HomeMy WebLinkAbout20050430.tiff RESOLUTION
RE: APPROVE CHILD PROTECTION AGREEMENT FOR SERVICES AND AUTHORIZE
CHAIR TO SIGN - ARAPAHOE HOUSE
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 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 Arapahoe
House, commencing January 1, 2005 and ending May 31, 2005,with further terms and conditions
being as stated in said agreement, and
WHEREAS,after review,the Board deems it advisable to approve said agreement,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 Arapahoe
House, be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to
sign said agreement.
The above and foregoing Resolution was,on motion duly made and seconded,adopted by
the following vote on the 7th day of February, A.D., 2005, nunc pro tunc January 1, 2005.
BOARD OF COUNTY COMMISSIONERS
I _.D0 , 4 WELD COUNTY, COLORADO
♦. 1� William H. rke, Chair
Clerk to the Board
1861 I! ��ev� i J. eile, Pro- m
e
p . I-rk to the Board
DaVong
r- ED AS TO
Robert D. Masden
Coun'rney .444/14, 6_.�ah„
4/* Glenn Vaad
Date of signature:
2005-0430
SS0032
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DEPARTMENT OF SOCIAL SERVICES
P.O. BOX A
GREELEY, CO. 80632
Website: www.co.weld.co.us
111k.
Administration and Public Assistance(970)352-1551
Child Support(970)352-6933
COLORADO
MEMORANDUM
TO: William H. Jerke, Chair Date: February 2, 2005
Board of County Commissioners
FR: Judy A. Griego, Director, Social ServicesQ- &.tcr
RE: Child Protection Agreement for Services Between the Weld County
Department of Social Services and Arapahoe House
Enclosed for Board approval is a Child Protection Agreement for Services between the Weld
County Department of Social Services and Arapahoe House. The Agreement was reviewed at the
Board's Work Session of November 5, 2004.
The major provisions of the Agreement are as follows:
1. The term period is from January 1,2005 through May 31, 2005.
2. The Department agrees to reimburse Arapahoe House for substance abuse services for
adults and youth involved in the child welfare system and located in the south Weld
County at rates provided in the Agreement, but not to exceed $50,000.
3. Arapahoe House will be provide client evaluations, outpatient, intensive outpatient,
transitional residential, day treatment,residential, therapeutic community, adolescent
RTC, extended detoxification, sobriety monitoring, case consultation and testimony in
Court.
If you have any questions,please feel free to ask me.
2005-0430
Contract Number 04-05 CORE-44
CHILD PROTECTION AGREEMENT FOR SERVICES
BETWEEN THE WELD COUNTY DEPARTMENT OF SOCIAL SERVICES
AND ARAPAHOE HOUSE,INC.
This Agreement,made and entered into the /s*day of February 2005,by and between the Board of Weld
County Commissioners,sitting as the Board of Social Services,on behalf of the Weld County Department of Social
Services,hereinafter referred to as"Social Services,"and Arapahoe House,Inc.,hereinafter referred to as
"Arapahoe House".
WITNESSETH
WHEREAS,required approval,clearance,and coordination have been accomplished from and with
appropriate agencies;and
WHEREAS,the Colorado Department of Human Services has provided Core Service funding to Social
Services for immediate referrals for monitored sobriety services for families,children,and adolescents; and
WHEREAS,Social Services requires the services of a substance abuse treatment provider to assist the
County to deliver services for immediate referrals for monitored sobriety to child welfare clients,and Arapahoe
House is willing and able to provide such services; and
WHEREAS,Social Services requires the services of a substance abuse treatment provider to assist Social
Services in delivering substance abuse treatment services to child welfare clients upon the depletion of Core Service
funding;and
WHEREAS,Arapahoe House is a Colorado non-profit corporation organized for the purpose of providing
and coordinating high quality,cost efficient,integrated chemical dependency and related behavioral health care
services in the State of Colorado.
NOW THEREFORE,in consideration of the premises,the parties hereto covenant and agree as follows:
1. Tenn
This Agreement shall become effective on January 1,2005,upon proper execution of this Agreement and
shall expire May 31,2005,unless sooner terminated as provided herein.
2. Scope of Services
Services shall be provided by Arapahoe House within its capability 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,"copies of which are
attached hereto and incorporated herein by reference.
"Payment Schedule"shall establish the maximum reimbursement,which will be paid from Core
Service funds during the duration of this Agreement.
Page 1 of 5
Contract Number 04-05 CORE-44
Arapahoe House in accordance with federal HIPAA regulations,will be adopting or has adopted
the standard transaction code set for all treatment services. Even though this compliance will
change the service labels and groupings;the net fees associated with those services will not
change.
b. Arapahoe House shall submit an itemized monthly bill to Social Services for all costs incurred for
services provided pursuant to Exhibit A of this Agreement in accordance with criteria established
by Social Services. Arapahoe House shall submit all itemized monthly billings to Social Services
no later than the twenty-fifth(25)day of the month following the month the services were
provided.
c. Payments of costs incurred pursuant to this Agreement is expressly contingent upon the
availability of Core Service 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. Work performed prior to the effective date 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,Arapahoe House shall
comply with all financial and audit requirements required by law for Core Funding contracts.
5. Payment Method
Unless otherwise provided in the Scope of Services and Payment Schedule:
a. Arapahoe House shall provide proper monthly invoices and itemization of services performed and
costs related to these services as provided under the agreement.
b. Social Services may withhold any payment if Arapahoe House has failed to comply with the
Financial Management Requirements,program objectives,contractual terms,or reporting
requirements. In the event of a forfeiture of reimbursements,Arapahoe House may appeal such
circumstance to the Director of Social Services. The decision of the Director of Social Services
shall be final.
6. Assurances
Arapahoe House shall abide by all assurances as set forth in the attached Exhibit C,which is attached hereto
and incorporated herein by reference.
7. Compliance with Applicable Laws
At all times during the performance of this contract,Arapahoe House 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 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. Arapahoe House acknowledges that the following
laws are included:
Page 2 of 5
Contract Number 04-05 CORE-44
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. If necessary,Arapahoe House and Social Services will resist in judicial proceedings any
efforts to obtain access to client records except as permitted by 42 CFR Part 2.
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
Arapahoe House 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 Evaluation
Arapahoe House and Social Services agree that monitoring and evaluation of the performance of this
Agreement shall be conducted by Arapahoe House and Social Services. The results of the monitoring and
evaluation shall be provided to the Board of Weld County Commissioners and Arapahoe House.
Arapahoe House shall permit Social Services,and any other duly authorized agent or governmental
agency,to monitor all activities conducted by Arapahoe House pursuant to the terms of this Agreement.
Social Services and any other duly authorized agent or governmental agency,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.
10. Modification of Agreement
All modifications to this agreement shall be in writing and signed by both parties.
Contract Number 04-05 CORE-44
Page 3 of 5
11. Remedies
The Director of Social Services or designee may exercise the following remedial actions should s/he find
Arapahoe House substantially failed to satisfy the scope of work found in this Agreement. Substantial
failure to satisfy the scope of work,as defined in Exhibit A,shall be defined to mean incorrect or improper
activities or inaction by Arapahoe House. These remedial actions are as follows:
a. Withhold payment to Arapahoe House until the necessary services or corrections in performance are
satisfactorily completed;
b. Deny payment or recover reimbursement for those services or deliverables,which have not been
performed and which due to circumstances caused by Arapahoe House,cannot be performed or if
performed would be of no value to Social Services. Denial of the amount of payment shall be
reasonably related to the amount of work or deliverables lost to Social Services;
c. Incorrect payment to Arapahoe House due to omission,error,fraud,and/or defalcation shall be
recovered from Arapahoe House,Inc.by deduction from subsequent payments under this Agreement
or other agreements between Social Services and Arapahoe House 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 Manager 4
Name Tide
For Arapahoe House:
Michael W.Kirby Jr.,Ph.D. Chief Executive Officer
Name Tide
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:
To: Social Services To: Arapahoe House
Judy A.Griego,Director Michael W.Kirby,Jr.,Ph.D,Chief Executive Officer
P.O.Box A 8801 Lir an Street
Greeley,CO 80632 Thornton,CO 80260
14. Litigation
Arapahoe House shall promptly notify Social Services in the event that Arapahoe House,Inc.learns of any
actual litigation in which it is a party defendant in a case that involves services provided under this
Agreement.Arapahoe House,Inc.,within five(5)calendar days after being served with a summons,
complaint,or other pleading involving services provided under this agreement,which has been filed in any
federal or state court or administrative agency,shall deliver copies of such document(s)to the Social
Contract Number 04-05 CORE-44
Page 4 of 5
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 finding. Arapahoe House reserves the right to suspend services to clients if
funding is no longer available.
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 V✓HOF,the parhtG duly executed the Agreement as of the day,month,and year first
'�;yyyr`ttea
�a •• r. r�� BOARD OF COUNTY
1861 BOARD COMMISSIONERS WELD Jl'� '
COUNTY,COLORADO
ett
® f By:
s. j ry,Clerk /. William H.Jerk,Chair
FEB 0 7 2005
APP TO FO . ARAPAHOE HOUSE,INC.
BY
ty Michael W.Kirby• .
Chief Executive cer
COUNTY DEPARTMENT
OF SOCIAL S RVICES
By: •
Ju y A.Grieg ,Directo
Page 5 of 5
9cCS-G 443O
Contract Number 04-05 CORE-44
EXHIBIT A
SCOPE OF SERVICES
1. Overall Project Description
Arapahoe House shall provide services including client evaluations,outpatient,intensive outpatient,
transitional residential,day treatment,residential,adolescent RTC,social mode V detoxification,sobriety
monitoring,case consultation and testimony in court for adults and adolescent clients referred by Social
Services. Each client's treatment needs will be assessed on an individual basis,and the level or modality of
treatment provided by Arapahoe House will be based on the client's needs,in accordance with the
American Society of Addiction Medicine's(ASAM)patient placement criteria.
2. Eligible Population for Services
Social Services shall refer to Arapahoe House only those child welfare cases that comply with the
following criteria:
A. The case is active on the TRAILS computerized tracking system;
B. The case meets Colorado Department of Human Services program category criteria 4,5,or 6;
C. The case meets the definition of`imminent risk for out of home placement/reunification,"as
defined by the laws or rules of the State of Colorado.
3. Types of Services To Be Provided
A. Alcohol and Drug Abuse Assessment
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,AODU[,Drinking History Questionnaire,Family Environment Scale)may be
given. Arapahoe House will provide two collateral contacts as part of the assessment.Arapahoe
House substance abuse evaluator will complete the assessment within 10 working days of the
face-to-face interview.
Arapahoe House agrees to include a Baseline Urinalysis Testing(11-Panel) as part of the
assessment
B. Treatment Options
1) American Society of Addition Medicine(ASAM)Level of Care
Arapahoe House's treatment options will be dependent upon the American Society of
Addiction Medicine(ASAM)level of care that is formulated at the completion of the
substance abuse assessment.Through group,family,and individual counseling,the
methods used to create change are generated through cognitive and behavioral therapy,
Gestalt,problem solving techniques,motivation enhancement,and solution focused
therapy. These methods will be used in conjunction with or alone depending upon the
client's needs. Arapahoe House agrees to provide the ASAM level of care as follows:
Page 1 of 7
Contract Number 04-05 CORE-44
Level of Care Description
.5=Evaluation Two to Three Hours coupled with a urinalysis
test.
1.0= 1 to 8.5 hours per week This includes individual,family and group
sessions depending on the clients needs.
2.1 =nine or more hours a week This includes a combination of individual,
family and group sessions dependent on the
clients needs.
2) Adult Detoxification Services
Adult Detoxification services through Arapahoe House focuses on detoxification
programs that facilitates a safe withdrawal from alcohol and drugs and engages
appropriate clients in treatment. These services will be available to Social Services'
clients through its various site locations in Aurora,Wheat Ridge,and Commerce City,
CO,locations. Arapahoe House operates three adult social-model detoxification
programs in Adams,Arapahoe,and Jefferson Counties. The Aurora Emergency
Treatment Unit located at 1290 S.Potomac Street,Aurora,CO, contains 30 licensed
beds. The Wheat Ridge facility in Jefferson County,Detox West,located at 4643
Wadsworth Boulevard,Wheat Ridge,CO,holds 50 licensed beds. Serving Adams
County,the Washington House facility located at 7373 Birch Street,Commerce City,
CO,contains 40 licensed beds. Together these three programs provide approximately
16,000 episodes of detoxification annually.
3) Adult Residential and Day Treatment
Arapahoe House's Adult Intensive Residential Treatment service located at 8801 Lipan
Street,Thornton,CO,offers flexible length-of-stay and individualized care to clients who
are 18 years of age or older. Its purpose is to provide treatments to individuals whose
substance use and for co-occurring mental illness have resulted in disruption of their
emotional,mental,physical,and/or socioeconomic functioning. This program is
designed for those clients whose treatment in a less restrictive setting would be unlikely
to result in changes in attitude and motivation sufficient to maintain abstinence from
alcohol and other drugs. The program is limited to those individuals who do not need a
locked environment and who do not have a physical,emotional,or psychiatric
impairment,which would require the availability of 24-hour medical staff.
4) The Wright Center
The Wright Center is an innovative transitional housing program located at 6195 W.38"
Avenue,Wheat Ridge,CO,for homeless clients who have completed intensive treatment.
Encompassing 22 beds for males and females,the program emphasizes relapse
prevention,and the acquisition of employment through job placement assistance. The
length of stay in this program,with its focus on transitional alcohol-and-drug-free
housing,may extend up to two years.
5) Housing and Employment Services
Recognizing the importance of housing in recovery,Arapahoe House has strengthened its
ability to house clients in the last few years. In addition to the Wright
Page 2 of 7
Contract Number 04-05 CORE-44
Center,Arapahoe House managers 75 Section 8 vouchers that clients can redeem in the
private housing market,paying only 30 percent of their income for rental housing. A
Transitional Housing Program sponsored by the Department of Housing and Urban
Development(HUD)provides tenant-based rental assistance for 18 families who can be
housed for two years while receiving intensive support services from agency staff.
Shelter+Care,another HUD program provides tenant-based rental assistance for up to
five years plus supportive services for seven families who have chronic problems that
affect their ability to maintain housing. Because meaningful recovery is intertwined with
a client's need for stable housing,increased social skills,and reliable employment,
agency vocational services include;assessment,employment preparation and retention
training,GED preparation,community linkages,and a"Job Center." These services help
clients achieve and maintain meaningful employment. The Housing and Employment
Services Program under Arapahoe House is located at 77 W.Fifth Avenue,Denver,CO.
6) Specialized Services for Individuals With Co-Occurring Mental Illness
Arapahoe House offers specialized services for individuals with co-occurring mental
illness. The Adult and Adolescent Residential programs,New Directions for Families,
and the central Denver Adult and Adolescent Outpatient clinics are licensed as mental
health clinics and provide integrated treatment of co-occurring mental illness and
substance abuse. Psychiatric evaluation and treatment is available and individual and
group sessions address issues of the interaction of mental illness and substance abuse and
dependence. For clients who are also homeless or have other special needs,a case
manager is assigned to coordinate linkage to other services and systems on behalf of the
client. The residential programs are located at 8801 Lipan Street,Thornton,CO. The
Denver Outpatient Clinic is located at 55 W.Fifth Avenue,Denver,CO. The New
Directions for Families location is not listed for security reasons.
7) Specialized Women's Services
Arapahoe House offers a continuum of specialized services for women,including
gender-specific groups and individual counseling in outpatient and residential settings.
Services include intensive dyadic case management to engage and coordinate the linkage
to multiple systems appropriate to the needs of pregnant women and women with
dependent children. Residential treatment programs provide parenting skills groups,
supervised visits,and designated areas for children who are visitors. Family planning
services have been made available on-site at the Lipan Residential and New Directions
for Families programs.
8) Adult Outpatient Clinics
Arapahoe House operates six outpatient clinics providing services to individuals assessed
appropriate for that level of placement in the continuum of care. Our outpatient
programs
provide individual and group counseling,specialized offender and women's services and
education,and therapy groups for clients referred for a DWAI or DUI offense. The
locations of such clinics are: Aurora Outpatient Clinic located at 3005 South Parker
Road, Suite C-330,Aurora,CO;Lakewood Outpatient Clinic located at 730 Simms St.,
Lakewood,CO;North Metro Outpatient Clinic located at 720 West 84th Avenue, Suite
224,Thornton,CO;Washington House Outpatient Clinic located at 7373 Birch St.,
Commerce City,CO;Denver Outpatient Clinic located at 55 West Fifth Avenue,Denver,
CO;and Wheat Ridge Outpatient Clinic located at 4643 Wadsworth Blvd.,Wheat Ridge,
CO.
Page 3 of 7
Contract Number 04-05 CORE-44
9) Strategies for Self-Improvement and Change(SSC)
Arapahoe House's Strategies for Self-Improvement and Change(SSC)is a traditional
outpatient program for male offenders structured around three phases of treatment:
Phase 1-Challenge to Change;Phase H-Commitment to Change; and Phase III-Taking
Ownership of Change. The program is designed to motivate clients to take responsibility
for their actions,to change negative self-concepts,and to break patterns of substance
abuse and criminal conduct. The program is located at Detox West,4643 Wadsworth
Blvd,Wheat Ridge,CO.
10) Cultural Services-Outpatient Services
Arapahoe House implements a structured Cultural Services program. The program has
been designed to expand and enhance the outpatient services previously offered by
Arapahoe House with a primary focus on providing linguistic and culturally appropriate
treatment services to the Latino population. Programmatic services include: individual
and group counseling,specialized offender services and education;abstinence
monitoring; and DUI Level II Education and Therapy. In addition,program staff is able
to complete alcohol and Drug Assessment for monolingual Spanish speaking clients upon
request by referring agencies. Arapahoe House hires bi-lingual counselors,receptionist,
and Information and Access(I&A)team member(s)to overcome the language and socio-
economic barriers. These services are offered at the Denver Outpatient Clinic located at
55 W.Fifth Ave.,Denver,CO,and Washington House Outpatient Clinic located at 7373
Birch St., Commerce City, CO.
11) The Aspen Center
Arapahoe House's Adolescent Residential Group Home program located at 4335 West
76th Avenue,Westminster,CO,is licensed as a Residential Treatment Center(RTC)and
Residential Child Care Facility(RCCF)as well as licensed by the Alcohol and Drug
Abuse Division. The group home provides a placement for 15 adolescent boys and girls
ages 12-19 who have no permanent family living situation;are in need of preparation for
independent adult living;and/or who are stepping down from residential treatment and
in need of a structured program in a less restrictive setting. The Aspen Center is
designed to help adolescents to learn to take responsibility for their behavior,to make
appropriate decisions,and to develop skills that will prepare the youth for successful
family and community living. The expected length of stay varies from 6 to 12 months.
An accredited on-site school is provided for clients who have not received a high school
diploma or are working towards their GED. Job skills training services are offered to all
residents.
12) New Directions For Families
Arapahoe House's New Directions for Families is a comprehensive residential program
that has the capacity to simultaneously serve 16 women and their dependent children.
The program has an on-site licensed childcare center for infants,toddlers, and
preschoolers. Children in treatment with their mothers receive individual assessment,
treatment,and case management for problems associated with having experienced
familial substance,mental health,and violence.
Page 4 of 7
Contract Number 04-05 CORE-44 •
C. Reporting
Arapahoe House will prowde monthly reports to Social Services concerning the status of each
participant including both monthly outcome reports(5A)and client progress reports. All client
progress reports submitted by Arapahoe House will be substantive, clearly written, and signed by
the clinician,therapist, or evaluator. Arapahoe House will utilize the monthly progress report
form created by Social Services. Arapahoe House will incorporate into each adult and youth
treatment plan the child welfare objective as identified by the Social Services caseworker. These
objectives are derived from the Social Services'caseworker's assessment and state what must be
done to undertake behavioral changes,to mitigate safety concerns,to resolve risks and to result in
family continuity and/or permanency. These reports will be provided to Social Services by the
twenty-fifth day of each month,following month in which services were provided.
4. Fee Schedule for Services
Arapahoe House's fee schedule for services is as follows:
Description of Services Fee/Cost
Drug and Alcohol Assessments,which $163.90 -This includes a two to three hour assessment
includes,ASAP,ASAM&ASI and a baseline Urine Analysis.
Detoxification $110.00 per day
Intensive Residential-Adult $163.90 per day
Transitional Residential $47.30 per day
Individual Session $75.90 per hour
Group Session $43.73 per hour
Family Session $81.40 per hour
UA/Treatment $27.10 up to three times per week per UA
(11 panel:Alcohol,Amphetamines,Barbiturates,
Benzododiazepines,Cocaine,Opiates,The (marijuana)
Phencyclidine,Methadone,Creatinine,Propoxyphene)
Antabuse Monitoring $3.02 per monitoring five loading days,followed by three
days per week of monitoring.
Intensive Residential—Adolescent $218.90 per day
New Directions for Families $163.90 per day
Court Testimony $65.72 per hour
Intake Fee $15.40 each
Breathalyzer $15.40
UA Confirmation(GCMS)for what $33.00 per positive substance
drugs
UA w/o Treatment(diagnostic) $33.27 per UA(11 panel)
Day Treatment—Adolescent $106.43 per day
Drug Patch Monitoring $44.00 each
Drug Patch Confirmation $27.50 per positive substance
Antabuse $66.00
Page 5 of 7
Contract Number 04-05 CORE-44
5. Measurable Outcomes and Objectives
Arapahoe House shall abide by Social Services outcome indicators of Safety,Permanency and Child and
Family Well-Being,which are provided under Adoption and Safe Families Act (ASFA), 1997;
Colorado Child and Family Services Plan 2000-2004;and ACF Reviews(Reference:Federal Register,
Volume 65,Number 16:45 CRF Parts 1355, 1356, and 1357),March 25,2000.
A. Outcome Reports as Prescribed by Social Services
Quarterly Outcome reports will be provided to Social Services and will include the following:
1) Number of clients served;
2) Number of clients currently in each level of care;
3) Number of clients that have successfully completed their treatment.This will be broken
down into each level of care primary;
4) Number of clients that no showed,were unsuccessfully discharged or moved to a higher
level of care. This will be broken down by level of care primary;
5) Number of clients served whose primary addiction is to methamphetamine;
6) Number of clients served with a dual diagnosis,including the client's primary mental
health diagnosis;
7) Percentage of client progress delineated by each outcome objective as described under
Item 5,C of the Agreement.
B. Client Objectives
The Social Services caseworker will identify a maximum of three child welfare objectives to be
addressed within each client's treatment plan. Arapahoe House shall develop action steps to reach
the identified child welfare objectives. Arapahoe House shall report monthly on each client's
progress in meeting the three identified objectives. Each objective will be measured via a
percentage Likert Scale to determine progress.
C. Overall Program Objectives
Arapahoe House and Social.Services agree to monitor the ability of the substance abuse program
offered by Arapahoe House to achieve objectives as follows:
1) Demonstrate Abstinence with the use of UA/Patch Monitoring Only (Code#100).
2) Improve parental capabilities currently impaired by substance abuse(Code#101).
3) Develop the capacity to ask for help and assistance without resorting back to substance
abuse(Code#102).
4) Develop or increase the ability to recognize,prioritize and meet child(ren)'s needs(Code
#103).
5) Parent will identify how theft substance use has affected their parenting(Code#104).
6) Parent will identify how their substance use got them involved with social services(Code
#105).
7) Parent will identify how their substance use helped them parent(Code#106).
8) Parent will identify relapse triggers and develop a safety plan for their children(Code
#107).
9) Parent will identify whom they consider to be a support in theft recovery(Code#108).
10) Parent will identify who will care for their children should they relapse(Code#109).
11) Parent will identify what they enjoy about parenting sober(Code#110).
12) Improve parent-child functioning to lower the risk of out of home placement(Code
#201).
Contract Number 04-05 CORE-44
Page 6 of 7
13) Parent will support their children in speaking about how living in a substance-effected
family has impacted them(Code#202).
14) Parents will demonstrate increased verbal skills,empathy and accountability with
child(ren) (Code#203).
15) Parent will identify their parenting strengths(Code#204).
16) Family members including significant other,children and extended family will increase
ability to communicate more effectively(Code#301).
17) Family members will identify how they can support the identified client in their recovery
(Code#302).
18) Family members will identify the positive parenting changes the substance-effected
person is making(Code#303).
19) Family members will identify who will care for the children in the event of a relapse
(Code#304).
20) Family members will identify relapse systems of the identified client(Code#305).
21) Family members will identify how they can reach out for help if a relapse occurs(Code
#306).
22) Increase level of functioning currently impaired by living in a substance affected family
(Code#401).
23) Identify how living in substance effected family has impacted their life(Code#402).
24) Improve level of fiinctioning currently impaired by substance abuse issues(Code#403).
25) Decrease aggressive behaviors at home and/or school and in the community(Code
#404).
26) Learn how to socialize without the use of substances(Code#405).
27) Identify relapse triggers(Code#406).
28) Create a sober support network(Code#407).
6. Staff Qualifications
Arapahoe House staff members who will provide services to Social Services clients will have credentials
and/or certifications as required by the Colorado Department of Human Services,Colorado Board of
Education,Alcohol and Drug Abuse Division,and the Colorado Board of Medical Examiners.
Contract Number 04-05 CORE-44
Page 7 of 7
EXHIBIT B
PAYMENT SCHEDULE
1. Funding and Method of Payment
Social Services agrees to reimburse to Arapahoe House in consideration for the work and services
performed,a total amount not to exceed Fifty Thousand Dollars($50,000.00)under Core Service funding.
Expenses incurred by Arapahoe House,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 Core Service funds,whether in whole or in part,is subject to and
contingent upon the continuing availability of Core Service 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
Fees for services will be based on services and fees as described in Exhibit A.
Social Services referrals will not be sent to collections by Arapahoe House 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.
Arapahoe House will collect any applicable sliding scale co-pays and credit Social Services for any
payments received on the monthly billing statements.
For those clients who have the responsibility to pay for their own treatment and related services as
documented by court order,Arapahoe House will treat such clients as a non-Social Services referral and
according to its rules and regulations afforded to other community clients.
3. Submittal of Vouchers
Arapahoe House shall prepare and submit monthly the itemized voucher according to the criteria listed
under"Standards of Responsibility"in Exhibit D,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.
Contract Number 04-05 CORE-44
Page 1 of 1
EXHIBIT C
ASSURANCES
1. Arapahoe House 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 and/or intentional misconduct of
Arapahoe House contracted providers or its employees,volunteers,or agents while performing duties as
described in this Agreement. Arapahoe House shall indemnify,defend,and hold harmless Weld County,
the Board of County Commissioners of Weld County,its employees,volunteers,and agents. Arapahoe
House 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,Arapahoe House 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. Arapahoe House 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. Arapahoe House 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
Arapahoe House. It is specially understood that all clinical records created by Arapahoe House for clients
herein are confidential and shall not be disclosed without proper written release and in accordance with
applicable law.
9. All such records,documents,communications,and other materials shall be the property of Social Services
and shall be maintained by Arapahoe House in a central location and custodian,in behalf of Social
Services,for a period of four(4)years from the date of final payment under this Contract,or for such
further period as may be necessary to resolve any matters which may be pending,or until an audit has been
Contract Number 04-05 CORE-44
Page 1 of 3
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. Arapahoe House assures to the extent permitted by applicable law 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 as permitted by applicable law.
11. This Contract shall be binding upon the parties hereto,their successors,heirs,legal representatives,and
assigns. Arapahoe House or Social Services may not assign any of its rights or obligations hereunder
without the prior written consent of both parties.
12. Arapahoe House certifies that federal appropriated funds have not been paid or will be paid,by or on
behalf of Arapahoe House 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. Arapahoe House assures that it will fully comply with all other applicable federal and state laws. Arapahoe
House understands that the source of funds to be used under this Contract is Core Service funds.
14. Arapahoe House assures and certifies that it 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.
15. The Appearance of Conflict of Interest applies to the relationship of a contractor with Social Services when
the contractor 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
Contract Number 04-05 CORE-44
Page 2 of 3
relationships are in opposition.During the term of the Contract,Arapahoe House 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,Arapahoe House,Inc. 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 Arapahoe House.
16. Arapahoe House shall protect the confidentiality of all applicant records and other materials that are
maintained in accordance with this Contract. Except for purposes directly connected with the
administration of Child Protection,no information about or obtained from any applicant/recipient in
possession of Arapahoe House shall be disclosed in a form identifiable with the applicant/recipient or a
minor's parent or guardian unless in accordance with Arapahoe House written policies governing access to,
duplication and dissemination of,all such information. Arapahoe House shall advise its employees,agents,
and subcontractor,if any,that they are subject to these confidentiality requirements. Arapahoe House 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(1)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 Arapahoe House in the course of providing services under this Contract will be accorded
at least the same precautions as are employed by Arapahoe House for similar information in the course of
its own business.
18. Arapahoe House certifies it will abide by Colorado Revised Statue(C.R.S.)26-6-104,requiring criminal
background record checks for all employees,contractors,and sub-contractors.
Page 3 of 3
Contract Number 04-05 CORE-44
EX UBIT D
CORE SERVICE FUNDS
STANDARDS OF RESPONSIBILITY
Arapahoe House agrees to:
1. Accept referrals for services from Social Services according to conditions and approval process for
referrals as follows:
a. Social Services caseworker will initiate the referral for substance abuse evaluations and treatment.
b. Elaine Furister,Core Services Specialist,or designee,will authorize the transmittal of all referrals,
as required through a substance abuse referral form,for evaluations and substance abuse
outpatient and intensive outpatient treatment.
c. Mary Gill,Substance Abuse Core Services Supervisor,or designee,will authorize and approve
substance abuse services that are beyond the scope of outpatient and intensive outpatient
treatment.
d. The substance abuse referral form,as authorized and provided by Social Services,will serve as
the authorization for evaluations and all other substance abuse services. The substance abuse
referral form will identify the level of care that is authorized,a referral ID number,and the time
period that services may be provided by Arapahoe House.
2. Submit requests for renewal of substance abuse services according to conditions and approval process for
such renewals as follows:
a. Arapahoe House may request a renewal of substance abuse services through a monthly brief
report,as referenced in Exhibit D,Item 3,Item 5,and Item 8.
b. Joyce Hause,Caseworker IV,or designee,will authorize renewal requests for outpatient and
intensive outpatient services.
c. Joyce Hause,Caseworker IV,and Mary Gill,Substance Abuse Core Services Supervisor, or
designees,will authorize renewals request for other non outpatient and intensive outpatient
services.
d. The substance abuse referral form,as authorized and provided by Social Services,will serve as
the authorization for renewal of service requests by Island Grove. The substance abuse referral
form will identify the level of care that is authorized,a referral ID number,and the time period
that services may be provided by Island Grove.
3. Report to Social Services a monthly brief report on the status of the program as prescribed by Social
Services.
4. Report to Social Services expenditures and case disbursement at agreed upon times.
5. Submit monthly-completed billing firms to Ms.Elaine Furister,Core Services Specialist, or designee
within twenty-five(25)calendar days of the month following service in order to receive payment.Failure
to submit in a timely and complete manner shall result in forfeiture of payment. To allow for payment by
Social Services within 60 days,Social Services requests that completed billings by Arapahoe House be
submitted to Social Services on or about the 10th day of the month after the month services were provided.
Contract Number 04-05 CORE-44
Page 1 of 2
6. In the event no service fees are provided during the service month,an Authorization for Contractual
Services stating no services were provided for that service month shall be submitted within twenty-five
(25)calendar days following the month of service.
7. Work with family to prepare to pay for services beyond established time frame.
8. A complete and timely billing form is identified by and must include the following elements.
a. The billing must be an original billing signed by the provider and/or designee.
b. The billing must include all forms designed for Child Welfare Administration funding
reimbursement and approved by the Department of Social Services including Colorado State
Department of Social Services Authorization for Contractual Services form and Weld County
Monthly Request for Reimbursement under Child Welfare Administration Funding.
9. Will develop and utilize evaluation tools(pre and post assessment test instruments)to collect necessary
data in cooperation with Social Services staff to monitor effectiveness of program.
10. Will meet with Social Services FPP Supervisor quarterly(more if needed)to review program usage and
effectiveness to discuss necessary improvements to better serve families or increase referrals.
11. Be available to meet with Social Service's staff to explain program,time lines of response to referrals and
answer questions to enhance program.
12. Be available for the Families,Youth and Children commission review and attendance at the FYC
meetings.
1
Weld County Department Of Social Services Child Welfare Substance Abuse Referral l.os
Program
Client Name: DOB: HH#: Client Suffix#:
Client Address:
Home Phone: Work: Sex:Type
MOE Status If MOE was previously completed provide date:
Trails Case ID#: Will an interpreter be needed?Answer
Name of the youngest child in the household: Youngest child Suffix#:
Caseworker Name: Extension#:
Referral For(check all that apply):
in Substance Abuse Evaluation (IG, Griffin House&Arapahoe House)
❑ Substance Abuse Treatment (IO, Griffin House&Arapahoe House) (based on evaluation)Specify
n Anger Management/Substance Evaluation(IG&Griffin House)
❑ DV/Substance Evaluation (JO Only) Specify
n Anger Management/Substance Abuse Treatment(IG& Griffin House)
n DV/Substance Abuse Treatment(IG Only)
Referral Court Ordered: Answer Date of Court Order:
Please specifically describe any current court orders for client compliance with Monitored Sobriety and or Treatment. Please
include court ordered timelines and consequences for the client should they not comply with the court order.
Does this case meet the definition of imminent risk of out of home placement/reunification:Answer
FSP 1,2,3 Attached Answer If the FSP 1,2,3 are not attached please state why
Please state the substance abuse issue that initiated this referral:
Has The Client Had Prior Treatment?: Answer (if yes,when,where,type)
Elaine Furister Authorization - Date: Referral#
Elaine Furister(Outpatient&Intensive Outpatient)Authorization Date:
Mary Gill(Inpatient,TRT or Halfway House)Authorization Date:
CASEWORKERS: PLEASE COMPLETE THE FOLLOWING PAGE!
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agittrttittiI�Y*Y114yl Ztt YL�I{il *211Si1V1 tttitt ZtaI�tttZttr*Stit .ittstr-
,.70 ZrZiCv`Z4Z;L'L'i' :41..7C:.L"01fl'i`L"L'i'w►L"i'FL'3'r3i"*ttreeZZZZZSZttw'+.
2
CASEWORKERS, PLEASE CHOOSE THREE OF THE FOLLOWING OBJECTLYES FOR
YOUR CLIENT IN YOUR REFERRAL.
❑ Demonstrate Abstinence with the use of UAPPatch Monitoring Only (Code#100).
n Improve parental capabilities currently impaired by substance abuse (Code#101).
n Develop the capacity to ask for help and assistance without resorting back to substance abuse(Code#102).
❑Develop or increase the ability to recognize,prioritize and meet child(ren)'s needs (Code#103).
❑ Parent will identify how their substance use has affected their parenting(Code#104).
n Parent will identify how their substance use got them involved with social services (Code#105).
IT Parent will identify how their substance use helped them parent(Code#106).
n Parent will identify relapse triggers and develop a safety plan for their children(Code#107).
❑Parent will identify whom they consider to be a support in their recovery(Code#108).
❑Parent will identify who will care for their children should they relapse (Code#109).
n Parent will identify what they enjoy about parenting sober(Code#110).
❑Improve parent-child functioning to lower the risk of out of home placement(Code#201).
❑Parent will support their children in speaking about how living in a substance-effected family has impacted them
(Code#202).
❑ Parents will demonstrate increased verbal skills, empathy and accountability with child(ren)(Code#203).
❑Parent will identify their parenting strengths (Code#204).
❑Family members including significant other,, children and extended family will increase ability to communicate
more effectively(Code#301).
❑ Family members will identify how they can support the identified client in their recovery(Code#302).
❑Family members will identify the positive parenting changes the substance-effected person is making(Code
#303).
9 Family members will identify who will care for the children in the event of a relapse (Code#304).
9 Family members will identify relapse systems of the identified client(Code#305).
9 Family members will identify how they can reach out for help if a relapse occurs(Code#306).
9 Increase level of functioning currently impaired by living in a substance affected family(Code#401).
9 Identify how living in substance effected family has impacted their life (Code#402).
Ti Improve level of functioning currently impaired by substance abuse issues (Code#403).
9 Decrease aggressive behaviors at home and/or school and in the community (Code#404).
9 Learn how to socialize without the use of substances(Code#405).
❑ Identify relapse triggers(Code#406).
n Create a sober support network(Code#407).
Contract Number 04-05 CORE-44
WELD COUNTY MONTHLY REQUEST FOR REIMBURSEMENT UNDER CORE SERVICES FUNDING
Remit to:Elaine Furister,CPS/CAP,Core Services Specialist
Name of Program Month of Service Weld County Department of Social Services
Notice to Providers:List all clients currently enrolled in your program. P.O.Box A,315 B N 11 Avenue,Greeley,CO 80632
Enter 0 if no services were provided during billing month Telephone: 970.352.1551, extension 6295
FAX: 970.346.7698
Client Name HH# Referral# Approved Approved Date of Actual Rate per Total Payment Social Services Payments Services
(If Entry Exit Date Service Hrs/Units Unit Requested Only-Comments Denied/Delayed Payable
applicable) Date
Social Service Codes: CE-Computation Error;NR-No Referral; EED-Exceeds End Date; EMH-Exceeds Maximum Hours;EMS-Exceeds Maximum Sessions;
NP-Not Payable;
PD-Payment Delayed; SPD; Submitted Past Deadline;NDC-No Face to Face Contact;NV-No Client Verification;ICMP-Initial Case Management Plan Needed;
PR-Progress Report Needed
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