HomeMy WebLinkAbout20022041.tiff RESOLUTION
RE: APPROVE SIXTEEN (16) AGREEMENTS TO PURCHASE RESIDENTIAL CHILD
CARE FACILITIES 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 sixteen (16) Agreements to Purchase
Residential Child Care Facilities 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) Arapahoe House
2) Griffith Center
3) El Pueblo Boys' and Girls' Ranch
4) Kids Ark In Sterling
5) Kids Ark In New Raymer Ranch
6) Monarch Youth - Berthoud, Blue Mountain Ranch
7) Monarch Youth - Loveland
8) Monarch Youth - Berthoud, Bryon Grismore Treatment Center
9) Namaqua Center- 8th Street Loveland
10) Namaqua Center- 7th Street Loveland
11) Third Way Center- York
12) Third Way Center- Pontiac
13) Third Way Center- Lincoln
14) Turning Point Center for Youth - Prospect/Fort Collins
15) Turning Point Center for Youth - Mathews/Fort Collins
16) Turning Point Center for Youth - Shields/Fort Collins, 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 sixteen (16) Agreements to
Purchase Residential Child Care Facilities 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 mentioned providers be, and hereby are,
approved.
2002-2041
SS0029
00 . 55
RE: SIXTEEN (16) AGREEMENTS TO PURCHASE RESIDENTIAL CHILD CARE FACILITIES
SERVICES
PAGE 2
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said agreements.
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: LAW � IE La EXCUSED DATE OF SIGNING (AYE)
�J Glenn ad, Chair� � 4
'
Weld County Clerk to the • .an
11, (-
1861 O?� �� C
f ♦ n )/
avid g, Pro-Tem
BY:
Deputy Clerk to the Boat` c 971 6(4.✓
M. J. eile pPRO AST M: EXCUSED DATE OF SIGNING (AYE)
'Ilia H. J rke
County Att ne
Robert D. Masden
Date of signature:
2002-2041
SS0029
DEPARTMENT OF SOCIAL SERVICES
ititR(141")%4\:,
PO BOX A
GREELEY,CO 80632
iiiWEBSITE:
www.co.weld.co.us
Administration and Public Assistance(970)352-1551
C. Child Support(970)352-6933
COLORADO MEMORANDUM
TO: Glenn Vaad, Chair Date: July 25, 2002
Board of County Commissioners
FR: Judy A. Griego, Director, Social Services- C�-r '
� , r ,
RE: Agreements to Purchase Residential Child are Facilities( CCF)
Services Between Weld County Department of Social Services with
Various Vendors
Enclosed for Board approval are Agreements to Purchase Residential Child Care Facilities
(RCCF) 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 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 at rates that will include room,board, and
treatment, as follows:
A. Arapahoe House: $82.89 per day
B. Griffith Center: $76.19 per day
C. El Pueblo Boy's and Girl's Ranch: $58.52 per day
D. Kids Ark in Sterling: $72.83 per day
E. Kids Ark in New Reymer Ranch: $72.83 per day
F. Monarch Youth-Berthoud: $95.48 per day
(Blue Mountain Ranch)
G. Monarch Youth-Loveland: $95.48 per day
H. Monarch Youth—Berthoud: $95.48 per day
(Bryon Grismore Treatment Center)
I. Namaqua Center-8th Street Loveland: $76.40 per day
J. Namaqua Center—7th Street Loveland: $76.40 per day
K. Third Way Center-York: $63.19 per day
L. Third Way Center—Pontiac: $63.19 per day
M. Third Way Center-Lincoln: $35.65 per day
N. Turning Point Center—Prospect/Ft. Collins: $75.77 per day
0. Turning Point Center—Mathews/Ft. Collins:$49.39 per day
P. Turning Point Center—Shields/Ft. Collins: $49.39 per day
If you have any questions,please telephone me at extension 6510.
2002-2041
Contract No.: PY 02/03-SS-23A-RCCF
AGREEMENT TO PURCHASE
RCCF 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 Arapahoe House,
8801 Lipan St, Thornton, 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 Residential Child Care Facility.
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 the care and services which are listed in this
Agreement at a rate of $82.89 per day for children placed within the Residential Child Care Facility
identified as Provider ID#88692. 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. 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.
3. 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 2 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.
4. 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
RCCF Services Rev 06/11/02
Contra-et No.: PY 02/03-SS-23A-RCCF
SECTION 1. DESCRIPTION OF SERVICES TO BE PURCHASED.
1. The services purchased under this Agreement are Residential Child Care Facility services and may include,
but are not limited to: Basic 24-hour care and child maintenance (food, shelter, clothing, educational
supplies and allowance), Direct Child Care, Transportation, Administrative Overhead, Support Overhead,
Therapeutic Recreation, Service delivery Staff, Direct therapy and evaluation, which may include but are
not limited to: Psychological,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, and Supervised Visitation.
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. My 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:
Facility ID#: 88692
Arapahoe House
8801 Lipan St
Thornton CO 80221
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
RCCF Services Rev 06/11/02
• Contract No.: PY 02/03-SS-23A-RCCF
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
RCCF Services Rev 06/11/02
• Contract No.: PY 02/03-SS-23A-RCCF
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 $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.
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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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.
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.
1. Assess and collect fees in accordance with the rules and regulations of the Colorado Department of Social
Services.
2. 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
RCCF Services Rev 06/11/02
.• Contract No.: PY 02/03-SS-23A-RCCF
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.
1. 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.
2. 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
RCCF Services Rev 06/11/02
. Contract No.: PY 02/03-SS-23A-RCCF
3. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their
officers or employees may possess, nor shall any portion of this Agreement be deemed to have 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 if k t e WELD COUNTY BOARD OF SOCIAL SERVICES,
ON BEHALF OF THE WELD COUNTY DEPARTMENT
1861 , OF SOCIAL SERVICES
SERVICEES
4..ditelec
Deputy Clerk to the Board�_ �� Glenn Vaad, Chair
( it 31 Sao)
APPROVED AS TO FORM:
•
CONTRACTOR
o Attorney
Arapahoe House
8801 Lipan St
Thornton,
CO 80221 80260
T By: (/ "---?
Michael W. K , , Ph.D.
WELD COUNTY DEPARTMENT Chief Executive Officer
OF SOCIAL SERVICES
By:
Direct t
Agreement to Purchase 7
RCCF Services Rev 06/11/02
' Contrzct No.: PY 02/03-SS-23A-RCCF
AGREEMENT TO PURCHASE
RCCF 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 Griffith Center, 8745
W 14th Ave#230, Lakewood, CO 80215, 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 Child Care Facility.
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 the care and services which are listed in this
Agreement at a rate of $76.19 per day for children placed within the Residential Child Care Facility
identified as Provider ID#49547. 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. 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.
3. 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 2 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.
4. 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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
SECTION 1. DESCRIPTION OF SERVICES TO BE PURCHASED.
1. The services purchased under this Agreement are Residential Child Care Facility services and may include,
but are not limited to: Basic 24-hour care and child maintenance (food, shelter, clothing, educational
supplies and allowance), Direct Child Care, Transportation, Administrative Overhead, Support Overhead,
Therapeutic Recreation, Service delivery Staff, Direct therapy and evaluation, which may include but are
not limited to: Psychological,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, and Supervised Visitation.
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:
Facility ID#: 49547
Griffith Center
12163 S Perry Park Rd
Larkspur CO 80118
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
RCCF Services 2 Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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 maybe 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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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 $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.
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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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.
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.
1. Assess and collect fees in accordance with the rules and regulations of the Colorado Department of Social
Services.
2. 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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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.
I. 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.
1. 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.
2. 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
5
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
3. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their
officers or employees may possess, nor shall any portion of this Agreement be deemed to have 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: ,!. 'la)
Weld County Cler WELD COUNTY BOARD OF SOCIAL SERVICES,
"QI` ON BEHALF OF THE WELD COUNTY DEPARTMENT
` OF SOCIAL SERVICES
Sot i
By: Deputy
�. :•a ri By: Phid
puty Clerk to the Boar ( �, GI ,Chair
(7/304)
APPROVED AS TO FORM: /
CONTRACTOR
ounty Atto iey
Griffith Center
8745 W 14th Ave#230
Lakewood, CO 80215
B}c-- C9--C
WELD COUNTY DEPARTMENT
OF SOCIAL SERVICES
�q
By: l/
ector I
Agreement to Purchase
'
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
AGREEMENT TO PURCHASE
RCCF SERVICESey
THIS AGREEMENT made this 1st day of July, 2002 between the Weld County Board of Social/We/9✓ices,
on behalf of the Weld County Department of Social Services hereinafter called "County" and El Pueblo Boys'4fid
Girls' Ranch, One El Pueblo Ranch Way, Pueblo, CO 81006, 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 Child Care Facility.
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 the care and services which are listed in this
Agreement at a rate of $58.52 per day for children placed within the Residential Child Care Facility
identified as Provider ID#45146. 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. 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.
3. 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 2 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.
4. 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
RCCF Services Rev 06/11/02
Contract No.a PY 02/03-SS-23A-RCCF
SECTION 1. DESCRIPTION OF SERVICES TO BE PURCHASED.
1. The services purchased under this Agreement are Residential Child Care Facility services and may include,
but are not limited to: Basic 24-hour care and child maintenance (food, shelter, clothing, educational
supplies and allowance), Direct Child Care, Transportation, Administrative Overhead, Support Overhead,
Therapeutic Recreation, Service delivery Staff, Direct therapy and evaluation, which may include but are
not limited to: Psychological, 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, and Supervised Visitation.
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:
Facility ID#: 45146
El Pueblo Boys' and Girls' Ranch
1591 Taos Rd.
Pueblo CO 81006
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
RCCF Services 2 Rev 06/11/02
Contract 14o t PY 02/03-SS-23A-RCCF
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
RCCF Services Rev 06/11/02
Contract No, PY 02/03-SS-23A-RCCF
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 $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.
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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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.
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.
1. Assess and collect fees in accordance with the rules and regulations of the Colorado Department of Social
Services.
2. 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 Fl, 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
RCCF Services Rev 06/11/02
Contract Not: PY 02/03-SS-23A-RCCF
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.
1. 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.
2. 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
RCCF Services Rev 06/11/02
Contrast No-: PY 02/03-SS-23A-RCCF
3. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their
officers or employees may possess, nor shall any portion of this Agreement be deemed to have 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: ... , li��/ :./�•i'►�
Weld County Clerk ai . A WELD COUNTY BOARD OF SOCIAL SERVICES,
�J ON BEHALF OF THE WELD COUNTY DEPARTMENT
OF SOCIAL SERVICE
1d51 y fit:_:
By: /� t BY
Deputy Clerk to the Boards • ft ,„u =, Glenn�'�ao ,Chair
APPROVED AS TO FORM:
CONTRACTOR
Cozen omey
El Pueblo Boys' and Girls'Ranch
One El Pueblo Ranch Way
Pueblo, CO 81006
By: ti G'. 6,ck.cct}
WELD COUNTY DEPARTMENT
OF SOCIAL SERVICES
By: D
Director
Agreement to Purchase 7
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
AGREEMENT TO PURCHASE
RCCF 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 Kids Ark In Sterling,
PO Box 1725, Sterling, CO 80751, 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 Child Care Facility.
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 the care and services which are listed in this
Agreement at a rate of $72.83 per day for children placed within the Residential Child Care Facility
identified as Provider ID#34340. 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. 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.
3. 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 2 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.
4. 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
RCCF Services Rev 06/11/02
'Contract No.: PY 02/03-SS-23A-RCCF
SECTION 1. DESCRIPTION OF SERVICES TO BE PURCHASED.
1. The services purchased under this Agreement are Residential Child Care Facility services and may include,
but are not limited to: Basic 24-hour care and child maintenance (food, shelter, clothing, educational
supplies and allowance), Direct Child Care, Transportation, Administrative Overhead, Support Overhead,
Therapeutic Recreation, Service delivery Staff, Direct therapy and evaluation, which may include but are
not limited to: Psychological, 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, and Supervised Visitation.
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:
Facility ID#: 34340
Kidz Ark In Sterling
17282 CR 32
Sterling CO 80751
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
RCCF Services 2 Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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
RCCF Services
Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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 $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.
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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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.
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.
1. Assess and collect fees in accordance with the rules and regulations of the Colorado Department of Social
Services.
2. 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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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.
1. 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.
2. 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
RCCF Services
Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
3. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their
officers or employees may possess, nor shall any portion of this Agreement be deemed to have 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: Li
Weld County Cler#fl1>*� ' WELD COUNTY BOARD OF SOCIAL SERVICES,
ON BEHALF OF THE WELD COUNTY DEPARTMENT
=� OF SOCIAL SERVICE
1861 -di?,
\;)ist;
By. n,%: o r � Sl` r- By:
Deputy Clerk to the Board C % I :i u ' Glenn as , Chair
P ri ►!r cal 4
302)
APPROVED AS TO FORM:
CONTRACTOR
ounty omey
Kids Ark In Sterling
PO Box 1725
Sterling, CO 80751
(1zit&
�lk
By: �WELD COUNTY DEPARTMENT
OF SOCIAL SERVICES
By: • tit s.
irector L
Agreement to Purchase 7
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
AGREEMENT TO PURCHASE
RCCF 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 Kids Ark In New
Reymer Ranch, PO Box 1725, Sterling, CO 80751, 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 Child Care Facility.
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 the care and services which are listed in this
Agreement at a rate of $72.83 per day for children placed within the Residential Child Care Facility
identified as Provider ID#34341. 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. 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.
3. 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 2 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.
4. 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
RCCF Services 1 Rev 06/11/02
Contract No;: PY 02/03-SS-23A-RCCF
SECTION 1. DESCRIPTION OF SERVICES TO BE PURCHASED.
1. The services purchased under this Agreement are Residential Child Care Facility services and may include,
but are not limited to: Basic 24-hour care and child maintenance (food, shelter, clothing, educational
supplies and allowance), Direct Child Care, Transportation, Administrative Overhead, Support Overhead,
Therapeutic Recreation, Service delivery Staff, Direct therapy and evaluation, which may include but are
not limited to: Psychological,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, and Supervised Visitation.
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:
Facility ID#: 34341
Kidz Ark New Raymer Ranch
Kidz Ark New Raymer Ranch
New Raymer CO 80742
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
RCCF Services Rev 06/11/02
Contract No. PY 02/03-SS-23A-RCCF
SECTION IL 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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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 $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.
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
RCCF Services Rev 06/11/02
Contract No,: PY 02/03-SS-23A-RCCF
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.
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.
1. Assess and collect fees in accordance with the rules and regulations of the Colorado Department of Social
Services.
2. 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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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.
1. 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.
2. 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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
3. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their
officers or employees may possess, nor shall any portion of this Agreement be deemed to have 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: Lo j�'(/V(i%
Weld County Clerk s e Y. 4,N) WELD COUNTY BOARD OF SOCIAL SERVICES,
ON BEHALF OF THE WELD COUNTY DEPARTMENT
( C>i OF SOCIAL SERVICES
+C
By: By:
Deputy Clerk to the Board ` (j dV at v Glenn Vaa ,
(7/3,/oz)
APPROVED AS TO FORM:
r
4t-----4
CONTRACTOR
Count Kids Ark In New Reymer Ranch
PO Box 1725
Sterling, CO 80751
By: 9t12c
a A C/L
WELD COUNTY DEPARTMENT
OF SOCIAL SERVICES
By e
: � I 1 ( —
alDirector'
Agreement to Purchase
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
AGREEMENT TO PURCHASE
RCCF 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 Monarch Youth, PO
Box K, Berthoud, CO 80513, 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 Child Care Facility.
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 the care and services which are listed in this
Agreement at a rate of $95.48 per day for children placed within the Residential Child Care Facility
identified as Provider ID#38462. 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. 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.
3. 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 2 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.
4. 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
RCCF Services 1
Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
SECTION 1. DESCRIPTION OF SERVICES TO BE PURCHASED.
1. The services purchased under this Agreement are Residential Child Care Facility services and may include,
but are not limited to: Basic 24-hour care and child maintenance (food, shelter, clothing, educational
supplies and allowance), Direct Child Care, Transportation, Administrative Overhead, Support Overhead,
Therapeutic Recreation, Service delivery Staff, Direct therapy and evaluation, which may include but are
not limited to: Psychological, 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, and Supervised Visitation.
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:
Facility ID#: 38462
Blue Mountian Ranch
2100 Blue Mountian Dr
Berthoud CO 80513
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
RCCF Services 2
Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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
RCCF Services 3
Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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 $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.
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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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.
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.
1. Assess and collect fees in accordance with the rules and regulations of the Colorado Department of Social
Services.
2. 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
RCCF Services Rev 06/11/02
Contract Na.: PY 02/03-SS-23A-RCCF
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.
1. 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.
2. 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
RCCF Services 6
Rev 06/11/02
•
Contract No.: PY 02/03-SS-23A-RCCF
3. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their
officers or employees may possess, nor shall any portion of this Agreement be deemed to have 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.
n 4
ATTEST: Weld
i/�/►" o;l
d County r k t. Fr WELD COUNTY BOARD OF SOCIAL SERVICES,
[EH i fci .-Y ON BEHALF OF THE WELD COUNTY DEPARTMENT
k OF SOCIAL SERVICES
JZ Off p
'S
By. CI By:
Deputy Clerk the Board ` Glenn , hair
(7/31/02)
APPROVED AS TO FORM:
CONTRACTOR
County A why
Monarch Youth L�
PO-Brix-KM w.6920-IP3 Bou 13 1 �1@MI-
By: V - CY 00,,,--Cktni
WELD COUNTY DEPARTMENT
OF SOCIAL SERVICES
By: , lLQVL
trector U
i U
Agreement to Purchase
RCCF Services Rev 06/11/02
•
ContracsNo.: PY 02/03-SS-23A-RCCF
AGREEMENT TO PURCHASE
RCCF 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 Monarch Youth, PO
Box K, Berthoud, CO 80513, 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 Child Care Facility.
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 the care and services which are listed in this
Agreement at a rate of $95.48 per day for children placed within the Residential Child Care Facility
identified as Provider ID#1500261. 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. 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.
3. 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 2 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.
4. 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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
SECTION 1. DESCRIPTION OF SERVICES TO BE PURCHASED.
1. The services purchased under this Agreement are Residential Child Care Facility services and may include,
but are not limited to: Basic 24-hour care and child maintenance (food, shelter, clothing, educational
supplies and allowance), Direct Child Care, Transportation, Administrative Overhead, Support Overhead,
Therapeutic Recreation, Service delivery Staff, Direct therapy and evaluation, which may include but are
not limited to: Psychological,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, and Supervised Visitation.
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:
Facility ID#: 1500261
Fox Drive Treatment Center
3400 Fox Dr
Loveland CO 80537
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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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 $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.
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
RCCF Services Rev 06/11/02
•
Contract No.: PY 02/03-SS-23A-RCCF
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.
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.
1. Assess and collect fees in accordance with the rules and regulations of the Colorado Department of Social
Services.
2. 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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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.
1. 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.
2. 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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
3. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their
officers or employees may possess, nor shall any portion of this Agreement be deemed to have created a
duty of care which did not previously exist with respect to any person not a party to this Agrent. The
parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or*.eplace
such immunities. v 3�
1..•
IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year 4
first above written.
ATTEST: " '
Weld County Cle�y'�� t ta'r. WELD COUNTY BOARD OF SOCIAL SERVICES,
ON BEHALF OF THE WELD COUNTY DEPARTMENT
;14,2; OF SOCIAL SERVICES
lip ( 'i �1 1/�
By �� . oFl A q By: AAA_/16-21404,L
Deputy Clerk to the Board s ��r� , Glenn V ad,Char
Cli31)O�
APPROVED AS TO FORM:
CONTRACTOR
ounty Attorney
Monarch Youth
.PIE)-&t 1(4(oQf cU . 1S -1: ,W:421: '
Berthoud, CO 80513 ` �TO,LO tact
By: J ��
WELD COUNTY DEPARTMENT ' '
OF SOCIAL SERVICES
By:
Direr r
Agreement to Purchase
RCCF Services Rev 06/11/02
CC.itract No.: PY 02/03-SS-23A-RCCF
AGREEMENT TO PURCHASE
RCCF 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 Monarch Youth, PO
Box K, Berthoud, CO 80513, 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 Child Care Facility.
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 the care and services which are listed in this
Agreement at a rate of $95.48 per day for children placed within the Residential Child Care Facility
identified as Provider ID#1503010. 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. 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.
3. 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 2 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.
4. 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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
SECTION 1. DESCRIPTION OF SERVICES TO BE PURCHASED.
1. The services purchased under this Agreement are Residential Child Care Facility services and may include,
but are not limited to: Basic 24-hour care and child maintenance (food, shelter, clothing, educational
supplies and allowance), Direct Child Care, Transportation, Administrative Overhead, Support Overhead,
Therapeutic Recreation, Service delivery Staff, Direct therapy and evaluation, which may include but are
not limited to: Psychological, 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, and Supervised Visitation.
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:
Facility ID#: 1503010
Byron Grizmore Treatment Center
204 WCR 10E
Berthoud CO 80513
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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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
RCCF Services Rev 06/11/02
•
Contract No.: PY 02/03-SS-23A-RCCF
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 $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.
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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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.
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.
1. Assess and collect fees in accordance with the rules and regulations of the Colorado Department of Social
Services.
2. 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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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.
1. 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.
2. 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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
3. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their
officers or employees may possess, nor shall any portion of this Agreement be deemed to have 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.
ji
ATTEST: / a' "'�
Weld County Clem th r "<4�` WELD COUNTY BOARD OF SOCIAL SERVICES,
14. �M Vii ON BEHALF OF THE WELD COUNTY DEPARTMENT
r OF SOCIAL SERVICES
,.)rte=t
q
By: UN Glenn Vaad, au
By: __IL, Li.adQ
Deputy Clerk to the Board
Ol31/OZ)
APPROVED AS TO FORM:
CONTRACTOR
Attorney Monarch Youth
�1 (r lergq <�F L�a
ox 4C W' 5
Beitlheud;-G9-00 WilVtiN 1 W PS31"
By: J ,
WELD COUNTY DEPARTMENT
OF SOCIAL SERVICES
By: i
Direct
k.
Agreement to Purchase 7Rev 06/11/02
RCCF Services
Centract 1Vo.: PY 02/03-SS-23A-RCCF
AGREEMENT TO PURCHASE
RCCF 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 Namaqua Center,
1327 W Eisenhower Blvd, Loveland, CO 80537, 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 Child Care Facility.
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 the care and services which are listed in this
Agreement at a rate of $76.40 per day for children placed within the Residential Child Care Facility
identified as Provider ID#45142. 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. 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.
3. 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 2 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.
4. 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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
SECTION 1. DESCRIPTION OF SERVICES TO BE PURCHASED.
1. The services purchased under this Agreement are Residential Child Care Facility services and may include,
but are not limited to: Basic 24-hour care and child maintenance (food, shelter, clothing, educational
supplies and allowance), Direct Child Care, Transportation, Administrative Overhead, Support Overhead,
Therapeutic Recreation, Service delivery Staff, Direct therapy and evaluation, which may include but are
not limited to: Psychological,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, and Supervised Visitation.
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:
Facility ID#: 45142
Namaqua Center
549 E 8th St
Loveland CO 80537
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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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
RCCF Services Rev 06/11/02
Cdntract No.: PY 02/03-SS-23A-RCCF
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 $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.
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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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.
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.
1. Assess and collect fees in accordance with the rules and regulations of the Colorado Department of Social
Services.
2. 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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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.
1. 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.
2. 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
RCCF Services Rev 06/11/02
Cannact No.: PY 02/03-SS-23A-RCCF
3. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their
officers or employees may possess, nor shall any portion of this Agreement be deemed to have 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:
eld County Cl I?r lit WELD COUNTY BOARD OF SOCIAL SERVICES,
ON BEHALF OF THE WELD COUNTY DEPARTMENT
OF SOCIAL SERVICES
� �� }•
By: La L 4«lr`t.� eI aa� By:
Deputy Clerk to the Boatel f Glenn Vaad,Chair
\ .!V\ of31'OL)
APPROVED AS TO FORM:
CONTRACTOR
oun Attorney
Namaqua Center
1327 W Eise wer B1v
aLoveland;CO 537,
By: LO-v
WELD COUNTY DEPARTMENT
OF SOCIAL SERVICES
By:
(
Direc
Agreement to Purchase
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
AGREEMENT TO PURCHASE
RCCF SERVICES
/A
THIS AGREEMENT made this 1st day of July, 2002 between the Weld County Board of Soervices,
on behalf of the Weld County Department of Social Services hereinafter called "County" and Namaqua%ter,
1327 W Eisenhower Blvd, Loveland, CO 80537, 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 Child Care Facility.
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 the care and services which are listed in this
Agreement at a rate of $76.40 per day for children placed within the Residential Child Care Facility
identified as Provider ID#100889. 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. 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.
3. 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 2 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.
4. 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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
SECTION 1. DESCRIPTION OF SERVICES TO BE PURCHASED.
1. The services purchased under this Agreement are Residential Child Care Facility services and may include,
but are not limited to: Basic 24-hour care and child maintenance (food, shelter, clothing, educational
supplies and allowance), Direct Child Care, Transportation, Administrative Overhead, Support Overhead,
Therapeutic Recreation, Service delivery Staff, Direct therapy and evaluation, which may include but are
not limited to: Psychological, 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, and Supervised Visitation.
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:
Facility ID#: 100889
Namaqua Center
404 E 7th St
Loveland CO 80537
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
RCCF Services 2 Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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 $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.
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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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.
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.
1. Assess and collect fees in accordance with the rules and regulations of the Colorado Department of Social
Services.
2. 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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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.
1. 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.
2. 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
RCCF Services 6 Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
3. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their
officers or employees may possess, nor shall any portion of this Agreement be deemed to have 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: a a
Weld County C r$ to)he'Btf* WELD COUNTY BOARD OF SOCIAL SERVICES,
ON BEHALF OF THE WELD COUNTY DEPARTMENT
i OF SOCIAL SERVICES
?
� ,� fi �l
BY: C2_,- .1rity iii rj rj p,j A By: Glenn Vak ,
Deputy Clerk to the Boar. ,' 'ANA U
..�i (7/34
APPROVED AS TO FORM:
CONTRACTOR
County Atto iey
Namaqua Center
1327 W Eise wer Blvd
By: Coseland, CO 5371 /
*t1 op
WELD COUNTY DEPARTMENT
OF SOCIAL SERVICES
'I
By: ( \i r
Direct' it
Agreement to Purchase
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
AGREEMENT TO PURCHASE
RCCF 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 Third Way Center,
PO Box 61385, Denver, CO 80206, 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 Child Care Facility.
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 the care and services which are listed in this
Agreement at a rate of $63.19 per day for children placed within the Residential Child Care Facility
identified as Provider ID#49487. 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. 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.
3. 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 2 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.
4. 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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
SECTION 1. DESCRIPTION OF SERVICES TO BE PURCHASED.
1. The services purchased under this Agreement are Residential Child Care Facility services and may include,
but are not limited to: Basic 24-hour care and child maintenance (food, shelter, clothing, educational
supplies and allowance), Direct Child Care, Transportation, Administrative Overhead, Support Overhead,
Therapeutic Recreation, Service delivery Staff, Direct therapy and evaluation, which may include but are
not limited to: Psychological, 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, and Supervised Visitation.
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 maybe 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:
Facility ID#: 49487
Third Way Center- York
1295 York St
Denver CO 80206
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
RCCF Services
Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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
RCCF Services 3
Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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 $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.
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
RCCF Services 4
Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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.
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.
1. Assess and collect fees in accordance with the rules and regulations of the Colorado Department of Social
Services.
2. 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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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.
1. 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.
2. 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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
3. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their
officers or employees may possess, nor shall any portion of this Agreement be deemed to have 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: atedi
Weld County C e, to . ' �:(s ` WELD COUNTY BOARD OF SOCIAL SERVICES,
3,_ d`'-' � ON BEHALF OF THE WELD COUNTY DEPARTMENT
"' . OF SOCIAL SERVICES
By: £� � a �I1� 4 /1 By A.A...c.A..24-6-el
Deputy Clerk to the Boar i% ( / I Glenn Vaad,Chair
��►� (7/3iq
APPROVED AS TO FORM:
CONTRACTOR
unty ttomey
Third Way Center
PO Box.61385
Deny r, O 8 6
By:
WELD COUNTY DEPARTMENT
OF SOCIAL SERVICES
By:
Direct
Agreement to Purchase
RCCF Services Rev 06/11/02
ContractNo.: PY 02/03-SS-23A-RCCF
AGREEMENT TO PURCHASE
RCCF 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 Third Way Center,
PO Box 61385, Denver, CO 80206, 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 Child Care Facility.
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 the care and services which are listed in this
Agreement at a rate of $63.19 per day for children placed within the Residential Child Care Facility
identified as Provider ID#65346. 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. 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.
3. 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 2 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.
4. 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
RCCF Services Rev 06/11/02
Contract,No.: PY 02/03-SS-23A-RCCF
SECTION 1. DESCRIPTION OF SERVICES TO BE PURCHASED.
1. The services purchased under this Agreement are Residential Child Care Facility services and may include,
but are not limited to: Basic 24-hour care and child maintenance (food, shelter, clothing, educational
supplies and allowance), Direct Child Care, Transportation, Administrative Overhead, Support Overhead,
Therapeutic Recreation, Service delivery Staff, Direct therapy and evaluation, which may include but are
not limited to: Psychological,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, and Supervised Visitation.
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:
Facility ID#: 65346
Third Way Center-Pontiac
1735 Pontiac St
Denver CO 80220
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
RCCF Services Rev 06/11/02
ContractNo.: PY 02/03-SS-23A-RCCF
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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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 $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.
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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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.
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.
1. Assess and collect fees in accordance with the rules and regulations of the Colorado Department of Social
Services.
2. 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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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.
1. 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.
2. 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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
•
3. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their
officers or employees may possess, nor shall any portion of this Agreement be deemed to have 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.
Lit
ATTEST:
Weld County CI;f o 04'4N\ WELD COUNTY BOARD OF SOCIAL SERVICES,
.4 ;v' ON BEHALF OF THE WELD COUNTY DEPARTMENT
1861 f 1�i � OF SOCIAL SERVICES
By: '� i reAABy:
Deputy Clerk to the Board ,� A Glennia6kair
0)302)
APPROVED AS TO FORM:
CONTRACTOR
C my [°mey
Third Way Center
PO Box 61385
De r, C 0206
By:
WELD COUNTY DEPARTMENT
OF SOCIAL SERVICES
By: ,t_flid 3V`
'recto
Agreement to Purchase
RCCF Services Rev 06/11/02
Conttact No.: PY 02/03-SS-23A-RCCF
AGREEMENT TO PURCHASE
RCCF 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 Third Way Center,
PO Box 61385, Denver, CO 80206, 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 Child Care Facility.
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 the care and services which are listed in this
Agreement at a rate of $35.65 per day for children placed within the Residential Child Care Facility
identified as Provider ID#77810. 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. 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.
3. 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 2 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.
4. 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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
SECTION 1. DESCRIPTION OF SERVICES TO BE PURCHASED.
1. The services purchased under this Agreement are Residential Child Care Facility services and may include,
but are not limited to: Basic 24-hour care and child maintenance (food, shelter, clothing, educational
supplies and allowance), Direct Child Care, Transportation, Administrative Overhead, Support Overhead,
Therapeutic Recreation, Service delivery Staff, Direct therapy and evaluation, which may include but are
not limited to: Psychological,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, and Supervised Visitation.
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:
Facility ID#: 77810
Third Way Center- Lincoln
1133 Lincoln
Denver CO 80203
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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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 $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.
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
RCCF Services Rev 06/11/02
Contact No.: PY 02/03-SS-23A-RCCF
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.
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.
1. Assess and collect fees in accordance with the rules and regulations of the Colorado Department of Social
Services.
2. 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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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.
1. 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.
2. 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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
3. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their
officers or employees may possess, nor shall any portion of this Agreement be deemed to have 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.
galadlei
ATTEST:
Weld County Cl tleJo9t WELD COUNTY BOARD OF SOCIAL SERVICES,
[4�
ON BEHALF OF THE WELD COUNTY DEPARTMENT
t OF SOCIAL SERVICES
By dL/ • — C f ? By:
Deputy Clerk to the Bdarci Glenn Vaa ,
(7/3t/n)
APPROVED AS TO FORM:
CONTRACTOR
Co ty ttorney
Third Way Center
PO ? 'x61385
�-nv , 0206
By:
WELD COUNTY DEPARTMENT
OF SOCIAL SERVICES By: Direc o$r
el
IJ
Agreement to Purchase
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
AGREEMENT TO PURCHASE
RCCF 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 Turning Point Center
for Youth, 1644 South College Ave,Fort Collins, CO 80525, 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 Child Care Facility.
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 the care and services which are listed in this
Agreement at a rate of $75.77 per day for children placed within the Residential Child Care Facility
identified as Provider ID#45178. 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. 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.
3. 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 2 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.
4. 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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
SECTION 1. DESCRIPTION OF SERVICES TO BE PURCHASED.
1. The services purchased under this Agreement are Residential Child Care Facility services and may include,
but are not limited to: Basic 24-hour care and child maintenance (food, shelter, clothing, educational
supplies and allowance), Direct Child Care, Transportation, Administrative Overhead, Support Overhead,
Therapeutic Recreation, Service delivery Staff, Direct therapy and evaluation, which may include but are
not limited to: Psychological,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, and Supervised Visitation.
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:
Facility ID#: 45178
Turning Point For Drugs and Alcohol
640 W Prospect St.
Fort Collins CO 80524
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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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 $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.
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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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.
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.
1. Assess and collect fees in accordance with the rules and regulations of the Colorado Department of Social
Services.
2. 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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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.
1. 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.
2. 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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
•
3. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their
officers or employees may possess, nor shall any portion of this Agreement be deemed to have 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:
I °. C ertFR.taa WELD COUNTY BOARD OF SOCIAL SERVICES,
ON BEHALF OF THE WELD COUNTY DEPARTMENT
OF SOCIAL SERVICES
,ayYYr� �'� 'r�
1861 ��� Q^9
By: G t I /„ ' A n By:
Deputy Clerk to the Bo��. -51 Glenn Vaad,‘4 (7-1N%—\1
1N%ti (7/31102)
APPROVED AS TO FORM:
CONTRACTOR
County Atto iey
Turning Point Center for Youth
1644 South College Ave
Fort Collins, CO 80525
By. n�
WELD COUNTY DEPARTMENT
OF SOCIAL SERVICES
By: C`
! 1 Direct
,J �J
Agreement to Purchase
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
AGREEMENT TO PURCHASE
RCCF 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 Turning Point Center
for Youth, 1644 South College Ave, Fort Collins, CO 80525, 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 Child Care Facility.
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 the care and services which are listed in this
Agreement at a rate of $49.39 per day for children placed within the Residential Child Care Facility
identified as Provider ID#45179. 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. 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.
3. 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 2 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.
4. 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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
SECTION 1. DESCRIPTION OF SERVICES TO BE PURCHASED.
1. The services purchased under this Agreement are Residential Child Care Facility services and may include,
but are not limited to: Basic 24-hour care and child maintenance (food, shelter, clothing, educational
supplies and allowance), Direct Child Care, Transportation, Administrative Overhead, Support Overhead,
Therapeutic Recreation, Service delivery Staff, Direct therapy and evaluation, which may include but are
not limited to: Psychological, 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, and Supervised Visitation.
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:
Facility ID#: 45179
Turning Point Mathews St
614 S Mathews St
Fort Collins CO 80521
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
RCCF Services
Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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
RCCF Services 3
Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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 $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.
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
RCCF Services
Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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.
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.
1. Assess and collect fees in accordance with the rules and regulations of the Colorado Department of Social
Services.
2. 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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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.
1. 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.
2. 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
RCCF Services
Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
3. No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their
officers or employees may possess, nor shall any portion of this Agreement be deemed to have 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 Cler Otit WELD COUNTY BOARD OF SOCIAL SERVICES,
r
• J ON BEHALF OF THE WELD COUNTY DEPARTMENT
)4 ..) OF SOCIAL SERVICES
18614h; //a&
By: (7: cl- By: Ail
Deputy Clerk to the Boar p�,N I Glehair
01302)
APPROVED AS TO FORM:
CONTRACTOR
County Att rney
Turning Point Center for Youth
1644 South College Ave
Fort Collins, CO 8052
By: ,
WELD COUNTY DEPARTMENT 2;1'cc_ Ctr-'eeA"
OF SOCIAL SERVICES
By: l U
jDirectoQ
Agreement to Purchase
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
AGREEMENT TO PURCHASE
RCCF 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 Turning Point Center
for Youth, 1644 South College Ave, Fort Collins, CO 80525, 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 Child Care Facility.
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 the care and services which are listed in this
Agreement at a rate of $49.39 per day for children placed within the Residential Child Care Facility
identified as Provider ID#100441. 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. 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.
3. 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 2 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.
4. 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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
SECTION 1. DESCRIPTION OF SERVICES TO BE PURCHASED.
1. The services purchased under this Agreement are Residential Child Care Facility services and may include,
but are not limited to: Basic 24-hour care and child maintenance (food, shelter, clothing, educational
supplies and allowance), Direct Child Care, Transportation, Administrative Overhead, Support Overhead,
Therapeutic Recreation, Service delivery Staff, Direct therapy and evaluation, which may include but are
not limited to: Psychological, 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, and Supervised Visitation.
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:
Facility ID#: 100441
Turning Point Center for Youth and Family
801 S Shields St
Fort Collins CO 80524
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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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 $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.
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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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.
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.
1. Assess and collect fees in accordance with the rules and regulations of the Colorado Department of Social
Services.
2. 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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
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.
1. 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.
2. 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
RCCF Services Rev 06/11/02
Contract No.: PY 02/03-SS-23A-RCCF
3: No portion of this Agreement shall be deemed to constitute a waiver of any immunities the parties or their
officers or employees may possess, nor shall any portion of this Agreement be deemed to have 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: , D '�� �. ':. /_ �1►
Weld County C = to B % WELD COUNTY BOARD OF SOCIAL SERVICES,
ON
1861 t (� c; OF SOCIAL SEBEHALF RVICES
F THE WELD COUNTY DEPARTMENT
o
By: -& I —o 9 By:
Deputy Clerk to the Board Glenn as , u
(-1131Uoa)
APPROVED AS TO FORM:
CONTRACTOR
otmty ttorney
Turning Point Center for Youth
1644 South College Ave
Fort Collins, CO 80525
By: �Gfi�G tt� Fyn!
iptrs.elders"
WELD COUNTY DEPARTMENT
OF SOCIAL SERVICES
By: i
Director
Agreement to Purchase
RCCF Services Rev 06/11/02
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