HomeMy WebLinkAbout20082417.tiff RESOLUTION
RE: APPROVE NINE CHILD PROTECTION AGREEMENTS FOR SERVICES WITH VARIOUS
PROVIDERS AND AUTHORIZE CHAIR TO SIGN
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board has been presented with nine Child Protection Agreements for
Services between the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County, on behalf of the Department of Human Services, and the
providers listed below, commencing June 1, 2008, and ending May 31, 2009, with further terms
and conditions being as stated in said agreements, and
1. Collaborative Services for Change, PC (Mental Health)
2. Collaborative Services for Change, PC (Sex Abuse Treatment - Offense Specific)
3. Shiloh Home, Inc. (Day Treatment)
4. Shiloh Home, Inc. (Mental Health)
5. Shiloh Home, Inc. (Home-Based)
6. Shiloh Home, Inc. (Sex Abuse Treatment - Offense Specific)
7. Mount Saint Vincent
8. Family Connects
9. The Family Center
WHEREAS,after review,the Board deems it advisable to approve said agreements,copies
of which are attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County, Colorado, that the nine Child Protection Agreements for Services between the County of
Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on
behalf of the Department of Human Services, and the providers listed above be, and hereby are,
approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to
sign said agreements.
2008-2417
H R0079
ee : i } s 09 _ �s 08-
NINE CHILD PROTECTION AGREEMENTS FOR SERVICES WITH VARIOUS PROVIDERS
PAGE 2
The above and foregoing Resolution was, on motion duly made and seconded, adopted by
the following vote on the 8th day of September, A.D., 2008, nunc pro tunc June 1, 2008.
BOARD OF COUNTY COMMISSIONERS
�� % ,;/a aWELD COUNTY, COLORADO
ATTEST: / a# e
{� , < illiam H. Jerke, Chair
Weld County Clerk to the Boa d�,' ''
(Cg
XCUSED
BY: ( Uai7 , �� Robert M o-Tem
De u y Cle to the Boar di
U /i ce
Willia Garcia
R D f2 :
David E. Long
ou ty Attorney ,lor
Date of signature:
qii/N Douglas ademacher
2008-2417
HR0079
M
Y
•
El 7 COUNTY
ract
Memorandum
NERS
-2? u P t,. ! 3
Date: September 8, 2008
' To: William H. Jerke, Chair, Board of County Commissioners
C.
COLORADO From: Judy A. Griego, Director, Human Sce epartment
RE: Child Protection Agreem is Bet een the eld C unty
Department of Human Se ices and Various Contractors
Enclosed for Board approval are Child Protection Agreements between the Weld County
Department of Human Services and various Contractors. These Agreements were reviewed at the
May 27, 2008 and the August 20, 2008 Board Work Session.
The major provisions of the Child Protection Agreements are listed below:
No. Contractor& Type of Service & Rate & Maximum
Term Founding Source Contract Amount
1. Collaborative Services for Individual and Family $75.00 Per Hour
Change Therapy
June 1, 08 —May 31, 09 CORE Max. $20,000.00
2. Collaborative Services for Offense Specific Mental $50.00 - $300.00
Change Health Services Per Episode
June 1, 08 —May 31, 09 CORE Max. $20,000.00
3. Shiloh Home, Inc. Day Treatment Services $1,546.38
Per Month
June 1, 08—May 31, 09 CORE Max. $10,000.00
4. Shiloh Home, Inc. Individual and Group $45.00—$100.00
Therapy Per Hour
June 1, 08 —May 31, 09 CORE Max. $30,000.00
5. Shiloh Home, Inc. Home Based Services $260.00 - $720.00
To Youth Per Week
June 1, 08 —May 31, 09 CORE Max. $10,000.00
Page 1 of 2 2008-2417
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t
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No. Contractor & Type of Service & Rate & Maximum
Term Founding Source Contract Amount
6. Shiloh Home, Inc. Offense Specific $45.00 - $90.00
Treatment Per Hour
June 1, 08 —May 31, 09 CORE Max. $10,000.00
7. Mount Saint Vincent Youth Day Treatment $105.00 Per Day
June 1, 08—May 31, 09 CORE Max. $25,000.00
8. Family Connects Therapy and Child Care $45.00-$76.00
Provider Training Per Hour
$614.00- $930.00
June 1, 08 —May 31, 09 Child Care Per Training
Max. $50,000.00
9. Family Connects Individual & Group $30.00 - $45.00
Therapy Per Group
$50.00 Per Hour
June 1, 08 —May 31, 09 CORE Max. $15,000.00
If you have any questions please give me a call at extension 6510.
Filed BM 09 08 08 I.DOC
Page 2 of 2
L,)G' ___
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PY-08-09-CORE-0135
CHILD PROTECTION AGREEMENT FOR SERVICES
BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES
AND COLLABORATIVE SERVICES FOR CHANGE,PC
This Agreement,made and entered into the 'q day of 2i_44A/22008,2008,by and between the Board of
Weld County Commissioners,sifting as the Board of Human Services,on behalf of the Weld County Department of
Human Services,hereinafter referred to as the"Department,"and Collaborative Services for Change,PC,
hereinafter referred to as"Contractor".
WITNESSETH
WHEREAS,required approval,clearance,and coordination have been accomplished from and with
appropriate agencies;and
WHEREAS,the Colorado Department of Human Services has provided Core Services funding to the
Department for Mental Health Services;and
NOW THEREFORE,in consideration of the premises,the parties hereto covenant and agree as follows:
1. Term
This Agreement shall become effective on June I,2008,upon proper execution of this Agreement and
shall expire May 31,2009,unless sooner terminated as provided herein.
2. Scope of Services
Services shall be provided by CONTRACTOR to any person(s)eligible for child protection services in
compliance with Exhibit A"Scope of Services,"a copy of which is attached by reference.
3. Payment
a. Payment shall be made on the basis of Exhibit B,"Payment Schedule,"of which are attached
hereto and incorporated herein by reference.
"Payment Schedule"shall establish the maximum reimbursement,which will be paid from
Core Services funding during the duration of this Agreement.
b. CONTRACTOR shall submit an itemized monthly bill to the Department for all costs incurred
and services provided pursuant to Exhibit A of this Agreement in accordance with criteria
established by the Department. CONTRACTOR shall submit all itemized monthly billings to
the Department by the 10th day of the month following the month the cost was incurred. If the
billing is not submitted within twenty-five(25)calendar days of the month following service,it
may result in forfeiture of payment.
c. Payments of costs incurred pursuant to this Agreement is expressly contingent upon the
availability of Core Services to the Department.
d. The Department shall not be billed for,and reimbursement shall not be made for time involved in
activities outside of those defined in Exhibit A. Work performed prior to the execution of this
Contract shall not be reimbursed or considered part of this Agreement.
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4. Financial Management
At all times from the effective date of this Contract until completion of this Contract,CONTRACTOR
shall
comply with the administrative requirements,cost principles and other requirements set forth in the
Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds
expended under Core Service funding must conform to the Single Audit Act of 1984 and OMB Circular A-
133.
5. Payment Method
Unless otherwise provided in the Scope of Services and Payment Schedule:
a. CONTRACTOR shall provide proper monthly invoices and itemization of services performed for
costs incurred in the performance of the agreement.
b. The Department may withhold any payment if CONTRACTOR has failed to comply with the
Financial Management Requirements,program objectives,contractual terms,or reporting
requirements. In the event of a forfeiture of reimbursements,CONTRACTOR may appeal such
circumstance to the Director of Human Services. The decision of the Director of Human Services
shall be final.
6. Assurances
CONTRACTOR shall abide by all assurances as set forth in the attached Exhibit C,which is attached hereto
and incorporated herein by reference.
7. Compliance with Applicable Laws
At all times during the performance of this contract,CONTRACTOR shall strictly adhere to all applicable
federal and state laws,orders,and all applicable standards,regulations,interpretations or guidelines issued
pursuant thereto. This includes the protection of the confidentiality of all applicant/recipient records,
papers,documents,tapes and any other materials that have been or may hereafter be established which
relate to the Contract. CONTRACTOR acknowledges that the following laws are included:
Title VI of the Civil Rights Act of 1964,42 U.S.C.Sections 2000d—1 et. and its implementing
regulation,45 C.F.R.Part 80 et cest.'and
Section 504 of the Rehabilitation Act of 1973,29 U.S.C.Section 794,and
its implementing regulations,45 CF.R Part 84;and
the Age Discrimination Act of 1975,42 U.S.C.Sections 6101 et.seq.and
its implementation regulations,45 C.F.R.Part 91;and
Title VII of the Civil Rights Act of 1964;and
the Age Discrimination in Employment Act of 1967;and
the Equal Pay Act of 1963;and
the Education Amendments of 1972;and
Immigration Reform and Control Act of 1986,P.L.99-603;
42 C.F.R.Part 2
and all regulations applicable to these laws prohibiting discrimination because of race,color,
National origin,and sex,religion and handicap,including Acquired Immune Deficiency Syndrome(AIDS)
or AIDS related conditions,covered under Section 504 of the Rehabilitation Act of 1973,as amended,
cited above. If necessary,CONTRACTOR and the Department will resist in judicial proceedings any
efforts to obtain access to client records except as permitted by 42 CFR Part 2.
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Included is 45 C.F.R.Part 74 Appendix G 9,which requires that affirmative steps be taken to assure that
small and minority businesses are utilized,when possible,as sources of supplies,equipment,construction
and services. This assurance is given in consideration of and for the purpose of obtaining any and all
federal and/or state financial assistance.
Any person who feels that s/he has been discriminated against has the right to file a complaint either with
the Colorado Department of Human Services or with the U.S.Department of Health and Human Services,
Office for Civil Rights.
8. Compliance with Child and Family Services Review
The Child and Family Services Reviews(CFSR)examines child welfare service outcomes in three areas;
Safety,Permanency and Well Being of families. For each outcome,data and performance indicators
measure each state's performance according to national standards and monitor progress over time.
Following the review,a Program Improvement Plan(PIP)will be implemented for the state to enhance
services to families.
CONTRACTORS providing services to the Department families and children must continually strive for
positive outcomes in the areas of safety,permanency and well being. Contractors providing services in
program areas identified by the Department are required to comply with a standard assessment and
reporting system set forth in Exhibit D which will address the aforementioned three areas.
9. Insurance
CONTRACTOR shall procure,at its own expense,and maintain for the duration of the work,the following
insurance coverage;Weld County,Colorado,by and through the Board of County Commissioners of Weld
County,its employees and agents,shall be named as additional named insured on the insurance policy.
a. Standard Workman's Compensation and Employer's Liability.
1. As required by state statute including occupational disease,covering all employees at
work site.
b. General Liability(PL&PD)(Minimum).
1. Combined single limit-$500,000 written on an occurrence basis.
2. Any aggregate limit will not be less than$1 million.
3. Provider must purchase additional insurance if claims reduce the annual aggregate below
$500,000.
4. State of Colorado to be named as additional insured on each comprehensive general
liability policy.
5. Certificate of insurance to be provided to Weld County and must be attached to the
contract.
6. Insurance shall include provisions preventing cancellation without 60 days prior notice
by certified mail to Weld County.
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c. Automobile Liability(Minimum).
1. Minimum of$500,000 combined single limit auto insurance.
d. Additional coverage may be required in specific program areas. For any insurances that are
required by this contract,a completed Standard Certificate of Insurance Form shall be provided to
the Department by the Contractor prior to the start of any contract.
10. Certifications
CONTRACTOR certifies that,at the time of entering into this Contract,it has currently in effect all
necessary licenses,approvals,insurance,etc.required to properly provide the services and/or supplies
covered by this contract. Copies of all necessary licenses shall be provided to the Departrnent by the
Contractor prior to the start of any contract.
11. Monitoring and Evaluation
CONTRACTOR and the Department agree that monitoring and evaluation of the performance of this
Agreement shall be conducted by CONTRACTOR and the Department. The results of the monitoring and
evaluation shall be provided to the Board of Weld County Commissioners,the Department and
CONTRACTOR.
CONTRACTOR shall permit the Department,and any other duly authorized agent or governmental
agency,to monitor all activities conducted by CONTRACTOR pursuant to the terms of this Agreement.
As the monitoring agency may in its sole discretion deem necessary or appropriate,such program data,
special analyses,on-site checking,formal audit examinations,or any other reasonable procedures. All
such monitoring shall be performed in a manner that will not unduly interfere with agreement work.
12. Modification of Agreement
All modifications to this agreement shall be in writing and signed by both parties.
13. Remedies
The Director of Human Services or designee may exercise the following remedial actions should s/he find
CONTRACTOR substantially failed to satisfy the scope of work found in this Agreement. Substantial
failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by
CONTRACTOR These remedial actions are as follows:
a. Withhold payment to CONTRACTOR until the necessary services or corrections in performance are
satisfactorily completed;
b. Deny payment or recover reimbursement for those services or deliverables,which have not been
performed and which due to circumstances caused by CONTRACTOR cannot be performed or if
performed would be of no value to the Department. Denial of the amount of payment shall be
reasonably related to the amount of work or deliverables lost to the Department;
c. Incorrect payment to CONTRACTOR due to omission,error,fraud,and/or defalcation shall be
recovered from CONTRACTOR by deduction from subsequent payments under this Agreement or
other agreements between the Department and CONTRACTOR,or by the Department as a debt due to
the Department or otherwise as provided by law.
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14. Representatives
For the purpose of this Agreement,the individuals identified below are hereby designated representatives
of the respective parties. Either party may from time to time designate in writing a new or substitute
representative(s):
For the Department:
Gloria Romansik Social Services Administrator
Name Title
For CONTRACTOR:
Marci Brewer,LCSW Clinical Director/Co-Owner
Name Tide
15. Notice
All notices required to be given by the parties hereunder shall be given by certified or registered mail to the
individuals at the addresses set forth below. Either party may from time to time designate in writing a
substitute person(s)or address to whom such notices shall be sent:
To: The Department To: CONTRACIUR
Judy A.Grieco,Director Marci Brewer,LCSW
P.O.Box A 2480 W.26th Avenue,#130-B
Greeley,CO 80632 Denver,CO 80211
(970)352-1551 (303)433-0188
16. Litigation
CONTRACTOR shall promptly notify the Department in the event that CONTRACTOR learns of any
actual litigation in which it is a party defendant in a case that involves services provided under this
Agreement.CONTRACTOR,within five(5)calendar days after being served with a summons,complaint,
or other pleading which has been filed in any federal or state court or administrative agency,shall deliver
copies of such document(s)to the Human Services Director. The term"litigation"includes an assignment
for the benefit of creditors,and filings in bankruptcy,reorganization and/or foreclosure.
17. Termination
This Agreement may be terminated at any time by either party given thirty(30)days written notice and is
subject to the availability of finding. CONFRAC'TUR reserves the right to suspend services to clients if
funding is no longer available.
18. Entire Agreement
This Agreement,together with all attachments hereto,constitutes the entire understanding between the
parties with respect to the subject matter hereof,and may not be changed or modified except as stated in
Paragraph 10 herein.
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IN WITNESS WHEREOF,the patties hereto have duly executed the Agreement as of the day,month,and year first
above written.
4 �
ATTEST:
WELD CO ify ' • OF COUNTY
CLERK f1I I I h 4•••I SSIONERS WELD
TY,COLORADO
By: . 'Y
Deputy Clerk ' William H.Jerke,Chair
SEP 0 8 2008
APPROVED AS T CONTRACTOR:
BY
Col A ey Marci Brewer,LCSW-Clinical Director/Co-Owner
WELD COUNTY DEPARTMENT
OF HUMAN SERVICES
By: 1
J A.Grie o, 'vest
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EXHIBIT A
SCOPE OF SERVICES
1. CONTRACTOR will provide mental health services to clients referred by the Department,in the Denver area.
Services include individual,couples and family therapy to address specific problematic issues that may
include,but are not limited to,abuse recovery,anger management,trauma recovery,behavior disorders,mood
disorders and social skills interventions. a,op j},0., V1 U, Ca,%_t.-p.npts_fy ,,,t."‘
2. All services will be provided by Marci Brewer,LCSW.
3. CONTRACTOR will identify in detail areas of continued concern and make recommendations to the lfn3.
Department regarding continuation of services and/or the need for additional services.
4. CONTRACTOR will document in detail any and all observed or verbalized concerns regarding any child
whom the CONTRACTOR is working with under an active referral.Areas of concern may include,but are not
limited to,any physical,emotional,educational or behavioral issues.Areas of concern should be reported
immediately AND on the required monthly report.
5. CONTRACTOR will submit reports on a monthly basis for each active referral.Reports will be submitted per
the online format required by the Department.
6. CONTRACTOR will participate in team reviews of ongoing services as requested.
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EXHIBIT B
PAYMENT SCHEDULE
1. Funding and Method of Payment
The Department agrees to reimburse CONTRACTOR in consideration for the work and services
performed from Core Services funding,not to exceed$20,000.00.
Expenses incurred by CONTRACTOR,in association with said project prior to the term of this agreement,
are not eligible Department expenditures and shall not be reimbursed by the Department.
Payment pursuant to this Contract,if Core Services funds,whether in whole or in part,is subject to and
contingent upon the continuing availability of said funds for the purposes hereof. In the event that said
funds,or any part thereof,become unavailable as determined by the Department,the Department may
immediately terminate this Contract or amend it accordingly.
2. Fees for Services 1
$75.00/Episode(Individual/Couples/Family Counseling,Face-to-Face Contact)
50/flc3nsr•.-. -QK- Ca CMov-tou+,cflc -.! — (v1
Department referrals will not be sent to collections by Contractor for default of co-pay/fees. Services will
144
be performed regardless of client's refusal or inability to pay co-pay.
Contractor will collect any applicable sliding scale co-pays and credit the Department for any payments
received on the monthly billing statements.
3. Submittal of Vouchers
CONTRACTOR shall prepare and submit monthly the itemized voucher and certify that the services
authorized were provided on the date indicated and the charges made were pursuant to the terms and
conditions of Exhibit A.
a. All billings are to be submitted by the 10the day of the month following the month of
service. If the billing is not submitted within twenty-five(25)calendar days of the month
following service,it may result in forfeiture of payment.
b. Billings must be submitted with the attached required forms,Authorization for
Contractual Services,Request for Reimbursement,Client Verification Form and monthly
report. The forms must be submitted with original signatures.
c. For monitored sobriety,proof of services rendered shall be a sign-in sheet with client
signatures or the test result.
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EXHIBIT C
ASSURANCES
1. CONTRACTOR agrees it is an independent contractor and that its officers and employees do not become
employees of Weld County,nor are they entitled to any employee benefits as Weld County employees,as
the result of the execution of this Agreement.
2. Weld County,the Board of County Commissioners of Weld County,its officers and employees,shall not
be held liable for injuries or damages caused by any negligent acts or omissions of CONTRACTOR-
contracted CONTRACTOR or its employees,volunteers,or agents while performing duties as described in
this Agreement.CONTRACTOR shall indemnify,defend,and hold harmless Weld County,the Board of
County Commissioners of Weld County,its employees,volunteers,and agents. CONTRACTOR shall
provide adequate liability and worker's compensation insurance for all its employees,volunteers,and
agents engaged in the performance of the Agreement upon request,CONTRACTOR shall provide the
Department with the acceptable evidence that such coverage is in effect.
3. No portion of this Contract shall be deemed to constitute a waiver of any immunities the parties or their
officers or employees may possess,not shall any portion of this Agreement be deemed to have created a
duty of care with respect to any persons not a party of this Agreement.
4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld, State
of Colorado,to expend funds not otherwise appropriated in each succeeding year.
5. If any section,subsection,paragraph,sentence,clause,or phrase of this Contract is for any reason held or
decided to be unconstitutional,such decision shall not affect the validity of the remaining portions. The
parties hereto declare that they would have entered into this Contract and each and every section,
subsection,paragraph,sentence,clause,and phrase thereof irrespective of the fact that any one or more
sections,subsections,paragraphs,sentences,clauses,or phrases might be declared to be unconstitutional or
invalid.
6. No officer,member or employee of Weld County and no member of their governing bodies shall have any
pecuniary interest,direct or indirect,in the approved Agreement or the proceeds thereof.
7. CONTRACTOR assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that no
person shall,on the grounds of race,creed,color,sex,or national origin,be excluded from participation in,
be denied the benefits of,or be otherwise subjected to discrimination under this approved Contract.
8. CONTRACTOR assures that sufficient,auditable,and otherwise adequate records that will provide
accurate,current,separate,and complete disclosure of the status of the funds received under the Contract
are maintained for three(3)years or the completion and resolution of an audit. Such records shall be
sufficient to allow authorized local,Federal,and State auditors,and representatives to audit and monitor
CONTRACTOR.
9. All such records,documents,communications,and other materials created pursuant or related to this
contract shall be maintained by CONTRACTOR,in a central location and shall be made available to
Social Services upon its request,for a period of seven(7)years from the date of final payment under this
Contract,or for such further period as may be necessary to resolve any matters which may be pending,or
until an audit has been completed with the following qualifications: If an audit by or on behalf of the
federal and/or state government has begun but is not completed at the end of the seven(7)year period,or if
audit findings have not been resolved after a seven(7)period,the materials shall be retained until the
resolution of the audit finding.
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10. CONTRACTOR assures that authorized local,federal,and state auditors and representatives shall,during
business hours,have access to inspect any copy records,and shall be allowed to monitor and review
through on-site visits,all contract activities,supported with funds under this Contract to ensure compliance
with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the
performance of the Agreement shall be conducted by appropriate funding sources. The results of the
monitoring and evaluation activities shall be provided to the appropriate and interested parties.
11. This Contract shall be binding upon the parties hereto,their successors,heirs,legal representatives,and
assigns. CONTRACTOR or the Department may not assign any of its rights or obligations hereunder
without the prior written consent of both parties.
12. CONTRACTOR certifies that federal appropriated funds have not been paid or will be paid,by or on
behalf of CONTRACTOR,to any person for influencing or attempting to influence an officer or employee
of an agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of
Congress in connection with the awarding of any Federal contract,the making of any federal grant,the
making of any federal loan,the entering into of any cooperative agreement,and the extension,
continuation,renewal,amendment,or modification of any Federal contract,loan,grant,or cooperative
agreement.
13. CONTRACTOR assures that it will fully comply with all other applicable federal and state laws.
CONTRACTOR understands that the source of funds to be used under this Contract is Core Services
funds.
14. CONTRACTOR assures and certifies that it and its principals:
a. Are not presently debarred,suspended,proposed for debarment,declared ineligible,or voluntarily
excluded from covered transaction by a federal department of agency.
b. Have not,within a three-year period preceding this Agreement,been convicted of or had a civil
judgment rendered against them for commission of fraud or a criminal offense in connection with
obtaining,attempting to obtain,or performing a public(federal,state,or local)transaction or
contract under a public transaction;violation of federal or state antitrust statutes or commission of
embezzlement,theft,forgery,bribery,falsification or destruction of records,making false
statements,or receiving stolen property;
c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity
(federal,state,or local)with commission of any of the offenses enumerated in paragraph 1 I(b)of
this certification;and
d. Have not,within a three-year period preceding this Contract,had one or more public transactions
(federal,state,and local)terminated for cause or default.
15. The Appearance of Conflict of Interest applies to the relationship of a CONTRACTOR with the
Department when the CONTRACTOR also maintains a relationship with a third party and the two
relationships are in opposition. In order to create the appearance of a conflict of interest,it is not necessary
for the contractor to gain from knowledge of these opposing interests. It is only necessary that the
contractor know that the two relationships are in opposition.During the term of the Contract,
CONTRACTOR shall not enter any third party relationship that gives the appearance of creating a conflict
of interest. Upon learning of an existing appearance of a conflict of interest situation,CONTRACTOR
shall submit to the Department,a full disclosure statement setting forth the details that create the
appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this
paragraph shall constitute grounds for the Department's termination,for cause,of its contract with
CONTRACTOR.
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16. CONTRACTOR shall protect the confidentiality of all applicant records and other materials that are
maintained in accordance with this Contract. Except for purposes directly connected with the
administration of Child Protection,no information about or obtained from any applicant/recipient in
possession of CONTRACTOR shall be disclosed in a form identifiable with the applicant/recipient or a
minor's parent or guardian unless in accordance with CONTRACTOR written policies governing access
to,duplication and dissemination of,all such information. CONTRACTOR shall advise its employees,
agents,and subcontractor,if any,that they are subject to these confidentiality requirements.
CONTRACTOR shall provide its employees,agents,and subcontractors,if any,with a copy or written
explanation of these confidentiality requirements before access to confidential data is permitted.
CONTRACTOR shall have its employees,agents,and subcontractors,if any,sign a written confidentiality
agreement and shall provide a copy of such agreement to the Department,if requested.
17. Proprietary information for the purposes of this contract is information relating to a party's research,
development,trade secrets,business affairs,internal operations and management procedures and those of
its customers,clients or affiliates,but does not include information(1)lawfully obtained from third parties,
(2)that which is in the public domain,or(3)that which is developed independently. Neither party
shall use or disclose directly or indirectly without prior written authorization any proprietary information
concerning the other party obtained as a result of this Contract. Any proprietary information removed from
the State's site by CONTRACTOR in the course of providing services under this Contract will be accorded
at least the same precautions as are employed by CONTRACTOR for similar information in the course of
its own business.
18. CONTRACTOR certifies it will abide by Colorado Revised Statue(C.R.S.)26-6-104,requiring criminal
background record checks for all employees,contractors,and sub-contractors.
19. Contractor certifies that it shall comply with the provisions of Colorado Revised Statutes(C.R.S.) 8-17.5-
101,et seq. Contractor shall not knowingly employ or contract with an illegal alien to perform work under
this Contract or enter into a contract with a subcontractor that fails to certify to Contractor that the
subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this
Contract. Contractor represents, warrants, and agrees that it (a) has verified that it does not employ any
illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by
the Social Security Administration and Department of Homeland Security, and (b) otherwise will comply
with the requirements of C.R.S. 8-17.5-102(2)(6). Contractor shall comply with all reasonable requests
made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and
Employment. If Contractor fails to comply with any requirement of this provision or C.R.S. 8-17.5-101, et
seq., the Department may terminate this Contract for breach and Contractor shall be liable for actual and
consequential damages to the Department.
Except where exempted by federal law and except as provided in C.R.S. 24-76.5-103(3), if Contractor
receives federal or state funds under this Contract, Contractor must confirm that any individual natural
person eighteen (18)years of age or older is lawfully present in the United States pursuant to C.R.S. 24-
76.5-103(4) if such individual applies for public benefits provided under this Contract. If Contractor
operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it(a) is a citizen of
the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall
produce one of the forms of identification required by C.R.S. 24-76.5-101, et seq., and (c) shall produce
one of the forms of identification required by C.R.S. 24-76.5-103 prior to the effective date of this
Contract.
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EXHIBIT D
CHILD and FAMILY SERVICES REVIEWS(CFSR)
The Child and Family Services Reviews(CFSR)examines child welfare service outcomes in three areas;Safety,
Permanency and Well Being of families. Colorado's next review will be held in March 2009. For each outcome,
data and performance indicators measure each state's performance according to national standards and monitors
progress over time. Following the review,a Performance Improvement Program(PIP)will be implemented for the
state to enhance services to families.
Additionally,the review will assess statewide,systemic factors to determine if the systems necessary to achieve
positive outcomes for families are in place.
All agencies that contract to provide service to families and children in Weld County must continually strive for
positive outcomes in the areas of safety,permanency and well-being for our youth. In order to insure continued
progress in this area,the Department is requiring providers to comply with a standard assessment and reporting
system which will address these three areas.*
The Department is requesting that provider reports include observations and recommendations regarding clients in a
way that specifically addresses the areas of safety,permanency and well-being. Below are the specific outcomes
that will be assessed by the CFSR in the areas of safety,permanency and well-being,followed by specific
considerations and tasks which must be addressed by the Department contracted providers.
Safety Outcomes
CFSR Outcome Measures
Safety 1 Children are,first and foremost,protected from abuse and neglect.
Safety 2 Children are safely maintained in their homes whenever possible and appropriate.
Considerations for the Department's providers
• Providers should always consider the following definitions regarding child safety when assessing families.
o Children are considered safe when there are no present dangers or impending danger threats,or
the caregivers'protective capacities control existing threats.
o Children are considered unsafe when they are vulnerable to present or impending danger threats,
and caregivers are unable or unwilling to provide protection.
o Risk is the likelihood(chance,potential,prospect)for parenting behavior that is harmful and
destructive to a child's cognitive,social,emotional and/or physical development,and those with
parenting responsibility are unwilling or unable to behave differently.
• Monthly reports should continually document an assessment of risk and safety concerns and the
interventions that are being offered by the provider to ameliorate those concerns.
• Monthly reports should make recommendations regarding services and/or safety measures that the provider
believes should be implemented to insure safety of the child(ren).
• Providers must specifically document efforts to engage families in services and to control for safety.
Permanency Outcomes
CFSR Outcome Measures
Permanency 1 Children have permanency and stability in their living situations.
Permanency 2 The continuity of family relationships and connections is preserved for children.
Considerations for the Department's providers:
• Provider reports should always note the primary permanency goal for the child and document how
interventions are working toward achieving that goal.
• Provider reports must indicate progress toward achieving the permanency goal and should make specific
recommendations regarding how the continuation of the service may assist in achieving the goal.
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• Providers should continually provide recommendations about whether any out-of-home placement
continues to be appropriate and should make recommendations regarding when changes in this area should
be made,in the providers' opinion.
• Providers should continually assess family relationships(parent/child,sibling/sibling,extended
family/child,etc.)and should report any concerning relationship issues which may be a barrier to achieving
permanency. Providers should document ongoing efforts to resolve those issues and/or make
recommendations regarding additional services that may be required to address relationship issues.
• Providers must document specific time frames when recommending ongoing services and/or
recommending changes to services and/or placements.
Child and Family Well-Being Outcomes
CFSR Outcome Measures
Well Being 1 Families have enhanced capacity to provide for their children's needs.
Well Being 2 Children receive appropriate services to meet their educational needs.
Well Being 3 Children receive adequate services to meet their physical and mental health needs.
Considerations for the Department's providers:
• Providers must engage in ongoing assessments of the parents' capacity to appropriately care for their
children and whether or not the service being provided continues to be appropriate. This must be clearly
documented in monthly reports.
• Providers should specifically detail areas of continued concern within the family and make
recommendations regarding whether that provider's service continues to be appropriate. Reports should
also document what barriers may be impeding progress.
• Providers should document any and all observed concerns regarding any child with whom the provider is
working. This should include concerns regarding physical,emotional,educational and behavioral well-
being of the child. When appropriate,providers should make recommendations regarding evaluations
and/or additional services that may address these concerns.
*Standardized reports will be provided and should be utilized by all agencies providing ongoing services to the
Department's families unless otherwise noted.
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CHILD PROTECTION AGREEMENT FOR SERVICES
BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES
AND COLLABORATIVE SERVICES FOR CHANGE,PC
This Agreement,made and entered into the A—day of 6eplab],bir2008,by and between the Board of
Weld County Commissioners,sifting as the Board of Human Services,on behalf of the Weld County Department of
Human Services,hereinafter referred to as the"Department,"and Collaborative Services for Change,PC,
hereinafter referred to as"Contractor".
WITNESSETH
WHEREAS,required approval,clearance,and coordination have been accomplished from and with
appropriate agencies;and
WHEREAS,the Colorado Department of Human Services has provided Core Services funding to the
Department for Sex Abuse Treatment(Offense Specific);and
NOW THEREFORE,in consideration of the premises,the parties hereto covenant and agree as follows:
1. Term
This Agreement shall become effective on June I,2008,upon proper execution of this Agreement and
shall expire May 31,2009,unless sooner terminated as provided herein.
2. Scope of Services
Services shall be provided by CONTRACTOR to any person(s)eligible for child protection services in
compliance with Exhibit A"Scope of Services,"a copy of which is attached by reference.
3. Payment
a. Payment shall be made on the basis of Exhibit B,"Payment Schedule,"of which are attached
hereto and incorporated herein by reference.
"Payment Schedule"shall establish the maximum reimbursement,which will be paid from
Core Services funding during the duration of this Agreement.
b. CONTRACTOR shall submit an itemized monthly bill to the Department for all costs incurred
and services provided pursuant to Exhibit A of this Agreement in accordance with criteria
established by the Department. CONTRACTOR shall submit all itemized monthly billings to
the Department by the 10th day of the month following the month the cost was incurred. If the
billing is not submitted within twenty-five(25)calendar days of the month following service,it
may result in forfeiture of payment.
c. Payments of costs incurred pursuant to this Agreement is expressly contingent upon the
availability of Core Services to the Department.
d. The Department shall not be billed for,and reimbursement shall not be made for time involved in
activities outside of those defined in Exhibit A. Work performed prior to the execution of this
Contract shall not be reimbursed or considered part of this Agreement.
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4. Financial Management
At all times from the effective date of this Contract until completion of this Contract,CONTRACTOR
shall
comply with the administrative requirements,cost principles and other requirements set forth in the
Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds
expended under Core Service funding must conform to the Single Audit Act of 1984 and OMB Circular A-
133.
5. Payment Method
Unless otherwise provided in the Scope of Services and Payment Schedule:
a. CONTRACTOR shall provide proper monthly invoices and itemization of services performed for
costs incurred in the performance of the agreement.
b. The Department may withhold any payment if CONTRACTOR has failed to comply with the
Financial Management Requirements,program objectives,contractual terms,or reporting
requirements. In the event of a forfeiture of reimbursements,CONTRACTOR may appeal such
circumstance to the Director of Human Services. The decision of the Director of Human Services
shall be final.
6. Assurances
CONTRACTOR shall abide by all assurances as set forth in the attached Exhibit C,which is attached hereto
and incorporated herein by reference.
7. Compliance with Applicable Laws
At all times during the performance of this contract,CONTRACTOR shall strictly adhere to all applicable
federal and state laws,orders,and all applicable standards,regulations,interpretations or guidelines issued
pursuant thereto. This includes the protection of the confidentiality of all applicant/recipient records,
papers,documents,tapes and any other materials that have been or may hereafter be established which
relate to the Contract. CONTRACTOR acknowledges that the following laws are included:
Title VI of the Civil Rights Act of 1964,42 U.S.C.Sections 2000d-1 et.seq.and its implementing
regulation,45 C.F.R.Part 80 et.seq.'and
Section 504 of the Rehabilitation Act of 1973,29 U.S.C.Section 794,and
its implementing regulations,45 C.F.R.Part 84;and
the Age Discrimination Act of 1975,42 U.S.C.Sections 6101 et.seq.and
its implementation regulations,45 C.F.R.Part 91;and
Title VII of the Civil Rights Act of 1964;and
the Age Discrimination in Employment Act of 1967;and
the Equal Pay Act of 1963;and
the Education Amendments of 1972;and
Immigration Reform and Control Act of 1986,P.L.99-603;
42 C.F.R.Part 2
and all regulations applicable to these laws prohibiting discrimination because of race,color,
National origin,and sex,religion and handicap,including Acquired Immune Deficiency Syndrome(AIDS)
or AIDS related conditions,covered under Section 504 of the Rehabilitation Act of 1973,as amended,
cited above. If necessary,CONTRACTOR and the Department will resist in judicial proceedings any
efforts to obtain access to client records except as permitted by 42 CFR Part 2.
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Included is 45 C.F.R.Part 74 Appendix G 9,which requires that affirmative steps be taken to assure that
small and minority businesses are utilized,when possible,as sources of supplies,equipment,construction
and services. This assurance is given in consideration of and for the purpose of obtaining any and all
federal and/or state financial assistance.
Any person who feels that s/he has been discriminated against has the right to file a complaint either with
the Colorado Department of Human Services or with the U.S.Department of Health and Human Services,
Office for Civil Rights.
8. Compliance with Child and Family Services Review
The Child and Family Services Reviews(CFSR)examines child welfare service outcomes in three areas;
Safety,Permanency and Well Being of families. For each outcome,data and performance indicators
measure each state's performance according to national standards and monitor progress over time.
Following the review,a Program Improvement Plan(PIP)will be implemented for the state to enhance
services to families.
CONTRACTORS providing services to the Department families and children must continually strive for
positive outcomes in the areas of safety,permanency and well being. Contractors providing services in
program areas identified by the Department are required to comply with a standard assessment and
reporting system set forth in Exhibit D which will address the aforementioned three areas.
9. Insurance
CONTRACTOR shall procure,at its own expense,and maintain for the duration of the work,the following
insurance coverage; Weld County,Colorado,by and through the Board of County Commissioners of Weld
County,its employees and agents,shall be named as additional named insured on the insurance policy.
a. Standard Workman's Compensation and Employer's Liability.
1. As required by state statute including occupational diceace,covering all employees at
work site.
b. General Liability(PL&PD)(Minimum).
1. Combined single limit-$500,000 written on an occurrence basis.
2. Any aggregate limit will not be less than$1 million.
3. Provider must purchase additional insurance if claims reduce the annual aggregate below
$500,000.
4. State of Colorado to be named as additional insured on each comprehensive general
liability policy.
5. Certificate of insurance to be provided to Weld County and must be attached to the
contract.
6. Insurance shall include provisions preventing cancellation without 60 days prior notice
by certified mail to Weld County.
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c. Automobile Liability(Minimum).
1. Minimum of$500,000 combined single limit auto insurance.
d. Additional coverage may be required in specific program areas. For any insurances that are
required by this contract,a completed Standard Certificate of Insurance Form shall be provided to
the Department by the Contractor prior to the start of any contract.
10. Certifications
CONTRACTOR certifies that,at the time of entering into this Contract,it has currently in effect all
necessary licenses,approvals,insurance,etc.required to properly provide the services and/or supplies
covered by this contract. Copies of all necessary licenses shall be provided to the Department by the
Contractor prior to the start of any contract.
11. Monitoring and Evaluation
CONTRACTOR and the Department agree that monitoring and evaluation of the performance of this
Agreement shall be conducted by CONTRACTOR and the Department. The results of the monitoring and
evaluation shall be provided to the Board of Weld County Commissioners,the Department and
CONTRACTOR.
CONTRACTOR shall permit the Department,and any other duly authorized agent or governmental
agency,to monitor all activities conducted by CONTRACTOR pursuant to the terms of this Agreement.
As the monitoring agency may in its sole discretion deem necessary or appropriate,such program data,
special analyses,on-site checking,formal audit examinations,or any other reasonable procedures. All
such monitoring shall be performed in a manner that will not unduly interfere with agreement work.
12. Modification of Agreement
All modifications to this agreement shall be in writing and signed by both parties.
13. Remedies
The Director of Human Services or designee may exercise the following remedial actions should s/he find
CONTRACTOR substantially failed to satisfy the scope of work found in this Agreement. Substantial
failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by
CONTRACTOR. These remedial actions are as follows:
a. Withhold payment to CONTRACTOR until the nerrcc ry services or couwlions in performance are
satisfactorily completed;
b. Deny payment or recover reimbursement for those services or deliverables,which have not been
performed and which due to circumstances caused by CONTRACTOR cannot be performed or if
performed would be of no value to the Department. Denial of the amount of payment shall be
reasonably related to the amount of work or deliverables lost to the Department;
c. Incorrect payment to CONTRAC IUR due to omission,error,fraud,and/or defalcation shall be
recovered from CONTRACTOR by deduction from subsequent payments under this Agreement or
other agreements between the Department and CONTRACTOR,or by the Department as a debt due to
the Department or otherwise as provided by law.
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14. Representatives
For the purpose of this Agreement,the individuals identified below are hereby designated representatives
of the respective parties. Either party may from time to time designate in writing a new or substitute
representative(s):
For the Department:
Gloria Romansik Social Services Administrator
Name Title
For CONTRACTOR:
Marci Brewer.LCSW Clinical Director/Co-Owner
Name Title
15. Notice
All notices required to be given by the parties hereunder shall be given by certified or registered mail to the
individuals at the addresses set forth below. Either party may from time to time designate in writing a
substitute person(s)or address to whom such notices shall be sent:
To: The Department To: CONTRACTOR
Judy A.Griego,Director Marci Brewer,LCSW
P.O.Box A 2480 W.261"Avenue,#130-B
Greeley,CO 80632 Denver,CO 80211
(970)352-1551 (303)433-0188
16. Litigation
CONTRACTOR shall promptly notify the Department in the event that CONTRACTOR learns of any
actual litigation in which it is a party defendant in a case that involves services provided under this
Agreement.CONTRACTOR,within five(5)calendar days after being served with a summons,complaint,
or other pleading which has been filed in any federal or state court or administrative agency,shall deliver
copies of such document(s)to the Human Services Director. The term"litigation"includes an assignment
for the benefit of creditors,and filings in bankruptcy,reorganization and/or foreclosure.
17. Termination
This Agreement may be terminated at any time by either party given thirty(30)days written notice and is
subject to the availability of funding. CONTRACIOR reserves the right to suspend services to clients if
funding is no longer available.
18. Entire Agreement
This Agreement,together with all attachments hereto,constitutes the entire understanding between the
parties with respect to the subject matter hereof,and may not be changed or modified except as stated in
Paragraph 10 herein.
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IN WITNESS WHEREOF,the parties hereto have duly executed the Agreement as of the day,month,and year first
above written.
ATTEST:
WELD CO e ,"•.\...„B.,�y, ' I OF COUNTY
CLERK TO� Y\� i I SSIONERS WELD
cc
ro TY,COLORADO
- s� .,. :.
By: /I>i!p. . ..�. 'r. y i� //L✓
Deputy Clerk d 1
r �, William H.Jerke,Chair SEP 0 $ 2008
R D AS • CONTRACTOR:
BY
C � ey Marci Brewer,LCSW-Clinical hector/Co-owner
WELD COUNTY DEPARTMENT
OF HUMAN SERVICES
By:
Ju .Griego, erector
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PY-08-09-CORE-0158
EXHIBIT A
SCOPE OF SERVICES
1. CONTRACTOR will provide offense specific services to clients referred by the Department,in the Denver
area. Services include intake assessments,offense specific evaluations,individual,family and group therapy,
specialty services for special needs and developmentally disabled youth,field(in-home)therapy in the
community,healthy sexuality curriculum and informed supervision training. {aO9 s\-a,c c nsS
2. All services will be provided by Marci Brewer,LCSW. (Qgi C"10natc mac-_ a,
3. CONTRACTOR will identify in detail areas of continued concern and make recommendations to the
Department regarding continuation of services and/or the need for additional services.
4. CONTRACTOR will document in detail any and all observed or verbalized concerns regarding any child
whom the CONTRACTOR is working with under an active referral.Areas of concern may include,but are not
limited to,any physical,emotional,educational or behavioral issues.Areas of concern should be reported
immediately AND on the required monthly report.
5. CONTRACTOR will submit reports on a monthly basis for each active referral.Reports will be submitted per
the online format required by the Department.
6. CONTRACTOR will participate in team reviews of ongoing services as requested.
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EXHIBIT B
PAYMENT SCHEDULE
Funding and Method of Payment
The Department agrees to reimburse CONTRACTOR in consideration for the work and services
performed from Core Services funding,not to exceed$20,000.00.
Expenses incurred by CONTRACTOR,in association with said project prior to the term of this agreement,
are not eligible Department expenditures and shall not be reimbursed by the Department.
Payment pursuant to this Contract,if Core Services funds,whether in whole or in part,is subject to and
contingent upon the continuing availability of said funds for the purposes hereof. In the event that said
funds,or any part thereof,become unavailable as determined by the Department,the Department may
immediately terminate this Contract or amend it accordingly.
2. Fees for Services
$50.00/Hour(Offense Specific Evaluation,Max=$950.00)
$75.00/Episode(Intake,50-minute session)
$75.00/Episode(Individual or Family Therapy,50-minute Session)
$50.00/Episode(Group Therapy,90-minute Session)
$75.00/Episode(Specialty Services for Disabled Youth,50-minute Session)
$100.00/Episode(Field/Off-site Therapy,50-minute Session)
$75.00/Episode(Informed Supervision, 1 Person)
$100.00/Episode(Informed Supervision,2-3 People)
$200.00/Episode(Informed Supervision,4-6 People)
$300.00/Episode(Informed Supervision,7-9 People)
$50.00/Month/Case(Case Management)
Department referrals will not be sent to collections by Contractor for default of co-pay/fees. Services will
be performed regardless of client's refusal or inability to pay co-pay.
Contractor will collect any applicable sliding scale co-pays and credit the Department for any payments
received on the monthly billing statements.
3. Submittal of Vouchers
CONTRACTOR shall prepare and submit monthly the itemized voucher and certify that the services
authorized were provided on the date indicated and the charges made were pursuant to the terms and
conditions of Exhibit A.
a. All billings are to be submitted by the 10the day of the month following the month of
service. If the billing is not submitted within twenty-five(25)calendar days of the month
following service,it may result in forfeiture of payment.
b. Billings must be submitted with the attached required forms,Authorization for
Contractual Services,Request for Reimbursement,Client Verification Form and monthly
report. The forms must be submitted with original signatures.
c. For monitored sobriety,proof of services rendered shall be a sign-in sheet with client
signatures or the test result.
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EXHIBIT C
ASSURANCES
1. CONTRACTOR agrees it is an independent contractor and that its officers and employees do not become
employees of Weld County,nor are they entitled to any employee benefits as Weld County employees,as
the result of the execution of this Agreement.
2. Weld County,the Board of County Commissioners of Weld County,its officers and employees,shall not
be held liable for injuries or damages caused by any negligent acts or omissions of CONTRACTOR-
contracted CONTRACTOR or its employees,volunteers,or agents while performing duties as described in
this Agreement.CONTRACTOR shall indemnify,defend,and hold harmless Weld County,the Board of
County Commissioners of Weld County,its employees,volunteers,and agents. CONTRACTOR shall
provide adequate liability and worker's compensation insurance for all its employees,volunteers,and
agents engaged in the performance of the Agreement upon request,CONTRACTOR shall provide the
Department with the acceptable evidence that such coverage is in effect.
3. No portion of this Contract shall be deemed to constitute a waiver of any immunities the parties or their
officers or employees may possess,not shall any portion of this Agreement be deemed to have created a
duty of care with respect to any persons not a party of this Agreement.
4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld,State
of Colorado,to expend funds not otherwise appropriated in each succeeding year.
5. If any section,subsection,paragraph,sentence,clause,or phrase of this Contract is for any reason held or
decided to be unconstitutional,such decision shall not affect the validity of the remaining portions. The
parties hereto declare that they would have entered into this Contract and each and every section,
subsection,paragraph,sentence,clause,and phrase thereof irrespective of the fact that any one or more
sections,subsections,paragraphs,sentences,clauses,or phrases might be declared to be unconstitutional or
invalid.
6. No officer,member or employee of Weld County and no member of their governing bodies shall have any
pecuniary interest,direct or indirect,in the approved Agreement or the proceeds thereof.
7. CONTRACTOR assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that no
person shall,on the grounds of race,creed,color,sex,or national origin,be excluded from participation in,
be denied the benefits of,or be otherwise subjected to discrimination under this approved Contract.
8. CONTRACTOR assures that sufficient,auditable,and otherwise adequate records that will provide
accurate,current,separate,and complete disclosure of the status of the funds received under the Contract
are maintained for three(3)years or the completion and resolution of an audit. Such records shall be
sufficient to allow authorized local,Federal,and State auditors,and representatives to audit and monitor
CONTRACTOR.
9. All such records,documents,communications,and other materials created pursuant or related to this
contract shall be maintained by CONTRACTOR,in a central location and shall be made available to
Social Services upon its request,for a period of seven(7)years from the date of final payment under this
Contract,or for such further period as may be necessary to resolve any matters which may be pending,or
until an audit has been completed with the following qualifications: If an audit by or on behalf of the
federal and/or state government has begun but is not completed at the end of the seven(7)year period,or if
audit findings have not been resolved after a seven(7)period,the materials shall be retained until the
resolution of the audit finding.
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10. CONTRACTOR assures that authorized local,federal,and state auditors and representatives shall,during
business hours,have access to inspect any copy records,and shall be allowed to monitor and review
through on-site visits,all contract activities,supported with funds under this Contract to ensure compliance
with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the
performance of the Agreement shall be conducted by appropriate funding sources. The results of the
monitoring and evaluation activities shall be provided to the appropriate and interested parties.
11. This Contract shall be binding upon the parties hereto,their successors,heirs,legal representatives,and
assigns. CONTRACTOR or the Department may not assign any of its rights or obligations hereunder
without the prior written consent of both parties.
12. CONTRACTOR certifies that federal appropriated funds have not been paid or will be paid,by or on
behalf of CONTRACTOR,to any person for influencing or attempting to influence an officer or employee
of an agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of
Congress in connection with the awarding of any Federal contract,the making of any federal grant,the
making of any federal loan,the entering into of any cooperative agreement,and the extension,
continuation,renewal,amendment,or modification of any Federal contract,loan,grant,or cooperative
agreement.
13. CONTRACTOR assures that it will fully comply with all other applicable federal and state laws.
CONTRACTOR understands that the source of funds to be used under this Contract is Core Services
funds.
14. CONTRACTOR assures and certifies that it and its principals:
a. Are not presently debarred,suspended,proposed for debarment,declared ineligible,or voluntarily
excluded from covered transaction by a federal department of agency.
b. Have not,within a three-year period preceding this Agreement,been convicted of or had a civil
judgment rendered against them for commission of fraud or a criminal offense in connection with
obtaining,attempting to obtain,or performing a public(federal,state,or local)transaction or
contract under a public transaction;violation of federal or state antitrust statutes or commission of
embezzlement,theft,forgery,bribery,falsification or destruction of records,making false
statements,or receiving stolen property;
c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity
(federal,state,or local)with commission of any of the offenses enumerated in paragraph 11(b)of
this certification;and
d. Have not,within a three-year period preceding this Contract,had one or more public transactions
(federal,state,and local)terminated for cause or default.
15. The Appearance of Conflict of Interest applies to the relationship of a CONTRACTOR with the
Department when the CONTRACTOR also maintains a relationship with a third party and the two
relationships are in opposition. In order to create the appearance of a conflict of interest,it is not necessary
for the contractor to gain from knowledge of these opposing interests. It is only necessary that the
contractor know that the two relationships are in opposition.During the term of the Contract,
CONTRACTOR shall not enter any third party relationship that gives the appearance of creating a conflict
of interest. Upon learning of an existing appearance of a conflict of interest situation,CONTRACTOR
shall submit to the Department,a full disclosure statement setting forth the details that create the
appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this
paragraph shall constitute grounds for the Department's termination,for cause,of its contract with
CONTRACTOR.
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16. CONTRACTOR shall protect the confidentiality of all applicant records and other materials that are
maintained in accordance with this Contract. Except for purposes directly connected with the
administration of Child Protection,no information about or obtained from any applicant/recipient in
possession of CONTRACTOR shall be disclosed in a form identifiable with the applicant/recipient or a
minor's parent or guardian unless in accordance with CONTRACTOR written policies governing access
to,duplication and dissemination of,all such information. CONTRACTOR shall advise its employees,
agents,and subcontractor,if any,that they are subject to these confidentiality requirements.
CONTRACTOR shall provide its employees,agents,and subcontractors,if any,with a copy or written
explanation of these confidentiality requirements before access to confidential data is permitted.
CONTRACTOR shall have its employees,agents,and subcontractors,if any,sign a written confidentiality
agreement and shall provide a copy of such agreement to the Department,if requested.
17. Proprietary information for the purposes of this contract is information relating to a party's research,
development,trade secrets,business affairs,internal operations and management procedures and those of
its customers,clients or affiliates,but does not include information(1)lawfully obtained from third parties,
(2)that which is in the public domain,or(3)that which is developed independently. Neither party
shall use or disclose directly or indirectly without prior written authorization any proprietary information
concerning the other party obtained as a result of this Contract. Any proprietary information removed from
the State's site by CONTRACTOR in the course of providing services under this Contract will be accorded
at least the same precautions as are employed by CONTRACTOR for similar information in the course of
its own business.
18. CONTRACTOR certifies it will abide by Colorado Revised Statue(C.R.S.)26-6-104,requiring criminal
background record checks for all employees,contractors,and sub-contractors.
19. Contractor certifies that it shall comply with the provisions of Colorado Revised Statutes(C.R.S.) 8-17.5-
101,et seq. Contractor shall not knowingly employ or contract with an illegal alien to perform work under
this Contract or enter into a contract with a subcontractor that fails to certify to Contractor that the
subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this
Contract. Contractor represents, warrants, and agrees that it(a) has verified that it does not employ any
illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by
the Social Security Administration and Department of Homeland Security, and(b)otherwise will comply
with the requirements of C.R.S. 8-17.5-102(2)(6). Contractor shall comply with all reasonable requests
made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and
Employment. If Contractor fails to comply with any requirement of this provision or C.R.S. 8-17.5-101,et
seq., the Department may terminate this Contract for breach and Contractor shall be liable for actual and
consequential damages to the Department.
Except where exempted by federal law and except as provided in C.R.S. 24-76.5-103(3), if Contractor
receives federal or state funds under this Contract, Contractor must confirm that any individual natural
person eighteen(18)years of age or older is lawfully present in the United States pursuant to C.R.S. 24-
76.5-103(4) if such individual applies for public benefits provided under this Contract. If Contractor
operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it(a)is a citizen of
the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall
produce one of the forms of identification required by C.R.S. 24-76.5-101, et seq., and (c) shall produce
one of the forms of identification required by C.R.S. 24-76.5-103 prior to the effective date of this
Contract.
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EXHIBIT D
CHILD and FAMILY SERVICES REVIEWS(CFSR)
The Child and Family Services Reviews(CFSR)examines child welfare service outcomes in three areas;Safety,
Permanency and Well Being of families. Colorado's next review will be held in March 2009. For each outcome,
data and performance indicators measure each state's performance according to national standards and monitors
progress over time. Following the review,a Performance Improvement Program(PIP)will be implemented for the
state to enhance services to families.
Additionally,the review will assess statewide,systemic factors to determine if the systems necessary to achieve
positive outcomes for families are in place.
All agencies that contract to provide service to families and children in Weld County must continually strive for
positive outcomes in the areas of safety,permanency and well-being for our youth. In order to insure continued
progress in this area,the Department is requiring providers to comply with a standard assessment and reporting
system which will address these three areas.*
The Department is requesting that provider reports include observations and recommendations regarding clients in a
way that specifically addresses the areas of safety,permanency and well-being. Below are the specific outcomes
that will be assessed by the CFSR in the areas of safety,permanency and well-being,followed by specific
considerations and tasks which must be addressed by the Department contracted providers.
Safety Outcomes
CFSR Outcome Measures
Safety 1 Children are,first and foremost,protected from abuse and neglect.
Safety 2 Children are safely maintained in their homes whenever possible and appropriate.
Considerations for the Department's providers
• Providers should always consider the following definitions regarding child safety when assessing families.
o Children are considered safe when there are no present dangers or impending danger threats,or
the caregivers'protective capacities control existing threats.
o Children are considered unsafe when they are vulnerable to present or impending danger threats,
and caregivers are unable or unwilling to provide protection.
o Risk is the likelihood(chance,potential,prospect)for parenting behavior that is harmful and
destructive to a child's cognitive,social,emotional and/or physical development,and those with
parenting responsibility are unwilling or unable to behave differently.
• Monthly reports should continually document an assessment of risk and safety concerns and the
interventions that are being offered by the provider to ameliorate those concerns.
• Monthly reports should make recommendations regarding services and/or safety measures that the provider
believes should be implemented to insure safety of the child(ren).
• Providers must specifically document efforts to engage families in services and to control for safety.
Permanency Outcomes
CFSR Outcome Measures
Permanency 1 Children have permanency and stability in their living situations.
Permanency 2 The continuity of family relationships and connections is preserved for children.
Considerations for the Department's providers:
• Provider reports should always note the primary permanency goal for the child and document how
interventions are working toward achieving that goal.
• Provider reports must indicate progress toward achieving the permanency goal and should make specific
recommendations regarding how the continuation of the service may assist in achieving the goal.
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• Providers should continually provide recommendations about whether any out-of-home placement
continues to be appropriate and should make recommendations regarding when changes in this area should
be made,in the providers' opinion.
• Providers should continually assess family relationships(parent/child,sibling/sibling,extended
family/child,etc.)and should report any concerning relationship issues which may be a barrier to achieving
permanency. Providers should document ongoing efforts to resolve those issues and/or make
recommendations regarding additional services that may be required to address relationship issues.
• Providers must document specific time frames when recommending ongoing services and/or
recommending changes to services and/or placements.
Child and Family Well-Being Outcomes
CFSR Outcome Measures
Well Being 1 Families have enhanced capacity to provide for their children's needs.
Well Being 2 Children receive appropriate services to meet their educational needs.
Well Being 3 Children receive adequate services to meet their physical and mental health needs.
Considerations for the Department's providers:
• Providers must engage in ongoing assessments of the parents' capacity to appropriately care for their
children and whether or not the service being provided continues to be appropriate. This must be clearly
documented in monthly reports.
• Providers should specifically detail areas of continued concern within the family and make
recommendations regarding whether that provider's service continues to be appropriate. Reports should
also document what barriers may be impeding progress.
• Providers should document any and all observed concerns regarding any child with whom the provider is
working. This should include concerns regarding physical,emotional,educational and behavioral well-
being of the child. When appropriate,providers should make recommendations regarding evaluations
and/or additional services that may address these concerns.
*Standardized reports will be provided and should be utilized by all agencies providing ongoing services to the
Department's families unless otherwise noted.
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CHILD PROTECTION AGREEMENT FOR SERVICES
BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES
AND SHILOH HOME, INC.!!'�
This Agreement,made and entered into the 0 day of.c p )4 (Wf r 2008,by and between the Board of
Weld County Commissioners,sifting as the Board of Human Services,on behalf of the Weld County Department of
Human Services,hereinafter referred to as the"Department,"and Shiloh Home,Inc.,hereinafter referred to as
"Contractor".
WITNESSETH
WHEREAS,required approval,clearance,and coordination have been accomplished from and with
appropriate agencies;and
WHEREAS,the Colorado Department of Human Services has provided Core Services funding to the
Department for Day Treatment;and
NOW THEREFORE,in consideration of the premises,the parties hereto covenant and agree as follows:
1. Term
This Agreement shall become effective on June 1,2008,upon proper execution of this Agreement and
shall expire May 31,2009,unless sooner terminated as provided herein.
2. Scope of Services
Services shall be provided by CONTRACTOR to any person(s)eligible for child protection services in
compliance with Exhibit A"Scope of Services,"a copy of which is attached by reference.
3. Payment
a. Payment shall be made on the basis of Exhibit B,"Payment Schedule,"of which are attached
hereto and incorporated herein by reference.
"Payment Schedule"shall establish the maximum reimbursement,which will be paid from
Core Services funding during the duration of this Agreement.
b. CONTRACTOR shall submit an itemized monthly bill to the Department for all costs incurred
and services provided pursuant to Exhibit A of this Agreement in accordance with criteria
established by the Department. CONTRACTOR shall submit all itemized monthly billings to
the Department by the 10'h day of the month following the month the cost was incurred. If the
billing is not submitted within twenty-five(25)calendar days of the month following service,it
may result in forfeiture of payment.
c. Payments of costs incurred pursuant to this Agreement is expressly contingent upon the
availability of Core Services to the Department.
d. The Department shall not be billed for,and reimbursement shall not be made for time involved in
activities outside of those defined in Exhibit A. Work performed prior to the execution of this
Contract shall not be reimbursed or considered part of this Agreement.
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4. Financial Management
At all times from the effective date of this Contract until completion of this Contract,CONTRACTOR
shall
comply with the administrative requirements,cost principles and other requirements set forth in the
Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds
expended under Core Service funding must conform to the Single Audit Act of 1984 and OMB Circular A-
133.
5. Payment Method
Unless otherwise provided in the Scope of Services and Payment Schedule:
a. CONTRACTOR shall provide proper monthly invoices and itemization of services performed for
costs incurred in the performance of the agreement.
b. The Department may withhold any payment if CONTRACTOR has failed to comply with the
Financial Management Requirements,program objectives,contractual terms,or reporting
requirements. In the event of a forfeiture of reimbursements,CONTRACTOR may appeal such
circumstance to the Director of Human Services. The decision of the Director of Human Services
shall be final.
6. Assurances
CONTRACTOR shall abide by all assurances as set forth in the attached Exhibit C,which is attached hereto
and incorporated herein by reference.
7. Compliance with Applicable Laws
At all times during the performance of this contract,CONTRACTOR shall strictly adhere to all applicable
federal and state laws,orders,and all applicable standards,regulations,interpretations or guidelines issued
pursuant thereto. This includes the protection of the confidentiality of all applicant/recipient records,
papers,documents,tapes and any other materials that have been or may hereafter be established which
relate to the Contract. CONTRACTOR acknowledges that the following laws are included:
Title VI of the Civil Rights Act of 1964,42 U.S.C.Sections 2000d—1 et.seq.and its implementing
regulation,45 C.F.R.Part 80 et.seq.;and
- Section 504 of the Rehabilitation Act of 1973,29 U.S.C.Section 794,and
- its implementing regulations,45 C.F.R.Part 84;and
- the Age Discrimination Act of 1975,42 U.S.C. Sections 6101 et.seq.and
its implementation regulations,45 C.F.R.Part 91;and
Title VII of the Civil Rights Act of 1964;and
- the Age Discrimination in Employment Act of 1967;and
- the Equal Pay Act of 1963;and
- the Education Amendments of 1972;and
- Immigration Reform and Control Act of 1986,P.L.99-603;
42 C.F.R.Part 2
and all regulations applicable to these laws prohibiting discrimination because of race,color,
National origin,and sex,religion and handicap,including Acquired Immune Deficiency Syndrome(AIDS)
or AIDS related conditions,covered under Section 504 of the Rehabilitation Act of 1973,as amended,
cited above. If necessary,CONTRACTOR and the Department will resist in judicial proceedings any
efforts to obtain access to client records except as permitted by 42 CFR Part 2.
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Included is 45 C.F.R. Part 74 Appendix G 9,which requires that affirmative steps be taken to assure that
small and minority businesses are utilized,when possible,as sources of supplies,equipment, construction
and services. This assurance is given in consideration of and for the purpose of obtaining any and all
federal and/or state financial assistance.
Any person who feels that s/he has been discriminated against has the right to file a complaint either with
the Colorado Department of Human Services or with the U.S.Department of Health and Human Services,
Office for Civil Rights.
8. Compliance with Child and Family Services Review
The Child and Family Services Reviews(CFSR)examines child welfare service outcomes in three areas;
Safety,Permanency and Well Being of families. For each outcome,data and performance indicators
measure each state's performance according to national standards and monitor progress over time.
Following the review,a Program Improvement Plan(PIP)will be implemented for the state to enhance
services to families.
CONTRACTORS providing services to the Department families and children must continually strive for
positive outcomes in the areas of safety,permanency and well being. Contractors providing services in
program areas identified by the Department are required to comply with a standard assessment and
reporting system set forth in Exhibit D which will address the aforementioned three areas.
9. Insurance
CONTRACTOR shall procure,at its own expense,and maintain for the duration of the work,the following
insurance coverage;Weld County,Colorado,by and through the Board of County Commissioners of Weld
County,its employees and agents, shall be named as additional named insured on the insurance policy.
a. Standard Workman's Compensation and Employer's Liability.
1. As required by state statute including occupational disease,covering all employees at
work site.
b. General Liability(PL&PD)(Minimum).
1. Combined single limit-$500,000 written on an occurrence basis.
2. Any aggregate limit will not be less than$1 million.
3. Provider must purchase additional insurance if claims reduce the annual aggregate below
$500,000.
4. State of Colorado to be named as additional insured on each comprehensive general
liability policy.
5. Certificate of insurance to be provided to Weld County and must be attached to the
contract.
6. Insurance shall include provisions preventing cancellation without 60 days prior notice
by certified mail to Weld County.
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c. Automobile Liability(Minimum).
1. Minimum of$500,000 combined single limit auto insurance.
d. Additional coverage may be required in specific program areas. For any insurances that are
required by this contract,a completed Standard Certificate of Insurance Form shall be provided to
the Department by the Contractor prior to the start of any contract.
10. Certifications
CONTRACTOR certifies that,at the time of entering into this Contract,it has currently in effect all
necessary licenses,approvals,insurance,etc.required to properly provide the services and/or supplies
covered by this contract. Copies of all necessary licenses shall be provided to the Department by the
Contractor prior to the start of any contract.
11. Monitoring and Evaluation
CONTRACTOR and the Department agree that monitoring and evaluation of the performance of this
Agreement shall be conducted by CONTRACTOR and the Department. The results of the monitoring and
evaluation shall be provided to the Board of Weld County Commissioners,the Department and
CONTRACTOR.
CONTRACTOR shall permit the Department,and any other duly authorized agent or governmental
agency,to monitor all activities conducted by CONTRACTOR pursuant to the terms of this Agreement.
As the monitoring agency may in its sole discretion deem necessary or appropriate,such program data,
special analyses,on-site checking,formal audit examinations,or any other reasonable procedures. All
such monitoring shall be performed in a manner that will not unduly interfere with agreement work.
12. Modification of Agreement
All modifications to this agreement shall be in writing and signed by both parties.
13. Remedies
The Director of Human Services or designee may exercise the following remedial actions should s/he find
CONTRACTOR substantially failed to satisfy the scope of work found in this Agreement. Substantial
failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by
CONTRACTOR. These remedial actions are as follows:
a. Withhold payment to CONTRACTOR until the necessary services or corrections in performance are
satisfactorily completed;
b. Deny payment or recover reimbursement for those services or deliverables,which have not been
performed and which due to circumstances caused by CONTRACTOR cannot be performed or if
performed would be of no value to the Department. Denial of the amount of payment shall be
reasonably related to the amount of work or deliverables lost to the Department;
c. Incorrect payment to CONTRACTOR due to omission,error,fraud,and/or defalcation shall be
recovered from CONTRACTOR by deduction from subsequent payments under this Agreement or
other agreements between the Department and CONTRACTOR,or by the Department as a debt due to
the Department or otherwise as provided by law.
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14. Representatives
For the purpose of this Agreement,the individuals identified below are hereby designated representatives
of the respective parties. Either party may from time to time designate in writing a new or substitute
representative(s):
For the Department:
Gloria Romansik Social Services Administrator
Name Title
For CONTRACTOR:
Steven Ramirez Chief Executive Officer
Name Title
15. Notice
All notices required to be given by the parties hereunder shall be given by certified or registered mail to the
individuals at the addresses set forth below. Either party may from time to time designate in writing a
substitute person(s)or address to whom such notices shall be sent:
To: The Department To: CONTRACTOR
Judy A.Griego,Director Steven Ramirez,Chief Executive Officer
P.O.Box A 6400 W.Coal Mine Avenue
Greeley,CO 80632 Littleton,CO 80123
(970)352-1551 (303)932-9599
16. Litigation
CONTRACTOR shall promptly notify the Department in the event that CONTRACTOR learns of any
actual litigation in which it is a party defendant in a case that involves services provided under this
Agreement.CONTRACTOR,within five(5)calendar days after being served with a summons,complaint,
or other pleading which has been filed in any federal or state court or administrative agency,shall deliver
copies of such document(s)to the Human Services Director. The term"litigation"includes an assignment
for the benefit of creditors,and filings in bankruptcy,reorganization and/or foreclosure.
17. Termination
This Agreement may be terminated at any time by either party given thirty(30)days written notice and is
subject to the availability of funding. CONTRACTOR reserves the right to suspend services to clients if
funding is no longer available.
18. Entire Agreement
This Agreement,together with all attachments hereto,constitutes the entire understanding between the
parties with respect to the subject matter hereof,and may not be changed or modified except as stated in
Paragraph 10 herein.
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IN WITNESS WHEREOF,the parties hereto have duly executed the Agreement as of the day,month,and year first
above written.
ATTEST:
WELD V a _ OARD OF COUNTY
CLERIC � r:. �s r COMMISSIONERS WELD
% _ ` OUNTY,COLORADO
By: L/i/./_ ��;l%,L_ . By:
Deputy Clerk � William H.Jerke,Chair SEP 0 8 7008
A OV AST CONTRACT R: �1
Co Att rney Stev n Ramirez,Ch f Executiv O cer
WELD COUNTY DEPARTMENT
OF HUMAN S RVICES
By: �I . . I%► . . i
Judy A Griego, I irector
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EXHIBIT A
SCOPE OF SERVICES
1. CONTRACTOR will provide day treatment services to male youth and adolescents,ages 12-18,at their
Longmont site,located at 745 HWY 119,as referred by the Department. Services include:
a. Development of a comprehensive services plan
b. Educational,psychological and clinical assessment services
c. Offense specific treatment services
d. Individual(weekly),family(weekly),group(weekly)and milieu therapies(daily)
e. Case management
f Academic curriculum credits transferable to public school
g. Special education services
h. Transportation to and from school(within a 15-mile radius)
i. In-home services(as needed)e---‘.& ccs ao,�..rvw�-c al ,..ti,t.�i-.-�.. d"u. ,60
�
j. Community activities
k. Monthly progress review
I. 24/7 on-call assistance
m. Random urinalysis
n. Transitional services to public school
o. Summer program with an experiential program component
p. Relapse prevention plan
2. Services are specifically designed for those male youth and adolescents who demonstrate a pattern of
maladaptive behaviors and associated thinking errors and where the use of a great repertoire of positive social
skills and adaptive coping skills is supported.
3. Referred youth and adolescents with severely limited cognitive abilities(IQ below 70),ongoing medical issues
that cannot be supervised/managed by staff,an inability or significantly impaired ability to understand and/or
communicate in English,and those who are actively psychotic are general not considered appropriate for this
program.
4. CONTRACTOR administers program year round,minimum of six(6)hours per day,five days per week
(excluding holidays and teacher in-service days).
5. CONTRACTOR will submit a report on a monthly basis for each active referral.
6. CONTRACTOR will participate in team reviews of ongoing services as needed.
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EXHIBIT B
PAYMENT SCHEDULE
1. Funding and Method of Payment
The Department agrees to reimburse CONTRACTOR in consideration for the work and services
performed from Core Services funding,not to exceed$10,000.00.
Expenses incurred by CONTRACTOR,in association with said project prior to the term of this agreement,
are not eligible Department expenditures and shall not be reimbursed by the Department.
Payment pursuant to this Contract,if Core Services funds,whether in whole or in part, is subject to and
contingent upon the continuing availability of said funds for the purposes hereof. In the event that said
funds,or any part thereof,become unavailable as determined by the Department,the Department may
immediately terminate this Contract or amend it accordingly.
2. Fees for Services
$1,546.38/Month(Pro-rated for any partial month of service)
Department referrals will not be sent to collections by Contractor for default of co-pay/fees. Services will
be performed regardless of client's refusal or inability to pay co-pay.
Contractor will collect any applicable sliding scale co-pays and credit the Department for any payments
received on the monthly billing statements.
3. Submittal of Vouchers
CONTRACTOR shall prepare and submit monthly the itemized voucher and certify that the services
authorized were provided on the date indicated and the charges made were pursuant to the terms and
conditions of Exhibit A.
a. All billings are to be submitted by the 10`h`day of the month following the month of
service. If the billing is not submitted within twenty-five(25)calendar days of the month
following service,it may result in forfeiture of payment.
b. Billings must be submitted with the attached required forms,Authorization for
Contractual Services, Request for Reimbursement,Client Verification Form and monthly
report. The forms must be submitted with original signatures.
c. For monitored sobriety,proof of services rendered shall be a sign-in sheet with client
signatures or the test result.
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EXHIBIT C
ASSURANCES
1. CONTRACTOR agrees it is an independent contractor and that its officers and employees do not become
employees of Weld County,nor are they entitled to any employee benefits as Weld County employees,as
the result of the execution of this Agreement.
2. Weld County,the Board of County Commissioners of Weld County,its officers and employees,shall not
be held liable for injuries or damages caused by any negligent acts or omissions of CONTRACTOR-
contracted CONTRACTOR or its employees,volunteers,or agents while performing duties as described in
this Agreement.CONTRACTOR shall indemnify,defend,and hold harmless Weld County,the Board of
County Commissioners of Weld County,its employees,volunteers,and agents. CONTRACTOR shall
provide adequate liability and worker's compensation insurance for all its employees,volunteers,and
agents engaged in the performance of the Agreement upon request,CONTRACTOR shall provide the
Department with the acceptable evidence that such coverage is in effect.
3. No portion of this Contract shall be deemed to constitute a waiver of any immunities the parties or their
officers or employees may possess,not shall any portion of this Agreement be deemed to have created a
duty of care with respect to any persons not a party of this Agreement.
4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld,State
of Colorado,to expend funds not otherwise appropriated in each succeeding year.
5. If any section,subsection,paragraph,sentence,clause,or phrase of this Contract is for any reason held or
decided to be unconstitutional,such decision shall not affect the validity of the remaining portions. The
parties hereto declare that they would have entered into this Contract and each and every section,
subsection,paragraph,sentence,clause,and phrase thereof irrespective of the fact that any one or more
sections,subsections,paragraphs,sentences,clauses,or phrases might be declared to be unconstitutional or
invalid.
6. No officer,member or employee of Weld County and no member of their governing bodies shall have any
pecuniary interest,direct or indirect,in the approved Agreement or the proceeds thereof
7. CONTRACTOR assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that no
person shall,on the grounds of race,creed,color, sex,or national origin,be excluded from participation in,
be denied the benefits of,or be otherwise subjected to discrimination under this approved Contract.
8. CONTRACTOR assures that sufficient,auditable,and otherwise adequate records that will provide
accurate,current,separate,and complete disclosure of the status of the funds received under the Contract
are maintained for three(3)years or the completion and resolution of an audit. Such records shall be
sufficient to allow authorized local,Federal,and State auditors,and representatives to audit and monitor
CONTRACTOR.
9. All such records,documents,communications,and other materials created pursuant or related to this
contract shall be maintained by CONTRACTOR,in a central location and shall be made available to
Social Services upon its request,for a period of seven(7)years from the date of final payment under this
Contract,or for such further period as may be necessary to resolve any matters which may be pending,or
until an audit has been completed with the following qualifications: If an audit by or on behalf of the
federal and/or state government has begun but is not completed at the end of the seven(7)year period,or if
audit findings have not been resolved after a seven(7)period,the materials shall be retained until the
resolution of the audit finding.
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10. CONTRACTOR assures that authorized local,federal,and state auditors and representatives shall,during
business hours,have access to inspect any copy records,and shall be allowed to monitor and review
through on-site visits,all contract activities,supported with funds under this Contract to ensure compliance
with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the
performance of the Agreement shall be conducted by appropriate funding sources. The results of the
monitoring and evaluation activities shall be provided to the appropriate and interested parties.
11. This Contract shall be binding upon the parties hereto,their successors,heirs,legal representatives,and
assigns. CONTRACTOR or the Department may not assign any of its rights or obligations hereunder
without the prior written consent of both parties.
12. CONTRACTOR certifies that federal appropriated funds have not been paid or will be paid,by or on
behalf of CONTRACTOR,to any person for influencing or attempting to influence an officer or employee
of an agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of
Congress in connection with the awarding of any Federal contract,the making of any federal grant,the
making of any federal loan,the entering into of any cooperative agreement,and the extension,
continuation,renewal,amendment,or modification of any Federal contract,loan,grant,or cooperative
agreement.
13. CONTRACTOR assures that it will fully comply with all other applicable federal and state laws.
CONTRACTOR understands that the source of funds to be used under this Contract is Core Services
funds.
14. CONTRACTOR assures and certifies that it and its principals:
a. Are not presently debarred,suspended,proposed for debarment,declared ineligible,or voluntarily
excluded from covered transaction by a federal department of agency.
b. Have not,within a three-year period preceding this Agreement,been convicted of or had a civil
judgment rendered against them for commission of fraud or a criminal offense in connection with
obtaining,attempting to obtain,or performing a public(federal,state,or local)transaction or
contract under a public transaction;violation of federal or state antitrust statutes or commission of
embezzlement,theft,forgery,bribery,falsification or destruction of records,making false
statements,or receiving stolen property;
c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity
(federal,state,or local)with commission of any of the offenses enumerated in paragraph 11(b)of
this certification;and
d. Have not,within a three-year period preceding this Contract,had one or more public transactions
(federal,state,and local)terminated for cause or default.
15. The Appearance of Conflict of Interest applies to the relationship of a CONTRACTOR with the
Department when the CONTRACTOR also maintains a relationship with a third party and the two
relationships are in opposition. In order to create the appearance of a conflict of interest,it is not necessary
for the contractor to gain from knowledge of these opposing interests. It is only necessary that the
contractor know that the two relationships are in opposition.During the term of the Contract,
CONTRACTOR shall not enter any third party relationship that gives the appearance of creating a conflict
of interest. Upon learning of an existing appearance of a conflict of interest situation,CONTRACTOR
shall submit to the Department,a full disclosure statement setting forth the details that create the
appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this
paragraph shall constitute grounds for the Department's termination,for cause,of its contract with
CONTRACTOR.
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16. CONTRACTOR shall protect the confidentiality of all applicant records and other materials that are
maintained in accordance with this Contract. Except for purposes directly connected with the
administration of Child Protection,no information about or obtained from any applicant/recipient in
possession of CONTRACTOR shall be disclosed in a form identifiable with the applicant/recipient or a
minor's parent or guardian unless in accordance with CONTRACTOR written policies governing access
to,duplication and dissemination of,all such information. CONTRACTOR shall advise its employees,
agents,and subcontractor, if any,that they are subject to these confidentiality requirements.
CONTRACTOR shall provide its employees,agents,and subcontractors,if any,with a copy or written
explanation of these confidentiality requirements before access to confidential data is permitted.
CONTRACTOR shall have its employees,agents,and subcontractors, if any,sign a written confidentiality
agreement and shall provide a copy of such agreement to the Department, if requested.
17. Proprietary information for the purposes of this contract is information relating to a party's research,
development,trade secrets,business affairs,internal operations and management procedures and those of
its customers,clients or affiliates,but does not include information(1)lawfully obtained from third parties,
(2)that which is in the public domain,or(3)that which is developed independently. Neither party
shall use or disclose directly or indirectly without prior written authorization any proprietary information
concerning the other party obtained as a result of this Contract. Any proprietary information removed from
the State's site by CONTRACTOR in the course of providing services under this Contract will be accorded
at least the same precautions as are employed by CONTRACTOR for similar information in the course of
its own business.
18. CONTRACTOR certifies it will abide by Colorado Revised Statue(C.R.S.)26-6-104,requiring criminal
background record checks for all employees,contractors,and sub-contractors.
19. Contractor certifies that it shall comply with the provisions of Colorado Revised Statutes (C.R.S.) 8-17.5-
101,et seq. Contractor shall not knowingly employ or contract with an illegal alien to perform work under
this Contract or enter into a contract with a subcontractor that fails to certify to Contractor that the
subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this
Contract. Contractor represents, warrants, and agrees that it (a) has verified that it does not employ any
illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by
the Social Security Administration and Department of Homeland Security, and (b) otherwise will comply
with the requirements of C.R.S. 8-17.5-102(2)(6). Contractor shall comply with all reasonable requests
made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and
Employment. If Contractor fails to comply with any requirement of this provision or C.R.S. 8-17.5-101,et
seq., the Department may terminate this Contract for breach and Contractor shall be liable for actual and
consequential damages to the Department.
Except where exempted by federal law and except as provided in C.R.S. 24-76.5-103(3), if Contractor
receives federal or state funds under this Contract, Contractor must confirm that any individual natural
person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. 24-
76.5-103(4) if such individual applies for public benefits provided under this Contract. If Contractor
operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it(a) is a citizen of
the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall
produce one of the forms of identification required by C.R.S. 24-76.5-101, et seq., and (c) shall produce
one of the forms of identification required by C.R.S. 24-76.5-103 prior to the effective date of this
Contract.
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EXHIBIT D
CHILD and FAMILY SERVICES REVIEWS(CFSR)
The Child and Family Services Reviews(CFSR)examines child welfare service outcomes in three areas;Safety,
Permanency and Well Being of families. Colorado's next review will be held in March 2009. For each outcome,
data and performance indicators measure each state's performance according to national standards and monitors
progress over time. Following the review,a Performance Improvement Program(PIP)will be implemented for the
state to enhance services to families.
Additionally,the review will assess statewide,systemic factors to determine if the systems necessary to achieve
positive outcomes for families are in place.
All agencies that contract to provide service to families and children in Weld County must continually strive for
positive outcomes in the areas of safety,permanency and well-being for our youth. In order to insure continued
progress in this area,the Department is requiring providers to comply with a standard assessment and reporting
system which will address these three areas.*
The Department is requesting that provider reports include observations and recommendations regarding clients in a
way that specifically addresses the areas of safety,permanency and well-being. Below are the specific outcomes
that will be assessed by the CFSR in the areas of safety,permanency and well-being,followed by specific
considerations and tasks which must be addressed by the Department contracted providers.
Safety Outcomes
CFSR Outcome Measures
Safety 1 Children are,first and foremost,protected from abuse and neglect.
Safety 2 Children are safely maintained in their homes whenever possible and appropriate.
Considerations for the Department's providers
• Providers should always consider the following definitions regarding child safety when assessing families.
o Children are considered safe when there are no present dangers or impending danger threats,or
the caregivers' protective capacities control existing threats.
o Children are considered unsafe when they are vulnerable to present or impending danger threats,
and caregivers are unable or unwilling to provide protection.
o Risk is the likelihood(chance,potential,prospect)for parenting behavior that is harmful and
destructive to a child's cognitive,social,emotional and/or physical development,and those with
parenting responsibility are unwilling or unable to behave differently.
• Monthly reports should continually document an assessment of risk and safety concerns and the
interventions that are being offered by the provider to ameliorate those concerns.
• Monthly reports should make recommendations regarding services and/or safety measures that the provider
believes should be implemented to insure safety of the child(ren).
• Providers must specifically document efforts to engage families in services and to control for safety.
Permanency Outcomes
CFSR Outcome Measures
Permanency 1 Children have permanency and stability in their living situations.
Permanency 2 The continuity of family relationships and connections is preserved for children.
Considerations for the Department's providers:
• Provider reports should always note the primary permanency goal for the child and document how
interventions are working toward achieving that goal.
• Provider reports must indicate progress toward achieving the permanency goal and should make specific
recommendations regarding how the continuation of the service may assist in achieving the goal.
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• Providers should continually provide recommendations about whether any out-of-home placement
continues to be appropriate and should make recommendations regarding when changes in this area should
be made,in the providers' opinion.
• Providers should continually assess family relationships(parent/child,sibling/sibling,extended
family/child,etc.)and should report any concerning relationship issues which may be a barrier to achieving
permanency. Providers should document ongoing efforts to resolve those issues and/or make
recommendations regarding additional services that may be required to address relationship issues.
• Providers must document specific time frames when recommending ongoing services and/or
recommending changes to services and/or placements.
Child and Family Well-Being Outcomes
CFSR Outcome Measures
Well Being 1 Families have enhanced capacity to provide for their children's needs.
Well Being 2 Children receive appropriate services to meet their educational needs.
Well Being 3 Children receive adequate services to meet their physical and mental health needs.
Considerations for the Department's providers:
• Providers must engage in ongoing assessments of the parents' capacity to appropriately care for their
children and whether or not the service being provided continues to be appropriate. This must be clearly
documented in monthly reports.
• Providers should specifically detail areas of continued concern within the family and make
recommendations regarding whether that provider's service continues to be appropriate. Reports should
also document what barriers may be impeding progress.
• Providers should document any and all observed concerns regarding any child with whom the provider is
working. This should include concerns regarding physical,emotional,educational and behavioral well-
being of the child. When appropriate,providers should make recommendations regarding evaluations
and/or additional services that may address these concerns.
*Standardized reports will be provided and should be utilized by all agencies providing ongoing services to the
Department's families unless otherwise noted.
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ti LI
PY-08-09-CORE-0143 #),N
ifee
CHILD PROTECTION AGREEMENT FOR SERVICES //2
BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES Cr
AND SHILOH HOME,INC.I
This Agreement,made and entered into the )j-day of / filier2008,by and between the Board of
Weld County Commissioners,sitting as the Board of Human Services,on behalf of the Weld County Department of
Human Services,hereinafter referred to as the"Department,"and Shiloh Home,Inc.,hereinafter referred to as
"Contractor".
WITNESSETH
WHEREAS,required approval,clearance,and coordination have been accomplished from and with
appropriate agencies;and
WHEREAS,the Colorado Department of Human Services has provided Core Services funding to the
Department for Mental Health Services;and
NOW THEREFORE, in consideration of the premises,the parties hereto covenant and agree as follows:
1. Term
This Agreement shall become effective on June 1,2008,upon proper execution of this Agreement and
shall expire May 31,2009,unless sooner terminated as provided herein.
2. Scope of Services
Services shall be provided by CONTRACTOR to any person(s)eligible for child protection services in
compliance with Exhibit A"Scope of Services,"a copy of which is attached by reference.
3. Payment
a. Payment shall be made on the basis of Exhibit B,"Payment Schedule,"of which are attached
hereto and incorporated herein by reference.
"Payment Schedule"shall establish the maximum reimbursement,which will be paid from
Core Services funding during the duration of this Agreement.
b. CONTRACTOR shall submit an itemized monthly bill to the Department for all costs incurred
and services provided pursuant to Exhibit A of this Agreement in accordance with criteria
established by the Department. CONTRACTOR shall submit all itemized monthly billings to
the Department by the 10th day of the month following the month the cost was incurred. If the
billing is not submitted within twenty-five(25)calendar days of the month following service,it
may result in forfeiture of payment.
c. Payments of costs incurred pursuant to this Agreement is expressly contingent upon the
availability of Core Services to the Department.
d. The Department shall not be billed for,and reimbursement shall not be made for time involved in
activities outside of those defined in Exhibit A. Work performed prior to the execution of this
Contract shall not be reimbursed or considered part of this Agreement.
c7opN- Gil
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4. Financial Management
At all times from the effective date of this Contract until completion of this Contract,CONTRACTOR
shall
comply with the administrative requirements,cost principles and other requirements set forth in the
Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds
expended under Core Service funding must conform to the Single Audit Act of 1984 and OMB Circular A-
133.
5. Payment Method
Unless otherwise provided in the Scope of Services and Payment Schedule:
a. CONTRACTOR shall provide proper monthly invoices and itemization of services performed for
costs incurred in the performance of the agreement.
b. The Department may withhold any payment if CONTRACTOR has failed to comply with the
Financial Management Requirements,program objectives,contractual terms,or reporting
requirements. In the event of a forfeiture of reimbursements,CONTRACTOR may appeal such
circumstance to the Director of Human Services. The decision of the Director of Human Services
shall be final.
6. Assurances
CONTRACTOR shall abide by all assurances as set forth in the attached Exhibit C,which is attached hereto
and incorporated herein by reference.
7. Compliance with Applicable Laws
At all times during the performance of this contract,CONTRACTOR shall strictly adhere to all applicable
federal and state laws,orders,and all applicable standards,regulations,interpretations or guidelines issued
pursuant thereto. This includes the protection of the confidentiality of all applicant/recipient records,
papers,documents,tapes and any other materials that have been or may hereafter be established which
relate to the Contract. CONTRACTOR acknowledges that the following laws are included:
Title VI of the Civil Rights Act of 1964,42 U.S.C.Sections 2000d—1 et.seq.and its implementing
regulation,45 C.F.R.Part 80 et.seq.;and
Section 504 of the Rehabilitation Act of 1973,29 U.S.C.Section 794,and
its implementing regulations,45 C.F.R.Part 84;and
the Age Discrimination Act of 1975,42 U.S.C.Sections 6101 et.seq.and
its implementation regulations,45 C.F.R.Part 91;and
Title VII of the Civil Rights Act of 1964;and
- the Age Discrimination in Employment Act of 1967;and
the Equal Pay Act of 1963;and
- the Education Amendments of 1972;and
Immigration Reform and Control Act of 1986,P.L.99-603;
42 C.F.R.Part 2
and all regulations applicable to these laws prohibiting discrimination because of race,color,
National origin,and sex,religion and handicap,including Acquired Immune Deficiency Syndrome(AIDS)
or AIDS related conditions,covered under Section 504 of the Rehabilitation Act of 1973,as amended,
cited above. If necessary,CONTRACTOR and the Department will resist in judicial proceedings any
efforts to obtain access to client records except as permitted by 42 CFR Part 2.
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Included is 45 C.F.R.Part 74 Appendix G 9,which requires that affirmative steps be taken to assure that
small and minority businesses are utilized,when possible,as sources of supplies,equipment,construction
and services. This assurance is given in consideration of and for the purpose of obtaining any and all
federal and/or state financial assistance.
Any person who feels that s/he has been discriminated against has the right to file a complaint either with
the Colorado Department of Human Services or with the U.S.Department of Health and Human Services,
Office for Civil Rights.
8. Compliance with Child and Family Services Review
The Child and Family Services Reviews(CFSR)examines child welfare service outcomes in three areas;
Safety,Permanency and Well Being of families. For each outcome,data and performance indicators
measure each state's performance according to national standards and monitor progress over time.
Following the review,a Program Improvement Plan(PIP)will be implemented for the state to enhance
services to families.
CONTRACTORS providing services to the Department families and children must continually strive for
positive outcomes in the areas of safety,permanency and well being. Contractors providing services in
program areas identified by the Department are required to comply with a standard assessment and
reporting system set forth in Exhibit D which will address the aforementioned three areas.
9. Insurance
CONTRACTOR shall procure,at its own expense,and maintain for the duration of the work,the following
insurance coverage; Weld County,Colorado,by and through the Board of County Commissioners of Weld
County,its employees and agents, shall be named as additional named insured on the insurance policy.
a. Standard Workman's Compensation and Employer's Liability.
I. As required by state statute including occupational disease,covering all employees at
work site.
b. General Liability(PL&PD)(Minimum).
L Combined single limit-$500,000 written on an occurrence basis.
2. Any aggregate limit will not be less than$1 million.
3. Provider must purchase additional insurance if claims reduce the annual aggregate below
$500,000.
4. State of Colorado to be named as additional insured on each comprehensive general
liability policy.
5. Certificate of insurance to be provided to Weld County and must be attached to the
contract.
6. Insurance shall include provisions preventing cancellation without 60 days prior notice
by certified mail to Weld County.
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c. Automobile Liability(Minimum).
1. Minimum of$500,000 combined single limit auto insurance.
d. Additional coverage may be required in specific program areas. For any insurances that are
required by this contract,a completed Standard Certificate of Insurance Form shall be provided to
the Department by the Contractor prior to the start of any contract.
10. Certifications
CONTRACTOR certifies that,at the time of entering into this Contract,it has currently in effect all
necessary licenses,approvals, insurance,etc.required to properly provide the services and/or supplies
covered by this contract. Copies of all necessary licenses shall be provided to the Department by the
Contractor prior to the start of any contract.
11. Monitoring and Evaluation
CONTRACTOR and the Department agree that monitoring and evaluation of the performance of this
Agreement shall be conducted by CONTRACTOR and the Department. The results of the monitoring and
evaluation shall be provided to the Board of Weld County Commissioners,the Department and
CONTRACTOR.
CONTRACTOR shall permit the Department,and any other duly authorized agent or governmental
agency,to monitor all activities conducted by CONTRACTOR pursuant to the terms of this Agreement.
As the monitoring agency may in its sole discretion deem necessary or appropriate,such program data,
special analyses,on-site checking,formal audit examinations,or any other reasonable procedures. All
such monitoring shall be performed in a manner that will not unduly interfere with agreement work.
12. Modification of Agreement
All modifications to this agreement shall be in writing and signed by both parties.
13. Remedies
The Director of Human Services or designee may exercise the following remedial actions should s/he find
CONTRACTOR substantially failed to satisfy the scope of work found in this Agreement. Substantial
failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by
CONTRACTOR. These remedial actions are as follows:
a. Withhold payment to CONTRACTOR until the necessary services or corrections in performance are
satisfactorily completed;
b. Deny payment or recover reimbursement for those services or deliverables,which have not been
performed and which due to circumstances caused by CONTRACTOR cannot be performed or if
performed would be of no value to the Department. Denial of the amount of payment shall be
reasonably related to the amount of work or deliverables lost to the Department;
c. Incorrect payment to CONTRACTOR due to omission,error,fraud,and/or defalcation shall be
recovered from CONTRACTOR by deduction from subsequent payments under this Agreement or
other agreements between the Department and CONTRACTOR,or by the Department as a debt due to
the Department or otherwise as provided by law.
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14. Representatives
For the purpose of this Agreement,the individuals identified below are hereby designated representatives
of the respective parties. Either party may from time to time designate in writing a new or substitute
representative(s):
For the Department:
Gloria Romansik Social Services Administrator
Name Title
For CONTRACTOR:
Steven Ramirez Chief Executive Officer
Name Title
15. Notice
All notices required to be given by the parties hereunder shall be given by certified or registered mail to the
individuals at the addresses set forth below. Either party may from time to time designate in writing a
substitute person(s)or address to whom such notices shall be sent:
To: The Department To: CONTRACTOR
Judy A.Griego.Director Steven Ramirez,Chief Executive Officer
P.O.Box A 6400 W.Coal Mine Avenue
Greeley,CO 80632 Littleton,CO 80123
(970)352-1551 (303)932-9599
16. Litigation
CONTRACTOR shall promptly notify the Department in the event that CONTRACTOR learns of any
actual litigation in which it is a party defendant in a case that involves services provided under this
Agreement.CONTRACTOR,within five(5)calendar days after being served with a summons,complaint,
or other pleading which has been filed in any federal or state court or administrative agency,shall deliver
copies of such document(s)to the Human Services Director. The term"litigation"includes an assignment
for the benefit of creditors,and filings in bankruptcy,reorganization and/or foreclosure.
17. Termination
This Agreement may be terminated at any time by either party given thirty(30)days written notice and is
subject to the availability of funding. CONTRACTOR reserves the right to suspend services to clients if
funding is no longer available.
18. Entire Agreement
This Agreement,together with all attachments hereto,constitutes the entire understanding between the
parties with respect to the subject matter hereof,and may not be changed or modified except as stated in
Paragraph 10 herein.
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IN WITNESS WHEREOF,the parties eto have duly executed the Agreement as of the day,month,and year first
above written. r
•
ATTEST:
WELD CO c OF COUNTY
CLERK TO T Et.t1/44-7 M ISSIONERS WELD
• TY,COLORADO
By: By:
Deputy Clerk William H.Jerke,Chair SEP 0 8 2008
AP V AST :NT :.115O
RAC
five Officer
WELD COUNTY DEPARTMENT
OF HUMAN SERVICES
By:
Jud .Grieg , irector
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070.08-ayi;
PY-08-09-CORE-0143
EXHIBIT A
SCOPE OF SERVICES
1. CONTRACTOR will provide mental health services to male youth and adolescents,as referred by the
Department. Services will be provided at 745 HWY 119,Longmont,CO 80501. Services include:
a. Individual Therapy
b. Family Therapy
c. Master's Level Group Therapy
d. In-home Family Therapy
e. Multi-family/parent Group Therapy
f Psychological Evaluations
2. Program provides support and education to the referred youth or adolescent and their family.
3. Program emphasizes active family/caregiver participation,accurate assessment of service plan needs,
connection of referred youth or adolescent and their family with appropriate community resources,and
treatment of identified mental health needs with an overall increase in mental health.
4. All therapy services will be provided by Master's level therapists.
5. CONTRACTOR will submit a report on a monthly basis for each active referral. Reports will be submitted per
the online format required by the Department,unless otherwise directed by the Department.
6. CONTRACTOR will participate in team reviews of ongoing services as needed.
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PY-08-09-CORE-0143
EXHIBIT B
PAYMENT SCHEDULE
1. Funding and Method of Payment
The Department agrees to reimburse CONTRACTOR in consideration for the work and services
performed from Core Services funding,not to exceed$30,000.00.
Expenses incurred by CONTRACTOR,in association with said project prior to the term of this agreement,
are not eligible Department expenditures and shall not be reimbursed by the Department.
Payment pursuant to this Contract,if Core Services funds,whether in whole or in part,is subject to and
contingent upon the continuing availability of said funds for the purposes hereof In the event that said
funds,or any part thereof,become unavailable as determined by the Department,the Department may
immediately terminate this Contract or amend it accordingly.
2. Fees for Services
$75.00/Hour(Individual or Family Therapy)
$45.00/Hour(Master's Level Group Therapy)
$45.00/Hour(Multi-family/parent Group Therapy)
$70.00/Hour(Psychological Evaluations)
$100.00/Hour(In-home Family Therapy)
Department referrals will not be sent to collections by Contractor for default of co-pay/fees. Services will
be performed regardless of client's refusal or inability to pay co-pay.
Contractor will collect any applicable sliding scale co-pays and credit the Department for any payments
received on the monthly billing statements.
3. Submittal of Vouchers
CONTRACTOR shall prepare and submit monthly the itemized voucher and certify that the services
authorized were provided on the date indicated and the charges made were pursuant to the terms and
conditions of Exhibit A.
a. All billings are to be submitted by the 10`"`day of the month following the month of
service. If the billing is not submitted within twenty-five(25)calendar days of the month
following service,it may result in forfeiture of payment.
b. Billings must be submitted with the attached required forms,Authorization for
Contractual Services,Request for Reimbursement,Client Verification Form and monthly
report. The forms must be submitted with original signatures.
c. For monitored sobriety,proof of services rendered shall be a sign-in sheet with client
signatures or the test result.
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EXHIBIT C
ASSURANCES
1. CONTRACTOR agrees it is an independent contractor and that its officers and employees do not become
employees of Weld County,nor are they entitled to any employee benefits as Weld County employees,as
the result of the execution of this Agreement.
2. Weld County,the Board of County Commissioners of Weld County,its officers and employees,shall not
be held liable for injuries or damages caused by any negligent acts or omissions of CONTRACTOR-
contracted CONTRACTOR or its employees,volunteers,or agents while performing duties as described in
this Agreement.CONTRACTOR shall indemnify,defend,and hold harmless Weld County,the Board of
County Commissioners of Weld County,its employees,volunteers,and agents. CONTRACTOR shall
provide adequate liability and worker's compensation insurance for all its employees,volunteers,and
agents engaged in the performance of the Agreement upon request,CONTRACTOR shall provide the
Department with the acceptable evidence that such coverage is in effect.
3. No portion of this Contract shall be deemed to constitute a waiver of any immunities the parties or their
officers or employees may possess,not shall any portion of this Agreement be deemed to have created a
duty of care with respect to any persons not a party of this Agreement.
4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld,State
of Colorado,to expend funds not otherwise appropriated in each succeeding year.
5. If any section,subsection,paragraph,sentence,clause,or phrase of this Contract is for any reason held or
decided to be unconstitutional,such decision shall not affect the validity of the remaining portions. The
parties hereto declare that they would have entered into this Contract and each and every section,
subsection,paragraph,sentence,clause,and phrase thereof irrespective of the fact that any one or more
sections,subsections,paragraphs,sentences,clauses,or phrases might be declared to be unconstitutional or
invalid.
6. No officer,member or employee of Weld County and no member of their governing bodies shall have any
pecuniary interest,direct or indirect,in the approved Agreement or the proceeds thereof.
7. CONTRACTOR assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that no
person shall,on the grounds of race,creed,color, sex,or national origin,be excluded from participation in,
be denied the benefits of,or be otherwise subjected to discrimination under this approved Contract.
8. CONTRACTOR assures that sufficient,auditable,and otherwise adequate records that will provide
accurate,current,separate,and complete disclosure of the status of the funds received under the Contract
are maintained for three(3)years or the completion and resolution of an audit. Such records shall be
sufficient to allow authorized local,Federal,and State auditors,and representatives to audit and monitor
CONTRACTOR.
9. All such records,documents,communications,and other materials created pursuant or related to this
contract shall be maintained by CONTRACTOR,in a central location and shall be made available to
Social Services upon its request,for a period of seven(7)years from the date of final payment under this
Contract,or for such further period as may be necessary to resolve any matters which may be pending,or
until an audit has been completed with the following qualifications: If an audit by or on behalf of the
federal and/or state government has begun but is not completed at the end of the seven(7)year period,or if
audit findings have not been resolved after a seven(7)period,the materials shall be retained until the
resolution of the audit finding.
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10. CONTRACTOR assures that authorized local,federal,and state auditors and representatives shall,during
business hours,have access to inspect any copy records,and shall be allowed to monitor and review
through on-site visits,all contract activities,supported with funds under this Contract to ensure compliance
with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the
performance of the Agreement shall be conducted by appropriate funding sources. The results of the
monitoring and evaluation activities shall be provided to the appropriate and interested parties.
11. This Contract shall be binding upon the parties hereto,their successors,heirs, legal representatives,and
assigns. CONTRACTOR or the Department may not assign any of its rights or obligations hereunder
without the prior written consent of both parties.
12. CONTRACTOR certifies that federal appropriated funds have not been paid or will be paid,by or on
behalf of CONTRACTOR,to any person for influencing or attempting to influence an officer or employee
of an agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of
Congress in connection with the awarding of any Federal contract,the making of any federal grant,the
making of any federal loan,the entering into of any cooperative agreement,and the extension,
continuation,renewal,amendment,or modification of any Federal contract,loan,grant,or cooperative
agreement.
13. CONTRACTOR assures that it will fully comply with all other applicable federal and state laws.
CONTRACTOR understands that the source of funds to be used under this Contract is Core Services
funds.
14. CONTRACTOR assures and certifies that it and its principals:
a. Are not presently debarred,suspended,proposed for debarment,declared ineligible,or voluntarily
excluded from covered transaction by a federal department of agency.
b. Have not,within a three-year period preceding this Agreement,been convicted of or had a civil
judgment rendered against them for commission of fraud or a criminal offense in connection with
obtaining,attempting to obtain,or performing a public(federal,state,or local)transaction or
contract under a public transaction;violation of federal or state antitrust statutes or commission of
embezzlement,theft,forgery,bribery,falsification or destruction of records,making false
statements,or receiving stolen property;
c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity
(federal,state,or local)with commission of any of the offenses enumerated in paragraph 11(b)of
this certification;and
d. Have not,within a three-year period preceding this Contract,had one or more public transactions
(federal,state,and local)terminated for cause or default.
15. The Appearance of Conflict of Interest applies to the relationship of a CONTRACTOR with the
Department when the CONTRACTOR also maintains a relationship with a third party and the two
relationships are in opposition. In order to create the appearance of a conflict of interest, it is not necessary
for the contractor to gain from knowledge of these opposing interests. It is only necessary that the
contractor know that the two relationships are in opposition. During the term of the Contract,
CONTRACTOR shall not enter any third party relationship that gives the appearance of creating a conflict
of interest. Upon learning of an existing appearance of a conflict of interest situation,CONTRACTOR
shall submit to the Department,a full disclosure statement setting forth the details that create the
appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this
paragraph shall constitute grounds for the Department's termination,for cause,of its contract with
CONTRACTOR.
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16. CONTRACTOR shall protect the confidentiality of all applicant records and other materials that are
maintained in accordance with this Contract. Except for purposes directly connected with the
administration of Child Protection,no information about or obtained from any applicant/recipient in
possession of CONTRACTOR shall be disclosed in a form identifiable with the applicant/recipient or a
minor's parent or guardian unless in accordance with CONTRACTOR written policies governing access
to,duplication and dissemination of,all such information. CONTRACTOR shall advise its employees,
agents,and subcontractor,if any,that they are subject to these confidentiality requirements.
CONTRACTOR shall provide its employees,agents,and subcontractors,if any,with a copy or written
explanation of these confidentiality requirements before access to confidential data is permitted.
CONTRACTOR shall have its employees,agents,and subcontractors,if any,sign a written confidentiality
agreement and shall provide a copy of such agreement to the Department, if requested.
17. Proprietary information for the purposes of this contract is information relating to a party's research,
development,trade secrets,business affairs,internal operations and management procedures and those of
its customers,clients or affiliates,but does not include information(I)lawfully obtained from third parties,
(2)that which is in the public domain,or(3)that which is developed independently. Neither party
shall use or disclose directly or indirectly without prior written authorization any proprietary information
concerning the other party obtained as a result of this Contract. Any proprietary information removed from
the State's site by CONTRACTOR in the course of providing services under this Contract will be accorded
at least the same precautions as are employed by CONTRACTOR for similar information in the course of
its own business.
18. CONTRACTOR certifies it will abide by Colorado Revised Statue(C.R.S.)26-6-104,requiring criminal
background record checks for all employees,contractors,and sub-contractors.
19. Contractor certifies that it shall comply with the provisions of Colorado Revised Statutes (C.R.S.) 8-17.5-
101,et seq. Contractor shall not knowingly employ or contract with an illegal alien to perform work under
this Contract or enter into a contract with a subcontractor that fails to certify to Contractor that the
subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this
Contract. Contractor represents, warrants, and agrees that it (a) has verified that it does not employ any
illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by
the Social Security Administration and Department of Homeland Security, and (b) otherwise will comply
with the requirements of C.R.S. 8-17.5-102(2)(b). Contractor shall comply with all reasonable requests
made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and
Employment. If Contractor fails to comply with any requirement of this provision or C.R.S. 8-17.5-101, et
seq., the Department may terminate this Contract for breach and Contractor shall be liable for actual and
consequential damages to the Department.
Except where exempted by federal law and except as provided in C.R.S. 24-76.5-103(3), if Contractor
receives federal or state funds under this Contract, Contractor must confirm that any individual natural
person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. 24-
76.5-103(4) if such individual applies for public benefits provided under this Contract. If Contractor
operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it(a) is a citizen of
the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall
produce one of the forms of identification required by C.R.S. 24-76.5-101, et seq., and (c) shall produce
one of the forms of identification required by C.R.S. 24-76.5-103 prior to the effective date of this
Contract.
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EXHIBIT D
CHILD and FAMILY SERVICES REVIEWS(CFSR)
The Child and Family Services Reviews(CFSR)examines child welfare service outcomes in three areas; Safety,
Permanency and Well Being of families. Colorado's next review will be held in March 2009. For each outcome,
data and performance indicators measure each state's performance according to national standards and monitors
progress over time. Following the review,a Performance Improvement Program(PIP)will be implemented for the
state to enhance services to families.
Additionally,the review will assess statewide,systemic factors to determine if the systems necessary to achieve
positive outcomes for families are in place.
All agencies that contract to provide service to families and children in Weld County must continually strive for
positive outcomes in the areas of safety,permanency and well-being for our youth. In order to insure continued
progress in this area,the Department is requiring providers to comply with a standard assessment and reporting
system which will address these three areas.*
The Department is requesting that provider reports include observations and recommendations regarding clients in a
way that specifically addresses the areas of safety,permanency and well-being. Below are the specific outcomes
that will be assessed by the CFSR in the areas of safety,permanency and well-being,followed by specific
considerations and tasks which must be addressed by the Department contracted providers.
Safety Outcomes
CFSR Outcome Measures
Safety 1 Children are,first and foremost,protected from abuse and neglect.
Safety 2 Children are safely maintained in their homes whenever possible and appropriate.
Considerations for the Department's providers
• Providers should always consider the following definitions regarding child safety when assessing families.
o Children are considered safe when there are no present dangers or impending danger threats,or
the caregivers'protective capacities control existing threats.
o Children are considered unsafe when they are vulnerable to present or impending danger threats,
and caregivers are unable or unwilling to provide protection.
o Risk is the likelihood(chance,potential,prospect)for parenting behavior that is harmful and
destructive to a child's cognitive,social,emotional and/or physical development,and those with
parenting responsibility are unwilling or unable to behave differently.
• Monthly reports should continually document an assessment of risk and safety concerns and the
interventions that are being offered by the provider to ameliorate those concerns.
• Monthly reports should make recommendations regarding services and/or safety measures that the provider
believes should be implemented to insure safety of the child(ren).
• Providers must specifically document efforts to engage families in services and to control for safety.
Permanency Outcomes
CFSR Outcome Measures
Permanency 1 Children have permanency and stability in their living situations.
Permanency 2 The continuity of family relationships and connections is preserved for children.
Considerations for the Department's providers:
• Provider reports should always note the primary permanency goal for the child and document how
interventions are working toward achieving that goal.
• Provider reports must indicate progress toward achieving the permanency goal and should make specific
recommendations regarding how the continuation of the service may assist in achieving the goal.
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• Providers should continually provide recommendations about whether any out-of-home placement
continues to be appropriate and should make recommendations regarding when changes in this area should
be made,in the providers' opinion.
• Providers should continually assess family relationships(parent/child,sibling/sibling,extended
family/child,etc.)and should report any concerning relationship issues which may be a barrier to achieving
permanency. Providers should document ongoing efforts to resolve those issues and/or make
recommendations regarding additional services that may be required to address relationship issues.
• Providers must document specific time frames when recommending ongoing services and/or
recommending changes to services and/or placements.
Child and Family Well-Being Outcomes
CFSR Outcome Measures
Well Being 1 Families have enhanced capacity to provide for their children's needs.
Well Being 2 Children receive appropriate services to meet their educational needs.
Well Being 3 Children receive adequate services to meet their physical and mental health needs.
Considerations for the Department's providers:
• Providers must engage in ongoing assessments of the parents' capacity to appropriately care for their
children and whether or not the service being provided continues to be appropriate. This must be clearly
documented in monthly reports.
• Providers should specifically detail areas of continued concern within the family and make
recommendations regarding whether that provider's service continues to be appropriate. Reports should
also document what barriers may be impeding progress.
• Providers should document any and all observed concerns regarding any child with whom the provider is
working. This should include concerns regarding physical,emotional,educational and behavioral well-
being of the child. When appropriate,providers should make recommendations regarding evaluations
and/or additional services that may address these concerns.
*Standardized reports will be provided and should be utilized by all agencies providing ongoing services to the
Department's families unless otherwise noted.
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PY-08-09-CORE-0151
CHILD PROTECTION AGREEMENT FOR SERVICES
BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES
AND SHILOH HOME,INC.
This Agreement,made and entered into the S-day of6 ,°bider 2008,by and between the Board of
Weld County Commissioners,sitting as the Board of Human Services,on behalf of the Weld County Department of
Human Services,hereinafter referred to as the"Department,"and Shiloh Home,Inc.,hereinafter referred to as
"Contractor".
WITNESSETH
WHEREAS,required approval,clearance,and coordination have been accomplished from and with
appropriate agencies;and
WHEREAS,the Colorado Department of Human Services has provided Core Services funding to the
Department for Home-Based Services;and
NOW THEREFORE, in consideration of the premises,the parties hereto covenant and agree as follows:
1. Term
This Agreement shall become effective on June 1,2008,upon proper execution of this Agreement and
shall expire May 31,2009,unless sooner terminated as provided herein.
2. Scope of Services
Services shall be provided by CONTRACTOR to any person(s)eligible for child protection services in
compliance with Exhibit A"Scope of Services,"a copy of which is attached by reference.
3. Payment
a. Payment shall be made on the basis of Exhibit B,"Payment Schedule,"of which are attached
hereto and incorporated herein by reference.
"Payment Schedule"shall establish the maximum reimbursement,which will be paid from
Core Services funding during the duration of this Agreement.
b. CONTRACTOR shall submit an itemized monthly bill to the Department for all costs incurred
and services provided pursuant to Exhibit A of this Agreement in accordance with criteria
established by the Department. CONTRACTOR shall submit all itemized monthly billings to
the Department by the 10a day of the month following the month the cost was incurred. If the
billing is not submitted within twenty-five(25)calendar days of the month following service,it
may result in forfeiture of payment.
c. Payments of costs incurred pursuant to this Agreement is expressly contingent upon the
availability of Core Services to the Department.
d. The Department shall not be billed for,and reimbursement shall not be made for time involved in
activities outside of those defined in Exhibit A. Work performed prior to the execution of this
Contract shall not be reimbursed or considered part of this Agreement.
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4. Financial Management
At all times from the effective date of this Contract until completion of this Contract,CONTRACTOR
shall
comply with the administrative requirements,cost principles and other requirements set forth in the
Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds
expended under Core Service funding must conform to the Single Audit Act of 1984 and OMB Circular A-
133.
5. Payment Method
Unless otherwise provided in the Scope of Services and Payment Schedule:
a. CONTRACTOR shall provide proper monthly invoices and itemization of services performed for
costs incurred in the performance of the agreement.
b. The Department may withhold any payment if CONTRACTOR has failed to comply with the
Financial Management Requirements,program objectives,contractual terms,or reporting
requirements. In the event of a forfeiture of reimbursements,CONTRACTOR may appeal such
circumstance to the Director of Human Services. The decision of the Director of Human Services
shall be final.
6. Assurances
CONTRACTOR shall abide by all assurances as set forth in the attached Exhibit C,which is attached hereto
and incorporated herein by reference.
7. Compliance with Applicable Laws
At all times during the performance of this contract,CONTRACTOR shall strictly adhere to all applicable
federal and state laws,orders,and all applicable standards,regulations,interpretations or guidelines issued
pursuant thereto. This includes the protection of the confidentiality of all applicant/recipient records,
papers,documents,tapes and any other materials that have been or may hereafter be established which
relate to the Contract. CONTRACTOR acknowledges that the following laws are included:
Title VI of the Civil Rights Act of 1964,42 U.S.C.Sections 2000d—1 et.seq.and its implementing
regulation,45 C.F.R.Part 80 et.seq.;and
Section 504 of the Rehabilitation Act of 1973,29 U.S.C.Section 794,and
- its implementing regulations,45 C.F.R.Part 84;and
the Age Discrimination Act of 1975,42 U.S.C.Sections 6101 et.seq.and
its implementation regulations,45 C.F.R.Part 91;and
Title VII of the Civil Rights Act of 1964;and
- the Age Discrimination in Employment Act of 1967;and
- the Equal Pay Act of 1963;and
- the Education Amendments of 1972;and
Immigration Reform and Control Act of 1986,P.L.99-603;
42 C.F.R.Part 2
and all regulations applicable to these laws prohibiting discrimination because of race,color,
National origin, and sex,religion and handicap,including Acquired Immune Deficiency Syndrome(AIDS)
or AIDS related conditions,covered under Section 504 of the Rehabilitation Act of 1973,as amended,
cited above. If necessary,CONTRACTOR and the Department will resist in judicial proceedings any
efforts to obtain access to client records except as permitted by 42 CFR Part 2.
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Included is 45 C.F.R. Part 74 Appendix G 9,which requires that affirmative steps be taken to assure that
small and minority businesses are utilized,when possible,as sources of supplies,equipment,construction
and services. This assurance is given in consideration of and for the purpose of obtaining any and all
federal and/or state financial assistance.
Any person who feels that s/he has been discriminated against has the right to file a complaint either with
the Colorado Department of Human Services or with the U.S.Department of Health and Human Services,
Office for Civil Rights.
8. Compliance with Child and Family Services Review
The Child and Family Services Reviews(CFSR)examines child welfare service outcomes in three areas;
Safety,Permanency and Well Being of families. For each outcome,data and performance indicators
measure each state's performance according to national standards and monitor progress over time.
Following the review,a Program Improvement Plan(PIP)will be implemented for the state to enhance
services to families.
CONTRACTORS providing services to the Department families and children must continually strive for
positive outcomes in the areas of safety,permanency and well being. Contractors providing services in
program areas identified by the Department are required to comply with a standard assessment and
reporting system set forth in Exhibit D which will address the aforementioned three areas.
9. Insurance
CONTRACTOR shall procure,at its own expense,and maintain for the duration of the work,the following
insurance coverage; Weld County,Colorado,by and through the Board of County Commissioners of Weld
County,its employees and agents,shall be named as additional named insured on the insurance policy.
a. Standard Workman's Compensation and Employer's Liability.
1. As required by state statute including occupational disease,covering all employees at
work site.
b. General Liability(PL&PD)(Minimum).
1. Combined single limit-$500,000 written on an occurrence basis.
2. Any aggregate limit will not be less than$1 million.
3. Provider must purchase additional insurance if claims reduce the annual aggregate below
$500,000.
4. State of Colorado to be named as additional insured on each comprehensive general
liability policy.
5. Certificate of insurance to be provided to Weld County and must be attached to the
contract.
6. Insurance shall include provisions preventing cancellation without 60 days prior notice
by certified mail to Weld County.
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c. Automobile Liability(Minimum).
1. Minimum of$500,000 combined single limit auto insurance.
d. Additional coverage may be required in specific program areas. For any insurances that are
required by this contract,a completed Standard Certificate of Insurance Form shall be provided to
the Department by the Contractor prior to the start of any contract.
10. Certifications
CONTRACTOR certifies that,at the time of entering into this Contract,it has currently in effect all
necessary licenses,approvals,insurance,etc.required to properly provide the services and/or supplies
covered by this contract. Copies of all necessary licenses shall be provided to the Department by the
Contractor prior to the start of any contract.
I I. Monitoring and Evaluation
CONTRACTOR and the Department agree that monitoring and evaluation of the performance of this
Agreement shall be conducted by CONTRACTOR and the Department. The results of the monitoring and
evaluation shall be provided to the Board of Weld County Commissioners,the Department and
CONTRACTOR.
CONTRACTOR shall permit the Department,and any other duly authorized agent or governmental
agency,to monitor all activities conducted by CONTRACTOR pursuant to the terms of this Agreement.
As the monitoring agency may in its sole discretion deem necessary or appropriate,such program data,
special analyses,on-site checking,formal audit examinations,or any other reasonable procedures. All
such monitoring shall be performed in a manner that will not unduly interfere with agreement work.
12. Modification of Agreement
All modifications to this agreement shall be in writing and signed by both parties.
13. Remedies
The Director of Human Services or designee may exercise the following remedial actions should s/he find
CONTRACTOR substantially failed to satisfy the scope of work found in this Agreement. Substantial
failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by
CONTRACTOR. These remedial actions are as follows:
a. Withhold payment to CONTRACTOR until the necessary services or corrections in performance are
satisfactorily completed;
b. Deny payment or recover reimbursement for those services or deliverables,which have not been
performed and which due to circumstances caused by CONTRACTOR cannot be performed or if
performed would be of no value to the Department. Denial of the amount of payment shall be
reasonably related to the amount of work or deliverables lost to the Department;
c. Incorrect payment to CONTRACTOR due to omission,error,fraud,and/or defalcation shall be
recovered from CONTRACTOR by deduction from subsequent payments under this Agreement or
other agreements between the Department and CONTRACTOR,or by the Department as a debt due to
the Department or otherwise as provided by law.
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14. Representatives
For the purpose of this Agreement,the individuals identified below are hereby designated representatives
of the respective parties. Either party may from time to time designate in writing a new or substitute
representative(s):
For the Department:
Gloria Romansik Social Services Administrator
Name Title
For CONTRACTOR:
Steven Ramirez Chief Executive Officer
Name Title
15. Notice
All notices required to be given by the parties hereunder shall be given by certified or registered mail to the
individuals at the addresses set forth below. Either party may from time to time designate in writing a
substitute person(s)or address to whom such notices shall be sent:
To: The Department To: CONTRACTOR
Judv A.Grieeo.Director Steven Ramirez,Chief Executive Officer
P.O.Box A 6400 W.Coal Mine Avenue
Greeley,CO 80632 Littleton,CO 80123
(970)352-1551 J303)932-9599
16. Litigation
CONTRACTOR shall promptly notify the Department in the event that CONTRACTOR learns of any
actual litigation in which it is a party defendant in a case that involves services provided under this
Agreement.CONTRACTOR,within five(5)calendar days after being served with a summons,complaint,
or other pleading which has been filed in any federal or state court or administrative agency,shall deliver
copies of such document(s)to the Human Services Director. The term"litigation"includes an assignment
for the benefit of creditors,and filings in bankruptcy,reorganization and/or foreclosure.
17. Termination
This Agreement may be terminated at any time by either party given thirty(30)days written notice and is
subject to the availability of funding. CONTRACTOR reserves the right to suspend services to clients if
funding is no longer available.
18. Entire Agreement
This Agreement,together with all attachments hereto,constitutes the entire understanding between the
parties with respect to the subject matter hereof,and may not be changed or modified except as stated in
Paragraph 10 herein.
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IN WITNESS WHEREOF,the parties e_duly executed the Agreement as of the day,month,and year first
above written.
y
ATTEST:
WELD CO 3" B RD OF COUNTY
CLERK T MISSIONERS WELD
NTY,COLORADO
By: By:
Deputy Clerk William H.Jerke,Chair SEP 0 8 2008
APP AS TO FO CONTRAC OR:I
Cwt
Cou ty ome en Ramirez, ief Ex q twe Officer
WELD COUNTY DEPARTMENT
OF HUMAN SERVICES
By:
Ju y Griego, irector
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PY-08-09-CORE-0151
EXHIBIT A
SCOPE OF SERVICES
1. CONTRACTOR will provide home-based services to youth transitioning from other systems of care,and
returning to and/or succeeding in a community-based setting,as referred by the Department. Services include:
a. Level One—Up to five(5)hours of service per week,with no less than 1.5 hours per week. Includes
1.5 hours per week of family therapy provided by a Master's level therapist,case management face-
to-face or in the home or office,and case management phone contact.
b. Level Two—Six(6)to nine(9)hours of service per week. Includes at least three(3)hours per week
of family therapy provided by a Master's level therapist,case management face-to-face or in the home
or office,and case management phone contact.
c. Level Three—Ten(10),or more,hours of service per week. Includes at least five(5)hours per week
of family therapy provided by a Master's level therapist,case management face-to-face or in the home
or office,and case management phone contact.
2. CONTRACTOR will submit a report on a monthly basis for each active referral. Reports will be submitted per
the online format required by the Department,unless otherwise directed by the Department.
3. CONTRACTOR will participate in team reviews of ongoing services as needed.
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EXHIBIT B
PAYMENT SCHEDULE
1. Funding and Method of Payment
The Department agrees to reimburse CONTRACTOR in consideration for the work and services
performed from Core Services funding,not to exceed$10,000.00.
Expenses incurred by CONTRACTOR, in association with said project prior to the term of this agreement,
are not eligible Department expenditures and shall not be reimbursed by the Department.
Payment pursuant to this Contract,if Core Services funds,whether in whole or in part,is subject to and
contingent upon the continuing availability of said funds for the purposes hereof. In the event that said
funds,or any part thereof,become unavailable as determined by the Department,the Department may
immediately terminate this Contract or amend it accordingly.
2. Fees for Services
$260.00/Week(Level One)
$490.00/Week(Level Two)
$720.00/Week(Level Three)
Department referrals will not be sent to collections by Contractor for default of co-pay/fees. Services will
be performed regardless of client's refusal or inability to pay co-pay.
Contractor will collect any applicable sliding scale co-pays and credit the Department for any payments
received on the monthly billing statements.
3. Submittal of Vouchers
CONTRACTOR shall prepare and submit monthly the itemized voucher and certify that the services
authorized were provided on the date indicated and the charges made were pursuant to the terms and
conditions of Exhibit A.
a. All billings are to be submitted by the l0`"`day of the month following the month of
service. If the billing is not submitted within twenty-five(25)calendar days of the month
following service,it may result in forfeiture of payment.
b. Billings must be submitted with the attached required forms,Authorization for
Contractual Services, Request for Reimbursement,Client Verification Form and monthly
report. The forms must be submitted with original signatures.
c. For monitored sobriety,proof of services rendered shall be a sign-in sheet with client
signatures or the test result.
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EXHIBIT C
ASSURANCES
CONTRACTOR agrees it is an independent contractor and that its officers and employees do not become
employees of Weld County,nor are they entitled to any employee benefits as Weld County employees,as
the result of the execution of this Agreement.
2. Weld County,the Board of County Commissioners of Weld County, its officers and employees,shall not
be held liable for injuries or damages caused by any negligent acts or omissions of CONTRACTOR-
contracted CONTRACTOR or its employees,volunteers,or agents while performing duties as described in
this Agreement.CONTRACTOR shall indemnify,defend,and hold harmless Weld County,the Board of
County Commissioners of Weld County,its employees,volunteers,and agents. CONTRACTOR shall
provide adequate liability and worker's compensation insurance for all its employees,volunteers,and
agents engaged in the performance of the Agreement upon request,CONTRACTOR shall provide the
Department with the acceptable evidence that such coverage is in effect.
3. No portion of this Contract shall be deemed to constitute a waiver of any immunities the parties or their
officers or employees may possess,not shall any portion of this Agreement be deemed to have created a
duty of care with respect to any persons not a party of this Agreement.
4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld,State
of Colorado,to expend funds not otherwise appropriated in each succeeding year.
5. If any section,subsection,paragraph,sentence,clause,or phrase of this Contract is for any reason held or
decided to be unconstitutional,such decision shall not affect the validity of the remaining portions. The
parties hereto declare that they would have entered into this Contract and each and every section,
subsection,paragraph,sentence,clause,and phrase thereof irrespective of the fact that any one or more
sections,subsections,paragraphs,sentences,clauses,or phrases might be declared to be unconstitutional or
invalid.
6. No officer,member or employee of Weld County and no member of their governing bodies shall have any
pecuniary interest,direct or indirect,in the approved Agreement or the proceeds thereof.
7. CONTRACTOR assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that no
person shall,on the grounds of race,creed,color, sex,or national origin,be excluded from participation in,
be denied the benefits of,or be otherwise subjected to discrimination under this approved Contract.
8. CONTRACTOR assures that sufficient,auditable,and otherwise adequate records that will provide
accurate,current,separate,and complete disclosure of the status of the funds received under the Contract
are maintained for three(3)years or the completion and resolution of an audit. Such records shall be
sufficient to allow authorized local, Federal,and State auditors,and representatives to audit and monitor
CONTRACTOR.
9. All such records,documents,communications,and other materials created pursuant or related to this
contract shall be maintained by CONTRACTOR,in a central location and shall be made available to
Social Services upon its request,for a period of seven(7)years from the date of final payment under this
Contract,or for such further period as may be necessary to resolve any matters which may be pending,or
until an audit has been completed with the following qualifications: If an audit by or on behalf of the
federal and/or state government has begun but is not completed at the end of the seven(7)year period,or if
audit findings have not been resolved after a seven(7)period,the materials shall be retained until the
resolution of the audit finding.
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10. CONTRACTOR assures that authorized local,federal,and state auditors and representatives shall,during
business hours,have access to inspect any copy records,and shall be allowed to monitor and review
through on-site visits,all contract activities,supported with funds under this Contract to ensure compliance
with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the
performance of the Agreement shall be conducted by appropriate funding sources. The results of the
monitoring and evaluation activities shall be provided to the appropriate and interested parties.
11. This Contract shall be binding upon the parties hereto,their successors,heirs,legal representatives,and
assigns. CONTRACTOR or the Department may not assign any of its rights or obligations hereunder
without the prior written consent of both parties.
12. CONTRACTOR certifies that federal appropriated funds have not been paid or will be paid,by or on
behalf of CONTRACTOR,to any person for influencing or attempting to influence an officer or employee
of an agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of
Congress in connection with the awarding of any Federal contract,the making of any federal grant,the
making of any federal loan,the entering into of any cooperative agreement,and the extension,
continuation,renewal,amendment,or modification of any Federal contract,loan,grant,or cooperative
agreement.
13. CONTRACTOR assures that it will fully comply with all other applicable federal and state laws.
CONTRACTOR understands that the source of funds to be used under this Contract is Core Services
funds.
14. CONTRACTOR assures and certifies that it and its principals:
a. Are not presently debarred,suspended,proposed for debarment,declared ineligible,or voluntarily
excluded from covered transaction by a federal department of agency.
b. Have not,within a three-year period preceding this Agreement,been convicted of or had a civil
judgment rendered against them for commission of fraud or a criminal offense in connection with
obtaining,attempting to obtain,or performing a public(federal,state,or local)transaction or
contract under a public transaction;violation of federal or state antitrust statutes or commission of
embezzlement,theft,forgery,bribery, falsification or destruction of records,making false
statements,or receiving stolen property;
c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity
(federal,state,or local)with commission of any of the offenses enumerated in paragraph 11(b)of
this certification;and
d. Have not,within a three-year period preceding this Contract,had one or more public transactions
(federal,state,and local)terminated for cause or default.
15. The Appearance of Conflict of Interest applies to the relationship of a CONTRACTOR with the
Department when the CONTRACTOR also maintains a relationship with a third party and the two
relationships are in opposition. In order to create the appearance of a conflict of interest,it is not necessary
for the contractor to gain from knowledge of these opposing interests. It is only necessary that the
contractor know that the two relationships are in opposition.During the term of the Contract,
CONTRACTOR shall not enter any third party relationship that gives the appearance of creating a conflict
of interest. Upon learning of an existing appearance of a conflict of interest situation,CONTRACTOR
shall submit to the Department,a full disclosure statement setting forth the details that create the
appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this
paragraph shall constitute grounds for the Department's termination,for cause,of its contract with
CONTRACTOR.
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16. CONTRACTOR shall protect the confidentiality of all applicant records and other materials that are
maintained in accordance with this Contract. Except for purposes directly connected with the
administration of Child Protection,no information about or obtained from any applicant/recipient in
possession of CONTRACTOR shall be disclosed in a form identifiable with the applicant/recipient or a
minor's parent or guardian unless in accordance with CONTRACTOR written policies governing access
to,duplication and dissemination of,all such information. CONTRACTOR shall advise its employees,
agents,and subcontractor,if any,that they are subject to these confidentiality requirements.
CONTRACTOR shall provide its employees,agents,and subcontractors,if any,with a copy or written
explanation of these confidentiality requirements before access to confidential data is permitted.
CONTRACTOR shall have its employees,agents,and subcontractors,if any,sign a written confidentiality
agreement and shall provide a copy of such agreement to the Department,if requested.
17. Proprietary information for the purposes of this contract is information relating to a party's research,
development,trade secrets,business affairs,internal operations and management procedures and those of
its customers,clients or affiliates,but does not include information(1)lawfully obtained from third parties,
(2)that which is in the public domain,or(3)that which is developed independently. Neither party
shall use or disclose directly or indirectly without prior written authorization any proprietary information
concerning the other party obtained as a result of this Contract. Any proprietary information removed from
the State's site by CONTRACTOR in the course of providing services under this Contract will be accorded
at least the same precautions as are employed by CONTRACTOR for similar information in the course of
its own business.
18. CONTRACTOR certifies it will abide by Colorado Revised Statue(C.R.S.)26-6-104,requiring criminal
background record checks for all employees,contractors,and sub-contractors.
19. Contractor certifies that it shall comply with the provisions of Colorado Revised Statutes (C.R.S.) 8-17.5-
101,et seq. Contractor shall not knowingly employ or contract with an illegal alien to perform work under
this Contract or enter into a contract with a subcontractor that fails to certify to Contractor that the
subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this
Contract. Contractor represents, warrants, and agrees that it (a) has verified that it does not employ any
illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by
the Social Security Administration and Department of Homeland Security, and (b) otherwise will comply
with the requirements of C.R.S. 8-17.5-102(2)(b). Contractor shall comply with all reasonable requests
made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and
Employment. If Contractor fails to comply with any requirement of this provision or C.R.S. 8-17.5-101, et
seq., the Department may terminate this Contract for breach and Contractor shall be liable for actual and
consequential damages to the Department.
Except where exempted by federal law and except as provided in C.R.S. 24-76.5-103(3), if Contractor
receives federal or state funds under this Contract, Contractor must confirm that any individual natural
person eighteen (18)years of age or older is lawfully present in the United States pursuant to C.R.S. 24-
76.5-103(4) if such individual applies for public benefits provided under this Contract. If Contractor
operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it(a) is a citizen of
the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall
produce one of the forms of identification required by C.R.S. 24-76.5-101, et seq., and (c) shall produce
one of the forms of identification required by C.R.S. 24-76.5-103 prior to the effective date of this
Contract.
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EXHIBIT D
CHILD and FAMILY SERVICES REVIEWS(CFSR)
The Child and Family Services Reviews(CFSR)examines child welfare service outcomes in three areas; Safety,
Permanency and Well Being of families. Colorado's next review will be held in March 2009. For each outcome,
data and performance indicators measure each state's performance according to national standards and monitors
progress over time. Following the review,a Performance Improvement Program(PIP)will be implemented for the
state to enhance services to families.
Additionally,the review will assess statewide,systemic factors to determine if the systems necessary to achieve
positive outcomes for families are in place.
All agencies that contract to provide service to families and children in Weld County must continually strive for
positive outcomes in the areas of safety,permanency and well-being for our youth. In order to insure continued
progress in this area,the Department is requiring providers to comply with a standard assessment and reporting
system which will address these three areas.*
The Department is requesting that provider reports include observations and recommendations regarding clients in a
way that specifically addresses the areas of safety,permanency and well-being. Below are the specific outcomes
that will be assessed by the CFSR in the areas of safety,permanency and well-being,followed by specific
considerations and tasks which must be addressed by the Department contracted providers.
Safety Outcomes
CFSR Outcome Measures
Safety 1 Children are,first and foremost,protected from abuse and neglect.
Safety 2 Children are safely maintained in their homes whenever possible and appropriate.
Considerations for the Department's providers
• Providers should always consider the following definitions regarding child safety when assessing families.
o Children are considered safe when there are no present dangers or impending danger threats,or
the caregivers'protective capacities control existing threats.
o Children are considered unsafe when they are vulnerable to present or impending danger threats,
and caregivers are unable or unwillin to provide protection.
o Risk is the likelihood(chance,potential,prospect)for parenting behavior that is harmful and
destructive to a child's cognitive,social,emotional and/or physical development,and those with
parenting responsibility are unwilling or unable to behave differently.
• Monthly reports should continually document an assessment of risk and safety concerns and the
interventions that are being offered by the provider to ameliorate those concerns.
• Monthly reports should make recommendations regarding services and/or safety measures that the provider
believes should be implemented to insure safety of the child(ren).
• Providers must specifically document efforts to engage families in services and to control for safety.
Permanency Outcomes
CFSR Outcome Measures
Permanency 1 Children have permanency and stability in their living situations.
Permanency 2 The continuity of family relationships and connections is preserved for children.
Considerations for the Department's providers:
• Provider reports should always note the primary permanency goal for the child and document how
interventions are working toward achieving that goal.
• Provider reports must indicate progress toward achieving the permanency goal and should make specific
recommendations regarding how the continuation of the service may assist in achieving the goal.
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PY-0S-09-CORE-0151
• Providers should continually provide recommendations about whether any out-of-home placement
continues to be appropriate and should make recommendations regarding when changes in this area should
be made,in the providers' opinion.
• Providers should continually assess family relationships(parent/child,sibling/sibling,extended
family/child,etc.)and should report any concerning relationship issues which may be a barrier to achieving
permanency. Providers should document ongoing efforts to resolve those issues and/or make
recommendations regarding additional services that may be required to address relationship issues.
• Providers must document specific time frames when recommending ongoing services and/or
recommending changes to services and/or placements.
Child and Family Well-Being Outcomes
CFSR Outcome Measures
Well Being I Families have enhanced capacity to provide for their children's needs.
Well Being 2 Children receive appropriate services to meet their educational needs.
Well Being 3 Children receive adequate services to meet their physical and mental health needs.
Considerations for the Department's providers:
• Providers must engage in ongoing assessments of the parents' capacity to appropriately care for their
children and whether or not the service being provided continues to be appropriate. This must be clearly
documented in monthly reports.
• Providers should specifically detail areas of continued concern within the family and make
recommendations regarding whether that provider's service continues to be appropriate. Reports should
also document what barriers may be impeding progress.
• Providers should document any and all observed concerns regarding any child with whom the provider is
working. This should include concerns regarding physical,emotional,educational and behavioral well-
being of the child. When appropriate,providers should make recommendations regarding evaluations
and/or additional services that may address these concerns.
*Standardized reports will be provided and should be utilized by all agencies providing ongoing services to the
Department's families unless otherwise noted.
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CHILD PROTECTION AGREEMENT FOR SERVICES
BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES
AND SHILOH HOME,INC.
This Agreement,made and entered into the 8— day 06pagpi Upr 2008,by and between the Board of
Weld County Commissioners,sitting as the Board of Human Services,on behalf of the Weld County Department of
Human Services,hereinafter referred to as the"Department,"and Shiloh Home,Inc.,hereinafter referred to as
"Contractor".
WITNESSETH
WHEREAS,required approval,clearance,and coordination have been accomplished from and with
appropriate agencies; and
WHEREAS,the Colorado Department of Human Services has provided Core Services funding to the
Department for Sex Abuse Treatment(Offense Specific);and
NOW THEREFORE,in consideration of the premises,the parties hereto covenant and agree as follows:
1. Term
This Agreement shall become effective on June 1,2008,upon proper execution of this Agreement and
shall expire May 31,2009,unless sooner terminated as provided herein.
2. Scope of Services
Services shall be provided by CONTRACTOR to any person(s)eligible for child protection services in
compliance with Exhibit A"Scope of Services,"a copy of which is attached by reference.
3. Payment
a. Payment shall be made on the basis of Exhibit B,"Payment Schedule,"of which are attached
hereto and incorporated herein by reference.
"Payment Schedule"shall establish the maximum reimbursement,which will be paid from
Core Services funding during the duration of this Agreement.
b. CONTRACTOR shall submit an itemized monthly bill to the Department for all costs incurred
and services provided pursuant to Exhibit A of this Agreement in accordance with criteria
established by the Department. CONTRACTOR shall submit all itemized monthly billings to
the Department by the 10th day of the month following the month the cost was incurred. If the
billing is not submitted within twenty-five(25)calendar days of the month following service,it
may result in forfeiture of payment.
c. Payments of costs incurred pursuant to this Agreement is expressly contingent upon the
availability of Core Services to the Department.
d. The Department shall not be billed for,and reimbursement shall not be made for time involved in
activities outside of those defined in Exhibit A. Work performed prior to the execution of this
Contract shall not be reimbursed or considered part of this Agreement.
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4. Financial Management
At all times from the effective date of this Contract until completion of this Contract,CONTRACTOR
shall
comply with the administrative requirements,cost principles and other requirements set forth in the
Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds
expended under Core Service funding must conform to the Single Audit Act of 1984 and OMB Circular A-
133.
5. Payment Method
Unless otherwise provided in the Scope of Services and Payment Schedule:
a. CONTRACTOR shall provide proper monthly invoices and itemization of services performed for
costs incurred in the performance of the agreement.
b. The Department may withhold any payment if CONTRACTOR has failed to comply with the
Financial Management Requirements,program objectives,contractual terms,or reporting
requirements. In the event of a forfeiture of reimbursements,CONTRACTOR may appeal such
circumstance to the Director of Human Services. The decision of the Director of Human Services
shall be final.
6. Assurances
CONTRACTOR shall abide by all assurances as set forth in the attached Exhibit C,which is attached hereto
and incorporated herein by reference.
7. Compliance with Applicable Laws
At all times during the performance of this contract,CONTRACTOR shall strictly adhere to all applicable
federal and state laws,orders,and all applicable standards,regulations,interpretations or guidelines issued
pursuant thereto. This includes the protection of the confidentiality of all applicant/recipient records,
papers,documents,tapes and any other materials that have been or may hereafter be established which
relate to the Contract. CONTRACTOR acknowledges that the following laws are included:
Title VI of the Civil Rights Act of 1964,42 U.S.C.Sections 2000d-1 et.seq.and its implementing
regulation,45 C.F.R.Part 80 et.seq.;and
Section 504 of the Rehabilitation Act of 1973,29 U.S.C.Section 794,and
its implementing regulations,45 C.F.R.Part 84;and
- the Age Discrimination Act of 1975,42 U.S.C.Sections 6101 et.seq.and
its implementation regulations,45 C.F.R.Part 91;and
Title VII of the Civil Rights Act of 1964;and
the Age Discrimination in Employment Act of 1967;and
the Equal Pay Act of 1963;and
the Education Amendments of 1972;and
- Immigration Reform and Control Act of 1986,P.L.99-603;
- 42 C.F.R.Part 2
and all regulations applicable to these laws prohibiting discrimination because of race,color,
National origin,and sex,religion and handicap,including Acquired Immune Deficiency Syndrome(AIDS)
or AIDS related conditions,covered under Section 504 of the Rehabilitation Act of 1973,as amended,
cited above. If necessary,CONTRACTOR and the Department will resist in judicial proceedings any
efforts to obtain access to client records except as permitted by 42 CFR Part 2.
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Included is 45 C.F.R. Part 74 Appendix G 9,which requires that affirmative steps be taken to assure that
small and minority businesses are utilized,when possible,as sources of supplies,equipment,construction
and services. This assurance is given in consideration of and for the purpose of obtaining any and all
federal and/or state financial assistance.
Any person who feels that s/he has been discriminated against has the right to file a complaint either with
the Colorado Department of Human Services or with the U.S.Department of Health and Human Services,
Office for Civil Rights.
8. Compliance with Child and Family Services Review
The Child and Family Services Reviews(CFSR)examines child welfare service outcomes in three areas;
Safety,Permanency and Well Being of families. For each outcome,data and performance indicators
measure each state's performance according to national standards and monitor progress over time.
Following the review,a Program Improvement Plan(PIP)will be implemented for the state to enhance
services to families.
CONTRACTORS providing services to the Department families and children must continually strive for
positive outcomes in the areas of safety,permanency and well being. Contractors providing services in
program areas identified by the Department are required to comply with a standard assessment and
reporting system set forth in Exhibit D which will address the aforementioned three areas.
9. Insurance
CONTRACTOR shall procure,at its own expense,and maintain for the duration of the work,the following
insurance coverage; Weld County,Colorado,by and through the Board of County Commissioners of Weld
County,its employees and agents,shall be named as additional named insured on the insurance policy.
a. Standard Workman's Compensation and Employer's Liability.
1. As required by state statute including occupational disease,covering all employees at
work site.
b. General Liability(PL&PD)(Minimum).
1. Combined single limit-$500,000 written on an occurrence basis.
2. Any aggregate limit will not be less than$1 million.
3. Provider must purchase additional insurance if claims reduce the annual aggregate below
$500,000.
4. State of Colorado to be named as additional insured on each comprehensive general
liability policy.
5. Certificate of insurance to be provided to Weld County and must be attached to the
contract.
6. Insurance shall include provisions preventing cancellation without 60 days prior notice
by certified mail to Weld County.
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c. Automobile Liability(Minimum).
I. Minimum of$500,000 combined single limit auto insurance.
d. Additional coverage may be required in specific program areas. For any insurances that are
required by this contract,a completed Standard Certificate of Insurance Form shall be provided to
the Department by the Contractor prior to the start of any contract.
10. Certifications
CONTRACTOR certifies that,at the time of entering into this Contract, it has currently in effect all
necessary licenses,approvals, insurance,etc.required to properly provide the services and/or supplies
covered by this contract. Copies of all necessary licenses shall be provided to the Department by the
Contractor prior to the start of any contract.
I I. Monitoring and Evaluation
CONTRACTOR and the Department agree that monitoring and evaluation of the performance of this
Agreement shall be conducted by CONTRACTOR and the Department. The results of the monitoring and
evaluation shall be provided to the Board of Weld County Commissioners,the Department and
CONTRACTOR.
CONTRACTOR shall permit the Department,and any other duly authorized agent or governmental
agency,to monitor all activities conducted by CONTRACTOR pursuant to the terms of this Agreement.
As the monitoring agency may in its sole discretion deem necessary or appropriate,such program data,
special analyses,on-site checking,formal audit examinations,or any other reasonable procedures. All
such monitoring shall be performed in a manner that will not unduly interfere with agreement work.
12. Modification of Agreement
All modifications to this agreement shall be in writing and signed by both parties.
13. Remedies
The Director of Human Services or designee may exercise the following remedial actions should s/he find
CONTRACTOR substantially failed to satisfy the scope of work found in this Agreement. Substantial
failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by
CONTRACTOR. These remedial actions are as follows:
a. Withhold payment to CONTRACTOR until the necessary services or corrections in performance are
satisfactorily completed;
b. Deny payment or recover reimbursement for those services or deliverables,which have not been
performed and which due to circumstances caused by CONTRACTOR cannot be performed or if
performed would be of no value to the Department. Denial of the amount of payment shall be
reasonably related to the amount of work or deliverables lost to the Department;
c. Incorrect payment to CONTRACTOR due to omission,error,fraud,and/or defalcation shall be
recovered from CONTRACTOR by deduction from subsequent payments under this Agreement or
other agreements between the Department and CONTRACTOR,or by the Department as a debt due to
the Department or otherwise as provided by law.
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14. Representatives
For the purpose of this Agreement,the individuals identified below are hereby designated representatives
of the respective parties. Either party may from time to time designate in writing a new or substitute
representative(s):
For the Department:
Gloria Romansik Social Services Administrator
Name Title
For CONTRACTOR:
Steven Ramirez Chief Executive Officer
Name Title
15. Notice
All notices required to be given by the parties hereunder shall be given by certified or registered mail to the
individuals at the addresses set forth below. Either party may from time to time designate in writing a
substitute person(s)or address to whom such notices shall be sent:
To: The Department To: CONTRACTOR
Judy A.Griego,Director Steven Ramirez,Chief Executive Officer
P.O.Box A 6400 W.Coal Mine Avenue
Greeley,CO 80632 Littleton,CO 80123
(970)352-1551 (303)932-9599
16. Litigation
CONTRACTOR shall promptly notify the Department in the event that CONTRACTOR learns of any
actual litigation in which it is a party defendant in a case that involves services provided under this
Agreement.CONTRACTOR,within five(5)calendar days after being served with a summons,complaint,
or other pleading which has been filed in any federal or state court or administrative agency,shall deliver
copies of such document(s)to the Human Services Director. The term"litigation"includes an assignment
for the benefit of creditors,and filings in bankruptcy,reorganization and/or foreclosure.
17. Termination
This Agreement may be terminated at any time by either party given thirty(30)days written notice and is
subject to the availability of funding. CONTRACTOR reserves the right to suspend services to clients if
funding is no longer available.
18. Entire Agreement
This Agreement,together with all attachments hereto,constitutes the entire understanding between the
parties with respect to the subject matter hereof,and may not be changed or modified except as stated in
Paragraph 10 herein.
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PY-08-09-CORE-0163
IN WITNESS WHEREOF,the parties heretghave.duly executed the Agreement as of the day,month,and year first
above written. - -
h)
ATTEST: IIIM
le
WELD COUN OF COUNTY
CLERK TO i^ . +, - SSIONERS WELD
"k? O1 COLORADO
By: L�.✓r/1 � ..4s>! , :. ,. •
Deputy Clerk William H.Jerke,Chair SEP 0 8 2008
AP V AS TO F� CONTRAC OR:
BY
C A torn y en Ramirez, f Execuf Officer
WELD COUNTY DEPARTMENT
OF HUMAN SE VICES
By:
Judy Griego, ctor
6
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PY-08-09-CORE-0163
EXHIBIT A
SCOPE OF SERVICES
1. CONTRACTOR will provide offense-specific treatment services to male youth and adolescents,ages 12-18,
who sexually offend,as referred by the Department. Services will be provided at 745 HWY 119,Longmont,
CO 80501. Services include:
a. Individual Therapy
b. Family Therapy
c. Offense Specific Group Therapy
d. Master's Level Group Therapy
e. In-home Family Therapy
f. Multi-family/parent Group Therapy
2. Program provides support and education to the referred youth or adolescent and their family.
3. Program emphasizes victim and community safety,active family participation,accurate assessment of service
plan needs,connection of referred youth or adolescent and their family with appropriate community resources,
and treatment of identified mental health needs with an overall increase in mental health.
4. CONTRACTOR will address risk assessment through the JSOAP,ongoing team and family collaboration,
treatment progress,team member input,and behavioral observation in all areas of the referred youth or
adolescent's life(home,school,job,social,community activities,etc.)
5. CONTRACTOR will comply with all Sex Offender Management Board(SOMB)guidelines and standards.
6. The referred youth or adolescent must have completed an offense-specific evaluation prior to or in conjunction
with the start of services.
7. CONTRACTOR will submit a report on a monthly basis for each active referral. Reports will be submitted per
the online format required by the Department,unless otherwise directed by the Department.
8, CONTRACTOR will participate in team reviews of ongoing services as needed.
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EXHIBIT B
PAYMENT SCHEDULE
1. Funding and Method of Payment
The Department agrees to reimburse CONTRACTOR in consideration for the work and services
performed from Core Services funding,not to exceed$10,000.00.
Expenses incurred by CONTRACTOR,in association with said project prior to the term of this agreement,
are not eligible Department expenditures and shall not be reimbursed by the Department.
Payment pursuant to this Contract,if Core Services funds,whether in whole or in part,is subject to and
contingent upon the continuing availability of said funds for the purposes hereof. In the event that said
funds,or any part thereof,become unavailable as determined by the Department,the Department may
immediately terminate this Contract or amend it accordingly.
2. Fees for Services
$75.00/Hour(Individual or Family Therapy)
$45.00/Hour(Offense Specific Group Therapy)
$45.00/Hour(Master's Level Group Therapy)
$45.00/Hour(Multi-family/parent Group Therapy)
$90.00/Hour(In-home Family Therapy)
Department referrals will not be sent to collections by Contractor for default of co-pay/fees. Services will
be performed regardless of client's refusal or inability to pay co-pay.
Contractor will collect any applicable sliding scale co-pays and credit the Department for any payments
received on the monthly billing statements.
3. Submittal of Vouchers
CONTRACTOR shall prepare and submit monthly the itemized voucher and certify that the services
authorized were provided on the date indicated and the charges made were pursuant to the terms and
conditions of Exhibit A.
a. All billings are to be submitted by the 10`h`day of the month following the month of
service. If the billing is not submitted within twenty-five(25)calendar days of the month
following service,it may result in forfeiture of payment.
b. Billings must be submitted with the attached required forms,Authorization for
Contractual Services,Request for Reimbursement,Client Verification Form and monthly
report. The forms must be submitted with original signatures.
c. For monitored sobriety,proof of services rendered shall be a sign-in sheet with client
signatures or the test result.
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EXHIBIT C
ASSURANCES
1. CONTRACTOR agrees it is an independent contractor and that its officers and employees do not become
employees of Weld County,nor are they entitled to any employee benefits as Weld County employees,as
the result of the execution of this Agreement.
2. Weld County,the Board of County Commissioners of Weld County,its officers and employees,shall not
be held liable for injuries or damages caused by any negligent acts or omissions of CONTRACTOR-
contracted CONTRACTOR or its employees,volunteers,or agents while performing duties as described in
this Agreement.CONTRACTOR shall indemnify,defend,and hold harmless Weld County,the Board of
County Commissioners of Weld County,its employees,volunteers,and agents. CONTRACTOR shall
provide adequate liability and worker's compensation insurance for all its employees,volunteers,and
agents engaged in the performance of the Agreement upon request,CONTRACTOR shall provide the
Department with the acceptable evidence that such coverage is in effect.
3. No portion of this Contract shall be deemed to constitute a waiver of any immunities the parties or their
officers or employees may possess,not shall any portion of this Agreement be deemed to have created a
duty of care with respect to any persons not a party of this Agreement.
4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld, State
of Colorado,to expend funds not otherwise appropriated in each succeeding year.
5. If any section,subsection,paragraph,sentence,clause,or phrase of this Contract is for any reason held or
decided to be unconstitutional,such decision shall not affect the validity of the remaining portions. The
parties hereto declare that they would have entered into this Contract and each and every section,
subsection,paragraph,sentence,clause,and phrase thereof irrespective of the fact that any one or more
sections,subsections,paragraphs,sentences, clauses,or phrases might be declared to be unconstitutional or
invalid.
6. No officer,member or employee of Weld County and no member of their governing bodies shall have any
pecuniary interest,direct or indirect, in the approved Agreement or the proceeds thereof.
7. CONTRACTOR assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that no
person shall,on the grounds of race,creed,color, sex,or national origin,be excluded from participation in,
be denied the benefits of,or be otherwise subjected to discrimination under this approved Contract.
8. CONTRACTOR assures that sufficient,auditable,and otherwise adequate records that will provide
accurate,current,separate,and complete disclosure of the status of the funds received under the Contract
are maintained for three(3)years or the completion and resolution of an audit. Such records shall be
sufficient to allow authorized local,Federal,and State auditors,and representatives to audit and monitor
CONTRACTOR.
9. All such records,documents,communications,and other materials created pursuant or related to this
contract shall be maintained by CONTRACTOR,in a central location and shall be made available to
Social Services upon its request,for a period of seven(7)years from the date of final payment under this
Contract,or for such further period as may be necessary to resolve any matters which may be pending,or
until an audit has been completed with the following qualifications: If an audit by or on behalf of the
federal and/or state government has begun but is not completed at the end of the seven(7)year period,or if
audit findings have not been resolved after a seven(7)period,the materials shall be retained until the
resolution of the audit finding.
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10. CONTRACTOR assures that authorized local,federal,and state auditors and representatives shall,during
business hours,have access to inspect any copy records,and shall be allowed to monitor and review
through on-site visits,all contract activities,supported with funds under this Contract to ensure compliance
with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the
performance of the Agreement shall be conducted by appropriate funding sources. The results of the
monitoring and evaluation activities shall be provided to the appropriate and interested parties.
11. This Contract shall be binding upon the parties hereto,their successors,heirs,legal representatives,and
assigns. CONTRACTOR or the Department may not assign any of its rights or obligations hereunder
without the prior written consent of both parties.
12. CONTRACTOR certifies that federal appropriated funds have not been paid or will be paid,by or on
behalf of CONTRACTOR,to any person for influencing or attempting to influence an officer or employee
of an agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of
Congress in connection with the awarding of any Federal contract,the making of any federal grant,the
making of any federal loan,the entering into of any cooperative agreement,and the extension,
continuation,renewal,amendment,or modification of any Federal contract, loan,grant,or cooperative
agreement.
13. CONTRACTOR assures that it will fully comply with all other applicable federal and state laws.
CONTRACTOR understands that the source of funds to be used under this Contract is Core Services
funds.
14. CONTRACTOR assures and certifies that it and its principals:
a. Are not presently debarred,suspended,proposed for debarment,declared ineligible,or voluntarily
excluded from covered transaction by a federal department of agency.
b. Have not,within a three-year period preceding this Agreement,been convicted of or had a civil
judgment rendered against them for commission of fraud or a criminal offense in connection with
obtaining,attempting to obtain,or performing a public(federal,state,or local)transaction or
contract under a public transaction;violation of federal or state antitrust statutes or commission of
embezzlement,theft,forgery,bribery,falsification or destruction of records,making false
statements,or receiving stolen property;
c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity
(federal,state,or local)with commission of any of the offenses enumerated in paragraph 11(b)of
this certification;and
d. Have not,within a three-year period preceding this Contract,had one or more public transactions
(federal,state,and local)terminated for cause or default.
15. The Appearance of Conflict of Interest applies to the relationship of a CONTRACTOR with the
Department when the CONTRACTOR also maintains a relationship with a third party and the two
relationships are in opposition. In order to create the appearance of a conflict of interest,it is not necessary
for the contractor to gain from knowledge of these opposing interests. It is only necessary that the
contractor know that the two relationships are in opposition. During the term of the Contract,
CONTRACTOR shall not enter any third party relationship that gives the appearance of creating a conflict
of interest. Upon learning of an existing appearance of a conflict of interest situation,CONTRACTOR
shall submit to the Department,a full disclosure statement setting forth the details that create the
appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this
paragraph shall constitute grounds for the Department's termination,for cause,of its contract with
CONTRACTOR.
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16. CONTRACTOR shall protect the confidentiality of all applicant records and other materials that are
maintained in accordance with this Contract. Except for purposes directly connected with the
administration of Child Protection,no information about or obtained from any applicant/recipient in
possession of CONTRACTOR shall be disclosed in a form identifiable with the applicant/recipient or a
minor's parent or guardian unless in accordance with CONTRACTOR written policies governing access
to,duplication and dissemination of,all such information. CONTRACTOR shall advise its employees,
agents,and subcontractor,if any,that they are subject to these confidentiality requirements.
CONTRACTOR shall provide its employees,agents,and subcontractors,if any,with a copy or written
explanation of these confidentiality requirements before access to confidential data is permitted.
CONTRACTOR shall have its employees,agents,and subcontractors,if any,sign a written confidentiality
agreement and shall provide a copy of such agreement to the Department,if requested.
17. Proprietary information for the purposes of this contract is information relating to a party's research,
development,trade secrets,business affairs,internal operations and management procedures and those of
its customers,clients or affiliates,but does not include information(1)lawfully obtained from third parties,
(2)that which is in the public domain,or(3)that which is developed independently. Neither party
shall use or disclose directly or indirectly without prior written authorization any proprietary information
concerning the other party obtained as a result of this Contract. Any proprietary information removed from
the State's site by CONTRACTOR in the course of providing services under this Contract will be accorded
at least the same precautions as are employed by CONTRACTOR for similar information in the course of
its own business.
18. CONTRACTOR certifies it will abide by Colorado Revised Statue(C.R.S.)26-6-104,requiring criminal
background record checks for all employees,contractors,and sub-contractors.
19. Contractor certifies that it shall comply with the provisions of Colorado Revised Statutes (C.R.S.) 8-17.5-
101,et seq. Contractor shall not knowingly employ or contract with an illegal alien to perform work under
this Contract or enter into a contract with a subcontractor that fails to certify to Contractor that the
subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this
Contract. Contractor represents, warrants, and agrees that it (a) has verified that it does not employ any
illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by
the Social Security Administration and Department of Homeland Security, and (b) otherwise will comply
with the requirements of C.R.S. 8-17.5-102(2)(b). Contractor shall comply with all reasonable requests
made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and
Employment. If Contractor fails to comply with any requirement of this provision or C.R.S. 8-17.5-101,et
seq., the Department may terminate this Contract for breach and Contractor shall be liable for actual and
consequential damages to the Department.
Except where exempted by federal law and except as provided in C.R.S. 24-76.5-103(3), if Contractor
receives federal or state funds under this Contract, Contractor must confirm that any individual natural
person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. 24-
76.5-103(4) if such individual applies for public benefits provided under this Contract. If Contractor
operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it(a) is a citizen of
the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall
produce one of the forms of identification required by C.R.S. 24-76.5-101, et seq., and (c) shall produce
one of the forms of identification required by C.R.S. 24-76.5-103 prior to the effective date of this
Contract.
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EXHIBIT D
CHILD and FAMILY SERVICES REVIEWS(CFSR)
The Child and Family Services Reviews(CFSR)examines child welfare service outcomes in three areas;Safety,
Permanency and Well Being of families. Colorado's next review will be held in March 2009. For each outcome,
data and performance indicators measure each state's performance according to national standards and monitors
progress over time. Following the review,a Performance Improvement Program(PIP)will be implemented for the
state to enhance services to families.
Additionally,the review will assess statewide,systemic factors to determine if the systems necessary to achieve
positive outcomes for families are in place.
All agencies that contract to provide service to families and children in Weld County must continually strive for
positive outcomes in the areas of safety,permanency and well-being for our youth. In order to insure continued
progress in this area,the Department is requiring providers to comply with a standard assessment and reporting
system which will address these three areas.*
The Department is requesting that provider reports include observations and recommendations regarding clients in a
way that specifically addresses the areas of safety,permanency and well-being. Below are the specific outcomes
that will be assessed by the CFSR in the areas of safety,permanency and well-being,followed by specific
considerations and tasks which must be addressed by the Department contracted providers.
Safety Outcomes
CFSR Outcome Measures
Safety 1 Children are,first and foremost,protected from abuse and neglect.
Safety 2 Children are safely maintained in their homes whenever possible and appropriate.
Considerations for the Department's providers
• Providers should always consider the following definitions regarding child safety when assessing families.
o Children are considered safe when there are no present dangers or impending danger threats,or
the caregivers'protective capacities control existing threats.
o Children are considered unsafe when they are vulnerable to present or impending danger threats,
and caregivers are unable or unwilling to provide protection.
o Risk is the likelihood(chance,potential,prospect)for parenting behavior that is harmful and
destructive to a child's cognitive,social,emotional and/or physical development,and those with
parenting responsibility are unwilling or unable to behave differently.
• Monthly reports should continually document an assessment of risk and safety concerns and the
interventions that are being offered by the provider to ameliorate those concerns.
• Monthly reports should make recommendations regarding services and/or safety measures that the provider
believes should be implemented to insure safety of the child(ren).
• Providers must specifically document efforts to engage families in services and to control for safety.
Permanency Outcomes
CFSR Outcome Measures
Permanency 1 Children have permanency and stability in their living situations.
Permanency 2 The continuity of family relationships and connections is preserved for children.
Considerations for the Department's providers:
• Provider reports should always note the primary permanency goal for the child and document how
interventions are working toward achieving that goal.
• Provider reports must indicate progress toward achieving the permanency goal and should make specific
recommendations regarding how the continuation of the service may assist in achieving the goal.
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• Providers should continually provide recommendations about whether any out-of-home placement
continues to be appropriate and should make recommendations regarding when changes in this area should
be made,in the providers' opinion.
• Providers should continually assess family relationships(parent/child, sibling/sibling,extended
family/child,etc.)and should report any concerning relationship issues which may be a barrier to achieving
permanency. Providers should document ongoing efforts to resolve those issues and/or make
recommendations regarding additional services that may be required to address relationship issues.
• Providers must document specific time frames when recommending ongoing services and/or
recommending changes to services and/or placements.
Child and Family Well-Being Outcomes
CFSR Outcome Measures
Well Being I Families have enhanced capacity to provide for their children's needs.
Well Being 2 Children receive appropriate services to meet their educational needs.
Well Being 3 Children receive adequate services to meet their physical and mental health needs.
Considerations for the Department's providers:
• Providers must engage in ongoing assessments of the parents' capacity to appropriately care for their
children and whether or not the service being provided continues to be appropriate. This must be clearly
documented in monthly reports.
• Providers should specifically detail areas of continued concern within the family and make
recommendations regarding whether that provider's service continues to be appropriate. Reports should
also document what barriers may be impeding progress.
• Providers should document any and all observed concerns regarding any child with whom the provider is
working. This should include concerns regarding physical,emotional,educational and behavioral well-
being of the child. When appropriate,providers should make recommendations regarding evaluations
and/or additional services that may address these concerns.
*Standardized reports will be provided and should be utilized by all agencies providing ongoing services to the
Department's families unless otherwise noted.
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CHILD PROTECTION AGREEMENT FOR SERVICES
BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES ± ��,C^3
AND MOUNT SAINT VINCENT
This Agreement, made and entered into the 1S day of fpryjM 2008,by and between the Board of
Weld County Commissioners, sitting as the Board of Human Services,on behalf of the Weld County Department of
Human Services,hereinafter referred to as the"Department,"and Mount Saint Vincent,hereinafter referred to as
"Contractor".
WITNESSETH
WHEREAS,required approval,clearance,and coordination have been accomplished from and with
appropriate agencies;and
WHEREAS,the Colorado Department of Human Services has provided Core Services funding to the
Department for Day Treatment;and
NOW THEREFORE, in consideration of the premises,the parties hereto covenant and agree as follows:
Term
This Agreement shall become effective on June 1,2008,upon proper execution of this Agreement and
shall expire May 31,2009,unless sooner terminated as provided herein.
2. Scope of Services
Services shall be provided by CONTRACTOR to any person(s)eligible for child protection services in
compliance with Exhibit A"Scope of Services,"a copy of which is attached by reference.
3. Payment
a. Payment shall be made on the basis of Exhibit B,"Payment Schedule,"of which are attached
hereto and incorporated herein by reference.
"Payment Schedule"shall establish the maximum reimbursement,which will be paid from
Core Services funding during the duration of this Agreement.
b. CONTRACTOR shall submit an itemized monthly bill to the Department for all costs incurred
and services provided pursuant to Exhibit A of this Agreement in accordance with criteria
established by the Department. CONTRACTOR shall submit all itemized monthly billings to
the Department by the 10th day of the month following the month the cost was incurred. If the
billing is not submitted within twenty-five(25)calendar days of the month following service,it
may result in forfeiture of payment.
c. Payments of costs incurred pursuant to this Agreement is expressly contingent upon the
availability of Core Services to the Department.
d. The Department shall not be billed for,and reimbursement shall not be made for time involved in
activities outside of those defined in Exhibit A. Work performed prior to the execution of this
Contract shall not be reimbursed or considered part of this Agreement.
a7vVir-079/7,
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4. Financial Management
At all times from the effective date of this Contract until completion of this Contract,CONTRACTOR
shall
comply with the administrative requirements,cost principles and other requirements set forth in the
Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds
expended under Core Service funding must conform to the Single Audit Act of 1984 and OMB Circular A-
133.
5. Payment Method
Unless otherwise provided in the Scope of Services and Payment Schedule:
a. CONTRACTOR shall provide proper monthly invoices and itemization of services performed for
costs incurred in the performance of the agreement.
b. The Department may withhold any payment if CONTRACTOR has failed to comply with the
Financial Management Requirements,program objectives,contractual terms,or reporting
requirements. In the event of a forfeiture of reimbursements,CONTRACTOR may appeal such
circumstance to the Director of Human Services. The decision of the Director of Human Services
shall be final.
6. Assurances
CONTRACTOR shall abide by all assurances as set forth in the attached Exhibit C,which is attached hereto
and incorporated herein by reference.
7. Compliance with Applicable Laws
At all times during the performance of this contract,CONTRACTOR shall strictly adhere to all applicable
federal and state laws,orders,and all applicable standards,regulations,interpretations or guidelines issued
pursuant thereto. This includes the protection of the confidentiality of all applicant/recipient records,
papers,documents,tapes and any other materials that have been or may hereafter be established which
relate to the Contract. CONTRACTOR acknowledges that the following laws are included:
- Title VI of the Civil Rights Act of 1964,42 U.S.C. Sections 2000d—1 et seq.and its implementing
regulation,45 C.F.R.Part 80 et.seq. and
- Section 504 of the Rehabilitation Act of 1973,29 U.S.C. Section 794,and
- its implementing regulations,45 C.F.R.Part 84;and
- the Age Discrimination Act of 1975,42 U.S.C.Sections 6101 et.seq.and
its implementation regulations,45 C.F.R. Part 91;and
Title VII of the Civil Rights Act of 1964;and
- the Age Discrimination in Employment Act of 1967;and
- the Equal Pay Act of 1963;and
the Education Amendments of 1972;and
- Immigration Reform and Control Act of 1986,P.L.99-603;
42 C.F.R.Part 2
and all regulations applicable to these laws prohibiting discrimination because of race,color,
National origin,and sex,religion and handicap,including Acquired Immune Deficiency Syndrome(AIDS)
or AIDS related conditions,covered under Section 504 of the Rehabilitation Act of 1973,as amended,
cited above. If necessary,CONTRACTOR and the Department will resist in judicial proceedings any
efforts to obtain access to client records except as permitted by 42 CFR Part 2.
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Included is 45 C.F.R.Part 74 Appendix G 9,which requires that affirmative steps be taken to assure that
small and minority businesses are utilized,when possible,as sources of supplies,equipment,construction
and services. This assurance is given in consideration of and for the purpose of obtaining any and all
federal and/or state financial assistance.
Any person who feels that s/he has been discriminated against has the right to file a complaint either with
the Colorado Department of Human Services or with the U.S. Department of Ilealth and Human Services,
Office for Civil Rights.
8. Compliance with Child and Family Services Review
The Child and Family Services Reviews(CFSR)examines child welfare service outcomes in three areas;
Safety,Permanency and Well Being of families. For each outcome,data and performance indicators
measure each state's performance according to national standards and monitor progress over time.
Following the review,a Program Improvement Plan(PIP)will be implemented for the state to enhance
services to families.
CONTRACTORS providing services to the Department families and children must continually strive for
positive outcomes in the areas of safety,permanency and well being. Contractors providing services in
program areas identified by the Department are required to comply with a standard assessment and
reporting system set forth in Exhibit D which will address the aforementioned three areas.
9. Insurance
CONTRACTOR shall procure,at its own expense,and maintain for the duration of the work,the following
insurance coverage; Weld County,Colorado,by and through the Board of County Commissioners of Weld
County,its employees and agents,shall be named as additional named insured on the insurance policy.
a. Standard Workman's Compensation and Employer's Liability.
I. As required by state statute including occupational disease,covering all employees at
work site.
b. General Liability(PL& PD)(Minimum).
1. Combined single limit- $500,000 written on an occurrence basis.
2. Any aggregate limit will not be less than$I million.
3. Provider must purchase additional insurance if claims reduce the annual aggregate below
$500,000.
4. State of Colorado to be named as additional insured on each comprehensive general
liability policy.
5. Certificate of insurance to be provided to Weld County and must be attached to the
contract.
6. Insurance shall include provisions preventing cancellation without 60 days prior notice
by certified mail to Weld County.
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c. Automobile Liability(Minimum).
1. Minimum of$500,000 combined single limit auto insurance.
d. Additional coverage may be required in specific program areas. For any insurances that are
required by this contract,a completed Standard Certificate of Insurance Form shall be provided to
the Department by the Contractor prior to the start of any contract.
10. Certifications
CONTRACTOR certifies that,at the time of entering into this Contract,it has currently in effect all
necessary licenses,approvals,insurance,etc. required to properly provide the services and/or supplies
covered by this contract. Copies of all necessary licenses shall be provided to the Department by the
Contractor prior to the start of any contract.
I I. Monitoring and Evaluation
CONTRACTOR and the Department agree that monitoring and evaluation of the performance of this
Agreement shall be conducted by CONTRACTOR and the Department. The results of the monitoring and
evaluation shall be provided to the Board of Weld County Commissioners,the Department and
CONTRACTOR.
CONTRACTOR shall permit the Department,and any other duly authorized agent or governmental
agency,to monitor all activities conducted by CONTRACTOR pursuant to the terms of this Agreement.
As the monitoring agency may in its sole discretion deem necessary or appropriate,such program data,
special analyses,on-site checking,formal audit examinations,or any other reasonable procedures. All
such monitoring shall be performed in a manner that will not unduly interfere with agreement work.
12. Modification of Agreement
All modifications to this agreement shall be in writing and signed by both parties.
13. Remedies
The Director of Human Services or designee may exercise the following remedial actions should s/he find
CONTRACTOR substantially failed to satisfy the scope of work found in this Agreement. Substantial
failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by
CONTRACTOR. These remedial actions are as follows:
a. Withhold payment to CONTRACTOR until the necessary services or corrections in performance are
satisfactorily completed;
b. Deny payment or recover reimbursement for those services or deliverables,which have not been
performed and which due to circumstances caused by CONTRACTOR cannot be performed or if
performed would be of no value to the Department. Denial of the amount of payment shall be
reasonably related to the amount of work or deliverables lost to the Department;
c. Incorrect payment to CONTRACTOR due to omission,error,fraud,and/or defalcation shall be
recovered from CONTRACTOR by deduction from subsequent payments under this Agreement or
other agreements between the Department and CONTRACTOR,or by the Department as a debt due to
the Department or otherwise as provided by law.
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14. Representatives
For the purpose of this Agreement,the individuals identified below are hereby designated representatives
of the respective parties. Either party may from time to time designate in writing a new or substitute
representative(s):
For the Department:
Gloria Romansik Social Services Administrator
Name Title
For CONTRACTOR:
Sister Amv Willcott,SCL Executive Director
Name Title
15. Notice
All notices required to be given by the parties hereunder shall be given by certified or registered mail to the
individuals at the addresses set forth below. Either party may from time to time designate in writing a
substitute person(s)or address to whom such notices shall be sent:
To: The Department To: CONTRACTOR
Judy A.Griego,Director Sister Amy Willcott,SCL,Executive Director
P.O.Box A 4159 Lowell Boulevard
Greeley,CO 80632 Denver,CO 80211
(970)352-1551 (303)458-7220,x226
16. Litigation
CONTRACTOR shall promptly notify the Department in the event that CONTRACTOR learns of any
actual litigation in which it is a party defendant in a case that involves services provided under this
Agreement.CONTRACTOR,within five(5)calendar days after being served with a summons,complaint,
or other pleading which has been filed in any federal or state court or administrative agency,shall deliver
copies of such document(s)to the Human Services Director. The term"litigation"includes an assignment
for the benefit of creditors,and filings in bankruptcy,reorganization and/or foreclosure.
17. Termination
This Agreement may be terminated at any time by either party given thirty(30)days written notice and is
subject to the availability of funding. CONTRACTOR reserves the right to suspend services to clients if
funding is no longer available.
18. Entire Agreement
This Agreement,together with all attachments hereto,constitutes the entire understanding between the
parties with respect to the subject matter hereof,and may not be changed or modified except as stated in
Paragraph 10 herein.
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IN WITNESS WHEREOF,the parties heret have duly executed the Agreement as of the day,month,and year first
above written.
-
ATTEST: �/ N C
WELD CO r 1�u C: D OF COUNTY
CLERK TO E I WC. ISSIONERS WELD
�. LAC•TNTY,COLORADO
By: LIti / !Il.'�; '%'� :y: -; /1—G.—.,.
Depu Clerk William H.Jerke,Chair SEP 0 8 2008
OV AS TO EO CONTRACTOR:
BY `' rtz,". 1, �.��' u�E
Cou ome Sister Amy W1cott,SCL Executive Director
WELD COUNTY DEPARTMENT
OF HUMANS RVICES
By:
Jud .Griego,D rector
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EXHIBIT A
SCOPE OF SERVICES
1. CONTRACTOR will provide day treatment services to youth,ages 5-]4(age limit of 12 at the time
admission),as referred by the Department,who have significant emotional disturbance and/or maladaptive
behaviors. Services include:
a. Accredited School Program with Individual Learning Plans for both Special Ed and regular education
b. Summer Program
c. Individual therapy(at least one time per week)
d. Family therapy(if appropriate)
e. Group therapy
f Recreational therapy
g. Psychiatric/medication consultation
h. Transportation within area
i. Breakfast, lunch and snacks
j. Field trips,art,music,swimming
k. Recommendations and coordination of plan,for after-care services, out patient services and school
transition planning when the child is ready for a step-down in treatment.
2. Services will be provided Monday through Friday from 8:00 a.m.to 3:00 p.m.
3. Classroom ratio is one(1)Special Education Teacher and one(1)Educational Mental Health Worker per
8-12 children.
4. CONTRACTOR provides a Crisis Intervention Team, Masters level therapists,psychologist,consulting
psychiatrists,and a nurse.
5. CONTRACTOR will work with the family and the Department to develop a treatment and educational plan
to meet the needs of the referred child or youth.
6. CONTRACTOR will identify in detail areas of continued concern and make recommendations to the
Department regarding continuation of services and/or the need for additional services.
7. CONTRACTOR will document in detail any and all observed or verbalized concerns regarding any child
whom the CONTRACTOR is working with under an active referral. Areas of concern may include,but are
not limited to,any physical,emotional,educational or behavioral issues.Areas of concern should be
reported immediately AND on the required monthly report.
8. CONTRACTOR will submit reports on a monthly basis for each active referral.
9. CONTRACTOR will participate in team reviews of ongoing services as requested.
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EXHIBIT B
PAYMENT SCHEDULE
Funding and Method of Payment
The Department agrees to reimburse CONTRACTOR in consideration for the work and services
performed from Core Services funding,not to exceed$25,000.00.
Expenses incurred by CONTRACTOR,in association with said project prior to the term of this agreement,
are not eligible Department expenditures and shall not be reimbursed by the Department.
Payment pursuant to this Contract,if Core Services funds,whether in whole or in part,is subject to and
contingent upon the continuing availability of said funds for the purposes hereof. In the event that said
funds,or any part thereof,become unavailable as determined by the Department,the Department may
immediately terminate this Contract or amend it accordingly.
2. Fees for Services
$105.00/Day(Day in attendance only)
Department referrals will not be sent to collections by Contractor for default of co-pay/fees. Services will
be performed regardless of client's refusal or inability to pay co-pay.
Contractor will collect any applicable sliding scale co-pays and credit the Department for any payments
received on the monthly billing statements.
3. Submittal of Vouchers
CONTRACTOR shall prepare and submit monthly the itemized voucher and certify that the services
authorized were provided on the date indicated and the charges made were pursuant to the terms and
conditions of Exhibit A.
a. All billings are to be submitted by the l0'h`day of the month following the
month of service. If the billing is not submitted within twenty-five(25)
calendar days of the month following service, it may result in forfeiture of
payment.
b. Billings must be submitted with the attached required forms,Authorization for
Contractual Services, Request for Reimbursement,Client Verification Form and monthly
report. The forms must be submitted with original signatures.
c. For monitored sobriety,proof of services rendered shall be a sign-in sheet with client
signatures or the test result.
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EXHIBIT C
ASSURANCES
1. CONTRACTOR agrees it is an independent contractor and that its officers and employees do not become
employees of Weld County,nor are they entitled to any employee benefits as Weld County employees,as
the result of the execution of this Agreement.
2. Weld County,the Board of County Commissioners of Weld County,its officers and employees,shall not
be held liable for injuries or damages caused by any negligent acts or omissions of CONTRACTOR-
contracted CONTRACTOR or its employees,volunteers,or agents while performing duties as described in
this Agreement.CONTRACTOR shall indemnify,defend,and hold harmless Weld County,the Board of
County Commissioners of Weld County, its employees,volunteers,and agents. CONTRACTOR shall
provide adequate liability and worker's compensation insurance for all its employees,volunteers,and
agents engaged in the performance of the Agreement upon request,CONTRACTOR shall provide the
Department with the acceptable evidence that such coverage is in effect.
3. No portion of this Contract shall be deemed to constitute a waiver of any immunities the parties or their
officers or employees may possess,not shall any portion of this Agreement be deemed to have created a
duty of care with respect to any persons not a party of this Agreement.
4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld, State
of Colorado,to expend funds not otherwise appropriated in each succeeding year.
5. If any section,subsection,paragraph, sentence,clause,or phrase of this Contract is for any reason held or
decided to be unconstitutional,such decision shall not affect the validity of the remaining portions. The
parties hereto declare that they would have entered into this Contract and each and every section,
subsection,paragraph, sentence,clause,and phrase thereof irrespective of the fact that any one or more
sections,subsections,paragraphs,sentences,clauses,or phrases might be declared to be unconstitutional or
invalid.
6. No officer,member or employee of Weld County and no member of their governing bodies shall have any
pecuniary interest,direct or indirect,in the approved Agreement or the proceeds thereof.
7. CONTRACTOR assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that no
person shall,on the grounds of race,creed,color, sex,or national origin,be excluded from participation in,
be denied the benefits of,or be otherwise subjected to discrimination under this approved Contract.
8. CONTRACTOR assures that sufficient,auditable,and otherwise adequate records that will provide
accurate,current,separate,and complete disclosure of the status of the funds received under the Contract
are maintained for three(3)years or the completion and resolution of an audit. Such records shall be
sufficient to allow authorized local,Federal,and State auditors,and representatives to audit and monitor
CONTRACTOR.
9. All such records,documents,communications,and other materials created pursuant or related to this
contract shall be maintained by CONTRACTOR,in a central location and shall be made available to
Social Services upon its request, for a period of seven(7)years from the date of final payment under this
Contract,or for such further period as may be necessary to resolve any matters which may be pending,or
until an audit has been completed with the following qualifications: If an audit by or on behalf of the
federal and/or state government has begun but is not completed at the end of the seven(7)year period,or if
audit findings have not been resolved after a seven(7)period,the materials shall be retained until the
resolution of the audit finding.
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10. CONTRACTOR assures that authorized local,federal,and state auditors and representatives shall,during
business hours,have access to inspect any copy records,and shall be allowed to monitor and review
through on-site visits,all contract activities,supported with funds under this Contract to ensure compliance
with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the
performance of the Agreement shall be conducted by appropriate funding sources. The results of the
monitoring and evaluation activities shall be provided to the appropriate and interested parties.
11. This Contract shall be binding upon the parties hereto,their successors,heirs,legal representatives, and
assigns. CONTRACTOR or the Department may not assign any of its rights or obligations hereunder
without the prior written consent of both parties.
12. CONTRACTOR certifies that federal appropriated funds have not been paid or will be paid,by or on
behalf of CONTRACTOR,to any person for influencing or attempting to influence an officer or employee
of an agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of
Congress in connection with the awarding of any Federal contract,the making of any federal grant,the
making of any federal loan,the entering into of any cooperative agreement,and the extension,
continuation,renewal,amendment,or modification of any Federal contract, loan,grant,or cooperative
agreement.
• 13. CONTRACTOR assures that it will fully comply with all other applicable federal and state laws.
CONTRACTOR understands that the source of funds to be used under this Contract is Core Services
funds.
14. CONTRACTOR assures and certifies that it and its principals:
a. Are not presently debarred, suspended,proposed for debarment,declared ineligible,or voluntarily
excluded from covered transaction by a federal department of agency.
b. Have not,within a three-year period preceding this Agreement,been convicted of or had a civil
judgment rendered against them for commission of fraud or a criminal offense in connection with
obtaining,attempting to obtain,or performing a public(federal,state,or local)transaction or
contract under a public transaction;violation of federal or state antitrust statutes or commission of
embezzlement,theft,forgery,bribery,falsification or destruction of records,making false
statements,or receiving stolen property;
c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity
(federal,state,or local)with commission of any of the offenses enumerated in paragraph 11(b)of
this certification;and
d. Have not,within a three-year period preceding this Contract,had one or more public transactions
(federal, state,and local)terminated for cause or default.
15. The Appearance of Conflict of Interest applies to the relationship of a CONTRACTOR with the
Department when the CONTRACTOR also maintains a relationship with a third party and the two
relationships are in opposition. In order to create the appearance of a conflict of interest,it is not necessary
for the contractor to gain from knowledge of these opposing interests. It is only necessary that the
contractor know that the two relationships are in opposition. During the term of the Contract,
CONTRACTOR shall not enter any third party relationship that gives the appearance of creating a conflict
of interest. Upon learning of an existing appearance of a conflict of interest situation,CONTRACTOR
shall submit to the Department,a full disclosure statement setting forth the details that create the
appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this
paragraph shall constitute grounds for the Department's termination,for cause,of its contract with
CONTRACTOR.
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16. CONTRACTOR shall protect the confidentiality of all applicant records and other materials that are
maintained in accordance with this Contract. Except for purposes directly connected with the
administration of Child Protection,no information about or obtained from any applicant/recipient in
possession of CONTRACTOR shall be disclosed in a form identifiable with the applicant/recipient or a
minor's parent or guardian unless in accordance with CONTRACTOR written policies governing access
to,duplication and dissemination of,all such information. CONTRACTOR shall advise its employees,
agents,and subcontractor,if any,that they are subject to these confidentiality requirements.
CONTRACTOR shall provide its employees,agents,and subcontractors, if any,with a copy or written
explanation of these confidentiality requirements before access to confidential data is permitted.
CONTRACTOR shall have its employees,agents,and subcontractors, if any, sign a written confidentiality
agreement and shall provide a copy of such agreement to the Department, if requested.
17. Proprietary information for the purposes of this contract is information relating to a party's research,
development,trade secrets,business affairs,internal operations and management procedures and those of
its customers,clients or affiliates,but does not include information(1)lawfully obtained from third parties,
(2)that which is in the public domain,or(3)that which is developed independently. Neither party
shall use or disclose directly or indirectly without prior written authorization any proprietary information
concerning the other party obtained as a result of this Contract. Any proprietary information removed from
the State's site by CONTRACTOR in the course of providing services under this Contract will be accorded
at least the same precautions as are employed by CONTRACTOR for similar information in the course of
its own business.
18. CONTRACTOR certifies it will abide by Colorado Revised Statue(C.R.S.)26-6-104,requiring criminal
background record checks for all employees,contractors,and sub-contractors.
19. Contractor certifies that it shall comply with the provisions of Colorado Revised Statutes (C.R.S.) 8-17.5-
101,et seq. Contractor shall not knowingly employ or contract with an illegal alien to perform work under
this Contract or enter into a contract with a subcontractor that fails to certify to Contractor that the
subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this
Contract. Contractor represents, warrants, and agrees that it (a) has verified that it does not employ any
illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by
the Social Security Administration and Department of Homeland Security, and (b) otherwise will comply
with the requirements of C.R.S. 8-17.5-102(2)(b). Contractor shall comply with all reasonable requests
made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and
• Employment. If Contractor fails to comply with any requirement of this provision or C.R.S. 8-17.5-101,et
seq., the Department may terminate this Contract for breach and Contractor shall be liable for actual and
consequential damages to the Department.
Except where exempted by federal law and except as provided in C.R.S. 24-76.5-103(3), if Contractor
receives federal or state funds under this Contract, Contractor must confirm that any individual natural
person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. 24-
76.5-103(4) if such individual applies for public benefits provided under this Contract. If Contractor
operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it (a) is a citizen of
the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall
produce one of the forms of identification required by C.R.S. 24-76.5-101, et seq., and (c) shall produce
one of the forms of identification required by C.R.S. 24-76.5-103 prior to the effective date of this
Contract.
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EXHIBIT D
CHILD and FAMILY SERVICES REVIEWS(CFSR)
The Child and Family Services Reviews(CFSR)examines child welfare service outcomes in three areas;Safety,
Permanency and Well Being of families. Colorado's next review will be held in March 2009. For each outcome,
data and performance indicators measure each state's performance according to national standards and monitors
progress over time. Following the review,a Performance Improvement Program(PIP)will be implemented for the
state to enhance services to families.
Additionally,the review will assess statewide,systemic factors to determine if the systems necessary to achieve
positive outcomes for families are in place.
All agencies that contract to provide service to families and children in Weld County must continually strive for
positive outcomes in the areas of safety,permanency and well-being for our youth. In order to insure continued
progress in this area,the Department is requiring providers to comply with a standard assessment and reporting
system which will address these three areas.*
The Department is requesting that provider reports include observations and recommendations regarding clients in a
way that specifically addresses the areas of safety,permanency and well-being. Below are the specific outcomes
that will be assessed by the CFSR in the areas of safety,permanency and well-being, followed by specific
considerations and tasks which must be addressed by the Department contracted providers.
Safety Outcomes
CFSR Outcome Measures
Safety 1 Children are, first and foremost,protected from abuse and neglect.
Safety 2 Children are safely maintained in their homes whenever possible and appropriate.
Considerations for the Department's providers
• Providers should always consider the following definitions regarding child safety when assessing families.
o Children are considered safe when there are no present dangers or impending danger threats,or
the caregivers'protective capacities control existing threats.
o Children are considered unsafe when they are vulnerable to present or impending danger threats,
and caregivers are unable or unwilling to provide protection.
o Risk is the likelihood(chance,potential,prospect)for parenting behavior that is harmful and
destructive to a child's cognitive,social,emotional and/or physical development,and those with
parenting responsibility are unwilling or unable to behave differently.
• Monthly reports should continually document an assessment of risk and safety concems and the
interventions that are being offered by the provider to ameliorate those concerns.
• Monthly reports should make recommendations regarding services and/or safety measures that the provider
believes should be implemented to insure safety of the child(ren).
• Providers must specifically document efforts to engage families in services and to control for safety.
Permanency Outcomes
CFSR Outcome Measures
Permanency I Children have permanency and stability in their living situations.
Permanency 2 The continuity of family relationships and connections is preserved for children.
Considerations for the Department's providers:
• Provider reports should always note the primary permanency goal for the child and document how
interventions are working toward achieving that goal.
• Provider reports must indicate progress toward achieving the permanency goal and should make specific
recommendations regarding how the continuation of the service may assist in achieving the goal.
12
PY-08-09-CORE-0167
• Providers should continually provide recommendations about whether any out-of-home placement
continues to be appropriate and should make recommendations regarding when changes in this area should
be made, in the providers' opinion.
• Providers should continually assess family relationships(parent/child,sibling/sibling,extended
family/child,etc.)and should report any concerning relationship issues which may be a barrier to achieving
permanency. Providers should document ongoing efforts to resolve those issues and/or make
recommendations regarding additional services that may be required to address relationship issues.
• Providers must document specific time frames when recommending ongoing services and/or
recommending changes to services and/or placements.
Child and Family Well-Being Outcomes
CFSR Outcome Measures
Well Being 1 Families have enhanced capacity to provide for their children's needs.
Well Being 2 Children receive appropriate services to meet their educational needs.
Well Being 3 Children receive adequate services to meet their physical and mental health needs.
Considerations for the Department's providers:
• Providers must engage in ongoing assessments of the parents' capacity to appropriately care for their
children and whether or not the service being provided continues to be appropriate. This must be clearly
documented in monthly reports.
• Providers should specifically detail areas of continued concern within the family and make
recommendations regarding whether that provider's service continues to be appropriate. Reports should
also document what barriers may be impeding progress.
• Providers should document any and all observed concems regarding any child with whom the provider is
working. This should include concems regarding physical,emotional,educational and behavioral well-
being of the child. When appropriate,providers should make recommendations regarding evaluations
and/or additional services that may address these concems.
*Standardized reports will be provided and should be utilized by all agencies providing ongoing services to the
Department's families unless otherwise noted.
13
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RECEIVED 6 y 688
Contract No.FY08-CC-02
AGREEMENT FOR SERVICES
BETWEEN THE WELD COUNTY DEPARTMENT
OF SOCIAL SERVICES AND FAMILY CONNECTS
r1
This Agreement,made and entered into this day o t P2008,by and between the Board of
County Commissioners,on behalf of the Weld County Department of Social Services,hereinafter referred to as
"Social Services," and "Family Connects,"hereinafter referred to as the"Contractor."
WITNESSETH
WHEREAS, required approval, clearance and coordination has been accomplished from and with
appropriate agencies; and
WHEREAS, the County of Weld,pursuant to the Weld County Home Rule
Charter,is providing Child Care and Child Welfare resources for capacity building at a Therapeutic Pre-School
to stabilize children and to prevent or minimize the risk of them being: expelled from a child care provider or
preschool,placed in an out of home placement, or placed with another foster care provider; and
WHEREAS, Social Services desires to enter into an agreement with the Contractor to assist Social
Services in providing support services to eligible individuals through the Therapeutic Pre-School.
NOW THEREFORE, in consideration of the premises, the parties hereto
covenant and agree as follows:
1. Terms
This Agreement shall become effective July 1, 2008, upon proper execution of this Agreement and
shall expire December 31,2008. The Contractor agrees that time is essence in their performance of its
obligations under this Agreement, and that completion of the Project shall occur no later than the
termination date of December 31, 2008.
2. Scope of Services
Services shall be provided by the Contractor to any person(s)eligible for services in compliance with
Exhibit A "Scope of Services," a copy of which is attached and incorporated by reference.
3. Payment Schedule
a. Payment shall be made on the basis of Exhibit B, "Payment Schedule," a copy of which is
attached and incorporated by reference.
The Agreement Budget shall establish the maximum reimbursement which will be paid from
county funds during the duration of this agreement.
b. The Contractor shall submit an itemized monthly billing to Social Services for all costs
incurred pursuant to Exhibit A of this Agreement in accordance with criteria established by
Social Services. The Contractor shall submit all itemized monthly billings to the Social
Services no later than the fifteenth (15)day of the month following the month the cost was
incurred. Billings must be signed by the Contractor. Failure to submit monthly billings in
accordance with the terms of this agreement shall result in the Contractor's forfeiture of all
rights to be reimbursed for such expenses.
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Contract No. FY08-CC-02
c. Payments to the Contractor shall be made monthly by Social Services upon receipt of such
itemized billings as required under Exhibits A and B.
d. Reimbursement of costs incurred pursuant to this Agreement is expressly contingent upon the
availability of Weld County funds to Social Services.
e. Social Services shall not be billed for, and reimbursement shall not be made for, time
involved in activities outside of those defined in Exhibit A. Work performed prior to the
execution of this Contract shall not be reimbursed or considered part of this Agreement.
3. Financial Management
At all times from the effective date of this Contract until completion of this Contract,the Contractor
shall comply with the administrative requirements,cost principles and other requirements set forth in
the Financial Management Manual adopted by the State of Colorado. The required annual audit of all
funds expended under General Assistance must conform to the Single Audit Act of 1984 and OMB
Circular A-128.
4. Payment Method
Unless otherwise provided in the Scope of Services and Payment Schedule:
a. The Contractor shall provide proper monthly invoices and verification of services performed
for costs incurred in the performance of the agreement.
b. Social Services may withhold any payment if the Contractor has failed to comply with the
Financial Management Requirements, program objectives, contractual terms, or reporting
requirements.
5. Assurances
The Contractor shall abide by all assurances as set forth in the attached Exhibit C,which is attached
hereto and incorporated herein by reference.
6. Compliance with Applicable Laws
At all times during the performance of this contract, the Contractor shall strictly adhere to all
applicable federal and state laws,orders, and all applicable standards,regulations,interpretations or
guidelines issued pursuant thereto. This includes the protection of the confidentiality of all
applicant/recipient records,papers, documents,tapes and any other materials that have been or may
hereafter be established which relate to this Contract. The Contractor acknowledges that the following
laws are included:
-Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d-1
et. seq. and its implementing regulation,45 C.F.R. Part 80 et. seq.;
and
- Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section
794, and its implementing regulation, 45 C.F.R. Part 84; and
-The Age Discrimination Act of 1975, 42 U.S.C. Sections 6101 et. seq.
and its implementation regulation, 45 C.F.R. Part 91; and
-Title VII of the Civil Rights Act of 1964; and
-The Age Discrimination in Employment Act of 1967; and
-the Equal Pay Act of 1963; and
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Contract No. FY08-CC-02
-the Education Amendments of 1972; and
-Immigration Reform and Control Act of 1986,P.L. 99-603;
and all regulations applicable to these laws prohibiting discrimination because of race,color,national
origin,and,sex,religion and handicap,including Acquired Immune Deficiency Syndrome(AIDS)or
AIDS related conditions, covered under Section 504 of the Rehabilitation Act of 1973, as amended,
cited above. Included if 45 C.F.R. Part 74 Appendix G 9, which requires that affirmative steps be
taken to assure that small and minority businesses are utilized,when possible,as sources of supplies,
equipment,construction and services. This assurance is given in consideration of and for the purpose
of obtaining any and all federal and/or state financial assistance.
Any person who feels that s/he has been discriminated against has the right to file a complaint either
with the Colorado Department of Social Services or with the U.S. Department of Health and Human
Services, Office for Civil Rights.
7. Certifications
Contractor certifies that, at the time of entering into this Contract, it has currently in effect all
necessary licenses,approvals,insurance,etc.required to properly provide the services and/or supplies
covered by this contract.
8. Monitoring and Evaluation
The Contractor and Social Services agree that monitoring and evaluation of the performance of this
Agreement shall be conducted by the Contractor and Social Services. The results of the monitoring
and evaluation shall be provided to the Board of Weld County Commissioners.
The Contractor shall permit Social Services, and any other duly authorized agent or governmental
agency,to monitor all activities conducted by the contractor pursuant to the terms of this Agreement.
As the monitoring agency may in its sole discretion deem necessary or appropriate,such program data,
special analyses,on-site checking,formal audit examinations,or any other reasonable procedures. All
such monitoring shall be performed in a manner that will not unduly interfere with agreement work.
9. Modification of Agreement
All modifications to this agreement shall be in writing and signed by both parties.
10. Remedies
The Director of Social 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 Social Services. Denial of the amount
of payment shall be reasonably related to the amount of work or deliverables lost to Social
Services;
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Contract No.FY08-CC-02
c. Incorrect payment to the Contractor due to omission,error,fraud,and/or defalcation shall be
recovered from Contractor by deduction from subsequent payments under this Agreement or
other agreements between Social Services and the Contractor,or by social Services as a debt
due to Social Services or otherwise as provided by law.
11. Representatives
For the purpose of this Agreement, the individuals identified below are hereby designated
representatives of the respective parties. Either party may from time to time designate in writing a new
or substitute representative(s):
For Social Services: For the Contractor:
John Kruse, A.P. Administrator Noelle Hause, Executive Director
Name Title Name Title
12. Notice
All notices required to be given by the parties hereunder shall be given by certified or registered mail
to the individuals at the addresses set forth below. Either party may from time to time designate in
writing a substitute person(s)or address to whom such notices shall be sent:
To: Social Services To:
Judy A. Griego, Director Noelle Hause, Executive Director
P.O. Box A 1610 29`"Avenue Place
Greeley, CO 80631 Greeley, CO 80634
13. Litigation
The Contractor shall promptly notify Social Services in the event that the Contractor learns of any
actual litigation in which it is a party defendant in a case which involves services provided under this
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 Social Services'Director. The term"litigation"
includes an assignment for the benefit of creditors, and filings in bankruptcy,reorganization and/or
foreclosure.
14. Termination
This Agreement may be terminated at any time by either party given thirty(30)days written notice and
is subject to the availability of funding.
15. Entire Agreement
This Agreement,together with all attachments hereto,constitutes the entire understanding between the
parties with respect to the subject matter hereof,and may not be changed or modified except as stated
in Paragraph 9 herein.
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Contract No.FY08-CC-02
IN WITNESS WHEREOF,the parties hereto have duly executed the Agreement as of the day,month,and year
first above writt
ATTEST:
Weld County Clerk to th V $4 . - C OARD OF COUNTY COMMISSIONERS
WELD COUNTY,COLORADO
Deputy Clerk to ;'e Board ��� , William H. Jerke, Chair SEP 0 8 2008
APPROVE P ' S TO FO
Family Connects
B ,ce :. e , ounty Attorney *,,e/J- J , d
Noelle Hause, Executive Director
WELD COUNTY DEPARTMENT
OF SOCIAL SERVICE
Jud .Grieg Director
•
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Contract No. FY08-CC-02
EXHIBIT A
SCOPE OF SERVICES
1. General Scope of Services
a. Therapeutic Consultation Services consisting of early mental health, occupational therapy,
physical therapy and speech/language therapy will be provided to the therapeutic preschool.
Consultation will include: consultation to preschool staff, teaming with the trans-disciplinary
team of therapists,assessment/evaluation and referral for community providers or child fmd
entities for special education evaluations as needed, in class intervention when appropriate.
Emphasis is placed on consultation.
b. Incredible Years Parent Education and Therapeutic Child Groups will be offered to families
with young children identified with early mental health concerns and challenging behaviors.
A Pre-/Post Parent Survey is completed to determine knowledge gained. This evidenced
based curriculum:
Increases parent positive affect, such as praise, and reduces the use of criticism and negative
commands.
• Increases parent use of effective limit-setting by replacing spanking and harsh discipline
with non-violent discipline techniques and increases monitoring of children.
• Reduces parental depression and increases parental self-confidence.
• Increases positive family communication and problem-solving.
• Reduces conduct problems in children's interactions with parents and increases their positive
affect and compliance to parental commands
c. Child Care Provider Training -Creating Community Capacity Promoting Social and
Emotional Competency and Social-Emotional Development Presentations -Child care
centers and home child care providers are selected based on the need,willingness and
commitment to increase their knowledge in supporting social-emotional development of the
young children they serve.
• Promoting Social and Emotional Competency— Social skills in young children are more
closely related with school readiness and success in kindergarten and first grade than
cognitive and academic skills(Raver and Knitzer, 2002; Smith 2004)In a study
commissioned by the Colorado legislature,early childhood teachers in Co-lorado rank their
need to learn how to teach social skills and deal with challenging behaviors as their number
one training need. (Hoover, 2006). Likewise,nationally EC teachers report that challenging
behavior and social skills problems are their greatest challenges and programs report
expelling preschoolers at a rate three times that for school age children(Gilliam, 2005;
Hemmeter et al.2007)
• Social and Emotional Development Presentations The ability to label emotions is a
developmental skill that is not present at birth it must be learned. And
just as there is wide variation in the point at which children start to demonstrate appropriate
use of books,begin writing, and recognize letters, some children's ability to identify,
understand, and label their emotions develops at a slower rate than others. Three variables
can underlie a child's growing ability to label emotions: (1)the child's temperament and
developmental status, (2)parental socialization and environmental support, and(3)the
Page 1 of 4
Contract No.FY08-CC-02
teacher and child care providers' emphasis on emotional literacy. Indeed, differences in the
way adults talk to and teach children about feelings and problem solving are related to
children's abilities to label emotions. (Fostering Emotional Literacy in Young Children:
Labeling Emotions,What Works Brief#21, by G. Joseph, P. Strain, M. M. Ostrosky-
Center on Social and Emotional Foundations for Early Learning). Social Emotional
Development presentations focus on child care providers(home and center— 1.5 hours of
continuing education.
• Transition Team—Includes time to transition graduates form the therapeutic preschool to
community child care providers. Transition time includes meetings with receiving provider
as well as follow consultation and direct support in the classroom with child if necessary.
2. Eligible Participants
Children age two and a half(2 %z)through five(5)years of age that are at risk of:
a. expulsion from child care/preschool settings
b. out of home placement
c. changes in foster care providers
3. Goals, Objectives,Activities, Outcomes,Measurements, and Indicators of Success
a. Incredible Years Parent Education and Therapeutic Child Groups
• Goal: Care givers will learn how to positively shape the social, emotional and behavioral
development of their children through every day interactions.
• Outcome:To provide parent education related to social/emotional development of their young
children.
• Activities: Incredible Years Parents Groups:
➢ Parents will meeting on a weekly basis and participate in the evidence-based
Incredible Years facilitated by a certified Incredible Years group facilitator and
therapeutic co-facilitator for 12 weeks.
➢ Teach effective and appropriate activities by planning and initiating activities and
discussing the value of each activity.
Si. Provide resource/referral to other community agencies/programs as needed.
➢ BilinguallCulturally competent program support staff will ensure that community
education efforts are provided to and understood by monolingual Spanish speaking
parents/caregivers as necessary.
• Measurable Outcomes: Caregiver/childcare providers will increase their knowledge related
to increasing their child's social competence and reduce behavior problems.
• How Measured: Pre/post Incredible Years parent survey
• Indicators of Success:
➢ Positive movement of scores from the pre-to post-tests on the Parent Survey
➢ Positive parent feedback collected from the Incredible Years Program Evaluation
➢ Feedback and/or facilitators observations as noted in anecdotal documentation
• Timelines: Groups will occur through December 31, 2008
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Contract No. FY08-CC-02
b. Promoting Social and Emotional Competency Curriculum
• Goal: Care givers will learn how to positively shape the social, emotional and behavioral
development of their children through every day interactions.
• Outcome: To provide education related to the promotion of social/emotional development of
young children in child care settings.
• Activities: Evidenced-based Promoting Social and Emotional Competence Curriculum
training will be provided for child care providers through:
➢ Monthly trainings
D. Consultation phone calls
D. Site visits
➢ Inventory of Practice
➢ Action plans
➢ Replication of training with additional center child care staff
• Measurable Outcomes: Caregiver/childcare providers will increase their knowledge
related to increasing their child's social competence and reduce behavior problems
• How Measured:
➢ Inventory of practices
➢ Caregivers will complete actions plans for Building Relationships and Providing
and Managing Environment Support.
➢ Caregivers will complete training feedback forms after each class
➢ Site visits
D. The number of Spanish speaking only and English speaking only recipients will
be tracked.
➢ The number of participants
• Indicators of Success:
➢ Positive changes from the Inventory of Practices to Action Plan
D. Action plan implementation
➢ Positive provider feedback collected from the training feedback forms.
➢ Feedback and/or facilitator observations as noted in anecdotal documentation
• Timeline: Groups will occur through December 31, 2008
c. Social and Emotional Development Presentations
• Goal: Care givers will learn how to positively shape the social, emotional and
behavioral development of their children through every day interactions
• Outcome: Care givers will learn how to positively shape the social,emotional and
behavioral development of their children through every day interactions
• Activities: Community presentations on social/emotional development will be provided to
centers and home childcare providers for continuing education credit of 1.5 contact hours
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Contract No.FY08-CC-02
• Measurable Outcomes: Caregiver/childcare providers will increase their knowledge related
to increasing their child's social competence and reduce behavior problems
• How Measured: Caregivers will complete a 10-item pre-/post survey to measure
knowledge learned.
• Indicators of Success: Positive movement of scores from the pre-to post-tests.
• Timelines: Groups will occur through December 31,2008
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Contract No.FY08-CC-02
EXHIBIT B
PAYMENT SCHEDULE
Funding and Method of Payment
Social Services agrees to reimburse to the Contractor a total amount not to exceed Fifty Thousand
Dollars($50,000.00).
Expenses incurred by the Contractor, in association with said project prior to the term of this
Agreement, are not eligible expenditures and shall not be reimbursed by Social Services.
Payment pursuant to this Contract,if Weld County funds,whether in whole or in part,is subject to and
contingent upon the continuing availability of Weld County funds for the purposed hereof. In the
event that said funds,or any part thereof,become unavailable as determined by Social Services,Social
Services may immediately terminate this Contract or amend it accordingly.
The Contractor will be provided supplies and equipment purchased by Social Services. A list will be
created and finalized by May 1,2008 by the Social Services and the Contractor detailing the supplies
and equipment that were provided to the Contractor.
Supplies are defined as disposable with limited per unit usage for the purpose of administering the
Therapeutic Pre-school Program.Equipment is defined as materials that have a per unit cost of$1,000
or more and does not have a limited per unit usage by nature for the purposes of administering the
Therapeutic Pre-school Program.
At the beginning of each agreement period,if not more frequent, Social Services and the Contractor
will inventory the list of equipment.
All salvageable equipment and unused supplies will be returned to Social Services at the termination
of this agreement.
2. Fee Schedule
a. Early Childhood Mental Health Consult $45.00/hr
b. Occupational Therapist $76.00/hr
c. Physical Therapist $76.00/hr
d. Speech/Language Therapist $76.00/hr
e. 12 Week Incredible Years-Parent-Guardian Intensive Training $930/family
f. Promoting Social and Emotional Competency Training $614./provider
g. Social and Emotional Development Presentations $195/each
h. Transition Team Time $35.00/hr
i. Transition Team mileage $.505/mile
3. Submittal of Invoices
Billings for payment shall be submitted to the Weld County Department of Social Services,P.O.Box
A,Greeley,Colorado 80632. When submitting billings for payment,the Contractor shall itemize the
name, amount of days and cost per child that is being billed.
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Contract No. FY08-CC-02
EXHIBIT C
ASSURANCES
1. The Contractor agrees it is an independent contractor and that its officers and employees do not
become employees of Weld County,nor are they entitled to any employee benefits as Weld County
employees, as the result of the execution of this Agreement.
2. Weld County,the Board of County Commissioners of Weld County,its officers and employees,shall
not be held liable for injuries or damages caused by any negligent acts or omissions of Contractor or
its employees, volunteers, or agents while performing duties as described in this Agreement.
Contractor shall indemnify, defend, and hold harmless Weld County, the Board of County
Commissioners of Weld County,its employees,volunteers,and agents. The Contractor shall provide
adequate liability and worker's compensation insurance for all its employees,volunteers,and agents
engaged in the performance of the Agreement upon request, the Contractor shall provide Social
Services with the acceptable evidence that such coverage is in effect.
3. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or
their officers or employees may possess,nor shall any portion of this Agreement be deemed to have
treated a duty of care with respect to any persons not a party to this Agreement.
4. No portion of this Agreement shall be deemed to create an obligation on the part of the County of
Weld, State of Colorado, to expend funds not otherwise appropriated in each succeeding year.
5. If any section,subsections,paragraph,sentence,clause,or phrase of this Agreement is for any reason
held or decided to be unconstitutional, such decision shall not effect the validity of the remaining
portions. The parties hereto declare that they would have entered into this Agreement and each and
every section,subsection,paragraph,sentence,clause,and phrase thereof irrespective of the fact that
any one or more sections,subsections,paragraphs,sentences,clauses,or phrases might be declared to
be unconstitutional or invalid.
6. No officer,member or employee of Weld County and no member of their governing bodies shall have
any pecuniary interest, direct or indirect, in the approved Agreement or the proceeds thereof.
7. The Contractor assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that
no person shall, on the grounds of race, creed, color, sex, or national origin, be excluded from
participation in, be denied the benefits of, or be otherwise subjected to discrimination under this
approved Agreement.
8. The Contractor assures that sufficient, auditable, and otherwise adequate records that will provide
accurate, current, separate, and complete disclosure of the status of the funds received under the
Agreement are maintained for three (3) years or the completion and resolution of an audit. Such
records shall be sufficient to allow authorized local,Federal,and State auditors and representatives to
audit and monitor the Contractor.
9. All such records, documents, communications, and other materials shall be the property of Social
Services and shall be maintained by the Contractor, in a central location and custodian, in behalf of
Social Services, for a period of three(3)years from the date of fmal payment under this Contract,or
for such further period as may be necessary to resolve any matters which may be pending,or until an
audit has been completed with the following qualification: If an audit by or on behalf of the federal
and/or state government has begun but is not completed at the end of the three(3)year period,or if
audit findings have not been resolved after a three(3)year period,the materials shall be retained until
the resolution of the audit finding.
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Contract No.FY08-CC-02
10. The Contractor assures that authorized local, federal and state auditors and representatives shall,
during business hours,have access to inspect any copy records,and shall be allowed to monitor and
review through on-site visits, all contract activities, supported with funds under this Agreement to
ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and
evaluation of the performance of the Agreement shall be conducted by appropriate funding sources.
The results of the monitoring and evaluation activities shall be provided to the appropriate and
interested parties.
11. This Agreement shall be binding upon the parties hereto,their successors,heirs,legal representatives,
and assigns. The Contractor of Social Services may not assign any of its rights or obligations
hereunder without the prior written consent of both parties.
12. The Contractor certifies that Federal appropriated funds have not been paid or will be paid,by or on
behalf of the Contractor, to any person for influencing or attempting to influence an officer or
employee of an agency,a Member of Congress,an officer or employee of Congress,or an employee of
a Member of Congress in connection with the awarding of any Federal contract, the making of any
federal grant,the making of any federal loan,the entering into of any cooperative agreement,and the
extension,continuation,renewal,amendment,or modification of any Federal contract,loan,grant,or
cooperative agreement.
13. The Contractor assures that it will fully comply with the General Assistance Program regulation
promulgated, and all other applicable federal and state laws, rules and regulations. The Contractor
understands that the source of funds to be used under this Agreement is: General Assistance Funds.
14. The Contractor assures and certifies that it and its principals:
a. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from covered transactions by a federal department of agency.
b. Have not,within a three-year period of preceding this Agreement,been convicted of or had a
civil judgment rendered against them for commission of fraud or a criminal offense in
connection with obtaining, attempting to obtain, or performing a public (federal, state, or
local)transaction or contract under a public transaction;violation of federal or state antitrust
statutes or commission of embezzlement,theft,forgery,bribery,falsification or destruction of
records, making false statements, or receiving stolen property;
c. Are not presently indicted for or otherwise criminally or civilly charged by a government
entity (federal, state, or local) with commission of any of the offenses enumerated in
paragraph 11(b)of this certification; and
d. Have not within a three-year period preceding this Agreement, had one or more public
transactions(federal, state, and local)terminated for cause or default.
15. The Appearance of Conflict of Interest applies to the relationship of a contractor with Social Services
when the Contractor also maintains a relationship with a third party and the two relationships are in
opposition. In order to create the appearance of a conflict of interest, it is not necessary for the
contractor to gain from knowledge of these opposing interests. It is only necessary that the contractor
know that the two relationships are in opposition.
During the term of the Contract the Contractor shall not enter any third party relationship that gives the
appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of
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Contract No. FY08-CC-02
interest situation, the Contractor shall submit to Social Services, a full disclosure statement setting
forth the details that create the appearance of a conflict of interest. Failure to promptly submit a
disclosure statement required by this paragraph shall constitute grounds for Social Services'
termination, for cause, of its contract with the Contractor.
16. Contractor shall protect the confidentiality of all applicant records and other materials that are
maintained in accordance with this Contract. Except for purposes directly connected the
administration of the General Assistance Program, no information about or obtained from any
applicant/recipient in possession of Contractor shall be disclosed in a form identifiable with the
applicant/recipient or a minor's parent or guardian. Contractor shall have written policies governing
access to, duplication and dissemination of, all such information. Contractor shall advise its
employees, agents and subcontractors, if any, that they are subject to these confidentiality
requirements. Contractor shall provide its employees,agents,and subcontractors,if any,with a copy
or written explanation of these confidentiality requirements before access to confidential data is
permitted.
17. Proprietary information for the purposes of this contract is information relating to a party's research,
development,trade secrets,business affairs,internal operations and management procedures and those
of its customers,clients or affiliates,but does not include information(1)lawfully obtained from third
parties, (2)that which is in the public domain, or(3)that which is developed independently.
Neither party shall use or disclose directly or indirectly without prior written authorization any
proprietary information concerning the other party obtained as a result of this Contract. Any
proprietary information removed from the State's site by the Contractor in the course of providing
services under this Contract will be accorded at least the same precautions as are employed by the
Contractor for similar information in the course of its own business.
18. The Contractor certifies it will abide by Colorado Revised Statue(C.R.S.)26-6-104,requiring
criminal background record checks for all employees,contractors, and sub-contractors.
19. Contractor certifies that it shall comply with the provisions of Colorado Revised Statutes(C.R.S.) 8-
17.5-101,et seq. Contractor shall not knowingly employ or contract with an illegal alien to perform
work under this Contract or enter into a contract with a subcontractor that fails to certify to Contractor
that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work
under this Contract. Contractor represents,warrants,and agrees that it(a)has verified that it does not
employ any illegal aliens,through participation in the Basic Pilot Employment Verification Program
administered by the Social Security Administration and Department of Homeland Security, and(b)
otherwise will comply with the requirements of C.R.S. 8-17.5-102(2)(b). Contractor shall comply
with all reasonable requests made in the course of an investigation under C.R.S. 8-17.5-102 by the
Colorado Department of Labor and Employment.If Contractor fails to comply with any requirement
of this provision or C.R.S. 8-17.5-101,et seq.,Social Services may terminate this Contract for breach
and Contractor shall be liable for actual and consequential damages to Social Services.
Except where exempted by federal law and except as provided in C.R.S.24-76.5-103(3),if Contractor
receives federal or state funds under this Contract,Contractor must confirm that any individual natural
person eighteen(18)years of age or older is lawfully present in the United States pursuant to C.R.S.
24-76.5-103(4) if such individual applies for public benefits provided under this Contract. If
Contractor operates as a sole proprietor,it hereby swears or affirms under penalty of perjury that it(a)
is a citizen of the United States or is otherwise lawfully present in the United States pursuant to federal
law, (b)shall produce one of the forms of identification required by C.R.S. 24-76.5-101,et seq.,and
(c) shall produce one of the forms of identification required by C.R.S. 24-76.5-103 prior to the
effective date of this Contract.
Page 3 of 3
PY-08-09-CORE-0166 • S
i
CHILD PROTECTION AGREEMENT FOR SERVICES '
BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES
AND THE FAMILY CENTER '4.
Att
This Agreement,made and entered into the day of2008,by and between the Board of
Weld County Commissioners,sitting as the Board of Human Services,on behalf of the Weld County Department of
Human Services,hereinafter referred to as the"Department,"and The Family Center,hereinafter referred to as
"Contractor".
WITNESSETH
WHEREAS,required approval,clearance,and coordination have been accomplished from and with
appropriate agencies;and
WHEREAS,the Colorado Department of Human Services has provided Core Services funding to the
Department for Sex Abuse Treatment(Offense Specific);and
NOW THEREFORE, in consideration of the premises,the parties hereto covenant and agree as follows:
Term
This Agreement shall become effective on June 1,2008, upon proper execution of this Agreement and
shall expire May 31,2009,unless sooner terminated as provided herein.
2. Scope of Services
Services shall be provided by CONTRACTOR to any person(s)eligible for child protection services in
compliance with Exhibit A "Scope of Services,"a copy of which is attached by reference.
3. Payment
a. Payment shall he made on the basis of Exhibit B,"Payment Schedule,"of which are attached
hereto and incorporated herein by reference.
"Payment Schedule"shall establish the maximum reimbursement,which will be paid from
Core Services funding during the duration of this Agreement.
b. CONTRACTOR shall submit an itemized monthly bill to the Department for all costs incurred
and services provided pursuant to Exhibit A of this Agreement in accordance with criteria
established by the Department. CONTRACTOR shall submit all itemized monthly billings to
the Department by the 10'"day of the month following the month the cost was incurred. If the
billing is not submitted within twenty-five(25)calendar days of the month following service, it
may result in forfeiture of payment.
c. Payments of costs incurred pursuant to this Agreement is expressly contingent upon the
availability of Core Services to the Department.
d. The Department shall not be billed for,and reimbursement shall not be made for time involved in
activities outside of those defined in Exhibit A. Work performed prior to the execution of this
Contract shall not be reimbursed or considered part of this Agreement.
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PY-08-09-CORE-0166
4. Financial Management
At all times from the effective date of this Contract until completion of this Contract,CONTRACTOR
shall
comply with the administrative requirements,cost principles and other requirements set forth in the
Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds
expended under Core Service funding must conform to the Single Audit Act of 1984 and OMB Circular A-
133.
5. Payment Method
Unless otherwise provided in the Scope of Services and Payment Schedule:
a. CONTRACTOR shall provide proper monthly invoices and itemization of services performed for
costs incurred in the performance of the agreement.
b. The Department may withhold any payment if CONTRACTOR has failed to comply with the
Financial Management Requirements,program objectives,contractual terms,or reporting
requirements. In the event of a forfeiture of reimbursements,CONTRACTOR may appeal such
circumstance to the Director of Human Services. The decision of the Director of Human Services
shall be final.
6. Assurances
CONTRACTOR shall abide by all assurances as set forth in the attached Exhibit C,which is attached hereto
and incorporated herein by reference.
7. Compliance with Applicable Laws
At all times during the performance of this contract,CONTRACTOR shall strictly adhere to all applicable
federal and state laws,orders,and all applicable standards,regulations, interpretations or guidelines issued
pursuant thereto. This includes the protection of the confidentiality of all applicant/recipient records,
papers,documents,tapes and any other materials that have been or may hereafter be established which
relate to the Contract. CONTRACTOR acknowledges that the following laws are included:
Title VI of the Civil Rights Act of 1964,42 U.S.C.Sections 2000d—I et seq.and its implementing
regulation,45 C.F.R. Part 80 a seq..and
- Section 504 of the Rehabilitation Act of 1973,29 U.S.C.Section 794,and
- its implementing regulations,45 C.F.R.Part 84;and
- the Age Discrimination Act of 1975,42 U.S.C.Sections 6101 et.seq.and
its implementation regulations,45 C.F.R.Part 91;and
Title VII of the Civil Rights Act of 1964;and
the Age Discrimination in Employment Act of 1967;and
the Equal Pay Act of 1963;and
the Education Amendments of 1972;and
Immigration Reform and Control Act of 1986,P.L.99-603;
42 C.F.R.Part 2
and all regulations applicable to these laws prohibiting discrimination because of race,color,
National origin,and sex,religion and handicap, including Acquired Immune Deficiency Syndrome(AIDS)
or AIDS related conditions,covered under Section 504 of the Rehabilitation Act of 1973,as amended,
cited above. If necessary,CONTRACTOR and the Department will resist in judicial proceedings any
efforts to obtain access to client records except as permitted by 42 CFR Part 2.
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Included is 45 C'.F.R. Part 74 Appendix G 9,which requires that affirmative steps be taken to assure that
small and minority businesses are utilized,when possible,as sources of supplies,equipment,construction
and services. This assurance is given in consideration of and for the purpose of obtaining any and all
federal and/or state financial assistance.
Any person who feels that s/he has been discriminated against has the right to file a complaint either with
the Colorado Department of Human Services or with the U.S. Department of Health and Human Services,
Office for Civil Rights.
8. Compliance with Child and Family Services Review
The Child and Family Services Reviews(CFSR)examines child welfare service outcomes in three areas;
Safety,Permanency and Well Being of families. For each outcome,data and performance indicators
measure each state's performance according to national standards and monitor progress over time.
Following the review,a Program Improvement Plan(PIP)will be implemented for the state to enhance
services to families.
CONTRACTORS providing services to the Department families and children must continually strive for
positive outcomes in the areas of safety,permanency and well being. Contractors providing services in
program areas identified by the Department are required to comply with a standard assessment and
reporting system set forth in Exhibit D which will address the aforementioned three areas.
9. Insurance
CONTRACTOR shall procure,at its own expense,and maintain for the duration of the work,the following
insurance coverage; Weld County,Colorado,by and through the Board of County Commissioners of Weld
County, its employees and agents,shall be named as additional named insured on the insurance policy.
a. Standard Workman's Compensation and Employer's Liability.
As required by state statute including occupational disease,covering all employees at
work site.
b. General Liability(PL&PD)(Minimum).
I. Combined single limit-$500,000 written on an occurrence basis.
2, Any aggregate limit will not he less than $I million.
3. Provider must purchase additional insurance if claims reduce the annual aggregate below
$500,000.
4. State of Colorado to be named as additional insured on each comprehensive general
liability policy.
5. Certificate of insurance to he provided to Weld County and must be attached to the
contract.
6. Insurance shall include provisions preventing cancellation without 60 days prior notice
by certified mail to Weld County.
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PY-08-09-CORE-0 I 66
c. Automobile Liability(Minimum).
I. Minimum of$500,000 combined single limit auto insurance.
d. Additional coverage may be required in specific program areas. For any insurances that are
required by this contract,a completed Standard Certificate of Insurance Form shall be provided to
the Department by the Contractor prior to the start of any contract.
10. Certifications
CONTRACTOR certifies that,at the time of entering into this Contract,it has currently in effect all
necessary licenses,approvals,insurance,etc.required to properly provide the services and/or supplies
covered by this contract. Copies of all necessary licenses shall be provided to the Department by the
Contractor prior to the start of any contract.
II. Monitoring and Evaluation
CONTRACTOR and the Department agree that monitoring and evaluation of the performance of this
Agreement shall be conducted by CONTRACTOR and the Department. The results of the monitoring and
evaluation shall be provided to the Board of Weld County Commissioners,the Department and
CONTRACTOR.
CONTRACTOR shall permit the Department,and any other duly authorized agent or governmental
agency,to monitor all activities conducted by CONTRACTOR pursuant to the terms of this Agreement.
As the monitoring agency may in its sole discretion deem necessary'or appropriate,such program data,
special analyses,on-site checking,formal audit examinations,or any other reasonable procedures. All
such monitoring shall be performed in a manner that will not unduly interfere with agreement work.
12. Modification of Agreement
All modifications to this agreement shall be in writing and signed by both parties.
13. Remedies
The Director of Human Services or designee may exercise the following remedial actions should s/he find
CONTRACTOR substantially failed to satisfy the scope of work found in this Agreement. Substantial
failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by
CONTRACTOR. These remedial actions are as follows:
a. Withhold payment to CONTRACTOR until the necessary services or corrections in performance are
satisfactorily completed;
h. Deny payment or recover reimbursement for those services or deliverables,which have not been
performed and which due to circumstances caused by CONTRACTOR cannot be performed or if
performed would be of no value to the Department. Denial of the amount of payment shall be
reasonably related to the amount of work or deliverables lost to the Department;
c. Incorrect payment to CONTRACTOR due to omission,error,fraud,and/or defalcation shall be
recovered from CONTRACTOR by deduction from subsequent payments under this Agreement or
other agreements between the Department and CONTRACTOR,or by the Department as a debt due to
the Department or otherwise as provided by law.
4
•
PY-08-09-CORE-0166
14. Representatives
For the purpose of this Agreement,the individuals identified below are hereby designated representatives
of the respective parties. Either party may from time to time designate in writing a new or substitute
representative(s):
For the Department:
Gloria Romansik Social Services Administrator
Name Title
For CONTRACTOR:
Gavle Christensen,LCSW President
Name Title
15. Notice
All notices required to be given by the parties hereunder shall be given by certified or registered mail to the
individuals at the addresses set forth below. Either party may from time to time designate in writing a
substitute person(s)or address to whom such notices shall be sent:
To: The Department To: CONTRACTOR
Judy A.Griego,Director Gayle Christensen,LCSW,President
P.O.Box A 1751 South 8th Street
Greeley,CO 80632 Colorado Springs,CO 80906
(970)352-1551 1319)471-1816,x11
16. Litigation
CONTRACTOR shall promptly notify the Department in the event that CONTRACTOR learns of any
actual litigation in which it is a party defendant in a case that involves services provided under this
Agreement.CONTRACTOR,within five(5)calendar days after being served with a summons,complaint,
or other pleading which has been filed in any federal or state court or administrative agency,shall deliver
copies of such document(s)to the Human Services Director. The term"litigation"includes an assignment
for the benefit of creditors,and filings in bankruptcy,reorganization and/or foreclosure.
17. Termination
This Agreement may be terminated at any time by either party given thirty(30)days written notice and is
subject to the availability of funding. CONTRACTOR reserves the right to suspend services to clients if
funding is no longer available.
18. Entire Agreement
This Agreement,together with all attachments hereto,constitutes the entire understanding between the
parties with respect to the subject matter hereof,and may not be changed or modified except as stated in
Paragraph 10 herein.
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PY-08-09-CORE-0166
IN WITNESS WHEREOF,the p h o have duly eseduted the Agreement as of the day,month,and year first
above written. ''
ATTEST:
WELD COUN ,tt D OF COUNTY
CLERK TO TH �L% j 11 MISSIONERS WELD
COUNTY,COLORADO
By: By _ Y'G7vI
eputy C'ler Willi�rke,Chair SEP 0 8 2008
A O D AS TO CONTRACT° •
B I�� S/ /
Co Attorney Gayle Christensen,LCSW-Presidentuv
WELD COUNTY DEPARTMENT
OF HUMAN SERVICES
1
By'
Ju .Griego Director
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PY-08-09-CORE-0166
EXHIBIT A
SCOPE OF SERVICES
I. CONTRACTOR will provide offense specific treatment services for juveniles who have committed sexual
offenses and are in the custody of the Department,as referred by the Department. Services include:
a) Individual Therapy—50 minutes per session.
b) OtTense Specific Group Therapy—90 minutes per group.
c) Healthy Sexuality Group—60 minutes per group.
d) OtTense specific services in four(4)phases:
I) Phase I: The juvenile will complete foundation assignments including three
assignments which the juvenile must complete that help the juvenile to
understand the treatment contract,begin to learn empathy,and teach about
informed consent.
2) Phase 2: The juvenile will complete a Sexual History in which the juvenile will
disclose in detail all aspects of their offense,as well as their own sexual
history.
3) Phase 3: The juvenile will write a detailed letter to each victim,in which the
juvenile takes full responsibility for their actions.
4) Phase 4: The juvenile will complete an extensive relapse prevention plan that
details their offense cycle and their present(non-otTending)cycle. The plan is
shared with the juvenile's caregivers and their supervising hoard,probation
officer,caseworker,and others as appropriate.
e) The juvenile will complete a polygraph during Phase 2 and upon exit from Phase 4. The Department will
pay for one(I)polygraph per year per client.
0 Healthy Sexuality Program—The juvenile will learn about health and appropriate boundaries,anger
management,sexually transmitted diseases,birth control,pregnancy,anatomy,informed consent,taking
responsibility for their actions,dating and domestic violence. The program teaches the juvenile how to
have healthy relationships with anyone that they may have a relationship with either intimate,professional
or personal.
2. The Healthy Sexuality Program is usually completed within six(6)months. Offense specific services are
ongoing until the juvenile completes are four(4)phases of the service and pass the required polygraphs.
3. CONTRACTOR works within a restitution based model which requires juveniles to help their victim(s)in
whatever way is most beneficial and appropriate for the victim(s).
4. All services are provided by Master's level clinicians and licensed clinicians under the supervision of a Sex
Offender Management Board(BOMB)Full Treatment Provider.
5. CONTRACTOR will submit a report on a monthly basis for each active referral. Reports will be submitted per
the online format required by the Department,unless otherwise directed by the Department.
6. CONTRACTOR will participate in team reviews of ongoing services as needed.
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PY-08-09-CORE-0 166
EXHIBIT B
PAYMENT SCHEDULE
Funding and Method of Payment
The Department agrees to reimburse CONTRACTOR in consideration for the work and services
performed from Core Services funding,not to exceed$15,000.00.
Expenses incurred by CONTRACTOR,in association with said project prior to the term of this agreement,
are not eligible Department expenditures and shall not be reimbursed by the Department.
Payment pursuant to this Contract,if Core Services funds,whether in whole or in part, is subject to and
contingent upon the continuing availability of said funds for the purposes hereof. In the event that said
funds,or any part thereof,become unavailable as determined by the Department,the Department may
immediately terminate this Contract or amend it accordingly.
2. Fees for Services
$50.00/Hour(Individual or Family Sessions)
$45.00/Hour(Offense-Specific Group Sessions)
$30.00/Week(Healthy Sexuality Group Sessions)
$225.00/Episode(One polygraph per year)
Department referrals will not be sent to collections by Contractor for default of co-pay/fees. Services will
be performed regardless of client's refusal or inability to pay co-pay.
Contractor will collect any applicable sliding scale co-pays and credit the Department for any payments
received on the monthly billing statements.
3. Submittal of Vouchers
CONTRACTOR shall prepare and submit monthly the itemized voucher and certify that the services
authorized were provided on the date indicated and the charges made were pursuant to the terms and
conditions of Exhibit A.
a. All billings are to be submitted by the I0°"day of the month following the month of
service. If the billing is not submitted within twenty-five(25)calendar days of the month
following service, it may result in forfeiture of payment.
b. Billings must be submitted with the attached required forms,Authorization for
Contractual Services,Request for Reimbursement,Client Verification Form and monthly
report. The forms must be submitted with original signatures.
c. For monitored sobriety,proof of services rendered shall be a sign-in sheet with client
signatures or the test result.
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EXHIBIT C
ASSURANCES
CONTRACTOR agrees it is an independent contractor and that its officers and employees do not become
employees of Weld County,nor are they entitled to any employee benefits as Weld County employees,as
the result of the execution of this Agreement.
2. Weld County,the Board of County Commissioners of Weld County,its officers and employees,shall not
be held liable for injuries or damages caused by any negligent acts or omissions of CONTRACTOR-
contracted CONTRACTOR or its employees,volunteers,or agents while performing duties as described in
this Agreement.CONTRACTOR shall indemnify,defend,and hold harmless Weld County,the Board of
County Commissioners of Weld County, its employees,volunteers,and agents. CONTRACTOR shall
provide adequate liability and worker's compensation insurance for all its employees,volunteers,and
agents engaged in the performance of the Agreement upon request,CONTRACTOR shall provide the
Department with the acceptable evidence that such coverage is in etTect.
3. No portion of this Contract shall be deemed to constitute a waiver of any immunities the parties or their
officers or employees may possess,not shall any portion of this Agreement be deemed to have created a
duty of care with respect to any persons not a party of this Agreement.
4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld,State
of Colorado,to expend funds not otherwise appropriated in each succeeding year.
5. If any section,subsection,paragraph,sentence,clause,or phrase of this Contract is for any reason held or
decided to be unconstitutional,such decision shall not affect the validity of the remaining portions. The
parties hereto declare that they would have entered into this Contract and each and every section,
subsection,paragraph,sentence,clause,and phrase thereof irrespective of the fact that any one or more
sections,subsections,paragraphs,sentences,clauses,or phrases might be declared to be unconstitutional or
invalid.
6. No officer,member or employee of Weld County and no member of their governing bodies shall have any
pecuniary interest,direct or indirect, in the approved Agreement or the proceeds thereof.
7. CONTRACTOR assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that no
person shall,on the grounds of race,creed,color,sex,or national origin,be excluded from participation in,
be denied the benefits of,or be otherwise subjected to discrimination under this approved Contract.
8. CONTRACTOR assures that sufficient,auditable,and otherwise adequate records that will provide
accurate,current,separate,and complete disclosure of the status of the funds received under the Contract
are maintained for three(3)years or the completion and resolution of an audit. Such records shall he
sufficient to allow authorized local,Federal,and State auditors,and representatives to audit and monitor
CONTRACTOR.
9. All such records,documents,communications,and other materials created pursuant or related to this
contract shall be maintained by CONTRACTOR, in a central location and shall be made available to
Social Services upon its request,for a period of seven(7)years from the date of final payment under this
Contract,or for such further period as may be necessary to resolve any matters which may be pending,or
until an audit has been completed with the following qualifications: If an audit by or on behalf of the
federal and/or state government has begun but is not completed at the end of the seven(7)year period,or if
audit findings have not been resolved after a seven(7)period,the materials shall be retained until the
resolution of the audit finding.
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10. CONTRACTOR assures that authorized local,federal,and state auditors and representatives shall,during
business hours,have access to inspect any copy records,and shall be allowed to monitor and review
through on-site visits,all contract activities,supported with funds under this Contract to ensure compliance
with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the
performance of the Agreement shall be conducted by appropriate funding sources. The results of the
monitoring and evaluation activities shall be provided to the appropriate and interested parties.
11. This Contract shall be binding upon the parties hereto,their successors,heirs, legal representatives,and
assigns. CONTRACTOR or the Department may not assign any of its rights or obligations hereunder
without the prior written consent of both parties.
12. CONTRACTOR certifies that federal appropriated funds have not been paid or will be paid, by or on
behalf of CONTRACTOR,to any person for influencing or attempting to influence an officer or employee
of an agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of
Congress in connection with the awarding of any Federal contract,the making of any federal grant,the
making of any federal loan,the entering into of any cooperative agreement,and the extension,
continuation,renewal,amendment,or modification of any Federal contract, loan,grant,or cooperative
agreement.
13. CONTRACTOR assures that it will fully comply with all other applicable federal and state laws.
CONTRACTOR understands that the source of funds to be used under this Contract is Core Services
funds.
14. CONTRACTOR assures and certifies that it and its principals:
a. Are not presently debarred,suspended,proposed for debarment,declared ineligible,or voluntarily
excluded from covered transaction by a federal department of agency.
b. Have not,within a three-year period preceding this Agreement,been convicted of or had a civil
judgment rendered against them for commission of fraud or a criminal offense in connection with
obtaining,attempting to obtain,or performing a public(federal,state,or local)transaction or
contract under a public transaction;violation of federal or state antitrust statutes or commission of
embezzlement,theft,forgery,bribery, falsification or destruction of records,making false
statements,or receiving stolen property;
c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity
(federal,state,or local)with commission of any of the offenses enumerated in paragraph I 1(b)of
this certification;and
d. Have not,within a three-year period preceding this Contract, had one or more public transactions
(federal,state,and local)terminated for cause or default.
15. The Appearance of Conflict of Interest applies to the relationship of a CONTRACTOR with the
Department when the CONTRACTOR also maintains a relationship with a third party and the two
relationships are in opposition. In order to create the appearance of a conflict of interest,it is not necessary
for the contractor to gain from knowledge of these opposing interests. It is only necessary that the
contractor know that the two relationships are in opposition. During the term of the Contract,
CONTRACTOR shall not enter any third party relationship that gives the appearance of creating a conflict
of interest. Upon learning of an existing appearance of a conflict of interest situation,CONTRACTOR
shall submit to the Department,a full disclosure statement setting forth the details that create the
appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this
paragraph shall constitute grounds for the Department's termination,for cause,of its contract with
CONTRACTOR.
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16. CONTRACTOR shall protect the confidentiality of all applicant records and other materials that are
maintained in accordance with this Contract. Except for purposes directly connected with the
administration of Child Protection,no information about or obtained from any applicant/recipient in
possession of CONTRACTOR shall be disclosed in a form identifiable with the applicant/recipient or a
minor's parent or guardian unless in accordance with CONTRACTOR written policies governing access
to,duplication and dissemination of,all such information. CONTRACTOR shall advise its employees,
agents,and subcontractor, if any,that they are subject to these confidentiality requirements.
CONTRACTOR shall provide its employees,agents,and subcontractors,if any,with a copy or written
explanation of these confidentiality requirements before access to confidential data is permitted.
CONTRACTOR shall have its employees,agents,and subcontractors, if any,sign a written confidentiality
agreement and shall provide a copy of such agreement to the Department,if requested.
17. Proprietary information for the purposes of this contract is information relating to a party's research,
development,trade secrets,business affairs, internal operations and management procedures and those of
its customers,clients or affiliates,but does not include information(I)lawfully obtained from third parties,
(2)that which is in the public domain,or(3)that which is developed independently. Neither party
shall use or disclose directly or indirectly without prior written authorization any proprietary information
concerning the other party obtained as a result of this Contract. Any proprietary information removed from
the State's site by CONTRACTOR in the course of providing services under this Contract will be accorded
at least the same precautions as are employed by CONTRACTOR for similar information in the course of
its own business.
18. CONTRACTOR certifies it will abide by Colorado Revised Statue(C.R.S.)26-6-104,requiring criminal
background record checks for all employees,contractors,and sub-contractors.
19. Contractor certifies that it shall comply with the provisions of Colorado Revised Statutes (C.R.S.) 8-17.5-
101,et seq. Contractor shall not knowingly employ or contract with an illegal alien to perform work under
this Contract or enter into a contract with a subcontractor that fails to certify to Contractor that the
subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this
Contract. Contractor represents, warrants, and agrees that it (a) has verified that it does not employ any
illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by
the Social Security Administration and Department of Homeland Security, and (h) otherwise will comply
with the requirements of C.R.S. 8-17.5-102(2)(6). Contractor shall comply with all reasonable requests
made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and
Employment. If Contractor fails to comply with any requirement of this provision or C.R.S.8-17.5-101, et
seq., the Department may terminate this Contract for breach and Contractor shall be liable for actual and
consequential damages to the Department.
Except where exempted by federal law and except as provided in C.R.S. 24-76.5-103(3), if Contractor
receives federal or state funds under this Contract, Contractor must confirm that any individual natural
person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. 24-
76.5-103(4) if such individual applies for public benefits provided under this Contract. If Contractor
operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it(a) is a citizen of
the United States or is otherwise lawfully present in the United States pursuant to federal law, (by shall
produce one of the forms of identification required by C.R.S.24-76.5-101, et seq., and (c) shall produce
one of the forms of identification required by C.R.S. 24-76.5-103 prior to the effective date of this
Contract.
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EXHIBIT D
CHILD and FAMILY SERVICES REVIEWS(CFSR)
The Child and Family Services Reviews(CFSR)examines child welfare service outcomes in three areas;Safety,
Permanency and Well Being of families. Colorado's next review will be held in March 2009. For each outcome,
data and performance indicators measure each state's performance according to national standards and monitors
progress over time. Following the review,a Performance Improvement Program(PIP)will be implemented for the
state to enhance services to families.
Additionally,the review will assess statewide,systemic factors to determine if the systems necessary to achieve
positive outcomes for families are in place.
All agencies that contract to provide service to families and children in Weld County must continually strive for
positive outcomes in the areas of safety,permanency and well-being for our youth. In order to insure continued
progress in this area,the Department is requiring providers to comply with a standard assessment and reporting
system which will address these three areas.*
The Department is requesting that provider reports include observations and recommendations regarding clients in a
way that specifically addresses the areas of safety, permanency and well-being. Below are the specific outcomes
that will be assessed by the CFSR in the areas of safety,permanency and well-being,followed by specific
considerations and tasks which must be addressed by the Department contracted providers.
Safety Outcomes
CFSR Outcome Measures
Safety I Children are, first and foremost,protected from abuse and neglect.
Safety 2 Children are safely maintained in their homes whenever possible and appropriate.
Considerations for the Department's providers
• Providers should always consider the following definitions regarding child safety when assessing families.
o Children are considered safe when there are no present dangers or impending danger threats,or
the caregivers' protective capacities control existing threats.
o Children are considered unsafe when they are vulnerable to present or impending danger threats,
and caregivers are unable or unwilling to provide protection.
o Risk is the likelihood(chance,potential,prospect)for parenting behavior that is harmful and
destructive to a child's cognitive,social,emotional and/or physical development,and those with
parenting responsibility are unwilling or unable to behave differently.
• Monthly reports should continually document an assessment of risk and safety concerns and the
interventions that are being offered by the provider to ameliorate those concerns.
• Monthly reports should make recommendations regarding services and/or safety measures that the provider
believes should be implemented to insure safety of the child(ren).
• Providers must specifically document efforts to engage families in services and to control for safety.
Permanency Outcomes
CFSR Outcome Measures
Permanency I Children have permanency and stability in their living situations.
Permanency 2 The continuity of family relationships and connections is preserved for children.
Considerations for the Department's providers:
• Provider reports should always note the primary permanency goal for the child and document how
interventions are working toward achieving that goal.
• Provider reports must indicate progress toward achieving the permanency goal and should make specific
recommendations regarding how the continuation of the service may assist in achieving the goal.
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• Providers should continually provide recommendations about whether any out-of-home placement
continues to be appropriate and should make recommendations regarding when changes in this area should
be made,in the providers'opinion.
• Providers should continually assess family relationships(parent/child,sibling/sibling,extended
family/child,etc.)and should report any concerning relationship issues which may be a barrier to achieving
permanency. Providers should document ongoing efforts to resolve those issues and/or make
recommendations regarding additional services that may be required to address relationship issues.
• Providers must document specific time frames when recommending ongoing services and/or
recommending changes to services and/or placements.
Child and Family Well-Being Outcomes
CFSR Outcome Measures
Well Being I Families have enhanced capacity to provide for their children's needs.
Well Being 2 Children receive appropriate services to meet their educational needs.
Well Being 3 Children receive adequate services to meet their physical and mental health needs.
Considerations for the Department's providers:
• Providers must engage in ongoing assessments of the parents'capacity to appropriately care for their
children and whether or not the service being provided continues to be appropriate. This must be clearly
documented in monthly reports.
• Providers should specifically detail areas of continued concern within the family and make
recommendations regarding whether that provider's service continues to be appropriate. Reports should
also document what barriers may be impeding progress.
• Providers should document any and all observed concerns regarding any child with whom the provider is
working. This should include concerns regarding physical,emotional,educational and behavioral well-
being of the child. When appropriate,providers should make recommendations regarding evaluations
and/or additional services that may address these concerns.
*Standardized reports will be provided and should be utilized by all agencies providing ongoing services to the
Department's families unless otherwise noted.
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