HomeMy WebLinkAbout20021570.tiff RESOLUTION
RE: APPROVE CHILD PROTECTION AGREEMENT FOR CORE SERVICES AND
AUTHORIZE CHAIR TO SIGN - ISLAND GROVE REGIONAL TREATMENT CENTER,
INC.
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 a Child Protection Agreement for Core
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 Aims
Community College, commencing June 1, 2002, and ending May 31, 2003, with further terms
and conditions being as stated in said, and
WHEREAS, after review, the Board deems it advisable to approve said, a copy of which
is 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 Child Protection
Agreement for 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 Island Grove Regional Treatment Center, Inc., be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 17th day of June, A.D., 2002, nunc pro tunc June 1, 2002.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY; COLORADO
ATTEST: LIP{;p �a (Ch
�k Gaad, Char
Weld County Clerk to O eV
e m�'
�p David E. ng, CC
BY: iw) 6
Deputy Clerk to the Board,_ �� 14w
M. J. eile
APPR 5VED AS / b /
illiam H. Jerke
oun At orne �1'..._.
Robert D. Masden
Date of signature: �fo
2002-1570
Ca S. S�� SS0029
DEPARTMENT OF SOCIAL SERVICES
PO BOX A
GREELEY,CO 80632
WEBSITE: w.co.weld.co.us
Administration and Public Assistance(970)352-1551
C 1/2w,w.co.weld.co.us
Support(970)352-6933
COLORADO MEMORANDUM
TO: Glenn Vaad, Chair Date: June 13, 2002
Board of County Commissioners
FR: Judy A. Griego, Director, Social Services tilhaa uz o
RE: Child Protection Agreement for Services B the Weld
County Department of Social Services and Island Grove Regional
Treatment Center, Inc.
Enclosed for Board approval is a Child Protection Agreement for Services between the
Weld County Department of Social Services and Island Grove Regional Treatment
Center, Inc. This Agreement was discussed in a Work Session with the Board on May
29, 2002.
The major provisions of the Agreement are as follows:
1. The term of the Agreement is June 1, 2002 through May 31, 2003.
2. The total funding available under the Agreement is $122,398 as follows:
A. Social Services agrees to reimburse Island Grove a total of$110,000
according to a schedule of rates provided in the Agreement for alcohol and
drug assessments, treatment options, and services to child welfare
families.
B. Social Services agrees to reimburse Island Grove a total of$12,398 for an
administrative fee.
C. Island Grove agrees to provide ADAD Additional Family Services (AFS)
resources through Island Grove to pay for their staff support to
caseworkers and related services to child welfare clients.
If you have any questions, please telephone me at extension 6510.
2002-1570
Contract No: PY02/03-CPS-30
CHILD PROTECTION AGREEMENT FOR CORE SERVICES
BETWEEN THE WELD COUNTY DEPARTMENT OF SOCIAL SERVICES
AND THE ISLAND GROVE REGIONAL TREATMENT CENTER,INC.
This Agreement,made and entered into the j]4 day of June 2002,by and between the Board of
Weld County Commissioners,on behalf of the Weld County Department of Social Services,hereinafter
referred to as"Social Services," and Island Grove Regional Treatment Center,referred to as"Island
Grove".
WITNESSETH
WHEREAS,required approval, clearance,and coordination have been accomplished from and
with appropriate agencies;and
WHEREAS,the Child Welfare Settlement Agreement requires,among other requirements, Social
Services to obtain outpatient core services for eligible clients who are at imminent risk for out-of-home
placement in the category of alcohol and drug services;and
WHEREAS,the Colorado Department of Human Services has provided Family Issues Cash Fund
resources to Social Services for outpatient and residential core services for families,children, and
adolescents; and
WHEREAS, Social Services and Island Grove desire to enter into an agreement in providing
outpatient and residential services for families, children, and adolescents.
NOW THEREFORE, in consideration of the premises,the parties hereto covenant and agree as
follows:
1. Tenn
This Agreement shall become effective on June 1, 2002,upon proper execution of this Agreement
and shall expire May 31,2003.
2. Scope of Services
Services shall be provided by Island Grove to any person(s)eligible for child protection services in
compliance with Exhibit A"Scope of Services,"a copy of which is attached by reference.
3. Payment
a. Payment shall be made on the basis of Exhibit B,"Payment Schedule," and Exhibit C,
"Region 1 Core Services Fee Schedule,"copies of which are attached hereto and
incorporated herein by reference.
"Payment Schedule"shall establish the maximum reimbursement,which will be paid from
Family Issues Cash Fund during the duration of this Agreement.
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Contract No: PY02/03-CPS-30
b. Island Grove shall submit an itemized monthly bill to Social Services for all costs
incurred and services provided pursuant to Exhibit A of this Agreement in accordance
with criteria established by Social Services, The Contractor shall submit all itemized
monthly billings to Social Services no later than the twenty-fifth(25) day of the month
following the month the cost was incurred.
Failure to submit monthly billings in accordance with the terms of this agreement may
result in Island Grove's forfeiture of all rights to be reimbursed for such expenses. In the
event of a forfeiture of reimbursement,Island Grove may appeal such circumstance to the
Director of Social Services. The decision of the Director of Social Services shall be final.
c. Payments of costs incurred pursuant to this Agreement is expressly contingent upon the
availability of Family Issues Cash Fund funds to Social Services.
d. Social Services shall not be billed for,and reimbursement shall not be made for time
involved in activities outside of those defined in Exhibit A or in the"Weld County
Guidelines." Work performed prior to the execution of this Contract shall not be
reimbursed or considered part of this Agreement.
4. Financial Management
At all times from the effective date of this Contract until completion of this Contract,the
Contractor shall comply with the administrative requirements,cost principles and other
requirements set forth in the Financial Management Manual adopted by the State of Colorado.
The required annual audit of all funds expended under General Assistance must conform to the
Single Audit Act of 1984 and OMB Circular A-133.
5. Payment Method
Unless otherwise provided in the Scope of Services and Payment Schedule:
a. Island Grove shall provide proper monthly invoices and verification of services performed
for costs incurred in the performance of the agreement.
b. Social Services may withhold any payment if Island Grove has failed to comply with the
Financial Management Requirements,program objectives,contractual terms,or reporting
requirements. In the event of a forfeiture of reimbursements, Island Grove may appeal
such circumstance to the Director of Social Services. The decision of the Director of
Social Services shall be final.
6. Accurances
Island Grove shall abide by all assurances as set forth in the attached Exhibit D, which is attached
hereto and incorporated herein by reference.
7. Compliance with Applicable T aws
At all times during the performance of this contract,Island Grove/SIGNAL shall strictly adhere to
all applicable federal and state laws,orders,and all applicable standards,regulations,
interpretations or guidelines issued pursuant thereto. This includes the protection of the
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Contract No: PY02/03-CPS-30
confidentiality of all applicant/recipient records,papers, documents,tapes and any other materials
that have been or may hereafter be established which relate to the Contract. Island Grove
acknowledges that the following laws are included:
- Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d —1 et seq and its
implementing regulation,45 C.F.R.Part 80 et seq and
Section 504 of the Rehabilitation Act of 1973,29 U.S.C. Section 794,and
its implementing regulations,45 C.F.R.Part 84;and
the Age Discrimination Act of 1975,42 U.S.C.Sections 6101 et seq. and
its implementation regulations,45 C.F.R.Part 91;and
- Title VII of the Civil Rights Act of 1964;and
the Age Discrimination in Employment Act of 1967;and
the Equal Pay Act of 1963;and
the Education Amendments of 1972;and
Immigration Reform and Control Act of 1986,P.L.99-603;
42 C.F.R.Part 2
and all regulations applicable to these laws prohibiting discrimination because of race,color,
national origin, and,sex,religion and handicap,including Acquired Immune Deficiency Syndrome
(AIDS)or AIDS related conditions,covered under Section 504 of the Rehabilitation Act of 1973,
as amended,cited above. Included is 45 C.F.R.Part 74 Appendix G 9, which requires that
affirmative steps be taken to assure that small and minority businesses are utilized, when possible,
as sources of supplies,equipment,construction and services. This assurance is given in
consideration of and for the purpose of obtaining any and all federal and/or state financial
assistance.
Any person who feels that s/he has been discriminated against has the right to file a complaint
either with the Colorado Department of Human Services or with the U.S. Department of Health
and Human Services, Office for Civil Rights.
8. certifications
Island Grove certifies that,at the time of entering into this Contract, it has currently in effect all
necessary licenses,approvals,insurance, etc. required to properly provide the services and/or
supplies covered by this contract.
9. Monitoring and Fvaluation
Island Grove and Social Services agree that monitoring and evaluation of the performance of this
Agreement shall be conducted by Island Grove and Social Services. The results of the monitoring
and evaluation shall be provided to the Board of Weld County Commissioners and Island Grove.
Island Grove shall permit Social Services, and any other duly authorized agent or governmental
agency,to monitor all activities conducted by the contractor pursuant to the terms of this
Agreement. As the monitoring agency may in its sole discretion deem necessary or appropriate,
such program data,special analyses, on-site checking,formal audit examinations, or any other
reasonable procedures. All such monitoring shall be performed in a manner that will not unduly
interfere with agreement work.
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Contract No: PY02/03-CPS-30
10. Modification of Agreement
All modifications to this agreement shall be in writing and signed by both parties.
11. Remedies
The Director of Social Services or designee may exercise the following remedial actions,should
s/he fmd Island Grove substantially failed to satisfy the scope of work found in this Agreement.
Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper
activities or inaction by Island Grove. These remedial actions are as follows:
a. Withhold payment of Island Grove until the necessary services or corrections in
performance are satisfactorily completed;
Deny payment or recover reimbursement for those services or deliverables,which have
not been performed and which due to circumstances caused by Island Grove cannot be
performed or if performed would be of no value to the Social Services. Denial of the
amount of payment shall be reasonably related to the amount of work or deliverables lost
to Social Services;
b. Incorrect payment to Island Groves due to omission,error,fraud, and/or defalcation shall be
recovered from Contractor by deduction from subsequent payments under this Agreement or
other agreements between Social Services and Island Grove, or by Social Services as a debt
due to Social Services or otherwise as provided by law.
12. Representatives
For the purpose of this Agreement,the individuals identified below are hereby designated
representatives of the respective parties. Either party may from time to time designate in writing a
new or substitute representative(s):
For Social Services:
Gloria Romansik Social Services Administrator
Name Title
For Island Grove:
B T Dean Executive Director,Island Grove
Name Title
13. Notice
All notices required to be given by the parties hereunder shall be given by certified or registered
mail to the individuals at the addresses set forth below. Either party may from time to time
designate in writing a substitute person(s)or address to whom such notices shall be sent:
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Contract No: PY02/03-CPS-30
To: Social Services To: Island Grove
I ndy A Crriego,Director B T Dean,Director
P O Box A 1140 M Street
Greeley,CO 80619 Greeley CO 80611
14. litigation
Island Grove shall promptly notify Social Services in the event that Island Grove learns of any
actual litigation in which it is a party defendant in a case which involves services provided under
this Agreement. Island Grove,within five(5)calendar days after being served with a summons,
complaint, or other pleading which has been filed in any federal or state court or administrative
agency, shall deliver copies of such document(s)to the Social Services Director. The term
"litigation" includes an assignment for the benefit of creditors,and filings in bankruptcy,
reorganization and/or foreclosure.
15. Termination
This Agreement may be terminated at any time by either party given thirty (30) days written notice
and is subject to the availability of funding.
16. Entire Agreement
This Agreement,together with all attachments hereto,constitutes the entire understanding between
the parties with respect to the subject matter hereof,and may not be changed or modified except as
stated in Paragraph 10 herein.
IN WITNESS WHEREOF,the parties hereto have duly executed the Agreement as of the day,month,and year
first above writt •
•.
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All_EST:
O,9
WELD COUNTY
OARD OF COUNTY
CLERK TO THE BOARD 1861 7. 7 .7 'h,�T' OMMISSIONERS WELD
OUNTY,COLORADO
q&�-qy� g
By: Gi. . .,`i,; /�n yy��yyI�1y� By:
Deputy Clerk � �V � Glenn Vaad,Chair O • °-1)
APPROVED AS �9,'6 : ISLAND GROVE REGIONAL TREATMENT
CENTER
i BY 'I
ounty"Attomey, B.J.Un,Executive Director
APPROVED AS TO FORM BY
WELD COUNTY DEPARTMENT SIGNAL AUTHORIZED
OF SOCIAL SERVICE REPRESENTATIVE
By: By AA (A ;
irect B1 Wendt,Chief Operating
Officer
Page 5 of 5
Contract No: PY02/03-CPS-30
EXHIBIT A
SCOPE OF SERVICES
Assessments
Alcohol and Drug Differential Assessment(2-Hours)
Assessment will evaluate alcohol/drug involvement as well as mental health
status,history of mental health issues,sexual history,legal history,and certain
standard tests (ASAP, ASAM PPC-2, ASI, SOCRATE, AODUI, Drinking History Questionnaire,
Family Environment Scale) may be given. Baseline Urinalysis Testing (7-Panel) is included.
Summary of assessment with recommendations sent to referral agency.
The 7-Panel baseline urinalysis test for alcohol and drugs screens for the following:
Tests determine what drugs are present in client. n
THC Cutoff Level: 50 ng/ml Amphetamines Cutoff Level: 100019 m
Cocaine Cutoff Level: 300 ng/ml Bafoiturates Cutoff Level: 200ng/ml
Benzodiazepines Cutoff Level: 200 ng/ml Opiates Cutoff Level: 200 ng/ml
Creatinine >20 mgDL is normal 3-Panel Amphetamines,
THC,Cocaine,
Co-Occurring Alcohol and Drug with Domestic Violence Assessment(l-Hours)
Summary of assessment with recommendations sent to referring agency. The following areas will be
assessed:
Criminal History Profile of Client's Violent Behaviors
Mental Health Status Client's Potential for Violence
Medical History Substance Abuse History
Suicidal/Psychological/Cultural History . Millon Test,if needed
Substance Abuse Forensic Evaluation(3hours)*
A forensic evaluation is specifically geared toward the substance-abusing offender. It involves
additional testing to determine the crimogenic aspect of the person to be taken into consideration
when developing treatment recommendations. Testing will be comprised of CVI, ASUS, SADDI,
Millon Clinical Multiaxial Inventory(MCMI-III), a clinical interview, and a behavioral profile. The
testing is cross-referenced with the clinical interview,and in relation to collateral data.
*As Staff Expertise Permits
Treatment Options
Co-Occurring Alcohol and Drug with Domestic Violence Group Therapy(average length of treatment, 74
to 16 weeks)
Groups for both men and women are offered. The group addresses anger management,healthy
relationships,male and female roles, and boundaries. As needed, a Millon Test may be given, a
standardized psychological test which measures functioning level in 22 personality disorders and
clinical syndromes for adults(8o°grade reading level: > 18; available in Spanish).
Family Therapy(average length of treatment, R to 16 sessions)
Involves two or more family members and provides therapeutic
intervention to improve family communications, functioning, and relationships. Length of
participation is dependent on client goals and progress toward meeting goals.
Page 1 of 4
Contract No: PY02/03-CPS-30
EXHIBIT A(Continued)
Individual Counseling(average length of treatment,6 to 12 sessions) _
Primary client is seen on an individual basis. Length of participation dependent on client goals and
progress toward goals.
Substance Abuse Therapy(average leng h of treatmentLL2 to 70 sessions)
A group to enhance positive coping skills by focusing on their lifestyle dealing with use and abuse
of chemicals.
Adult Intensive Outpatient(average length of treatment,4 to 12 weeks)An intensive outpatient group therapy track that offers groups every evening,Monday through
Friday,with a family program component. This program will include medical aspects of addiction
and adult relapse education components focusing on understanding the relapse process as well as
group process(focuses on individual issues relating to their abuse of alcohol). The program length
and participation level will be individualized based on the presenting issues and other factors.
Women's Group(average length of treatment, 17-20 session)
A gender-specific group addressing issues affecting women and their relationships, such as family
violence, co-dependency, self-esteem and stress management.
Motivational Enhancement Therapy and Cognitive Behavioral Therapy for Adolescent Cannabis I Jsets
(MET/CRT5 average length of treatment 5-11 weeks.)
The MET/CBT5 is a brief treatment approach for cannabis abusing adolescents.
Treatment consists of two individual motivational enhancement therapy sessions(MET)
Sessions,followed by participation in three group cognitive behavioral therapy
(CBT)sessions. The assessment includes a psychosocial history and data from
the Global Assessment of Individual Needs(CAIN), and a personalized feedback
report. (Begins January 2003)
Special Programs
Special Connections(through pregnancy and up to one year postpartum)
A gender-specific program that focuses on healthy babies, appropriate child care,prenatal care,
birth control, developmental stages of the baby,parenting skills,relationship issues, and other
issues as identified by the counselor. Services include group and individual therapy, case
management and family health education.
Miscellaneous Services
Case Aide
This position will assist in family visits to determine how the family is functioning together while
in the home,and to improve the family's ability to access resources in the community. The case
aide can take direction from the primary therapist assigned to the family or the Social Services
caseworker.Duties to be performed by the case aide include,but are not limited to,providing
transportation to therapy,doctors appointments and court,supervised visits,child care while
family is in treatment,run errands such as filling prescriptions,shopping, and assisting in living
skill development, assist the family in developing other service links and miscellaneous functions
to facilitate the stabilization of the family. (Case Aide tasks will be mutually agreed upon between
counselor and caseworker and identified in the"Services Plan".)
Page 2 of 4
Contract No: PY02/03-CPS-30
EXHIBIT A(Continued)
Fast Track Adolescent Program
The Fast Track Adolescent Program is an Intensive Outpatient Program with supportive housing
services if clinically necessary. The targeted population ranges from 13 to 17 years of age who
demonstrate substance abuse problems. The goal is to have these adolescents discover positive
alternatives to their current use behavior.
The program consists of a comprehensive differential assessment compiling personal and collateral
information as well as data obtained from the Addiction Severity Index(ASI), Substance Abuse
Subtle Screening Inventory(SASSI)and the Adolescent Self-Assessment Profile(ASAP)
instruments. This data is utilized to develop an individualized treatment plan. Clients receive a
minimum of three individual sessions with the focus on achieving their treatment goals and attend
three groups per week and three per day if in residential with the primary focus on education and
motivational topics. Family therapy is encouraged as a part of the client's treatment. A discharge
planning session will be implemented focusing on appropriate referrals addressing the needs and
motivation of the adolescent and family.
Referral Process to Fact Track Program:
Contact Program Manager of Youth Services at(970)356-6664,extension 16. If she is not on
duty,inform the staff person that Social Services is referring a Fast Track adolescent and give the
youth's case worker's name so that the Fast Track staff can contact the caseworker when they
return to duty.
On-Site Staff Services
The scope of the services offered to the local Social Services agency by ADAD approved staff
placed on site by the licensed ADAD program may include performing alcohol and drug
assessments,brief therapy(under 8 hours), case consultation,case management, and in-house
training on pertinent alcohol/drug issues as requested and training evaluation of care givers. In
addition to this, on-site staff may accompany Social Services staff on follow-up visits to perform a
behavioral health screening for the purpose of identifying clients who could benefit from further
assessments for alcohol/drug interventions or mental health interventions.
Off-Site Evaluations
When Island Grove is asked to perform a differential assessment/evaluation away from Social
Services premises or Island Grove premises.This covers the additional cost of travel and staff time
(for example,time for staff to clear security at the jail).
Extended Detnx Stay
This is an option when case management goals require that the person be in a stable environment
until they can be referred to the next level of care.
Enhanced Services
Enhanced services as approved services that are requested by Social Services for specific cases,
which fall outside of the definitions, listed above in the description of the ADAD menu of services.
Enhanced services may be services not described on the menu,services not included in the
definition or due to lack of economy of scale, or rural location,or result in additional costs to
Island Grove. In order for Island Grove to provide enhanced service,the cost would be outside of
the approved rates. Any additional fees would be negotiated on a case-by-case basis.
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Contract No: PY02/03-CPS-30
EXHIBIT A(Continued)
An example of a service outside of the approved definitions would be a request for a system
evaluation. This would include collateral contacts as appropriate with schools,parents,primary
care giver,probation,and other significant persons in the identified client's life. The information
gathered from the collateral contacts would be included in the assessment findings and treatment
recommendations. If additional service is needed in order to meet a request by a local department
such as parenting skills assessment,additional fees may be added to the basic assessment fee.
Psychological exams and psychiatric testing are not included in the definition of the alcohol and
drug evaluation. Normally this type of assessment would be done with mental health dollars and
not alcohol and drug(ADAD)funding. Other services such as home-based services,which have a
designated core service funding source,should be paid for out of those funds. Island Grove could
supplement the home-based services provided by a non-alcohol and drug specific program with in-
home family alcohol and drug services as appropriate.
Island Grove can arrange for services outside of the approved definitions,but the Social Service
Department requesting the specialized service will be charged an additional fee that would be
negotiated on a case by case basis by the designated representative listed in the contract.
Another example of enhanced services which may be provided with higher fees may be intensive
outpatient services,or the use of a floater* or approved subcontractor for a specific task. The
additional cost would be negotiated with the respective Social Services Department.
*Floater—a temporarily assigned staff or subcontractor to perform a time specified
alcohol or drug related approved task.
Page 4 of 4
Contract No: PY02/03-CPS-30
EXHIBIT B
PAYMENT SCHEDULE
1. Funding and Method of Payment
Social Services agrees to reimburse to Island Grove in consideration for the work and Services
performed, a total amount not to exceed One Hundred Twenty-two Thousand Three Hundred
Ninety-Eight Dollars($122,398.00)under Fund Code 1889 and Object Code 104. Of this total
amount, Social Services agrees to pay an administrative fee not to exceed Twelve Thousand
Dollars Three Hundred Ninety-Eight Dollars($12,398) or 10%of the total amount authorized in
this Agreement.
Expenses incurred by Island Grove, in association with said project prior to the term of this
agreement,are not eligible Social Services expenditures and shall not be reimbursed by Social
Services.
Payment pursuant to this Contract, if Family Issues Cash funds,whether in whole or in part, is
subject to and contingent upon the continuing availability of Family Issues Cash funds for the
purposes hereof. In the event that said funds, or any part thereof,become unavailable as
determined by Social Services, Social Services may immediately terminate this Contract or amend
it accordingly.
2. Fees for Services—as shown on the attached Exhibit C"Core Services Fee Schedule"
Social Service referrals will not be sent to collections by Island Grove for default of co-pay/fees.
Services will be performed regardless of client's refusal or inability to pay co-pay.
The Sliding Fee Schedule will only be applied to those services as noted on the fee schedule, all
other fees will be charged directly to Social Services.
Island Grove will collect any applicable sliding scale co-pays and credit Social Services for any
payments received on the monthly billing statements.
3. Submittal of Vouchers
Island Grove shall prepare and submit monthly the itemized voucher and certify that the services
authorized were provided on the date indicated and the charges made were pursuant to the terms
and conditions of Exhibit A.
Page 1 of 1
Contract No: PY02/03-CPS-30
EXHTRTT C'
Core Services' Funds
Region 1-Fee Schedule-2002-2003
Accescments
Alcohol and Drug Differential Assessment $155.00
(Includes baseline 7 panel Urinalysis Test)
Off-site Differential Assessment $200.00
Co-Occurring Alcohol and Drug with Domestic Violence $155.00
Forensic Evaluation $175.00
Treatment Options
Co-Occurring Alcohol and Drug with Domestic Violence
Group Therapy-Two Hour Limit $15.00/per hour
Family Therapy-One Hour Limit $ 80.00/per hour
Intensive Family Therapy-One Hour Limit $100.00/per hour
Intensive Family Therapy(Home Based) $110.00/per hour
Individual Counseling-Two Hour Limit $ 60.00/per hour (t W
hour b� y
Substance Abuse Group Therapy-Two Hour Limit $ 1515.00/cgs:gen
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Adult Intensive Outpatient Group-Two Hour Limit $25.00/s4+
Women's Services
Differential Assessment $155.00
(Without UA-$135.00)
Individual Counseling-One Hour Limit $60.00/per hour
Group Counseling-Two Hour Limit $ 15.00/per hour
Health Education Services-One Hour Limit $ 15.00/per hour
Special Connections—Treatment for pregnant women and postpartum women(Medicaid reimbursement
eligible)
If on Medicaid, Island Grove will bill Medicaid directly.
If not on Medicaid, fees are as stated above in Women's Services.
Page 1 of3
Contract No: PY02/03-CPS-30
EXHIBIT C(Continued)
•
Youth Services
Adolescent Detox $185.00/per day
Adolescent IOP(Fast Track)-One Hour Limit $ 50.00/per hour
Adolescent Residential Support Services IOP $120.00/day
Assessment $155.00
Includes a 7 panel UA
Family Counseling-One Hour Limit $ 80.00/per hour
Individual Counseling-One Hour Limit $60.00/per hour ,a1)
Outpatient Group Counseling-Two Hour Limit $ 30.00/per group ($15.00/hour
Miscellaneous Services
Case Aide/Case Management Services $35.00/per hour
Expert Testimony-Four Hour Limit . $75.00/per hour
Case Consultation $40.00/per hour
(Interdisciplinary Assessment Process)
On-Site Staff Services $ 55.00/per hour
Enhanced Services(negotiated on a case by case basis)
Residential Services
Adult Residential Services(Island Grove) $115.00/day
Out-of-Area Adolescent and Adult Residential Services(negotiated on individual basis)
Methadone(negotiated on individual basis)
Other Services
Breathalyser Testing $ 2.00/test
Urinalysis Testing(7-Panel) $25.00/test
(3-Panel) $20.00/test
UA Confirmation $ 35.00
Monitored Antabuse $2.00/monitor
(If client is not currently enrolled in weekly counseling program(s)of Island Grove Center)
Patch Monitoring (Includes Confirmation) $50.00/each patch
Administration Fee
A 10%administration fee will be added to the total monthly bill.
Page 2 of 3
Contract No: PY02/03-CPS-3O
EXHIBIT C (Continued)
Weld County Guidelines—2002-2003
On-Site Staff Services
Child Welfare Section:Minimum of 15 hours per week,maximum of 28—Weld County will pay
for 15 hours per week from Core service dollars regardless of utilization of on-site staff person by
Social Services. Island Grove will bill the additional on-site staff time to the AFS contract on an
"as used"basis. Weld County will not be billed for hours that the staff person is not on site(due to
illness,vacation,educational leave etc.)during the 15-hour minimum.
Assessments
All assessments will be paid for through the Social Services CORE service contract. Island Grove
will deliver the completed evaluation to Social Services within two weeks of the client's evaluation
meeting with the staff person.
Case Aide/rase Management
Youth in Conflict Section:Minimum of 16 hours per week,a maximum of 24. Island Grove will
bill the minimum weekly amount to the AFS contract regardless of utilization of the on-site case
aide/case management by Social Services. Any hours above the 16 per week would also be billed
to the AFS contract on an"as used"basis. Island Grove will not bill AFS for hours that the staff
person is not on-site(due to illness,vacation,educational leave etc.)during the 16-hour minimum.
Residential
Adult residential services for eligible persons may be paid from AFS the ADAD Additional Family
Services(AFS)allocations. Youth residential services will be billed to core or AFS or a
combination of funding streams.
Ongoing Treatment
On going treatment services will be assigned to funding streams according to usage.
Youth Services
If Weld County does not approve Youth in Conflict(YIC)cases eligible for services through Core
Service dollars then all on-going YIC adolescent services will be paid for from the ADAD AFS
funding stream.
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Contract No: PY02/03-CPS-30
EXHIBIT D
ASSURANCES
1. Island Grove agrees it is an independent contractor and that its officers and employees do not
become employees of Weld County,nor are they entitled to any employee benefits as Weld County
employees, as the result of the execution of this Agreement.
2. Weld County,the Board of County Commissioners of Weld County,its officers and employees,
shall not be held liable for injuries or damages caused by any negligent acts or omissions of Island
Grove or its employees,volunteers,or agents while performing duties as described in this
Agreement. Island Grove shall indemnify,defend,and hold harmless Weld County,the Board of
County Commissioners of Weld County, its employees,volunteers,and agents. Island Grove shall
provide adequate liability and worker's compensation insurance for all its employees,volunteers,
and agents engaged in the performance of the Agreement upon request,Island Grove shall provide
Social Services with the acceptable evidence that such coverage is in effect.
3. No portion of this Contract shall be deemed to constitute a waiver of any immunities the parties or
their officers or employees may possess,not shall any portion of this Agreement be deemed to
have treated a duty of care with respect to any persons not a party of this Agreement.
4. No portion of this Contract shall be deemed to create an obligation on the part of the County of
Weld, State of Colorado,to expend funds not otherwise appropriated in each succeeding year.
5. If any section,subsections,paragraph,sentence,clause,or phrase of this Contract is for any reason
held or decided to be unconstitutional, such decision shall not affect the validity of the remaining
portions. The parties hereto declare that they would have entered into this Contract and each and
every section,subsection,paragraph,sentence, clause,and phrase thereof irrespective of the fact
that any one or more sections, subsections,paragraphs,sentences, clauses,or phrases might be
declared to be unconstitutional or invalid.
6. No officer,member or employee of Weld County and no member of their governing bodies shall
have any pecuniary interest,direct or indirect,in the approved Agreement or the proceeds thereof.
7. Island Grove assures that they will comply with the Title VI of the Civil Rights Act of 1986 and
that no person shall,on the grounds of race, creed,color, sex, or national origin,be excluded from
participation in,be denied the benefits of,or be otherwise subjected to discrimination under this
approved Contract.
8. Island Grove assures that sufficient, auditable, and otherwise adequate records that will provide
accurate,current,separate,and complete disclosure of the status of the funds received under the
Contract are maintained for three(3)years or the completion and resolution of an audit. Such
records shall be sufficient to allow authorized local,Federal, and State auditors and representatives
to audit and monitor Island Grove.
9. All such records, documents, communications,and other materials shall be the property of Social
Services and shall be maintained by Island Grove, in a central location and custodian,in behalf of
Social Services,for a period of four(4)years from the date of fmal payment under this Contract,
or for such further period as may be necessary to resolve any matters which may be pending,or
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Contract No: PY02/03-CPS-30
EXHIBIT D (continued)
until an audit has been completed with the following qualifications: If an audit by or on behalf of
the federal and/or state government has begun but is not completed at the end of the four(4)year
period, or if audit findings have not been resolved after a four(4)year period,the materials shall
be retained until the resolution of the audit finding.
10. Island Grove assures that authorized local, federal and state auditors and representatives shall,
during business hours,have access to inspect any copy records,and shall be allowed to monitor
and review through on-site visits,all contract activities, supported with funds under this Contract
to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring
and evaluation of the performance of the Agreement shall be conducted by appropriate funding
sources. The results of the monitoring and evaluation activities shall be provided to the
appropriate and interested parties.
11. This Contract shall be binding upon the parties hereto,their successors,heirs,legal representatives,
and assigns. Island Grove or Social Services may not assign any of its rights or obligations
hereunder without the prior written consent of both parties.
12. Island Grove certifies that Federal appropriated funds have not been paid or will be paid,by or on
behalf of Island Grove,to any person for influencing or attempting to influence an officer or
employee of an agency, a Member of Congress, an officer or employee of Congress, or an
employee of a Member of Congress in connection with the awarding of any Federal contract,the
making of any federal grant,the making of any federal loan,the entering into of any cooperative
agreement,and the extension, continuation,renewal,amendment, or modification of any Federal
contract,loan,grant, or cooperative agreement.
13. Island Grove assures that it will fully comply with all other applicable federal and state laws.
Island Grove/Signal understands that the source of funds to be used under this Contract is:Family
Issues Cash Funds.
14. Island Grove assures and certifies that is and its principals:
a. Are not presently debarred, suspended,proposed for debarment, declared ineligible,or
voluntarily excluded from covered transaction by a federal department of agency.
b. Have not,within a three-year period of preceding this Agreement,been convicted of or
had a civil judgment rendered against them for commission of fraud or a criminal offense
in connection with obtaining,attempting to obtain, or performing a public(federal, state,
or local)transaction or contract under a public transaction;violation of federal or state
antitrust statutes or commission of embezzlement,theft,forgery,bribery, falsification or
destruction of records,making false statements,or receiving stolen property;
c. Are not presently indicted for or otherwise criminally or civilly charged by a government
entity(federal,state,or local)with commission of any of the
offenses enumerated in paragraph 11(b)of this certification; and
d. Have not within a three-year period preceding this Contract,had one or more public
transactions(federal, state,and local)terminated for cause or default.
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Contract No: PY02/03-CPS-30
EXHIBIT D (continued)
15. The Appearance of Conflict of Interest applies to the relationship of a contractor with Social
Services when Island Grove also maintains a relationship with a third party and the two
relationships are in opposition. In order to create the appearance of a conflict of interest,it is not
necessary for the contractor to gain from knowledge of these opposing interests. It is only
necessary that the contractor know that the two relationships are in opposition.
During the term of the Contract,Island Grove shall not enter any third party relationship that gives
the appearance of creating a conflict of interest. Upon learning of an existing appearance of a
conflict of interest situation,Island Grove shall submit to Social Services, a full disclosure
statement setting forth the details that create the appearance of a conflict of interest. Failure to
promptly submit a disclosure statement required by this paragraph shall constitute grounds for
Social Services' termination,for cause, of its contract with Island Grove.
16. Island Grove shall protect the confidentiality of all applicant records and other materials that are
maintained in accordance with this Contract. Except for purposes directly connected the
administration of the Child Protection,no information about or obtained from any
applicant/recipient in possession of Island Grove shall be disclosed in a form identifiable with the
applicant/recipient or a minor's parent or guardian unless in accordance with Island Grove written
policies governing access to, duplication and dissemination of,all such information. Island Grove
shall advise its employees, agents, and subcontractors,if any,that they are subject to these
confidentiality requirements. Island Grove shall provide its employees, agents,and subcontractors,
if any, with a copy or written explanation of these confidentiality requirements before access to
confidential data is permitted.
17. Proprietary information for the purposes of this contract is information relating to a party's
research, development,trade secrets,business affairs,internal operations and management
procedures and those of its customers, clients or affiliates,but does not include information(I)
lawfully obtained from third parties, (2)that which is in the public domain,or(3)that which is
developed independently. Neither party shall use or disclose directly or indirectly without prior
written authorization any proprietary information concerning the other party obtained as a result of
this Contract. Any proprietary information removed from the State's site by Island Grove in the
course of providing services under this Contract will be accorded at least the same precautions as
are employed by Island Grove for similar information in the course of its own business.
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Contract No: PY02/03-CPS-30
EXHIBIT E
CORE SERVICES
Billing Period:
ISLAND GROVE REGIONAL TREATMENT CENTER
Date Client Name Caseworker Assigned Household Services Time/Unit(s) Total
Counselor Number Rendered Billed Fee
TOTAL DUE FOR MONTH OF $
Date:
Island Grove Regional Treatment Center
Financial Officer
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