HomeMy WebLinkAbout20022009.tiff RESOLUTION
RE: APPROVE THREE (3) AGREEMENTS TO PURCHASE RESIDENTIAL TREATMENT
CENTER 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 three (3) Agreements to Purchase
Residential Treatment Center 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) Children's Ark, Inc. (Ute Pass)
2) Children's Ark, Inc. (Pueblo)
3) Children's Ark, Inc. (Green Mountain Pass), 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 three (3) Agreements to
Purchase Residential Treatment Center 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.
�l 2002-2009
•
CSC . �
C�61 Kg) SS0029
RE: THREE (3) AGREEMENTS TO PURCHASE RESIDENTIAL TREATMENT CENTER
SERVICES
PAGE 2
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 29th day of July, A.D., 2002, nunc pro tunc July 1, 2002.
BOARD OF COUNTY COMMISSIONERS
/ ���� WELD COU�Y/COLORADO
ATTEST: /��(/v �'�� E�, /�///aad, PI
t A, 44444
GI Vaad, Chair
Weld County Clerk to the �•ar � � �` � I
rr ,,',
R51
J y ���avid E. L g, Pro-Tern
BY: cc'� L
Deputy Clerk to the Bo:I1,s N I
M. J. eile
AP ED AS TO RM: / Jl
liam H. Jerk
unty Attorne
Robert D. Malden
Date of signature:
2002-2009
SS0029
16#Ct.
DEPARTMENT OF SOCIAL SERVICES
PO BOX A
GREELEY,CO 80632
' WEBSITE:www.co.weld.co.us
Administration and Public Assistance(970)352-1551
C Child Support(970)352-6933
111
COLORADO
MEMORANDUM
TO: Glenn Vaad, Chair Date: July 12, 2002
Board of County Commissioners
FR: Judy A. Griego,Director, Social Services £
RE: Agreements to Purchase Residential Treatment Center(RTC) Services
Between Weld County Department of Social Services with Various
Vendors
Enclosed for Board approval are Agreements to Purchase Residential Treatment Center(RTC)
Services between the Weld County Department 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 15, 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 at rates including room and board costs and
excluding Medicaid treatment costs. The rates are as follows:
A. Children's Ark: $26.56 per day
(Ute Pass)
B. Children's Ark: $26.56 per day
(Pueblo)
C. Children's Ark: $26.56 per day
(Green Mountain Pass)
If you have any questions,please telephone me at extension 6510.
2002-2009
•
Contact No.: PY 02/03-SS-23A-RTC
AGREEMENT TO PURCHASE
RESIDENTIAL TREATMENT CENTER SERVICES
THIS AGREEMENT made this 15t 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 Childrens Ark, Inc,
PO Box 1007,Green Mountain Falls, CO 80819, 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 Residential Treatment Center.
NOW THEREFORE, it is hereby agreed that in consideration of the mutual Undertakings County and Contractor
agree as follows:
1. County agrees to purchase and Contractor agrees to provide Room and Board services which are listed in
this Agreement at a rate of$26.56 per day for children placed within the Residential Treatment Center
identified as Provider lD#4261. These services will be for children who have been deemed eligible for
social services under the statutes, rules and regulations of the State of Colorado.
2. Contractor shall be reimbursed by Medicaid for services provided to County children placed with
Contractor. Medicaid reimbursement shall be based off of the StateVendor Rate for the approved Level of
Care. The assessment instrument used to determine the Level of Care will be the Colorado Client
Assessment Record(CCAR) as per outlined in the Department of Health Care policy and Finance, Staff
Manual Vol. 8, Section 8.765.30.
3. This Agreement shall be in force from July 1, 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
RTC Services Rev 06/11/02
•
• Contract No.: PY 02/03-SS-23A-RTC
SECTION 1. DESCRIPTION OF SERVICES TO BE PURCHASED.
1. The services purchased under this Agreement as Room and Board costs for Residential Treatment Center
facility services, as outlined in the Department of Health Care policy and Finance, Staff Manual Vol. 8,
Section 8.765.503 may include,but are not limited to: Basic 24-hour care and child maintenance (food,
shelter, clothing, educational supplies and allowance), Administration, Administrative Overhead, Support
Staff, Support Overhead, and Sleep-over Staff.
2. The services reimbursable by Medicaid for treatment services under this Agreement, as outlined in the
Department of Health Care policy and Finance, Staff Manual Vol. 8, Section 8.765.502 may include, but
are not limited to: Evaluation Services (psychological, and/or neurological% Medication and follow-up,
Family Therapy, Individual Therapy, Group Therapy, Sex Offender Evaluation and/ r Sex Offender
Treatment as prescribed by the Sex Offender Management Board Policy,4 p ,Plcthysmograph'
Parent Training for Teens, Independent Living Training, Mentor/Advocate, Supervised Visitation,
Therapeutic Recreation, Direct Child Care, and Transportation.
3. 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).
4. 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.
5. 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.
6. 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.
7. Contractor will provide the purchased care and services at:
Facility ID#: 4261
Childrens Ark at Ute Pass
10460 W Hwy 24
Green Mountain Falls CO 80819
8. Contractor shall not charge any additional fees to children or families of children referred by County for
services provided under this Agreement.
9. 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
RTC Services Rev 06/11/02
ContractNo.: PY 02/03-SS-23A-RTC
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
RTC Services Rev 06/11/02
Contact No.: PY 02/03-SS-23A-RTC
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.
1. Maintain during the term of this Agreement a liability insurance policy of at least $400,000 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.
2. 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
RTC Services Rev 06/11/02
•
Contract No.: PY 02/03-SS-23A-RTC
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 RTC 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.
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.
Agreement to Purchase
5
RTC Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RTC
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.
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.
Agreement to Purchase
6
RTC Services Rev 06/11/02
ul/1u/uZ 14:21 FAX 970 348 7891 WELD CTY S0C SERVICES f0J008
ContractNa.: PY 02/03-SS-23A-RTC
IN WITNESS WHEREOF,the parties hereto have duly executed the Agreement as o€the day,month, and year.
first above written. Q
ATTEST: /""" 7 ��'"//"' e�,
Weld County Clerk 4L? j 4% WELD COUNTY BOARD OF SOCIAL ON BEHALF OF THE WELD-COUNTYSERVICES,
ON
wMM r _siX OF SOCIAL SERVICES /I 1 cx,
/ 1861tit% .1 _e�U A 0, Jy.
Deputy Clerk to the Hoard r Glenn V aad,Chair
APPROVED AS TO FORM:
CONTRACTOR
Coup Atto7y
Children&Mc,Inc
PO Box 1007
Green Mountain Falls, CO 8O8Y9-
By: •
r .S.
WELD COUNTY DEPARTMENT
OF SOCIAL SERVICES
By:
for
Agreerucnt.to Pwchace
7
RTC Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RTC
Addendum to the
AGREEMENT TO PRUCHASE RTC SERVICES
This addendum 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 Childrens
ARK,Inc.,PO Box 1007 Green Mountain falls,CO 80819,hereinafter called"Contractor" is designed
to be incorporated into the AGREEMENT between said County and Contractor for Facility
ID#:04261.
The following services: 1)Neurological Evaluations,2)Polygraphs,and 3)Plethysmographs shall be
stricken from Section 1.Description of Services to be Purchased. Reimbursement for said services
shall be negotiated between the Coountyy and the Contractor on a child-by-child basis.
Wait/
O
07/10/02 14:24 FAX 970 346 7691 WELD CTY SOC SERVICES ( O16
Contract No.: PY 02/03-SS-23A-RTC
AGREEMENT TO PURCHASE
RESIDENTIAL.TREATMENT CENTER SERVICES
THIS AGREEMENT made this la 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 Childrens Ark,Inc,
PO Box 1007,Green Mountain Falls, CO 80819,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 Residential Treatment Center.
NOW THEREFORE,it is hereby agreed that in consideration of the mutual Undertakings County and Contractor
agree as follows:
t. County agrees to purchase and Contractor agrees to provide Room and Board services which are listed in
this Agreement at a rate of 526.56 per day for children placed within the Residential Treatment Center
identified as Provider ID#40322. These services will be for children who have been deemed eligible for
social services under the statutes,rules and regulations of the State of Colorado.
2. Contractor shall be reimbursed by Medicaid for services provided to County children placed with
Contractor. Medicaid reimbursement shall be based off of the StateVendor Rate for the approved Level of
Care. The assessment instrument used to determine the Level of Care will be the Colorado Client
Assessment Record(CCAR) as per outlined in the Department of Health Care policy and Finance, Staff
Manual Vol. 8, Section 8.765.30:
3. This Agreement shall be in force from July 1, 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 reps wentatives 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 front 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
RTC Services Rcv 06/11/02
07/10/02 14:24 FAX 970 348 7691 WELD CTY SOC SERVICES 121017
Contiact No.: PY 02/03-SS-23A-RTC
SECTION 1. DESCRIPTION OF SERVICES TO BE PURCHASED.
1. The services purchased under this Agreement as Room and Board costs for Residential Treatment Center
facility services, as outlined in the Department of Health Care policy and Finance, Staff Manual Vol. 8,
Section 8.765.503 may include,but are not limited to:Basic 24-hour care and child maintenance(food,
shelter,clothing,educational supplies and allowance), Administration, Administrative Overhead, Support
Staff,Support Overhead, and Sleep-over Staff.
2. The services reimbursable by Medicaid for treatment services under this Agreement, as outlined in the
Department of Health Care policy and Finance, Staff Manual Vol. 8,Sectio 8.765.502 may include,but
are not limited to: Evaluation Services (psychological, and/or neurelegiea , Medication and follow-tip,
Family Therapy,.Individual Therapy, Group Therapy,Sex Offender Evaluation and/or Sex Offender
Treatment as prescribed by the Sex Offender Management Board Policy,Polygrallf,Pl rhyst,t yaj
Parent Training for Teens,Independent Living Training,Mentor/Advocate,Supervised Visitation,
Therapeutic Recreation,Direct Child Care,and Transportation.
3. 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).
4. 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.
5. 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.
6. 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 treatruutt/case plan, and those persons shall
acknowledge their responsibility by signing the treatment/case plan.
7. Contractor will provide the purchased care and services at:
Facility ID#: 40322
Childrens Ark at Pueblo
400 E Routt Ave
Pueblo CO 81004
8. Contractor shall not charge any additional fees to children or families of children referred by County for
services provided under this Agreement.
9. 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
RTC Services Rev O6/11/O2
07/10/02 14:24 FAX 970 346 7891 WELD CTY SOC SERVICES O018
Contract No.: PY 02/03..SS-23A-RTC
SECTION II. MEDICAL CARE
1. In accordance with the Weld County Department of Social Services policies(2.710.70,2.710.71, 1710.72,
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 ofthe 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 curial
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
RTC Services Rev 06/11/02
07/10/02 14:25 FAX 970 346 7691 WELD CTY SOC SERVICES 019
ConttactNo.: PY02103.SS-23A-RTC
SECTION III. REASONS FOR REFERRAL AND TREATMENT PLAN
1. Attachment A will be designated as the Placement Referral fort. 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.
1. Maintain during the term of this Agreement a liability insurance policy of at least$400,000 for property
damage liability,$150,000 for injury and/or damage to any one person,and$400,00G for total injuries
arising from any one accident.
2. 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
RTC Services Rev 06/11102
07/10/02 14:25 FAX 970 346 7691 WELD CTY SOC SERVICES tm020
Contract No.: PY 02/03-SS-23A-RTC
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 RTC 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.
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 orrevised.
Agreement to Purchase 5
RTC Services Rev 06/11/02
07/10L0_2. 14:28 FAX 970 348 7891 WELD CTY SOC SERVICES tl021
Contract No.' PY 02/03-SS-23A-RTC
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,Of
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.
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.
Agreement to Purchase 6
RTC Services Rev 06/11/02
07/10/02 14:28 FAX 970 346 7891 WELD CTY SOC SERVICES O 022
Contract No.: PY 02/03-SS-23A-RTC
IN WITNESS WHEREOF,the parties hereto have duly executed,the Agreement as of the day,month, and year
first above written.
ATTEST:
Weld Conn Cerk ®� WELD COUNTY BOARD OF SOCIAL SERVICES,
c -.r�.�%:- �
t. ON BEHALF OF THE WELD COUNTY DEPARTMENT
j(?� OF SOCIAL SERVICES
1861 �{ :.,-,4t2 /
By: ..,/� .- ,,.�: , By:
Deputy Clerk to the Board +' *' 1 , Glean Vaad,Chair
4,,(,..II I � (1429/D°0-1)
APPROVED AS TO FORM:
7C CONTRACTOR
oun Att rney
Children Ark,Inc
PO Box 1007
Green Mountain Falls, CO 80814
By: •a:5.
„--bi,-..A2 Za
WELD COUNTY DEPARTMENT
OF SOCIAL SERVICES
By: m
cctor
Agreement to Purchase 7
RTC Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RTC
Addendum to the
AGREEMENT TO PRUCHASE RTC SERVICES
This addendum 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 Childrens
ARK,Inc.,PO Box 1007 Green Mountain falls,CO 80819,hereinafter called"Contractor"is designed
to be incorporated into the AGREEMENT between said County and Contractor for Facility
ID#:40322.
The following services: 1)Neurological Evaluations,2)Polygraphs,and 3)Plethysmographs shall be
stricken from Section 1.Description of Services to be Purchased. Reimbursement for said services
shall be negotiated between the County and the Contractor on a child-by-child basis.
07/10/02 14:18 FAX 970 346 7691 WELD CTY SOC SERv1ihS Iguuz
Contract No.: PY 02/03-SS•23A-RTC
AGREEMENT TO PURCHASE
RESIDENTIAL TREATMENT CENTER SERVICES
THIS AGREEMENT made this Vt 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 Childrens Ark,Inc,
PO Box 1007,Green Mountain Falls, CO 808I9,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 Residential Treatment Center.
NOW THEREFORE, it is hereby agreed that in consideration of the mutual Undertakings County and Contractor
agree as follows: -
1. County agrees to purchase and Contractor agrees to provide Room and Board services which are listed in
this Agreement at a rate of$26.56 per day for children placed within the Residential Treatment Center
identified as Provider ID#96480. These services will be for children who have been deemed eligible for
social services under the statutes,nilesand regulations of the State-of-Colorado.
2. Contractor shall be reimbursed by Medicaid for services provided to County children placed with
Contractor. Medicaid reimbursement shall be based off of the StateVendor Rate for the approved Level of
Care. The assessment instrument used to determine the Level of Care will be the Colorado Client
Assessment Record(CCAR)as per outlined in the Department of Health Care-policy and Finance, Staff
Manual Vol. 8,Section 8.765.30.
3. This Agreement shall be in force from July 1,2002, until the end o€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
RTC Services 1 Rev 06/11/02
07/10/02 14:19 FAX 970 346 7691 WELD CTY SOC SERVICES IJ 00a
ContractNo.: PY 02/03-SS-23A-RTC
SECTION 1. DESCRIPTION OF SERVICES TO BE PURCHASED.
1. The services-purchased under this Agreement as Room and Board costs for Residential Treatment Center
facility services, as outlined in the Department of Health Care policy and Finance, Staff Manual Vol. 8,
Section 8.765.503 may include,but are not limited to: Basic 24-hour care and child maintenance(food,
shelter,clothing, educational supplies and allowance), Administration, Administrative Overhead, Support
Staff, Support Overhead, and Sleep-over Staff.
2. The services reimbursable by Medicaid for treatment services under this Agreement, as-outlined in the
Department of Health Care policy and Finance, Staff Manual Vol. 8, Sectio 8.765.502 may include,but
are not limited to-: Evaluation Services (psychological, and/or-rte elr s , Medicationand-follow-up,
Family Therapy,Individual Therapy, Group Therapy, Sex Offender Evaluation an r Sex Offender
Treatment as-prescribed by the Sex Offender Management Board Policy, ,Plethycmografl`t,F
Parent Training for Teens, Independent Living Training,Mentor/Advocate, Supervised Visitation,
Therapeutic Recreation,Direct Child Care, and Transportation.
3. 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),
4. 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_
5. 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.
6. 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.
1. Contractor will provide the purchased care and services at:
Facility Wig: 96480
Childrens Ark at Green Mountain
I093O1Iundv Ave
Green Mountain Falls CO 80819
&. Contractor shall not charge any additional fees to children-or families of children referred by County for
services provided-under this Agreement.
9. 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
RTC Services Rev 06/11/02
07/10/02 14:19 FAX 970 346 7891 WELD CTY SOC SERVICES 19.1004
Contract No.: PY 02/03-SS-23A-RTC
SECTION II. MEDICAL CARE
1. In accordance with the Weld County Department of Social Services pohcies(2.710.7-0.2.710.71, 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 authorityto,
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 wilt 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,Diagnesis-
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
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 front 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
RTC Services Rev 06/11102
07/10/02 14: 20 FAX 970 348 7691 WELD CTY SOC SERVICES Il 005
Contract Nu.: PY 02/03-SS-23A-RTC
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 inthis 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.
•
1. Maintain during the term of this Agreement a liability insurance policy of at least $400,000 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.
2. Maintain during the terms of this Agreement a fidelity bond of at least$25,000 or two(2)months gross.
receipts,whichever is greater,coveting 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.
& 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 contractor 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
RTC Services- Rev 06111[02
07/10/02 14:20 FAX 970 346 7691 WELD CTY SOC SERVICES 1l 000
ContractNo.: PY 02/03-SS-23A-RTC
7. Maintain service program records, fiscal records, documentation and other records,which will sufficiently
and properly reflect all direct and indirect costs M 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 helduntilthe 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)wrrtrcwrittcn,
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-shortenthe
duration of placement at RTC 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 ofplacement and forward all appropriate information to the
County.
13-. A full evaluation of an Individualized Educational Plan(LEP>for youth designated as a Special Ediratinn.
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 LEP. 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 Stott
Department Staff Manual,Volume VII, and provide consultation and/or technical assistance to Contractor
in-relation to the services purchased under this-Agreement.
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.
Agreement to Purchase -5
RTC Services Rev 06/11/02
07/10/02 14:20 FAX 970 346 7691 WELD CTY SOC SERVICES COQ?
Contract No:: PY 02/03-SS-23A-RTC
SECTION VI. GENERAL PROVISIONS.
k. 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 ofColorado and federal funds-for the
purpose thereof.
3. It is agreed that if, after investigation,it is-shown-that reasonable care was given to guardand 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 o€all understandings between theparties.- Na 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 sufficientlyto 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 dicrretinn
of the County until final audit. Incorrect payments to the Contractor due to omission, error,fraud,or
misuse of funds shallbe recovered from the Contractor either by deduction from-subsequentpayments
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 giveorallow any claim orright 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.
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 acknowledgeand agree that no part of this Agreementis intended to circumvent or replace
such immunities.
Agrccmcntto.Purchase. 5 Rev 06/11/02
RTC Services
Contract No.: PY 02/03-SS-23A-RTC
IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year
first above written.
ATTEST:
Weld County Clet �i`1�CC7 da\ WELD COUNTY BOARD OF SOCIAL SERVICES,
ON BEHALF OF THE WELD COUNTY DEPARTMENT
ab`� � O.` OF SOCIAL SERVICES
1861 i`�(4YI4tOcit``%ID
By: .:4_41 .. ��4. a F _4 1 By:
Deputy Clerk to the Bo n, Glenn Vaad, air
APPROVED AS TO FORM:
CONTRACTOR
County tto ey
Children Ark, Inc
PO Box 1007
Green Mountain Falls, CO 80819
By: �LG.Z�� �
WELD COUNTY DEPARTMENT
,tYl2PC
OF SOCIAL SERVICES
By:
uector
Agreement to Purchase
RTC Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RTC
Addendumto the
AGREEMENT TO PRUCHASE RTC SERVICES
This addendum 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 Childrens
ARK,Inc.,PO Box 1007 Green Mountain falls,CO 80819,hereinafter called"Contractor"is designed
to be incorporated into the AGREEMENT between said County and Contractor for Facility
ID#:96480.
The following services: 1)Neurological Evaluations,2)Polygraphs,and 3)Plethysmographs shall be
stricken from Section 1.Description of Services to be Purchased. Reimbursement for said services
shall be negotiated between the County and the Contractor on a child-by-child basis.
VA04/1401-4:ef-1
et
Hello