HomeMy WebLinkAbout20022039.tiff RESOLUTION
RE: APPROVE FIVE (5) AGREEMENTS TO PURCHASE CHILD PLACEMENT AGENCY
SERVICES WITH VARIOUS PROVIDERS AND AUTHORIZE CHAIR TO SIGN
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board has been presented with five (5) Agreements to Purchase Child
Placement Agency Services between the County of Weld, State of Colorado, by and through
the Board of County Commissioners of Weld County, on behalf of the Department of Social
Services, and the following service providers, with terms commencing July 1, 2002, and ending
June 30, 2003, with further terms and conditions being as stated in said agreements:
1) Adoption Alliance
2) Creative Beginnings
3) Frontier Family Services
4) Hope Family Services
5) Kids Resources Network, Inc., and
WHEREAS, after review, the Board deems it advisable to approve said agreements,
copies of which are attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of
Weld County, Colorado, ex-officio Board of Social Services, that the five (5) Agreements to
Purchase Child Placement Agency Services between the County of Weld, State of Colorado, by
and through the Board of County Commissioners of Weld County, on behalf of the Department
of Social Services, and the above listed providers be, and hereby are, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said agreements.
2002-2039
SS0029
cQ : SS Ca may)
RE: FIVE (5) AGREEMENTS TO PURCHASE CHILD PLACEMENT AGENCY SERVICES
PAGE 2
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 31st day of July, A.D., 2002, nunc pro tunc July 1, 2002.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST: { L r{, / EXCUSED DATE OF SIGNING (AYE)
Lk,
99 ° ' �N Gle aad, Chair
Weld County Clerk to t : '.�>•� C�
zee
David ng, Pro-Tern
BY: Deputy C i Boa
;� 7,77
Clerk to the Boa ,��.�*/ �� 444.*f
M. J. Geile
AP E S T EXCUSED DATE OF SIGNING (AYE)
W' liam H. Jerke
ou> nt9 Att rrtey
Robe . Masden
Date of signature:
2002-2039
SS0029
� • 4
DEPARTMENT OF SOCIAL SERVICES
PO BOX A
GREELEY,CO 80632
WEBSITE:www.co.weld.co.us
Administration and Public Assistance(970)352-1551
CChild Support(970)352-6933
O
COLORADO MEMORANDUM
TO: Glenn Vaad, Chair Date: July 25, 2002
Board of County Commissioners
FR: Judy A. Griego, Director, Social Services) L0-
RE: ��Agreements to Purchase Child Placementgency Services
Between Weld County Department of Social Services
Enclosed for Board approval are Agreements to Purchase Child Placement Agency
Services between the Weld County Depatment of Social Services with various vendors.
These yearly Agreements are in accordance with Board approved policies of Sections
2.320 and 2.902.22 of the Weld County Department of Social Services Operations
Manual. These Agreements were reviewed at the Board's Work Session of July 30,
2002.
The major provisions of the Agreements as follows:
1. The term is July 1, 2002 through June 30, 2003.
2. The Department agrees to reimburse vendors according to State approved Needs
Based Care Assessment levels and rate table. The rates include charges for room,
board, and treatment. These vendors are as follows:
A. Adoption Alliance
B. Creative Beginnings
C. Frontier Family Services
D. Hope Family Services
E. Kids Resources Network, Inc.
If you have any questions,please telephone me at extension 6510.
2002-2039
•
Contract No: PY 02/03-SS-23A-CPA
AGREEMENT TO PURCHASE
CHILD PLACEMENT AGENCY SERVICES 1O2
fey/
THIS AGREEMENT made this 1st day of July, 2002 between the Weld County Board of Soc alc trvices,
on behalf of the Weld County Department of Social Services hereinafter called "County" and Adoption All4ificc,
2121 S. Oneda St, Suite 420,Denver, CO 80224, hereinafter called "Contractor". 2)
WHEREAS, the Colorado State Department of Social Services,hereinafter called "State Department" is
authorized to provide social services to individuals and families of individuals through its agents, County
Departments of Social Services, and
WHEREAS, County is authorized to purchase certain services for eligible children under State Department rules,
and
WHEREAS, County wishes to provide these services by purchasing them from Contractor, and,
WHEREAS, Contractor is licensed as a Child Placement Agency.
NOW THEREFORE, it is hereby agreed that in consideration of the mutual Undertakings County and Contractor
agree as follows:
1. A child specific Needs Based Care Assessment, designated as Attachment B, shall be used to determine
levels of care for each child placed with Contractor.
2. County agrees to purchase and Contractor agrees to provide the care and services, which are listed in this
Agreement,based on the Needs Based Care Assessment levels determined. The specific rate of payment
will be paid for each level of service, as indicated by the Needs Based Care Rate Table, designated as
Attachment C, for children placed within the CPA identified as Provider ID#71259. 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.
3. This Agreement shall be in force from July 1st, 2002, until the end of the Colorado fiscal year, June 30,
2003; or until the child is removed by the County; or if the child's behavior would cause harm to himself or
other children, and Contractor seeks approval from the County and the County agrees, in writing, to
terminate this Agreement, whichever event occurs first.
•
4. This Agreement may be renewed only by entering into a new written Agreement, such as this Agreement,
signed by the authorized representatives of the parties. In addition to the termination provisions in
Paragraph 3 above, either party shall have the right to terminate this contract by giving the other party thirty
(30) days notice by registered mail, return receipt requested. If notice is so given, this contract shall
terminate on the expiration of the thirty(30) days or until the eligible child can be placed elsewhere,
whichever occurs earlier, and the liability of the parties hereunder for further performance of the terms of
this Agreement shall thereupon cease,but the parties shall not be released from the duty to perform their
obligations up to the date of termination.
5. This Agreement is in lieu of and supersedes all prior agreements between the parties hereto and relating to
the care and services herein described.
Agreement to Purchase 1
CPA Foster Care Services Rev 06/11/02
Contract No: PY 02/03-SS-23A-CPA
SECTION 1. DESCRIPTION OF SERVICES TO BE PURCHASED.
1. The services purchased under this Agreement are Child Placement Agency services and may include,but
are not limited to: Basic 24-hour care and child maintenance (food, shelter, clothing, educational supplies
and allowance), Administrative Overhead, Case Management, Direct therapy and evaluation, which may
include but are not limited to: Psychological and/or Neurological, Medication and follow-up, Family
Therapy, Individual Therapy, Group Therapy, Sex Offender Evaluation and/or Sex Offender Treatment as
prescribed by the Sex Offender Management Board Policy, Polygraph, Plethysmograph, Parent Training
for Teens, Independent Living Training, Mentor/Advocate, Supervised Visitation, Direct Child Care,
Therapeutic Recreation, Transportation, and Special Needs (requires SS-22).
2. Payment for a child's temporary absence from the facility, including absence due to hospitalization,will be
made in accordance with State Department rules in Staff Manual Volume VII, 7.406.1 (F).
3. Transportation shall be furnished by County between the child's residence and Contractor's facility for the
initial placement and return after the treatment plan is completed. If the child runs away from the
Contractor's facility, the County shall provide transportation to either return the child to the facility or to
other care as arranged by the County. The County will make the decision to return the child to the facility,
with input from the Contractor.
4. All other transportation associated with the Contractor's proposed services will be provided by Contractor.
Any transportation costs not covered or contemplated in the original treatment plan must be negotiated
between County and Contractor and are not subject to reimbursement under this Agreement. However,
provisions for payment of other transportation may be provided for in the treatment/case plan.
5. Any transportation costs to be incurred on behalf of this child which are to be borne by persons or agencies
which are not a party to this contract shall be specified in the treatment/case plan, and those persons shall
acknowledge their responsibility by signing the treatment/case plan.
6. Contractor will provide the purchased care and services at:
Provider ID#: 71259
Adoption Alliance
2121 S. Oneda St, Suite 420
Denver, CO 80224
7. Contractor shall not charge any additional fees to children or families of children referred by County for
services provided under this Agreement.
8. Contractor agrees not to assign the obligations under this Agreement nor enter into any sub-contracts
without the express written approval of the Executive Director of the Colorado Department of Social
Services or his appointed designee.
Agreement to Purchase 2
CPA Foster Care Services Rev 06/11/02
Contract No: PY 02/03-SS-23A-CPA
SECTION II. MEDICAL CARE
1. In accordance with the Weld County Department of Social Services policies (2.710.70, 2.710.71, 2.710.72,
2.710.73, 2.710.74) and Colorado Department of Human Services Child Care Licensing Division policy
(7.714.131), the contractor may obtain: 1) Ordinary medical care, and 2) Emergency medical, surgical or
dental care for said child after making reasonable efforts to contact the County to obtain consent.
Emergency care is defined as any medical treatment as recommended by a licensed medical authority to
protect the life and health of a child and treatment cannot be delayed without placing the child at risk.
2. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will not be
made through phone mail messages.
3. Between 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) 350-8389.
4. The County will be notified by the facility no later than the following working day of any administration of
emergency medical, surgical or dental services provided under this authorization.
5. Prior to any elective, non-routine or non-emergency medical, surgical or dental services being provided,
authorization must be obtained from the assigned caseworker or supervisor. If parental rights are intact,
authorization or attempts to obtain authorization from the parent(s) should also be documented. If the
placement is made through a voluntary placement agreement between the parent(s) and the County, the
parent(s)must be contacted for authorization.
6. The Contractor is required to maintain a complete record of all medical, surgical or dental services
provided and the medications administered to the child.
7. The Contractor will provide an up-to-date copy of the medical record to the County at the time of submittal
of each progress report, including the discharge report at the time of the child's termination from the care
of the Contractor.
8. County and Contractor shall insure that the Child is enrolled in the Early and Periodic Screening, Diagnosis
and Treatment Program.
9. It is agreed and permission is granted for the child to participate in planned recreational and social
activities of Contractor, including supervised off grounds excursions and extended trips within the State,
provided that Contractor has written permission from County and legal custodian for any trips out of
Colorado for any reason and any planned absence from the facility of over seven(7) days within a
consecutive 30-day period. Such written permission may be in the treatment/case plan. Further,
Contractor and County will also secure, where possible, permission from parents or guardians of the child
placed with the Contractor.
10. County and Contractor shall inform each other and the local school district of any changes in parental
residence affecting educational status, which comes to their attention.
Agreement to Purchase 3
CPA Foster Care Services Rev 06/11/02
Contract No: PY 02/03-SS-23A-CPA
SECTION III. REASONS FOR REFERRAL AND TREATMENT PLAN
1. Attachment A will be designated as the Placement Referral form. This referral will be child specific and
shall include the initial Treatment Plan that shall be goal oriented and time-limited.
2. The Treatment Plan shall include the anticipated living arrangement and the anticipated educational
arrangement for the child upon completion. Also included will be the anticipated date for discharge from
treatment purchased as well as provisions concerning the involvement of the child's family in treatment of
the child.
3. County and Contractor agree and understand that the psychological (mental and behavioral) or physical
problems which necessitate purchasing services for this child are specified in the Attachment A.
4. Modifications to the initial Treatment Plan shall be agreed upon by the County and Contractor and shall be
reflected in the Attachment A.
5. At no longer than thirty-day(30) intervals after placement, Contractor shall provide County with written
reports which address changes to the child's physical or psychological condition, changes in the child's
family situation, education progress, significant incidents or disciplinary actions, and progress made to
achieve goals specified in the Treatment Plan. Contractor shall participate in all Foster Care Reviews
as scheduled by the County and insure the attendance of the child.
SECTION IV. CONTRACTOR SHALL:
1. Conform with and abide by all rules and regulations of the Colorado Department of Social Services, the
State of Colorado and any federal laws and regulations, as such, which may be amended from time to time,
and shall be binding on Contractor and control any disputes in this Agreement.
2. Maintain a current license and maintain license requirements as specified under State law.
3. Abide by all applicable provisions of Title VI and VII of the Federal Civil Rights Act of 1964, Section 504
of the Rehabilitation Act of 1973, Title XX of the Social Security Act of 1975 as revised, and provide
confidentiality of information concerning the child and the child's family.
4. Maintain during the term of this Agreement a liability insurance policy of at least $25,000 for property
damage liability, $150,000 for injury and/or damage to any one person, and $400,000 for total injuries
arising from any one accident.
5. Maintain during the terms of this Agreement a fidelity bond of at least $25,000 or two (2) months gross
receipts, whichever is greater, covering the activities of any of its officers, agents or employees responsible
for the implementation and/or administration of this contract in order to make reparations for any wrongful
acts, omissions, or any other defalcations of the Contractor.
6. Indemnify County, the Colorado Department of Social Services and the State of Colorado against any and
loss against all claims and actions based upon or arising out of damage or injury, including death, to
persons or property caused or sustained in connection with the performance of this contract or by
conditions created thereby, or based upon any violations of any statute, ordinance, or regulation and the
defense of any such claims or actions.
Agreement to Purchase 4
CPA Foster Care Services Rev 06/11/02
Contract No: PY 02/03-SS-23A-CPA
7. Maintain service program records, fiscal records, documentation and other records, which will sufficiently
and properly reflect all direct and indirect costs of any nature incurred in the performance of this
Agreement. The above shall be subject at all reasonable times to inspection, review or audit by federal,
State Department or county personnel, and other persons authorized in writing by the Executive Director,
Colorado Department of Social Services.
8. Bill the County for services rendered, using the required Division of Child Welfare Provider Roster. This
roster is to be mailed to the County department by the last day of the month of care. If Provider Rosters are
not received, payments will be held until the required paperwork is received.
9. Attend and participate in Foster Care Reviews for children in placement longer than 60 days, and any
subsequent appeal process, for children in placement with the Contractor pursuant to two (2) weeks written
notice by the County. If the facility is in a different part of the state from the county in which the review is
held, participation may be by teleconference.
10. Agree to cooperate with any vendors hired by Weld County Department of Social Services to shorten the
duration of placement at CPA level.
11. Obtain physical examinations within 14 days of placement and forward all appropriate information to the
County.
12. Obtain Dental examinations within 60 days of placement and forward all appropriate information to the
i
County.
13. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education
Students 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.
SECTION V. COUNTY SHALL:
I. Determine eligibility of the child under this Agreement for placement and medical coverage.
2. Assess and collect fees in accordance with the rules and regulations of the Colorado Department of Social
Services.
3. Reimburse Contractor by the 15th of the following month in accordance with fiscal system time frames for
services purchased under this Agreement in accordance with the established rate specified herein, when
Provider Rosters are submitted as described in Section IV, Number 8.
4. Abide by all the rules and regulations of the Colorado Department of Social Services, federal rules and
regulations and the laws of the State of Colorado, any of which maybe amended from time to time.
5. Monitor child's progress in accordance with the treatment/case plan and the requirements of State
Department Staff Manual, Volume VII, and provide consultation and/or technical assistance to Contractor
in relation to the services purchased under this Agreement.
Agreement to Purchase
5
CPA Foster Care Services Rev 06/11/02
Contract No: PY 02/03-SS-23A-CPA
6. Involve Contractor in planning for the child and give the Contractor a copy of the Discrete Case Plan at
time of placement or as soon as completed and when updated or revised.
SECTION VI. GENERAL PROVISIONS.
1. The Parties to this Agreement intend that the relationship between them, contemplated by this Agreement
is that of employer-independent contractor. No agent, employee, or servant of Contractor shall be deemed
to be an employee, agent, or servant of County. Contractor will be solely and entirely responsible for its
acts or of any agent, employee, servants and sub-contractors during the performance of this Agreement.
2. Payment pursuant to this Agreement, if in State of Colorado or federal funds, whether in whole or in part,
is subject to and contingent upon the continuing availability of State of Colorado and federal funds for the
purpose thereof.
3. It is agreed that if, after investigation, it is shown that reasonable care was given to guard and protect
personal items brought to Contractor by the Child, Contractor will be released from responsibility for loss
or damage to such personal items.
4. This Contract is intended as the complete integration of all understandings between the parties. No prior or
contemporaneous addition, deletion, or other amendment hereto shall have any force or effect whatsoever,
unless embodied herein in writing. No subsequent notation,renewal, addition, deletion, or other
amendment hereto shall have any force or effect unless embodied in a written Agreement.
5. The Contract shall permit the Colorado Department of Social Services to monitor the service program,
fiscal books and other records sufficiently to assure the purchase of services in this Agreement are carried
out for the benefit of the aforementioned child through program reports, on-site visits where applicable and
other contracts as deemed necessary. The Contractor understands that the Colorado Department of Social
Services will provide consultation and technical assistance to Contractor to assure satisfactory performance
in the provision of purchased services under this Agreement.
6. In the event this contract is terminated, final payment to the Contractor may be withheld at their discretion
of the County until final audit. Incorrect payments to the Contractor due to omission, error, fraud, or
misuse of funds shall be recovered from the Contractor either by deduction from subsequent payments
under this contract or other contracts between the County and the Contractor or by the County, as a debt
due to both the State of Colorado, Colorado Department of Social Services and the County. The waiver of
any violation shall not be construed as a waiver of any other or subsequent violation of this contract or
appropriate statutes and regulations.
7. 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.
Agreement to Purchase 6
CPA Foster Care Services Rev 06/11/02
Contract No: PY 02/03-SS-23A-CPA
8. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their
officers or employees may possess, nor shall any portion of this Agreement be deemed to have created a
duty of care which 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.
IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year
first above written.
ATTEST:
Weld County f'k ' !t /. ` WELD COUNTY BOARD OF SOCIAL SERVICES,
ON BEHALF OF THE WELD COUNTY DEPARTMENT
86 �Nr 4 =, OF SOCIAL SERVICES
By: /i-: � : By: �� U
Deputy Clerk to the B It~J 1 Vad A ,Chair
�Y�°� � (-/31/oz)
APROVED AS TO FORM:,
CONTRACTOR
County j ttorney
Adoption Alliance
2121 S. Oneda St, Suite 420
Denver, CO 80224
By: 7(72,-44.75
77. l2c&e, i A.
WELD COUNTY DEPARTMENT
OF SOCIAL SERVICES r` .
By:
'rector
Agreement to Purchase
CPA Foster Care Services Rev 06/11/02
07/18/02 13:02 FAX 970 348 7691 WELD CTY SOC SERVICES Z,003
Contract No; PY 07303-SS-23A-CPA
AGREEMENT TO PURCHASE
CHILD PLACEMENT AGENCY SERVICES ('CP ff�
THIS AGREEMENT made this l't day of July,2002 between the Weld County Board of Soc1dSgtyices,
on behalf of the Weld County Department of Social Services hereinafter called"County" and Creative BegmtQrt3sp
7100 N. Broadway Unit 6-0,Denver,CO 80221,hereinafter called "Contractor".
WHEREAS,the Colorado State Department of Social Services,hereinafter called "State Department" is
authorized to provide social services to individuals and families of individuals through its agents, County
Departments of Social Services, and
WHEREAS, County is authorized to purchase certain services for eligible children under State Department rules,
and
WHEREAS, County wishes to provide these services by purchasing them from Contractor, and,
WHEREAS, Contractor is licensed as a Child Placement Agency.
NOW THEREFORE, it is hereby agreed that in consideration of the mutual Undertakings County and Contractor
agree as follows:
1. A child specific Needs Based Care Assessment, designated as Attachment B, shall be used to determine
levels of care for each child placed with Contractor.
2. County agrees to purchase and Contractor agrees to provide the care and services,which are listed in this
Agreement,based on the Needs Based Care Assessment levels determined. The specific rate of payment
will be paid for each level of service, as indicated by the Needs Based Care Rate Table, designated as
Attachment C, for children placed within the CPA identified as Provider ID#39342. 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.
3. This Agreement shall be in force from July Ist, 2002, until the end of the Colorado fiscal year,June 30,
2003: or until the child is removed by the County;or if the child's behavior would cause harm to himself or
other children, and Contractor seeks approval from the County and the County agrees, in writing,to
terminate this Agreement,whichever event occurs first.
4. This Agreement may be renewed only by entering into a new written Agreement, such as this Agreement,
signed by the authorized representatives of the parties. In addition to the termination provisions in
Paragraph 3 above, either party shall have the right to terminate this contract by giving the other party thirty
(30) days notice by registered mail,return receipt requested. If notice is so given,this contract shall
terminate on the expiration of the thirty(30) days or until the eligible child can be placed elsewhere,
whichever occurs earlier,and the liability of the parties hereunder for further performance of the terms of
this Agreement shall thereupon cease,but the parties shall not be released from the duty to perform their
obligations up to the date of termination.
5. This Agreement is in lieu of and supersedes all prior agreements between the panics hereto and relating to
the care and services herein described.
Agreemot to Purchase 1 Rcv 0611 1/02
CPA Foster Care Services
07/18/02 13:02 FAX 970 346 7691 WELD CTY SOC SERVICES ft 004—Contract No: PY 02!03-SS-23A-CPA
SECTION I. DESCRIPTION OF SERVICES TO BE PURCHASED.
1. The services purchased under this Agreement are Child Placement Agency services and may include,but
are not limited to: Basic.24-hour care and child maintenance(food, shelter,clothing, educational supplies
and allowance), Administrative Overhead,Case Management,Direct therapy and evaluation,which may
include but are not limited to: Psychological and/or Neurological,Medication and follow-up,Family
Therapy,Individual Therapy, Group Therapy, Sex Offender Evaluation and/or Sex Offender Treatment as
prescribed by the Sex Offender Management Board Policy, Polygraph,Plethystnograph,Parent Training
for Teens, Independent Living Training, Mentor/Advocate, Supervised Visitation,Direct Child Care,
Therapeutic Recreation,Transportation, and Special Needs(requires SS-22).
2. Payment for a child's temporary absence from the facility, including absence due to hospitalization,will be
made in accordance with State Department rules in Staff Manual Volume VII, 7,406.1 (F).
3. Transportation shall be furnished by County between the child's residence and Contractor's facility for the
initial placement and return after the treatment plan is completed. If the child runs away from the
Contractor's facility,the County shall provide transportation to either return the child to the facility or to
other care as arranged by the County. The County will make the decision to return the child to the facility,
with input from the Contractor.
4. All other transportation associated with the Contractor's proposed services will be provided by Contractor.
Any transportation costs not covered or contemplated in the original treatment plan must be negotiated
between County and Contractor and are not subject to reimbursement under this Agreement However,
provisions for payment of other transportation may be provided for in the treatment/case plan
5. Any transportation costs to be incurred on behalf of this child which are to be borne by persons or agencies
which are not a party to this contract shall be specified in the treatment/case plan, and those persons shall
acknowledge their responsibility by signing the treatment/case plan.
6. Contractor will provide the purchased care and services at:
Provider ID#: 39342
Creative Beginnings
7100 N. Broadway Unit 6-0
Denver,CO E0221
7. Contractor shall not charge any additional fees to children or families of children referred by County for
services provided under this Agreement.
8. Contractor agrees not to assign the obligations under this Agreement nor enter into any sub-contracts
without the express written approval of the Executive Director of the Colorado Department of Social
Services or his appointed designee.
Agreement to Purchase 2
CPA Foster Cate Services Rev 06/11/02
0.7,18/02 13:03 FAX 970 346 7691 WELD CTY SOC SERVICES 005
Contract No: PY 02/03-SS•23A•CPA
SECTION 11. MEDICAL CARE
In accordance with the Weld County Department of Social Services policies (2.71030,2,710.71,2.710.72,
2.710.73, 2.710.74)and Colorado Department of Human Services Child Care Licensing Division policy
(7.714.131),the contractor may obtain: 1) Ordinary medical care,and 2)Emergency medical,surgical or
dental care for said child after making reasonable efforts to contact the County to obtain consent.
Emergency care is defined as any medical treatment as recommended by a licensed medical authority to
protect the life and health of a child and treatment cannot be delayed without placing the child at risk.
2. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will not be
made through phone mail messages.
3, Between 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)350-8389.
4. The County will be notified by the facility no later than the following working day of any administration of
emergency medical, surgical or dental services provided under this authorization.
5. Prior to any elective, non-routine or non-emergency medical,surgical or dental services being provided,
authorization must be obtained from the assigned caseworker or supervisor. If parental rights are intact,
authorization or attempts to obtain authorization from the parent(s) should also be documented. If the
placement is made through a voluntary placement agreement between the parent(s) and the County,the
parent(s)must be contacted for authorization.
6. The Contractor is required to maintain a complete record of all medical, surgical or dental services
provided and the medications administered to the child,
7. The Contractor will provide an up-to-date copy of the medical record to the County at the time of submittal
of each progress report, including the discharge report at the time of the child's termination from the care
of the Contractor.
8. County and Contractor shall insure that the Child is enrolled in the Early and Periodic Screening, Diagnosis
and Treatment Program.
9- It is agreed and permission is granted for the child to participate in planned recreational and social
activities of Contractor, including supervised off grounds excursions and extended trips within the State,
provided that Contractor has written permission from County and legal custodian for any trips out of
Colorado for any reason and any planned absence from the facility of over seven(7) days within a
consecutive 30-day period. Such written permission may be in the treatment/ease plan. Further,
Contractor and County will also secure,where possible,permission from parents or guardians of the child
placed with the Contractor.
10. County and Contractor shall inform each other and the local school district of any changes in parental
residence affecting educational status,which comes to their attention.
Agreement to Purchase Rev 06/11/02
CPA Foster Care Services
07./18102 13:04 FAIL 970 346 7891 WELD CTY SQC SERVICES l?000
Contract No; PY 02/03-SS-23A-CPA
SECTION III. REASONS FOR REFERRAL AND TREATMENT PLAN
1. Attachment A will be designated as the Placement Referral form, This referral will be child specific and
shall include the initial Treatment Plan that shall be goal oriented and time-lirruted,
2. The Treatment Plan shall include the anticipated living arrangement and the anticipated educational
arrangement for the child upon completion. Also included will be the anticipated date for discharge from
treatment purchased as well as provisions concerning the involvement of the child's family in treatment of
the child.
3. County and Contractor agree and understand that the psychological (mental and behavioral)or physical
problems which necessitate purchasing services for this child are specified in the Attachment A.
4, Modifications to the initial Treatment Plan shall be agreed upon by the County and Contractor and shall be
reflected in the Attachment A.
5. At no longer than thirty-day(30)intervals after placement, Contractor shall provide County with written
reports which address changes to the child's physical or psychological condition,changes in the child's
family situation, education progress,significant incidents or disciplinary actions,and progress made to
achieve goals specified in the Treatment Plan. Contractor shall participate in all Foster Care Reviews
as scheduled by the County and insure the attendance of the child.
SECTION IV. CONTRACTOR SHALL:
1. Conform with and abide by all rules and regulations of the Colorado Department of Social Services,the
State of Colorado and any federal laws and regulations, as such,which may be amended from time to time,
and shall be binding on Contractor and control any disputes in this Agreement.
2. Maintain a current license and maintain license requirements as specified under State law.
3. Abide by all applicable provisions of Title VI and VU of the Federal Civil Rights Act of 1964,Section 504
of the Rehabilitation Act of 1973,Title XX of the Social Security Act of 1975 as revised, and provide
confidentiality of information concerning the child and the child's family.
4. Maintain during the term of this Agreement a liability insurance policy of at least $25,000 for property
damage liability, $150,000 for injury and/or damage to any one person, and$400,000 for total injuries
arising from any one accident.
5. Maintain during the terms of this Agreement a fidelity bond of at least$25,000 or two (2)months gross
receipts, whichever is greater, covering the activities of any of its officers, agents or employees responsible
for the implementation and/or administration of this contract in order to make reparations for any wrongful
acts,omissions,or any other defalcations of the Contractor.
6. Indemnify County,the Colorado Department of Social Services and the State of Colorado against any and
loss against all claims and actions based upon or arising out of damage or injury, including death,to
persons or property caused or sustained in connection with the performance of this contract or by
conditions created thereby, or based upon any violations of any statute, ordinance,or regulation and the
defense of any such claims or actions.
Agreemcut to Purchase 4 Rev 06%11(02
CIA Foster Care Services
07/.18/02 13:04 FAX 970 346 7691 WELD CTY SOC SERVICES fE!007
CoatractNo: PY 02/03-SS-23A-CPA
7. Maintain service program records, fiscal records, documentation and other records, which will sufficiently
and properly reflect all direct and indirect costs of any nature incurred in the performance of this
Agreement. The above shall be subject at all reasonable times to inspection,review or audit by federal,
State Department or county personnel, and other persons authorized in writing by the Executive Director,
Colorado Department of Social Services.
8. Bill the County for services rendered,using the required Division of Child Welfare Provider Roster. This
roster is to be mailed to the County department by the last day of the month of care. If Provider Rosters are
not received,payments will be held until the required paperwork is received.
9, Attend and participate in Foster Care Reviews for children in placement longer than 60 days, and any
subsequent appeal process, for children in placement with the Contractor pursuant to two(2)weeks written
notice by the County. If the facility is in a different part of the state from the county in which the review is
held,participation may be by teleconference.
l0. Agree to cooperate with any vendors hired by Weld County Department of Social Services to shorten the
duration of placement at CPA level.
11. Obtain physical examinations within 14 days of placement and forward all appropriate information to the
County.
12. Obtain Dental examinations within 60 days of placement and forward all appropriate information to the
County.
13. A full evaluation of an Individualized Educational Plan(IEP) for youth designated as a Special Education
Students 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.
SECTION V. COUNTY SHALL:
1. Determine eligibility of the child under this Agreement for placement and medical coverage.
2. Assess and collect fees in accordance with the rules and regulations of the Colorado Department of Social
Services.
3. Reimburse Contractor by the 15th of the following month in accordance with fiscal system time frames for
services purchased under this Agreement in accordance with the established rare specified herein,when
Provider Rosters are submitted as described in Section IV,Number 8.
4. Abide by all the rules and regulations of the Colorado Department of Social Services, federal rules and
regulations and the laws of the State of Colorado, any of which may be amended from time to time.
5. Monitor child's progress in accordance with the treatment'case plan and the requirements of State
Department Staff Manual,Volume VII, and provide consultation and/or technical assistance to Contractor
in relation to the services purchased under this Agreement.
Agree-meat to Purchase 5 Rev 06/1 1/02
CPA Foster Care services
q7/18/02 13:05 FAX 970 348 7691 WELD l`TP Soc SERVICES 009
Conaact No' PY 02/03-SS-23A-CPA
6. Involve Contractor in planning for the child and give the Contractor a copy of the Discrete Case Plan at
time of placement or as soon as completed and when updated or revised.
SECTION VI. GENERAL PROVISIONS.
1. The Parties to this Agreement intend that the relationship between theme contemplated by this Agreement
is that of employer-independent contractor. No agent,employee,or servant of Contractor shall be deemed
tobeor employee,a agent, employee, servants and sub-contractors during responsible
r its
the performance of this Agreemo
acts Agreement.
2. Payment pursuant to this Agreement,if in State of Colorado or federal funds,whether in whole or in part,
is subject to and contingent upon the continuing availability of State of Colorado and federal funds for the
purpose thereof.
3. It is agreed that if, after investigation,it is shown that reasonable care was given to guard and protect
personal items brought to Contractor by the Child,Contractor will be released from responsibility for loss
or damage to such personal items.
4. This Contract is intended as the complete integration of all understandings between the parties. No prior or
contemporaneous addition, deletion, or other amendment hereto shall have any force or effect whatsoever,
unless embodied herein in writing. No subsequent notation,renewal, addition, deletion, or other
amendment hereto shall have any force or effect unless embodied hi a written Agreement.
5. The Contract shall permit the Colorado Department of Social Services to monitor the service program.
fiscal books and other records sufficiently to assure the purchase ofort�ces inehisiis Atswhere at a are
carried
and
out for the benefit of the aforementioned child through program rep
other contracts as deemed necessary. The Contractor understands that the Colorado Department of Social
Services will provide consultation and technical assistance to Contractor to assure satisfactory performance
in the provision of purchased services under this Agreement.
6. In the event this contract is terminated,final payment to the Contractor may be withheld at their discretion
of the County until final audit. Incorrect payments to the Contractor due to omission. error, fraud,or
misuse of funds shall be recovered from the Contractor either by deduction from subsequent payments
under this contract or other contracts between the County and the Contractor or by the County, as a debt
due to both the State of Colorado,Colorado Department of Social Services and the County. The waiver of
any violation shall not be construed as a waiver of any other or subsequent violation of this contract or
appropriate statutes and regulations.
7. 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.
Agreement to Purcbasc 6 Rev 06'11102
CPA Foster Care Services
07/18/02 13:06 FAX 970 346 7691 WELD CTY S0C SERVICES_., x:009
Contract No: PY 02/03-SS-23A-CPA
8. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the patties or their
officers or employees may possess,nor shall any portion of this Agreement be deemed to have created a
duty of care which did not previously exist with respect to any person not a party to this Agreement. The
parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace
such immunities.
IN WITNESS WHEREOF,the parties hereto have duly executed the Agreement as of the day,month, and year
first above written.
ATTEST: Weld County WELD COUNTY BOARD OF SOCIAL SLSERVICES,►i6' `;S,js:c::l.�_-��
ON BEHALF OF THE WELD COUNTY DEPARTMENT
OF SOCIAL SERVICES
1861 cevt.4I2
.,
t ' r• By:
By: 9, Olean Van Che'
Deputy Clerk to the B•Ti�)ni �.PWs ,�
( (7/31/04
APROVED AS TO FORM:
CONTRACTOR
County ttomey
Creative Beginnings
7100 N. Broadway Unit 6-0
Denver, CO 80221
By: Q key-�`=
WELD COUNTY DEPARTMENT
OF SOCIAL SERVICES
By:
hector
Agreement w Purchase 7Rev 06/11/02
CPA Foster Care Services
•
Contract No: PY 02/03-SS-23A-CPA
AGREEMENT TO PURCHASE
CHILD PLACEMENT AGENCY SERVICES
THIS AGREEMENT made this 1st day of July, 2002 between the Weld County Board of Social Services,
on behalf of the Weld County Department of Social Services hereinafter called "County" and Frontier Family
Services, 1290 Boston Ave, Longmont, CO 80501-5810, hereinafter called "Contractor".
WHEREAS, the Colorado State Department of Social Services, hereinafter called "State Department" is
authorized to provide social services to individuals and families of individuals through its agents, County
Departments of Social Services, and
WHEREAS, County is authorized to purchase certain services for eligible children under State Department rules,
and
WHEREAS, County wishes to provide these services by purchasing them from Contractor, and,
WHEREAS, Contractor is licensed as a Child Placement Agency.
NOW THEREFORE, it is hereby agreed that in consideration of the mutual Undertakings County and Contractor
agree as follows:
1. A child specific Needs Based Care Assessment, designated as Attachment B, shall be used to determine
levels of care for each child placed with Contractor.
2. County agrees to purchase and Contractor agrees to provide the care and services, which are listed in this
Agreement, based on the Needs Based Care Assessment levels determined. The specific rate of payment
will be paid for each level of service, as indicated by the Needs Based Care Rate Table, designated as
Attachment C, for children placed within the CPA identified as Provider ID#38041. 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.
3. This Agreement shall be in force from July 1st, 2002, until the end of the Colorado fiscal year, June 30,
2003; or until the child is removed by the County; or if the child's behavior would cause harm to himself or
other children, and Contractor seeks approval from the County and the County agrees, in writing, to
terminate this Agreement, whichever event occurs first.
4. This Agreement may be renewed only by entering into a new written Agreement, such as this Agreement,
signed by the authorized representatives of the parties. In addition to the termination provisions in
Paragraph 3 above, either party shall have the right to terminate this contract by giving the other party thirty
(30) days notice by registered mail, return receipt requested. If notice is so given, this contract shall
terminate on the expiration of the thirty(30) days or until the eligible child can be placed elsewhere,
whichever occurs earlier, and the liability of the parties hereunder for further performance of the terms of
this Agreement shall thereupon cease, but the parties shall not be released from the duty to perform their
obligations up to the date of termination.
5. This Agreement is in lieu of and supersedes all prior agreements between the parties hereto and relating to
the care and services herein described.
Agreement to Purchase
1
CPA Foster Care Services Rev 06/11/02
Contract No: PY 02/03-SS-23A-CPA
SECTION 1. DESCRIPTION OF SERVICES TO BE PURCHASED.
1. The services purchased under this Agreement are Child Placement Agency services and may include,but
are not limited to: Basic 24-hour care and child maintenance (food, shelter, clothing, educational supplies
and allowance), Administrative Overhead, Case Management, Direct therapy and evaluation,which may
include but are not limited to: Psychological and/or Neurological, Medication and follow-up, Family
Therapy, Individual Therapy, Group Therapy, Sex Offender Evaluation and/or Sex Offender Treatment as
prescribed by the Sex Offender Management Board Policy, Polygraph, Plethysmograph, Parent Training
for Teens, Independent Living Training, Mentor/Advocate, Supervised Visitation, Direct Child Care,
Therapeutic Recreation, Transportation, and Special Needs (requires SS-22).
2. Payment for a child's temporary absence from the facility, including absence due to hospitalization, will be
made in accordance with State Department rules in Staff Manual Volume VII, 7.406.1 (F).
3. Transportation shall be famished by County between the child's residence and Contractor's facility for the
initial placement and return after the treatment plan is completed. If the child runs away from the
Contractor's facility, the County shall provide transportation to either return the child to the facility or to
other care as arranged by the County. The County will make the decision to return the child to the facility,
with input from the Contractor.
4. All other transportation associated with the Contractor's proposed services will be provided by Contractor.
Any transportation costs not covered or contemplated in the original treatment plan must be negotiated
between County and Contractor and are not subject to reimbursement under this Agreement. However,
provisions for payment of other transportation may be provided for in the treatment/case plan.
5. Any transportation costs to be incurred on behalf of this child which are to be borne by persons or agencies
which are not a party to this contract shall be specified in the treatment/case plan, and those persons shall
acknowledge their responsibility by signing the treatment/case plan.
6. Contractor will provide the purchased care and services at:
Provider ID#: 38041
Frontier Family Services
1290 Boston Ave
Longmont, CO 80501-5810
7. Contractor shall not charge any additional fees to children or families of children referred by County for
services provided under this Agreement.
8. Contractor agrees not to assign the obligations under this Agreement nor enter into any sub-contracts
without the express written approval of the Executive Director of the Colorado Department of Social
Services or his appointed designee.
Agreement to Purchase
2
CPA Foster Care Services Rev 06/11/02
Contiact No: PY 02/03-SS-23A-CPA
SECTION II. MEDICAL CARE
1. In accordance with the Weld County Department of Social Services policies (2.710.70, 2.710.71, 2.710.72,
2.710.73, 2.710.74) and Colorado Department of Human Services Child Care Licensing Division policy
(7.714.131), the contractor may obtain: 1) Ordinary medical care, and 2) Emergency medical, surgical or
dental care for said child after making reasonable efforts to contact the County to obtain consent.
Emergency care is defined as any medical treatment as recommended by a licensed medical authority to
protect the life and health of a child and treatment cannot be delayed without placing the child at risk.
2. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will not be
made through phone mail messages.
3. Between 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) 350-8389.
4. The County will be notified by the facility no later than the following working day of any administration of
emergency medical, surgical or dental services provided under this authorization.
5. Prior to any elective, non-routine or non-emergency medical, surgical or dental services being provided,
authorization must be obtained from the assigned caseworker or supervisor. If parental rights are intact,
authorization or attempts to obtain authorization from the parent(s) should also be documented. If the
placement is made through a voluntary placement agreement between the parent(s) and the County, the
parent(s) must be contacted for authorization.
6. The Contractor is required to maintain a complete record of all medical, surgical or dental services
provided and the medications administered to the child.
7. The Contractor will provide an up-to-date copy of the medical record to the County at the time of submittal
of each progress report, including the discharge report at the time of the child's termination from the care
of the Contractor.
8. County and Contractor shall insure that the Child is enrolled in the Early and Periodic Screening, Diagnosis
and Treatment Program.
9. It is agreed and permission is granted for the child to participate in planned recreational and social
activities of Contractor, including supervised off grounds excursions and extended trips within the State,
provided that Contractor has written permission from County and legal custodian for any trips out of
Colorado for any reason and any planned absence from the facility of over seven (7) days within a
consecutive 30-day period. Such written permission may be in the treatment/case plan. Further,
Contractor and County will also secure, where possible, permission from parents or guardians of the child
placed with the Contractor.
10. County and Contractor shall inform each other and the local school district of any changes in parental
residence affecting educational status, which comes to their attention.
Agreement to Purchase
3
CPA Foster Care Services Rev 06/11/02
Contact No: PY 02/03-SS-23A-CPA
SECTION III. REASONS FOR REFERRAL AND TREATMENT PLAN
1. Attachment A will be designated as the Placement Referral form. This referral will be child specific and
shall include the initial Treatment Plan that shall be goal oriented and time-limited.
2. The Treatment Plan shall include the anticipated living arrangement and the anticipated educational
arrangement for the child upon completion. Also included will be the anticipated date for discharge from
treatment purchased as well as provisions concerning the involvement of the child's family in treatment of
the child.
3. County and Contractor agree and understand that the psychological (mental and behavioral) or physical
problems which necessitate purchasing services for this child are specified in the Attachment A.
4. Modifications to the initial Treatment Plan shall be agreed upon by the County and Contractor and shall be
reflected in the Attachment A.
5. At no longer than thirty-day(30) intervals after placement, Contractor shall provide County with written
reports which address changes to the child's physical or psychological condition, changes in the child's
family situation, education progress, significant incidents or disciplinary actions, and progress made to
achieve goals specified in the Treatment Plan. Contractor shall participate in all Foster Care Reviews
as scheduled by the County and insure the attendance of the child.
SECTION IV. CONTRACTOR SHALL:
1. Conform with and abide by all rules and regulations of the Colorado Department of Social Services, the
State of Colorado and any federal laws and regulations, as such, which maybe amended from time to time,
and shall be binding on Contractor and control any disputes in this Agreement.
2. Maintain a current license and maintain license requirements as specified under State law.
3. Abide by all applicable provisions of Title VI and VII of the Federal Civil Rights Act of 1964, Section 504
of the Rehabilitation Act of 1973, Title XX of the Social Security Act of 1975 as revised, and provide
confidentiality of information concerning the child and the child's family.
4. Maintain during the term of this Agreement a liability insurance policy of at least $25,000 for property
damage liability, $150,000 for injury and/or damage to any one person, and $400,000 for total injuries
arising from any one accident.
5. Maintain during the terms of this Agreement a fidelity bond of at least $25,000 or two (2) months gross
receipts, whichever is greater, covering the activities of any of its officers, agents or employees responsible
for the implementation and/or administration of this contract in order to make reparations for any wrongful
acts, omissions, or any other defalcations of the Contractor.
6. Indemnify County, the Colorado Department of Social Services and the State of Colorado against any and
loss against all claims and actions based upon or arising out of damage or injury, including death, to
persons or property caused or sustained in connection with the performance of this contract or by
conditions created thereby, or based upon any violations of any statute, ordinance, or regulation and the
defense of any such claims or actions.
Agreement to Purchase
4
CPA Foster Care Services Rev 06/11/02
•
Contract No: PY 02/03-SS-23A-CPA
7. Maintain service program records, fiscal records, documentation and other records, which will sufficiently
and properly reflect all direct and indirect costs of any nature incurred in the performance of this
Agreement. The above shall be subject at all reasonable times to inspection, review or audit by federal,
State Department or county personnel, and other persons authorized in writing by the Executive Director,
Colorado Department of Social Services.
8. Bill the County for services rendered, using the required Division of Child Welfare Provider Roster. This
roster is to be mailed to the County department by the last day of the month of care. If Provider Rosters are
not received, payments will be held until the required paperwork is received.
9. Attend and participate in Foster Care Reviews for children in placement longer than 60 days, and any
subsequent appeal process, for children in placement with the Contractor pursuant to two (2)weeks written
notice by the County. If the facility is in a different part of the state from the county in which the review is
held, participation may be by teleconference.
10. Agree to cooperate with any vendors hired by Weld County Department of Social Services to shorten the
duration of placement at CPA level.
11. Obtain physical examinations within 14 days of placement and forward all appropriate information to the
County.
12. Obtain Dental examinations within 60 days of placement and forward all appropriate information to the
County.
13. A full evaluation of an Individualized Educational Plan(IEP) for youth designated as a Special Education
Students 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.
SECTION V. COUNTY SHALL:
1. Determine eligibility of the child under this Agreement for placement and medical coverage.
2. Assess and collect fees in accordance with the rules and regulations of the Colorado Department of Social
Services.
3. Reimburse Contractor by the 15th of the following month in accordance with fiscal system time frames for
services purchased under this Agreement in accordance with the established rate specified herein, when
Provider Rosters are submitted as described in Section IV, Number 8.
4. Abide by all the rules and regulations of the Colorado Department of Social Services, federal rules and
regulations and the laws of the State of Colorado, any of which may be amended from time to time.
5. Monitor child's progress in accordance with the treatment/case plan and the requirements of State
Department Staff Manual, Volume VII, and provide consultation and/or technical assistance to Contractor
in relation to the services purchased under this Agreement.
Agreement to Purchase
5
CPA Foster Care Services Rev 06/11/02
Contract No: PY 02/03-SS-23A-CPA
6. Involve Contractor in planning for the child and give the Contractor a copy of the Discrete Case Plan at
time of placement or as soon as completed and when updated or revised.
SECTION VI. GENERAL PROVISIONS.
1. The Parties to this Agreement intend that the relationship between them, contemplated by this Agreement
is that of employer-independent contractor. No agent, employee, or servant of Contractor shall be deemed
to be an employee, agent, or servant of County. Contractor will be solely and entirely responsible for its
acts or of any agent, employee, servants and sub-contractors during the performance of this Agreement.
2. Payment pursuant to this Agreement, if in State of Colorado or federal funds,whether in whole or in part,
is subject to and contingent upon the continuing availability of State of Colorado and federal funds for the
purpose thereof.
3. It is agreed that if, after investigation, it is shown that reasonable care was given to guard and protect
personal items brought to Contractor by the Child, Contractor will be released from responsibility for loss
or damage to such personal items.
4. This Contract is intended as the complete integration of all understandings between the parties. No prior or
contemporaneous addition, deletion, or other amendment hereto shall have any force or effect whatsoever,
unless embodied herein in writing. No subsequent notation, renewal, addition, deletion, or other
amendment hereto shall have any force or effect unless embodied in a written Agreement.
5. The Contract shall permit the Colorado Department of Social Services to monitor the service program,
fiscal books and other records sufficiently to assure the purchase of services in this Agreement are carried
out for the benefit of the aforementioned child through program reports, on-site visits where applicable and
other contracts as deemed necessary. The Contractor understands that the Colorado Department of Social
Services will provide consultation and technical assistance to Contractor to assure satisfactory performance
in the provision of purchased services under this Agreement.
6. In the event this contract is terminated, final payment to the Contractor may be withheld at their discretion
of the County until final audit. Incorrect payments to the Contractor due to omission, error, fraud, or
misuse of funds shall be recovered from the Contractor either by deduction from subsequent payments
under this contract or other contracts between the County and the Contractor or by the County, as a debt
due to both the State of Colorado, Colorado Department of Social Services and the County. The waiver of
any violation shall not be construed as a waiver of any other or subsequent violation of this contract or
appropriate statutes and regulations.
7. 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.
Agreement to Purchase
6
CPA Foster Care Services Rev 06/11/02
7-18-202 1 : 12PM FROM FRONTIER FAMILY SERV 303 702 0956 P. 2
lair/18/ue iva is *AA 9/U :nth /e91 WELD CIY SOC SERVICES IQ 608/008
Conn-act No PY 02/03-SS-23A-CPA
8. No portion of this Agreement shall be deemed to constituteaa waiver A of any immunities
d mie t haveair
officers or employees may possess,nor shall any portion �m this have createdent The
duty of care which did not previously exist with respect to any person not a party
to parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace
such immunities.
IN WITNESS WHEREOF,the parties hereto have duly executed the Agreement as of the day,month,and year
first above written.
ATTEST: WELD COUNTY BOARD OF SOCIAL SERVICES,
Wald County Clerk. :. '�' "/ ` ON BEHALF OF THE WELD COUNTY DEPARTMENT
OF SOCIAL SERVICES
Le
Ey. /" Clerk to ! .,� ST-4`" ,l BY: Gtennvaad
Deputy CletheBoard fipvv,' ` " ( 11
1( z)
APROVEL)AS TO FORM:
CONTRACTOR
county Ak rney .�
Frontier Family Services
1290 Boston Ave
Longmont,CO 80501-5810
WELD COUNTY DEPARTMENT
OF SOCIAL SERVICES
By:
Ai or
Agreement to Purchase Rev 06/11102
CPA Foster Care Services
Cdnttact No: PY 02/03-SS-23A-CPA
AGREEMENT TO PURCHASE
CHILD PLACEMENT AGENCY SERVICES
72'f
THIS AGREEMENT made this 1st day of July, 2002 between the Weld`Cotintb,Bo*rd of Social Services,
on behalf of the Weld County Department of Social Services hereinafter called "County" Sid Vioper Family
Services, 1115 11th St, Greeley, CO, 80631, hereinafter called "Contractor".
WHEREAS, the Colorado State Department of Social Services, hereinafter called "State Department" is
authorized to provide social services to individuals and families of individuals through its agents, County
Departments of Social Services, and
WHEREAS, County is authorized to purchase certain services for eligible children under State Department rules,
and
WHEREAS, County wishes to provide these services by purchasing them from Contractor, and, .1
WHEREAS, Contractor is licensed as a Child Placement Agency.
NOW THEREFORE, it is hereby agreed that in consideration of the mutual Undertakings County ar4 Contractor
agree as follows:
1. A child specific Needs Based Care Assessment, designated as Attachment B, shall be used tletermine
levels of care for each child placed with Contractor.
2. County agrees to purchase and Contractor agrees to provide the care and services, which are listed in this
Agreement, based on the Needs Based Care Assessment levels determined. The specific rate of payment
will be paid for each level of service, as indicated by the Needs Based Care Rate Table, designated as
Attachment C, for children placed within the CPA identified as Provider ID#42942. 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.
3. This Agreement shall be in force from July 1st, 2002, until the end of the Colorado fiscal year, June 30,
2003; or until the child is removed by the County; or if the child's behavior would cause harm to himself or
other children, and Contractor seeks approval from the County and the County agrees, in writing, to
terminate this Agreement, whichever event occurs first.
4. This Agreement may be renewed only by entering into a new written Agreement, such as this Agreement,
signed by the authorized representatives of the parties. In addition to the termination provisions in
Paragraph 3 above, either party shall have the right to terminate this contract by giving the other party thirty
(30) days notice by registered mail, return receipt requested. If notice is so given, this contract shall
terminate on the expiration of the thirty(30) days or until the eligible child can be placed elsewhere,
whichever occurs earlier, and the liability of the parties hereunder for further performance of the terms of
this Agreement shall thereupon cease, but the parties shall not be released from the duty to perform their
obligations up to the date of termination.
5. This Agreement is in lieu of and supersedes all prior agreements between the parties hereto and relating to
the care and services herein described.
Agreement to Purchase
1
CPA Foster Care Services Rev 06/11/02
Cdntfact No: PY 02/03-SS-23A-CPA
SECTION 1. DESCRIPTION OF SERVICES TO BE PURCHASED.
1. The services purchased under this Agreement are Child Placement Agency services and may include, but
are not limited to: Basic 24-hour care and child maintenance (food, shelter, clothing, educational supplies
and allowance), Administrative Overhead, Case Management, Direct therapy and evaluation, which may
include but are not limited to: Psychological and/or Neurological, Medication and follow-up, Family
Therapy, Individual Therapy, Group Therapy, Sex Offender Evaluation and/or Sex Offender Treatment as
prescribed by the Sex Offender Management Board Policy, Polygraph, Plethysmograph, Parent Training
for Teens, Independent Living Training, Mentor/Advocate, Supervised Visitation, Direct Child Care,
Therapeutic Recreation, Transportation, and Special Needs (requires SS-22).
2. Payment for a child's temporary absence from the facility, including absence due to hospitalization, will be
made in accordance with State Department rules in Staff Manual Volume VII, 7.406.1 (F).
3. Transportation shall be furnished by County between the child's residence and Contractor's facility for the
initial placement and return after the treatment plan is completed. If the child runs away from the
Contractor's facility, the County shall provide transportation to either return the child to the facility or to
other care as arranged by the County. The County will make the decision to return the child to the facility,
with input from the Contractor.
4. All other transportation associated with the Contractor's proposed services will be provided by Contractor.
Any transportation costs not covered or contemplated in the original treatment plan must be negotiated
between County and Contractor and are not subject to reimbursement under this Agreement. However,
provisions for payment of other transportation may be provided for in the treatment/case plan.
5. Any transportation costs to be incurred on behalf of this child which are to be borne by persons or agencies
which are not a party to this contract shall be specified in the treatment/case plan, and those persons shall
acknowledge their responsibility by signing the treatment/case plan.
6. Contractor will provide the purchased care and services at:
Provider ID#: 42942
Hope Family Services
1115 11th St
Greeley, CO 80631
7. Contractor shall not charge any additional fees to children or families of children referred by County for
services provided under this Agreement.
8. Contractor agrees not to assign the obligations under this Agreement nor enter into any sub-contracts
without the express written approval of the Executive Director of the Colorado Department of Social
Services or his appointed designee.
Agreement to Purchase
2
CPA Foster Care Services Rev 06/11/02
Contract No: PY 02/03-SS-23A-CPA
SECTION II. MEDICAL CARE
1. In accordance with the Weld County Department of Social Services policies (2.710.70, 2.710.71, 2.710.72,
2.710.73, 2.710.74) and Colorado Department of Human Services Child Care Licensing Division policy
(7.714.131), the contractor may obtain: 1) Ordinary medical care, and 2) Emergency medical, surgical or
dental care for said child after making reasonable efforts to contact the County to obtain consent.
Emergency care is defined as any medical treatment as recommended by a licensed medical authority to
protect the life and health of a child and treatment cannot be delayed without placing the child at risk.
2. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will not be
made through phone mail messages.
3. Between 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) 350-8389.
4. The County will be notified by the facility no later than the following working day of any administration of
emergency medical, surgical or dental services provided under this authorization.
5. Prior to any elective, non-routine or non-emergency medical, surgical or dental services being provided,
authorization must be obtained from the assigned caseworker or supervisor. If parental rights are intact,
authorization or attempts to obtain authorization from the parent(s) should also be documented. If the
placement is made through a voluntary placement agreement between the parent(s) and the County, the
parent(s)must be contacted for authorization.
6. The Contractor is required to maintain a complete record of all medical, surgical or dental services
provided and the medications administered to the child.
7. The Contractor will provide an up-to-date copy of the medical record to the County at the time of submittal
of each progress report, including the discharge report at the time of the child's termination from the care
of the Contractor.
8. County and Contractor shall insure that the Child is enrolled in the Early and Periodic Screening, Diagnosis
and Treatment Program.
9. It is agreed and permission is granted for the child to participate in planned recreational and social
activities of Contractor, including supervised off grounds excursions and extended trips within the State,
provided that Contractor has written permission from County and legal custodian for any trips out of
Colorado for any reason and any planned absence from the facility of over seven(7) days within a
consecutive 30-day period. Such written permission may be in the treatment/case plan. Further,
Contractor and County will also secure, where possible, permission from parents or guardians of the child
placed with the Contractor.
10. County and Contractor shall inform each other and the local school district of any changes in parental
residence affecting educational status, which comes to their attention.
Agreement to Purchase
CPA Foster Care Services 3 Rev 06/11/02
Contract No: PY 02/03-SS-23A-CPA
SECTION III. REASONS FOR REFERRAL AND TREATMENT PLAN
1. Attachment A will be designated as the Placement Referral form. This referral will be child specific and
shall include the initial Treatment Plan that shall be goal oriented and time-limited.
2. The Treatment Plan shall include the anticipated living arrangement and the anticipated educational
arrangement for the child upon completion. Also included will be the anticipated date for discharge from
treatment purchased as well as provisions concerning the involvement of the child's family in treatment of
the child.
3. County and Contractor agree and understand that the psychological (mental and behavioral) or physical
problems which necessitate purchasing services for this child are specified in the Attachment A.
4. Modifications to the initial Treatment Plan shall be agreed upon by the County and Contractor and shall be
reflected in the Attachment A.
5. At no longer than thirty-day(30) intervals after placement, Contractor shall provide County with written
reports which address changes to the child's physical or psychological condition, changes in the child's
family situation, education progress, significant incidents or disciplinary actions, and progress made to
achieve goals specified in the Treatment Plan. Contractor shall participate in all Foster Care Reviews
as scheduled by the County and insure the attendance of the child.
SECTION IV. CONTRACTOR SHALL:
1. Conform with and abide by all rules and regulations of the Colorado Department of Social Services, the
State of Colorado and any federal laws and regulations, as such, which may be amended from time to time,
and shall be binding on Contractor and control any disputes in this Agreement.
2. Maintain a current license and maintain license requirements as specified under State law.
3. Abide by all applicable provisions of Title VI and VII of the Federal Civil Rights Act of 1964, Section 504
of the Rehabilitation Act of 1973, Title XX of the Social Security Act of 1975 as revised, and provide
confidentiality of information concerning the child and the child's family.
4. Maintain during the term of this Agreement a liability insurance policy of at least $25,000 for property
damage liability, $150,000 for injury and/or damage to any one person, and $400,000 for total injuries
arising from any one accident.
5. Maintain during the terms of this Agreement a fidelity bond of at least $25,000 or two (2) months gross
receipts, whichever is greater, covering the activities of any of its officers, agents or employees responsible
for the implementation and/or administration of this contract in order to make reparations for any wrongful
acts, omissions, or any other defalcations of the Contractor.
6. Indemnify County, the Colorado Department of Social Services and the State of Colorado against any and
loss against all claims and actions based upon or arising out of damage or injury, including death, to
persons or property caused or sustained in connection with the performance of this contract or by
conditions created thereby, or based upon any violations of any statute, ordinance, or regulation and the
defense of any such claims or actions.
Agreement to Purchase
4
CPA Foster Care Services Rev 06/11/02
Contfact No: PY 02/03-SS-23A-CPA
7. Maintain service program records, fiscal records, documentation and other records, which will sufficiently
and properly reflect all direct and indirect costs of any nature incurred in the performance of this
Agreement. The above shall be subject at all reasonable times to inspection, review or audit by federal,
State Department or county personnel, and other persons authorized in writing by the Executive Director,
Colorado Department of Social Services.
8. Bill the County for services rendered, using the required Division of Child Welfare Provider Roster. This
roster is to be mailed to the County department by the last day of the month of care. If Provider Rosters are
not received,payments will be held until the required paperwork is received.
9. Attend and participate in Foster Care Reviews for children in placement longer than 60 days, and any
subsequent appeal process, for children in placement with the Contractor pursuant to two (2) weeks written
notice by the County. If the facility is in a different part of the state from the county in which the review is
held, participation may be by teleconference.
10. Agree to cooperate with any vendors hired by Weld County Department of Social Services to shorten the
duration of placement at CPA level.
11. Obtain physical examinations within 14 days of placement and forward all appropriate information to the
County.
12. Obtain Dental examinations within 60 days of placement and forward all appropriate information to the
County.
13. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education
Students 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.
SECTION V. COUNTY SHALL:
1. Determine eligibility of the child under this Agreement for placement and medical coverage.
2. Assess and collect fees in accordance with the rules and regulations of the Colorado Department of Social
Services.
3. Reimburse Contractor by the 15th of the following month in accordance with fiscal system time frames for
services purchased under this Agreement in accordance with the established rate specified herein, when
Provider Rosters are submitted as described in Section IV, Number 8.
4. Abide by all the rules and regulations of the Colorado Department of Social Services, federal rules and
regulations and the laws of the State of Colorado, any of which may be amended from time to time.
5. Monitor child's progress in accordance with the treatment/case plan and the requirements of State
Department Staff Manual, Volume VII, and provide consultation and/or technical assistance to Contractor
in relation to the services purchased under this Agreement.
Agreement to Purchase
5
CPA Foster Care Services Rev 06/11/02
tonti'act No: PY 02/03-SS-23A-CPA
6. Involve Contractor in planning for the child and give the Contractor a copy of the Discrete Case Plan at
time of placement or as soon as completed and when updated or revised.
SECTION VI. GENERAL PROVISIONS.
1. The Parties to this Agreement intend that the relationship between them, contemplated by this Agreement
is that of employer-independent contractor. No agent, employee, or servant of Contractor shall be deemed
to be an employee, agent, or servant of County. Contractor will be solely and entirely responsible for its
acts or of any agent, employee, servants and sub-contractors during the performance of this Agreement.
2. Payment pursuant to this Agreement, if in State of Colorado or federal funds, whether in whole or in part,
is subject to and contingent upon the continuing availability of State of Colorado and federal funds for the
purpose thereof.
3. It is agreed that if, after investigation, it is shown that reasonable care was given to guard and protect
personal items brought to Contractor by the Child, Contractor will be released from responsibility for loss
or damage to such personal items.
4. This Contract is intended as the complete integration of all understandings between the parties. No prior or
contemporaneous addition, deletion, or other amendment hereto shall have any force or effect whatsoever,
unless embodied herein in writing. No subsequent notation, renewal, addition, deletion, or other
amendment hereto shall have any force or effect unless embodied in a written Agreement.
5. The Contract shall permit the Colorado Department of Social Services to monitor the service program,
fiscal books and other records sufficiently to assure the purchase of services in this Agreement are carried
out for the benefit of the aforementioned child through program reports, on-site visits where applicable and
other contracts as deemed necessary. The Contractor understands that the Colorado Department of Social
Services will provide consultation and technical assistance to Contractor to assure satisfactory performance
in the provision of purchased services under this Agreement.
6. In the event this contract is terminated, final payment to the Contractor may be withheld at their discretion
of the County until final audit. Incorrect payments to the Contractor due to omission, error, fraud, or
misuse of funds shall be recovered from the Contractor either by deduction from subsequent payments
under this contract or other contracts between the County and the Contractor or by the County, as a debt
due to both the State of Colorado, Colorado Department of Social Services and the County. The waiver of
any violation shall not be construed as a waiver of any other or subsequent violation of this contract or
appropriate statutes and regulations.
7. 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.
Agreement to Purchase
6
CPA Foster Care Services Rev 06/11/02
-Cont'ract No: PY 02/03-SS-23A-CPA
8. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their
officers or employees may possess, nor shall any portion of this Agreement be deemed to have created a
duty of care which 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.
IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year
first above written.
ATTEST:
Weld Conn C r to ` WELD COUNTY BOARD OF SOCIAL SERVICES,
`tp ON BEHALF OF THE WELD COUNTY DEPARTMENT
1861 - A-! tiv.� OF SOCIAL SERVICES
By: /$4\ _ i By:
Deputy Clerk to the Boar U NI Glenn V 'r
C7/3'W&
APROVED AS TO FORM:
CONTRACTOR
County ttomey —...
Hope Family Services
1115 11th St
ley, CO 806 1
Mr,..,
By: I l la
WELD COUNTY DEPARTMENT
_ OF SOCIAL SERVICES
►ii ector f
Agreement to Purchase
CPA Foster Care Services Rev 06/11/02
•
Contract No: PY 02/03-SS-23A-CPA
AGREEMENT TO PURCHASE
CHILD PLACEMENT AGENCY SERVICES
THIS AGREEMENT made this lst day of July, 2002 between the Weld County Board of Social Services,
on behalf of th e d County De ent of Social Services hereinafter called "County" and Kids Resources
Network In , 'n9 10114-St, Boulder, CO, 0303, hereinafter called "Contractor".
g ji eACijutt
WHEREAS, Colorado State Department of Social Services, hereinafter called "State Department" is
authorized to provide s ' is sfdividuals and families of individuals through its agents, County
Departments of Social Services, and
WHEREAS, County is authorized to purchase certain services for eligible children under State Department rules,
and
WHEREAS, County wishes to provide these services by purchasing them from Contractor, and,
WHEREAS, Contractor is licensed as a Child Placement Agency.
NOW THEREFORE, it is hereby agreed that in consideration of the mutual Undertakings County and Contractor
agree as follows:
1. A child specific Needs Based Care Assessment, designated as Attachment B, shall be used to determine
levels of care for each child placed with Contractor.
2. County agrees to purchase and Contractor agrees to provide the care and services, which are listed in this
Agreement, based on the Needs Based Care Assessment levels determined. The specific rate of payment
will be paid for each level of service, as indicated by the Needs Based Care Rate Table, designated as
Attachment C, for children placed within the CPA identified as Provider ID#45183. 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.
3. This Agreement shall be in force from July 1st, 2002, until the end of the Colorado fiscal year, June 30,
2003; or until the child is removed by the County; or if the child's behavior would cause harm to himself or
other children, and Contractor seeks approval from the County and the County agrees, in writing, to
terminate this Agreement, whichever event occurs first.
4. This Agreement may be renewed only by entering into a new written Agreement, such as this Agreement,
signed by the authorized representatives of the parties. In addition to the termination provisions in
Paragraph 3 above, either party shall have the right to terminate this contract by giving the other party thirty
(30) days notice by registered mail, return receipt requested. If notice is so given, this contract shall
terminate on the expiration of the thirty(30) days or until the eligible child can be placed elsewhere,
whichever occurs earlier, and the liability of the parties hereunder for further performance of the terms of
this Agreement shall thereupon cease, but the parties shall not be released from the duty to perform their
obligations up to the date of termination.
5. This Agreement is in lieu of and supersedes all prior agreements between the parties hereto and relating to
the care and services herein described.
Agreement to Purchase
1
CPA Foster Care Services Rev 06/11/02
Contract No: PY 02/03-SS-23A-CPA
SECTION 1. DESCRIPTION OF SERVICES TO BE PURCHASED.
1. The services purchased under this Agreement are Child Placement Agency services and may include, but
are not limited to: Basic 24-hour care and child maintenance (food, shelter, clothing, educational supplies
and allowance), Administrative Overhead, Case Management, Direct therapy and evaluation, which may
include but are not limited to: Psychological and/or Neurological, Medication and follow-up, Family
Therapy, Individual Therapy, Group Therapy, Sex Offender Evaluation and/or Sex Offender Treatment as
prescribed by the Sex Offender Management Board Policy, Polygraph, Plethysmograph, Parent Training
for Teens, Independent Living Training, Mentor/Advocate, Supervised Visitation, Direct Child Care,
Therapeutic Recreation, Transportation, and Special Needs (requires SS-22).
2. Payment for a child's temporary absence from the facility, including absence due to hospitalization, will be
made in accordance with State Department rules in Staff Manual Volume VII, 7.406.1 (F).
3. Transportation shall be furnished by County between the child's residence and Contractor's facility for the
initial placement and return after the treatment plan is completed. If the child runs away from the
Contractor's facility, the County shall provide transportation to either return the child to the facility or to
other care as arranged by the County. The County will make the decision to return the child to the facility,
with input from the Contractor.
4. All other transportation associated with the Contractor's proposed services will be provided by Contractor.
Any transportation costs not covered or contemplated in the original treatment plan must be negotiated
between County and Contractor and are not subject to reimbursement under this Agreement. However,
provisions for payment of other transportation may be provided for in the treatment/case plan.
5. Any transportation costs to be incurred on behalf of this child which are to be borne by persons or agencies
which are not a party to this contract shall be specified in the treatment/case plan, and those persons shall
acknowledge their responsibility by signing the treatment/case plan.
6. Contractor will provide the purchased care and services at:
Provider ID#: 45183
Kids Resources Network Inc
200 30th St 1 q 1 eact r.[cf L4_ri-C
Boulder, CO 80303
7. Contractor shall not charge any additional fees to children or families of children referred by County for
services provided under this Agreement.
8. Contractor agrees not to assign the obligations under this Agreement nor enter into any sub-contracts
without the express written approval of the Executive Director of the Colorado Department of Social
Services or his appointed designee.
Agreement to Purchase
2
CPA Foster Care Services Rev 06/11/02
Contract No: PY 02/03-SS-23A-CPA
SECTION II. MEDICAL CARE
1. In accordance with the Weld County Department of Social Services policies (2.710.70, 2.710.71, 2.710.72,
2.710.73, 2.710.74) and Colorado Department of Human Services Child Care Licensing Division policy
(7.714.131), the contractor may obtain: 1) Ordinary medical care, and 2) Emergency medical, surgical or
dental care for said child after making reasonable efforts to contact the County to obtain consent.
Emergency care is defined as any medical treatment as recommended by a licensed medical authority to
protect the life and health of a child and treatment cannot be delayed without placing the child at risk.
2. Contact by the Contractor with the County regarding emergency medical, surgical or dental care will not be
made through phone mail messages.
3. Between 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) 350-8389.
4. The County will be notified by the facility no later than the following working day of any administration of
emergency medical, surgical or dental services provided under this authorization.
5. Prior to any elective, non-routine or non-emergency medical, surgical or dental services being provided,
authorization must be obtained from the assigned caseworker or supervisor. If parental rights are intact,
authorization or attempts to obtain authorization from the parent(s) should also be documented. If the
placement is made through a voluntary placement agreement between the parent(s) and the County, the
parent(s) must be contacted for authorization.
6. The Contractor is required to maintain a complete record of all medical, surgical or dental services
provided and the medications administered to the child.
7. The Contractor will provide an up-to-date copy of the medical record to the County at the time of submittal
of each progress report, including the discharge report at the time of the child's termination from the care
of the Contractor.
8. County and Contractor shall insure that the Child is enrolled in the Early and Periodic Screening, Diagnosis
and Treatment Program.
9. It is agreed and permission is granted for the child to participate in planned recreational and social
activities of Contractor, including supervised off grounds excursions and extended trips within the State,
provided that Contractor has written permission from County and legal custodian for any trips out of
Colorado for any reason and any planned absence from the facility of over seven (7) days within a
consecutive 30-day period. Such written permission may be in the treatment/case plan. Further,
Contractor and County will also secure, where possible, permission from parents or guardians of the child
placed with the Contractor.
10. County and Contractor shall inform each other and the local school district of any changes in parental
residence affecting educational status, which comes to their attention.
Agreement to Purchase
3
CPA Foster Care Services Rev 06/11/02
Contract No: PY 02/03-SS-23A-CPA
SECTION III. REASONS FOR REFERRAL AND TREATMENT PLAN
1. Attachment A will be designated as the Placement Referral form. This referral will be child specific and
shall include the initial Treatment Plan that shall be goal oriented and time-limited.
2. The Treatment Plan shall include the anticipated living arrangement and the anticipated educational
arrangement for the child upon completion. Also included will be the anticipated date for discharge from
treatment purchased as well as provisions concerning the involvement of the child's family in treatment of
the child.
3. County and Contractor agree and understand that the psychological (mental and behavioral) or physical
problems which necessitate purchasing services for this child are specified in the Attachment A.
4. Modifications to the initial Treatment Plan shall be agreed upon by the County and Contractor and shall be
reflected in the Attachment A.
5. At no longer than thirty-day(30) intervals after placement, Contractor shall provide County with written
reports which address changes to the child's physical or psychological condition, changes in the child's
family situation, education progress, significant incidents or disciplinary actions, and progress made to
achieve goals specified in the Treatment Plan. Contractor shall participate in all Foster Care Reviews
as scheduled by the County and insure the attendance of the child.
SECTION IV. CONTRACTOR SHALL:
1. Conform with and abide by all rules and regulations of the Colorado Department of Social Services, the
State of Colorado and any federal laws and regulations, as such, which may be amended from time to time,
and shall be binding on Contractor and control any disputes in this Agreement.
2. Maintain a current license and maintain license requirements as specified under State law.
3. Abide by all applicable provisions of Title VI and VII of the Federal Civil Rights Act of 1964, Section 504
of the Rehabilitation Act of 1973, Title XX of the Social Security Act of 1975 as revised, and provide
confidentiality of information concerning the child and the child's family.
4. Maintain during the term of this Agreement a liability insurance policy of at least $25,000 for property
damage liability, $150,000 for injury and/or damage to any one person, and $400,000 for total injuries
arising from any one accident.
5. Maintain during the terms of this Agreement a fidelity bond of at least $25,000 or two (2) months gross
receipts, whichever is greater, covering the activities of any of its officers, agents or employees responsible
for the implementation and/or administration of this contract in order to make reparations for any wrongful
acts, omissions, or any other defalcations of the Contractor.
6. Indemnify County, the Colorado Department of Social Services and the State of Colorado against any and
loss against all claims and actions based upon or arising out of damage or injury, including death, to
persons or property caused or sustained in connection with the performance of this contract or by
conditions created thereby, or based upon any violations of any statute, ordinance, or regulation and the
defense of any such claims or actions.
Agreement to Purchase
4
CPA Foster Care Services Rev 06/11/02
Contract No: PY 02/03-SS-23A-CPA
7. Maintain service program records, fiscal records, documentation and other records, which will sufficiently
and properly reflect all direct and indirect costs of any nature incurred in the performance of this
Agreement. The above shall be subject at all reasonable times to inspection, review or audit by federal,
State Department or county personnel, and other persons authorized in writing by the Executive Director,
Colorado Department of Social Services.
8. Bill the County for services rendered, using the required Division of Child Welfare Provider Roster. This
roster is to be mailed to the County department by the last day of the month of care. If Provider Rosters are
not received,payments will be held until the required paperwork is received.
9. Attend and participate in Foster Care Reviews for children in placement longer than 60 days, and any
subsequent appeal process, for children in placement with the Contractor pursuant to two (2) weeks written
notice by the County. If the facility is in a different part of the state from the county in which the review is
held, participation may be by teleconference.
10. Agree to cooperate with any vendors hired by Weld County Department of Social Services to shorten the
duration of placement at CPA level.
11. Obtain physical examinations within 14 days of placement and forward all appropriate information to the
County.
12. Obtain Dental examinations within 60 days of placement and forward all appropriate information to the
County.
13. A full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education
Students 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.
SECTION V. COUNTY SHALL:
1. Determine eligibility of the child under this Agreement for placement and medical coverage.
2. Assess and collect fees in accordance with the rules and regulations of the Colorado Department of Social
Services.
3. Reimburse Contractor by the 15th of the following month in accordance with fiscal system time frames for
services purchased under this Agreement in accordance with the established rate specified herein, when
Provider Rosters are submitted as described in Section IV, Number 8.
4. Abide by all the rules and regulations of the Colorado Department of Social Services, federal rules and
regulations and the laws of the State of Colorado, any of which may be amended from time to time.
5. Monitor child's progress in accordance with the treatment/case plan and the requirements of State
Department Staff Manual, Volume VII, and provide consultation and/or technical assistance to Contractor
in relation to the services purchased under this Agreement.
Agreement to Purchase
5
CPA Foster Care Services Rev 06/11/02
Contract No: PY 02/03-SS-23A-CPA
6. Involve Contractor in planning for the child and give the Contractor a copy of the Discrete Case Plan at
time of placement or as soon as completed and when updated or revised.
SECTION VI. GENERAL PROVISIONS.
1. The Parties to this Agreement intend that the relationship between them, contemplated by this Agreement
is that of employer-independent contractor. No agent, employee, or servant of Contractor shall be deemed
to be an employee, agent, or servant of County. Contractor will be solely and entirely responsible for its
acts or of any agent, employee, servants and sub-contractors during the performance of this Agreement.
2. Payment pursuant to this Agreement, if in State of Colorado or federal funds, whether in whole or in part,
is subject to and contingent upon the continuing availability of State of Colorado and federal funds for the
purpose thereof.
3. It is agreed that if, after investigation, it is shown that reasonable care was given to guard and protect
personal items brought to Contractor by the Child, Contractor will he released from responsibility for loss
or damage to such personal items.
4. This Contract is intended as the complete integration of all understandings between the parties. No prior or
contemporaneous addition, deletion, or other amendment hereto shall have any force or effect whatsoever,
unless embodied herein in writing. No subsequent notation, renewal, addition, deletion, or other
amendment hereto shall have any force or effect unless embodied in a written Agreement.
5. The Contract shall permit the Colorado Department of Social Services to monitor the service program,
fiscal books and other records sufficiently to assure the purchase of services in this Agreement are carried
out for the benefit of the aforementioned child through program reports, on-site visits where applicable and
other contracts as deemed necessary. The Contractor understands that the Colorado Department of Social
Services will provide consultation and technical assistance to Contractor to assure satisfactory performance
in the provision of purchased services under this Agreement.
6. In the event this contract is terminated, final payment to the Contractor may be withheld at their discretion
of the County until final audit. Incorrect payments to the Contractor due to omission, error, fraud, or
misuse of funds shall be recovered from the Contractor either by deduction from subsequent payments
under this contract or other contracts between the County and the Contractor or by the County, as a debt
due to both the State of Colorado, Colorado Department of Social Services and the County. The waiver of
any violation shall not be construed as a waiver of any other or subsequent violation of this contract or
appropriate statutes and regulations.
7. 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.
Agreement to Purchase
6
CPA Foster Care Services Rev 06/11/02
Contract No: PY 02/03-SS-23A-CPA
8. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their
officers or employees may possess, nor shall any portion of this Agreement be deemed to have created a
duty of care which 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.
IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year
first above written.
ATTEST:
Weld County Clerk t r SL WELD COUNTY BOARD OF SOCIAL SERVICES,
ON BEHALF OF THE WELD COUNTY DEPARTMENT
OF SOCIAL SERVICES
1861 '\r
By: .�I�/i !'� .n B
y
Deputy Clerk to the Boar�� W Glenn Vaa ,
?' O/302)
APROVED AS TO FORM:
CONTRACTOR
o fltt mey
Kids Resources Network Inc
X09 30th St c4 ��C �Zl�� [�-✓ic,
Bo er, CO 80303
By:
WELD COUNTY DEPARTMENT
OF SOCIAL SERVICES
By:
ector
Agreement to Purchase
CPA Foster Care Services 7Rev 06/11/02
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