The URL can be used to link to this page

Browse Search

Home My WebLink About20022584.tiff RESOLUTION RE: APPROVE FOUR AGREEMENTS TO PURCHASE RESIDENTIAL CHILD CARE FACILITY 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 four Agreements to Purchase Residential Child Care Facility 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) Colorado Christian Home 2) Synergy 3) Kathleen Painter Littler/North Range Behavioral Health 4) Cedar Springs Hospital, Inc., dba Cedar Springs Behavioral System, 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 four Agreements to Purchase Residential Child Care Facility 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. 2002-2584 SS0029 Co : SS (c;)° 9) RE: FOUR 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 23rd day of September, A.D., 2002, nunc pro tunc July 1, 2002. BOARD OF COUNTY COMMISSIONERS WELD, COLORADO ATTEST: /L a 'Ij E Glenn Vaad, Chair Weld County Clerk to thfo;: a1 ` , XCUSED DATE OF SIGNING (AYE) ♦ David E. Lo g, Pro-Tern BY: • s � , Deputy Clerk to the Bo- . l,l/ k 7� M. J. Geile pplErciD AS TO EXCUSED DATE OF SIGNING (AYE) illiam H. Jwke\�f ounty At orne � Robert D. Masden /a/ Date of signature: 2002-2584 SS0029 07/2JUL 25 '02 114641 CCH 7691 WELD CTY SOC SERVICES P.4iIg3 Contra=No.: FX 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 Colorado Christian Home, 2950 Tennyson St,Denver, CO 80212-3029,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 wider State Department rules, and WHEREAS, County wishes to provide these services by purchasing them from Contractor, and, WHEREAS, Contractor is licensed as a Residential Cbi1d 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 d Contractor agrees to provide the care and services which are listed in this Agreement at a rate • 76,4- per day for children placed within the Residential Child Care Facility identified as Provid- - 205. 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 enuring 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 patty thirty (30) days notice by registered mail,return receipt requested. 11 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 oftrrm+nation. 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 07/21611"25 102 1iT46RM 'ad) 7691 WELD CTY SOC SERVICES P. +� 4 Si19 ConhsctNo: 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 Stag 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. lithe 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 farfity, with input from the Contractor. 4. All other transportation associated with the Centractofs 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/ease plan, and those persons shall aoloaowledge their responsibility by signing the treatment/case plan. 6_ Contractor will provide the purchased care and services at; FacilitylD#:45205 Colorado Christian Home 2950 Tennyson St Denver CO 80212-3029 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 tc Parebase 2 RCCF Services Ray 06/11/02 07/2361 �e.% e n"n eee 691 WELD CTY SOC SERVICES i.nnnc JUL 25 '82 11�47RM CC P.6i19 • Contact No.: PY 02/03-SS-23A RCCF SECTION II. MEDICAL CARE I. In accordance/with the Weld County Department of Social Services policies(2.710.70,2.710.71,2.710.72, 2.710.73,2.710/4)and Colorado Department of Human Services Child Care T.iesncing 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 main every effort to notify the assigned caseworker, supervisor,or Intake Sareener of any emergency medical, surgical or dental issues prior to granting authorization_ During non-regular work hours,weekends and holidays,the Contactor 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 flout 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 parents) and the County,the parerlt(s)must be contacted for authorization. 6. The Contractor is required to maintain a complete record of all mr4ical,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 Comity 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 07/2161"25-30 " 11•47RM CCH 7691 WELD CTY SOC SERVICES p 7,1916 ContactNo.: PY02/03-SS•23ApRCCS SECTION M. 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 lime-limited. 1 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 disrharge 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 5400,000 for total injuries arising from any one accident. 5. Maintain dining 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 Rev 06/11/02 07/23/S L 25 '02 11r48RM ICCFT6a1 WELD CTY SOC SERVICES p1 Bi19 . Coroner No.: PY 02/113SS-23A-RCCP 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. S. 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,paynfnts 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. lithe 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 shotteo 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 art Individualized Educational Plan(IEP)for youth designated as a Special Education Students will be conducted every 3 years and reviewed every year. lithe 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 RCCF Services 5 Rev 06/11/02 07/2711r25'102' 11~48RM -ten 7691 NELb CTY SOC SERVICES p 9i19�8 Contract No.: PY 02/03-SS,28A ItCCF 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 finds,whether in whole or in part, is subject to and contingent upon the c tineinz 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 street 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 contacts 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 contact 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 contacts 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 07/2J/uUL 26 02a_ 05 06PM46 7691. WELD CT? SOC SERVICES PM-721 Contract No.: PT 02/03.SS-23A RCCF 3. No portion of this Agreement shall be deemed to constitute a waiver of any immtimities the patties or their officers or employees may possess,nor shall any portion of this Agreement be deemed to have created a duty of care which did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. IN WITNESS WHEREOF,the parties hereto have duly executed the Agreement as of the day,month,and year first above written. ATTEST: Weld County r-.�. ` :; -'� WELD COUNTY BOARD OF SOCIAL SERVICES, ON BEHALF OF THE WELD COUNTY DEPARTMENT a►c ♦ OF SOCIAL SERVICES By is6ic0'6� er By Deputy Clerk the B `j (C , Glenn Vaad,Chair (91,23/Q00 t, APPROVED AS TO FORM: CONTRACTOR utiry =ay Colorado Christian Home 2950 Tennyson St D er,CO 80212-33029 BY: _ 1,1411114"N/ /.e t�2" WELD COUNTY DEPARTMENT (( OF SOCIAL SERVICES By : P to= • Agrcemem to Pmvbase 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'cynergy, 3738 W Princeton Cir, Denver, CO 80236, 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 $71.18 per day for children placed within the Residential Child Care Facility identified as Provider ID#49488. 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 Countyand 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. *The Regents of the University of Colorado on behalf of the Health Sciences Center 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#: 49488, Synergy 3660-80 W Princeton Cir Denver CO 80236 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 e£at-least$400,000. c.property 'if' damage liabil4yy,-$1-54,000 for-injury and/or damage to-any one person,and S400,000-fer4etalanjuries arising from.any-o n-accident.equal to damages under the Colorado Governmental Immunity Act 5. iA4airttaie t}g-tl}e rxseflki�AgrePmenia-fidelity-boudefat-least$25,900 or ua(2)-nuuatlasgcass rereiptc whichever-1c g aatP- covering the acti3citiesof any e£its.officers,agPvts.o employeesresluuzsihle for the implementation and/esadmioistrationof-this-sontract-in-erder4.e-ro-ake-reparations-for any wrongful actsromissicartsrepanyother-defalcationsefiheCot actor. To the extent permitted under the Colorado Governmental Immunity act 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.r 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�� WELD COUNTY BOARD OF SOCIAL SERVICES, I , ON BEHALF OF THE WELD COUNTY DEPARTMENT id' � OF SOCIAL SERVICE 1861 ©'Ip_,,:� By fi:95 By: Deputy Clerk to the Boar,I 4' Glenn as hair (q ja3f a) APPROVED AS TO FORM: CONTRACTOR flbrney The University of colorado Health Sciences Center dba Synergy 3738 W Princeton Cir Denver, CO 80236 By: WELD COUNTY DEPARTMENT Kristin O. Moyer OF SOCIAL SERVICES Manacier -'r a-Award Grants and Contracts By: irector Agreement to Purchase RCCF Services Rev 06/11/02 ' Contract No.: PY 02/03-SS-23A-RCCF AGREEMENT TO PURCHASE RCCF SERVICES c'"), THIS AGREEMENT made this 1st day of July, 2002 between the Weld County Board of Sai1,ill//Services, on behalf of the Weld County Department of Social Services hereinafter called "County" and Kathleen'Patt ter Littler/North Range Behavioral Health, 2350 3rd St Rd, Greeley, CO 80631, hereinafter called "Contractor". WHEREAS, the Colorado State Department of Social Services, hereinafter called "State Department" is authorized to provide social services to individuals and families of individuals through its agents, County Departments of Social Services, and WHEREAS, County is authorized to purchase certain services for eligible children under State Department rules, and WHEREAS, County wishes to provide these services by purchasing them from Contractor, and, 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$76.18 per day for children placed within the Residential Child Care Facility identified as Provider ID#6220. 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#: 6220 Kathleen Painter Littler/North Range Behavioral Health 2350 3rd St Rd Greeley CO 80631 7. Contractor shall not charge any additional fees to children or families of children referred by County for services provided under this Agreement. 8. Contractor agrees not to assign the obligations under this Agreement nor enter into any sub-contracts without the express written approval of the Executive Director of the Colorado Department of Social Services or his appointed designee. Agreement to Purchase 2 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 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 RCCF Services 5 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: Weld Coun ler. , ' WELD COUNTY BOARD OF SOCIAL SERVICES, ON BEHALF OF THE 11861 '' Q OF SOCIAL SERVICESELD COUNTY DEPARTMENT By: /L / By: -�LJ - L A4 / , Deputy Clerk to the Boar_,,.' Glenn Vaad,Char' (q jr,I APPROVED AS TO FORM: CONTRACTOR Co Attorney Kathleen Painter Littler/North Range Behavioral Health 2350 3rd St Rd Greeley, CO 80631 By: Way tita/"G t„-'t�� WELD COUNTY DEPARTMENT OF SOCIAL SERVICES By: Dir ctor Agreement to Purchase RCCF Services Rev 06/11/02 PLACEMENT REFERRAL FOR RCCF SERVICES (Attachment A) Child's Name: State ID No: Date of Placement: I. Reasons for purchasing services for this child are: REASON (If Other please Explain) II. Please mark services already utilized. ❑ In home services 0 Kinship Care 0 Receiving Home 0 Placement with Relative 0 Shelter Care 0 County Foster Care O County Critical Care Foster Care ❑ CPA 0 Group Home 0 CORE Services ❑ Independent Living ❑ Day Treatment ❑ Substance Abuse Treatment 0 Other(Explain) III. Please mark most appropriate services needed within the Initial Treatment Plan. Appropriate Setting: ❑ Therapeutic(Behavior Modification) ❑ Secure 0 Other(Explain) Appropriate Counseling: 0 Individual 0 Family ❑ Group Appropriate Treatment: ❑ Sex Offender 0 AggressiveNiolent ❑ Substance Abuse 0 Truancy ❑ Victim Behavior 0 Depression 0 Self-destructive 0 Delinquency ❑ Special Medical Needs 0 Behavior Modification 0 Anger Management 0 Other (Explain) Appropriate Educational Services: ❑ Special Ed. ❑ Public School 0 Day Treatment ❑ On-grounds School 0 Additional Tutoring 0 Independent Living Training 0 Other (Explain) Estimated date for accomplishing treatment plan goals are June 30, 2003, or before. IV. CCAR Level of Care: (for RTC Placements Only) (Level) (copy to Business Office) 0 This child is in need of rehabilitative services. (Mark if child is placed within a RTC) Need Based Care Assessment Completed. (CPA Placements Only) n Yes n No (copy to Business Office) V. The anticipated living arrangement of child upon completion of the Treatment Plan is: ARRANGEMENT (If other,please explain) If the outcomes are not achieved in the amount of time as planned, Contractor agrees to meet with the County to revise this plan. COUNTY FACILITY Weld County Department of Social Services Facility Name PO Box A Address Greeley CO 80632 City, State,Zip Caseworker's Name and Date Provider Info: (If applicable) Foster Care Provider Provider Address Caseworker Signature City, State,Zip Gloria Romansik,Administrator Signature of Person Authorized to Sign Agreement Date Date Completed Referral Distribution: E-mail completed form to Business Office(Cynthia and Lesley)and D&N cases only to Legal(Mary and Sally) Print 2 copies for Administrator to sign and mail to Facility. 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 Boarckof Social Services, on behalf of the Weld County Department of Social Services hereinafter called "County" and Cedar Springs Behavioral System, 2135 Southgate Rd, Colorado Springs, CO 80906-2605, hereinafter called "Contractor".WC *Cedar Springs Hospital, Inc. dba 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 $75.75 per day for children placed within the Residential Child Care Facility identified as Provider ID#70716. 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#: 70716 Cedar Springs Behavioral System 2135 Southgate Rd Colorado Springs CO 80906-2605 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 Contjact 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 Cle/' i' 7+ 1- WELD COUNTY BOARD OF SOCIAL SERVICES, ON BEHALF OF THE WELD COUNTY DEPARTMENT OF SOCIAL SERVICES ' 1861 to iiszp Le j By: -C 2-'lO N�"� � By: ))tA . - Deputy Clerk to the Board` e j \ ' Glenn Vaad, Chair APPROVED AS TO FORM: l CONTRACTOR Cozen omey Cedar Springs Hospital, Inc. dba Cedar Springs Behavioral System 2135 Southgate Rd Colorado Springs, CO 80906-2605 By ary Wilke WELD COUNTY DEPARTMENT VP, Corpor to Controller OF SOCIAL SERVICES By: o %ector-±‘ Agreement to Purchase RCCF Services Rev 06/11/02 • DEPARTMENT OF SOCIAL SERVICES PO BOX A GREELEY,CO 80632 ivWEBSITE:www.co.weld.co.us 1.111(ttill'Ils 4 Administration and Public Assistance(970)352-1551 1111 II O Child Support(970)352-6933 COLORADO MEMORANDUM • TO: Glenn Vaad, Chair Date: September 18, 2002 Board of County Commissioners FR: Judy A. Griego, Director, Social Services , vitlt ,\ (A �' n i u£ RE: Agreements to Purchase Residential Child Care Facilities(RCCF) 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 September 18, 2002. The major provisions of the Agreements are 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. Colorado Christian Home: $76.42 per day B. Synergy: $71.18 per day C. Kathleen Painter Littler/North Range Behavioral $76.18 per day Health: D. Cedar Springs Hospital, Inc. dba Cedar Springs $75.75 per day Behavioral System: If you have any questions,please telephone me at extension 6510. 2002-2584 Hello