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Home My WebLink About20041566.tiff RESOLUTION RE: APPROVE THREE CHILD PROTECTION AGREEMENTS FOR SERVICES FOR MENTAL HEALTH EVALUATIONS WITH VARIOUS PROVIDERS AND AUTHORIZE CHAIR TO SIGN WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with three Child Protection Agreements for Services for Mental Health Evaluations between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Social Services, and the following vendors,commencing February 1,2004,and ending May 31, 2005,with further terms and conditions being as stated in said agreements, and 1. Barry Lindstrom 2. Greeley Counseling Center 3. Victor Cordero WHEREAS,after review,the Board deems it advisable to approve said agreements,copies of which are attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County,Colorado,ex-officio Board of Social Services,that the three Child Protection Agreements for Services for Mental Health Evaluations between the County of Weld,State of Colorado, by and through the Board of County Commissioners of Weld County,on behalf of the Department of Social Services, and the above listed vendors be, and hereby are, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said agreements. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 7th day of June, A.D., 2004, nunc pro tunc February 1, 2004. BOARD OF COUNTY COMMISSIONERS ll WELD COUNTY, COLORADO Jl ��ATTEST: /��(/(/U.4 6 UV'U�• Robert D. Masden, Chair unty Clerk to the Board / William H Jerke, Pro-Tem 1861 (( �erk to the Board � 122.A, M. UGeile AS TO \C)-- g 4cgy .2 David E. Long my Attorne EXCUSED Glenn Vaad Date of signature: All/iy 2004-1566 SS0031 0 SS �� 5� (72H-/7 •-(, a rs DEPARTMENT OF SOCIAL SERVICES P.O. BOX A GREELEY,CO. 80632 Website: www.co.weld.co.us el • Administration and Public Assistance(970)352-1551 MEMORANDUM Child Support(970)352-6933 TO: Robert D. Malden, Chair Date: June 2, 2004 COLORADO Board of County Commissioners FR: Judy A. Griego,Director, Social Services aqui. RE: Child Protection Agreements for Services tween the Weld County Department of Social Services with Various Contractors Enclosed for Board approval are Child Protection Agreements for Services between the Weld County Department of Social Services (Department) and various Contractors. These Agreements were reviewed at the Board's Work Session of April 26, 2004. The major provisions of the Agreements are: pc_i4 1. Each Agreement's term is Juttw 1, 2004 through May 31, 2005. 2. Each Contractor will provide mental health evaluations for child welfare families. 3. The Department agrees to reimburse the Contractors through Child Welfare or Core Services funding at rates described as follows: Name of Provider Services Provided Rates/Costs Barry Lindstrom,Mental a. Interactional evaluations $140 per hour for items a Health Provider b. Psychological evaluations through c. c. Case consultation Greeley Counseling Center a. Psychological evaluations a. $1000/$800 for additional parties b. Interactional evaluations b. $100 per hour c. Court preparation/testimony c. $130 per hour d. Individual/family therapy d. $100 per hour e. Court facilitation, e. $100 per hour medication, staffing f. Consultation f. $100 per hour Victor Cordero,Mental a. Mental health evaluation a. $550 per evaluation Health Provider b. Psychological evaluation b. $725 per evaluation c. Psychological evaluation c. $850 per evaluation with testing d. Interactional evaluation d. $800-$1200 per evaluation e. Individual Therapy e. $70-$85 per hour If you have any questions,please telephone me at extension 6510. 2004-1566 05-CORE-0035 CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF SOCIAL SERVICES AND BARRY LINDSTROM This Agreement,made and entered into the day of May 2004,by and between the Board of Weld County Commissioners,sifting as the Board of Social Services,on behalf of the Weld County Department of Social Services,hereinafter referred to as"Social Services,"and BARRY LINDSTROM. 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 Child Welfare Regular Administration funding and Core Services Mental Health funding to Social Services for mental health evaluations; and NOW THEREFORE,in consideration of the premises,the parties hereto covenant and agree as follows: 1. Tema rchruQ< This Agreement shall become effective on Inne 1,2004 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 BARRY LINDSTROM 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,"of which are attached hereto and incorporated herein by reference. "Payment Schedule"shall establish the maximum reimbursement,which will be paid from Child Welfare Regular Administration funds during the duration of this Agreement. b. BARRY LINDSTROM 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. BARRY LINDSTROM shall submit all itemized monthly billings to Social Services no later than the twenty-fifth(25)day of the month following the month the service was completed. c. Payments of costs incurred pursuant to this Agreement is expressly contingent upon the availability of Child Welfare Regular Administration and Core Service Mental Health 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 execution of this 1 . t2cy/S66 05-CORE-0035 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,BARRY LINDSTROM 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 Child Welfare Regular Administration funding 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. BARRY LINDSTROM shall provide proper monthly invoices and itemization of services performed for costs incurred in the performance of the agreement. b. Social Services may withhold any payment if BARRY LINDSTROM has failed to comply with the Financial Management Requirements,program objectives,contractual terms,or reporting requirements. In the event of a forfeiture of reimbursements,BARRY LINDSTROM may appeal such circumstance to the Director of Social Services. The decision of the Director of Social Services shall be final. 6. Assurances BARRY LINDSTROM 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 I aws At all times during the performance of this contract,BARRY LINDSTROM 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. Barry Lindstrom 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) 2 05-CORE-0035 or AIDS related conditions,covered under Section 504 of the Rehabilitation Act of 1973,as amended,cited above. If necessary,BARRY LINDSTROM 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 BARRY LINDSTROM 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 BARRY LINDSTROM and Social Services agree that monitoring and evaluation of the performance of this Agreement shall be conducted by BARRY LINDSTROM and Social Services. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners and BARRY LINDSTROM. BARRY LINDSTROM shall permit Social Services,and any other duly authorized agent or governmental agency,to monitor all activities conducted by BARRY LINDSTROM 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. 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 find BARRY LINDSTROM 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 Barry Lindstrom. These remedial actions are as follows: a. Withhold payment to BARRY LINDSTROM 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 BARRY LINDSTROM 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; c. Incorrect payment to BARRY LINDSTROM due to omission,error,fraud,and/or defalcation shall be 3 05-CORE-0035 recovered from BARRY LINDSTROM by deduction from subsequent payments under this Agreement or other agreements between Social Services and BARRY LINDSTROM,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 BARRY LINDSTROM: Barry I indstrom Mental Health Provider 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: To: Social Services To: BARRY LINDSTROM Tufty A Griego Director 3711 70'h Street,Suite D p O Box A lrrelry,rn an634 Greeley,CO 80617 14. J itigation BARRY LINDSTROM shall promptly notify Social Services in the event that BARRY LINDSTROM learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement.BARRY LINDSTROM,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 finding. BARRY LINDSTROM reserves the right to suspend services to clients if funding is no longer available. 16. Fntire 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. 4 • 05-CORE-0035 IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day,month,and year first above written. E WELD COUNTY BOARD OF COUNTY �, CLERK TO THE BOARD COMMISSIONERS WELD COUNTY,COLORADO itil 41:2 / - y C-fc By: eep Clerk Robert D.Masden,Chair JUN 0 7 2004 a r" AS 'F ': MENTAL LTH PROVIi c/ l BY �At County Att.. ey Y LI 6M (7 9 L UC WELD COUNTY DEPARTMENT OF SOCIAL SERVICES By: ctor 5 a?cey-/564 05-CORE-0035 EXHIBIT A SCOPE OF SERVICES Upon receiving a written referral from the Department,the following services can be preformed. Interactional Evaluations include the following: Individual Clinical Interview(s)with each family member(1 to 2 hours for each member) Conjoint clinical interviews with family members(minimum 3 hours) Psychological Testing(MMPI-2)for each adult family member(1 hour each) Review of case records and previous evaluations(1 to 2 hours) Collateral contacts/consultation with past or current treatment providers(1 to 2 hours) Preparation of Court Reports(2 hours) Court Facilitator Staffmgs as requested(1 to 2 hours) Court Testimony as requested(2 hours) Psychological Evaluations include the following: Individual Clinical Interviews(3 to 5 hours) Psychological Testing(MMPI-2 etc)(1 to 5 hours as needed) Review of case records and previous evaluations(1 to 2 hours) Collateral contacts/consultation with past or current treatment providers(1 to 2 hours) Court Facilitator Staffings as requested(1 to 2 hours) Court Testimony as requested(2 hours) Case consultation is also available. 6 05-CORE-0035 EXHIBIT B PAYMENT SCHEDULE 1. Funding and Method of Payment Social Services agrees to reimburse BARRY LINDSTROM in consideration for the work and services performed under Child Welfare Regular Administration or Core Services Mental Health funding. Expenses incurred by BARRY LINDSTROM,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 Child Welfare Regular Administration or Core Services Mental Health funds,whether in whole or in part,is subject to and contingent upon the continuing availability of Child Welfare Regular Administration or Core Services Mental Health 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 Hourly rate of$140 Social Services referrals will not be sent to collections by BARRY LINDSTROM for default of co- pay/fees. Services will be performed regardless of client's refusal or inability to pay co-pay. BARRY LINDSTROM 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 BARRY LINDSTROM 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. 7 05-CORE-0035 EXHIBIT C ASSURANCES 1. BARRY LINDSTROM 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 BARRY LINDSTROM- contracted or his employees,volunteers, or agents while performing duties as described in this Agreement. BARRY LINDSTROM shall indemnify,defend,and hold harmless Weld County,the Board of County Commissioners of Weld County,its employees,volunteers, and agents. BARRY LINDSTROM 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,BARRY LINDSTROM 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. BARRY LINDSTROM 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. BARRY LINDSTROM 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 BARRY LINDSTROM. 9. All such records,documents,communications, and other materials shall be the property of Social Services and shall be maintained by BARRY LINDSTROM,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 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 fmdings have not been resolved after a four(4)year period,the materials shall be retained until the resolution of the audit finding. 8 05-CORE-0035 10. BARRY LINDSTROM 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. BARRY LINDSTROM or Social Services may not assign any of its rights or obligations hereunder without the prior written consent of both parties. 12. BARRY LINDSTROM certifies that federal appropriated funds have not been paid or will be paid,by or on behalf of BARRY LINDSTROM,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. BARRY LINDSTROM assures that it will fully comply with all other applicable federal and state laws. BARRY LINDSTROM understands that the source of funds to be used under this Contract is Child Welfare Regular Administration funds. 14. BARRY LINDSTROM 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 necescary 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,BARRY LINDSTROM 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,BARRY LINDSTROM 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 BARRY LINDSTROM. 9 05-CORE-0035 16. BARRY LINDSTROM 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 BARRY LINDSTROM shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with BARRY LINDSTROM written policies governing access to,duplication and dissemination of, all such information. BARRY LINDSTROM shall advise its employees, agents,and subcontractor,if any,that they are subject to these confidentiality requirements. BARRY LINDSTROM 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 BARRY LINDSTROM in the course of providing services under this Contract will be accorded at least the same precautions as are employed by BARRY LINDSTROM for similar information in the course of its own business. 10 eelb 05-CORE-0034 'Oft /12rn CHILD PROTECTION AGREEMENT FOR SERVICES / BETWEEN THE WELD COUNTY DEPARTMENT OF SOCIAL SERVICES AND GREELEY COUNSELING CENTER,P.C. This Agreement,made and entered into the day of May 2004,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 GREELEY COUNSELING CENTER,P.C. 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 Child Welfare Regular Administration funding and Core Services Mental Health funding to Social Services for mental health evaluations and therapy; and NOW THEREFORE, in consideration of the premises,the parties hereto covenant and agree as follows: 1. Term Fe cct— This Agreement shall become effective on Imte 1,2004 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 GREELEY COUNSELING CENTER,P.C.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,"of which are attached hereto and incorporated herein by reference. "Payment Schedule"shall establish the maximum reimbursement,which will be paid from Child Welfare Regular Administration funds during the duration of this Agreement. b. GREELEY COUNSELING CENTER,P.C. 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. GREELEY COUNSELING CENTER, P.C. shall submit all itemized monthly billings to Social Services no later than the twenty-fifth(25) day of the month following the month the service was completed. c. Payments of costs incurred pursuant to this Agreement is expressly contingent upon the availability of Child Welfare Regular Administration and Core Service Mental Health funds to Social Services. d. Social Services shall not be billed for,and reimbursement shall not be made for time involved in 1 &CL' y-i5-!l • 05-CORE-0034 activities outside of those defined in Exhibit A. 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,GREELEY COUNSELING CENTER,P.C. 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 Child Welfare Regular Administration funding 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. GREELEY COUNSELING CENTER,P.C.shall provide proper monthly invoices and itemization of services performed for costs incurred in the performance of the agreement. b. Social Services may withhold any payment if GREELEY COUNSELING CENTER,P.C.has failed to comply with the Financial Management Requirements,program objectives, contractual terms, or reporting requirements. In the event of a forfeiture of reimbursements,GREELEY COUNSELING CENTER,P.C. may appeal such circumstance to the Director of Social Services. The decision of the Director of Social Services shall be final. 6. Assurances GREELEY COUNSELING CENTER,P.C.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 I aws At all times during the performance of this contract,GREELEY COUNSELING CENTER,P.C. 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.GREELEY COUNSELING CENTER,P.C 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, 2 05-CORE-0034 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, GREELEY COUNSELING CENTER,P.C. 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 GREELEY COUNSELING CENTER,P.C. 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. &hmnitoring and Evaluation GREELEY COUNSELING CENTER,P.C. and Social Services agree that monitoring and evaluation of the performance of this Agreement shall be conducted by GREELEY COUNSELING CENTER,P.C. and Social Services. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners and GREELEY COUNSELING CENTER,P.C.. GREELEY COUNSELING CENTER,P.C. shall permit Social Services, and any other duly authorized agent or governmental agency, to monitor all activities conducted by GREELEY COUNSELING CENTER, P.C.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. 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 find GREELEY COUNSELING CENTER,P.C. 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 GREELEY COUNSELING CENTER,P.C.. These remedial actions are as follows: a. Withhold payment to GREELEY COUNSELING CENTER,P.C.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 GREELEY COUNSELING CENTER,P.C. 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; 3 05-CORE-0034 c. Incorrect payment to GREELEY COUNSELING CENTER,P.C. due to omission,error,fraud, and/or defalcation shall be recovered from GREELEY COUNSELING CENTER,P.C.by deduction from subsequent payments under this Agreement or other agreements between Social Services and GREELEY COUNSELING CENTER,P.C.,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 GREELEY COUNSELING CENTER,P.C.: Turk Gardner,Psy Tl Mental Health Provider 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: To: Social Services To: GREELEY COUNSELING CENTER,P.C. Judy A Grief Director 1278 8th Street P O Box A rapplPy, rn Rout[ Greeley,CO 80617 14. litigation GREELEY COUNSELING CENTER,P.C. shall promptly notify Social Services in the event that GREELEY COUNSELING CENTER,P.C. learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement. GREELEY COUNSELING CENTER,P.C., 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. GREELEY COUNSELING CENTER,P.C.reserves the right to suspend services to clients if finding is no longer available. 16. Fntire 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. 4 • 05-CORE-0034 IN WITNESS WHEREOF,the parties hereto have duly executed the Agreement as of the day,month,and year first above written. A • �. I� (J.,� A ELD C UNTY BOARD OF COUNTY �° °�t• LERK TO THE BOARD COMMISSIONERS WELD • COUNTY, OLORADO �( 1861 z. By: �+ Robert D.Malden,Chair O ;+4 p�� __ JUN 0 7 2004 �I`. •►'O • MENTAL HEALTH PROVIDER t'•� t County Atto 'ey J'dfk Gar r,Psy..D. WELD COUNTY DEPARTMENT OF SOCIAL SERVICES By: Dir c or 5 axe, y-/SE 05-CORE-0034 EXHIBIT A SCOPE OF SERVICES Upon receiving a written referral from the Department,the following services can be preformed. Psychological Evaluation report one party and additional parties Interactional Evaluation report at the Department or home visits Individual Therapy per hour Court preparation and testimony Consultation Individual and Family Therapy Court Facilitation,Mediation,or Staffing No Shows(Client Terminated after three no shows) 6 05-CORE-0034 EXHIBIT B PAYMENT SCHEDULE 1. Funding and Method of Payment Social Services agrees to reimburse GREELEY COUNSELING CENTER,P.C. in consideration for the work and services performed under Child Welfare Regular Administration or Core Services Mental Health funding. Expenses incurred by GREELEY COUNSELING CENTER,P.C.,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 Child Welfare Regular Administration or Core Services Mental Health funds,whether in whole or in part, is subject to and contingent upon the continuing availability of Child Welfare Regular Administration or Core Services Mental Health 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 Psychological Evaluation for one party$1000 Additional parties$800/ea Interactional Evaluations at the Department or Home Visit$100/hr Court preparation and testimony$130/hr Individual and Family Therapy$100/hr Court Facilitation,Mediation,or Staffing$100/hr No shows(client terminated after three no shows)$50/hr Consultation$100/hr Social Services referrals will not be sent to collections by GREELEY COUNSELING CENTER,P.C. for default of co-pay/fees. Services will be performed regardless of client's refusal or inability to pay co-pay. GREELEY COUNSELING CENTER,P.C.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 GREELEY COUNSELING CENTER,P.C. 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. 7 05-CORE-0034 EXHIBIT C ASSURANCES 1. GREELEY COUNSELING CENTER,P.C. 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 GREELEY COUNSELING CENTER,P.C. or its employees,volunteers,or agents while performing duties as described in this Agreement. GREELEY COUNSELING CENTER,P.C. shall indemnify,defend, and hold harmless Weld County,the Board of County Commissioners of Weld County,its employees,volunteers,and agents. GREELEY COUNSELING CENTER,P.C. 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,GREELEY COUNSELING CENTER,P.C. 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. GREELEY COUNSELING CENTER,P.C. 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. GREELEY COUNSELING CENTER,P.C. 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 GREELEY COUNSELING CENTER,P.C.. 9. All such records,documents, communications,and other materials shall be the property of Social Services and shall be maintained by GREELEY COUNSELING CENTER,P.C.,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 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. 8 05-CORE-0034 10. GREELEY COUNSELING CENTER,P.C. 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. GREELEY COUNSELING CENTER,P.C. or Social Services may not assign any of its rights or obligations hereunder without the prior written consent of both parties. 12. GREELEY COUNSELING CENTER,P.C.certifies that federal appropriated funds have not been paid or will be paid,by or on behalf of GREELEY COUNSELING CENTER,P.C.,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. GREELEY COUNSELING CENTER,P.C. assures that it will fully comply with all other applicable federal and state laws. GREELEY COUNSELING CENTER,P.C.understands that the source of funds to be used under this Contract is Child Welfare Regular Administration funds. 14. GREELEY COUNSELING CENTER,P.C.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 relationships are in opposition.During the term of the Contract,GREELEY COUNSELING CENTER,P.C. 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,GREELEY COUNSELING CENTER, P.C. 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 9 05-CORE-0034 GREELEY COUNSELING CENTER,P.C. 16. GREELEY COUNSELING CENTER,P.C. 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 GREELEY COUNSELING CENTER,P.C. shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with GREELEY COUNSELING CENTER,P.C.written policies governing access to,duplication and dissemination of, all such information. GREELEY COUNSELING CENTER,P.C. shall advise its employees, agents,and subcontractor,if any,that they are subject to these confidentiality requirements. GREELEY COUNSELING CENTER,P.C. 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 GREELEY COUNSELING CENTER,P.C.in the course of providing services under this Contract will be accorded at least the same precautions as are employed by GREELEY COUNSELING CENTER,P.C. for similar information in the course of its own business. 10 05-CORE-0036 CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF SOCIAL SERVICES AND VICTOR CORDERO This Agreement,made and entered into the day of May 2004,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 VICTOR CORDERO. 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 Child Welfare Regular Administration funding and Core Services Mental Health funding to Social Services for mental health evaluations and therapy;and NOW THEREFORE,in consideration of the premises,the parties hereto covenant and agree as follows: 1. Tr® regj . This Agreement shall become effective on June 1,2004 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 VICTOR CORDERO 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,"of which are attached hereto and incorporated herein by reference. "Payment Schedule"shall establish the maximum reimbursement,which will be paid from Child Welfare Regular Administration funds during the duration of this Agreement. b. VICTOR CORDERO 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. VICTOR CORDERO shall submit all itemized monthly billings to Social Services no later than the twenty-fifth(25)day of the month following the month the service was completed. c. Payments of costs incurred pursuant to this Agreement is expressly contingent upon the availability of Child Welfare Regular Administration and Core Service Mental Health 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 execution of this Contract shall not be reimbursed or considered part of this Agreement. 1 dace,5/-✓soe 05-CORE-0036 4. Financial Management At all times from the effective date of this Contract until completion of this Contract,VICTOR CORDERO 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 Child Welfare Regular Administration funding 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. VICTOR CORDERO shall provide proper monthly invoices and itemization of services performed for costs incurred in the performance of the agreement. b. Social Services may withhold any payment if VICTOR CORDERO has failed to comply with the Financial Management Requirements,program objectives, contractual terms, or reporting requirements. In the event of a forfeiture of reimbursements,VICTOR CORDERO may appeal such circumstance to the Director of Social Services. The decision of the Director of Social Services shall be final. 6. Assurances VICTOR CORDERO 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,VICTOR CORDERO 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. VICTOR CORDERO 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 eL 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,VICTOR CORDERO and Social Services will resist in judicial proceedings any efforts 2 05-CORE-0036 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 VICTOR CORDERO 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 VICTOR CORDERO and Social Services agree that monitoring and evaluation of the performance of this Agreement shall be conducted by VICTOR CORDERO and Social Services. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners and VICTOR CORDERO. VICTOR CORDERO shall permit Social Services, and any other duly authorized agent or governmental agency,to monitor all activities conducted by VICTOR CORDERO 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. 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 find VICTOR CORDERO 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 VICTOR CORDERO. These remedial actions are as follows: a. Withhold payment to VICTOR CORDERO 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 VICTOR CORDERO 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; c. Incorrect payment to VICTOR CORDERO due to omission,error,fraud,and/or defalcation shall be recovered from VICTOR CORDERO by deduction from subsequent payments under this Agreement or other agreements between Social Services and VICTOR CORDERO,or by Social Services as a debt due to Social Services or otherwise as provided by law. 3 • 05-CORE-0036 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 Snrial Services Administrator Name Title For VICTOR CORDERO: Victor Cordern Mental Health Provider 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: To: Social Services To: VICTOR CORDERO Judy A Griego Director 2R7R Speer Blvd,unit 11R P O Box A Danvcr,M Rmt t Greeley,CO R0637 14. J itigation VICTOR CORDERO shall promptly notify Social Services in the event that VICTOR CORDERO learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement. VICTOR CORDERO,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 maybe terminated at any time by either party given thirty(30)days written notice and is subject to the availability of funding. VICTOR CORDERO reserves the right to suspend services to clients if funding is no longer available. 16. Fntire 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. 4 05-CORE-0036 IN WITNESS WHEREOF,the parties hereto have duly executed the Agreement as of the day,month,and year fust above written. �o �� I,!'tri, ®� !l I_ 4 COUNTY BOARD OF COUNTY { " .iNe" TO THE BOARD COMMISSIONERS WELD 1161 ..,. ._. // l y COUNTY,COLORADO� p �� t i•' ` ,Gi✓f/ 7 tt By: 1 ji &. it pr Clerk %- Robert D.Masden,Chair JUN 0 ? 2004 vviSara %44. ; AS TO F • MENTAL E TH PROVCt --1-1 _ BY _ �� LA r�iey CTOR CORDERO WELD COUNTY DEPARTMENT OF SOCIAL SERVICES By: ctor 5 *)ccn V/-/5 05-CORE-0036 EXHIBIT A SCOPE OF SERVICES Upon receiving a written referral from the Department,the following services can be preformed. Mental Health Evaluation includes the following: Clinical Interview Mental Status Examination Can include a Measure of Personality Testing Can include a Projective Test and/or 1-2 Behaviorally Anchored Not an extensive psychosocial history History more specific to the presenting problem or to mental health related issues only Psychological Evaluations include the following: Extended Clinical Interview Mental Status Examination Multiple Personality Assessment Tools Administered Various Additional mood/coping,adaptation, Screening Instruments Projective Assessment Tools Administered Miscellaneous Psychological/Behavioral Assessment Tools Administered Extended Psychosocial History Interview Extended Collateral Reports Review and Contacts made/attempted Interactional Evaluations Assess a wide range of paret-child dynamics,parent-child interactions,child response, integration of parenting instruction or any other relevant referral question which falls in th realm of parent-child relationships. Individual Therapy per hour 6 05-CORE-0036 EXHIBIT B PAYMENT SCHEDULE 1. Funding and Method of Payment Social Services agrees to reimburse VICTOR CORDERO in consideration for the work and services performed under Child Welfare Regular Administration or Core Services Mental Health funding. Expenses incurred by VICTOR CORDERO, 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 Child Welfare Regular Administration or Core Services Mental Health funds,whether in whole or in part, is subject to and contingent upon the continuing availability of Child Welfare Regular Administration or Core Services Mental Health 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 Mental Health Evaluation$550 Psychological Evaluation$725 Psychological Evaluation w/IQ or Intellectual/cognitive testing$850 Interactional Evaluations$800-$1200 Individual Therapy$70-$85/Clinical Hour Social Services referrals will nut be sent to collections by VICTOR CORDERO for default of co-pay/fees. Services will be performed regardless of client's refusal or inability to pay co-pay. VICTOR CORDERO 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 VICTOR CORDERO 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. 7 05-CORE-0036 EXHIBIT C ASSURANCES VICTOR CORDERO 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 VICTOR CORDERO- contracted or his employees,volunteers,or agents while performing duties as described in this Agreement. VICTOR CORDERO shall indemnify,defend, and hold harmless Weld County,the Board of County Commissioners of Weld County, its employees,volunteers,and agents. VICTOR CORDERO 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,VICTOR CORDERO 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. VICTOR CORDERO 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. VICTOR CORDERO 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 VICTOR CORDERO. 9. All such records,documents,communications,and other materials shall be the property of Social Services and shall be maintained by VICTOR CORDERO, 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 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 fmding. 8 05-CORE-0036 10. VICTOR CORDERO 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. VICTOR CORDERO or Social Services may not assign any of its rights or obligations hereunder without the prior written consent of both parties. 12. VICTOR CORDERO certifies that federal appropriated funds have not been paid or will be paid,by or on behalf of VICTOR CORDERO,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. VICTOR CORDERO assures that it will fully comply with all other applicable federal and state laws. VICTOR CORDERO understands that the source of funds to be used under this Contract is Child Welfare Regular Administration funds. 14. VICTOR CORDERO 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 relationships are in opposition.During the term of the Contract,VICTOR CORDERO 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,VICTOR CORDERO 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 VICTOR CORDERO. 9 • 05-CORE-0036 16. VICTOR CORDERO 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 VICTOR CORDERO shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with VICTOR CORDERO written policies governing access to, duplication and dissemination of, all such information. VICTOR CORDERO shall advise its employees,agents, and subcontractor, if any,that they are subject to these confidentiality requirements. VICTOR CORDERO 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 VICTOR CORDERO in the course of providing services under this Contract will be accorded at least the same precautions as are employed by VICTOR CORDERO for similar information in the course of its own business. 10 Hello