of problems; appropriate coping techniques; and insight and self-awareness. Savio RTC Program Description, Page 10 Some students respond more readily to interaction with their peer group members, especially if the issue is of a sensitive or personal nature. Other adolescents require the higher level of anxiety associated with a house meeting, which includes all students and staff. House meetings are also conducted for the more serious rule infractions or when the problem or conflict involves more than one student. The peer group meetings and house meetings are task-oriented and adhere to a specific format. During the spontaneous meetings, the acting-out child is to identify the problem or issue, accept responsibility for the problem, describe why he acted in a negative manner, and state how he will respond or conduct himself in the future. The student's peers have the responsibility of confronting the negative action(s) and suggesting alternatives. As the troubled student gains support and new ideas, the peers benefit by verbalizing and reinforcing their own positive values and/or skills and by listening to others problem-solve on common issues. Students often feel a sense of teamwork and accomplishment following a spontaneous peer group meeting or house meeting. The student for whom the meeting is called leads the discussion by: • Identifying his issues: lying, denying, minimizing, and blaming (My issues are....); • Detailing what he did (What I did was....); • Explaining why he did it (Why I did it is because....) • Each peer confronts the issue person(s) (You are the issue....) who must sit quietly, make eye contact and act responsibly; • The issue person summarizes his issues after being confronted by all group members (My issues were...what I did ... why I did it...) each time convincing his peers and staff of his sincerity; and, • The meeting concludes with a discussion (What did I learn...what are you going to do next time....). • Spontaneous house and group meetings permit the student to: • Trust the group; • Understand the peer process both positive and negative and how to respond to both; • Appropriately confront others and to receive confrontation; • Develop and maintain hope in the group therapy process; • Learn from the corrective recapitulation of the primary family group; • To learn the idea of being altruistic by showing concern for others, remorse for inappropriate activities, the ability to make choices and take responsibility for them; • To stand behind one's word; • Help others which helps themselves and begins the evolution of the altruistic lifestyle; • Develop acceptable social skills; and, • Become a responsible and contributing member of society. SCHEDULED HOUSE MEETINGS Every morning peers gather to initiate and plan for their day. The Scheduled House Meeting agenda includes: • Morning roll call after breakfast; • Identifying group chore assignments; Savio RTC Program Description, Page 11 • Review of appointments and schedule for the day; • Assessment of student emotional status; and, • Notification of any peer group responsibilities. FOCUS GROUPS Focus groups of a therapeutic and educational nature are conducted on an as needed basis for the special needs of students. These groups have a specific topic: • Drug and alcohol abuse; • Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) by Power Moves; and, • Aggression Replacement Training with the components of moral reasoning, anger control and pro-social skills. SUPPLEMENTAL LEARNING PROGRAM This program is provided for students based on need and focuses on family taught skills. There are skills and support areas which are generally not addressed or found outside of the family. The peers are tracked into Emancipation classes, depending on need and age. The group meets during school and is an educational elective course. Content for the class is as follows: • Emancipation and independent living; • Current events; • Job skills training All students receive education related to decision-making, social skills, interpersonal skills and utilizing resources during evening treatment groups. The curriculum is presented at minimum, two times per week for 90 minutes. EMANCIPATION TO INDEPENDENT LIVING For the older adolescent for whom a return home is not appropriate, staff begin a treatment plan of independent living preparation immediately after admission. In addition to the aforementioned educational group, students receive individualized programming in anticipation of their graduation. The Savio emancipation social worker provides each student with job development, placement and supervision. Students are taught the mechanics of payroll and must establish a budget that will create a sizable savings in preparation for their move to independent living. Emancipation training also involves life skills training, conflict resolution, help in locating legal services, sex education and establishing or strengthening family ties wherever possible. Thirty days prior to graduation the social worker and student begin an apartment search. Once the location has been found, staff begin moving the student by providing donated furnishings, food and personal care products. Savio coordinates the move and assists the student in readjusting his budget with the deposit and rent payments. The student is then discharged from Savio RTC Program Description, Page 12 Savio supervision or given aftercare services through Residential program if necessary and requested by the referral source. RESTORATIVE JUSTICE COMMUNITY SERVICE Although a popular idea today, community service has long been a central part of Savio as it is the mission of the Lion's Club of Denver, Savio's sponsor. Their motto, We Serve, has been practiced from the very beginning at Savio, not during school or therapeutic schedules, but in their leisure hours after school and on weekends when true community service is performed. Planting trees in a local park alongside of VISTA volunteers in Savio's earliest days, to the distribution of groceries for the elderly and graffiti clean-up today, the youth of Savio learn the value and benefit of serving and being part of the community. RESTITUTION Savio House stresses the importance of making amends and paying for one's wrong decisions and hurtful actions. Any student who has court ordered restitution or court fines will be required to pay off all or that amount the adolescent is able to earn prior to graduation from the program. Students receive assistance in gaining employment and a significant amount of each paycheck is sent to the court until the obligation is resolved. Students are also referred to restitution programming in the community, such as the Freshstart program. BEHAVIOR-SHAPING TECHNIQUES Behavior-shaping techniques are used to limit and consequent negative behavior and to teach and/or redirect the adolescent in the proper behavior. These tools reinforce positive behavior and deter negative behavior and help the student internalize his own rules. Savio House seeks to reach and maintain the delicate balance between nurturing and discipline. This approach teaches and reinforces the process of socialization which is critical for success while in the program and upon returning to society. POSITIVE REINFORCEMENTS (VERBAL) Adolescents are more receptive to redirection or confrontation when they feel cared for and respected by those adults who work with them. Staff strive to form relationships with students that are based on these two values. Staff recognize positive attitudes and behaviors to teach adolescents what is expected and condoned in society. Staff reinforce these desired actions by making positive, caring comments such as, "That was kind of you to help your roommate", or "You are a very good listener". The goal is that staff will offer four positive comments per each confrontation or redirection. Savio RTC Program Description, Page 13 MEN OF THE WEEK AWARD Adolescents appreciate recognition and material rewards for doing good deeds and/or putting forth extra effort. Every week, each team of staff (5 teams) select students who have been doing well in the program. The chosen students are recognized in the presence of their peers and are allowed to pick an item of new clothing from a designated allotment. If a child "wins" four times, he receives a new pair of tennis shoes or a new winter coat. This award is immediate and reinforces extra effort or increased cooperation with the program expectations. Receiving this award often motivates those students who are just beginning to exhibit changed behaviors but struggle with consistency. MAN OF THE MONTH AWARD This award is voted on by all staff at the end of each month with the purpose of recognizing students who have shown significant improvement or who have exhibited consistency in their improved behaviors and/or attitudes. The "Man of the Month" goes shopping and may spend money on clothing of his choice. Each "Man of the Month" is photographed and the pictures are compiled in a "Men of the Month" collage by year that are hung in the boys dormitory. MAN OF THE YEAR AWARD At the end of each year, all of the "Men of the Month" are eligible to be voted on as the "Man of the Year" by staff. Similar to the above awards, this award reinforces outstanding performance or progress in the program or dramatic improvement in behaviors and attitudes. This present or past student is taken shopping and is allowed to spend money on clothing of his choice. The name of each student who achieves the "Man of the Year" award is engraved on a plaque that hangs in the boys dormitory. The "Man of the Year" award is the most esteemed award and the highest honor that any student can acquire while at Savio House. RECREATION Recreational activities serve many important purposes in working with troubled adolescents. In addition to exposing youth to new and appropriate uses of free time, recreation is utilized as a behavior-shaping technique. The Recreation Coordinator schedules and implements various fun and exciting recreation events that often prompt students to exhibit more effort to "earn" more frequent and more special recreation opportunities. All students participate in recreation however the higher the level (the Level System is described later), the better the recreation event. Students on lower levels may recreate on-grounds while students on higher levels participate in a wide variety of community activities (sporting events, concerts, outdoor recreation, etc.). REDIRECTIONS Adolescents in the program often think and act in a negative, anti-social manner that can be destructive to themselves and others if not addressed and modified. This pattern has most likely resulted in delinquent acts and social and familial conflict prior to placement. Savio RTC Program Description, Page 14 Staff are responsible for confronting negative actions, rule infractions, anti-social attitudes, hurtful comments, etc. In addition, staff will process the underlying thoughts behind the negativity and correct or teach pro-social thoughts and actions. These interventions occur many times a day and are used with the premise that spontaneous and frequent redirections assist in the replacement of negative cognitive patterns that dictate anti-social behaviors. Staff can redirect youth with motivational statements ("I know you can remain positive throughout this activity."); teaching of new skills ("Try taking a time out to regain control."); reminders of a goal or task ("Remember that your task is to have no verbal assaults."); teaching of new skills ("A time out may help you to feel better."); redirecting statements ("Complete your schoolwork instead of talking to your peer."); or ultimate confrontations ("You can not and will not threaten other students."). In most cases, the adolescent responds positively and does not require further limit-setting. WORK/TALK TIME Work-time is given to peers for negative behavior in exact amounts as identified for the specific behavior. Examples are ten minutes for foul language, one hour for negative attitude and three hours for lying. The student must then "work off' his time by completing chores or discussing his issue(s) in an On-going House Meeting. Work-time has a therapeutic aspect in that the adolescent realizes that he must account for his mistake. After a negative incident, staff attempt to create or invoke a sense of remorse and ownership for the incident. Good, hard effort has the effect of resolving feelings of remorse and instilling a positive feeling of "paying for" the wrongful action. Likewise, an On-going House Meeting allows the student to explore the incident, and associated thoughts and feelings, that resulted in his earning the consequence. Work-time is given in small increments so as to consequent the negative behavior without overwhelming the student with an insurmountable amount of work-time after the conflict. GROUP CONSEQUENCES Group consequences are utilized at times to instill the idea that the attitudes and actions of an individual impact others, positively and negatively. Consequenting both roommates for tobacco found in their room, for example, encourages remorse for the affected roommate. In the future, the innocent one will most likely advise and remind his roommate not to have tobacco because he now has a vested interest in the possible consequences. POSITIVE TIME("FIVE POS") Staff may use another form of behavior shaping known as giving "pos time". When an adolescent is exceptionally positive in behavior and/or attitude, staff may take hours off his total work-time amount. The total "pos time" a student may receive is three hours per day. "Pos time" is only given by the Residential Counseling team. Positive time is also implemented when a student has an enormous load of work-time and needs to be motivated and when a counselor is confronted with a negative group situation in which he/she needs to encourage some group members to alter the overall group direction. Savio RTC Program Description, Page 15 Other staff members, including the Social Work team, teachers, cooks and administrative staff, may reward students for their behavior through use of "pos slips." These slips may be used in the "pos store" to purchase items such as clothing, candy or arts and crafts activities. Students may save "pos slips" so they may purchase what they would like in the store. QUIET TIME Quiet time may also be used in small increments to bring a negative child or group under control and to give him or them the opportunity to think about the seriousness of the issue. Often, quiet time encourages a potentially negative child to stop and think about his behavior and probable consequences or allows staff redirections to "sink in" and become achievable. WORK PROJECTS Work Projects are another aspect of limit setting for adolescents who are behaving negatively. For example, on Saturdays, any student who has received consequences for using tobacco or tobacco products must complete a work crew. Students complete the crew as a group, participate in an assigned work project or house meeting for the entire afternoon. The purpose of this activity is to allow the mis-directed youth the opportunity to "work or talk off' their accumulated work-time hours and to pay retribution for wrongful behavior and/or attitude. In addition, the adolescents must agree to work or talk cooperatively as a group. This process often results in the development of a group leader who then motivates the other youth toward having a more positive attitude and completing the assigned project or successfully discussing issues in a house meeting. LEVEL SYSTEM Savio House utilizes a Level System to reward and consequent the effort, behavior, and attitude of students throughout involvement in the program. Upon admission, each student is informed of the expectations of the program, the philosophy of the level system, the criteria for achievement of each level and the privileges associated with the different levels. Youth enter on a base level of II then advance on a specific time schedule to higher levels as effort and improvement are noted. Attainment of higher levels result in generally more freedom and rewards. Recreation activities, week-end check-outs and week-end home passes are closely tied into the Level System in order to motivate youth to be receptive to treatment, to cooperate with the expectations of the milieu, and to exhibit more positive behaviors and attitudes. A student earns his level based on his progress in seven areas; school, peer relations, adult relations, community relations, group treatment, specialized treatment and responsibility. He receives a score (1-4) daily in each area and the scores are posted in the dormitory the following morning, allowing the student to track his progress and discuss the reasoning he were given his scores. The criteria used to eam different scores is objective and realistic. For example, if a student earns a 1 in responsibility he has blamed others for his actions, stolen, or has refused to complete chores or other duties. If he earns a 3, he has completed his chores, taking responsibility for his actions without blaming, admitted to mistakes or offered assistance to persons in need. Savio RTC Program Description, Page 16 ADDITIONAL REINFORCEMENTS Staff may use alternative measures to redirect behaviors or to consequent negative behaviors, especially with youth who may not respond well to more traditional behavior-shaping techniques. Staff may have the acting-out youth write an essay or apology letter. Youth often respond to staff taking away small increments of recreation time or awarding extra or special recreation. Staff may utilize other behavior modification techniques such as having a student go to the front or the end of the meal line based on behavior. Many adolescents will react positively to one-on-one time with a staff or to special visits from family members as an incentive for positive effort. Staff often match the reward or consequence to the age and developmental level of each child and to the degree of external motivation needed to prompt more appropriate behaviors. As an example, a twelve year-old child has different needs and may respond much more positively to a nightly phone call to home then to the threat of work time consequences. DISCHARGE FROM THE PROGRAM PHILOSOPHY Transition planning is a priority at the beginning of and throughout the placement period. The philosophy is that placement should be effective, efficient and time-limited and that all involved parties must work as a team to accomplish this goal. During treatment, all involved parties write a Transition Plan which includes a summary of helpful information concerning the youth and his family and a plan of action which includes who will complete what tasks and when the tasks will be completed in order to ensure a successful transition. Students and their families appear to be more invested and motivated when given an estimated time frame of services. Staff focus on transition planning in all phases of treatment with the goal of a successful return to the home and to public school. Interventions stress the teaching of skills in order for the child to remain home with no further dependence on outside systems. As the student and family exhibit evidence of improvement and higher functioning, staff advocate for the student to be served in the least restrictive environment. Savio House provides necessary services and support to ensure that the student is successful as he moves to a different level of structure. CRITERIA A student is considered eligible for discharge from the program when he has resolved his presenting problems; has achieved his clinical and education goals; and exhibits the attitudes, skills, and behaviors necessary to function in a less restrictive environment. Plans for successful transitioning are discussed in daily group sessions, weekly family therapy sessions, and during monthly staffings. Outside parties associated with the student participate in the decision to begin the transition process. Lastly, the Juvenile Court must approve the student to return home. This decision is often based on the report of noted progress and a perceived readiness to leave the program. Savio RTC Program Description, Page 17 PROCESS The transitioning student begins to have extended home passes to practice changed behaviors in his home and neighborhood. The family is encouraged to communicate closely with staff to discuss any potential obstacles or challenges. Staff take initiative, where appropriate, to explore needed resources, making contacts and referrals if necessary. Drug testing (urinalysis) is conducted to assure that the student has not been using illegal substances, when necessary. The student will focus on relapse and reoffense prevention in group therapy, house meetings and family therapy to further prepare the student for a successful transition. When returning home is the plan, the family will practice maintaining a home environment conducive to supporting and encouraging the student, while holding him accountable for his actions. Education and clinical staff constantly remind the student of expected behaviors in the home, public school and community. In addition, the student is praised and reinforced, when he utilizes internal motivation, as opposed to responding to external forces, to remain positive throughout the end of his placement. Every transitioning student participates in a Graduation Ceremony that includes the student, family members, key staff members and chosen peers. The participants talk about their relationships with the graduating student and note changes that have been made. This discussion reinforces the student's improvements yet also motivates the other students who are present. Staff serve snacks to the guests and may present art work that emphasizes the graduating student. Lastly, the student is presented with a framed Certificate of Achievement that states the child's name and date of graduation and is signed by the President of Savio's Board of Directors. The ceremony brings the treatment process to a close in a festive manner that allows the student, the family and involved parties to feel positive about their efforts and accomplishments. The student checks out of his room, withdraws his savings, collects his medications and belongings and leaves the program with his parent, guardian or caseworker. A discharge summary is written within 15 days of the student's discharge and is distributed to the Social Services Caseworker and Probation Officer. The legal guardian will be provided a copy of all health records as recorded on the health passport. AFTERCARE Children in residential care are eligible for the Residential Aftercare program as they are reunified with their families. These services meet the needs of these adolescents by providing a "safety net" for the inevitable struggles as the student adjusts to a new environment. The Residential Aftercare program serves the adolescent and his family in his home, school and community and provides counseling, mentoring, supervision, crisis intervention, transportation, job skills training and educational support. The student and his family will continue to work with the same therapist, with whom they have already established a relationship. The family uses the therapeutic relationship and a strengths-based focus to assist the transitioned adolescent as his newly acquired attitudes and behaviors solidify and he is able to function independently. The program is usually ninety-days in duration; however, individualized services and length of involvement can be tailored to the adolescent's need. Savio RTC Program Description, Page 18 PROGRAM EVALUATION Program effectiveness is evaluated through collection of demographic and discharge data, the administration of evaluations and surveys, and through extemal inspections. Evaluations promote program awareness and growth and initiate necessary changes to ensure that services are of the highest quality. Upon each youth's discharge from the program, staff record demographic information, placement information and the discharge status (positive versus negative). Staff conduct one year follow-up studies of all discharged youth to identify the living situation, education or employment status and legal status. Client and Parent Satisfaction Surveys are administered twice yearly to assess satisfaction with overall services and with specific aspects of the program. Referral source satisfaction surveys are also completed twice yearly. This data is compiled in an annual report which also describes noted trends and comparisons to previous years. At the beginning of each year, the Coordinator and program staff identify goals and objectives and formulate a formal WorkPlan which provides focus and direction to program planning and implementation. The WorkPlan is reviewed at year's end to assess achievement of goals and areas of program strengths and possible weaknesses. Lastly, quality assurance procedures are implemented throughout the program through the use of quarterly reviews of all files, maintenance of a Cornell Physical Restraint Log, quarterly grievance reviews, staff review of every student discharge, and regularly scheduled utilization staffings. In addition, the residential program is reviewed annually for licensing and accreditation purposes. LICENSURE/ACCREDITATION Savio House is licensed and supervised by several state and national organizations. The Colorado Department of Human Service licenses, supervises, and does therapeutic monitoring through the Division of Child Care and the Division of Mental Health, respectively. The Colorado Department of Education has determined the Paul G. Tschetter Education Center to be a school in good standing. Savio is also licensed by the Alcohol and Drug Abuse Division of the Department of Human Services to provide outpatient alcohol and drug services. The Savio School is accredited by the Commission on Schools of the North Central Association of Colleges and Schools. All Savio programs are nationally accredited by the Council on Accreditation of Services for Families and Children, Inc. 8/02 Savio RTC Program Description, Page 19 Exhibit A SAVIO HOUSE TRCCF/RCCF RATES July 1 , 2008 - June 30, 2009 TRCCF General Delinquent and Drug/Alcohol Delinquent -Current daily state rate ($178.08 per day) plus Medicaid Sex Offenders -$182.30 per day plus Medicaid RCCF -$192.00 per day all clients WELD COUNTY ADDENDUM 484, To that certain Agreement to Purchase Therapeutic Residential Child Csax, Facility Services and Residential Child Care Facility Services (the 4,, "Agreement") between Third Way Center and Weld County Department of a j� Human Services for the period from July 1, 2008 through /June 30, 2009. The following provisions, made this//' day of ,1`/!{(/y5/ , 2008, are added to the referenced Agreement. Except as modified hereby, all terms of the Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#77810, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$179.24 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$179.24 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Human Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 12. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. 13. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 14. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 15. Add Paragraph 9 to Section VI. The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: A. Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed; B. Deny payment or recover reimbursement for those services or deliverables which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Human Services and the Contractor, or by Human Services as a debt to Human Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 16. Add Paragraph 10 to Section VI. The contractor shall promptly notify Human Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five(5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Human Services' Director. The term "litigation"includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ' ATTEST: i"�""'"'� �t"d"'^'"h Weld C o the Board CA (I, 2 f ;7,4,.,� WELD COUNTY BOARD OF 4c )a �\ HUMAN SERVICES, ON BEHALF iv,i . OF THE WELD COUNTY ,n tic ' DEPARTMENT OF HUMAN ,(ill r- SERVICES By: ' 4., By: .1--G. Deputy Cle to the Board Chair Signature William H. Jerke AUG 1 1 2008 CONTRACTOR Third Way Ce r PO Box 61 5 Denver, 8 06 By: WELD COUNTY DEPARTMENT OF HUMAN SERVICES By: �� (kucsD Dir ctor v 4 Weld County SS-23A Addendum Exhibit A Third Way Center — Lincoln Street Apartments Facility Information _ a zw Facility Name: Lincoln Street Apartments Parent Company (If applicable): Third Way Center Daily Rate: State Set Vendor Rate Director: David F Eisner Facility Main Phone: (303) 780-9191 Facility Fax Number: (303) 780-9192 Facility Address: PO Box 61385, Denver CO 80206 Placement Referral Contact Name: Renee Johnson Placement Referral Phone: (303) 780-9191 x 462 Web Page: www.thirdwaycenter.org General E-mail Address: info@thirdwaycenter.org Licensed as/by: ® TRCCF ® RCCF ® Medicaid N ADAD Program Information Genders Served: ®Males ® Females Ages Accepted: 16-20 Placement Disqualifiers: Third Way Center may reject persons having a recent history of physical violence, arson, or gang related activity. Number of Beds: 23 youth+up to 2 children of clients Treatment Services Provided: NMH N Boys N Girls N Sex Off ® D&A Tx Program Description: Treatment Services: Programming at the Lincoln Street Apartments features the same fundamental therapeutic services that are offered at York,Pontiac and Teen Mom House but adds on a greater emphasis on the acquisition of independent living skills. Clients live in a secured building staffed around the clock by a multidisciplinary treatment team. The residents have keys to their own apartments,they sign a lease,and pay thirty percent of their monthly net income for rent. Staff work closely with the residents to budget the remaining seventy percent of their income for groceries, transportation, entertainment and savings. This program enables clients to practice living on their own while still receiving the intensive therapy and structured environment that they need to succeed. All clients who are classified as Level B receive the following minimum services: • Family Therapy 1-2 hours per week by a Master's Level Therapist • Psychiatric Evaluations and Medication Monitoring 1-2 hours per week • Individual Therapy 2-4 hours per week by a Master's Level Therapist • Group Therapy 6-10 hours per week by a Master's Level Therapist • Independent Living Training 1-5 hours per week Groups offered are three House Groups,Males Group,Females Group,DYC Group,Drug and Alcohol Group, Special Issues Group(victims of physical or sexual abuse), Sexual Perpetration Group(2 per week),Grief Group,Independent Living Group,Family Support Group, and Parenting Group. We work with Redirecting Sexual Aggression to do psycho-sexual evaluations,co-facilitate groups,conduct plethysmagraphs and polygraphs for our sexual perpetrators. We are limited to how many clients with these issues we can take per house. Each client receives between 8 and 16 hours of direct clinical service per week. In addition,being a therapeutic community,milieu therapy is conducted on a 24/7 basis. Their negative interactions,which caused their placements, are often replayed in the milieu,and can be observed,addressed,and treated on a therapeutic level. All therapy is Exhibit A either conducted or supervised by a licensed therapist. Third Way Center also has all-inclusive services,which address the teaching of survival skills to assist our youth in learning to live independently. This is done both within the milieu and in specific independent living groups. At all our facilities,with staff supervision,the clients do the menu planning,cooking,cleaning,and grocery shopping. We also address issues such as budgeting,using public transportation,and banking. This is a hands-on approach that requires client participation(i.e.most of our clients use public transportation,have joint bank accounts with our staff and are required to save 80%of their paychecks and appropriately budget the rest). At our Lincoln facility,each client is required to attend 12 independent living groups and display competencies in the following areas: cleaning, apartment comfort,hygiene,apartment information,cooking and menu planning,shopping and food storage, budgeting skills, savings and checking, school and work,being alone and support systems,leisure time and time management,conflict resolution and anger management. These skills are integrated into the treatment plan and are essential for successful discharge into the community. This is an ongoing treatment issue while in placement. In addition,we have a Nutritionist who helps with the menu planning. Upon entry to Third Way Center each client completes an Academic and Employment Assessment. This includes obtaining an educational and employment background,goal setting(short and long term)and assessing community resources. Clients attend weekly groups pertaining to career exploration,employment and job hunting skills. Once a client is determined to be ready to seek employment he/she will attend a 5-8 session seminar which covers: interviewing skills,including videotaped practice interviews;resume writing;job hunting; filling out job applications;career exploration;job retention; and how to access community resources available to them. Individual job coaching is provided during each stage of the job search,including: picking up applications,completing and submitting applications,and interview preparation. There is a vocational/educational resource room that has educational and financial aid information,software for ACT, SAT reading skill development, GED preparation, career exploration,keyboard skills,and post secondary educational and vocational training resources. Follow-up services include staff maintaining contact with employers to address progress and problem solving as well as assisting them in developing community-based resources. Community based services are regularly accessed, including Vocational Rehabilitation,Job Corp,Youth at Work,Mile High Youth Corp,One Stop Career Centers, Safe City,Goodwill's Earn and Learn,Youth Biz, Summer Scholars,Governors Summer Job Hunt,Art Street, Elitches Summer Job Program,Arapahoe/Douglas Works,Women's Bean Project,and Colorado Women's Employment and Education. There is a part-time Career and Academic Development Coordinator that supervises the above listed services and a full-time Vocational/Educational Counselor. The average length of stay is 6 months. Education Services: At admission,Third Way Center works with the case worker to develop an educational plan for each client. Third Way Center operates our own CDE approved high school,The Joan Farley Academy. The Joan Farley Academy provides an environment that addresses our clients' special education needs. All our teachers and supervisors either have their Masters in Special Ed or have a T.T.E. Through small class sizes, individualized attention and close work with the treatment team,students work towards a diploma or GED. JFA faculty uses experiential learning to combine core academics with real life applications. The initiative-building environment allows students to plan and participate in various service learning projects. In addition to building leadership and self-esteem, service learning gives students the chance to explore several career paths and understand the importance of civic responsibility. Third Way Center offers in-house GED programming but when appropriate,we also access community based high schools and GED programs. The GED programs we use are Emily Griffith,Empowerment Program, and Northeast Women's Center. In addition,each client receives individualized tutoring to help them with GED preparation. When a client is ready for post-secondary education,our Vocational/Educational program assists them with visiting and selecting the appropriate college,the application and financial aid process,course selection,and coordinating the use of academic support services. We have clients who attend local community colleges,Metro State,technical colleges and other universities. Program Overview: Third Way Center is a non-profit agency that has a 38-year history of providing community based de- institutionalized residential treatment for adolescents with behavioral and psychiatric disorders. We emphasize an intensive treatment program with the teaching of independent living skills. We offer a continuum of services which leads either to the client emancipating into the community or returning to the home of parent or relatives. Third Way Center operates five residential facilities that are licensed as Therapeutic Residential Child Care Facilities. We also Exhibit A have ten scattered sites apartments in our Next Steps Program. Next Steps is step down program from our Lincoln Street facility that helps clients emancipate into their own apartment or with family reunification. Services we provide in all of our facilities include,but are not limited to psychiatric evaluations,medication prescribing and monitoring,individual,group and family therapy,teaching of independent living skills,substance abuse counseling, vocational counseling and recreational programming. In addition,we have 15 years of experience serving teen mothers. Currently we serve up to thirteen teen mothers at our Teen Mother House and up to two at the Lincoln street facility. Our senior staff averages 25 years of experience at Third Way Center. The Program Founder and Medical Director have been with the program since its inception and the Executive Director has been at Third Way Center for over 30 years. York,Pontiac and Lincoln facilities are centrally located in Denver County and we have a 38 year positive history working with the Colorado Department of Human Services. York,Pontiac,Lincoln,and the Joan Farley Academy are located in Central Denver. The Teen Mother House is located in Englewood. All clients receive appropriate mental health services. This includes initial psychiatric evaluation,medication evaluation,medication prescription and monitoring,and professional supervision and treatment planning. We have two full-time psychiatrists on staff who directly do all the psychiatric and medication assessment.In addition there is our Clinical Director(LCSW,CACIII, SOMB board certified)and Assistant Clinical Director(LPC) who do all supervision with the psychiatrists. Our Drug and Alcohol Treatment Coordinator(CACIII)supervises all substance abuse treatment. Our Clinical Director supervises all sexual perpetration treatment. They have direct contact with both the clients and the therapists. Clinical supervision is conducted at a minimum of once per week. The above supervisors are part of all treatment planning. Menu of Services: Offense Specific Treatment Program $10 per day WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Third Way Center and Weld County Department of Human Services for the period from July 1, 2008 through June 30, 2009. The following provisions, made this // —day of 1--)49/,s r 2008, are added to the referenced Agreement. Except as modified hereby, all terms of the Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#65346, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$179.24 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$179.24 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); Weld County SS-23A Addendum E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Human Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public(federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 12. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. 13. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 14. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 15. Add Paragraph 9 to Section VI. The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: A. Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed; B. Deny payment or recover reimbursement for those services or deliverables which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Human Services and the Contractor, or by Human Services as a debt to Human Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 16. Add Paragraph 10 to Section VI. The contractor shall promptly notify Human Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Human Services' Director. The term"litigation"includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: 4"4/111a^4 Weld Okkto the Board ,y � WELD COUNTY BOARD OF ,ti,, ; ,4- 1. 1.. HUMAN SERVICES, ON BEHALF i °;;-,'J ` OF THE WELD COUNTY i~Mx f'' l i DEPARTMENT OF HUMAN C `; ;✓�/ SERVICES By: f �/s,/ i ' (4� By: Deputy Cle to die Board Chair Signature William H. Jerke AUG 1 1 2008 CONTRACTOR Third Way Center PO Box 613: Denver,, C G '0 06 By: WELD COUNTY DEPARTMENT OF HUMAN SERVICES By: L 't4 (Jvu Di ctor ' I L 4 Weld County SS-23A Addendum oilvf-o?/a • Exhibit A a<< ' Third Way Center - Pontiac Aw Facility Information Facility Name: Pontiac Parent Company (If applicable): Third Way Center Daily Rate: State Set Vendor Rate Director: David F Eisner Facility Main Phone: (303) 780-9191 Facility Fax Number: (303) 780-9192 Facility Address: PO Box 61385, Denver CO 80206 Placement Referral Contact Name: David F Eisner Placement Referral Phone: (303) 780-9191 x 460 Web Page: www.thirdwaycenter.org General E-mail Address: infona,thirdwavicenter.org Licensed as/by: ® RCCF ® TRCCF ® Medicaid Z ADAD Program Information Genders Served: ® Males ® Females Ages Accepted: 13-18 Placement Disqualifiers: Third Way Center may reject persons having a recent history of physical violence, arson, or gang related activity. Number of Beds: 16 youth Treatment Services Provided: ®MH ® Boys ® Girls ® Sex Off ® D&A Tx Program Description: Treatment Services: All clients receive the following minimum services: • Family Therapy 1-2 hours per week by a Master's Level Therapist • Psychiatric Evaluations and Medication Monitoring 1-2 hours per week • Individual Therapy 2-4 hours per week by a Master's Level Therapist • Group Therapy 6-10 hours per week by a Master's Level Therapist • Independent Living Training 1-5 hours per week Groups offered are three House Groups,Males Group,Females Group,DYC Group,Drug and Alcohol Group, Special Issues Group(victims of physical or sexual abuse), Sexual Perpetration Group(2 per week),Grief Group,Independent Living Group,Family Support Group, and Parenting Group. We work with Redirecting Sexual Aggression to do psycho-sexual evaluations,co-facilitate groups,conduct plethysmagraphs and polygraphs for our sexual perpetrators. We are limited to how many clients with these issues we can take per house. Each child receives between 8 and 16 hours of direct clinical service per week. In addition,being a therapeutic community,milieu therapy is conducted on a 24/7 basis. Their negative interactions,which caused their placements, are often replayed in the milieu,and can be observed,addressed,and treated on a therapeutic level. All therapy is either conducted or supervised by a licensed therapist. Upon entry to Third Way Center each client completes an Academic and Employment Assessment. This includes obtaining an educational and employment background,goal setting(short and long term)and assessing community resources. Individual job coaching is provided during each stage of the job search, including:picking up applications,completing and submitting applications,and interview preparation. Follow-up services include staff maintaining contact with employers to address progress and problem solving as well as assisting them in developing community-based resources. There is a part-time Career and Academic Development Coordinator that supervises the above listed services and a full-time Vocational/Educational Counselor. Exhibit A The average length of stay is 6 months. Education Services: At admission,Third Way Center works with the caseworker to develop an educational plan for each client. Third Way Center operates our own certified high school,The Joan Farley Academy. The Joan Farley Academy provides an environment that addresses our clients' special education needs. All our teachers and supervisors either have their Masters in Special Ed or have a T.T.E. Through small class sizes, individualized attention and close work with the treatment team,students work towards a diploma or GED. JFA faculty uses experiential learning to combine core academics with real life applications. The initiative-building environment allows students to plan and participate in various service learning projects. In addition to building leadership and self-esteem,service learning gives students the chance to explore several career paths and understand the importance of civic responsibility. When appropriate,we also access community based high schools and GED programs. The GED programs we use are Emily Griffith, Empowerment Program, and Northeast Women's Center. In addition, each client receives individualized tutoring to help them with GED preparation. When a client is ready for post-secondary education, our Vocational/Educational program assists them with visiting and selecting the appropriate college,the application and financial aid process,course selection,and coordinating the use of academic support services. We have clients who attend local community colleges,Metro State,technical colleges and other universities. Program Overview: Third Way Center is a non-profit agency that has a 38-year history of providing community based de- institutionalized residential treatment for adolescents with behavioral and psychiatric disorders. We emphasize an intensive treatment program with the teaching of independent living skills. We offer a continuum of services which leads either to the client emancipating into the community or returning to the home of parent or relatives. Third Way Center operates four residential facilities that are licensed as Therapeutic Residential Child Care Facilities. We also have ten scattered sites apartments in our Next Steps Program. Next Steps is step down program from our Lincoln Street facility that helps clients emancipate into their own apartment or with family reunification. Services we provide in all of our facilities include,but are not limited to psychiatric evaluations,medication prescribing and monitoring,individual,group and family therapy,teaching of independent living skills,substance abuse counseling, vocational counseling and recreational programming. In addition,we have 15 years of experience serving teen mothers. Currently we serve up to thirteen teen mothers at our Teen Mother House and up to two at the Lincoln street facility. Our senior staff averages 25 years of experience at Third Way Center. The Program Founder and Medical Director have been with the program since its inception and the Executive Director has been at Third Way Center for over 30 years. York,Pontiac and Lincoln facilities are centrally located in Denver County and we have a 38 year positive history working with the Colorado Department of Human Services. York,Pontiac,Lincoln,and the Joan Farley Academy are located in Central Denver. The Teen Mother House is located in Englewood. All clients receive appropriate mental health services. This includes initial psychiatric evaluation,medication evaluation, medication prescription and monitoring,and professional supervision and treatment planning. We have two full-time psychiatrists on staff who directly do all the psychiatric and medication assessment. In addition there is our Clinical Director(LCSW,CACIII,SOMB board certified)and Assistant Clinical Director(LPC)who do all supervision with the psychiatrists. Our Drug and Alcohol Treatment Coordinator(CACIII) supervises all substance abuse treatment. Our Clinical Director supervises all sexual perpetration treatment. They have direct contact with both the clients and the therapists. Clinical supervision is conducted at a minimum of once per week. The above supervisors are part of all treatment planning. Menu of Services: Offense Specific Treatment Program $10 per day WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Third Way Center and Weld County Department of Human Services for the period from July 1, 2008 through June 30, 2009. The following provisions, made this //-ay of/4L c a,S 2008, are added to the referenced Agreement. Except as modified hereby, all terms of the Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#49487, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$179.24 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$179.24 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis,based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing (3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum &C' CQ/hCf E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Human Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery,bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 12. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. 13. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 14. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 15. Add Paragraph 9 to Section VI. The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: A. Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed; B. Deny payment or recover reimbursement for those services or deliverables which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Human Services and the Contractor, or by Human Services as a debt to Human Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 16. Add Paragraph 10 to Section VI. The contractor shall promptly notify Human Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Human Services' Director. The term "litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: ia'"""'ttell Weld Co i erk rk to the Board WELD COUNTY BOARD OF HUMAN SERVICES, ON BEHALF sF' �t �. ' •* OF THE WELD COUNTY DEPARTMENT OF HUMAN ' SERVICES By: /�� _ By: Deputy Cler o the Board Chair Signature William H. Jerke AUG 1 1 2008 CONTRACTOR Third Way Center PO Box 61385 Denver, C By: WELD COUNTY DEPARTMENT OF HUMAN SERVICES By hector 4 Weld County SS-23A Addendum e ^ / Q • Exhibit A Third Way Center - York �^ " r xrlb" zti Facility Information • t Facility Name: York yK} Parent Company: Third Way Center, Inc. Daily Rate: State Set Vendor Rate Director: David F Eisner Facility Main Phone: (303) 780-9191 Facility Fax Number: (303) 780-9192 Facility Address: PO Box 61385,Denver CO 80206 Placement Referral Contact Name: David F Eisner Placement Referral Phone: (303)780-9191 x 460 Web Page: www.thirdwaycenter.org General E-mail Address: info@thirdwaycenter.org Licensed as/by: ® RCCF ® TRCCF ® Medicaid ® ADAD Program Information Genders Served: ® Males ® Females Ages Accepted: 13-18 Placement Disqualifiers: Third Way Center may reject persons having a recent history of physical violence, arson, or gang related activity. Number of Beds: 16 youth Treatment Services Provided: ®MH ® Boys ® Girls ® Sex Off ® D&A Tx Treatment Services: All clients receive the following minimum services: • Family Therapy 1-2 hours per week by a Master's Level Therapist • Psychiatric Evaluations and Medication Monitoring 1-2 hours per week • Individual Therapy 2-4 hours per week by a Master's Level Therapist • Group Therapy 6-10 hours per week by a Master's Level Therapist • Independent Living Training 1-5 hours per week Groups offered are three I-louse Groups,Males Group,Females Group,DYC Group,Drug and Alcohol Group,Special Issues Group(victims of physical or sexual abuse), Sexual Perpetration Group(2 per week),Grief Group, Independent Living Group,Family Support Group,and Parenting Group. We work with Redirecting Sexual Aggression to do psycho-sexual evaluations,co-facilitate groups,conduct plethysmagraphs and polygraphs for our sexual perpetrators. We are limited to how many clients with these issues we can take per house. Each child receives between 8 and 16 hours of direct clinical service per week. In addition,being a therapeutic community,milieu therapy is conducted on a 24/7 basis. Their negative interactions,which caused their placements, are often replayed in the milieu,and can be observed,addressed,and treated on a therapeutic level. All therapy is either conducted or supervised by a licensed therapist. Upon entry to Third Way Center each client completes an Academic and Employment Assessment. This includes obtaining an educational and employment background,goal setting(short and long term)and assessing community resources. Individual job coaching is provided during each stage of the job search,including:picking up applications,completing and submitting applications,and interview preparation. Follow-up services include staff maintaining contact with employers to address progress and problem solving as well as assisting them in developing community-based resources. There is a part-time Career and Academic Development Coordinator that supervises the above listed services and a full-time Vocational/Educational Counselor. Exhibit A The average length of stay is 6 months. Education Services: At admission,Third Way Center works with the caseworker to develop an educational plan for each client. Third Way Center operates our own certified high school,The Joan Farley Academy. The Joan Farley Academy provides an environment that addresses our clients' special education needs. All our teachers and supervisors either have their Masters in Special Ed or have a T.T.E. Through small class sizes,individualized attention and close work with the treatment team,students work towards a diploma or GED. JFA faculty uses experiential learning to combine core academics with real life applications. The initiative-building environment allows students to plan and participate in various service learning projects. In addition to building leadership and self-esteem,service learning gives students the chance to explore several career paths and understand the importance of civic responsibility. Third Way Center offers in-house GED programming but when appropriate,we also access community based high schools and GED programs. The GED programs we use are Emily Griffith,Empowerment Program,and Northeast Women's Center. In addition, each client receives individualized tutoring to help them with GED preparation. When a client is ready for post-secondary education,our Vocational/Educational program assists them with visiting and selecting the appropriate college, the application and financial aid process,course selection,and coordinating the use of academic support services. We have clients who attend local community colleges,Metro State,technical colleges and other universities. Program Overview: Third Way Center is a non-profit agency that has a 38-year history of providing community based de- institutionalized residential treatment for adolescents with behavioral and psychiatric disorders. We emphasize an intensive treatment program with the teaching of independent living skills. We offer a continuum of services which leads either to the client emancipating into the community or returning to the home of parent or relatives. Third Way Center operates four residential facilities that are licensed as Therapeutic Residential Child Care Facilities. We also have ten scattered sites apartments in our Next Steps Program. Next Steps is step down program from our Lincoln Street facility that helps clients emancipate into their own apartment or with family reunification. Services we provide in all of our facilities include,but are not limited to psychiatric evaluations,medication prescribing and monitoring,individual,group and family therapy,teaching of independent living skills,substance abuse counseling, vocational counseling and recreational programming. In addition,we have 15 years of experience serving teen mothers. Currently we serve up to thirteen teen mothers at our Teen Mother House and up to two at the Lincoln street facility. Our senior staff averages 25 years of experience at Third Way Center. The Program Founder and Medical Director have been with the program since its inception and the Executive Director has been at Third Way Center for over 30 years. York,Pontiac and Lincoln facilities are centrally located in Denver County and we have a 38 year positive history working with the Colorado Department of Human Services. York,Pontiac,Lincoln,and the Joan Farley Academy are located in Central Denver. The Teen Mother House is located in Englewood. All clients receive appropriate mental health services. This includes initial psychiatric evaluation,medication evaluation,medication prescription and monitoring,and professional supervision and treatment planning. We have two fill-time psychiatrists on staff who directly do all the psychiatric and medication assessment. In addition there is our Clinical Director(LCSW,CACIII, SOMB board certified)and Assistant Clinical Director(LPC)who do all supervision with the psychiatrists. Our Drug and Alcohol Treatment Coordinator(CACIII)supervises all substance abuse treatment. Our Clinical Director supervises all sexual perpetration treatment. They have direct contact with both the clients and the therapists. Clinical supervision is conducted at a minimum of once per week. The above supervisors are part of all treatment planning. Menu of Services: Offense Specific Treatment Program $10 per day WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Third Way Center and Weld County Department of Human Services for the period from July 1, 2008 through June 30, 2009. The following provisions, made this // ay of /2a9S, 2008, are added to the referenced Agreement. Except as modified hereby, all terms of the Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#1507881, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$179.24 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$179.24 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); Weld County SS-23A Addendum a-Pea 07/68 E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Depaitnient of Human Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public(federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 12. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. 13. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 14. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 15. Add Paragraph 9 to Section VI. The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: A. Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed; B. Deny payment or recover reimbursement for those services or deliverables which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Human Services and the Contractor, or by Human Services as a debt to Human Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 16. Add Paragraph 10 to Section VI. The contractor shall promptly notify Human Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five(5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Human Services' Director. The term "litigation"includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: Midiamt Weld 1.J "'•+t, . to the Board COUNTY BOARD OF IWELD NHUMAN SERVICES, ON BEHALF w „� OF THE WELD COUNTY ixg DEPARTMENT OF HUMAN \`.,,I „ f b s SERVICES n`! :.. „, By: AYI1 ,41J L-- By: i..c ti—L Deputy Cle to the Board Chair Signature William H. Jerke AUG 1 1 2008 CONTRACTOR Third Way Center PO Box 61385 Denver, C 0 By: WELD COUNTY DEPARTMENT OF HUMAN SERVICES By: (1\ Aki_ )) �D]rector 4 Weld County SS-23A Addendum &G1d'— 62168 Exhibit A Third Way Center— Teen Mother House Facility Information f Facility Name: Teen Mother House Parent Company (If applicable): Third Way Center Daily Rate: State Set Vendor Rate Director: David F Eisner Facility Main Phone: (303) 780-9191 Facility Fax Number: (303) 761-5003 Facility Address: PO Box 61385, Denver CO 80206 Placement Referral Contact Name: Renee Johnson Placement Referral Phone: (303) 780-9191 x 462 Web Page: www.thirdwaycenter.org General E-mail Address: infoAthirdwaycenter.org Licensed as/by: ® RCCF ® TRCCF ® Medicaid Z ADAD Program Information Genders Served: ❑Males ® Females Ages Accepted: 14-19 Placement Disqualifiers: Third Way Center may reject persons having a recent history of physical violence, arson, or gang related activity. Number of Beds: 13 females and up to 9 babies Program Description: Treatment Services: Third Way Center has 15 years of experience in serving Teen Mothers. This program offers the same core therapeutic services as York and Pontiac but also focuses on the unique needs of pregnant or parenting teens, including girls who are working to regain custody. The Teen Mother House offers a strong program for learning parenting skills. The treatment team teaches the mothers in small groups,using lectures,demonstrations,videos,and books. Ongoing outings provide our mothers with the opportunity to practice childcare and to look after the general well being of their children with the guidance and supervision of experienced staff. Third Way conducts separate groups to address the girls' needs as mothers and their relationships with their families and the babies' fathers. Fathers are included in counseling sessions when appropriate. All clients receive the following minimum services: • Family Therapy 1-2 hours per week by a Master's Level Therapist • Psychiatric Evaluations and Medication Monitoring 1-2 hours per week • Individual Therapy 2-4 hours per week by a Master's Level Therapist • Group Therapy 6-10 hours per week by a Master's Level Therapist • Independent Living Training 1-5 hours per week Groups offered are three House Groups,Females Group,DYC Group,Drug and Alcohol Group, Special Issues Group(victims of physical or sexual abuse),Grief Group,Independent Living Group,Play Group,Family Support Group,and Mom's Group. Each client receives between 8 and 16 hours of direct clinical service per week. In addition,being a therapeutic community,milieu therapy is conducted on a 24/7 basis. Their negative interactions are often replayed in the milieu, and can be observed,addressed,and treated on a therapeutic level. All therapy is either conducted or supervised by a licensed therapist. Exhibit A Third Way Center also has all-inclusive services,which address the teaching of survival skills to assist our youth in learning to live independently. This is done both within the milieu and in specific independent living groups. At all our facilities,with staff supervision,the clients do the menu planning,cooking,cleaning,and grocery shopping. We also address issues such as budgeting,using public transportation,and banking. This is a hands-on approach that requires client participation(i.e.most of our clients use public transportation,have joint bank accounts with our staff and are required to save 80%of their paychecks and appropriately budget the rest). These skills are integrated into the treatment plan and are essential for successful discharge into the community. This is an ongoing treatment issue while in placement. In addition,we have a Nutritionist who helps with the menu planning. Upon entry to Third Way Center each client completes an Academic and Employment Assessment. This includes obtaining an educational and employment background,goal setting(short and long term)and assessing community resources. Individual job coaching is provided during each stage of the job search,including: picking up applications,completing and submitting applications,and interview preparation. Follow-up services include staff maintaining contact with employers to address progress and problem solving as well as assisting them in developing community-based resources. Community based services are regularly accessed, including Vocational Rehabilitation, Job Corp,Youth at Work,Mile High Youth Corp,One Stop Career Centers, Safe City,Goodwill's Earn and Learn, Youth Biz,Summer Scholars,Governors Summer Job Hunt,Art Street, Elitches Summer Job Program, Arapahoe/Douglas Works,Women's Bean Project,and Colorado Women's Employment and Education. There is a part-time Career and Academic Development Coordinator that supervises the above listed services and a full-time Vocational/Educational Counselor. The average length of stay is 6 months. Education Services: At admission,Third Way Center works with the caseworker to develop an educational plan for each client. Third Way Center operates our own certified high school,The Joan Farley Academy. The Joan Farley Academy provides an environment that addresses our clients' special education needs. All our teachers and supervisors either have their Masters in Special Ed or have a T.T.E. Through small class sizes, individualized attention and close work with the treatment team, students work towards a diploma or GED. JFA faculty uses experiential learning to combine core academics with real life applications. The initiative-building environment allows students to plan and participate in various service learning projects. In addition to building leadership and self-esteem,service learning gives students the chance to explore several career paths and understand the importance of civic responsibility. Third Way Center offers in-house GED programming but when appropriate,we also access community based high schools and GED programs. The GED programs we use are Emily Griffith,Empowerment Program,and Northeast Women's Center. In addition, each client receives individualized tutoring to help them with GED preparation. When a client is ready for post-secondary education,our Vocational/Educational program assists them with visiting and selecting the appropriate college,the application and financial aid process,course selection,and coordinating the use of academic support services. We have clients who attend local community colleges, Metro State,technical colleges and other universities. Program Overview: Third Way Center is a non-profit agency that has a 38-year history of providing community based de- institutionalized residential treatment for adolescents with behavioral and psychiatric disorders. We emphasize an intensive treatment program with the teaching of independent living skills. We offer a continuum of services which leads either to the client emancipating into the community or returning to the home of parent or relatives. Third Way Center operates four residential facilities that are licensed as Therapeutic Residential Child Care Facilities. We also have ten scattered sites apartments in our Next Steps Program. Next Steps is step down program from our Lincoln Street facility that helps clients emancipate into their own apartment or with family reunification. Services we provide in all of our facilities include,but are not limited to psychiatric evaluations,medication prescribing and monitoring,individual,group and family therapy,teaching of independent living skills,substance abuse counseling, vocational counseling and recreational programming. In addition,we have 15 years of experience serving teen mothers. Currently we serve up to thirteen teen mothers at our Teen Mother House and up to two at the Lincoln street facility. Our senior staff averages 25 years of experience at Third Way Center. The Program Founder and Medical Director have been with the program since its inception and the Executive Director has been at Third Way Center for over 30 years. York,Pontiac and Lincoln facilities are centrally located in Denver County and we have a 38 year positive history working with the Colorado Department of Human Services. York,Pontiac,Lincoln,and the Joan Farley Exhibit A Academy are located in Central Denver. The Teen Mother House is located in Englewood. All clients receive appropriate mental health services. This includes initial psychiatric evaluation,medication evaluation, medication prescription and monitoring,and professional supervision and treatment planning. We have two hill-time psychiatrists on staff who directly do all the psychiatric and medication assessment. In addition there is our Clinical Director(LCSW,CACIII, SOMB board certified) and Assistant Clinical Director(LPC)who do all supervision with the psychiatrists. Our Drug and Alcohol Treatment Coordinator(CACIII)supervises all substance abuse treatment. Our Clinical Director supervises all sexual perpetration treatment. They have direct contact with both the clients and the therapists. Clinical supervision is conducted at a minimum of once per week. The above supervisors are part of all treatment planning. Exhibit A Third Way Center — Next Steps Facility Information Facility Name: scattered site apartments and home-based care Parent Company (If applicable): Third Way Center Daily Rate: Variable(see below) Director: David F Eisner Facility Main Phone: (303) 780-9191 Facility Fax Number: (303) 780-9192 Facility Address: PO Box 61385,Denver CO 80206 Placement Referral Contact Name: Renee Johnson Placement Referral Phone: (303) 780-9191 x 462 Web Page: www.thirdwaycenter.org General E-mail Address: info@thirdwaycenter.org Program Information Genders Served: ® Males ® Females Ages Accepted: 16-20 Placement Disqualifiers: Third Way Center may reject persons having a recent history of physical violence, arson, or gang related activity. Number of Beds: 10 youth Treatment Services Provided: NMH N Boys ® Girls ® Sex Off ® D&A Tx Program Description: Treatment Services: Next Steps is a two phase step-down program designed for adolescents leaving a higher level of care and those in the foster care system who are in need of transitional independent living services. It was opened to better ease the transition from Third Way Center's Lincoln Apartments into the community and shorten the overall length of care. We have recently added the two phase component to further facilitate a successful transition to independence. The program has the capacity of 10 clients and is directed by a full-time LSW Treatment Coordinator,in addition to a full-time Bachelors Level Counselor. Most clients in the Next Steps program move into apartments in the community. The residents pay a percentage of their income toward rent,with the percentage gradually increasing to help the resident adjust to living on their own. In addition, some clients are reunified with their families and they receive home-based transition services through Next Steps. A case manager supervises the resident's living situation. The amount of time a resident stays in Next Steps is determined by social services and Third Way Center personnel. There is a full-time psychiatrist on staff to both prescribe and monitor medication administration. The doctor will also provide well baby care. And our Lincoln facility offers respite care,24 hour on call support,and crisis management. Preparation for life on their own is of paramount importance in Next Steps and as part of this goal the life skills groups focus on a variety of independent living topics,such as: ➢ Budgeting > Grocery shopping > Cooking > Cleaning > Employment counseling-short/long term Exhibit A ➢ Educational guidance(finding appropriate educational program) ➢ Finding leisure time activities ➢ Increasing awareness of community resources Phase 1—($72 per day) This encompasses the first 60 days of the program. Services included are as follows: O Staff works with client on apartment hunting. This includes identifying and screening units for safety, affordability,ease of access to work,transportation and resources. Staff also guides the clients through the process,paperwork,and responsibilities associated with signing a rental lease. O Staff conducts daily checks for the first two weeks then daily phone contact afterwards. O Minimum of four physical contacts per week are made(including spot checks at night,and two apartment checks) O Client pays '/3 the monthly rent. O Transportation to appointments, interviews or meetings as necessary. O Therapeutic Intervention-Therapy is conducted by a Master's level therapist employed through Third Way Center. Most of the group therapy is based out of Lincoln to provide for greater continuity. Groups offered include,but are not limited to: Drug and Alcohol Group, Special Issues Group(victims of physical or sexual abuse), Sexual Perpetration Group(co-facilitated with Redirecting Sexual Aggression),Grief Group, Life Skills Group,and Parenting Group.Next Steps also includes services for teenage mothers. Client participates in the following therapeutic services: o Two-three individual therapy sessions per week. o A weekly family therapy session,when appropriate. o Two—five therapeutic or life skills groups per week. O Medication monitoring and consultation with Dr.Hildegard Messenbaugh. O Weekly work and/or school contact. O Random urinalysis screening O Respite care and 24 hour support services at our Lincoln facility. O If other therapeutic services are needed, such as Offense Specific,this can be negotiated on a case by case basis. Phase 2—($57 per day)This phase begins at the beginning of month three. During this phase the following services are offered: O Staff makes phone contact with client a minimum of 2 times per week. O A minimum of one apartment check per week. O Client pays ''A the monthly rent. O Therapeutic Intervention-Therapy is conducted by a Master's level therapist employed through Third Way Center. Most of the group therapy is based out of Lincoln to provide for greater continuity. Groups offered include,but are not limited to:Drug and Alcohol Group, Special Issues Group(victims of physical or sexual abuse), Sexual Perpetration Group(co-facilitated with Redirecting Sexual Aggression),Grief Group, Life Skills Group,and Parenting Group.Next Steps also includes services for teenage mothers. Client participates in the following therapeutic services: o Two-three individual therapy sessions per week. o Weekly family phone contact,when appropriate. o Two—five therapeutic or life skills groups per week. O Medication monitoring and consultation with Dr.Hildegard Messenbaugh. O Weekly work and/or school contact. O Random urinalysis screening O Respite care and 24 hour support services at our Lincoln facility. O If other therapeutic services are needed, such as Offense Specific, this can be negotiated on a case by case basis. Home Based Services—($45 per day) O Staff makes phone contact with client a minimum of 2 times per week. Exhibit A O A minimum of two home visits per week. O Therapeutic Intervention-Therapy is conducted by a Master's level therapist employed through Third Way Center. Group therapy will be provided on an as needed basis. Client participates in the following therapeutic services: o Minimum of one individual therapy session per week. o Weekly family meeting. O Medication monitoring and consultation with Dr.Hildegard Messenbaugh. O Four hours of home therapeutic and case management services O Weekly work and/or school contact,as needed. O Random urinalysis screening O Respite care and 24 hour support services at our Lincoln facility. O If other therapeutic services are needed, such as Offense Specific,this can be negotiated on a case by case basis. O In order to ensure continuity of care,the therapeutic services will be provided by the youth's ongoing therapist from TRCCF care. Psychiatric services will continue to be provided by either Dr.Messenbaugh or Dr. Merker. The in-home and case management services will be provided by our Next Steps staff Education Services: At admission,Third Way Center works with the caseworker to develop an educational plan for each client. Third Way Center operates our own certified high school,The Joan Farley Academy. The Joan Farley Academy provides an environment that addresses our clients' special education needs. All our teachers and supervisors either have their Masters in Special Ed or have a T.T.E. Third Way Center offers in-house GED programming but when appropriate,we also access community based high schools and GED programs. The GED programs we use are Emily Griffith,Empowerment Program,and Northeast Women's Center. In addition,each client receives individualized tutoring to help them with GED preparation. When a client is ready for post-secondary education,our VocationaUEducational program assists them with visiting and selecting the appropriate college,the application and financial aid process,course selection, and coordinating the use of academic support services. We have clients who attend local community colleges,Metro State,technical colleges and other universities. Program Overview: Third Way Center is a non-profit agency that has a 38-year history of providing community based de- institutionalized residential treatment for adolescents with behavioral and psychiatric disorders. We emphasize an intensive treatment program with the teaching of independent living skills. We offer a continuum of services which leads either to the client emancipating into the community or returning to the home of parent or relatives. Third Way Center operates four residential facilities that are licensed as Therapeutic Residential Child Care Facilities. We also have ten scattered sites apartments in our Next Steps Program. Next Steps is step down program from our Lincoln Street facility that helps clients emancipate into their own apartment or with family reunification. Services we provide in all of our facilities include,but are not limited to psychiatric evaluations,medication prescribing and monitoring,individual,group and family therapy,teaching of independent living skills,substance abuse counseling, vocational counseling and recreational programming. In addition, we have 15 years of experience serving teen mothers. Currently we serve up to thirteen teen mothers at our Teen Mother House and up to two at the Lincoln street facility. Our senior staff averages 25 years of experience at Third Way Center. The Program Founder and Medical Director have been with the program since its inception and the Executive Director has been at Third Way Center for over 30 years. York,Pontiac,Lowry,Lincoln, and the Joan Farley Academy are centrally located in Denver County and we have a 38 year positive history working with the Colorado Department of Human Services. The Teen Mother House is located in Englewood. All clients receive appropriate mental health services. This includes initial psychiatric evaluation,medication evaluation, medication prescription and monitoring,and professional supervision and treatment planning. We have two full-time psychiatrists on staff who directly do all the psychiatric and medication assessment. In addition there is Exhibit A our Clinical Director(LCSW,CACIII, SOMB board certified)and Assistant Clinical Director(LPC)who do all supervision with the psychiatrists. Our Drug and Alcohol Treatment Coordinator(CACIII)supervises all substance abuse treatment. Our Clinical Director supervises all sexual perpetration treatment. They have direct contact with both the clients and the therapists. Clinical supervision is conducted at a minimum of once per week. The above supervisors are part of all treatment planning. WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Third Way Center and Weld County Department of Human Services for the period from July 1, 2008 through June 30, 2009. The following provisions, made this // ay of HugJe s f, 2008, are added to the referenced Agreement. Except as modified hereby, all terms of tlfe Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#1547437, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$175.71 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$175.71 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); ] Weld County SS-23A Addendum E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include,but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Human Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 12. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. 13. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 14. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 15. Add Paragraph 9 to Section VI. The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: A. Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed; B. Deny payment or recover reimbursement for those services or deliverables which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Human Services and the Contractor, or by Human Services as a debt to Human Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 16. Add Paragraph 10 to Section VI. The contractor shall promptly notify Human Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five(5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Human Services' Director. The term "litigation"includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. laAtiff ATTEST: Mil_______ Wel to the Board , WELD COUNTY BOARD OF IV"' ,y'1 HUMAN SERVICES, ON BEHALF s Ky y OF THE WELD COUNTY DEPARTMENT OF HUMAN „ mr � n,11 j v‘:. ; SERVICES BY �212�- Q�Ly e �C, By: C7/��i Deputy Cle to the Board Chair Signature William H. Jerke AUG 1 1 2008 CONTRACTOR Third Way Center PO Box 61385 Denver, C0 By: WELD COUNTY DEPARTMENT OF HUMAN SERVICES y By: i 7 irector 4 Weld County SS-23A Addendum / 7a9cp cQ�t Exhibit A Third Way Center - Lowry Facility Information Facility Name: Lowry Parent Company (If applicable): Third Way Center Daily Rate: State Set Vendor Rate Director: David F Eisner Facility Main Phone: (303) 780-9191 Facility Fax Number: (303) 780-9192 Facility Address: PO Box 61385, Denver CO 80206 Placement Referral Contact Name: David F Eisner Placement Referral Phone: (303) 780-9191 x 460 Web Page: www.thirdwaycenter.org General E-mail Address: infoc thirdwaycenter.org Licensed as/by: ® TRCCF ® RCCF ® Medicaid ® ADAD Program Information Genders Served: ® Males ® Females Ages Accepted: 13-18 Placement Disqualifiers: Third Way Center may reject persons having a recent history of physical violence, arson, or gang related activity. Number of Beds: 8 youth Treatment Services Provided: ®MH ® Boys ® Girls ® Sex Off ® D&A Tx Program Description: Treatment Services: Recently,Third Way Center was granted 1.8 acres on the grounds of the new Lowry Redevelopment Project in east Denver. We are building a specialized residential treatment campus on this acreage at Lowry. This site will include four residential,ranch style cottages that have a homelike and non-institutional feel. Each cottage will accommodate eight children in their own small bedroom. The cottages will have lots of light,central air,a central sound system,an open kitchen/dining area,staff offices,therapy offices and an on-site school in each building. They each have a private outdoor space and also surround a large shared central courtyard area that can be utilized for recreational space,picnics,and outdoor activities. This program will be much like all of our other programs, teaching survival skills while working intensively on the therapeutic issues which have brought these children to our programs. However,this program will be more structured,and offer much more assessment and diagnostic services. We offer a staff ratio of 1:4. Features of the Lowry Campus: •Doors are locked using a"delayed locking system." This enables to staff to come and go at will with a key,but if residents try to leave without a staff member,an alarm will sound and the door will not unlock for 30 seconds. This enables the staff to try and"talk the client out of leaving,"before they go. •The floor plan of the cottages is very open and designed with ease of supervision in mind. The bedrooms all surround a central living space and from one end of the building staff can easily monitor the entire space. •A camera system monitors the interior and exterior for further security and supervision and windows are alarmed. *Lowry will provide educational services on campus. •Medications will be monitored by our two full-time psychiatrists(MD)and will be distributed only by medication administration certified staff. *These homes will offer enhanced assessment and diagnostics. Exhibit A •Perimeter 6'wrought iron fencing surrounds the campus. •The anticipated length of stay will be from 30 days to 3 months and then most likely the client will then be moved to a less structured community based program at one of our other facilities or any other appropriate disposition plan. The first cottage,Hope Place,opened in 2007 and another will open in late 2008. The remaining will open every 6-9 months until all four are completed. Each cottage will house 8 clients with an eventual campus capacity of 32 youth. All clients receive the following minimum services: •Family Therapy 1-2 hours per week by a Master's Level Therapist *Psychiatric Evaluations and Medication Monitoring 1-2 hours per week -Individual Therapy 2-4 hours per week by a Master's Level Therapist •Group Therapy 6-10 hours per week by a Master's Level Therapist •Independent Living Training 1-5 hours per week Groups offered are three House Groups,Males Group,Females Group,DYC Group,Drug and Alcohol Group, Special Issues Group(victims of physical or sexual abuse), Sexual Perpetration Group(2 per week),Grief Group,and Parenting Group. We work with Redirecting Sexual Aggression to do psycho-sexual evaluations,co- facilitate groups,conduct plethysmagraphs and polygraphs for our sexual perpetrators. We are limited to how many clients with these issues we can take per house. Each child receives between 8 and 16 hours of direct clinical service per week. In addition,being a therapeutic community,milieu therapy is conducted on a 24/7 basis. Their negative interactions,which caused their placements, are often replayed in the milieu,and can be observed,addressed,and treated on a therapeutic level. All therapy is either conducted or supervised by a licensed therapist. Education Services: At admission,Third Way Center works with the caseworker to develop an educational plan for each client. Educational Services will be offered on site. All our teachers and supervisors either have their Masters in Special Ed or have a T.T.E. Through small class sizes, individualized attention and close work with the treatment team, students work towards a diploma or GED. Program Overview: Third Way Center is a non-profit agency that has a 38-year history of providing community based de- institutionalized residential treatment for adolescents with behavioral and psychiatric disorders. We emphasize an intensive treatment program with the teaching of independent living skills. We offer a continuum of services which leads either to the client emancipating into the community or returning to the home of parent or relatives. Third Way Center operates five residential facilities that are licensed as Therapeutic Residential Child Care Facilities. We also have ten scattered sites apartments in our Next Steps Program. Next Steps is step down program from our Lincoln Street facility that helps clients emancipate into their own apartment or with family reunification. Services we provide in all of our facilities include,but are not limited to psychiatric evaluations,medication prescribing and monitoring,individual,group and family therapy, teaching of independent living skills,substance abuse counseling, vocational counseling and recreational programming. In addition,we have 15 years of experience serving teen mothers. Currently we serve up to thirteen teen mothers at our Teen Mother House and up to two at the Lincoln street facility. Our senior staff averages 25 years of experience at Third Way Center. The Program Founder and Medical Director have been with the program since its inception and the Executive Director has been at Third Way Center for over 30 years. York,Pontiac and Lincoln facilities are centrally located in Denver County and we have a 38 year positive history working with the Colorado Department of Human Services. York,Pontiac,Lincoln,and the Joan Farley Academy are located in Central Denver. The Teen Mother House is located in Englewood. All clients receive appropriate mental health services. This includes initial psychiatric evaluation,medication evaluation, medication prescription and monitoring,and professional supervision and treatment planning. We have two full-time psychiatrists on staff who directly do all the psychiatric and medication assessment.In addition there is our Clinical Director(LCSW,CACIII,SOMB board certified)and Assistant Clinical Director(LPC)who do all supervision with the psychiatrists. Our Drug and Alcohol Treatment Coordinator(CACIII)supervises all substance Exhibit A abuse treatment. Our Clinical Director supervises all sexual perpetration treatment. They have direct contact with both the clients and the therapists. Clinical supervision is conducted at a minimum of once per week. The above supervisors are part of all treatment planning. Menu of Services: Offense Specific Treatment Program $10 per day WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Turning Point Center for Youth and Weld County Department of Human Services for the period from July 1, 2008 through June 30, 2009. The following provisions, made this //—day of S , 2008, are added to the referenced Agreement. Except as modified hereby, all terms ofement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#45179, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.02 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.02 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum c9zV2- c?/4l E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be famished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Human Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 12. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. 13. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 14. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 15. Add Paragraph 9 to Section VI. The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: A. Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed; B. Deny payment or recover reimbursement for those services or deliverables which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Human Services and the Contractor, or by Human Services as a debt to Human Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 16. Add Paragraph 10 to Section VI. The contractor shall promptly notify Human Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Human Services' Director. The term"litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: iada Weld Cou to the Board ~. .( J WELD COUNTY BOARD OF ite15) HUMAN SERVICES, ON BEHALF OF THE WELD COUNTY l a r,- r‘ 1 DEPARTMENT OF HUMAN \,ti. (\-:,..i.:1 ,;'- SERVICES BY: 472121441.- .j,dIAL By: 'Ini -' Deputy Cle o the Board Chair Signature William H. Jerke AUG 1 1 2008 CONTRACTOR Turning Point Center for Youth 1644 South College Ave Fort Collins, CO 80525 WELD COUNTY DEPARTMENT OF HUMAN SERVICES BY: .N, U (ri4_.( D rector JJJ v 4 Weld County SS-23A Addendum o?%I>,>,S'-'�/d WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Turning Point Center for Youth and Weld County Department of Human Services for the period from July 1, 2008 through June 30,2009. The following provisions, made this // ay of 2008, are added to the referenced Agreement. Except as modified hereby, all terms of t e Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#100441, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.02 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.02 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County,prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Human Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 12. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. 13. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 14. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 15. Add Paragraph 9 to Section VI. The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: A. Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed; B. Deny payment or recover reimbursement for those services or deliverables which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Human Services and the Contractor, or by Human Services as a debt to Human Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 16. Add Paragraph 10 to Section VI. The contractor shall promptly notify Human Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Human Services' Director. The term "litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: /"_^_1 ___laAT Weld Coun Board .: 1,f7?,..‘ a WELD COUNTY BOARD OF 4".(47 � HUMAN SERVICES, ON BEHALF +6 1 / OF THE WELD COUNTY DEPARTMENT OF HUMAN �u i,.- SERVICES BY: r By: '\---i .�1„.-_/ Deputy CI to the Board Chair Signature William H. Jerke AUG 1 1 2UUd CONTRACTOR Turning Point Center for Youth 1644 South College Ave Fort Collins, CO 80525 WELD COUNTY DEPARTMENT OF HUMAN SERVICES By: U Dir ctor 4 Weld County SS-23A Addendum 07/241-7- aid( WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Youthtrack and Weld County Department of Human Services for the period from July 1, 2008 through June 30, 2009. The following provisions,made this /l day of4jQyf , 2008, are added to the referenced Agreement. Except as modified hereby, all terms of the Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#11725, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$141.50 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$141.50 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum n �f E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Human Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public(federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 12. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. 13. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 14. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 15. Add Paragraph 9 to Section VI. The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: A. Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed; B. Deny payment or recover reimbursement for those services or deliverables which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Human Services and the Contractor, or by Human Services as a debt to Human Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 16. Add Paragraph 10 to Section VI. The contractor shall promptly notify Human Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Human Services' Director. The term "litigation"includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. 1444114 ATTEST: Weld County the Board �� fa WELD COUNTY BOARD OF HUMAN SERVICES, ON BEHALF R OF THE WELD COUNTY \ � y r y DEPARTMENT OF HUMAN // ::T; By: 9 /LC GJ�{!J Deputy Cl to the Board Chair Signature William H. Jerke AUG 1 1 2000 CONTRACTOR Youthtrack 1375 Ken Pratt Blvd Longmont 'O 80 By: WELD COUNTY DEPARTMENT OF HUMAN SERVICES r By: V\ 1,1�'l.45/‘J Di ector 4 Weld County SS-23A Addendum aL,v. ,c' ii.,8 WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Youthtrack and Weld County Department of Human Services for the period from July 1, 2008 through June 30, 2009. The following provisions, made this//day of Aga ct, 2008, are added to the referenced Agreement. Except as modified hereby, all terms of the Agreement remain unchanged. County agrees to purchase and Contractor, identified as Provider ID#11724, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$129.23 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$129.23 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum awe ova? E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Human Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public(federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum r C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local)terminated for cause or default. 12. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. 13. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 14. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 15. Add Paragraph 9 to Section VI. The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: A. Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed; B. Deny payment or recover reimbursement for those services or deliverables which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Human Services. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to Human Services; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Human Services and the Contractor, or by Human Services as a debt to Human Services or otherwise as provided by law. 3 Weld County SS-23A Addendum w 16. Add Paragraph 10 to Section VI. The contractor shall promptly notify Human Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Human Services' Director. The term "litigation"includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: tat4 "'1 4/1"4 Weld Co the Board / `. ' WELD COUNTY BOARD OF ��'s 186! r ^` HUMAN SERVICES, ON BEHALF r �Ym^ OF THE WELD COUNTY f, DEPARTMENT OF HUMAN �tC ,., SERVICES try By: By: ��v.� Deputy erk to the Board Chair Signature William H. Jerke AUG 1 1 2008 CONTRACTOR Youthtrack 1375 Ken Pra Bly Longmo , CO 0 01 By: rtnrc G re— WELD COUNTY DEPARTMENT OF HUMAN SERVICES By: C,k0j/i/U, nl i Di ector Li 4 Weld County SS-23A Addendum (960(F (0/42 Hello