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Home My WebLink About20072847.tiff Kis0 DEPARTMENT OF SOCIAL SERVICES P.O. BOX A ' GREELEY, CO. 80632 Website:www.co.weld.co.us Administration and Public Assistance(970)352-1551 OFax Number(970)353-5215 COLORADO MEMORANDUM TO: Judy Griego - Director FROM: Lesley Cobb - Child Welfare Rate Negotiator DATE: August 23, 2007 SUBJECT: Weld County Addendums to the Agreement to Purchase — State SS-23A Attached please find the Weld County Addendums to the Agreement to Purchase RCCF/TRCCF Services for the following providers: 1) Alternative Homes for Youth—Provider ID 2016 2) Arapahoe House—Provider ID 88692 3) Childrens Ark—Provider ID 4261 4) Childrens Ark—Provider ID 40322 5) Childrens Ark—Provider ID 96480 6) Courthouse Inc. —Provider ID 45724 7) Courthouse Inc.—Provider ID 46050 8) Devereux Cleo Wallace—Provider ID 39794 9) El Pueblo Boys and Girls Ranch—Provider ID 45146 10)Excelsior Youth Centers —Provider ID 45243 11)Griffith Centers for Children Inc. —Provider ID 39212 12)Griffith Centers for Children Inc. —Provider ID 49547 13)Griffith Centers for Children Inc. —Provider ID y1534554 14)Jefferson Hills—Provider ID 88459 15)Jefferson Hills—Provider ID 12284 16)Kids Ark—Provider ID 34340 17)Kids Ark—Provider ID 34341 18)Mountain Crest/Poudre Valley Health Systems— Provider ID 42261 19)Mountain Star Center—Provider ID 13363 20)Namaqua Center—Provider ID 45142 21)Namaqua Center—Provider ID 100889 22)Reflections for Youth, Inc.—Provider ID 1530128 Ss 4.354 23)Reflections for Youth, Inc. —Provider ID 1530130 24)Reflections for Youth, Inc.—Provider ID 1530131 2007-2847 Ccl ise,l.`f a- (ct (CsI3�6�7 CtC ' �S j l0 aoO7 25)Tennyson Center for Children—Provider ID 45205 26)Third Way Center—Provider ID 49487 27)Third Way Center—Provider ID 65346 28)Third Way Center—Provider ID 77810 29)Third Way Center—Provider ID 1507881 30)Turning Point Center for Youth—Provider ID 45179 31)Turning Point Center for Youth—Provider ID 100441 32)Turning Point Center for Youth—Provider ID 1531089 3,3)Youthtrack—Provider ID 11724 4) Ycav1 -rack— 4 p;der ID ina-5 These contracts have been approved for consent by the Board of County Commissioners however; I am requesting your signature along with the Boards to complete these contracts for the FY 2007-2008. If you have any questions please call me at Ext. 6441. WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Alternative Homes For Youth and Weld County Department of Social Services for the period from July 1, 2007 through June 30, 2008. The following provisions, made this / day of U v 4 , 2007, are added to the referenced Agreement. Except as modified hereby, all terms of the Aki-eement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#2016, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.08 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.08 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); a0n- 07812 1 Weld County SS-23A Addendum E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Social Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended,proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County 55-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 11. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Social Services Policy and Procedure Manual. 12. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 13. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 14. Add Paragraph 9 to Section VI. The Director of 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; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Social Services and the Contractor, or by Social Services as a debt to Social Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 15. Add Paragraph 10 to Section VI. The contractor shall promptly notify Social Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five(5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Social Services' Director. The term "litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: ' % ::.�' Weld County t 6-# .r+ =� rgs ,I WELD COUNTY BOARD OF (lag ��, SERVICES, BEHALF OF THE WELD COUNTY DEPARTMENT OF SOCIAL SERVICES By: By: Deputy erk to the Board David E. Long, ha EP 0 5 2007 CONTRACTOR Alternative Homes For Youth 700 West 84th Ave Thornton, CO 80260 WELD COUNTY DEPARTMENT ®o7 OF SOCIAL SERVICES By: irector o7D07-o?'V7 4 Weld County 55-23A Addendum Exhibit A Alternative Homes Exploring Life Experiences for 66 PP Yout -, & Creating Positive Futures j 7 Residential Treatment Program (for youth who have committed sex offenses): AHFY is licensed by the State of Colorado as a 26 bed Therapeutic Residential Child Care Facility (TRCCF) for males ages 13-21. AHFY is also a licensed Residential Child Care Facility (RCCF). The client population is separated by age on two separate units. AHFY is an offense specific (O.S.) treatment facility serving adolescent males with sex offending behaviors. AHFY adheres to and follows the standards and guidelines established by the Sex Offender Management Board (SOMB) which includes providing supervision and oversight of the O.S. Treatment Program by an approved full operating provider. AHFY clinicians are either licensed or provisionally licensed therapists responsible for providing treatment services and coordination of their client's individual treatment plan in collaboration with the Multi-Disciplinary Team (MDT). Clinicians are supervised by the Clinical Director who is a licensed professional counselor approved to provide and supervise Medicaid reimbursable services. Independent Living Program: The Independent Living Program for youth with sexually abusive behaviors provides a step down(less restrictive) program for youth 16 and older who have completed the majority of the core components of their treatment plan and who are preparing to transition back into the community. This program is for those youth who rate as a"low risk" to re-offend but who either require additional support involving a gradual transition or those who do not have the option of returning home or to live with family. The Independent Living program offers the youth continued offense specific treatment and practical application for learning independent living skills. AHFY's Philosophy: AHFY's approach to treatment is child centered and family focused and utilizes"best practice" and strength based interventions for working with youth with sex offending behaviors by following SOMB standards. AHFY's prime directive is ensuring that victim and community safety is paramount. We believe that it is essential to treat the entirety of the sexual abuser and therefore must also address the trauma and sexual victimization that he may have endured. In order to effectively treat children who have suffered trauma, treatment must include a variety of types of therapeutic practices. We have found that talk therapy alone is not as effective as a therapeutic regime that includes a variety of therapeutic modalities and stategies. Therefore, we offer a holistic approach to working with our young clients and their families by providing an array of therapeutic strategies and interventions. Criteria for admission: We recognize that we can not be successful with every client; therefore we are very selective on who we accept into the program. Minimum criteria are as follows: • Youth admitting to sexual offense and who are within the appropriate age range. • Referred from county departments of social services or probation • Youth that are able to be keep themselves and others safe with out constant redirection • For Independent Living Program only- Youth who are assessed as low risk to re-offend and have an MDT that has deemed them appropriate for outpatient or community based treatment. • Prior to be admitted to the program a preliminary assessment must be completed • Youth with current sexual offense adjudications • Youth who are in the process of being adjudicated for a sexually based crime • Youth who have been adjudicated of other crimes, and have inappropriate sexual behavior toward others that were not included in their adjudication,but need to be addressed • Youth who have admitted guilt and are invested in changing their sexually abusive behavior • Youth with adequate intelligence and social functioning(IQ of at least 80) • Youth with sexual or incestuous crimes against other children. 1110 M. Street Greeley CO 80631 (970) 353-6010 FAX (970) 353-5636 Exhibit A SCOPE OF SERVICES Included in the residential treatment package: ▪ Board and Room- each youth shares a room with no more than 2 other youth and receives 3 nutritional meals plus snacks per day. • Case Management- Each client receives a minimum of 10 hours/month of case management provided by the case manager in collaboration with the client's therapist to ensure consistency of care. • Milieu Therapy- The milieu is staffed at a minimum of 1 Youth Advisor for every 10 clients. In addition, a back-up Youth Advisor or a supervisor is available for support during the youth's waking hours. Overnight, during sleeping hours, the milieu is staffed with 1 (awake) Youth Advisor for every 11 clients. Random bed checks are conducted 4 times per hour. A therapist is on-call 24/7. • Survivor's of Sexual Abuse Group- the group meets one time per week at 1 `/z hours per session and is specifically for those clients that are victims of sexual abuse. This is a supportive, therapeutic group facilitated by a Licensed Marriage and Family Therapist and Certified Trauma Therapist. • Healthy Relationships Group- This group meets one time per week and is facilitated by a team of Counselors. This group is psycho-educational in nature and teaches the clients about healthy relationships including healthy sexuality. • Substance Abuse Group Therapy- This group meets one time per week and is only open to those clients that have abused drugs and/or alcohol. The group is facilitated by a Licensed Professional Counselor, Certified Addictions Counselor- Level III and the curriculum is modeled after a curriculum that was accepted by the Alcohol and Drug Abuse Division. • Eye Movement Desensitization and Reprocessing(Francine Shapiro)-We have one Licensed Professional Counselor and an additional therapist that are trained in using EMDR with clients who have experienced severe trauma. EMDR is used in individual therapy as needed. • Parent's Group- Parents group is held every month for at least 1 %z hours per session. This group is conducted by a Master's level therapist and is an opportunity for the client's parents to learn about the concepts their son is learning in treatment as well as offering support for each other. All parents are encouraged to attend and regular attendance in this group is a requirement for the parents to be able to take their sons on pass when applicable. • Mentoring (for Independent Living Program only)- Each client will be assigned a mentor to help him apply the knowledge he is learning on how to be independent including but not limited to using public transportation,job searching and budgeting. • Education and Employment- AHFY provides an on-site education program for both middle and high school levels that includes special education and GED preparation classes. AHFY's education programs are approved by the Colorado Department of Education. For the independent living program; the youth can attend school at the facility, at a community public school or, if appropriate, be working toward their GED. Community employment is also an option for the independent living program participants who will receive assistance with job seeking, completing and submitting job applications and interviewing. • Independent Living Skills- The Independent Living participants meet one time per week to learn various independent living skills including: how to prepare meals, shop on a budget, file taxes, look for a job, prepare a resume, complete a job application, obtain identification, find insurance, apply to college, clean a house, do laundry, maintain good hygiene, use public transportation, open a checking/savings account, write a check,pay a bill, etc. The curriculum incorporates the Casey Life Skills curriculum. • Ongoing risk assessment- Client's level of risk will periodically be assessed using the J-SOAP II(Prentky and Righthand). • Informed Supervision: 2 levels of informed supervision is provided for parents and other approved adults. 1110 M. Street Greeley CO 80631 (970) 353-6010 FAX (970) 353-5636 Exhibit A The following services are provided for Medicaid recipients*;billed to and paid by Medicaid: ▪ Cognitive Behavior Group Therapy- meets 2 times per week for 1 'h hours per session. The group consists of a psycho-educational component and a therapeutic component. This group is facilitated by a Licensed Professional Counselor with Full Operating Level Provider status and co facilitated by a licensed or provisionally licensed therapist. • Individual Therapy- Each client is assigned a therapist. The client will meet with his therapist for a minimum of one hour per week. This therapist will also act as the client's case manager to ensure consistency of care. • Family Therapy- If applicable since some clients entering the program may not have family involved. However, if the youth's family is involved, we feel family therapy is crucial to the overall and lasting success of each youth in treatment. Family therapy is conducted with the same therapist as the client's individual therapist and is scheduled weekly. Regular attendance and participation in.family therapy is a requirement for the parents to be able to take their sons on pass. * These services are also available for non-Medicaid eligible clients on a fee for service basis. MENU OF SERVICES: The Following are Additional Services Available on a Fee for Service Basis (Services may be provided by AHFY or through a third party provider) Psychosexual Evaluation: Alternative Homes for Youth offers Psychosexual Evaluations for an additional charge to the monthly rate. Clients are not required to be in AHFY's programs to be eligible for this service. AHFY offers comprehensive evaluations which include sex history, mental health testing, risk assessment, clinical interview and testing for sexual interest. These evaluations are assembled with written interpretations and recommendations that provide insight for and assist in the supervision and treatment of the individual. Psychological testing includes but is not limited to: 1. Administering the Multiphase Sexual Inventory(MSI) - measures sexual knowledge attitudes and interest in treatment. 2. Shipley Institute of Living-measures a quick intellectual ability score. 3. State -Trait Anger Expression Inventory-2(STAXI-2), provides information about anger and anger behavior. 4. Million Adolescent Clinical Inventory(MACI) is a personality inventory and offers a snapshot at how the adolescent interprets his world. 5. Jessness Inventory-R(JI-R) helps the evaluator to see how the adolescent thinks about anti-social attitudes and behavior. 6. Hare Psychopathy Checklist: Youth Version(PCL: YV) is a diagnostic tool to aid in severe conduct disorders that have a high correlation with psychopathy in adulthood. 7. Substance Abuse Subtle Screening Inventory-A2 (SASSI-A2) helps the evaluator better understand the youth substance abuse issues. 8. Abel Assessment of Sexual Interest(ASI) gives a measure of the youth's sexual interest, both healthy and deviant. 1110 M. Street Greeley CO 80631 (970) 353-6010 FAX(970) 353-5636 Exhibit A Vicarious Sensitization(VS) is a form of conditioning for the treatment of teenage boys who molest younger children. Clients are exposed to an audio taped personal fantasy designed to evoke arousal to children that is followed immediately by an aversive video vignette. The aversive stimuli consist of videotaped portrayals of adolescent sex offenders who must contend with the negative social, emotional, physical, and legal consequences of their crimes against young children. As with other conditioning procedures, many trials are necessary for cues associated with illicit sexual activity to evoke anxiety rather than deviant fantasies or actual abuse. Polygraph Examinations: are scheduled and coordinated by AHFY with a third party licensed polygraph examiner. Refer to Section 7.1 of the SOMB standards for requirements and details of the polygraph examination process. Drug Screening — Saliva or Urine Analysis: AHFY offers either a 6 panel instant oral (saliva) test or a 5 panel urine dip (UA). Both test for Methamphetamine (meth), cocaine, opiates, THC, and amphetamines with the addition of PCP with the saliva screen. Substitutes can be made for meth and THC with the urine dip but no substitutes can be made with the saliva screen. All residents returning from pass receive a UA. This service is also available on an out patient basis. Post Discharge Support Services: on-going support is available in the form of out patient individual and family therapy. For certain youth, this service is highly recommended to increase the chance for long term success and in most cases can be provided by the youth's original therapist to maintain continuity. For more information and pricing on the above fee for service components please contact AHFY's clinical director at 303-881-1247. 1110 M. Street Greeley CO 80631 (970) 353-6010 FAX (970) 353-5636 Exhibit A Alternative Homes for Youth rates for fiscal year July 1, 2007—June 30, 2008 The TRCCF and RCCF daily rate (child maintenance, administrative maintenance and services): $178.08 (see Scope of Services—residential treatment package)plus OS treatment for a total of$197.92*. *Beginning July 1, 2007, offense specific treatment fees will be in addition to the child maintenance, administrative maintenance and services rate and will be charged as a per diem rate of$19.84 (see State guidelines attached) and includes the following: 1 individual session/week 2 offense specific groups/week 1 family/multi-family session per week **Offense specific treatment fees of$19.84 will be waived for youth referred by Weld DSS. Fee for Service rates are as follows: 1. Psychosexual evaluation (includes ABEL Screen) - $775.00 2. Vicarious Sensitization- $35.00 per hour, typically 30 hours in length over 2- 3 months 3. Polygraph Examinations - $275 provided by ri party polygrapher 4. Drug Screening— Saliva or Urine Analysis - $12.00 (see below) 5. Post Discharge Support Services - $45 per hour Drug Screening Services (Saliva or Urine Analysis) Alternative Homes for Youth (AHFY) currently conducts 2 types of drug screens that test for the following substances: • Instant Oral 6 panel : Methamphetamine, cocaine, opiates, PCP, THC and amphetamines (pre-made kits - substitutes cannot be made) • Urine dip 5 panel: Methamphetamine (aka Meth) , cocaine, opiates, THC, and amphetamines (substitutions for meth and THC can be made) The rate for either of the above screens is $12.00 per test* which includes time and materials. *Additional charges may apply if test results need to be sent to a lab for further analysis. WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Arapahoe House and Weld County Department of Social Services for the period from July 1, 2007 through June 30, 2008. The following provisions, made this 1 day of Sv , 2007, are added to the referenced Agreement. Except as modified hereby, all terms of the A//greement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#88692, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.08 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.08 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum ia9-asN7 • E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include,but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Social Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records,making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum • C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 11. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Social Services Policy and Procedure Manual. 12. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 13. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 14. Add Paragraph 9 to Section VI. The Director of 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; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Social Services and the Contractor, or by Social Services as a debt to Social Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 15. Add Paragraph 10 to Section VI. The contractor shall promptly notify Social Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Social Services' Director. The term "litigation"includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written.Ai"ATTEST: ` irt�5%►J9u' Weld County ® � WELD COUNTY BOARD OF , SOCIAL SERVICES, ON BEHALF OF THE WELD COUNTY DEPARTMENT OF SOCIAL SERVICES � I By: , By: 3%. Deputy Cl to the Board David E. Long, C ai SEP 0 5 2007 CONTRACTOR Arapahoe House 8801 Lipan St Tho o CO 80260 By: CA.e-Cs's,.IL,,iffir WELD COUNTY DEPARTMENT OF SOCIAL SERVICES By: 4� Director 4 Weld County SS-23A Addendum • (Exhibit A) Scope of Services Arapahoe House, Inc. Therapeutic Residential Child Care Facility StepWise Program Mental Health Services* • Psychiatric Evaluation • Medication Monitoring • Individual Therapy • Family/ Conjoint Therapy • Group Therapy Routine Medical and Dental Services* Social and Recreational Activities Case Management Child Maintenance • Food • Clothing • Hygiene Supplies • Milieu Therapy Education Services • On Site Accredited School Basic LifeSkills Development Substance Abuse/Dependency Treatment • Treatment Groups • Random Urinalysis Screenings *If client is Medicaid eligible and meets medical necessity treatment is billed Fee for Service (Exhibit A) Arapahoe House le? ill S Help • Hope • „ � • 04 Comprehensive Alcohol , Drug and Behavioral Health Services 8801 Li IYS re a7 Thornton, CO 80260 • Main: 303.657.3700 • Fax: 303.657.3727 • www.arapahoehouse.org Lesley Cobb Weld County DSS PO Box A Greeley, CO 80632 RE: Requested Scope of Work and Rate Dear Lesley: This is a follow up to our phone conversation last Friday. As discussed,the Aspen Center is now the The Aspen Center for Women. The program is for pregnant women with children. I have enclosed the scope of work for our Stepwise Program at Lipan. As discussed we have not received our new rates for the Adolescents at Lipan. However, we charge the rate assigned by the state and you indicated that was $178.08. If you need any additional information,please contact me. Sincerely, oge�� Con cts Administrator 303-412-3678 fhodge@ahinc.org DAVID G.MURPHY,, CHIEF EXECUTIVE OFFICER BOARD OF DIRECTORS:Norma Anderson,President• Thomas Clark • Marilyn Dana • Linda J. Daniel• Lynn Miller Doyle Adrienne Ruston Fitzgibbons•John Fitzgibbons• Lucille "Lucky"Gallagher• Senator Bob Hagedor n • David]. Kohlwey •Ellen Miller-Brown Brian D. Milligan • Scott E.Pope • Christine C. Powers • Marcella C. Rapp •Henry "Hank"Robinson • Lamm Romero rev.12/06 Ex OFFICIO MEMBERS:Many Baca • Goven:or Bill Owens • Commissioner Larry W Pace WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Childrens Ark, Inc and Weld County Department of Social Services for the period from July 1, 2007 through June 30, 2008. The following provisions, made this / day of U crcr , 2007, are added to the referenced Agreement. Except as modified hereby, all terms of the*cement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#4261, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$162.49 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$162.49 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include,but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum am 9- 9T E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Social Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 11. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Social Services Policy and Procedure Manual. 12. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 13. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 14. Add Paragraph 9 to Section VI. The Director of 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; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Social Services and the Contractor, or by Social Services as a debt to Social Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 15. Add Paragraph 10 to Section VI. The contractor shall promptly notify Social Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Social Services' Director. The term "litigation"includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: 1 .'• Weld County Cl`r to I8614 `,-;:t; WELD COUNTY BOARD OF SOCIAL SERVICES, ON BEHALF r .W''...-4, OF THE WELD COUNTY �� : DEPARTMENT OF SOCIAL SERVICES By: By: Deputy Cler o the Board David E. Long, Chai EP 0 5 2007 CONTRACTOR Childrens Ark, Inc 10460 W Hwy 24 Green Mountain Falls, CO 80819 By: C "1-4 WELD COUNTY DEPARTMENT OF SOCIAL SERVICES By: irector 4 Weld County SS-23A Addendum aao-9-aerci WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Childrens Ark, Inc and Weld County Department of Social Services for the period from July 1, 2007 through June 30, 2008. The following provisions, made this / day of tT , 2007, are added to the referenced Agreement. Except as modified hereby, all terms of the Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#40322, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$162.49 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$162.49 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing (3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); ] Weld County SS-23A Addendum aoo awl E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests,plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Social Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 11. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Social Services Policy and Procedure Manual. 12. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 13. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 14. Add Paragraph 9 to Section VI. The Director of 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; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Social Services and the Contractor, or by Social Services as a debt to Social Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 15. Add Paragraph 10 to Section VI. The contractor shall promptly notify Social Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five(5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Social Services' Director. The term "litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: atilt Weld County C c t e fw WELD COUNTY BOARD OF SOCIAL SERVICES, ON BEHALF OF THE WELD COUNTY `rte DEPARTMENT OF SOCIAL SERVICES By: By: c Deputy Clerl o the Board David E. Long, C air P 0.5 2007 CONTRACTOR Childrens Ark, Inc 10460 W Hwy 24 Green Mountain Falls, CO 80819 BY: 9,04, 91 WELD COUNTY DEPARTMENT OF SOCIAL SERVICES By: `K Direct 4 Weld County SS-23A Addendum Goo 9-a8`/7 • WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Childrens Ark, Inc and Weld County Department of Social Services for the period from July 1, 2007 through June 30, 2008. The following provisions, made this / day of O7;Ly , 2007, are added to the referenced Agreement. Except as modified hereby, all terms of the A/greement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#96480, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$162.49 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$162.49 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis,based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-I1-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include,but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Social Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local)transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery,bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 11. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Social Services Policy and Procedure Manual. 12. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 13. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 14. Add Paragraph 9 to Section VI. The Director of 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; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Social Services and the Contractor, or by Social Services as a debt to Social Services or otherwise as provided by law. 3 Weld County SS-23A Addendum • 15. Add Paragraph 10 to Section VI. The contractor shall promptly notify Social Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five(5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Social Services' Director. The term"litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: gill Weld County rk IF6.1 �, WELD COUNTY BOARD OF rN,''' SOCIAL SERVICES, ON BEHALF 1,2 ti-nt / OF THE WELD COUNTY ?` , DEPARTMENT OF SOCIAL ".. SERVICES By: By: F Deputy Clei c to the Board avid E. Long, Chai S 0 5 2007 CONTRACTOR Childrens Ark, Inc 10460 W Hwy 24 Green Mountain Falls, CO 80819 By: flnM 7x,6_ - WELD COUNTY DEPARTMENT OF SOCIAL SERVICES By: ct irector 4 Weld County SS-23A Addendum Qoo 7 -, ce9i WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Courthouse Inc. and Weld County Department of Social Services for the period from July 1, 2007 through June 30, 2008. The following provisions, made this day of , 2007, are added to the referenced Agreement. Except as modified hereby, all terms of the Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#45724, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.08 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.08 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include,but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum o?oo7- at97 • E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Social Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery,bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum • C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 11. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Social Services Policy and Procedure Manual. 12. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 13. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 14. Add Paragraph 9 to Section VI. The Director of 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; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Social Services and the Contractor, or by Social Services as a debt to Social Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 15. Add Paragraph 10 to Section VI. The contractor shall promptly notify Social Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Social Services' Director. The term "litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: a" 1 Weld County c t e Bbl I. °� 1 } — " WELD COUNTY BOARD OF k, J/ SOCIAL SERVICES, ON BEHALF -.. �4 y OF THE WELD COUNTY `-- i'k <7=. DEPARTMENT OF SOCIAL t 1 SERVICES By: ' pitt 'fj By: :. C.a Deputy Clerk the Board David E. Long, C i ai 0 5 2007 CONTRACTOR Courthouse Inc. 333 W Hampden Ave, Suite 305 Englewood, CO 80111-2333 BY: _//zlpx/tid�1 t= WELD COUNTY DEPARTMENT OF SOCIAL SERVICES By: erector 4 Weld County SS-23A Addendum ,2DD 2- 'd'9 2 WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Courthouse Inc. and Weld County Department of Social Services for the period from July 1, 2007 through June 30, 2008. The following provisions, made this / day of jiiti , 2007, are added to the referenced Agreement. Except as modified hereby, all terms of the Xgreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#46050, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.08 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.08 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing (3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child(30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum a007- a8 � ' E. Other/miscellaneous items considered usual in the care and supervision of the child, include,but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Social Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 11. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Social Services Policy and Procedure Manual. 12. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 13. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 14. Add Paragraph 9 to Section VI. The Director of 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; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Social Services and the Contractor, or by Social Services as a debt to Social Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 15. Add Paragraph 10 to Section VI. The contractor shall promptly notify Social Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Social Services' Director. The term "litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: fat/ Weld County erl 6 ?�'' - WELD COUNTY BOARD OF ' .- SOCIAL SERVICES, ON BEHALF �' OF THE WELD COUNTY J r 1 DEPARTMENT OF SOCIAL SERVICES 77 By: By: Deputy Cler to the Board David E. Long, h 'r S 0 S 2007 CONTRACTOR Courthouse Inc. 333 W Hampden Ave, Suite 305 Englewood, CO 80110-2333 By:7 174(Al �Lf L- ' WELD COUNTY DEPARTMENT OF SOCIAL SERVICES By: iI\D rector 4 Weld County SS-23A Addendum aOD7- ae92 ' WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Resid&nti4,Child Care Facility Services and Residential Child Care Facility ServicesVie", "Agreement") between Devereux Cleo Wallace and Weld County Department of Social Services for the period from July 1, 2007 through June 30, 2008. The following provisions, made this l day of v� // , 2007, are added to the referenced Agreement. Except as modified hereby, all terms of the Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#39794, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.08 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.08 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Depachuent of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County,prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Social Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery,bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 11. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Social Services Policy and Procedure Manual. 12. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 13. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 14. Add Paragraph 9 to Section VI. The Director of 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; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Social Services and the Contractor, or by Social Services as a debt to Social Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 15. Add Paragraph 10 to Section VI. The contractor shall promptly notify Social Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Social Services' Director. The term "litigation"includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: ^" " / Weld County rk �� ,s,i (f ?si WELD COUNTY BOARD OF SOCIAL SERVICES, ON BEHALF OF THE WELD COUNTY DEPARTMENT OF SOCIAL - SERVICES By: v1�_ R ��GGlif> By: �o Deputy Cler1,to the Board David . Long, Char 0 5 2007 CONTRACTOR Devereux Cleo Wallace 8405 Church Ranch Blvd Westminster, CO 80021 By: Iturai WELD COUNTY DEPARTMENT OF SOCIAL SERVICES By: irector 4 Weld County SS-23A Addendum 0712.02-acfy7 WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between El Pueblo Boys' and Girls' Ranch and Weld County Department of Social Services for the period from July 1, 2007 through June 30, 2008. The following provisions, made this ) day of L)v/y , 2007, are added to the referenced Agreement. Except as modified hereby, all terms of the Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#45146, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.08 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.08 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include,but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing (3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); ] Weld County 55-23A Addendum ao®7- R8 '7 • E. Other/miscellaneous items considered usual in the care and supervision of the child, include,but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests,plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Social Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum • C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 11. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Social Services Policy and Procedure Manual. 12. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 13. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 14. Add Paragraph 9 to Section VI. The Director of 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; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Social Services and the Contractor, or by Social Services as a debt to Social Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 15. Add Paragraph 10 to Section VI. The contractor shall promptly notify Social Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Social Services' Director. The term "litigation"includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: 1 / Weld County er tI e�b IS61 '1': ' 9I,.9 I x " A -1 WELD COUNTY BOARD OF 14 :, a-i SOCIAL SERVICES, ON BEHALF �-V 1,,,q`v. OF THE WELD COUNTY DEPARTMENT OF SOCIAL SERVICES %' 9 .7 By: By: \, _ Deputy Clerk o the Board David E. Long, Ch.i S.j' 0 S 2007 CONTRACTOR El Pueblo Boys' and Girls' Ranch One El Pueblo Ranch Way Pueblo, CO 81006 By: ccp C1Cu`w WELD COUNTY DEPARTMENT OF SOCIAL SERVICES By: a 'rector 4 Weld County SS-23A Addendum &o02- 4%7SY? I Exhibit A CONFIDENTIAL FOR PROFESSIONAL USE ONLY DO NOT FORWARD OR DUPLICATE TO ' OTHER AGENCIES OR INDIVIDUALS Mission El Pueblo...an Adolescent Treatment Community is a private, non-profit organization serving the needs of at-risk youth and their families. By creating an environment of safety and loving care, I1 youth and their families learn the skills they need to become productive members of the community. l Vision El Pueblo...an Adolescent Treatment Community is a financially secure youth treatment center meeting the needs of a diverse population from an expanded community by maintaining the 1, highest standard of care. We believe our vision is unique and sets us apart from any other residential treatment facility. It tells internal and external stakeholders that El Pueblo is different, and we are prepared to communicate what makes us singular and unequaled. Having such vision allows us to attract and retain employees, customers, and investors. '.I LE Ii s` rir a V S / S is I ii "Our goal is to restructure the child's thoughts, perceptions, and beliefs. " ©2007, El Pueblo...an Adolescent Treatment Community Pueblo, CO. Rev. 06/26/07/elr Exhibit A CONFIDENTIAL FOR PROFESSIONAL USE ONLY DO NOT FORWARD OR DUPLICATE TO OTHER AGENCIES OR INDIVIDUALS Treatment Philosophy Any child who meets the admission criteria set forth by El Pueblo and who is accepted into its' program shall receive the prescribed treatment without prejudice to race, color, creed, gender, a sexual orientation or socio-economic background. El Pueblo believes that its' Residents have the capacity to succeed with emotional support and guidance from adults. All Residents' opinions and their views of life experiences are respected. Residents' views of self are validated and a positive approach is offered to make decisions for their present and future according to their hopes and wishes. Effective treatment is rendered with sensitivity, compassion, and respect to the dignity of the Residents; never with ridicule, shame or intimidation. Treatment is not punitive in nature, nor does it dwell on the negative behaviors, but emphasizes the Residents' strengths and reinforces positive behavior. Residents are counseled to take responsibility for the natural consequences of their behaviors. Good choices for positive behaviors are rewarded. El Pueblo's primary concerns in treatment are to meet the needs of the Resident, rather than the j therapeutic agent, and to move the Resident at a pace that is not threatening. Through the El Pueblo Performance Program for Youth®, skills are taught and opportunities are provided for the Resident to apply their learning and ensure that additional skills are built upon previous learning. El Pueblo believes that the Residents will modify their behavior in response to positive feedback and encouragement, and that they will dismiss undesirable behaviors as a result of strengthening their positive view of self. I I I I I ©2007, El Pueblo...an Adolescent Treatment Community 2 Pueblo, CO. Rev. 06/26/07/elr CONFIDENTIAL Exhibit A FOR PROFESSIONAL USE ONLY DO NOT FORWARD OR DUPLICATE TO OTHER AGENCIES OR INDIVIDUALS Population Served El Pueblo serves boys and girls ages 10— 18 without regard to race, color, creed, national origin, sex, sexual orientation, religion, age, disability or other legally protected status in admission to, access to, or operations of its programs, services or activities. All youth served at El Pueblo have a psychiatric disorder as described in DSM IV. Male clients may also be classified as sex offenders, have severe cognitive behavioral disorders, substance abuse issues, or cognitive delays. Female clients may also have cognitive behavioral disorders and/or substance abuse issues. The boys are served through the following programs: CHANGE Commitment, Honor, Achievement and New Growth Experiences OSTAY Offense Specific Treatment of Aggressive Youth STRIVE Strength, Teamwork, Respect,Independence, and Vision for Excellence The girls are served through the SPIRIT (Self, Pride, Integrity, Resiliency and Independence Training)Program. Both boys and girls with substance use/abuse issues are served through the Substance Education and Addiction Recovery (SEAR) Program Residents accepted to El Pueblo exhibit behaviors that indicate that they cannot be adequately or safely treated in a less restrictive setting. Referred residents typically present with issues of lying,; stealing; running away; substance abuse; school expulsion; sexual promiscuity; fire setting; history of being abused or neglected and inability to function in school, home, or foster care. The typical resident has failed in outpatient treatment and foster care. Typical diagnosis would be Post Traumatic Stress Disorder; Oppositional Defiant Disorder, Mood Disorders, Bipolar Disorder; Attention —Deficit Hyperactivity Disorder; Substance Abuse or Dependence; Cyclothymic Disorder;Dysthymic Disorder; other Depressive Disorders, and Anxiety Disorders. Staff Ratio Staff ratios are as follows: • Therapeutic Cottages 6:1 • Reflection Centers 4:1 • Donegan Hall 6:1 • Transition Houses 10:1 • STRIVE Cottages 3:1 ©2007, El Pueblo...an Adolescent Treatment Community 3 Pueblo, CO. Rev. 06/26/07/elr Exhibit A • CONFIDENTIAL FOR PROFESSIONAL USE ONLY DO NOT FORWARD OR DUPLICATE TO OTHER AGENCIES OR INDIVIDUALS Admission Criteria El Pueblo accepts Boys and Girls that meet the following Admission Criteria • Must be between the ages of 10— 18 years • Must have no active psychosis. • Must have an IQ sufficient for comprehension of treatment material (functioning of 70 or above), and reading and writing skills of at least third grade level. o For children with an IQ lower than 70, please refer to the PROGRAM ENHANCEMENTS — STRIVE PROGRAM for specific program admission criteria. • Must be willing to participate in treatment. • Must meet DSM IV medical necessity criteria for residential treatment center placement. o Must have a psychiatric disorder as described in DSM IV. o The adolescent is being treated in the most appropriate and least restrictive setting. o The severity of illness must make it impossible to manage the treatment in a normal home environment or in an alternate living situation such as a group home, foster care placement, etc. o One or more of the following Severity of Illness Criteria must be met. • Impaired ability to maintain/sustain adequate functioning in three of the major life areas (school, social, family, and psychosocial) • Significant risk of harm to self and/or others such as substance abuse, aggression, or self-abusive behavior. • Demonstrated inability to be managed in a less restrictive setting. • Inability to cope with stressors without victimizing self or others. o The parent/guardian/family member or custodian accepts responsibility for participating in the treatment program and/or permanency planning. \ o Planned treatment services can reasonably be expected to improve the adolescent's conditions. Potential exclusion criteria • Requiring a locked facility — El Pueblo...an Adolescent Treatment Community is not a locked facility. • Acute Level of Violence — If a youth presents a level of violence that is considered li unmanageable at this level. For example a youth who is being charged for murder or major assaults against staff and/or peers. The Director of Clinical Services evaluates the behavior of each youth on a case-by-case basis. • Acute Inpatient Medical / Surgical Care — A youth who may have a medical condition that may require intense medical care • Refusal to Contract for Safety — A youth who is actively suicidal or homicidal and refuses to contract for safety. The Director of Clinical Services will also evaluate the behavior of a youth who has or may have recently tried to commit suicide. ©2007, El Pueblo...an Adolescent Treatment Community 4 Pueblo, CO. Rev. 06/26/07/elr 1 Exhibit A CONFIDENTIAL FOR PROFESSIONAL USE ONLY DO NOT FORWARD OR DUPLICATE TO OTHER AGENCIES OR INDIVIDUALS II Referral Process 1. Contact Admissions Department at 719-404-1107 to ascertain bed availability and potential length of wait for an opening. 2. A referral packet will be required which consists of the following: • A Psychological Evaluation completed within the past three years (must provide I.Q. and diagnosis). • Documentation of current problems, that bring about the need for placement and current medications. • Family and Social History, to include previous treatment and/or placements, and resident and family response to treatment. • A police report, investigation or interview, polygraph results, and other documents will be requested if the youth is accepted to assist in breaking through the denial of the problems. 3. Clinical Director and Admissions Officer will review the material to conduct a preliminary assessment of presenting problems in social, physical health, mental health, psychological concerns, physical and/or sexual abuse, and any concerns about assaultive or destructive behavior. The youth's motivation and ability to benefit from the treatment program are also assessed. If it is determined that El Pueblo is the least restrictive setting and appropriate to meet the youth's needs, the Admissions Officer will contact the referring person and inform them of the youth's acceptance or non-acceptance into the program within 48 hours of receipt of the additional referral information. Possible admission dates will be identified at that time. The Admissions Officer will mail admission consents and releases required for intake to the parent(s) of the youth to facilitate a smooth intake process. 4. Copies of the youth's birth certificate, social security card, immunization record and record of last school attended will be required prior to actual admission. Treatment Approach The El Pueblo Boys' & Girls'Ranch Performance Program for Youth© is based on a Positive Cognitive Behavioral approach to deal with the biological, psychological, intellectual, spiritual, and social needs of the children placed in our care. The staff use a psychotherapeutic approach to help promote positive change in the boys and girls, to help alleviate emotional distress, and to address a myriad of psycho/social/behavioral issues. Our Rehabilitative Services Teams identify and treat difficulties arising from a child's irrational thinking, misperceptions, dysfunctional thoughts, and faulty learning. Therapy is conducted individually with the youth, and collectively with their families. ©2007, El Pueblo...an Adolescent Treatment Community 5 Pueblo, CO. Rev. 06/26/07/elr Exhibit A • CONFIDENTIAL FOR PROFESSIONAL USE ONLY DO NOT FORWARD OR DUPLICATE TO OTHER AGENCIES OR INDIVIDUALS A holistic approach to treatment is sought with a consistent message being delivered throughout the various components of the program — clinical, milieu, education, and recreation and leisure. The El Pueblo Boys' & Girls' Ranch Performance Program for Youth© incorporates — structure, discipline, consistency, safety, and positive reinforcement. Our goal is to restructure the child's thoughts, perceptions, and beliefs. Such restructuring facilitates behavioral and emotional change. During therapy and daily milieu, coping skills and abilities are assessed and further developed. The El Pueblo Boys' and & Girls'Ranch Performance Program for Youth© consists of five performance standards: Performance Standard I: Orientation& Evaluation Getting to Know Self/Getting to Know the Rules of El Pueblo Performance Standard II: Skill Development Improving Self Performance Standard III: Self Development Enhancing Self-Esteem & Self Worth Performance Standard IV: Social Application Applying Learned Skills Performance Standard V: Leadership Choosing Service over Self Interest Treatment Review Rehabilitative Services Team Rehabilitation teams consist of the therapist, recreation staff, milieu staff, nursing, and education personnel. The rehabilitation team meets every week. Individual residents are reviewed to ensure collaboration and coordination of services. Residents who are eligible for Performance Standard advancement come before the rehabilitation team for an oral exam and review of accomplishments. Advancement to the next Performance Standard is determined by this team. Residents who are exhibiting significant behavioral problems are also required to come before this team to address the problematic behaviors. Individual plans or contracts to help the resident with behavioral improvement are developed in the rehabilitation team meeting. In addition, privilege requests are reviewed for team approval. The rehabilitation team makes recommendations for discharge. Provisions of Care Clinical Services Treatment is individualized based on the child's needs. Clinical Services are administered by Master's level therapists who have credentials as L.P.C.'s, C.A.C. III's, L.A.C, M.S.W., and 0 2007, El Pueblo...an Adolescent Treatment Community 6 Pueblo, CO. Rev. 06/26/07/elr Exhibit A • CONFIDENTIAL FOR PROFESSIONAL USE ONLY DO NOT FORWARD OR DUPLICATE TO OTHER AGENCIES OR INDIVIDUALS ' A.T.R. Several of El Pueblo's therapists have training in Dialectic Behavior Therapy (DBT) and Eye Movement Desensitization Replacement Therapy (EMDR). With this specialized training, treatment can more effectively address self-harm behavior, trauma, victimization and sexually reactive problems, sexual compulsivity, and sexual abuse behavior. Individual Therapy Individual therapy is provided by Master's level, licensed therapists who build on the child's strengths, are goal oriented, and individualize treatment based upon the individual presenting problems and ability to participate in treatment. Themes in individual therapy are derived from the Individual Comprehensive Service Plan and are focused on building skills, self awareness, and resolution of conflicts around historical events and current problems with functioning in the community. The frequency of individual therapy is determined by the resident's Individualized Comprehensive Service Plan. Typically individual therapy takes place once a week when the resident is in early stages of treatment and may be increased or decreased as needed. Family Therapy Family therapy will be scheduled as soon as the resident has stabilized; usually within 7 to 10 days of admission. Family sessions will be conducted from one time per week to one time per month depending upon parent's ability to come to El Pueblo. Telephone conference calls may be used for residents whose parents live a significant distance from the facility. As the resident approaches the last three months of his treatment at El Pueblo, parents will be asked to participate in family therapy on a more frequent basis. Group Therapy Residents are assigned to specific groups based upon the treatment needs. A variety of topics are offered on a rotating basis. Groups offered include, but are not limited to the following. Anger Management, Thinking for a Change, Survivors, DBT, Healthy Sexuality, Self Esteem, Guided Imagery, Boys to Men, Child of Addicts, Social Skills, Stress Management, and Substance Abuse treatment. Psychiatric Services El Pueblo has a half-time psychiatrist who provides case supervision and medication management services. Interdisciplinary staffings are held on a monthly basis with the on-staff psychiatrist. ©2007, El Pueblo...an Adolescent Treatment Community 7 Pueblo, CO. Rev. 06/26/07/elr CONFIDENTIAL Exhibit A FOR PROFESSIONAL USE ONLY DO NOT FORWARD OR DUPLICATE TO OTHER AGENCIES OR INDIVIDUALS Medical Services All residents at El Pueblo are provided medical services. A physical examination is scheduled at Pueblo Community Health Center (PCHC) after admission unless a physical examination has been completed within 30 days. All residents are registered at PCHC. Request for medical/health services or information are forwarded to the nursing department via a Medical Needs Screening Sheet, which is responded to by the nursing department. Requests for immediate medical services are sent to the medical/nursing department for prompt responses. New residents are also scheduled for dental services at Takaki Dental or at their private dentist if appropriate. Eye examinations are done at Abba eye care, who provide glasses for residents. All medication administered to El Pueblo residents is ordered by the onsite psychiatrist. Medication coming in with residents is continued until seen by the onsite psychiatrist. Medication consents are obtained from family/guardian or caseworker prior to administration. Medication teaching is done by the psychiatrist and nursing staff at El Pueblo. Medications are obtained from a local pharmacy and refilled as necessary. Medication is administered by licensed nursing staff and by qualified medication administrators who pass a State of Colorado class and test. Medication administration is monitored by the Milieu Director and by the Nursing Department. Medications for medical conditions are ordered by Pueblo Community Health Center (PCHC) or by area health providers. They are dispensed by the local pharmacy or by Walgreen's pharmacies after hours. All medications administered are recorded on agency approved medication administration sheets. Prescription Not Required (PRN) medications are recorded on PRN sheets which indicate the condition for which the medication is given and the resident's response to the medication. Controlled drugs are counted each shift and documented on a control drug sheet when administered. When residents are transferred from one cottage to another, medications are counted and a medication transfer sheet is attached to the medication and sent to the receiving cottage. When residents are not Medicaid-eligible, services are arranged utilizing private insurance carriers. Milieu Services Residents benefit from 24 hour structured milieu services. The milieu program provides repetitive learning scenarios with immediate rewards of increased levels of freedom and privileges. The Performance Standards also offers a resident immediate feedback, and a chance for processing. Natural consequences occur when a resident does not comply with the daily schedule. The Performance Standards Program is also used as a tool to monitor the general health of the milieu. Residents must meet the requirements of each Performance Standard as to daily behaviors, learning, therapeutic components, and academic and recreation criteria to be eligible to advance to the next Performance Standard. ©2007, El Pueblo...an Adolescent Treatment Community 8 Pueblo, CO. Rev. 06/26/07/elr CONFIDENTIAL Exhibit A FOR PROFESSIONAL USE ONLY DO NOT FORWARD OR DUPLICATE TO OTHER AGENCIES OR INDIVIDUALS Crisis Intervention All staff members are trained in crisis intervention techniques. El Pueblo emphasizes using crises as opportunities for learning. Residents are taught to recognize their "triggers" and to learn to intervene in their cycle of dysfunctional behavior in response to these triggers, thereby acquiring new skills for effective daily living. Social Skills Training Youth Service Workers provide ongoing social skills training. Recreation and Leisure Therapy . El Pueblo takes a holistic approach to healing each child. The recreation and leisure therapy component exposes the boys and girls to healthy lifestyle choices, community service involvement, and allows the kids to explore a variety of activities to learn how to make personal choices about their likes and dislikes. Some of the activities include: 4-H, the miniature horse program, student council, team and individual sports, and Girl Scouts. The kids learn how to engage in positive outlets for energy and anger release. There are regularly scheduled recreational events as well as special events. Residents will have organized staff-directed and supervised recreation activities for at least one hour a day. Part of the recreation schedule will include three hours per week of instruction from a recreation specialist who is under the supervision of a Certified Therapeutic Recreation Specialist. El Pueblo provides two distinct recreational programs; a stimulation/skill building program and a support/maintenance program. Both programs are designed to promote the independence and self-care capabilities of the residents. Each resident is placed in one of the following programs based on information collected through a recreational needs assessment process. The stimulation/skill building program is designed to service the residents in the STRIVE Program. Recreation specialists conduct group activities that are designed to address teamwork, trust, behavior, motor functioning, intellectual functioning, perceptual skills and community reintegration. The support/maintenance program serves the general population who need continued support to prevent regression and teach healthy lifestyles. Recreation specialists conduct group activities that are therapeutically designed to address teamwork and trust. At the end of each activity, the specialists process with the residents to assist them in gaining an ©2007, El Pueblo...an Adolescent Treatment Community Pueblo, CO. 9 Rev. 06/26/07/elr Exhibit A CONFIDENTIAL FOR PROFESSIONAL USE ONLY DO NOT FORWARD OR DUPLICATE TO OTHER AGENCIES OR INDIVIDUALS understanding of their interactions with others. In addition, residents will have one hour a day of physical fitness exercises with large muscle activity. The key difference between the stimulation/skills building program and the support/maintenance program, are the special staff-directed interventions and activities to meet individual goals. Education Services El Pueblo...an Adolescent Treatment Community operates the El Pueblo School, (approved as an alternative school by the Colorado Department of Education), an on-site school that ensures continuous learning for every child. Residents receive 6 hours of educational programming daily, Monday through Friday and work at their own level and pace in an individualized instruction program. Residents have sociaUbehavioral and instructional needs that must be addressed in the educational setting. Residents are scheduled for classes according to both socialbehavioral interventions and instructional needs. Record review, testing, classroom observation and assessment determine instructional needs. Residents earn education credits that can be transferred to the next school district in which the child may reside. In addition to academic instruction, educational programming includes physical education, and basic life skills. Teachers are State of Colorado certified teachers. Paraprofessionals provide teacher aide services and individual tutoring to students. Teamwork is emphasized with both the teachers and youth service workers. Collaboration and cooperation is foundational to educational services. ©2007, El Pueblo...an Adolescent Treatment Community 10 Pueblo, CO. Rev. 06/26/07/elr • • WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Excelsior Youth Centers and Weld County Department of Social Services for the period from July 1, 2007 through June 30, 2008. The following provisions, made this / day of v'CI , 2007, are added to the referenced Agreement. Except as modified hereby, all terms of the Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#45243, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.08 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.08 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing (3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum ao92- RW1 • E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Social Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum • C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 11. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Social Services Policy and Procedure Manual. 12. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 13. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 14. Add Paragraph 9 to Section VI. The Director of 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; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Social Services and the Contractor, or by Social Services as a debt to Social Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 15. Add Paragraph 10 to Section VI. The contractor shall promptly notify Social Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Social Services' Director. The term "litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: Weld County rk' `9ft1 1, ' ! WELD COUNTY BOARD OF tr-k SOCIAL SERVICES, ON BEHALF ; OF THE WELD COUNTY DEPARTMENT OF SOCIAL SERVICES By: � q d�J I yLCL i4s�� By: _• ' Deputy Cler to Board David E. Long, Cha r SEP1 1 S 2007 CONTRACTOR Excelsior Youth Centers 15001 E. Oxford Ave Aurora, CO 80014 13),;__,4 c_ ) 1C 'J �1 l Q 9 Th WELD COUNTY DEPARTMENT OF SOCIAL SERVICES By: irec 4 Weld County SS-23A Addendum aov 7-a ef97 Exhibit A PROGRAM DESCRIPTION MISSION • Excelsior Youth Center is committed to the treatment and education of young females to enhance their successful re-integration into their families and their communities. I. GENERAL DESCRIPTION A. Excelsior Youth Centers,Inc., 15001 East Oxford Avenue, Aurora, Colorado, 80014-303-693- 1550,a Colorado Non-Profit Corporation.Located 30 minutes from Denver International Airport, Excelsior sits on 33 acres of land with 11 individual cottages, generally housing up to 18 clients each B. Licensed through the State of Colorado and accredited through the Council on Accreditation (COA). C. Licensed capacity-204/Average capacity—179 D. General Overview-Excelsior Youth Center offers therapeutic residential and day treatment for adolescent females with emotional and behavioral disturbances. A full curriculum,North Central Association accredited Junior-Senior High School is located on the campus. The Excelsior program emphasizes four primary program components: formal therapy,recreation, daily living skills,and education. E. Length of stay range is from 6 months through completion of program.Average length of stay is 13 months. II. POPULATION SERVED A. Sex—female B. Age Range- 11-21 years C. The most common diagnoses include mood/depressive disorders, conduct and oppositional defiant disorders, post traumatic stress, substance abuse, reactive attachment and attention deficits. D. General Characteristics-psychiatrically and behaviorally disturbed girls between the ages of 11 and 21 years. III. INTAKE CRITERIA AND ADMISSION PROCEDURES A. Excelsior accepts adolescent girls with a broad range of emotional and behavioral problems and levels of functioning. Referrals considered appropriate for placement will meet the following criteria: • intellectually functioning above a mildly retarded level • potential to behave appropriately and safely within the treatment milieu • potential for insight and understanding • assaultive or self destructive behaviors that are manageable • not able to function in a program with a lower level of services or less restrictive setting • not pregnant,with exceptions determined by Executive Director Included among the problems are depression,withdrawal,chronic runaway,substance abuse, delinquency and pre-delinquency, self-abuse, assaultive and aggressive behavior, sexual acting out, inability to function within the family, inability to function in the public school classroom,etc. Exhibit A Requirements for admission are clearly communicated to referral sources and, when appropriate,to the prospective client's family. They are given enough information about the care or services to make a knowledgeable decision about whether to make the placement. B. Excelsior prides itself on an accelerated referral process. It is our policy that a decision regarding a referral be given to the referring agencies within 48 hours of receipt of background materials. Admission times vary throughout the year depending on length of waiting list and turnover factor: We do not discriminate in any way as to the routing a referral must take. It can be through an agency,insurance company or a private individual. An application can be completed by phone or referral letter to our Admissions Director. A comprehensive review of background history and treatment, educational,and medical information is completed prior to excluding any child for admissions. C. Insurance coverage and managed care arrangements are explained as part of the referral and admissions process when applicable. Insurance and managed care utilization reviewers as well as case management professionals may contribute to clinical decisions. IV. TREATMENT A. Treatment Modalities—The program promotes development in the areas of physical, cognitive, emotional,moral,social and sexual growth in addition to a philosophic base that is implemented through a Phase/Level system. Excelsior uses individual psychotherapy, group therapy, and family therapy as its primary treatment modalities.The programs that address those areas include life skills,parenting,cultural diversity,recreational,milieu therapy,and spiritual counseling. B. Within the framework of Reality Therapy principals a variety of treatment tools and techniques are used to best meet the individual needs of each client Among these are: • Dialectical Behavioral Therapy • Gender specific programming • Animal assisted therapy • Eye Movement Desensitization Response • Play,art,movement therapies C. Therapists are responsible for the delivery of casework services to each client enrolled. These services are planned and documented in the client's initial Master Treatment Plan, and reviewed and updated quarterly by her treatment team. D. Professional Services — Excelsior has full time, on site psychiatric services available for assessments and consultations. A psychiatric screening is completed on each newly admitted client and psychological testing may be completed if a need is indicated. Excelsior contracts with a local community physician who is responsible for consultation with our medical staff, nurse practitioner and nurses. Other specialists in the.medical community are available for services to our clientele. E. Community Resources—Excelsior is associated with several national and community outreach groups. These groups offer opportunities for our clients to develop leadership skills, promote physical fitness and safety, address barriers that impede clients from realizing successful, independent and fulfilling lives. Theses programs include: 1. Artreach-a community service organization that provides our clients access to art,sporting, and cultural events while developing the ability to express themselves. 2. National Sports Center for the Disabled - an organization that offers many fun, physical activities like skiing (down hill and cross country), snowboarding , and mountain biking, for the developmentally or physically challenged. Exhibit A 3. Girls, Inc. - an organization for the empowerment of girls that encourages them to master challenges and build self esteem to help them achieve confidence and responsibility. 4. Chill-a program sponsored by Burton Snowboards that teaches snowboarding skills. 5. Open Fairways-a non-profit organization dedicated to improving the lives of at risk youth through the game of golf, and it core values of honor,etiquette and respect, on and off the course. 6. Junior Optimist-a program with the goal to bring together a group of young people who will become active and involved in helping both their communities and society.They sponsor the on campus JO01 Club and the Girl of the Month Recognition program. In addition, Excelsior also engages the girls in a variety of community projects, arts and craft activities,cultural programming,fitness programs,and women's awareness issues. F. Recreation- Excelsior's Recreational staff plan all campus , off campus recreational activities , and fitness programming to promote healthy, age appropriate activities for all the clients. They are current on youth development trends and programming frameworks, and incorporate them into the year round, comprehensive recreational activities. In addition we offer the "Special Friends"program by interviewing,screening and selecting individuals or families who wish to act as resources and friends to our clients. Excelsior has several athletic teams as well as an award winning,competitive Step Team. G. Excelsior offers a full continuum of care,from the Treatment and Learning Center(a short term, highly staffed behavior modification based unit for clients needing stabilization)to the Day Treatment Program. Unlike many therapeutic residential facilities,Excelsior has an Intervention Unit,a separate area where clients experiencing an immediate crisis can be kept safe. We can also provide a Supervised Independent Living program for youth who demonstrate a mastery of living skills in the areas of health care,money management,and have a general knowledge of the responsibilities involved in living independently. Acceptance of clients to the Supervised Independent Living program is by special permission of the Director of Treatment Excelsior provides access to services 24 hours per day and 7 days per week for the clients in the Supervised Independent Living program.The program will address the acquisition of life skills which include sex education,job ethics,utilization of leisure time,healthy decision making, budgeting,money management,accessing health care and mental health care resources,in addition to food and clothing management. V. TREATMENT GOALS AND TIME FRAMES A. Objectives-Excelsior's desire is that each of its clients achieve a level of functioning that would be considered optimal in light of her capacities. Therapy is done within the framework of reality therapy principles which stresses individual responsibility for one's own actions. It is hoped that graduates of this program will be better able to manage their behavior and effectively function within their communities. Also, within this course of accelerated rehabilitation, our objective is to have assisted individual clients with their interpersonal psychotherapeutic issues. In that our focus is a "total child" focus our aim is for each client to grow, develop, and mature within a healthy,wholesome milieu during her stay at Excelsior. B. Treatment Planning Process-the formulation of Master Treatment Plans and implementation of same are the responsibility of the Treatment and Team Coordinator, therapist, direct care counselors,and Recreation Counselor. One teacher from the school also participates as a liaison between the school and cottage counseling staff and an assigned medical staff consults with cottage on medical issues.. Consultation as to Treatment Plans is available from a staff psychiatrist, psychologist, and nurse practitioner. Treatment team meetings are held for one and one-half hours, four times weekly, as well as one four hour meeting per month, and one all day team meeting every six months. Decisions as to a recommended promotion within the Phase Program for a student,as well as assignments to specialized therapy groups are also made in this meeting. Treatment Plan Reviews are held every 30-90 days and address objectives,justification Exhibit A for treatment, Individual Transition Plan, family involvement, and disposition. Caseworkers, Probation Officers,other vested parties and significant family members are encouraged to attend these meetings.Long range plans, such as tentative discharge dates,and future goals are another element in Treatment Plan designs. Treatment Plan decisions are generally made by consensus within the treatment team, with final authority and responsibility resting with the Treatment and Team Coordinator. All Treatment and Team Coordinators are supervised by the Director of Treatment Additionally, all treatment teams are evaluated annually through the Utilization Review Committee. C. Projected Length of Treatment-6 to 12 months D. Outcome Goals - it is projected that during their stay clients will have experienced a thorough course of individual therapy focused at their personal and family issues,participation in between two and four therapy groups each of which is focused on a pathology common to individuals assigned to that particular group, and involvement in family therapy, whenever appropriate, and in conjunction with the Family Service Plan aimed at resolution of issues creating dysfunction. Accelerated academic achievement is desired in that the student is enrolled in a year-round school program. Additionally, aside from the formal therapy and academic program, the student will have participated in various forms of healthy wholesome recreational pursuits. E. Specialized therapy groups — in addition to regular milieu groups, goal setting and problem solving groups, topical interest groups which are held daily, clients benefit from the advanced training of the master's level clinicians by participating in therapy groups based on individual needs. These topics vary as the population dynamics vary.Examples of such groups include: • Dynamics of Addiction • Relapse Prevention • Substance Abuse • Resocialization(conduct disorder and substance abuse) • Peer Mediation/Conflict Resolution • Survivors of Sexual Abuse • Perpetrators of Abuse • General Sexuality • Sexual Con Games • Relationships(friendships) • Family Relationships(for clients returning to family) • Family Dynamics(Domestic violence and dysfunctional patterns) • Mind Over Mood • DBT(Dialectical Behavioral Therapy) • Play Therapy • Creative Expressions/Movement Therapy • Nutrition/Total Body Fitness • AA/NA(strictly voluntary) • Animal Assisted Therapy • Independent Living Skills VI. EDUCATIONAL AND VOCATIONAL SERVICES A. Agency Provided Educational Components - Excelsior has a fully approved year-round Junior/Senior High School on its main campus. The school program is North Central Association accredited,and Colorado Department of Education accredited. In addition to the regular academic program, Excelsior has a Colorado Licensed Cosmetology School and vocational Culinary Arts program, Office Procedure Program,and bicycle mechanics program on-grounds. Within the school component,individual educational testing as well as psychological testing, remedial classes,tutoring, and educational and vocational counseling Exhibit A are offered. School offers an array of on-campus extracurricular activities, including interschool basketball and volleyball, school newspaper and social events. A nearby recreation facility provides a swimming pool. The school has membership in the Colorado High School Activities Association and participates in sporting events with public school leagues. B. Use of Community Schools - When appropriate, toward the end of a client's course of treatment, she may attend local public school classes. Generally the purpose of this transfer is to assist the student in transition to the community. Excelsior is fortunate to have an excellent relationship with the local school district.All facilities and resources of said district are available to our clients on request. C. Special Education Components-Special Education classrooms and teachers are incorporated into the school setting. This program is funded as a component of Excelsior's educational program. D. Tutoring - Individual tutoring is available to clients on an as needed basis throughout the school day. In addition, tutoring and academics is attended to in the cottage setting and evening tutorial sessions in the school. E. Skills Training-Training in daily living skills is an important element of the Excelsior Phase Program. Each student is monitored and counseled daily regarding her hygiene, care of her environment, and ability to relate effectively to peers and adults. In addition, the school program includes courses in home economics, childcare, sexuality, business skills, etc. Training for other specific skills can be tailored according to the client's individual need. F. Health, Sex and Drug Education-Certain therapy groups are specifically focused on issues such as sexuality and substance abuse. In addition, resources are brought to the academic setting where a didactic approach is utilized to address these issues. Classes such as Womanhood,Health and Human Body and Exploring Self cover the topics extensively. VII. MEDICAL SERVICES A. Excelsior contracts with a local physician who is responsible for consultation with the nurse practitioner, registered nurses, licensed practical nurses and medical assistants, and our medical records department. She/he refers to other medical specialists in the community with whom Excelsior maintains a relationship. Dental care is provided by community dentists pending insurance coverage. Excelsior's staff psychiatrists complete a psychiatric screening on all new entering clients. Vision and auditory screenings are completed on all new clients and updated as needed. B. Excelsior's nurses are responsible for supervising and administering medications, day to day medical decision-making,client health education and conducting inservice training in health care for professional staff. During each shin, there are several staff trained in Medication Administration. Additionally, many staff are trained as First Responders to address crises and insure safety of the clients. VIII. RELIGIOUS RESOURCES • A. Excelsior employs a Religious Activities Coordinator. This individual is responsible to acquaint clients with religious philosophies and oversee various religious activities that occur both on and off campus. Exhibit A B. The Religious Activities Coordinator provides contacts with community religious resources and maintains an on going spiritual counselor relationship with clients who wish to participate. A weekly (Sunday) non-denominational religious service is provided Attendance at this service is non-compulsory. IX. DISCHARGE POLICY AND Ali I hRCARE B. In union with the placing agency, decisions regarding discharge are made by the treatment team. Discharge is an agenda item addressed in the monthly Treatment Plan review process. Ideally the student will have completed goals and objectives outlined in the treatment plans set forth by placing agencies prior to discharge. This program of growth development and maturation can be applied to students according to their individual capacities. The client's ability to function within the family or in an alternative setting and in the public school setting or preparing for emancipation and independent living are also criteria considered prior to discharge. B. Excelsior provides aftercare services on an as needed basis. Typically,close communication with treatment staff is maintained with the client immediately following discharge from the program. This communication may involve visits to the Center, correspondence, and telephone contacts. All discharged clients are invited to attend Aftercare groups held throughout the year. The Aftercare Coordinator helps prepare clients for discharge and follows up on clients who need assistance within the community. X. STAFF DEVELOPMENT A. An on going staff development program is incorporated under the supervision of the Associate Director and Human Resources department All new employees are required to attend a week long Orientation Program, which includes life skills,. parenting, gender specific, normal adolescent development, professionalism, cultural diversity, emergency procedures, suicide assessment and prevention, and male/female issues, program history, philosophy, procedures, Crisis Intervention , CPR and First Aid Training, conducted by various administrative and supervisory staff. The Associate Director coordinates professional training sessions for treatment staff on a monthly basis. The Excelsior High School Principal is responsible to implement a regular training program for teachers. B. Each employee will have a designated supervisor to whom s/he is accountable. This supervisor is responsible for giving feedback to the employee on his/her job performance. The supervisor may provide an opportunity for the employee to communicate about job performance,the Center,policies or procedures,decisions,new ideas or suggestions. C. Consultants are utilized in spc_.ial staffings for individual girls as well as assisting treatment teams in team functioning and team dynamics. D. Training for professional development is stressed and Excelsior makes extensive use of local workshops and seminars to assist staff in upgrading skills. Staff members frequently are enrolled in local college and university programs sePlring advanced degrees. The internal intranet provides a wealth of timely and practical information as well. pauline/terry/program description 8/21/06 Exhibit A • "Over 30 years of service to youth" Excelsior Youth Centers,Inc. 15001 E.Oxford Avenue/Aurora,Colorado 80014/(303)693-1550/Fax(303)693-8309/www.excelsioryc.org THE TREATMENT AND LEARNING CENTER The Treatment and Learning Center, in accord with Excelsior's basic philosophy, is essentially reality-oriented. We believe that the individual has the potential ability and responsibility to make decisions concerning ones life, and it is our purpose to teach girls to make productive decisions. While this learning process is going on,we accept the responsibility of making some of those decisions by offering necessary physical structure. Decisions have consequences, and being able to predict those consequences is important for rational decision making. We introduce this rationality by making consequences for behavior very clear and consistent. These procedures enable the girls to discriminate easily between productive and counterproductive decisions and behaviors. This process affords the opportunity for predictability and control over ones environment, enhancing self-image and breaking the pattern of self-destructiveness. The program's objectives are to provide a positive learning and growing experience for each girl as a unique individual in a setting which provides a sense of security, warmth and caring. The Treatment and Learning Center is a highly structured treatment facility, the purposes of which are to (1)provide individualized, intensive treatment; (2)provide crisis intervention for the Excelsior campus. The TLC team provides a positive learning experience by delegating to the girls the responsibility to choose their behavior, which includes consequences of that choice. Our goal is to help the girls: (1)enhance their sense of self-worth; (2)develop realistic relationships; and(3) see authority as a positive influence in their lives. These goals are achieved by presenting the girls with well-defined expectations and procedures, giving them a sense of security and well being. The girls are also required to maintain academic involvement either by attending classes or doing assignments in the unit. The girls are responsible for completing daily tasks, which include personal hygiene,rooms and closets, and morning chores. The security this routine provides enable the girls to take advantage of the therapy program which consists of(1) psychiatric evaluation and consultation; (2)individual and family counseling; and (3) group therapy, i.e., psychoeducational,psychotherapeutic, and recreational therapies. Revised 6/7/07 pauline/forms/TLC Exhibit A "Over 30 years of service to youth" • Excelsior Youth Centers,Inc. 15001 E.Oxford Avenue/Aurora,Colorado 80014/(303)693-1550/Fax(303) 693-8309/www.excelsioryc.org THE TREATMENT AND LEARNING CENTER The Treatment and Learning Center (TLC) is Excelsior's most structured and secure treatment unit. The TLC unit serves a significant role at Excelsior providing individualized and intensive treatment for girls who have not responded well to less restrictive methods or have become an extreme safety risk. In addition, TLC provides crisis intervention for the Excelsior campus. The goal of the TLC unit is to provide a positive learning experience by delegating to the girls the responsibility to choose their behavior, which includes consequences of that choice. Our goal is to help the girls enhance their self-worth, develop realistic relationships, and see authority as a positive influence in their lives. These goals are achieved by presenting the girls with well-defined expectations and procedures, giving them a sense of security and well-being. As a staff-secure facility, safety is the top priority. In TLC several measures are in place to promote a safe environment: 1. All staff are CPI trained(Crisis Prevention Institute), CPR and First Aid Certified. 2. The TLC unit is physically connected to the Intervention Unit for added staff support and crisis intervention. 3. Access to personal belongings is limited and monitored by staff. 4. A high staff to client ratio provides more individualized attention to behaviors. 5. TLC Supervisor's office is connected to the unit for direct supervision and clinical support. 6. Locked windows, alarmed exits and crisis alarm system provides for immediate. response to any girl trying to leave without permission. 7. Staff station positioned at entry to unit to allow unimpeded supervision of all girl's rooms and the milieu. 8. Regular supervision and team meetings provide for consistency among team members in regards to treatment programming and safety procedures and interventions. With appropriate security and supervision in place, the TLC unit enables girls to take advantage of the treatment program which consists of psychiatric evaluation and consultation, individual and family counseling, and group therapy. REVISED 6/4/07 Council on Accreditation of Service for Families and Children, Inc. J Exhibit A • "Over 30 years of service to youth" Excelsior Youth Centers,Inc. 15001 E.Oxford Avenue/Aurora,Colorado 80014/(303)693-1550/Fax(303)693-8309/www.excelsioryc.org Daily rate of service: We have not received an official notification of the new rate for the 2007-2008 fiscal year. Our Director of Finance is thinking it will be somewhere around $178.08 per day. Once we have received that notification, I will e-mail that to you. Menu of Services: Substance Abuse Group—4 groups per month at $20.00 per group. Non-Special Ed. Students excess cost - $39.27/per day— school days only (clients who are not special education when they enter our facility) 064, Council on Accreditation of Service for Families and Children, Inc. WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Griffith Centers for Children Inc. and Weld County Department of Social Services for the period from July 1, 2007 through June 30, 2008. The following provisions, made this / day of �✓ , 2007, are added to the referenced Agreement. Except as modified hereby, all terms of the greement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#39212, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.08 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.08 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis,based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing (3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child(30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum 07007- awe • • • E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting g Yg g g authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Social Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum • • C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement,had one or more public transactions (federal, state, and local) terminated for cause or default. 11. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Social Services Policy and Procedure Manual. 12. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 13. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 14. Add Paragraph 9 to Section VI. The Director of 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; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Social Services and the Contractor, or by Social Services as a debt to Social Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 15: Add Paragraph 10 to Section VI. The contractor shall promptly notify Social Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Social Services' Director. The term "litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: /�v►u� Weld County rk ,9 WELD COUNTY BOARD OF SOCIAL SERVICES, ON BEHALF '`-, A OF THE WELD COUNTY DEPARTMENT OF SOCIAL - SERVICES i By: 711Cte, By: e�� Deputy Cler 'to the Board )avid E. Long, C . . EP 052007 CONTRACTOR Griffith Centers for Children Inc. 14142 Denver West Pkwy, Suite -;3.5 #225 Lakewood, CO 80401-3189 By: 00-5.x --` WELD COUNTY DEPARTMENT OF SOCIAL SERVICES BY: Cf\AAf< 'rector Cr\11) 4 Weld County SS-23A Addendum ,goo -ad)y2 Exhibit A Griffith Centers for Children Scope of Services July 3, 2007 Colorado Springs and Chins Up Center Treatment Residential Child Care Facility(TRCCF) and Residential Child Care Facility (RCCF) Specializing in serving males age 13-21 who are unable to successfully receive treatment services in their community. Clients and their families are provided with comprehensive therapeutic, psychiatric and medical services, specialized education services, supported daily living, elective spiritual services, and experiential opportunities (equestrian/wilderness/ropes courses). Continuity of Care Program Continuity of care services utilize a family-focused, strength-based approach to provide continuous treatment and support to the child and family from point o f entry through completion of their permanency plan.The point that the child enters residential care through their return home and for 12 months after discharge from residential care,the client and family can depend on in-home support, integrated treatment services, mad comprehensive reunification services, in addition to continuity in treatment planning and consistency of therapeutic personnel. Independent Living Program Providing independent living skill training and development including job assistance and coaching within a supportive atmosphere which encourages personal responsibility and accountability. Post-discharge monitoring and support can be contracted. Group Homes: Meridian Youth Ranch located in Falcon, Colorado and Prospect Youth Home on Griffith's Colorado Springs Campus serving boys aged 15+, and 13-15, respectively. In addition to the supported living environment, Griffith day treatment and out-patient services can be contracted. Day Treatment Program Providing Accredited, Specialized Education services to Middle School and High School aged males as well as Individual, Family and Group Therapy using conventional approaches and experiential modalities. Family Preservation mad Psychiatric/Medication Monitoring Services are included. Education Only Program: Providing Accredited, Specialized Education to Middle School and High School aged males. Additional Griffith out-patient services can be contracted. Out-Patient Therapy Services providing individual and Family therapy services for adults and children in the greater Colorado Springs area. Home Based Services Including Multi-Systemic Therapy (MST), Functional Family Therapy (FFT) and Family Preservation are provided to support families in the region with successfully maintaining their children in their homes. Foster Care and Multidimensional Treatment Foster Care(MTFC) services are available for children who need a caring home environment in which to thrive. Family Cottage. An on-grounds home away from home provided for the convenience of families we serve. • WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Griffith Centers for Children Inc. and Weld County Department of Social Services for the period from July 1, 2007 through June 30, 2008. The following provisions, made this day of , 2007, are added to the referenced Agreement. Except as modified hereby, all terms of the Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#49547, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.08 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.08 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include,but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child(30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum 1. E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County,prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Social Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local)transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 11. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Social Services Policy and Procedure Manual. 12. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 13. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 14. Add Paragraph 9 to Section VI. The Director of 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; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Social Services and the Contractor, or by Social Services as a debt to Social Services or otherwise as provided by law. 3 Weld County SS-23A Addendum . 15. Add Paragraph 10 to Section VI. The contractor shall promptly notify Social Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Social Services' Director. The term "litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: Lima) Weld County Cl eia WELD COUNTY BOARD OF ISf.-, i SOCIAL SERVICES, ON BEHALF OF THE WELD COUNTY DEPARTMENT OF SOCIAL SERVICES &I Deputy Clerk to e Board David E. Long, C a SE 0 5 2007 CONTRACTOR Griffith Centers for Children Inc. 14142 Denver West Pkwy, Suite c96 #225 Lake o d, CO 80401-3189 By: J ems.C-L--.__ WELD COUNTY DEPARTMENT OF SOCIAL SERVICES By: rector 4 Weld County SS-23A Addendum v ^ n it Exhibit A Griffith Centers for Children Scope of Services July 3, 2007 Larkspur Center Treatment Residential Child Care Facility(TRCCF) and Residential Child Care Facility (RCCF) specializing in serving males age 10-21 who are unable to successfully receive treatment services in their community. Clients mad their families are provided with comprehensive therapeutic,psychiatric and medical services, specialized education services, supported daily living, elective spiritual services, and experiential opportunities(equestrian/wildemess/ropes courses). Continuity of Care Program Utilizing a family-focused, strength-based approach to provide continuous treatment services to the child and family from the point that the child enters residential care through their return home and for 12 months after discharge from residential care. In-home support,training,treatment and comprehensive reunification services will start during the residential treatment phase mad continue for 12 months after discharge from residential care. Coining Soon Spruce Mountain Group Home on the Griffith Larkspur Center campus. In addition to the supported living environment, Griffith day treatment and outpatient services will be available for contracting. Day Treatment Program Providing Accredited, Specialized Education services to males aged 10-21 as well as Individual, Family and Group Therapy using conventional approaches and experiential modalities. Psychiatric/Medication Monitoring Services are excluded. Education Only Program: Providing Accredited, Specialized Education services to males aged 10- 21. Family Cottage An on-grounds home away from home provided for the convenience of families we serve. Home Based Services Including Multi-Systemic Therapy(MST), Functional Family Therapy (FFT),Multidimensional Treatment Foster Care(MTFC),and Family Preservation are available to support families in the community with successfully maintaining their children in their homes. WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Griffith Centers for Children Inc. and Weld County Department of Social Services for the period from July 1, 2007 through June 30, 2008. The following provisions, made this / day of 0/ , 2007, are added to the referenced Agreement. Except as modified hereby, all terms of the Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#1534554, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.08 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.08 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); ] Weld County 55-23A Addendum aool- a83/7 • • E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Social Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum • • C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 11. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Social Services Policy and Procedure Manual. 12. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 13. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 14. Add Paragraph 9 to Section VI. The Director of 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; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Social Services and the Contractor, or by Social Services as a debt to Social Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 15. Add Paragraph 10 to Section VI. The contractor shall promptly notify Social Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Social Services' Director. The term "litigation"includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: gull Weld County 1861 -' �1 WELD COUNTY BOARD OF C f 74 ' SOCIAL SERVICES, ON BEHALF �t W AOF THE WELD COUNTY �`(IJ 1 t, DEPARTMENT OF SOCIAL SERVICES BY: ��127t1lef _ 3--By: e Deputy Clerk t the Board David E. Long, air EP 0 5 2007 CONTRACTOR Griffith Centers for Children Inc. 14142 Denver West Pkwy, SuiteAN #225 Lakewo d, CO 80401-3189 By: __-:;-.) -17124-0------ WELD COUNTY DEPARTMENT OF SOCIAL SERVICES By: /� { (`/ hector �� / J �J 4 Weld County SS-23A Addendum 07.002-a(fr7 Exhibit A Griffith Centers for Children Scope of Services July 3, 2007 Grand Junction Center Treatment Residential Child Care Facility(TRCCF) and Residential Child Care Facility (RCCF) Specializing in serving females age 10-21 who are unable to successfully receive treatment services in their community and require out of home placement. Clients and their families are provided with comprehensive therapeutic,psychiatric and medical services, specialized education services, supported daily living, and experiential opportunities. Coming Soon! Treatment Residential Child Care Facility(TRCCF) and Residential Child Care Facility (RCCF) Serving males age 10-21. Home Based Services Including Multi-Systemic Therapy(MST),Functional Family Therapy (FFT), and Family Preservation are provided to support families in the community with successfully maintaining their children in their homes. Foster Care services are continually being developed some are available for children who need a caring home environment in which to thrive. WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Jefferson Hills and Weld County Department of Social Services for the period from July 1, 2007 through June 30, 2008. The following provisions, made this ( day of , 2007, are added to the referenced Agreement. Except as modified hereby, all terms of the greement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#88459, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$168.77 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$168.77 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include,but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum aeil2 aev7 • E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests,plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Social Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum • • C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement,had one or more public transactions (federal, state, and local) terminated for cause or default. 11. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Social Services Policy and Procedure Manual. 12. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 13. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 14. Add Paragraph 9 to Section VI. The Director of 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; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Social Services and the Contractor, or by Social Services as a debt to Social Services or otherwise as provided by law. 3 Weld County SS-23A Addendum • 15. Add Paragraph 10 to Section VI. The contractor shall promptly notify Social Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Social Services' Director. The term "litigation"includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ELM liotr."-sit ATTEST: Weld Cou VC1 R' e = altz c-' I, 1861 /f, - I' �im WELD COUNTY BOARD OF '' SOCIAL SERVICES, ON BEHALF ,O W A,, OF THE WELD COUNTY %%©, ��, DEPARTMENT OF SOCIAL SERVICES BY: i/� 92tY.�142 R J�f By: C Deputy Cle to the Board avid E. Long, C it S P 052007 CONTRACTOR Jefferson Hills 421 Zang St Lakewood, CO 80228 By: WELD COUNTY DEPARTMENT ,754 -, OF SOCIAL SERVICES By: 'rector 4 Weld County SS-23A Addendum Exhibit A Jefferson Hills Scope of Work Submitted to Weld County, Department of Human Services July, 2007 1. Name and Address of the Program Jefferson Hills Corporation Lakewood site and mailing address: Aurora site 421 Zang Street 1290 S. Potomac Lakewood, Colorado 80228 Aurora, CO 80012 2. Type of License or Certification Licensed by Division of Child Care as a Residential Child Care Facility Designated by Division of Mental Health as a C.R.S. 27-10 Facility and Therapeutic Residential Child Care Facility 3. Description of all Program Services Facility Capacity The TRCCF/RCCF licensing capacity at Lakewood is 70 and Aurora is 90. Current maximum usable capacity is 70 at Lakewood and 85 at Aurora. This is capacity for all Jefferson Hills contracts, which includes both child welfare and DYC. Current capacity includes offender beds in Aurora and female beds at both sites. Referral Process and Timelines The Jefferson Hills Admissions Coordinator accepts referral packets from caseworkers. These are logged into the computer in the order they are received. A paper review is conducted and then a personal interview. The interview takes place within 7 days, but no more than 21 days, depending on the number of referrals and the length of the wait list. The Admissions Coordinator works in collaboration with the caseworker and Jefferson Hills team to admit the resident. Average Length of Stay The average length of stay at the Lakewood site is 7 months. The average length of stay at the Aurora site is 10 months. Criteria for Placement 1 Exhibit A Jefferson Hills Lakewood serves adolescents ages 12 — 18 'h years of age, males and females. Jefferson Hills Aurora serves adolescents 12—20 years of age, males and females. Exclusions for admission include: • Medical instability, including not being stabilized sufficiently on psychotropic medication • Required drug or alcohol detoxification • Serious contagious disease or other condition requiring significant nursing care • Unacceptable risk to other residents for any reason (e.g. fire setting, extreme homicidal risk) • Suicidal risk of high lethality or medium lethality without appropriate support • Moderate to profound mental retardation • Psychosis to the degree that the resident is unable to complete daily living functions Program Descriptions Jefferson Hills operates a staff secure residential program for males and females ages 12 —21 at its Lakewood and Aurora sites. Program descriptions can be found in the Policies and Procedures Manuel, which is subject to change as the program develops and needs are identified. Below are listed general minimum frequency of services, subject to program changes and staffing. The frequency of services is specified in each resident's individualized treatment plan. Treatment services—treatment services are provided to establish a therapeutic alliance in which the adolescent can make behavioral changes and address presenting problems. Jefferson Hills provides a number of modalities to maximize the therapeutic potential, including: individual therapy, family therapy, multi-family therapy, and group therapy(educational and psycho-therapeutic). Treatment services are eligible for Medicaid reimbursement and provided by licensed, Master's clinicians or unlicensed Master's clinicians working toward licensure and under the supervision of a licensed clinician. Generally, individual therapy is conducted weekly and group psychotherapy conducted at least 3x per week. In addition, non-Medicaid eligible treatment services are also provided such as psycho-educational groups, milieu management, case management, and experiential programs. 2 Exhibit A Educational services—Jefferson Hills provides an on-grounds school approved as a facility school through the Colorado Department of Education. This includes special education services for students who qualify. Pre-vocational services are also provided. The school year runs 180 days and the calendar is available on request. Pre- and post- academic testing using the Kaufman Test for Educational Achievement (KTEA) is conducted on all students and progress data is available upon request. Jefferson Hills complies with Colorado's standard based curriculum for its educational program. Medical services—Jefferson Hills provides routine and emergency medical services to residents. History and physicals are completed on new admissions not having recent physicals already completed. Sick call is identified daily. The nurse practitioners are available weekly. On-site physician consultation and direct care is provided as scheduled. On-call medical consultation is provided. Family Services —Jefferson Hills believes the family is an integral part of the resident's treatment, when clinically appropriate. In addition to family therapy and multi-family group, family visitation and inclusion in the treatment planning and case reviews is encouraged. When family therapy is clinically indicated, it is encouraged at least twice per month. Family therapy is a Medicaid eligible service. Medication Management—Jefferson Hills contracts with part-time on-site psychiatrists to provide psychotropic medication assessment, education, and management as clinically indicated. The psychiatrist meets with residents on psychotropic medication monthly. Specialized Tracks/Programs Drug/alcohol services—Jefferson Hills provides drug/alcohol services in the form of weekly education, treatment and relapse prevention groups, as needs are identified in the treatment plan. Urinalysis and drug screens are available according to policy and individual need. Substance abuse curriculum and programming is under the supervision of CAC certified staff. Sexual perpetration/victimization—(available at Aurora only) — Jefferson Hills provides sexual offense specific treatment for identified male and female residents. This includes weekly individual and group psychotherapy. Jefferson Hills is registered with the Sex Offender Management Board and employs full operating level therapists as well as those working on their SOMB certification. Gender specific therapy—Jefferson Hills provides female gender specific therapy for its female units in collaboration with other female programs and Girls, Etc. 3 Exhibit A Recreational services—recreation is built into the daily schedule for all residents, unless clinically or medically contraindicated. This may be use of the gym, outdoors, or leisure activities. Jefferson Hills employs a certified P.E. teacher who oversees the recreation program. Religious services—religious programming is developed as residents and staff identify spiritual needs. Case Management—the treatment coordinator provides case management services for the resident to facilitate treatment and transition back into the community. This includes communication with family, referral and receiving sources and community linkages. Evidenced-based Practices and Promising Practices—Jefferson Hills utilizes several evidenced based practices, including: Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy(DBT), Aggression Replacement Training (ART), Eye Movement De-Sensitization and Reprocessing (EMDR) 4. Staffing Pattern Jefferson Hills complies with all staffing requirements of its license and designations. Program/clinical staff include: milieu counselors, milieu supervisors, unit managers, nurses, licensed therapists, certified teachers, certified special education teachers, substitute teachers, lead teachers, psychologists, psychiatrists, nurse practitioners, and the physician. Support staff include: maintenance, food service, housekeeping and accounting/finance. Staffing patterns are based on two items: 1) Colorado Department of Human Services Licensing regulations (as well as other regulators), 2) client need and acuity. Our staffing patterns in general range from 1:7 to 1:20. However, staff to client ratios can range from as high as 1:1, depending on client need and acuity, to as low as the CDHS Licensing regulation minimum standards of 1:10 during awake hours and 1:20 during sleeping hours. Our ratios do not fall below CDHS minimum requirements. Staff qualifications, education, and licensure adhere to the State standards for residential child care facilities, treatment residential child care facilities, and alternative/facility school. Position Minimum Qualifications Milieu Counselor High school plus 2 years experience Milieu Supervisor High school plus 6 years experience On-Call Milieu Counselor High school plus 1 year experience Licensed Treatment Coordinator Master's degree, 2 yrs. experience 4 Exhibit A Licensed Unit Manager Master's degree, 5 yrs exp Licensed Clinical/Program Director Master's, license eligible, 5 yrs exp Psychiatrist Board certified, adol. experience Psychologist Licensed, adolescent experience Teacher Bachelor's, teaching certificate Special Education Teacher Bachelor's degree, teaching certificate, Temporary Teaching Eligibility(TTE) Education Director Master's degree, teaching certificate Assistant Education Director Bachelor's, teaching certificate, TTE Nurse LPN or RN Support staff High school plus 2 years experience (food service, housekeeping, and maintenance) Accounting staff High school plus 2 years experience (HR, payroll, AR/AP) Executive management - support B.A. plus 5 years experience Executive management—program Master's level, licensed, 5 years experience Interns-M.A. and B.A. level Enrollment in approved program 5. Training plan Jefferson Hills provides extensive training to include meeting the mandatory requirements of its license, designations, and referral sources. Documentation of these trainings is maintained in the personnel records. Training includes internal inservices as well as external workshops and conferences. 6. Rate Requested: Anchor Rate provided by the State of Colorado: Lakewood site: $168.77 per resident per day Aurora site: $173.48 per resident per day Does not include Medicaid-eligible services or education services 5 • WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Jefferson Hills and Weld County Department of Social Services for the period from July 1, 2007 through June 30, 2008. The following provisions, made this / day of O a , 2007, are added to the referenced Agreement. Except as modified hereby, all terms of the Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#12284, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$173.48 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$173.48 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis,based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child(30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); t Weld County SS-23A Addendum aoo7-acf97 E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Social Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 11. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Social Services Policy and Procedure Manual. 12. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 13. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 14. Add Paragraph 9 to Section VI. The Director of 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; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Social Services and the Contractor, or by Social Services as a debt to Social Services or otherwise as provided by law. 3 Weld County SS-23A Addendum • 15. Add Paragraph 10 to Section VI. The contractor shall promptly notify Social Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five(5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Social Services' Director. The term"litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: Weld Co y -r id 1861 If tt& �.� C WELD COUNTY BOARD OF O �7 j SOCIAL SERVICES, ON BEHALF ®fi e l OF THE WELD COUNTY 7=12-7-_,-- DEPARTMENT OF SOCIAL SERVICES 3-By: By: cM Deputy Cle t to the Board David E. Long, C SE 0 5 2007 CONTRACTOR Jefferson Hills 421 Zang St Lakewood, CO 80228 By:c Q iu..kesientad WELD COUNTY DEPARTMENT , OF SOCIAL SERVICES By: . lA irector 4 Weld County SS-23A Addendum 2007- ai777 Exhibit A Jefferson Hills Scope of Work Submitted to Weld County, Department of Human Services July, 2007 1. Name and Address of the Program Jefferson Hills Corporation Lakewood site and mailing address: Aurora site 421 Zang Street 1290 S. Potomac Lakewood, Colorado 80228 Aurora, CO 80012 2. Type of License or Certification Licensed by Division of Child Care as a Residential Child Care Facility Designated by Division of Mental Health as a C.R.S. 27-10 Facility and Therapeutic Residential Child Care Facility 3. Description of all Program Services Facility Capacity The TRCCF/RCCF licensing capacity at Lakewood is 70 and Aurora is 90. Current maximum usable capacity is 70 at Lakewood and 85 at Aurora. This is capacity for all Jefferson Hills contracts, which includes both child welfare and DYC. Current capacity includes offender beds in Aurora and female beds at both sites. Referral Process and Timelines The Jefferson Hills Admissions Coordinator accepts referral packets from caseworkers. These are logged into the computer in the order they are received. A paper review is conducted and then a personal interview. The interview takes place within 7 days, but no more than 21 days, depending on the number of referrals and the length of the wait list. The Admissions Coordinator works in collaboration with the caseworker and Jefferson Hills team to admit the resident. Average Length of Stay The average length of stay at the Lakewood site is 7 months. The average length of stay at the Aurora site is 10 months. Criteria for Placement 1 Exhibit A Jefferson Hills Lakewood serves adolescents ages 12 — 18 Yz years of age, males and females. Jefferson Hills Aurora serves adolescents 12 —20 years of age, males and females. Exclusions for admission include: • Medical instability, including not being stabilized sufficiently on psychotropic medication • Required drug or alcohol detoxification • Serious contagious disease or other condition requiring significant nursing care • Unacceptable risk to other residents for any reason (e.g. fire setting, extreme homicidal risk) • Suicidal risk of high lethality or medium lethality without appropriate support • Moderate to profound mental retardation • Psychosis to the degree that the resident is unable to complete daily living functions Program Descriptions Jefferson Hills operates a staff secure residential program for males and females ages 12 —21 at its Lakewood and Aurora sites. Program descriptions can be found in the Policies and Procedures Manuel, which is subject to change as the program develops and needs are identified. Below are listed general minimum frequency of services, subject to program changes and staffing. The frequency of services is specified in each resident's individualized treatment plan. Treatment services—treatment services are provided to establish a therapeutic alliance in which the adolescent can make behavioral changes and address presenting problems. Jefferson Hills provides a number of modalities to maximize the therapeutic potential, including: individual therapy, family therapy, multi-family therapy, and group therapy(educational and psycho-therapeutic). Treatment services are eligible for Medicaid reimbursement and provided by licensed, Master's clinicians or unlicensed Master's clinicians working toward licensure and under the supervision of a licensed clinician. Generally, individual therapy is conducted weekly and group psychotherapy conducted at least 3x per week. In addition, non-Medicaid eligible treatment services are also provided such as psycho-educational groups,milieu management, case management, and experiential programs. 2 • Exhibit A Educational services—Jefferson Hills provides an on-grounds school approved as a facility school through the Colorado Department of Education. This includes special education services for students who qualify. Pre-vocational services are also provided. The school year runs 180 days and the calendar is available on request. Pre- and post- academic testing using the Kaufman Test for Educational Achievement (KTEA) is conducted on all students and progress data is available upon request. Jefferson Hills complies with Colorado's standard based curriculum for its educational program. Medical services—Jefferson Hills provides routine and emergency medical services to residents. History and physicals are completed on new admissions not having recent physicals already completed. Sick call is identified daily. The nurse practitioners are available weekly. On-site physician consultation and direct care is provided as scheduled. On-call medical consultation is provided. Family Services—Jefferson Hills believes the family is an integral part of the resident's treatment, when clinically appropriate. In addition to family therapy and multi-family group, family visitation and inclusion in the treatment planning and case reviews is encouraged. When family therapy is clinically indicated, it is encouraged at least twice per month. Family therapy is a Medicaid eligible service. Medication Management—Jefferson Hills contracts with part-time on-site psychiatrists to provide psychotropic medication assessment, education, and management as clinically indicated. The psychiatrist meets with residents on psychotropic medication monthly. Specialized Tracks/Programs Drug/alcohol services—Jefferson Hills provides drug/alcohol services in the form of weekly education, treatment and relapse prevention groups, as needs are identified in the treatment plan. Urinalysis and drug screens are available according to policy and individual need. Substance abuse curriculum and programming is under the supervision of CAC certified staff. Sexual perpetration/victimization—(available at Aurora only)— Jefferson Hills provides sexual offense specific treatment for identified male and female residents. This includes weekly individual and group psychotherapy. Jefferson Hills is registered with the Sex Offender Management Board and employs full operating level therapists as well as those working on their SOMB certification. Gender specific therapy—Jefferson Hills provides female gender specific therapy for its female units in collaboration with other female programs and Girls, Etc. 3 Exhibit A Recreational services—recreation is built into the daily schedule for all residents, unless clinically or medically contraindicated. This maybe use of the gym, outdoors, or leisure activities. Jefferson Hills employs a certified P.E. teacher who oversees the recreation program. Religious services—religious programming is developed as residents and staff identify spiritual needs. Case Management—the treatment coordinator provides case management services for the resident to facilitate treatment and transition back into the community. This includes communication with family, referral and receiving sources and community linkages. Evidenced-based Practices and Promising Practices—Jefferson Hills utilizes several evidenced based practices, including: Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Aggression Replacement Training (ART), Eye Movement De-Sensitization and Reprocessing(EMDR) 4. Staffing Pattern Jefferson Hills complies with all staffing requirements of its license and designations. Program/clinical staff include: milieu counselors, milieu supervisors, unit managers, nurses, licensed therapists, certified teachers, certified special education teachers, substitute teachers, lead teachers, psychologists, psychiatrists, nurse practitioners, and the physician. Support staff include: maintenance, food service, housekeeping and accounting/finance. Staffing patterns are based on two items: 1) Colorado Department of Human Services Licensing regulations (as well as other regulators), 2) client need and acuity. Our staffing patterns in general range from 1:7 to 1:20. However, staff to client ratios can range from as high as 1:1, depending on client need and acuity, to as low as the CDHS Licensing regulation minimum standards of 1:10 during awake hours and 1:20 during sleeping hours. Our ratios do not fall below CDHS minimum requirements. Staff qualifications, education, and licensure adhere to the State standards for residential child care facilities, treatment residential child care facilities, and alternative/facility school. Position Minimum Qualifications Milieu Counselor High school plus 2 years experience Milieu Supervisor High school plus 6 years experience On-Call Milieu Counselor High school plus 1 year experience Licensed Treatment Coordinator Master's degree, 2 yrs. experience 4 • Exhibit A Licensed Unit Manager Master's degree, 5 yrs exp Licensed Clinical/Program Director Master's, license eligible, 5 yrs exp Psychiatrist Board certified, adol. experience Psychologist Licensed, adolescent experience Teacher Bachelor's, teaching certificate Special Education Teacher Bachelor's degree, teaching certificate, Temporary Teaching Eligibility(TTE) Education Director Master's degree, teaching certificate Assistant Education Director Bachelor's, teaching certificate, TTE Nurse LPN or RN Support staff High school plus 2 years experience (food service, housekeeping, and maintenance) Accounting staff High school plus 2 years experience (HR, payroll, AR/AP) Executive management - support B.A. plus 5 years experience Executive management—program Master's level, licensed, 5 years experience Interns-M.A. and B.A. level Enrollment in approved program 5. Training plan Jefferson Hills provides extensive training to include meeting the mandatory requirements of its license, designations, and referral sources. Documentation of these trainings is maintained in the personnel records. Training includes internal inservices as well as external workshops and conferences. 6. Rate Requested: Anchor Rate provided by the State of Colorado: Lakewood site: $168.77 per resident per day Aurora site: $173.48 per resident per day Does not include Medicaid-eligible services or education services 5 • WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Kids Ark In Sterling and Weld County Department of Social Services for the period from July 1, 2007 through June 30, 2008. The following provisions, made this / day of C�ri / , 2007, are added to the referenced Agreement. Except as modified hereby, all terms of the Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#34340, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.08 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.08 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include,but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing (3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child(30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum aoo2- i fY7 E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests,plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Social Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended,proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 11. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Social Services Policy and Procedure Manual. 12. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 13. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 14. Add Paragraph 9 to Section VI. The Director of 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; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Social Services and the Contractor, or by Social Services as a debt to Social Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 15. Add Paragraph 10 to Section VI. The contractor shall promptly notify Social Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Social Services' Director. The term "litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: fate# �►iCfe,ahr'� Weld Coin `!aJR1�L^I/��% ,i d ct,O k2 IN �� WELD COUNTY BOARD OF SOCIAL SERVICES, ON BEHALF W OF THE WELD COUNTY �(Il yikli of DEPARTMENT OF SOCIAL SERVICES By t.et-- i-x•he y��/I, By: ` r e Deputy Cle to the Board David E. Long, C a' S ,' 052007 CONTRACTOR Kids Ark In Sterling PO Box 1725 Sterling, CO 80751 By: aCta WELD COUNTY DEPARTMENT OF SOCIAL SERVICES By: Director t 4 Weld County SS-23A Addendum ., N • WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Kids Ark In New Raymer Ranch and Weld County Department of Social Services for the period from July 1, 2007 through June 30, 2008. The following provisions, made this / day of DV , 2007, are added to the referenced Agreement. Except as modified hereby, all terms of the Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#34341, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.08 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.08 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or maybe a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum ow9-a an • E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests,plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Social Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local)transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County 55-23A Addendum • C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 11. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Social Services Policy and Procedure Manual. 12. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 13. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 14. Add Paragraph 9 to Section VI. The Director of 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; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Social Services and the Contractor, or by Social Services as a debt to Social Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 15. Add Paragraph 10 to Section VI. The contractor shall promptly notify Social Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Social Services' Director. The term"litigation"includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: I► ali± , Weld Count er o :�`� 't ►� r 1861 r = �Yr}{` WELD COUNTY BOARD OF Ft 21/4 SOCIAL SERVICES, ON BEHALF 0,1,- �,� OF THE WELD COUNTY DEPARTMENT OF SOCIAL SERVICES By: `ll( �f rJ By: Deputy Cle to the Board David E. Long, C SE 0 5 2007 CONTRACTOR Kids Ark In New Raymer Ranch PO Box 1725 Sterlin , CO 80751 By: k WELD COUNTY DEPARTMENT OF SOCIAL SERVICES By: irector 4 Weld County SS-23A Addendum 02oo7-a?y7 WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Mountain Crest/Poudre Valley Health Systems and Weld County Department of Social Services for the period from July 1, 2007 through June 30, 2008. 161 The following provisions, made this /day of , 2007, are added to the referenced Agreement. Except as modified hereby, all terms of e Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#42261, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.08 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.08 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis,based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum aW7-as;y7 E. Other/miscellaneous items considered usual in the care and supervision of the child, include,but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include,but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Social Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum • • C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 11. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Social Services Policy and Procedure Manual. 12. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 13. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 14. Add Paragraph 9 to Section VI. The Director of 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; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Social Services and the Contractor, or by Social Services as a debt to Social Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 15. Add Paragraph 10 to Section VI. The contractor shall promptly notify Social Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Social Services' Director. The term"litigation"includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: Weld Coun Jo i 185 ( �l � WELD COUNTY BOARD OF SOCIAL SERVICES, ON BEHALF 0y OF THE WELD COUNTY � � q°t\ DEPARTMENT OF SOCIAL SERVICES i By: - By: Deputy Clerk t the Board David E. Long, air EP 0 5 2007 CONTRACTOR Mountain Crest/Poudre Valley Health Systems 4601 Corbett DR Fort Collins, CO, 80528 B : QlLc2Gri WELD COUNTY DEPARTMENT OF SOCIAL SERVICES By: ector 4 Weld County SS-23A Addendum WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Mountain Star Center and Weld County Department of Social Services for the period from July 1, 2007 through June 30, 2008. The following provisions, made this / day of gl.//t4 , 2007, are added to the referenced Agreement. Except as modified hereby, all terms of the Areement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#13363, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.08 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.08 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential a p Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing (3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum 0709'7-chi gy 7 ` - ' E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include,but are not limited to; polygraph tests,plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Social Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended,proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum a ' C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local)terminated for cause or default. 11. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Social Services Policy and Procedure Manual. 12. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 13. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 14. Add Paragraph 9 to Section VI. The Director of 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; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Social Services and the Contractor, or by Social Services as a debt to Social Services or otherwise as provided by law. 3 Weld County SS-23A Addendum '15. Add Paragraph 10 to Section VI. The contractor shall promptly notify Social Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Social Services' Director. The term "litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: Weld County (isal f -� WELD COUNTY BOARD OF �, SOCIAL SERVICES, ON BEHALF Ch OF THE WELD COUNTY �UNI , DEPARTMENT OF SOCIAL SERVICES By: r By: E Deputy Cl <to the Board David E. Long, Ch SE 0 5 2007 CONTRACTOR Mountain Star Center 3520 W Oxford Ave Denver, CO 802364 -e-e A 7. By: WELD COUNTY DEPARTMENT OF SOCIAL SERVICES By: 'rector 4 Weld County SS-23A Addendum Exhibit A + STATE OF COLORADO dhs %D,Fy ak cn.Colorado Department of Human Services MAID' people who help people OFFICE OF BEHAVIORAL HEALTH AND HOUSING Bill Ritter,Jr. Deborah L.Trout,Ph.D.,Director Governor COLORADO MENTAL HEALTH INSTITUTE AT FORT LOGAN Karen L.Beye 3520 West Oxford Avenue Executive Director Denver,Colorado 80236 Phone 303-866-7066 TDD 303-789-4272 FAX 303-866-7088 www,cdhsslate co us Keith M.LaGrenade,M.D. Hospital Director MOUNTAIN STAR CENTER AT COLORADO MENTAL HEALTH INSTITUTE AT FORT LOGAN 3520 W.Oxford Avenue,Denver,CO 80236 Phone: 303-866-7777 Fax: 303-866-7776 BACKGROUND AND DESCRIPTION Mountain Star Center is a state operated Therapeutic Residential Child Care Facility located on the campus of Colorado Mental Health Institute at Fort Logan. Mountain Star opened as a residential program in 1998 to provide a continuum of mental health services at the state hospital. Mountain Star is accredited by the Joint Commission on Accreditation of Hospital Organizations (JCAHO) and CRS 27-10 certified. Mountain Star Center has 20 beds for adolescent males and females ages 12-18 years. Youngsters admitted to the program must be Colorado residents in custody of a county department of human services or committed to the Division of Youth Corrections. Mountain Star specializes in treating adolescents with serious mental illness. Mountain Star has an ethnically and culturally diverse population. Our clients have typically experienced multiple out of home placements and psychiatric hospitalizations. Many clients are admitted directly to us from the inpatient units at CMHI-Fort Logan. Mountain Star can serve some clients who are dually diagnosed with a mental illness and a developmental disability. Youth served at Mountain Star often have histories of abuse and neglect. Many have been involved in the legal system due to criminal activities. Impulse control problems, depression, psychosis, mood instability and anger management difficulties are common issues among our clientele. LENGTH OF STAY The placing agency and the Mountain Star clinical personnel determine the length of stay jointly. The goal for discharge is that a client has achieved his or her treatment goals, demonstrating the ability to Our Mission is to Design and Deliver Quality Human Services that Improve the Safety and Independence of the People of Colorado Exhibit A live safely and productively in a less intensive setting. The average Mountain Star client is in treatment for 9 to 12 months. TREATMENT PROGRAM Mountain Star provides an array of services and programming designed to foster personal growth and skill development. The program is reality oriented, enhancing a process that encourages residents to deal with their current life situation, take responsibility for their behavior and make productive decisions about their lives. The staff strive to provide the structure necessary to create a safe, accepting and stimulating environment, which encourages each youngster to explore their potential and take positive risks to change and grow. Staff provide 24-hour supervision, consistency, nurturing and examples of healthy mature adult behaviors. Most importantly we help teenagers learn to control destructive behaviors, preparing them to move to less-restrictive settings. Case management, individual, group and family therapy are conducted by licensed clinical social workers or licensed Ph.D/Psy.D. psychologists. A current list of therapists is attached to this document. Client to case manager ratio meets or exceeds CDHS requirements. Clients receive a minimum of 1 hour of individual therapy and 3 hours of group therapy per week. Family therapy is offered one hour per week. Family therapy is highly encouraged. Passes with family are recommended when clinically appropriate and with the permission of the placing agency. Mountain Star has a psychiatrist available daily to provide clinical direction, evaluate residents and prescribe medication as needed. Mountain Star, along with the rest of Fort Logan has access to on- grounds medical doctors and registered nurses 24/7 every day of the year. The milieu staff is highly experienced in mental health and includes registered nurses, mental health clinicians, and licensed psychiatric technicians. Staffing ratios meet or exceed CDHS requirements for TRCCFs. The milieu program provides a variety of psycho-educational groups and enrichment activities to help clients develop the skills necessary to function successfully in the community. Interpersonal skills and emotion regulation are emphasized. A certified music therapist and a certified recreation therapist provide approximately 20 hours of groups and activities each week. A list of groups and activities are attached to this document. Interventions Mountain Star uses a dynamic level system, which is individualized to the specific needs of each resident. Clients quickly achieve success with this program and are positively reinforced with increasing privileges. Residents who demonstrate behavior that is destructive, dangerous or excessively disruptive to the milieu may receive consequences that temporarily remove them from the milieu. Staff give them support so they can regroup, reflect on their choices and identify alternative coping strategies. In extreme instances when a resident demonstrates behavior that is highly dangerous to self or others and is unable to cease this destructive behavior, he or she may be placed in the seclusion/locked quiet room. A doctor's order must be obtained to use this intervention. A physician evaluates the client face- to-face within one hour. He or she is monitored continuously by staff during the seclusion episode and is exited at the earliest, safest moment. Exhibit A . Mountain Star residents who experience a psychiatric crisis that requires a higher level of care may be admitted to the Adolescent or Children's inpatient units at Fort Logan for stabilization of behavior and symptoms. Only clients who present as a danger to self or others as assessed by a physician will be transferred. When this occurs, the Mountain Star case manager works closely with the inpatient team to ensure continuity of care. The client is returned to the TRCCF at the earliest appropriate time with consent of the referring agency. OTHER SERVICES Chaplain Services Non-denominational church services are offered every week and on many holidays in the on-grounds chapel. The Chaplain meets with residents individually as requested. He can access religious practitioners from a variety of faiths as needed to meet residents' spiritual preferences. He also conducts an optional weekly"Spirituality Group" for Mountain Star residents. Medical and Dental Services Medical and dental care is provided at the on-grounds Medical Clinic. Residents have immediate access to physicians for routine and minor medical care around the clock. A dentist and dental hygienist provide oral health care. X-ray, laboratory, physical therapy, occupational therapy, and pharmacy services are also provided on-grounds. Specialist can be accessed as needed. Neuropsychological and Psychological Testing A neuropsychologist is available on-grounds to conduct testing when a possible brain abnormality is suspected. PhD level psychologists can administer a battery of tests to obtain diagnostic information that could assist to determining an appropriate course of treatment. Security Officers Safety Officers at Fort Logan are specially trained in working with psychiatric populations and available 24 hours per day to assist staff and clients. Recreation Recreation is provided 10 hoursper week minimally. Mountain Star utilizes the many recreational areas Y available on-grounds including 2 gymnasiums, a weight and exercise room, and playing fields. Clients may be taken on community outings weekly to various cultural and recreational activities in the Denver area. Rehabilitation Services Residents who are 16 years of age may be recommended for the on-grounds work therapy program. Work Therapy personnel provide opportunities for residents to learn employment skills. Clients can actually be paid for working in this program. School Residents attend the year round on-grounds school that is staffed with licensed special education teachers and a speech and language therapist. An on-grounds library is available to residents. Mountain Star residents earn credits toward graduation and may participate in GED preparation and testing as appropriate. Exhibit A TREATMENT PLANNING AND MONTHLY REVIEWS On the day of admission to the program, the Mountain Star case manager meets with the client, family and DHS caseworker, as available to establish an initial plan of care. Treatment needs are determined and initial goals and objectives are identified. A formal multidisciplinary treatment plan staffing is scheduled within 10 days of the resident's arrival. The DHS caseworker or DYC client manager, family and other appropriate parties are invited to participate in developing the Master Plan of Care. The treatment plan is reviewed every month in a staffing attended by the multidisciplinary team, DHS caseworker, family, resident and other appropriate parties. Changes to the plan are made when clinically indicated. REFERRAL AND ADMISSION PROCESS Mountain Star accepts referrals made by a Colorado county department of human services or by the Division of Youth Corrections. DHS or DYC personal may call 303-866-7772 to make a referral. Information obtained from the referring source is reviewed by clinical staff to determine whether Mountain Star can effectively meet the youngster's needs. A face-to-face interview with the youngster is conducted whenever possible. Youth with a significant history of running away or those who pose a significant risk to other children may be eliminated from consideration. Mountain Star cannot accept adjudicated sexual offenders. Clients must also have an Individual Education Plan. Referrals are placed on a waiting list when there is no current bed availability. Referrals of clients who are currently patients at Fort Logan, may receive priority admission status. Therapeutic Groups and Milieu Activities Provided Psychotherapy Dialectical Behavior Therapy Group Community Meeting Anger Management Group Hygiene and Self Care Group Boundary (Social and Physical) Group Substance Abuse Education Health Teaching Social Skills Vocational and Transition Education Work Skills Group Medication Teaching Community Access Personal Fitness Music Therapy Groups Stress Management Relaxation Therapy Arts and Crafts Social Skills Games Group Exhibit A Karaoke Night Sports Groups Cooking Group Gender Specific Groups Current Events Group Licensed Therapists Jodi Dooling-Litfin, PhD Stephanie Altman, LCSW Abe Tenorio, LCSW Brandi Patton, LCSW Attending Psychiatrist Robert Hernandez, MD Daily Rate Effective July 1, 2007 the total base anchor rate as established by the state is $178.08 a day. For additional information about Mountain Star Center, please contact Laura Chauncey by phone at 303- 866-7772 or e-mail at Laura.Chauncey(aistate.co.us WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Namaqua Center and Weld County Department of Social Services for the period from July 1, 2007 through June 30, 2008. The following provisions, made this / day of G' , 2007, are added to the referenced Agreement. Except as modified hereby, all terms of the AWreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#45142, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.08 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.08 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis,based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing,personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum ae -aN Y E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include,but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Social Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local)transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 11. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Social Services Policy and Procedure Manual. 12. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 13. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 14. Add Paragraph 9 to Section VI. The Director of 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; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Social Services and the Contractor, or by Social Services as a debt to Social Services or otherwise as provided by law. 3 Weld County SS-23A Addendum . 15. Add Paragraph 10 to Section VI. The contractor shall promptly notify Social Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Social Services' Director. The term "litigation"includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: Mi4�tFirF lL '� Weld County rk` '��. �E/ 1 1861 t;f"e;; iv �� WELD COUNTY BOARD OF ' ?_ SOCIAL SERVICES, ON BEHALF � , is UN` 4 OF THE WELD COUNTY DEPARTMENT OF SOCIAL SERVICES By: //l�iG�/� L�Z�/% i By: ';'1_3_1 . Deputy Clerk to the Board Davi E. Long, Chai SEP 5 2007 CONTRACTOR Namaqua Center 404 East 7th Street Love!tTh , CO 80537 By: i-/ 'GIP WELD COUNTY DEPARTMENT OF SOCIAL SERVICES By: irector 4 Weld County SS-23A Addendum,con G`/,�/[( ? WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Namaqua Center and Weld County Department of Social Services for the period from July 1, 2007 through June 30, 2008. The following provisions, made this / day of O ` , 2007, are added to the referenced Agreement. Except as modified hereby, all terms of the Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#100889, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.08 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$178.08 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum aer7- 0?if E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Social Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local)transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery,bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local)terminated for cause or default. 11. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Social Services Policy and Procedure Manual. 12. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 13. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 14. Add Paragraph 9 to Section VI. The Director of 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; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Social Services and the Contractor, or by Social Services as a debt to Social Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 15. Add Paragraph 10 to Section VI. The contractor shall promptly notify Social Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Social Services' Director. The term "litigation"includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: gte Weld Count e 1861 4 7k 9v WELD COUNTY BOARD OF �M> SOCIAL SERVICES, ON BEHALF O A� OF THE WELD COUNTY O/T1;�c• ):' ' DEPARTMENT OF SOCIAL SERVICES By: By: E Deputy Cler c to the Board David E. Long, Cha' SE 0 5 2007 CONTRACTOR Namaqua Center 404 East 7th Street Lovelan CO 80537 j By: 'L1 4 GCip WELD COUNTY DEPARTMENT OF SOCIAL SERVICES By: J(Aitt, a Director 4 Weld County SS-23A Addendum moo'7-d(1)y7 ' WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Reflections For Youth, Inc. and Weld County Department of Social Services for the period from July 1,2007 through June 30, 2008. The following provisions, made this / day of , 2007, are added to the referenced Agreement. Except as modified hereby, all terms of the greement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#1530128, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$161.44 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$161.44 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include,but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing (3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum _ 02Dp9-a Ef7 E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Social Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public(federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery,bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local)terminated for cause or default. 11. Section V,Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Social Services Policy and Procedure Manual. 12. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 13. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 14. Add Paragraph 9 to Section VI. The Director of 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; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Social Services and the Contractor, or by Social Services as a debt to Social Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 15. Add Paragraph 10 to Section VI. The contractor shall promptly notify Social Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Social Services' Director. The term "litigation"includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: I �ct�rr�riL�'� vti�t °t• I� .. .Weld Coun 1 1861 t- , TN WELD COUNTY BOARD OF ' f �� SOCIAL SERVICES, ON BEHALF % v"Y OF THE WELD COUNTY ° ,V114 DEPARTMENT OF SOCIAL ��► SERVICES By: By: 6 Deputy CI e c to the Board David E. Long, Ch it SEP 0 5 2007 CONTRACTOR Reflections For Youth, Inc. PO Box 1860 Berthoud CO^8,0'5113 By: V" �t ! WELD COUNTY DEPARTMENT OF SOCIAL SERVICES By. 'rector 4 Weld County SS-23A Addendum • Exhibit A Reflections for Youth, Inc. "Discovering the Power of Positive Choice" P.O. Box 1860 Berthoud, CO 80513 (970) 344-1380 (p) (970) 344-1394 (f) (1) Scope of Service: An agreement has been reached between Weld County DSS and Reflections for Youth, Inc. for the purchase of four guaranteed beds during the fiscal year July 1, 2007 — June 30, 2008. It is understood that the emphasis is on placements for females but can be used for males as well provided that less than four females are in placement. It is further understood that Weld County DSS can place additional youth in placement at Reflections under the existing placement contract and provided that space is available at the time of the referral. B. Scope of Service Prairie View: RFY Prairie View TRCCF program is open to any male youth requiring a well structured community-based program, consistent supervision, therapeutic/mental health services, and extra support educationally. An I.E.P. is preferred but not required. Youth who are dependent, neglected, abused or delinquent are considered for admission. Typically such youth will demonstrate behavioral and emotional difficulties and have a history that involves one or more of the following: family conflict/dysfunction, physical abuse, sexual abuse, running away, substance abuse, sexual acting out, oppositional/conduct difficulties, self-defeating behaviors/activities, delinquent acts and adjudications and learning disorders. Reflections employs a contracted child psychiatrist and accepts youth currently taking and/or in need of psychotropic medications. All medication evaluation and management appointments are billed directly to Medicaid. Reflections will not reject any referral solely on the basis of the youth's psychiatric/emotional history, placement history, committed delinquent acts and/or adjudications and/or running behavior. Youth with an extensive history of aggression to self and/or others and requiring repeated restraint for the protection of self and others, as well as adjudicated sexual offenders will be assessed on a case-by-case basis. Reflections will work with sex offenders and all staff are certified in Informed Supervision and Therapeutic Care for Juveniles that Sexually Offend. Reflections for Youth, Inc. contracts with two separate agencies that work to provide SOMB approved sex offender support and employs a licensed therapist that provides Informed Supervision and Therapeutic Care training to all staff and families of youth placed in our facility. Reflections for Youth, Inc. also employs a master's level therapist that has completed the six-day Kempe Center, SOMB approved training as a necessary step in becoming a SOMB fully operating offender therapist. Youth with full-scale IQ below 70 and youth requiring routine emergency medical assistance (diabetic, seizure disorders, etc) will also be assessed on a case-by-case basis. Actively suicidal or homicidal youth will not be accepted until the criteria for 27-10 is no longer being met. Reflections maintains the right, after screening and appropriate Exhibit A professional discussions, to the deny acceptance of a referral with either or both of the described issues. Minimum ratios of 4:1 are maintained at all awake times during all awake non-school hours. During the weekday hours of approximately 8:00am to 6:00 p.m. the 4:1 ratio is enhanced with the presence of House Managers and Therapists on site. On-call support is available at ALL times. The ratio is 10:1 for overnight awake shifts at the Prairie View Treatment Facility. Roles for each staff are as follows. The House Manager is responsible for the supervision of all staff and insuring the program is following the state and placing agency guidelines and the mission and treatment philosophy of Reflections for Youth, Inc. The House Manager is charged with the authority to implement, evaluate, and ensure consistent application of policy and procedure within the group home/treatment center. Of highest priority is safety of the residents. The House Manager is responsible for the curb appeal, interior cleanliness, maintenance, and overall appearance of the home and property. In addition the House Manger is responsible for the overall quality and effectiveness of the treatment milieu. In addition to working direct care with the residents in place of any Child Care Worker position. The Associate House Manager is responsible to cooperate with the House Manager and ensure a safe, nurturing environment for residents, as well as providing direct milieu counseling support. Further, the AHM must be able to step-in and continue with the consistence application of polices and procedures as well as state regulations should the HM be absent, and/or for any absent Child Care Worker. The Special Education Teacher is the primary staff responsible for classroom instruction as well as assistance to the Educational Director regarding the student testing, IEP process, and student transcripts. The Teachers Assistant/Day Counselor is responsible for assisting the Special Ed. Teacher with classroom instruction and management and also to be available for transportation and at times of planned interventions or crisis to supervise youth that are not involved in the school program due to behavior problems, illness, outside appointments or other approved reasons. The Child Care Worker/Milieu Counselor is responsible to assist with daily scheduling and routines; to provide encouragement and motivation; to facilitate personal development and maturation by modeling behavior, appropriate social skills, restorative justice in the milieu and problem solving skills; and to implement behavior management and modification techniques, including a phase system as warranted. The Overnight Child Care Workers has the same responsibilities and additionally needs to check on the residents every 15 minutes and document accordingly to ensure safety. Therapists have responsibility to provide individual and family therapy to the residents assigned by the Clinical Directors as a "case load". They assess, write and document monthly treatment plans and therapy notes. They maintain contact with the caseworkers, probation officers, and GAL's, and provide family support during non- • • Exhibit A therapy times as needed. They have regular bi-weekly consultation with residential staff support meetings and are available as needed. Therapists are available for crisis intervention within the milieu. Therapists complete after-care agreements with residents and their families. They oversee discharge planning with external systems and complete discharge summaries. They are responsible for all required documentation and record keeping. They maintain their licensure as LCSW, LMFT or LPC and actively seek educational opportunities and offer Medicaid eligible individual, family and group therapies to all TRCCF youth in placement. All program staff that support the program at each of the facilities but are not directly assigned to any one facility are as follows; Executive Director, Educational Director, Treatment Coordinator, Medical Services Coordinator and Client Services Coordinator. The Executive Director is responsible for the supervision of the daily operation of the program at Reflections for Youth, Inc. The Executive Director is held accountable for census, IEP status, staffing patterns, resident and employee record keeping, treatment plans for clients, and operating budget compliance. In addition, it is the responsibility of the Executive Director to maintain a professional operation while constantly seeking to improve services and operational systems. Reflections' Executive Director is also a Licensed Professional Counselor and is available for TRCCF level Medicaid services that include individual therapy sessions and group therapy at this time. The Educational Director is the leader of the educational team. The Educational Director is responsible for curriculum, teacher quality, and the maintenance of an excellent learning environment. In addition, the Educational Director is charged with the authority to implement, evaluate, and insure consistent application of corporate policy and procedure. The Educational Director also attends a majority of all twice monthly treatments planning sessions and staffings. The Treatment Coordinator is a new addition to our team and oversees the non-Medicaid billable mental health services offered in the program. These include attending facility specific meetings and treatment team meetings to ensure that milieu-based counseling and support is occurring regularly and that all Family Service Plans and Discrete Case Plans are being followed and implemented. It also includes attending monthly staffings to monitor overall progress and to evaluate and change the Reflections Treatment Plan as needed for the benefit of the client and with the approval of the treatment team. The Treatment Coordinator gathers information from the Client Services Coordinator and other collaterals to complete the Initial Treatment Plan as soon as possible after intake but no later that 14 days after intake. The Medical Coordinator is responsible for ensuring that all policies and procedures that are related to the medical program at Reflections for Youth, Inc. are in compliance with licensing and are being followed at all times. This includes ensuring that initial physical, dental and vision appointments are scheduled timely and that all medication prescriptions are filled and kept in order. The Medical Coordinator conducts weekly audits of medical charts and coordinates with the House Manager of each facility to meet the needs of the youth in care. She also schedules all medication/psychiatric evaluation appointments and provides information to our Child Psychiatrist from counseling staff, therapists, managers, parents and placement workers so that he may serve the needs of the youth with all of the information available. The Client Services Coordinator has responsibilities in the areas of intake, drug and alcohol education and support services, including initial screening and testing for youth in need of drug and alcohol services, and within the Family:Family program at Reflections providing in-home services to the youth and family while the • • Exhibit A youth is still in placement at Reflections. As we begin developing our wrap-around services, the Client Services Coordinator, Therapist, Treatment Coordinator and Executive Director will be intimately involved in the design and implementation of the program. Based on information provided to the state of Colorado Department of Human Services in the completion of our cost reports for the time periods July 1, 2007— February 2008, our average length of stay was 121 days. Reflections has worked hard to provide extensive transition services and planning and offers continuing support services through our core service home-based option B and day treatment programs to enable youths to step-down sooner with continuing support. In addition, while a youth is still in TRCCF level placement, our family:family program is offered as a home-based service for family support and planning prior to the youth returning home. This is a program in addition to the Medicaid-billed therapeutic services offered to the family and was specifically put into place to reduce length of stays as possible and to promote a positive continuum of care. Reflections for Youth, Inc. operates a state-certified, centralized special education/regular education school. With a student-to-teacher ratio of no more than 5:1, and a year-round school offering three full semesters of education, students have the opportunity to get closer to or achieve the credits necessary for grade level education. A state curriculum of academics is presented with the goal for each youth to eventually transfer back to the public school system or to graduate from Reflections Academy. Reflections Academy employs a master's level, certified school administrator, state- certified special education teachers and qualified associate teachers. Reflections Academy assures a continuity of care for each of the youth in residential treatment by providing education experiences which remediate, maintain and improve academic, intellectual and social functioning. Educational experiences include occupational and recreational classes and opportunities as well as academic and remedial classes. Reflections for Youth, Inc. maintains a professional working relationship with Colorado Department of Education's Special Services Unit. Reflections operates a centralized school for its residential students and day treatment students, including female youth in the girl's adolescent residential program. The school must comply with CDE's teacher and administrator licensing requirements, state and national curriculum standards, the administration of CSAP testing each calendar year, October 1 and December counting reports, Title I compliance, No Child Left Behind, Special Education Law (IDEA) and FAPE (Free and Public Education). Reflections for Youth's educational program consists of a minimum of 6.5 hours of school daily and is offered year round. Students do not attend on regularly scheduled holidays and teacher workdays throughout the year. Upon entering the program, teachers and educational staff use a variety of formal and informal measures to assess student growth and achievement on a regular basis. When a student enters without an I.E.P. or if further testing is appropriate, a wide range achievement test is administered and scores are used for making education placement decisions. At the time of intake into the educational program, requests are immediately made for past school records, including a current I.E.P. if applicable and the student's home school is notified of the placement. • Exhibit A The I.E.P. is reviewed for compliance and used as-is if appropriate. If the I.E.P. is out of compliance, an annual or triennial review will be scheduled in cooperation with the student's district of residence. Reflections for Youth teachers are state certified Special Education Generalists. All teachers are either master's level educators or are working towards their master's degree in special education and teacher preparation (Temporary Teacher Equivalency credentialed). Classroom paraprofessionals have at least a bachelor's level education and are state substitute certified. RFY also employs a Title I Reading Specialist on a yearly basis to meet the needs of students struggling with reading and mathematics. Reflections for Youth's educational program is overseen by a master's level Special Education Director and RFY employs master's level therapists only. Reflections believes it is important to offer gender specific programming because albeit some of the issues facing adolescents today are similar, most research agrees that females in our society face a certain specific set of issues, different from those of adolescent males. Some of the issues discussed and processed in the curriculum may even be the same issues but within the gender specific programming they are looked at in a different way and from the female adolescent perspective Minimum ratios of 4:1 are maintained at all awake times during all awake non-school hours. During the weekday hours of approximately 8:00am to 6:00 p.m. the 4:1 ratio is enhanced with the presence of House Managers and Therapists on site. On-call support is available at ALL times. The ratio is 8:1 for overnight awake shifts at the Wilderness Treatment Facility. Roles for each staff are as follows. The House Manager is responsible for the supervision of all staff and insuring the program is following the state and placing agency guidelines and the mission and treatment philosophy of Reflections for Youth, Inc. The House Manager is charged with the authority to implement, evaluate, and ensure consistent application of policy and procedure within the group home/treatment center. Of highest priority is safety of the residents. The House Manager is responsible for the curb appeal, interior cleanliness, maintenance, and overall appearance of the home and property. In addition the House Manger is responsible for the overall quality and effectiveness of the treatment milieu. In addition to working direct care with the residents in place of any Child Care Worker position. The Associate House Manager is responsible to cooperate with the House Manager and ensure a safe, nurturing environment for residents, as well as providing direct milieu counseling support. Further, the AHM must be able to step-in and continue with the consistence application of polices and procedures as well as state regulations should the HM be absent, and/or for any absent Child Care Worker. The Special Education Teacher is the primary staff responsible for classroom instruction as well as assistance to the Educational Director regarding the student testing, IEP process, and student transcripts. Exhibit A The Teachers Assistant/Day Counselor is responsible for assisting the Special Ed. Teacher with classroom instruction and management and also to be available for transportation and at times of planned interventions or crisis to supervise youth that are not involved in the school program due to behavior problems, illness, outside appointments or other approved reasons. The Child Care Worker/Milieu Counselor is responsible to assist with daily scheduling and routines; to provide encouragement and motivation; to facilitate personal development and maturation by modeling behavior, appropriate social skills, restorative justice in the milieu and problem solving skills; and to implement behavior management and modification techniques, including a phase system as warranted. The Overnight Child Care Workers has the same responsibilities and additionally needs to check on the residents every 15 minutes and document accordingly to ensure safety. Therapists have responsibility to provide individual and family therapy to the residents assigned by the Clinical Directors as a"case load". They assess, write and document monthly treatment plans and therapy notes. They maintain contact with the caseworkers, probation officers, and GAL's, and provide family support during non- therapy times as needed. They have regular bi-weekly consultation with residential staff support meetings and are available as needed. Therapists are available for crisis intervention within the milieu. Therapists complete after-care agreements with residents and their families. They oversee discharge planning with external systems and complete discharge summaries. They are responsible for all required documentation and record keeping. They maintain their licensure as LCSW, LMFT or LPC and actively seek educational opportunities and offer Medicaid eligible individual, family and group therapies to all TRCCF youth in placement. All program staff that support the program at each of the facilities but are not directly assigned to any one facility are as follows; Executive Director, Educational Director, Treatment Coordinator, Medical Services Coordinator and Client Services Coordinator. The Executive Director is responsible for the supervision of the daily operation of the program at Reflections for Youth, Inc. The Executive Director is held accountable for census, IEP status, staffing patterns, resident and employee record keeping, treatment plans for clients, and operating budget compliance. In addition, it is the responsibility of the Executive Director to maintain a professional operation while constantly seeking to improve services and operational systems. Reflections' Executive Director is also a Licensed Professional Counselor and is available for TRCCF level Medicaid services that include individual therapy sessions and group therapy at this time. The Educational Director is the leader of the educational team. The Educational Director is responsible for curriculum, teacher quality, and the maintenance of an excellent learning environment. In addition, the Educational Director is charged with the authority to implement, evaluate, and insure consistent application of corporate policy and procedure. The Educational Director also attends a majority of all twice monthly treatments planning sessions and staffings. The Treatment Coordinator is a new addition to our team and oversees the non-Medicaid billable mental health services offered in the program. These include attending facility specific meetings and treatment team meetings to ensure that milieu-based counseling and support is occurring regularly and that all Family Service Plans and Discrete Case Plans are being followed and implemented. It also includes • Exhibit A attending monthly staffings to monitor overall progress and to evaluate and change the Reflections Treatment Plan as needed for the benefit of the client and with the approval of the treatment team. The Treatment Coordinator gathers information from the Client Services Coordinator and other collaterals to complete the Initial Treatment Plan as soon as possible after intake but no later that 14 days after intake. The Medical Coordinator is responsible for ensuring that all policies and procedures that are related to the medical program at Reflections for Youth, Inc. are in compliance with licensing and are being followed at all times. This includes ensuring that initial physical, dental and vision appointments are scheduled timely and that all medication prescriptions are filled and kept in order. The Medical Coordinator conducts weekly audits of medical charts and coordinates with the House Manager of each facility to meet the needs of the youth in care. She also schedules all medication/psychiatric evaluation appointments and provides information to our Child Psychiatrist from counseling staff, therapists, managers, parents and placement workers so that he may serve the needs of the youth with all of the information available. The Client Services Coordinator has responsibilities in the areas of intake, drug and alcohol education and support services, including initial screening and testing for youth in need of drug and alcohol services, and within the Family:Family program at Reflections providing in-home services to the youth and family while the youth is still in placement at Reflections. As we begin developing our wrap-around services, the Client Services Coordinator, Therapist, Treatment Coordinator and Executive Director will be intimately involved in the design and implementation of the program. Based on information provided to the state of Colorado Department of Human Services in the completion of our cost reports for the time periods July 1, 2007— February 2008, our average length of stay was 121 days. Reflections has worked hard to provide extensive transition services and planning and offers continuing support services through our core service home-based option B and day treatment programs to enable youths to step-down sooner with continuing support. In addition, while a youth is still in TRCCF level placement, our family:family program is offered as a home-based service for family support and planning prior to the youth returning home. This is a program in addition to the Medicaid-billed therapeutic services offered to the family and was specifically put into place to reduce length of stays as possible and to promote a positive continuum of care. Reflections for Youth, Inc. operates a state-certified, centralized special education/regular education school. With a student-to-teacher ratio of no more than 5:1, and a year-round school offering three full semesters of education, students have the opportunity to get closer to or achieve the credits necessary for grade level education. A state curriculum of academics is presented with the goal for each youth to eventually transfer back to the public school system or to graduate from Reflections Academy. Reflections Academy employs a master's level, certified school administrator, state- certified special education teachers and qualified associate teachers. Reflections Academy assures a continuity of care for each of the youth in residential treatment by providing education experiences which remediate, maintain and improve academic, intellectual and social functioning. Educational experiences include occupational and recreational classes and opportunities as well as academic and remedial classes. Exhibit A Reflections for Youth, Inc. maintains a professional working relationship with Colorado Department of Education's Special Services Unit. Reflections operates a centralized school for its residential students and day treatment students, including female youth in the girl's adolescent residential program. The school must comply with CDE's teacher and administrator licensing requirements, state and national curriculum standards, the administration of CSAP testing each calendar year, October 1 and December counting reports, Title I compliance, No Child Left Behind, Special Education Law (IDEA) and FAPE (Free and Public Education). Reflections for Youth's educational program consists of a minimum of 6.5 hours of school daily and is offered year round. Students do not attend on regularly scheduled holidays and teacher workdays throughout the year. Upon entering the program, teachers and educational staff use a variety of formal and informal measures to assess student growth and achievement on a regular basis. When a student enters without an I.E.P. or if further testing is appropriate, a wide range achievement test is administered and scores are used for making education placement decisions. At the time of intake into the educational program, requests are immediately made for past school records, including a current I.E.P. if applicable and the student's home school is notified of the placement. The I.E.P. is reviewed for compliance and used as-is if appropriate. If the I.E.P. is out of compliance, an annual or triennial review will be scheduled in cooperation with the student's district of residence. Reflections for Youth teachers are state certified Special Education Generalists. All teachers are either master's level educators or are working towards their master's degree in special education and teacher preparation (Temporary Teacher Equivalency credentialed). Classroom paraprofessionals have at least a bachelor's level education and are state substitute certified. RFY also employs a Title I Reading Specialist on a yearly basis to meet the needs of students struggling with reading and mathematics. Reflections for Youth's educational program is overseen by a master's level Special Education Director and RFY employs master's level therapists only. (2) Daily Rate for Service: Reflections for Youth, Inc. daily rate for service will be the anchor rates that the state has established of$161.44 for all three of our facilities; Wilderness, Prairie View and Grismore respectively. This rate does not reflect the fee-for-service piece that is billable directly to Medicaid. (3) Menu of Services: Additional fees that were paid last year and once again asked for this year include drug and alcohol services, if needed based on history, initial testing and CCAR and beyond education and for specific offender service treatments. An additional $9.75 per day is requested if drug and alcohol services,beyond education, are needed. This can be a negotiated rate depending upon level of service that is needed. Reflections is in the • Exhibit A process of becoming ADAD certified and is expecting certification by October 2007. What follows is an entire description of the drug and alcohol program offered at Reflections for Youth, Inc. The Drug and Alcohol program is a divided into educational and treatment service components. The therapeutic and treatment portion is named the Substance Abuse and Dependency Program. Clients in the Substance Abuse and Dependency Program also receive the services offered in the Drug and Alcohol educational program. In this way Reflections for Youth, Inc. offers Education program, Comprehensive prevention program, Intervention program and Treatment level program. The mission of Reflections for Youth, Inc. Drug and Alcohol Program is to provide education and access to prevention services to every youth in the community based residential and day treatment programs. These services are provided through weekly educational/support and therapy groups. Educational groups are facilitated by a CAC I or Milieu Counselor. Educational services are initiated at intake as students are immediately enrolled in a once weekly class. (Educational Program) Prevention services and support/therapy groups are conducted by CACII, CACIII or licensed therapists. Access to these services is determined by the administration of an assessment tool (SASSI), DSM IV diagnosis, interviews with the client, family and Case Worker, and a history/documentation review. These initial assessments are conducted by a CAC II level staff member. Once the assessment procedures are completed a licensed therapist recommends that the resident either participate in only the educational portion of the Drug and Alcohol Program or the Substance Abuse and Dependency Program. Random UA screenings are provided by Reflections for Youth as part of the residential program. In most circumstances youth classified as experimental users will be eligible to participate in the weekly coping skills group. This group includes the skills portion of the DBT model and incorporates educational and prevention components, such as safety planning, cognitive distortions and further education not included in the educational services. This group is facilitated by a licensed therapist and/or CAC II level counselor. The decision for this level of program involvement will be made by the Reflections clinical team, Substance Abuse and Dependency Program staff and the Client Manager. (Comprehensive prevention program and Intervention Program) Anyone deemed as "dependent"on the SASSI Assessment is required to attend AA or NA meetings in their home environment while on home passes, and get a sponsor. They must have a 12 step attendance form signed and have sponsor make contact with the facility to speak with the House Manager of Client Services Coordinator. For youth involved in need of the Comprehensive prevention and Intervention program, recommendations may be made and requirements put in place for the youth(s) to attend AA or NA in the community while in placement in addition to during times of home visits. The mission of Reflections for Youth's Substance Abuse and Dependency Program is for each participant to understand the power of a sober life by developing coping strategies independent of substances, developing healthful ways to think about the world and themselves, identifying and addressing any underlying causes to the dependent behavior, and by creating personal situations that sustain abstinence and a healthy lifestyle. The additional services provided above the educational and coping skills • Exhibit A component are weekly therapy group; every third week art therapy group conducted by a CAC III, access to individual support sessions with CAC II level counselor, and focused cognitive behavioral assignments for individual and family therapy. The therapeutic assignments assist the individual to identify their cycle of abuse(triggers, cognitive distortions and unhealthy coping strategies), the underlying causes of their abuse/dependency, the specific belief systems that create their cycle of abuse/dependency, and the provocation of thinking about their future in planning for a life of abstinence from drugs and alcohol. For youth that are referred to the program and in need of drug and alcohol services beyond education, there is an additional daily rate charge of$9.75/day. The therapy group is structured to protect the safety of its members by requiring that the 1st cognitive behavioral therapy assignment is completed and that all members have respectfully put effort into and participated in the educational and coping skills group. Additionally, students are required to have reports from staff and their therapist that indicate they practice and use the coping skills discussed in the group. These requirements help create a safe group where participants are able to talk openly about their underlying causes and provide support or feedback regarding their belief systems that are not conducive to sobriety. All members of the program generate safety plans prior to passes and members of the abuse and dependency program must complete their relapse prevention plan to successfully complete the program. (Treatment level program). Because the Substance abuse and dependency program is tied to the residential program, therapeutic, educational and milieu services are provide conjointly. Substance abuse program members have milieu goals that focus on their substance use in addition to any other behavioral or emotional concerns. In the event an offender youth is placed by Weld County DSS, Weld County DSS would have an option of contracting with the S.O. provider directly for all services, including polygraphs and other services required as part of the SO treatment and pay directly to the provider or could contract with Reflections at a cost of$31.40 per day and Reflections would pay all provider costs for therapy, attending staffings, court, etc., including polygraphers, and any additional staff or services involved. • • WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Reflections For Youth, Inc. and Weld County Department of Social Services for the period from July 1, 2007 through June 30, 2008. The following provisions, made this / day of LT-wit/ , 2007, are added to the referenced Agreement. Except as modified hereby, all terms of the Agreement remain unchanged. 1. County agrees to purchase and Contractor, identified as Provider ID#1530130, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$161.44 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$161.44 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis, based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include,but are not limited to: Food, shelter, clothing,personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum aCe2- a�s�7 E. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include,but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Social Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum • C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement,had one or more public transactions (federal, state, and local) terminated for cause or default. 11. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Social Services Policy and Procedure Manual. 12. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 13. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 14. Add Paragraph 9 to Section VI. The Director of 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; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Social Services and the Contractor, or by Social Services as a debt to Social Services or otherwise as provided by law. 3 Weld County SS-23A Addendum 15. Add Paragraph 10 to Section VI. The contractor shall promptly notify Social Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Social Services' Director. The term "litigation"includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: A,'/ / . •l Weld Coun 41'4 and 6t ote% WELD COUNTY BOARD OF lA2 SOCIAL SERVICES, ON BEHALF it.7' aloft OF THE WELD COUNTY V � , DEPARTMENT OF SOCIAL ®� Vie, SERVICES BY: / G/Qyffx_ 2� �C.� J By: Affix_ Deputy Clefk to the Board David E. Long, Cha r S P 0 5 2007 CONTRACTOR Reflections For Youth, Inc. PO Box 1860 Berthoud CO 8051 By: WELD COUNTY DEPARTMENT OF SOCIAL SERVICES By: ar irectoC 4 Weld County SS-23A Addendum aDO?-AcfW Exhibit A Reflections for Youth, Inc. "Discovering the Power of Positive Choice" P.O. Box 1860 Berthoud, CO 80513 (970) 344-1380 (p) (970) 344-1394 (0 (1) Scope of Service: An agreement has been reached between Weld County DSS and Reflections for Youth, Inc. for the purchase of four guaranteed beds during the fiscal year July 1, 2007— June 30, 2008. It is understood that the emphasis is on placements for females but can be used for males as well provided that less than four females are in placement. It is further understood that Weld County DSS can place additional youth in placement at Reflections under the existing placement contract and provided that space is available at the time of the referral. A. Scope of Service Grismore: RFY Grismore TRCCF program is open to any male youth requiring a well structured community-based program, consistent supervision, therapeutic/mental health services, and extra support educationally. An I.E.P. is preferred but not required. Youth who are dependent, neglected, abused or delinquent are considered for admission. Typically such youth will demonstrate behavioral and emotional difficulties and have a history that involves one or more of the following: family conflict/dysfunction,physical abuse, sexual abuse, running away, substance abuse, sexual acting out, oppositional/conduct difficulties, self-defeating behaviors/activities, delinquent acts and adjudications and learning disorders. Reflections employs a contracted child psychiatrist and accepts youth currently taking and/or in need of psychotropic medications. All medication evaluation and management appointments are billed directly to Medicaid. Reflections will not reject any referral solely on the basis of the youth's psychiatric/emotional history, placement history, committed delinquent acts and/or adjudications and/or running behavior. Youth with an extensive history of aggression to self and/or others and requiring repeated restraint for the protection of self and others, as well as adjudicated sexual offenders will be assessed on a case-by-case basis. Reflections will work with sex offenders and all staff are certified in Informed Supervision and Therapeutic Care for Juveniles that Sexually Offend. Reflections for Youth, Inc. contracts with two separate agencies that work to provide SOMB approved sex offender support and employs a licensed therapist that provides Informed Supervision and Therapeutic Care training to all staff and families of youth placed in our facility. Reflections for Youth, Inc. also employs a master's level therapist that has completed the six-day Kempe Center, SOMB approved training as a necessary step in becoming a SOMB fully operating offender therapist. Youth with full-scale IQ below 70 and youth requiring routine emergency medical assistance (diabetic, seizure disorders, etc) will also be assessed on a case-by-case basis. Actively suicidal or homicidal youth will not be accepted until the criteria for 27-10 is no longer being met. Reflections maintains the right, after screening and appropriate professional discussions, to the deny acceptance of a referral with either or both of the described issues. Exhibit A Minimum ratios of 4:1 are maintained at all awake times during all awake non-school hours. During the weekday hours of approximately 8:00am to 6:00 p.m. the 4:1 ratio is enhanced with the presence of House Managers and Therapists on site. On-call support is available at ALL times. The ratio is 10:1 for overnight awake shift at the Grismore Treatment Facility. Roles for each staff are as follows. The House Manager is responsible for the supervision of all staff and insuring the program is following the state and placing agency guidelines and the mission and treatment philosophy of Reflections for Youth, Inc. The House Manager is charged with the authority to implement, evaluate, and ensure consistent application of policy and procedure within the group home/treatment center. Of highest priority is safety of the residents. The House Manager is responsible for the curb appeal, interior cleanliness, maintenance, and overall appearance of the home and property. In addition the House Manger is responsible for the overall quality and effectiveness of the treatment milieu. In addition to working direct care with the residents in place of any Child Care Worker position. The Associate House Manager is responsible to cooperate with the House Manager and ensure a safe, nurturing environment for residents, as well as providing direct milieu counseling support. Further, the AHM must be able to step-in and continue with the consistence application of polices and procedures as well as state regulations should the HM be absent, and/or for any absent Child Care Worker. The Special Education Teacher is the primary staff responsible for classroom instruction as well as assistance to the Educational Director regarding the student testing, IEP process, and student transcripts. The Teachers Assistant/Day Counselor is responsible for assisting the Special Ed. Teacher with classroom instruction and management and also to be available for transportation and at times of planned interventions or crisis to supervise youth that are not involved in the school program due to behavior problems, illness, outside appointments or other approved reasons. The Child Care Worker/Milieu Counselor is responsible to assist with daily scheduling and routines; to provide encouragement and motivation; to facilitate personal development and maturation by modeling behavior, appropriate social skills, restorative justice in the milieu and problem solving skills; and to implement behavior management and modification techniques, including a phase system as warranted. The Overnight Child Care Workers has the same responsibilities and additionally needs to check on the residents every 15 minutes and document accordingly to ensure safety. Therapists have responsibility to provide individual and family therapy to the residents assigned by the Clinical Directors as a"case load". They assess, write and document monthly treatment plans and therapy notes. They maintain contact with the caseworkers, probation officers, and GAL's, and provide family support during non- therapy times as needed. They have regular bi-weekly consultation with residential staff support meetings and are available as needed. Therapists are available for crisis • Exhibit A intervention within the milieu. Therapists complete after-care agreements with residents and their families. They oversee discharge planning with external systems and complete discharge summaries. They are responsible for all required documentation and record keeping. They maintain their licensure as LCSW, LMFT or LPC and actively seek educational opportunities and offer Medicaid eligible individual, family and group therapies to all TRCCF youth in placement. All program staff that support the program at each of the facilities but are not directly assigned to any one facility are as follows; Executive Director, Educational Director, Treatment Coordinator, Medical Services Coordinator and Client Services Coordinator. The Executive Director is responsible for the supervision of the daily operation of the program at Reflections for Youth, Inc. The Executive Director is held accountable for census, IEP status, staffing patterns, resident and employee record keeping, treatment plans for clients, and operating budget compliance. In addition, it is the responsibility of the Executive Director to maintain a professional operation while constantly seeking to improve services and operational systems. Reflections' Executive Director is also a Licensed Professional Counselor and is available for TRCCF level Medicaid services that include individual therapy sessions and group therapy at this time. The Educational Director is the leader of the educational team. The Educational Director is responsible for curriculum, teacher quality, and the maintenance of an excellent learning environment. In addition, the Educational Director is charged with the authority to implement, evaluate, and insure consistent application of corporate policy and procedure. The Educational Director also attends a majority of all twice monthly treatments planning sessions and staffings. The Treatment Coordinator is a new addition to our team and oversees the non-Medicaid billable mental health services offered in the program. These include attending facility specific meetings and treatment team meetings to ensure that milieu-based counseling and support is occurring regularly and that all Family Service Plans and Discrete Case Plans are being followed and implemented. It also includes attending monthly staffings to monitor overall progress and to evaluate and change the Reflections Treatment Plan as needed for the benefit of the client and with the approval of the treatment team. The Treatment Coordinator gathers information from the Client Services Coordinator and other collaterals to complete the Initial Treatment Plan as soon as possible after intake but no later that 14 days after intake. The Medical Coordinator is responsible for ensuring that all policies and procedures that are related to the medical program at Reflections for Youth, Inc. are in compliance with licensing and are being followed at all times. This includes ensuring that initial physical, dental and vision appointments are scheduled timely and that all medication prescriptions are filled and kept in order. The Medical Coordinator conducts weekly audits of medical charts and coordinates with the House Manager of each facility to meet the needs of the youth in care. She also schedules all medication/psychiatric evaluation appointments and provides information to our Child Psychiatrist from counseling staff, therapists, managers, parents and placement workers so that he may serve the needs of the youth with all of the information available. The Client Services Coordinator has responsibilities in the areas of intake, drug and alcohol education and support services, including initial screening and testing for youth in need of drug and alcohol services, and within the Family:Family program at Reflections providing in-home services to the youth and family while the youth is still in placement at Reflections. As we begin developing our wrap-around services, the Client Services Coordinator, Therapist, Treatment Coordinator and Exhibit A Executive Director will be intimately involved in the design and implementation of the program. Based on information provided to the state of Colorado Department of Human Services in the completion of our cost reports for the timeperiods 1, 2007— P P July February 2008, our average length of stay was 121 days. Reflections has worked hard to provide extensive transition services and planning and offers continuing support services through our core service home-based option B and day treatment programs to enable youths to step-down sooner with continuing support. In addition, while a youth is still in TRCCF level placement, our family:family program is offered as a home-based service for family support and planning prior to the youth returning home. This is a program in addition to the Medicaid-billed therapeutic services offered to the family and was specifically put into place to reduce length of stays as possible and to promote a positive continuum of care. Reflections for Youth, Inc. operates a state-certified, centralized special education/regular education school. With a student-to-teacher ratio of no more than 5:1, and a year-round school offering three full semesters of education, students have the opportunity to get closer to or achieve the credits necessary for grade level education. A state curriculum of academics is presented with the goal for each youth to eventually transfer back to the public school system or to graduate from Reflections Academy. Reflections Academy employs a master's level, certified school administrator, state- certified special education teachers and qualified associate teachers. Reflections Academy assures a continuity of care for each of the youth in residential treatment by providing education experiences which remediate, maintain and improve academic, intellectual and social functioning. Educational experiences include occupational and recreational classes and opportunities as well as academic and remedial classes. Reflections for Youth, Inc. maintains a professional working relationship with Colorado Department of Education's Special Services Unit. Reflections operates a centralized school for its residential students and day treatment students, including female youth in the girl's adolescent residential program. The school must comply with CDE's teacher and administrator licensing requirements, state and national curriculum standards, the administration of CSAP testing each calendar year, October 1 and December counting reports, Title I compliance, No Child Left Behind, Special Education Law (IDEA) and FAPE(Free and Public Education). Reflections for Youth's educational program consists of a minimum of 6.5 hours of school daily and is offered year round. Students do not attend on regularly scheduled holidays and teacher workdays throughout the year. Upon entering the program, teachers and educational staff use a variety of formal and informal measures to assess student growth and achievement on a regular basis. When a student enters without an I.E.P. or if further testing is appropriate, a wide range achievement test is administered and scores are used for making education placement decisions. At the time of intake into the educational program, requests are immediately made for past school records, including a current I.E.P. if applicable and the student's home school is notified of the placement. The I.E.P. is reviewed for compliance and used as-is if appropriate. If the I.E.P. is out of Exhibit A compliance, an annual or triennial review will be scheduled in cooperation with the student's district of residence. Reflections for Youth teachers are state certified Special Education Generalists. All teachers are either master's level educators or are working towards their master's degree in special education and teacher preparation (Temporary Teacher Equivalency credentialed). Classroom paraprofessionals have at least a bachelor's level education and are state substitute certified. RFY also employs a Title I Reading Specialist on a yearly basis to meet the needs of students struggling with reading and mathematics. Reflections for Youth's educational program is overseen by a master's level Special Education Director and RFY employs master's level therapists only. Reflections believes it is important to offer gender specific programming because albeit some of the issues facing adolescents today are similar, most research agrees that females in our society face a certain specific set of issues, different from those of adolescent males. Some of the issues discussed and processed in the curriculum may even be the same issues but within the gender specific programming they are looked at in a different way and from the female adolescent perspective Minimum ratios of 4:1 are maintained at all awake times during all awake non-school hours. During the weekday hours of approximately 8:00am to 6:00 p.m. the 4:1 ratio is enhanced with the presence of House Managers and Therapists on site. On-call support is available at ALL times. The ratio is 8:1 for overnight awake shifts at the Wilderness Treatment Facility. Roles for each staff are as follows. The House Manager is responsible for the supervision of all staff and insuring the program is following the state and placing agency guidelines and the mission and treatment philosophy of Reflections for Youth, Inc. The House Manager is charged with the authority to implement, evaluate, and ensure consistent application of policy and procedure within the group home/treatment center. Of highest priority is safety of the residents. The House Manager is responsible for the curb appeal, interior cleanliness, maintenance, and overall appearance of the home and property. In addition the House Manger is responsible for the overall quality and effectiveness of the treatment milieu. In addition to working direct care with the residents in place of any Child Care Worker position. The Associate House Manager is responsible to cooperate with the House Manager and ensure a safe, nurturing environment for residents, as well as providing direct milieu counseling support. Further, the AHM must be able to step-in and continue with the consistence application of polices and procedures as well as state regulations should the HM be absent, and/or for any absent Child Care Worker. The Special Education Teacher is the primary staff responsible for classroom instruction as well as assistance to the Educational Director regarding the student testing, IEP process, and student transcripts. The Teachers Assistant/Day Counselor is responsible for assisting the Special Ed. Teacher with classroom instruction and management and also to be available for Exhibit A transportation and at times of planned interventions or crisis to supervise youth that are not involved in the school program due to behavior problems, illness, outside appointments or other approved reasons. The Child Care Worker/Milieu Counselor is responsible to assist with daily scheduling and routines; to provide encouragement and motivation; to facilitate personal development and maturation by modeling behavior, appropriate social skills, restorative justice in the milieu and problem solving skills; and to implement behavior management and modification techniques, including a phase system as warranted. The Overnight Child Care Workers has the same responsibilities and additionally needs to check on the residents every 15 minutes and document accordingly to ensure safety. Therapists have responsibility to provide individual and family therapy to the residents assigned by the Clinical Directors as a"case load". They assess, write and document monthly treatment plans and therapy notes. They maintain contact with the caseworkers, probation officers, and GAL's, and provide family support during non- therapy times as needed. They have regular bi-weekly consultation with residential staff support meetings and are available as needed. Therapists are available for crisis intervention within the milieu. Therapists complete after-care agreements with residents and their families. They oversee discharge planning with external systems and complete discharge summaries. They are responsible for all required documentation and record keeping. They maintain their licensure as LCSW, LMFT or LPC and actively seek educational opportunities and offer Medicaid eligible individual, family and group therapies to all TRCCF youth in placement. All program staff that support the program at each of the facilities but are not directly assigned to any one facility are as follows; Executive Director, Educational Director, Treatment Coordinator, Medical Services Coordinator and Client Services Coordinator. The Executive Director is responsible for the supervision of the daily operation of the program at Reflections for Youth, Inc. The Executive Director is held accountable for census, IEP status, staffing patterns, resident and employee record keeping, treatment plans for clients, and operating budget compliance. In addition, it is the responsibility of the Executive Director to maintain a professional operation while constantly seeking to improve services and operational systems. Reflections' Executive Director is also a Licensed Professional Counselor and is available for TRCCF level Medicaid services that include individual therapy sessions and group therapy at this time. The Educational Director is the leader of the educational team. The Educational Director is responsible for curriculum, teacher quality, and the maintenance of an excellent learning environment. In addition, the Educational Director is charged with the authority to implement, evaluate, and insure consistent application of corporate policy and procedure. The Educational Director also attends a majority of all twice monthly treatments planning sessions and staffings. The Treatment Coordinator is a new addition to our team and oversees the non-Medicaid billable mental health services offered in the program. These include attending facility specific meetings and treatment team meetings to ensure that milieu-based counseling and support is occurring regularly and that all Family Service Plans and Discrete Case Plans are being followed and implemented. It also includes attending monthly staffings to monitor overall progress and to evaluate and change the Reflections Treatment Plan as needed for the benefit of the client and with the approval • Exhibit A of the treatment team. The Treatment Coordinator gathers information from the Client Services Coordinator and other collaterals to complete the Initial Treatment Plan as soon as possible after intake but no later that 14 days after intake. The Medical Coordinator is responsible for ensuring that all policies and procedures that are related to the medical program at Reflections for Youth, Inc. are in compliance with licensing and are being followed at all times. This includes ensuring that initial physical, dental and vision appointments are scheduled timely and that all medication prescriptions are filled and kept in order. The Medical Coordinator conducts weekly audits of medical charts and coordinates with the House Manager of each facility to meet the needs of the youth in care. She also schedules all medication/psychiatric evaluation appointments and provides information to our Child Psychiatrist from counseling staff, therapists, managers, parents and placement workers so that he may serve the needs of the youth with all of the information available. The Client Services Coordinator has responsibilities in the areas of intake, drug and alcohol education and support services, including initial screening and testing for youth in need of drug and alcohol services, and within the Family:Family program at Reflections providing in-home services to the youth and family while the youth is still in placement at Reflections. As we begin developing our wrap-around services, the Client Services Coordinator, Therapist, Treatment Coordinator and Executive Director will be intimately involved in the design and implementation of the program. Based on information provided to the state of Colorado Department of Human Services in the completion of our cost reports for the time periods July 1, 2007— February 2008, our average length of stay was 121 days. Reflections has worked hard to provide extensive transition services and planning and offers continuing support services through our core service home-based option B and day treatment programs to enable youths to step-down sooner with continuing support. In addition, while a youth is still in TRCCF level placement, our family:family program is offered as a home-based service for family support and planning prior to the youth returning home. This is a program in addition to the Medicaid-billed therapeutic services offered to the family and was specifically put into place to reduce length of stays as possible and to promote a positive continuum of care. Reflections for Youth, Inc. operates a state-certified, centralized special education/regular education school. With a student-to-teacher ratio of no more than 5:1, and a year-round school offering three full semesters of education, students have the opportunity to get closer to or achieve the credits necessary for grade level education. A state curriculum of academics is presented with the goal for each youth to eventually transfer back to the public school system or to graduate from Reflections Academy. Reflections Academy employs a master's level, certified school administrator, state- certified special education teachers and qualified associate teachers. Reflections Academy assures a continuity of care for each of the youth in residential treatment by providing education experiences which remediate, maintain and improve academic, intellectual and social functioning. Educational experiences include occupational and recreational classes and opportunities as well as academic and remedial classes. Reflections for Youth, Inc. maintains a professional working relationship with Colorado Department of Education's Special Services Unit. Reflections operates a Exhibit A centralized school for its residential students and day treatment students, including female youth in the girl's adolescent residential program. The school must comply with CDE's teacher and administrator licensing requirements, state and national curriculum standards, the administration of CSAP testing each calendar year, October 1 and December counting reports, Title I compliance, No Child Left Behind, Special Education Law (IDEA) and FAPE (Free and Public Education). Reflections for Youth's educational program consists of a minimum of 6.5 hours of school daily and is offered year round. Students do not attend on regularly scheduled holidays and teacher workdays throughout the year. Upon entering the program, teachers and educational staff use a variety of formal and informal measures to assess student growth and achievement on a regular basis. When a student enters without an I.E.P. or if further testing is appropriate, a wide range achievement test is administered and scores are used for making education placement decisions. At the time of intake into the educational program, requests are immediately made for past school records, including a current I.E.P. if applicable and the student's home school is notified of the placement. The I.E.P. is reviewed for compliance and used as-is if appropriate. If the I.E.P. is out of compliance, an annual or triennial review will be scheduled in cooperation with the student's district of residence. Reflections for Youth teachers are state certified Special Education Generalists. All teachers are either master's level educators or are working towards their master's degree in special education and teacher preparation (Temporary Teacher Equivalency credentialed). Classroom paraprofessionals have at least a bachelor's level education and are state substitute certified. RFY also employs a Title I Reading Specialist on a yearly basis to meet the needs of students struggling with reading and mathematics. Reflections for Youth's educational program is overseen by a master's level Special Education Director and RFY employs master's level therapists only. (2) Daily Rate for Service: Reflections for Youth, Inc. daily rate for service will be the anchor rates that the state has established of$161.44 for all three of our facilities; Wilderness, Prairie View and Grismore respectively. This rate does not reflect the fee-for-service piece that is billable directly to Medicaid. (3) Menu of Services: Additional fees that were paid last year and once again asked for this year include drug and alcohol services, if needed based on history, initial testing and CCAR and beyond education and for specific offender service treatments. An additional $9.75 per day is requested if drug and alcohol services,beyond education, are needed. This can be a negotiated rate depending upon level of service that is needed. Reflections is in the process of becoming ADAD certified and is expecting certification by October 2007. Exhibit A What follows is an entire description of the drug and alcohol program offered at Reflections for Youth, Inc. The Drug and Alcohol program is a divided into educational and treatment service components. The therapeutic and treatment portion is named the Substance Abuse and Dependency Program. Clients in the Substance Abuse and Dependency Program also receive the services offered in the Drug and Alcohol educational program. In this way Reflections for Youth, Inc. offers Education program, Comprehensive prevention program, Intervention program and Treatment level program. The mission of Reflections for Youth, Inc. Drug and Alcohol Program is to provide education and access to prevention services to every youth in the community based residential and day treatment programs. These services are provided through weekly educational/support and therapy groups. Educational groups are facilitated by a CAC I or Milieu Counselor. Educational services are initiated at intake as students are immediately enrolled in a once weekly class. (Educational Program) Prevention services and support/therapy groups are conducted by CACII, CACIII or licensed therapists. Access to these services is determined by the administration of an assessment tool (SASSI), DSM IV diagnosis, interviews with the client, family and Case Worker, and a history/documentation review. These initial assessments are conducted by a CAC II level staff member. Once the assessment procedures are completed a licensed therapist recommends that the resident either participate in only the educational portion of the Drug and Alcohol Program or the Substance Abuse and Dependency Program. Random UA screenings are provided by Reflections for Youth as part of the residential program. In most circumstances youth classified as experimental users will be eligible to participate in the weekly coping skills group. This group includes the skills portion of the DBT model and incorporates educational and prevention components, such as safety planning, cognitive distortions and further education not included in the educational services. This group is facilitated by a licensed therapist and/or CAC II level counselor. The decision for this level of program involvement will be made by the Reflections clinical team, Substance Abuse and Dependency Program staff and the Client Manager. (Comprehensive prevention program and Intervention Program) Anyone deemed as "dependent" on the SASSI Assessment is required to attend AA or NA meetings in their home environment while on home passes, and get a sponsor. They must have a 12 step attendance form signed and have sponsor make contact with the facility to speak with the House Manager of Client Services Coordinator. For youth involved in need of the Comprehensive prevention and Intervention program, recommendations may be made and requirements put in place for the youth(s)to attend AA or NA in the community while in placement in addition to during times of home visits. The mission of Reflections for Youth's Substance Abuse and Dependency Program is for each participant to understand the power of a sober life by developing coping strategies independent of substances, developing healthful ways to think about the world and themselves, identifying and addressing any underlying causes to the dependent behavior, and by creating personal situations that sustain abstinence and a healthy lifestyle. The additional services provided above the educational and coping skills component are weekly therapy group; every third week art therapy group conducted by a Exhibit A CAC III, access to individual support sessions with CAC II level counselor, and focused cognitive behavioral assignments for individual and family therapy. The therapeutic assignments assist the individual to identify their cycle of abuse (triggers, cognitive distortions and unhealthy coping strategies), the underlying causes of their abuse/dependency, the specific belief systems that create their cycle of abuse/dependency, and the provocation of thinking about their future in planning for a life of abstinence from drugs and alcohol. For youth that are referred to the program and in need of drug and alcohol services beyond education, there is an additional daily rate charge of$9.75/day. The therapy group is structured to protect the safety of its members by requiring that the lst cognitive behavioral therapy assignment is completed and that all members have respectfully put effort into and participated in the educational and coping skills group. Additionally, students are required to have reports from staff and their therapist that indicate they practice and use the coping skills discussed in the group. These requirements help create a safe group where participants are able to talk openly about their underlying causes and provide support or feedback regarding their belief systems that are not conducive to sobriety. All members of the program generate safety plans prior to passes and members of the abuse and dependency program must complete their relapse prevention plan to successfully complete the program. (Treatment level program). Because the Substance abuse and dependency program is tied to the residential program, therapeutic, educational and milieu services are provide conjointly. Substance abuse program members have milieu goals that focus on their substance use in addition to any other behavioral or emotional concerns. In the event an offender youth is placed by Weld County DSS, Weld County DSS would have an option of contracting with the S.O. provider directly for all services, including polygraphs and other services required as part of the SO treatment and pay directly to the provider or could contract with Reflections at a cost of$31.40 per day and Reflections would pay all provider costs for therapy, attending staffings, court, etc., including polygraphers, and any additional staff or services involved. WELD COUNTY ADDENDUM To that certain Agreement to Purchase Therapeutic Residential Child Care Facility Services and Residential Child Care Facility Services (the "Agreement") between Reflections For Youth, Inc. and Weld County Department of Social Services for the period from July 1, 2007 through July 30, 2007. The following provisions, made this / day of tr iv f , 2007, are added to the referenced Agreement. Except as modified hereby, all terms of the Agreement remain unchanged. County agrees to purchase and Contractor, identified as Provider ID#1530131, agrees to provide: A. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$161.44 per day for children placed within the Therapeutic Residential Child Care Facility. B. Child Maintenance, Administrative Maintenance and Services, which are listed in this Agreement at a rate of$161.44 per day for children placed within the Residential Child Care Facility. C. Additional services not covered by Medicaid or considered within the above vendor rate. These additional services/rates may be negotiated on a child by child basis,based on the needs of the child and in accordance with the Colorado Department of Human Services Agency Letter CW-06-11-I dated June 8, 2006. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. Section I, Paragraph 2. All bed hold authorizations and payments are subject to a 3 day maximum for a child's temporary absence from a facility, including hospitalization. Bed hold requests must have prior written authorization from the Department Administrator before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. No child maintenance will be paid for bed holds, due to the child's absence. 3. Add Paragraph 6 to Section I. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Therapeutic Residential Child Care Facilities and Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep-over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training,mentor/advocate, supervised visitation and all other services as outlined in the Contractor's scope of service attached as Exhibit A or the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: A. Food, including meals and snacks (25%); B. Clothing(3%); C. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%); D. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%); 1 Weld County SS-23A Addendum ate 9-al77 • E. Other/miscellaneous items considered usual in the care and supervision of the child, include,but are not limited to, transportation, recreation and overhead (40%) 4. Add Paragraph 7 to Section I. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 5. Add Paragraph 8 to Section I. Any additional costs for specialized services, which include, but are not limited to; polygraph tests, plethysmographs, and urinalysis screens, that is not provided within the vendor rate or attached Scope of Service, will need be negotiated and authorized, in writing by the County, prior to the service being performed. Any payment for specialized services not authorized in writing will be denied. 6. Add Paragraph 5 to Section II. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will be made in person-to-person communication, not through phone mail messages. During regular work hours, the Contractor will make every effort to notify the assigned caseworker, supervisor, or intake screener of any emergency medical, surgical or dental issues prior to granting authorization. During non-regular work hours, weekends and holidays, the Contractor will contact the Emergency Duty Worker at the pager number(970) 304-2749. 7. Section III, Paragraph 5. Contractor additionally agrees to have appropriate personnel available for staffing current placements with the Utilization Review Team. This review team convenes every Monday morning, excluding holidays. 8. Add Paragraph 13 to Section IV. Agree to cooperate with any vendors hired by Weld County Department of Social Services to shorten the duration of placement. 9. Add Paragraph 14 to Section IV. Agree to schedule physical examinations within 14 days after placement, dental examinations within 60 days after placement and forward all appropriate information to the County. 10. Add Paragraph 15 to Section IV. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student will be conducted every 3 years and reviewed every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 11. Add Paragraph 16 to Section IV. Assure and certify that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 2 Weld County SS-23A Addendum • C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 11. Section V, Paragraph 5. Children in Therapeutic Residential Child Care Facilities, Residential Child Care Facilities and Child Placement Agencies are not eligible to receive clothing allowances as outlined in the Weld County Department of Social Services Policy and Procedure Manual. 12. Add Paragraph 7 to Section VI. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 13. Add Paragraph 8 to Section VI. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may posses, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 14. Add Paragraph 9 to Section VI. The Director of 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; C. Recover from the Contractor any incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement or other agreements between Social Services and the Contractor, or by Social Services as a debt to Social Services or otherwise as provided by law. 3 Weld County SS-23A Addendum ' 15'. Add Paragraph 10 to Section VI. The contractor shall promptly notify Social Services in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five(5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the Social Services' Director. The term "litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. IN WITNESS WHEREOF, the parties hereto have duly executed the Addendum as of the day, month, and year first above written. ATTEST: Weld Cou Cl t C '�2 hr COUNTY BOARD OF ,. y SOCIAL SERVICES, ON BEHALF "' " fl OF THE WELD COUNTY : F<i DEPARTMENT OF SOCIAL SERVICES By: VILA, , By Deputy Clerl o the Board David E. Long, Chai SEP 5 2007 CONTRACTOR Reflections For Youth, Inc. PO Box 1860 Berthoud CO 80513 / By Ca WELD COUNTY DEPARTMENT OF SOCIAL SERVICES By: Director 4 Weld County SS-23A Addendum . Exhibit A Reflections for Youth, Inc. "Discovering the Power of Positive Choice" P.O. Box 1860 Berthoud, CO 80513 (970) 344-1380 (p) (970) 344-1394 (f) (1) Scope of Service: C. Scope of Service Wilderness: RFY Wilderness TRCCF program is open to any female youth requiring a well structured community-based program, consistent supervision, therapeutic/mental health services, and extra support educationally. An I.E.P. is preferred but not required. Youth who are dependent, neglected, abused or delinquent are considered for admission. Typically such youth will demonstrate behavioral and emotional difficulties and have a history that involves one or more of the following: family conflict/dysfunction, physical abuse, sexual abuse, running away, substance abuse, sexual acting out, oppositional/conduct difficulties, self-defeating behaviors/activities, delinquent acts and adjudications and learning disorders. Reflections employs a contracted child psychiatrist and accepts youth currently taking and/or in need of psychotropic medications. All medication evaluation and management appointments are billed directly to Medicaid. Reflections will not reject any referral solely on the basis of the youth's psychiatric/emotional history, placement history, committed delinquent acts and/or adjudications and/or running behavior. Youth with an extensive history of aggression to self and/or others and requiring repeated restraint for the protection of self and others, as well as adjudicated sexual offenders will be assessed on a case-by-case basis. Reflections will work with sex offenders and all staff are certified in Informed Supervision and Therapeutic Care for Juveniles that Sexually Offend. Reflections for Youth, Inc. contracts with two separate agencies that work to provide SOMB approved sex offender support and employs a licensed therapist that provides Informed Supervision and Therapeutic Care training to all staff and families of youth placed in our facility. Reflections for Youth, Inc. also employs a master's level therapist that has completed the six-day Kempe Center, SOMB approved training as a necessary step in becoming a SOMB fully operating offender therapist. Youth with full-scale IQ below 70 and youth requiring routine emergency medical assistance (diabetic, seizure disorders, etc) will also be assessed on a case-by-case basis. Actively suicidal or homicidal youth will not be accepted until the criteria for 27-10 is no longer being met. Reflections maintains the right, after screening and appropriate professional discussions, to the deny acceptance of a referral with either or both of the described issues. Reflections Wilderness offers a 17 session Teen Life Skills Health Education Program curriculum to all female youth in the residential program. The curriculum is designed so that new youth can enter the curriculum at anytime and continue through the completion of the curriculum. The curriculum is as follows: • Exhibit A • Our bodies, Ourselves • Reproduction 101 • Hormones 101 • What's Happened to My Self-Esteem? • What Do I Value? • Choices and Conscious Decisions—Intentionality • How Can I Be Assertive Without Being Aggressive? • Sexuality • Contraception • Sexually Transmitted Diseases • Are You or Are Not You My Friend? • Dating Violence • Sexual Exploitation • Free to Be, You and Me • Identifying and Understanding Eating Disorders • Women's History is Now My History • Joumaling My Story. It is Important! Reflections believes it is important to offer gender specific programming because albeit some of the issues facing adolescents today are similar, most research agrees that females in our society face a certain specific set of issues, different from those of adolescent males. Some of the issues discussed and processed in the curriculum may even be the same issues but within the gender specific programming they are looked at in a different way and from the female adolescent perspective Minimum ratios of 4:1 are maintained at all awake times during all awake non-school hours. During the weekday hours of approximately 8:00am to 6:00 p.m. the 4:1 ratio is enhanced with the presence of House Managers and Therapists on site. On-call support is available at ALL times. The ratio is 8:1 for overnight awake shifts at the Wilderness Treatment Facility. Roles for each staff are as follows. The House Manager is responsible for the supervision of all staff and insuring the program is following the state and placing agency guidelines and the mission and treatment philosophy of Reflections for Youth, Inc. The House Manager is charged with the authority to implement, evaluate, and ensure consistent application of policy and procedure within the group home/treatment center. Of highest priority is safety of the residents. The House Manager is responsible for the curb appeal, interior cleanliness,maintenance, and overall appearance of the home and property. In addition the House Manger is responsible for the overall quality and effectiveness of the treatment milieu. In addition to working direct care with the residents in place of any Child Care Worker position. The Associate House Manager is responsible to cooperate with the House Manager and ensure a safe, nurturing environment for residents, as well as providing direct milieu counseling support. Further, the AHM must be able to step-in and continue with the consistence application of polices and procedures as well as state regulations should the HM be absent, and/or for any absent Child Care Worker. • . Exhibit A The Special Education Teacher is the primary staff responsible for classroom instruction as well as assistance to the Educational Director regarding the student testing, IEP process, and student transcripts. The Teachers Assistant/Day Counselor is responsible for assisting the Special Ed. Teacher with classroom instruction and management and also to be available for transportation and at times of planned interventions or crisis to supervise youth that are not involved in the school program due to behavior problems, illness, outside appointments or other approved reasons. The Child Care Worker/Milieu Counselor is responsible to assist with daily scheduling and routines; to provide encouragement and motivation; to facilitate personal development and maturation by modeling behavior, appropriate social skills, restorative justice in the milieu and problem solving skills; and to implement behavior management and modification techniques, including a phase system as warranted. The Overnight Child Care Workers has the same responsibilities and additionally needs to check on the residents every 15 minutes and document accordingly to ensure safety. Therapists have responsibility to provide individual and family therapy to the residents assigned by the Clinical Directors as a"case load". They assess, write and document monthly treatment plans and therapy notes. They maintain contact with the caseworkers, probation officers, and GAL's, and provide family support during non- therapy times as needed. They have regular bi-weekly consultation with residential staff support meetings and are available as needed. Therapists are available for crisis intervention within the milieu. Therapists complete after-care agreements with residents and their families. They oversee discharge planning with external systems and complete discharge summaries. They are responsible for all required documentation and record keeping. They maintain their licensure as LCSW, LMFT or LPC and actively seek educational opportunities and offer Medicaid eligible individual, family and group therapies to all TRCCF youth in placement. All program staff that support the program at each of the facilities but are not directly assigned to any one facility are as follows; Executive Director, Educational Director, Treatment Coordinator, Medical Services Coordinator and Client Services Coordinator. The Executive Director is responsible for the supervision of the daily operation of the program at Reflections for Youth, Inc. The Executive Director is held accountable for census, IEP status, staffing patterns, resident and employee record keeping, treatment plans for clients, and operating budget compliance. In addition, it is the responsibility of the Executive Director to maintain a professional operation while constantly seeking to improve services and operational systems. Reflections' Executive Director is also a Licensed Professional Counselor and is available for TRCCF level Medicaid services that include individual therapy sessions and group therapy at this time. The Educational Director is the leader of the educational team. The Educational Director is responsible for curriculum, teacher quality, and the maintenance of an excellent learning environment. In addition, the Educational Director is charged with the authority to implement, evaluate, and insure consistent application of corporate policy and procedure. The Educational Director also attends a majority of all twice monthly treatments planning • Exhibit A sessions and staffings. The Treatment Coordinator is a new addition to our team and oversees the non-Medicaid billable mental health services offered in the program. These include attending facility specific meetings and treatment team meetings to ensure that milieu-based counseling and support is occurring regularly and that all Family Service Plans and Discrete Case Plans are being followed and implemented. It also includes attending monthly staffings to monitor overall progress and to evaluate and change the Reflections Treatment Plan as needed for the benefit of the client and with the approval of the treatment team. The Treatment Coordinator gathers information from the Client Services Coordinator and other collaterals to complete the Initial Treatment Plan as soon as possible after intake but no later that 14 days after intake. The Medical Coordinator is responsible for ensuring that all policies and procedures that are related to the medical program at Reflections for Youth, Inc. are in compliance with licensing and are being followed at all times. This includes ensuring that initial physical, dental and vision appointments are scheduled timely and that all medication prescriptions are filled and kept in order. The Medical Coordinator conducts weekly audits of medical charts and coordinates with the House Manager of each facility to meet the needs of the youth in care. She also schedules all medication/psychiatric evaluation appointments and provides information to our Child Psychiatrist from counseling staff, therapists, managers, parents and placement workers so that he may serve the needs of the youth with all of the information available. The Client Services Coordinator has responsibilities in the areas of intake, drug and alcohol education and support services, including initial screening and testing for youth in need of drug and alcohol services, and within the Family:Family program at Reflections providing in-home services to the youth and family while the youth is still in placement at Reflections. As we begin developing our wrap-around services, the Client Services Coordinator, Therapist, Treatment Coordinator and Executive Director will be intimately involved in the design and implementation of the program. Based on information provided to the state of Colorado Department of Human Services in the completion of our cost reports for the time periods July 1, 2007 — February 2008, our average length of stay was 121 days. Reflections has worked hard to provide extensive transition services and planning and offers continuing support services through our core service home-based option B and day treatment programs to enable youths to step-down sooner with continuing support. In addition, while a youth is still in TRCCF level placement, our family:family program is offered as a home-based service for family support and planning prior to the youth returning home. This is a program in addition to the Medicaid-billed therapeutic services offered to the family and was specifically put into place to reduce length of stays as possible and to promote a positive continuum of care. Reflections for Youth, Inc. operates a state-certified, centralized special education/regular education school. With a student-to-teacher ratio of no more than 5:1, and a year-round school offering three full semesters of education, students have the opportunity to get closer to or achieve the credits necessary for grade level education. A state curriculum of academics is presented with the goal for each youth to eventually transfer back to the public school system or to graduate from Reflections Academy. Reflections Academy employs a master's level, certified school administrator, state- certified special education teachers and qualified associate teachers. Reflections • Exhibit A Academy assures a continuity of care for each of the youth in residential treatment by providing education experiences which remediate, maintain and improve academic, intellectual and social functioning. Educational experiences include occupational and recreational classes and opportunities as well as academic and remedial classes. Reflections for Youth, Inc. maintains a professional working relationship with Colorado Department of Education's Special Services Unit. Reflections operates a centralized school for its residential students and day treatment students, including female youth in the girl's adolescent residential program. The school must comply with CDE's teacher and administrator licensing requirements, state and national curriculum standards, the administration of CSAP testing each calendar year, October 1 and December counting reports, Title I compliance, No Child Left Behind, Special Education Law (IDEA) and FAPE (Free and Public Education). Reflections for Youth's educational program consists of a minimum of 6.5 hours of school daily and is offered year round. Students do not attend on regularly scheduled holidays and teacher workdays throughout the year. Upon entering the program, teachers and educational staff use a variety of formal and informal measures to assess student growth and achievement on a regular basis. When a student enters without an I.E.P. or if further testing is appropriate, a wide range achievement test is administered and scores are used for making education placement decisions. At the time of intake into the educational program, requests are immediately made for past school records, including a current I.E.P. if applicable and the student's home school is notified of the placement. The I.E.P. is reviewed for compliance and used as-is if appropriate. If the I.E.P. is out of compliance, an annual or triennial review will be scheduled in cooperation with the student's district of residence. Reflections for Youth teachers are state certified Special Education Generalists. All teachers are either master's level educators or are working towards their master's degree in special education and teacher preparation (Temporary Teacher Equivalency credentialed). Classroom paraprofessionals have at least a bachelor's level education and are state substitute certified. RFY also employs a Title I Reading Specialist on a yearly basis to meet the needs of students struggling with reading and mathematics. Reflections for Youth's educational program is overseen by a master's level Special Education Director and RFY employs master's level therapists only. (2) Daily Rate for Service: Reflections for Youth, Inc. daily rate for service will be the anchor rates that the state has established of$161.44 for all three of our facilities; Wilderness, Prairie View and Grismore respectively. This rate does not reflect the fee-for-service piece that is billable directly to Medicaid. (3) Menu of Services: Exhibit A Additional fees that were paid last year and once again asked for this year include drug and alcohol services, if needed based on history, initial testing and CCAR and beyond education and for specific offender service treatments. An additional $9.75 per day is requested if drug and alcohol services, beyond education, are needed. This can be a negotiated rate depending upon level of service that is needed. Reflections is in the process of becoming ADAD certified and is expecting certification by October 2007. What follows is an entire description of the drug and alcohol program offered at Reflections for Youth, Inc. The Drug and Alcohol program is a divided into educational and treatment service components. The therapeutic and treatment portion is named the Substance Abuse and Dependency Program. Clients in the Substance Abuse and Dependency Program also receive the services offered in the Drug and Alcohol educational program. In this way Reflections for Youth, Inc. offers Education program, Comprehensive prevention program, Intervention program and Treatment level program. The mission of Reflections for Youth, Inc. Drug and Alcohol Program is to provide education and access to prevention services to every youth in the community based residential and day treatment programs. These services are provided through weekly educational/support and therapy groups. Educational groups are facilitated by a CAC I or Milieu Counselor. Educational services are initiated at intake as students are immediately enrolled in a once weekly class. (Educational Program) Prevention services and support/therapy groups are conducted by CACII, CACIII or licensed therapists. Access to these services is determined by the administration of an assessment tool (SASSI), DSM IV diagnosis, interviews with the client, family and Case Worker, and a history/documentation review. These initial assessments are conducted by a CAC II level staff member. Once the assessment procedures are completed a licensed therapist recommends that the resident either participate in only the educational portion of the Drug and Alcohol Program or the Substance Abuse and Dependency Program. Random UA screenings are provided by Reflections for Youth as part of the residential program. In most circumstances youth classified as experimental users will be eligible to participate in the weekly coping skills group. This group includes the skills portion of the DBT model and incorporates educational and prevention components, such as safety planning, cognitive distortions and further education not included in the educational services. This group is facilitated by a licensed therapist and/or CAC II level counselor. The decision for this level of program involvement will be made by the Reflections clinical team, Substance Abuse and Dependency Program staff and the Client Manager. (Comprehensive prevention program and Intervention Program) Anyone deemed as "dependent"on the SASSI Assessment is required to attend AA or NA meetings in their home environment while on home passes, and get a sponsor. They must have a 12 step attendance form signed and have sponsor make contact with the facility to speak with the House Manager of Client Services Coordinator. For youth involved in need of the Comprehensive prevention and Intervention program, recommendations may be made and requirements put in place for the youth(s) to attend AA or NA in the community while in placement in addition to during times of home visits. . e Exhibit A The mission of Reflections for Youth's Substance Abuse and Dependency Program is for each participant to understand the power of a sober life by developing coping strategies independent of substances, developing healthful ways to think about the world and themselves, identifying and addressing any underlying causes to the dependent behavior, and by creating personal situations that sustain abstinence and a healthy lifestyle. The additional services provided above the educational and coping skills component are weekly therapy group; every third week art therapy group conducted by a CAC III, access to individual support sessions with CAC II level counselor, and focused cognitive behavioral assignments for individual and family therapy. The therapeutic assignments assist the individual to identify their cycle of abuse(triggers, cognitive distortions and unhealthy coping strategies), the underlying causes of their abuse/dependency, the specific belief systems that create their cycle of abuse/dependency, and the provocation of thinking about their future in planning for a life of abstinence from drugs and alcohol. For youth that are referred to the program and in need of drug and alcohol services beyond education, there is an additional daily rate charge of$9.75/day. The therapy group is structured to protect the safety of its members by requiring that the 1st cognitive behavioral therapy assignment is completed and that all members have respectfully put effort into and participated in the educational and coping skills group. Additionally, students are required to have reports from staff and their therapist that indicate they practice and use the coping skills discussed in the group. These requirements help create a safe group where participants are able to talk openly about their underlying causes and provide support or feedback regarding their belief systems that are not conducive to sobriety. All members of the program generate safety plans prior to passes and members of the abuse and dependency program must complete their relapse prevention plan to successfully complete the program. (Treatment level program). Because the Substance abuse and dependency program is tied to the residential program, therapeutic, educational and milieu services are provide conjointly. Substance abuse program members have milieu goals that focus on their substance use in addition to any other behavioral or emotional concerns. In the event an offender youth is placed by Weld County DSS, Weld County DSS would have an option of contracting with the S.O. provider directly for all services, including polygraphs and other services required as part of the SO treatment and pay directly to the provider or could contract with Reflections at a cost of$31.40 per day and Reflections would pay all provider costs for therapy, attending staffings, court, etc., including polygraphers, and any additional staff or services involved. Hello