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Home My WebLink About20221916.tiffCar�Ivacfit1Asvc3 I BOARD OF COUNTY COMMISSIONERS PASS -AROUND REVIEW PASS -AROUND TITLE: Professional Services Agreement Amendments for Core/Non-Core Contracted Services Bid # B22000040 DEPARTMENT: Human Services DATE: April 2, 2024 PERSON REQUESTING: Jamie Ulrich, Director, Human Services Brief description of the problem/issue: The Department entered into Agreements with various Child Welfare Service Providers through Request for Proposal (RFP) Bid #B2200040, identified as Tyler ID 2022-0410. These Agreements were issued for a period of three (3) years with the option to renew annually. The Department is now requesting to renew the current agreements for eight (8) of these providers with minor changes. The attached list indicates the minor changes in red for each provider. The Human Services Advisory Commission (HSAC) has reviewed and approved this information. What options exist for the Board? Approval of the eight (8) Child Welfare Core/Non-Core Services Agreement Amendments. Deny approval of the eight (8) Child Welfare Core/Non-Core Services Agreement Amendments. Consequences: Child Welfare Core/Non-Core Service Agreement Amendments will not be executed. Impacts: Weld County clients will not continue to receive needed services. Costs (Current Fiscal Year / Ongoing or Subsequent Fiscal Years): Total Cost = Various depending on services provided. Funded through Child Welfare Core/Non-Core Service funding. Pass -Around Memorandum; April 2, 2024 - CMS ID Varies Az) C de- 5 /22/ 24 2oZ2- Iii l� Recommendation: • Approval of the Agreement Amendments and authorize the Chair to sign. Support Recommendation Schedule Place on BOCC Agenda Work Session Other/Comments: Perry L. Buck, Pro-Tem Mike Freeman Scott K. James Kevin D. Ross, Chair Lori Saine fp Vitt, JAW, Pass -Around Memorandum; April 2, 2024 - CMS ID Various Karla Ford From: Sent: To: Subject: yes Lori Saine Weld County Commissioner, District 3 1150 O Street PO Box 758 Greeley CO 80632 Phone: 970-400-4205 Fax: 970-336-7233 Email: Isaine@weldgov.com Website: www.co.weld.co.us In God We Trust Lori Saine Tuesday, April 2, 2024 2:06 PM Karla Ford RE: 9 Please Reply - PA FOR ROUTING: Core/Non Core 2022-23 Minor Changes (CMS Various) Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. From: Karla Ford <kford@weld.gov> @we ld.gov> Sent: Tuesday, April 2, 2024 1:26 PM To: Lori Saine <Isaine@weld.gov> Subject: 9 - Please Reply - PA FOR ROUTING: Core/Non-Core 2022-23 Minor Changes (CMS Various) Importance: High Please advise tf you support recommendation and to have department place on the agenda. Karla Ford 1 Minor Core Bid Services Changes Year 2022-23 for 2024-25 Providers Centers, Inc Griffith Pir' Program Area 111"- - Service Name _ . Rate ....0. Unit Type Other Day Treatment Day Treatment $ 1,648.00 Month Address Change Day Treatment Mileage: Day Treatment $ 300.00 Month Address Change Home -Based Services Family Community Preservation: In -Home or $ 120.00 Hour Address Change Home -Based Services Family Preservation: In-Office/Video $ 105.00 Hour Address Change Life Skills Life Skills: Mileage �� 0.65 Mile Address Change Life Skills Life Skills: No Show $ 55.00 Each Address Change Mental Health Services Mental Professional Health Services: Staffing FTM, TDM, $ 75.00 Hour Address Change Mental Health Services Mental Health Services: No Show $ 55.00 Each Address Change Mentoring Mentoring: Mileage $ 0.65 Mile Address Change Mentoring Mentoring: No Show $ 55.00 Each Address Change Life Skills Parenting Community Skills: In -Home or S 105.00 Hour Address Change Life Skills Parenting Skills: with Transportation $ 110.00 Hour Address Change Life Skills Parenting Skills: In-Office/Video $ 90.00 Hour Address Change Life Skills Supervised Community Visitation: In -Home or $ 110.00 Hour Address Change Life Skills Supervised Transportation Visitation: with $ 115.00 Hour Address Change Program Area Service Name Rate Unit Type Other Life Skills Supervised Visitation: In-Office/Video $ 100.00 Hour Address Change Life Skills Therapeutic Community Visitation: In -Home or $ 120.00 Hour Address Change Life Skills Therapeutic Transportation Visitation: with $ 125.00 Hour Address Change Life Skills Therapeutic Office/Video Visitation: In - $ 105.00 Hour Address Change Mental Health Services Family Community Therapy: In -Home or $ 130.00 Hour Address Change Mental Health Services Family Therapy: In-Office/Video $ 125.00 Hour Address Change Mental Health Services Group In -Home Therapy: or Community In-Office/Video AND $ 45.00 Hour Address Change Mental Health Services Individual Community Therapy: In -Home 4 or $ 130.00 Hour Address Change Mental Health Services Individual Therapy: In-Office/Video $ 125.00 Hour Address Change Home -Based Services Family Professional Preservation: Staffing FTM, TDM, $ 75.00 Hour Address Change Home -Based Services Family Preservation: Mileage $ 0.65 Mile Address Change Mental Health Services Mental Health Services: Mileage � 0.65 Mile Address Change Mental Health Services Therapeutic Community Intake: In -Home or $ 100.00 Hour Address Change Mental Health Services Therapeutic Intake: In-Office/Video $ 90.00 Hour Address Change Mentoring Home Mentoring/Behavior or Community Coaching: In- $ 93.00 Hour Address Change Mentoring Mentoring/Behavior Transportation Coaching: with $ 103.00 Hour Address Change Mentoring Mentoring/Behavior Office/Video Coaching: In- $ 88.00 Hour Address Change Mentoring Mentoring: Staffing FTM, TDM, Professional $ 75.00 Hour Address Change Home -Based Services Family Preservation: No Show $ 55.00 Each Address Change Program Area Service Name Rate Unit Type Other Life Skills Life Staffing Skills: FTM, TDM, Professional $ 75.00 Hour Address Change Foster Support Care/Adoption Foster Professional Parent Staffing Education: FTM, TDM, $ 35.00 Hour Address Change Foster Support Care/Adoption Foster Community Parent Education: In -Home or $ 92.00 Hour Address Change Foster Support Care/Adoption Foster office/Video Parent Education: In - 64.00 Hour Address Change Foster Support Care/Adoption Foster Parent Education: No Show S 30.00 Each Address Change Foster Support Care/Adoption Relinquishment TDM, Professional Counseling: Staffing FTM, $ 75.00 Hour Address Change Foster Support Care/Adoption Relinquishment or Community Counseling: In -Home $ 130.00 Hour Address Change Foster Support Care/Adoption Relinquishment Office/Video Counseling: In - $ 125.00 Hour Address Change Foster Support Care/Adoption Relinquishment Counseling: Mileage $ 0.65 Mile Address Change Foster Support Care/Adoption Relinquishment Counseling: No -Show $ 55.00 Each Address Change Lutheran Family Services Rocky Mountains Program Area Service Name Rate Unit Type Other Life Skills Supervised Community Family Time: In -Home or $ 101.00 Hour Name Change Life Skills Supervised Office/Video Family Time: In - $ 90.00 Hour Name Change Life Skills Therapeutic Office/Video Family Time: In - $ 101.00 Hour Name Change Life Skills (Therapeutic Therapeutic Community) Homebased Visitation: Services In -Home or $ 140.00 Hour Name Change Maple Star Colorado Program Area Service Name Rate Unit Type Other Home -Based Services Aftercare Engagement Support Team Services (ASSET) and $ 2,300.00 Month Name Address Change Change & Program Area Service Name Rate Unit Type Other Home -Based Services Stabilizing (STAY): At Teens Risk and Youth in Home $ 1,300.00 Month Name Address Change Change & Home -Based Services Stabilizing (STAY): High Teens Risk and Youth in Home $ 2,600.00 Month Name Address Change Change & Home -Based Services Stabilizing (STAY): Imminent and Risk Youth in Home $ 4,000.00 Month Name Address Change Change & Teens Life Skills Life Staffing Skills: FTM, TDM, Professional $ 93.00 Hour Name Address Change Change & Life Skills Life Skills: Mileage `; 0.65 Mile Name Address Change Change Life Skills Life Skills: No Show 3 65.00 Each Name Address Change Change & Life Skills RAPT Training or Community - Resilient, (Parent Attuned Coaching): Parent In -Home $ 105.00 Hour Name Address Change Change & Life Skills RAPT Training Office/Video - Resilient, (Parent Attuned Coaching): Parent In- $ 89.00 Hour Name Address Change Change & Life Skills Supervised Community Family AND with Time: Transportation In -Home or $ 120.00 Hour Name Address Change Change & Life Skills Supervised Office/Video Family Time: In- 89.00 Hour Name Address Change Change & Life Skills Therapeutic Community AND Family with Time: Transportation In -Home or $ 168.00 Hour Name Address Change Change & Life Skills Therapeutic Office/Video Family Time: In- $ 118.00 Hour Name Address Change Change & Mental Health Services Mental Office/Video Community Health AND Services: In -Home In- or $ 130.00 Hour Name Address Change Change & Mental Health Services Mental Health Services: No Show $ 65.00 Each Name Address Change Change & Mental Health Services Mental Professional Health: Staffing FTM, TDM, $ 93.00 Hour Name Address Change Change & Mental Health Services Mental Health Services: Mileage $ 0.65 Mile Name Address Change Change & Martinez, dba Assurance Therapeutic TM Tim Program Area Service Name Rate Unit Type Other Sex Abuse Treatment Offense with Abel Specific Assessment Juvenile Evaluation $ 1,200.00 Episode Program Area Service Name Rate Unit Type Other Sex Abuse Treatment i Offense i Without Specific Abel Juvenile Assessment Evaluation $ 1,000.00 Episode Sex Abuse Treatment Therapy Offense Specific Treatment: Family 100.00 Hour Rate Change Sex Abuse Treatment Offense Therapy Specific Treatment: Individual $ 100.00 Hour Rate Change Sex Abuse Treatment Sex Professional Abuse Treatment: Staffing FTM, —DM, $ 75.00 Hour Sex Abuse Treatment Sex Abuse Treatment: Mileage $ 0.33 Mile Northern Colorado Youth for Christ dba Rebalance Program Area �- Service Name Rat Unit Type Other Mental Health Services Rebalance $ 45.00 Hour Mental Health Services Rebalance: No Show $ 20.00 Each Mentoring Mentoring S 80.00 Hour Rate Change David Kalis, Inc. dba Parker Personal Care Homes Program Area Service Name Rate Unit Type Other Foster Support Care/Adoption Foster Masters: Staffing Care/Adoption FTM, TDM, Support Professional - 200.00 Hour Rate Change Foster Support Care/Adoption Foster Masters: Care/Adoption No Show Support - $ 150.00 Each Rate Change Foster Support Care/Adoption Foster Mileage Care/Adoption Support: $ 0.50 Mile Foster Support Care/Adoption In-Office/Video Foster Community Parent Consultation AND In -Home - Masters: or 5 200.00 Hour Rate Change Foster Support Care/Adoption Foster Office/Video Community Parent Training AND In -Home - Masters: or In - _ 200.00 Hour Rate Change Home -Based Services In Aftercare Masters -Home Therapy Level: or Community & In-Office/Video Consultation AND - S 200.00 Hour Rate Change Home -Based Services In-Office/Video Home Community Based Intervention AND In -Home - Masters: or $ 200.00 Hour Rate Change Home -Based Services Home FTM, TDM, Based Professional Intervention Staffing - Masters: $ 200.00 Hour Rate Change Program Area Service Name Rate Unit Type Other Home -Based Services Home No Show Based Intervention - Masters: $ 150.00 Each Rate Change Home -Based Services Home -Based Services: Mileage $ 0.50 Mile Life Skills Life Professional Skills - Masters: Staffing FTM, TDM, S 200.00 Hour Rate Change Life Skills Life Skills - Masters: No Show $ 150.00 Each Rate Change Life Skills Life Skills: Mileage $ 0.50 Mile Life Skills Parent Office/Video Community Coaching AND - Masters: In -Home In- or $ 200.00 Hour Rate Change Life Skills Supervised Office/Video Community Family AND In Time -Home - Masters: or In- $ 200.00 Hour Rate Change Life Skills Therapeutic In-Office/Video Community Family AND Time In -Home - Masters: or $ 200.00 Hour Rate Change Mental Health Services Consultation Office/Video Community - AND Masters: In -Home In- or $ 200.00 Hour Rate Change Mental Health Services Consultation AND In -Home - or PhD: Community In-Office/Video $ 250.00 Hour Rate Change Mental Health Services Counseling/Psychotherapy FTM, TDM, Professional Staffing - Masters: $ 200.00 Hour Rate Change Mental Health Services Counseling/Psychotherapy In-Office/Video Community AND In -Home -Masters: or $ 200.00 Hour Rate Change Mental Health Services Counseling/Psychotherapy Office/Video Community AND In -Home -PhD: or In- $ 250.00 Hour Rate Change Mental Health Services Evaluation & Assessment: No Show $ 500.00 Each Rate Change Mental Health Services Functional in-Office/Video Community Family AND Therapy In -Home - Masters: or $ 200.00 Hour Rate Change Mental Health Services Functional Office/Video Community Family AND Therapy In -Home - or PhD: In- S 250.00 Hour Rate Change Mental Health Services Mental FTM, TDM, Health Professional Services - Masters: Staffing $ 200.00 Hour Rate Change Program Area Service Name Rate Unit Type Other Mental Health Services Mental Show Health Services - Masters: No $ 150.00 Each Rate Change Mental Health Services Mental TDM, Professional Health Services Staffing - PhD: FTM, $ 250.00 Hour Rate Change Mental Health Services Mental Show Health Services - PhD: No $ 250.00 Each Rate Change Mental Health Services Mental Health Services: Mileage $ 0.50 Mile Mental Health Services Multisystemic Office/Video Community AND Therapy In -Home - Masters: or In- $ 200.00 Hour Rate Change Mental Health Services Parent In-Office/Video Community -Child Interactional AND In -Home Evaluation: or $ 500.00 Hour Rate Change Mental Health Services Psychological Office/Video Community Evaluation: AND In -Home In- or $ 500.00 Hour Rate Change Mental Health Services Trauma AND In -Home Assessment: or Community In-Office/Video $ 500.00 Hour Rate Change N/A Anger Prevention AND In Management -Home - Masters: or Community Treatment/DV In-Office/Video $ 200.00 Hour Rate Change N/A Child FTM, Welfare TDM, Professional Block funded Staffing - Masters: 200.00 Hour Rate Change N/A Child No Show Welfare Block Funded - Masters: $ 150.00 Each Rate Change N/A Child Welfare Block Funded: Mileage $ 0.50 Mile N/A Mediation AND In -Home - Masters: or In-Office/Video Community r 200.00 Hour Rate Change N/A In-Office/Video Relinquishment Community Counseling AND In -Home - Masters: or $ 200.00 Hour Rate Change Sex Abuse Treatment Psychosexual/Sex Evaluation - Masters: Offender In-Office/Video Specific $ 400.00 Hour Rate Change Sex Abuse Treatment Psychosexual/Sex Evaluation: PhD Offender Level testing Specific $ 500.00 Hour Rate Change Sex Abuse Treatment Sexual FTM, TDM, Abuse Professional Treatment - Staffing Masters: $ 200.00 Hour Rate Change Sex Abuse Treatment Sexual No Show Abuse Treatment - Masters: $ 150.00 Each Rate Change Program Area Service Name Rate Unit Type Other Sex Abuse Treatment Sexual Consultation Office/Video Community Abuse Treatment - AND Masters: In -Home Therapy In- or and $ 200.00 Hour Rate Change Sex Abuse Treatment Sexual Abuse Treatment: Mileage $ 0.50 Mile Substance Treatment Abuse Substance Masters: Home Community Abuse In-Office/Video Evaluation AND - In - $ 400.00 Hour Rate Change Substance Treatment Abuse Substance Level Testing Abuse Evaluation: PhD $ 500.00 hour Rate Change Substance Treatment Abuse Substance Masters: No Abuse Show Treatment - $ 150.00 Each Rate Change Substance Treatment Abuse Substance Consultation Office/Video Community Abuse - AND Masters: Treatment In -Home In - and or $ 200.00 Hour Rate Change Substance Treatment Abuse Substance FTM, TDM, Abuse Professional Treatment- Staffing Masters: $ 200.00 Hour Rate Change Substance Treatment Abuse Substance Abuse Treatment: Mileage $ 0.50 Mile Therapeutic Services Kinship Therapeutic Masters: Staffing FTM, Kinship TDM, Services Professional $ 200.00 Hour Rate Change Therapeutic Services Kinship Therapeutic Masters: Home In-Office/Video or Community Kinship Services AND - In - 5 200.00 Hour Rate Change Therapeutic Services Kinship Therapeutic Masters: No Kinship Show Services - $ 150.00 Each Rate Change Therapeutic Services Kinship Therapeutic Kinship Services: Mileage $ 0.50 Mile Shiloh Home Program Area Service Name Rate Unit Type Other Day Treatment Day Treatment $ 2,125.00 Month Day Treatment Evening Reporting Center $ 98.50 Day Foster Support Care/Adoption Foster Mileage Care/Adoption Support: $ 0.59 Mile Foster Support Care/Adoption Foster FTM, TDM, Parent Professional Consultation Staffing Coaching: $ 80.00 Hour .., .�rArea � Service Name Rate Unit Type Other _ Foster Support Care/Adoption Foster In -Home Parent Consultation or Community Coaching: $ 80.00 Hour Foster Support Care/Adoption Foster In-Office/Video Parent Consultation Coaching: $ 65.00 Hour Foster Support Care/Adoption Foster No Show Parent Consultation Coaching: $ 60.00 Each Foster Support Care/Adoption Foster FTM, TDM, Parent Professional Consultation Staffing Therapy: $ 95.00 Hour Foster Support Care/Adoption Foster In -Home Parent or Community Consultation Therapy: $ 120.00 Hour Foster Support Care/Adoption Foster In-Office/Video Parent Consultation $ 95.00 Hour Therapy: Foster Support Care/Adoption Foster No Show Parent Consultation Therapy: $ 75.00 Each Foster Support Care/Adoption Foster with Transportation Parent Consultation Therapy: $ 120.00 Hour Home -Based Services Aftercare FTM, TDM, Individual/Family Prof Staffing Therapy: $ 85.00 Hour Home -Based Services Aftercare In -Home Transportation or Individual/Family Community AND Therapy: with $ 115.00 Hour Home -Based Services Aftercare In-Office/Video Individual/Family Therapy: $ 85.00 Hour Home -Based Services Aftercare No Show Individual/Family Therapy: $ 75.00 Each Home -Based Services Aftercare Based TDM, In Family Professional -Home Support and Staffing Community Services: FTM, $ 85.00 Hour Home -Based Services Aftercare Based Office/Video Family In -Home Support and Community Services: In - $ 85.00 Hour Home -Based Services Aftercare Based Show Family In -Home Support and Community Services: No $ 60.00 Each Home -Based Services Home -Based Services: Mileage $ 0.59 Mile Home -Based Services Rapid Staffing Response: FTM, TDM, prof. $ 95.00 Hour Home -Based Services Rapid Community Response: AND In -Home with Transportation or $ 140.00 Hour Home -Based Services Rapid Response: In-Office/Video $ 95.00 Hour Home -Based Services Rapid Response: No Show $ 75.00 Each Program Area Service Name Rate Unit Type Other Home -Based Services Youth FTM, Intervention TDM, Prof.Staffing Family Coaching: $ 65.00 Hour Home -Based Services Youth In -Home Transportation Intervention or Community Family AND Coaching: with $ 80.00 Hour Home -Based Services Youth In-Office/Video Intervention Family Coaching: $ 65.00 Hour Home -Based Services Youth No Show Intervention Family Coaching: $ 60.00 Each Home -Based Services Youth FTM, Interventions TDM, Prof.Staffing Therapy Services: $ 95.00 Hour Home -Based Services Youth In -Home Transportation Interventions or Community Therapy AND Services: with $ 125.00 Hour Home -Based Services Youth In-Office/Video Interventions Therapy Services: $ 95.00 Hour Home -Based Services Youth No Show Interventions Therapy Services: $ 75.00 Each Life Skills Beyond the Walls $ 1,115.00 Month Life Skills Comprehensive TDM, Prof.Staffing Parenting Time: FTM, $ 80.00 Hour Name Change Life Skills Comprehensive Home Transportation or Community Parenting AND Time: with In - $ 85.00 Hour Name Change Life Skills Comprehensive Office/Video Parenting Time: In - $ 80.00 Hour Name Change Life Skills Comprehensive Show Parenting Time: No $ 70.00 Each Name Change Life Skills Life Skills: FTM, TDM, Prof.Staffing $ 85.00 Hour Life Skills Life Skills: In -Home or Community $ 85.00 Hour Life Skills Life Skills: In-Office/Video $ 65.00 Hour Life Skills Life Skills: Mileage $ 0.59 Mile Life Skills Life Skills: No Show $ 60.00 Each Life Skills Parents as Teachers $ 600.00 Month Life Skills Therapeutic Prof.Staffing Family Time: FTM, TDM, $ 95.00 Hour Name Change Life Skills Therapeutic Community AND Family with Time: Transportation In -Home or $ 120.00 Hour Name Change Program Area Service Name Rate Unit Type Other Life Skills Therapeutic Office/Video Parenting Time: In - $ 95.00 Hour Name Change Life Skills Therapeutic Parenting Time: No Show $ 75.00 Each Name Change Mental Health Services Individual TDM, Prof.Staffing and Family Therapy: FTM, $ 95.00 Hour Mental Health Services Individual Home Transportation or and Community Family Therapy: AND with In - $ 120.00 Hour Mental Health Services Individual Office/Video and Family Therapy: In - $ 95.00 Hour Mental Health Services Individual Show and Family Therapy: No $ 75.00 Each Mental Health Services Mental Health Services: Mileage $ 0.59 Mile N/A FP & KP Training - 11 -hour class $ 1,760.00 Each N/A FP & KP Training - 3 -hour class $ 480.00 Each N/A FP Sexually Reactive & KP Training Abusive Youth - The and Truth Sexually about $ 480.00 Each Sex Abuse Treatment Community Youth Conduct Community with Coaching: Problematic Based AND with Treatment In -Home Transportation Sexual or for $ 130.00 Hour Sex Abuse Treatment Community Youth Conduct with Coaching: Problematic Based Treatment In-Office/'✓ideo Sexual for $ 95.00 Hour Sex Abuse Treatment Individual Home Transportation or and Community Family Treatment: AND with In - $ 130.00 Hour Sex Abuse Treatment Individual Office/Video and Family Treatment: In - $ 130.00 Hour Sex Abuse Treatment Informed Supervision $ 300.00 Each Sex Abuse Treatment Sex Abuse Professional Treatment: Staffing FTM, TDM, $ 95.00 Hour Sex Abuse Treatment Sex Abuse Treatment: Mileage $ 0.59 Mile Sex Abuse Treatment Sex Abuse Treatment: No Show $ 75.00 Each Transitions Psychology Group ,_ Program Area Service Name: Rate _ 0 Unit Type Other Foster Support Care/Adoption Foster Therapeutic TDM, Prof. Parent Staffing Consultation Kinship Services: and FTM, $ 140.00 Hour Foster Support Care/Adoption Foster Therapeutic or Transportation Community Parent Consultation Kinship AND Services: with and In Home $ 188.00 Hour Rate Change Foster Support Care/Adoption Foster Therapeutic Office/Video Parent Consultation Kinship Services: and In S 125.00 Hour Rate Change Foster Support Care/Adoption Foster Therapeutic Parent Consultation Kinship Services: and Mileage $ 0.58 Mile Foster Support Care/Adoption Foster Therapeutic Show Parent Consultation Kinship Services: and No $ 90.00 Each Life Skills In -Home In Transportation Home Family or Community Prevention AND Program: with $ 188.00 Hour Rate Change Life Skills In -Home In Office/Video Family Prevention Program: $ 125.00 Hour Rate Change Life Skills LIFE Staffing SKILLS: FTM, TDM, Professional $ 140.00 Hour Life Skills LIFE SKILLS: Mileage $ 0.58 Mile Life Skills LIFE SKILLS: No Show $ 90.00 Each Lite Skills Therapeutic Community Visitation: AND with Transportation In Home or $ 188.00 Hour Rate Change Life Skills Therapeutic Office/Video Visitation: In - $ 125.00 Hour Rate Change N/A Additional Adult $ 300.00 Each N/A Child TDM, Welfare Professional Block Staffing Funded: FTM, $ 140.00 Hour N/A Full Home Study $ 1,350.00 Episode N/A Home Studies: Mileage $ 0.58 Mile N/A Partial Home Study $ 300.00 Episode N/A Relinquishment or Community Counseling: In Home $ 180.00 Hour N/A Relinquishment Office/Video Counseling: In $ 140.00 Hour N/A Updated Home Study $ 700.00 Episode AGREEMENT AMENDMENT BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND PARKER PERSONAL CARE HOMES, INC., DBA DAVID KALIS This Agreement Amendment made and entered into ZZn day of 1 v 1a.4.42024 by and between the Board of Weld County Commissioners, on behalf of the Welci'County Department of Human Services, hereinafter referred to as the "Department", and Parker Personal Care Homes, Inc., dba David Kalis, hereinafter referred to as the "Contractor". WHEREAS the parties entered into an Agreement for Anger Management/Domestic Violence, Foster Care/Adoption Support, Foster Parent Training, Home -Based Intervention, Kinship Services (Therapeutic), Life Skills, Mediation, Mental Health Services, Relinquishment Counseling, Sex Abuse Treatment, and Substance Abuse Treatment, (the "Original Agreement") identified by the Weld County Clerk to the Board of County Commissioners as document No. 2022-1916, approved on July 6, 2022. WHEREAS the parties hereby agree to amend the term of the Original Agreement in accordance with the terms of the Original Agreement and any previously adopted amendment, which is incorporated by reference herein, as well as the terms provided herein. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: • The Original Agreement was set to end on May 31, 2023. • The Original Agreement was amended on: • May 3, 2023, to extend the term date through May 31, 2024. • This Amendment is identified by the Weld County Clerk to the Board of County Commissioners as document number 2022-1916. • This Amendment, together with the Original Agreement, constitutes the entire understanding between the parties. The following additional changes are hereby made to the current Agreement as of June 1, 2024: 1. Term This agreement is being renewed for the third and final year, for the period June 1, 2024 through May 31, 2025. 2. Exhibit A, Scope of Service, is hereby amended as attached. 3. Exhibit B, Rate Schedule, is hereby amended as attached. • All other terms and conditions of the Original Agreement remain unchanged. IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. COUNTY: J c-idt0;11 BOARD OF COUNTY COMMISSIONERS WELD COUNTY CQL. ADO evin D. Ross, Chair MAY 2 2 2024 arker Personal Care Homes, Inc., dba David Kalis P.O. Box 271168 Louisville, Colorado 80027 By: Tiffany Montano, Director of Behavioral Health Date: May 9, 2024 2.O2_2- Ict 16 SIGNATURE REQUESTED: Weld/Parker PC Amendment #2 Final Audit Report 2024-05-09 Created: 2024-05-08 By: Windy Luna (wluna@weld.gov) Status: Signed Transaction ID: CBJCHBCAABAAkVheAMf6zARVEbD89eVgL646UoEDSk "SIGNATURE REQUESTED: Weld/Parker PC Amendment #2" History 5 Document created by Windy Luna (wluna@weld.gov) 2024-05-08 - 10:45:49 PM GMT- IP address: 204.133.39.9 El. Document emailed to Tiffany Montano (tmontano@parkerpch.com) for signature 2024-05-08 - 10:46:22 PM GMT 5 Email viewed by Tiffany Montano (tmontano@parkerpch.com) 2024-05-09 - 8:51:16 PM GMT- IP address: 104.47.58.254 4, Document e -signed by Tiffany Montano (tmontano@parkerpch.com) Signature Date: 2024-05-09 - 8:52:08 PM GMT - Time Source: server- IP address: 76.155.43.245 O Agreement completed. 2024-05-09 - 8:52:08 PM GMT Powered by Adobe Acrobat Sign Contract Form Entity Information Entity Name* Entity ID* PARKER PERSONAL CARE HOMES @00042447 INC Contract Name * PARKER PERSONAL CARE HOMES INC (PROFESSIONAL SERVICES AGREEMENT AMENDMENT #2 RELATED TO BID #B2200040( Contract Status CTB REVIEW Contract ID 8189 Contract Lead * WLUNA Q New Entity? Parent Contract ID 20231916 Requires Board Approval YES Contract Lead Email Department Project # wluna@weldgov.com;cob bxxlk@weldgov.com Contract Description* (CONSENT) PARKER PERSONAL CARE HOMES INC PROFESSIONAL SERVICES AGREEMENT AMENDMENT #2 RELATED TO BID #B2200040. TERM: 06/01 /2024 THROUGH 05/31 /2025. Contract Description 2 PROVIDER WAS LISTED ON APPROVED VENDOR LIST PRESENTED TO THE BOCC ON 04/10/24. Contract Type* AMENDMENT Amount* $0.00 Renewable* NO Automatic Renewal Grant IGA Department Requested BOCC Agenda Due Date HUMAN SERVICES Date* 05/16/2024 05/20/2024 Department Email CM- HumanServices@weldgov. com Department Head Email CM-HumanServices- DeptHead@weldgov.com County Attorney GENERAL COUNTY ATTORNEY EMAIL County Attorney Email CM- COUNTYATTORNEY@WEL DGOV.COM Will a work session with BOCC be required?* NO Does Contract require Purchasing Dept. to be included? If this is a renewal enter previous Contract ID If this is part of a MSA enter MSA Contract ID Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in OnBase Contract Dates Effective Date Review Date* Renewal Date 03/31/2025 Termination Notice Period Contact Information Committed Delivery Date Expiration Date* 05/31/2025 Contact Info Contact Name Contact Type Contact Email Contact Phone 1 Contact Phone 2 Purchasing Purchasing Approver Purchasing Approved Date CONSENT 05/13/2024 Approval Process Department Head Finance Approver Legal Counsel JAMIE ULRICH CONSENT CONSENT DH Approved Date Finance Approved Date Legal Counsel Approved Date 05/13/2024 05/13/2024 05/13/2024 Final Approval BOCC Approved Tyler Ref* AG 052224 BOCC Signed Date Originator WLUNA BOCC Agenda Date 05/22/2024 Ctiliva&i D*(903 PRIVILEGED AND CONFIDENTIAL MEMORANDUM DATE: March 28, 2023 TO: Board of County Commissioners — Pass -Around FR: Jamie Ulrich, Director, Human Services RE: Child Protection Agreement Amendments for 2022-23 Core/Non-Core Contracted Services B2200040 Please review and indicate if you would like a work session prior to placing this item on the Board's agenda. Request Board Approval of the Department's Child Protection Agreement Amendments for 2022-23 Core/Non-Core Contracted Services 82200040. The Department entered into Agreements with various Child Welfare Service Providers through the 2022-23 Request for Proposal (RFP), Bid Number: B2200040, identified as Tyler ID 2022-0410. These Agreements were issued for a period of three (3) years with the option to renew annually. The Department is requesting to renew the current Agreements with no changes for thirty-one (31) Providers reflected in the attached list. Agreements will be renewed for the second year, for the period of June 1, 2023 through May 31, 2024. The Human Services Advisory Commission (HSAC) has reviewed and approved this information. Upon Board approval of this pass -around, signed Agreement Amendments will be obtained from Providers and submitted to the Board for approval and Chair signature. I do not recommend a Work Session. I recommend approval of these Agreement Amendments and authorize the Chair to sign. Approve Recommendation Perry L. Buck, Pro -Tern Mike Freeman, Chair Scott K. James Kevin D. Ross Lori Saine Schedule Work Session Other/Comments: Pass -Around Memorandum; March 28, 2023 — CMS ID Variou Page 1 eet 01,84421, ll‘.0) COn,0111- droL ,/(3 a3 ?biz-- i91 co 05/03/23 RRW14 PRIVILEGED AND CONFIDENTIAL CMS ID BID # r BID YEAR TYLER ID _.. -., B2200040 2022-23 I 2022-1543 Arief C nical Services Aver P 7ychological & Wellness Services B2200040 2022-23 1 2022-1476 Braes House B2200040 2022-23 2022-1537 Cer-i. dr . ilal BOCES B2200040 2022-23 2022-1471 Chril tia risen, David L B2200040 { 2022-23 2022-1467 DAY3 Denver Area Youth Services } B22000/10 2022-23 ' 2022-1539 f-- Ebbi 1g2aus, Krystal B2200040 2022-23 2022-1464 Fl ni i Counselin , LLC B2200040 2022-23 2022-1466 B2200040 2022-23 2022-1592 Garda =armily Guidance Inc. IDEA F )rum, Inc. B2200040 2022-23 2022-1813 lnspi =ed Pathways Counseling Services. LLC B2200040 2022-23 12022-1591 Inter'e ton, Inc. B2200040 2022-23 2022-1540 Jacoo Family Services, Inc. DBA The Jacob Center B2200040 2022-23 2022-1538 Lifes ar ce Health B2200040 2022-23 2022-2674 Lutheran, C�rni Family t� Services Services Rocky Rocky Mountains onnnnnnn 82200040 nn n n2022-1468 2022-23 B2200040 2022-23 2022-2398 Wart nFl, Tim DBA Assurance Therapeutic Services, LTD B2200040 2022-23 2022-1546 North Fange Behavioral Health _ _ Nortf ern Colorado Youth for Christ B2.200040 2022-23 2022-1470 Parker Personal Care Homes, Inc. oba David Kalis B2200040 2022-23 2022-1916 B2200040 2022-23 2022-1544 Perky Center for Psychotherapy B2200040 2022-23 2022-1541 Rourdt ibles Collaborations of Colorado (Rick Hartman) Sur u►jy Hs, Julie A. B2200040 2022-23 2022-1533 B2200040 2022-23 2022-1673 Smitt frgency B2200040 2022-23 2022-1596 Soec _ Coloiaco, al 7ed Inc. Alternatives (SAFY) for Families and Youth of Strorg =oundations, LLC fB2200040 _ 2022-23 2022-1597 SwlsimeL Nathan R2200040 I 2022-23 i 2022-1474 Tenn /son Center for Children B2200040 2022-23 2022-1593 Third Nay Center B2200040 2022-23 2022-1477 TranE iti&ns Psychology Group; LLC B2200040 2022-23 2022-1542 Turni Inc. ig Point Center for Youth and Family Development, B2200040 , 2022-23 - 2022-1475 1 _.i___UABrnC LLC __— _ L B2200040 2022-23 x2022-1728 Pass-Arourd : Aernorandum; March 28, 2023 — CMS ID Various Page 2 AGREEMENT AMENDMENT BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND PARKER PERSONAL CARE HOMES, INC. DBA DAVID KALIS This Agreement Amendment, made and entered into 24 O day of 2023 by and between the Board of Weld County Commissioners, on behalf of the Weld County epartment of Human Services, hereinafter referred to as the "Department", and Parker Personal Care Homes, Inc. dba David Kalis, hereinafter referred to as the "Contractor". WHEREAS the parties entered into an Agreement for Aftercare Services, Anger Management/Domestic Violence, Foster Parent Consultation, Foster Parent Training, Home -Based Intervention, Kinship Services (Therapeutic), Life Skills, Mediation, Mental Health Services, Relinquishment Counseling, Sexual Abuse Treatment, Substance Abuse Treatment, Functional Family Therapy, and Multisystemic Therapy, (the "Original Agreement") identified by the Weld County Clerk to the Board of County Commissioners as document No. 2022-1916, approved on July 6, 2022. WHEREAS the parties hereby agree to amend the term of the Original Agreement in accordance with the terms of the Original Agreement and any previously adopted amendment, which is incorporated by reference herein, as well as the terms provided herein. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: The Original Agreement will end on May 31, 2023. This Amendment, together with the Original Agreement, constitutes the entire understanding between the parties. The following additional changes are hereby made to the current Agreement: 1. Term This agreement is being renewed for the second year, for the period of June 1, 2023 through May 31, 2024. All other terms and conditions of the Original Agreement remain unchanged. IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. ATTEST: BY: Deputy Cler COUNTY: BOARD OF COUNTY COMMISSIONERS erk to the Board WELD COUNTY, COLORADO Mike Freeman, Chair MAY 0 3 2323 Parker Personal Care Homes, Inc., dba David Kalis P.O. Box 271168 Louisville, Colorado 80027 (303)482-7041 Kate Veeolei By: Kate Veeder (Apr 26, 2023 12:15 MDT) Kate Veeder, Clinical Director of Behavioral Health and Licensed Programs Date: 0,26,2°23 022.201— / 9/h' SIGNATURE REQUESTED: Weld/Parker Personal Care Home, Inc. dba David Kalis Amendment #1 2023-24 Final Audit Report 2023-04-26 Created: 2023-04-14 By: Windy Luna (wluna@co.weld.co.us) Status: Signed Transaction ID: CBJCHBCAABAAOzrE19GLcWIcdoOTNF1xwE3AdW_nTaYG "SIGNATURE REQUESTED: Weld/Parker Personal Care Home, Inc. dba David Kalis Amendment #1 2023-24" History n Document created by Windy Luna (wluna@co.weld.co.us) 2023-04-14 - 8:15:47 PM GMT 01 Document emailed to kveeder@parkerpch.com for signature 2023-04-14 - 8:17:38 PM GMT ,'n Email viewed by kveeder@parkerpch.com 2023-04-18 - 8:44:44 PM GMT t Email viewed by kveeder@parkerpch.com 2023-04-25 - 4:21:26 AM GMT 5 Email viewed by kveeder@parkerpch.com 2023-04-26 - 6:14:44 PM GMT O0, New document URL requested by kveeder@parkerpch.com 2023-04-26 - 6:14:49 PM GMT giS® Signer kveeder@parkerpch.com entered name at signing as Kate Veeder 2023-04-26 - 6:15:18 PM GMT 06 Document e -signed by Kate Veeder (kveeder@parkerpch.com) Signature Date: 2023-04-26 - 6:15:20 PM GMT - Time Source: server d Agreement completed. 2023-04-26 - 6:15:20 PM GMT Powered by Adobe Acrobat Sign Contract Form New Contract Request Entity Information Entity Name. Entity ID PARKER PERSONAL CARE HOMES INC 110042447 Contract Name. Contract ID PARKER PERSONAL CARE HOMES INC. (CHILD PROTECTION 6905 AGREEMENT AMENDMENT #1) Contract Status CTB REVIEW Contract Lead WLUNA ❑ New Entity? Parent Contract ID 20221916 Requires Board Approval YES Contract Lead Email Department Project wlunaOweldgov.com;cobbx xlk_tweldgov.com Contract Description. (CONSENT) PARKER PERSONAL CARE HOMES INC. CHILD PROTECTION AGREEMENT AMENDMENT 91. TERM: 06,01 a 2023 THROUGH 05.'31 12024. Contract Description 2 PROVIDER WAS LISTED ON APPROVED VENDOR LIST PRESENTED TO THE BOCC ON 03,29 2023 AND SENT AS A COMMUNICAITON ITEM SPA TO CTB ON 03/30,2023. Contract Type AGREEMENT Amount' $0.00 Renewable NO is Renewal Grant Department HUMAN SERVICES Department Email CM- HurnanServices@weldgov.co Department Head Email CM-HumanServices- De ptH e ad Owe I dgov. c o m County Attorney GENERAL COUNTY ATTORNEY EMAIL County Attorney Email CM- COUNTYATTORNEY NELDG OV.COM Requested BOCC Agenda Date. 05.'10,2023 Due Date 05106,`2023 Will a work session with BOCC be required?* NO Does Contract require Purchasing Dept. to be included? If this is a renewal enter previous Contract ID If this is part of a MSA enter MSA Contract ID Note_ the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in OnBase Contract Dates Effective Date Review Date* 03/29/2024 Renewal Date Termination Notice Period Contact Information Contact Info Contact Name Contact Type Purchasing Purchasing Approver Approval Process Department Head JAMIE ULRICH DH Approved Date 04,26,2023 Final Approval B0CC Approved B0CC Signed Date BO CC Agenda Date 05/03 ,-)_023 Originator WLUNA Committed Delivery Date Finance Approver CHERYL PATTELLI Expiration Date* 05/31/2024 it Contact Phone 1 Purchasing Approved Date Legal Counsel MATTHEW CONROY Contact Phone 2 Finance Approved Date Legal Counsel Approved Date 04,2712023 04/27,'2023 Tyler Ref I AG 050323 Con-h/a c+-1 iptkoo--73 CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND PARKER PERSONAL CARE HOMES, INC., DBA DAVID KALIS This Agreement, made and entered into the tday of V ikj ,f A , 2022, by and between the Board of Weld County Commissioners, on behalf of the Weld County Departmetqf Human Services, hereinafter referred to as the "Department" and Parker Personal Care Homes, Inc., dba David Kalis, hereinafter referred to as the "Contractor". The parties to this Agreement understand and agree that the provisions of this Agreement specifically include the following documents: Exhibit A, Scope of Services, Exhibit B, Rate Schedule, Exhibit C, Weld County's Request for Proposal, and Exhibit D, Contractor's Response to Request for Proposal. Exhibit A, B, and D are attached hereto and incorporated herein by this reference. Exhibit Cis Weld County's Request for Proposal Number B220040 which is incorporated into this agreement by reference and will be provided upon request to the Department. 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 Services or other funding to the Department for Aftercare Services, Anger Management/Domestic Violence, Foster Parent Consultation, Foster Parent Training, Home -Based Intervention, Kinship Services (Therapeutic), Life Skills, Mediation, Mental Health Services, Relinquishment Counseling, Sexual Abuse Treatment, Substance Abuse Treatment, Functional Family Therapy, and Multisystemic Therapy. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: 1. Term This agreement shall become effective on June 1, 2022, upon proper execution of this Agreement and shall expire May 31, 2023, unless sooner terminated as provided herein. This agreement may be renewed for 2 additional terms by written agreement of both parties. 2. Scope of Services Services shall be provided by the Contractor to any person(s) eligible for services in compliance with Exhibit A Scope of Services, and Exhibit D, Contractor's Response to Request for Proposal. 3. Referrals, Billing and Tracking a. Contractor understands and will comply with all aspects of the referral authorization, billing and tracking requirements as set forth by the Department. Failure to comply with all aspects may result in a forfeiture of payment. b. Contractor agrees to receive referrals for services through e-mail and will provide an identified e- mail address prior to the start of this Agreement. Contractor acknowledges that services are not authorized until the Contractor has received an authorized referral form from the Department. Contractor further acknowledges that services provided prior to the authorized start date or outside the scope of services on the referral form will not be eligible for reimbursement. Contractor acknowledges that any and all modifications to an existing referral must be approved through the Quality Assurance Team (HS-CWOualitvAssurance(auweldgov.com). No other Department staff or other party to the case may authorize services or modifications to services. CO WI+ rt9a1Ct ��. C)4,66461-1)) 2022-1916 ()WO (0/ ZZ � 0-12009 LI. c. Contractor agrees to submit a complete Request for Reimbursement and supporting documentation by the 7th of the month, following the month of service, utilizing billing forms required by the Department. Requests for Reimbursement Forms received after 45 days from the date of service may result in delay or forfeiture of payment. Consistent failure to meet 45 -day deadline may result in termination of the Agreement. d. Contractor agrees to submit a monthly report by the '7th of the month, following the month of service, for each client receiving ongoing services. Monthly reports will be submitted through the Department's online reporting system, unless otherwise directed or agreed to by the Department. Monthly reports for ongoing services must include the following information, entered in the "Narrative" box for each date of service: a. Date and time(s) of service (i.e. two hours or 2-4pm) b. Location of where the service took place (i.e. clinician's office, client's home, in the community.) c. Clinician/therapist name d. Clients participating e. What interventions were used, recommendations and/or goals discussed f. Any and all safety concerns One-time services will be verified through receipt of the completed product (ex. psychological evaluation, substance abuse evaluation, home study). Verification of Monitored Sobriety Services will be the test result. A completed home study may be a full, partial or denied study, as determined by the Department. Contractor will document in detail any and all observed or verbalized concerns regarding any child whom the Contractor is working with under the Agreement. Areas of concern may include, but are not limited to, any physical, emotional, educational or behavioral issues. Areas of concern should be reported immediately to the caseworker AND on the required monthly report. 4. Payment a. The Department and the Contractor agree that all benefits from private insurance and/or other funding sources such as Medicaid (if Contractor is a Medicaid eligible provider) or Victim's Compensation must be exhausted before Core Services or other Department funds can be accessed for services. Exceptions to this Paragraph may include, if approved by the Department, the following: i. The service being provided by the contractor is not a Medicaid eligible service; ii. The service is not deemed medically necessary; iii. The Court with jurisdiction over the case has ordered that a non -Medicaid provider or service be used; iv. A Medicaid provider is not available to provide the needed service; v. Medicaid is exhausted for the needed service; or vi. Medicaid denied service. vii. The client is not eligible for Medicaid. b. Payment shall be made in accordance with Exhibit A, Scope of Services , Exhibit B, Rate Schedule, Exhibit C, Weld County's Request for Proposal, and Exhibit D, Contractor's Response to Request for Proposal., attached hereto and incorporated herein by reference, so long as services are rendered satisfactorily and in accordance with the Agreement. c. Payment pursuant to this Agreement, whether in whole or in part, is subject to, and contingent upon, the continuing availability of said funds for the purposes hereof. d. The Department may withhold reimbursement if Contractor has failed to comply with any part of the Agreement, including the Financial Management requirements, program objectives, contractual terms, or reporting requirements. In the event of forfeiture of reimbursement, Contractor may appeal such circumstance in writing to the Director of Human Services. The decision of the Director of 2 Human Services shall be final. 5. Financial Management At all times from the effective date of the Agreement until completion of the Agreement, Contractor shall comply with the administrative requirements, cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under this Agreement must conform to the Single Audit Act of 1984 and OMB Circular A-133. 6. Payment Method Unless otherwise provided in Exhibit A, Scope of Services, Exhibit B, Rate Schedule, and Exhibit D, Contractor's Proposal: a. If services are funded through Core Services, Contractor agrees to accept reimbursement through ACH direct deposit one time per month. b. If Contractor is not currently set up with the State of Colorado to accept direct deposit, Contractor agrees to complete and submit a State of Colorado direct deposit enrollment form, which will be provided by the Department, with a voided check. Failure to complete and submit this form and voided check in a timely and accurate manner may result in a delay of payment. c. Contractor agrees to accept payment through county warrant when funding source does not allow for direct deposit. 7. Compliance with Applicable Laws a. At all times during the performance of this Agreement, Contractor will strictly adhere to all applicable Federal and State laws, order, and applicable standards, regulations, interpretations and/or guidelines issued pursuant thereto. This includes 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 Agreement. Contractor shall abide by all applicable laws and regulations, including, but not limited to the following: - Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d-1 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 - all provisions of the Civil Rights Act of 1986 so 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 the approved Agreement. - 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. Section 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 3 - all regulations applicable to these laws prohibiting discrimination because of race, color, national origin, 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, Contractor and the Department will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 C.F.R. Part 2. 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 all Federal and/or State financial assistance. - Colorado Revised Statute (C.R.S.) 26-6-104, requiring criminal background record checks for all employees, contractors and sub -contractors. b. Contractor is further charged with the knowledge that 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 United States Department of Health and Human Services, Office for Civil Rights. c. Contractor assures that it will fully comply with all other applicable Federal and State laws which may govern the ability of the Department to comply with the relevant funding requirements. Contractor understands the source of funds to be accessed under the Agreement is determined by the Department. d. Contractor assures and certifies that it and its principals: - Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transaction by a Federal or State department or agency; and - have not, within a three-year period preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or Local) transaction or contract under 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; and 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 this certification; and - have not, within a three-year period preceding this Agreement, had one or more public transactions (federal, state, or local) terminated for cause or default. e. Public Contracts for Services C.R.S. §8-17.5-101. Contractor certifies, warrants, and agrees that it does not knowingly employ or contract with an illegal alien who will perform work under this contract. Contractor will confirm the employment eligibility of all employees who are newly hired for employment in the United States to perform work under this Agreement, through participation in the E - Verify program or the State of Colorado program established pursuant to C.R.S. §8-17.5- 102(5)(c). Contractor shall not knowingly employ or contract with an illegal alien to perform work under this Agreement or enter into a contract with a subcontractor that fails to certify with Contractor that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this Agreement. Contractor shall not use E -Verify Program or State of Colorado program procedures to undertake pre -employment screening or job applicants while this Agreement is being performed. If Contractor obtains actual knowledge that a subcontractor performing work under the public contract for services knowingly employs or contracts with an illegal alien Contractor shall notify the subcontractor 4 and the Department within three (3) days that Contractor has actual knowledge that a subcontractor is employing or contracting with an illegal alien and shall terminate the subcontract if a subcontractor does not stop employing or contracting with the illegal alien within three (3) days of receiving notice. Contractor shall not terminate the contract if within three days the subcontractor provides information to establish that the subcontractor has not knowingly employed or contracted with an illegal alien. shall comply with reasonable requests made in the course of an investigation, undertaken pursuant to C.R.S. §8-17.5-102(5), by the Colorado Department of Labor and Employment. If Contractor participates in the State of Colorado program, Contractor shall, within twenty days after hiring a new employee to perform work under the contract, affirm that Contractor has examined the legal work status of such employee, retained file copies of the documents, and not altered or falsified the identification documents for such employees. Contractor shall deliver to the Department, a written notarized affirmation that it has examined the legal work status of such employee and shall comply with all of the other requirements of the State of Colorado program. If Contractor fails to comply with any requirement of this provision or of C.R.S. §8-17.5-101 et seq., the Department, may terminate this Agreement for breach, and if so terminated, Contractor shall be liable for actual and consequential damages. f. Except where exempted by federal law and except as provided in C.R.S. § 24-76.5-103(3), if Contractor receives federal or state funds under the contract, Contractor must confirm that any individual natural person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. § 24-76.5-103(4), if such individual applies for public benefits provided under the contract. If Contractor operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it: (a) is a citizen of the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall produce one of the forms of identification required by C.R.S. § 24- 76.5-101, et seq., and (c) shall produce one of the forms of identification required by C.R.S. § 24-76.5- 103 prior to the effective date of the contract. 8. Compliance with Child and Family Services Review The Child and Family Services Review (CFSR) examines child welfare service outcomes in three areas; Safety, Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's performance according to national standards and monitor progress over time. Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance services to families. Contractor agrees to continually strive for positive outcomes in the areas of Safety, Permanency and Well Being. Contractor will ensure that any employee or subcontractor of Contractor providing services under this Agreement will work towards positive outcomes in the aforementioned three areas as outlined under the Child and Family Services Review (CFSR), and will address the aforementioned three areas when completing monthly reports as required by Paragraph 3(d) of this Agreement. 9. Insurance Requirements Contractor and the Department agree that 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 the Contractor, it subcontractor, or their employees, volunteers, or agents while performing duties described in this Agreement. Contractor shall indemnify, defend and hold harmless Weld County, the Board of County Commissioners of Weld County, its employees, volunteers and agents. Contractor shall provide the liability insurances (including professional liability insurances where necessary) and worker's compensation insurances for all its employees, volunteers, and agents engaged in the performance of this Agreement which are required under Weld County's Request for Proposal, and required by the Colorado Worker's Compensation Act. Contractor shall provide the Department with the acceptable evidence that such coverage is in effect prior to execution of this Agreement. At a minimum, Contractor shall procure, either personally or through its employer as applicable to the 5 Contractor's business, at its own expense, and maintain for the duration of the work, insurance coverage listed in this agreement. The Board of County Commissioners of Weld County and its Officers/Employees shall be named as additional insured. a. General Requirements: Contractors must secure, at or before the time of execution of any agreement or commencement of any work, the following insurance covering all operations, goods or services provided pursuant to this request. Contractors shall keep the required insurance coverage in force at all times during the term of the Agreement, or any extension thereof, and during any warranty period. The required insurance shall be underwritten by an insurer licensed to do business in Colorado and rated by A.M. Best Company as "A"VIII or better. Each policy shall contain a valid provision or endorsement stating "Should any of the above -described policies by canceled or should any coverage be reduced before the expiration date thereof, the issuing company shall send written notice to the Weld County Director of General Services by certified mail, return receipt requested. Such written notice shall be sent thirty (30) days prior to such cancellation or reduction unless due to non-payment of premiums for which notice shall be sent ten (10) days prior. If any policy is in excess of a deductible or self -insured retention, the Department must be notified by the Contractor. Contractor shall be responsible for the payment of any deductible or self -insured retention. The Department reserves the right to require Contractor to provide a bond, at no cost to the Department, in the amount of the deductible or self -insured retention to guarantee payment of claims. The insurance coverages specified in this Agreement are the minimum requirements, and these requirements do not decrease or limit the liability of Contractor. Contractor shall maintain, at its own expense, any additional kinds or amounts of insurance that it may deem necessary to cover its obligations and liabilities under this Agreement. b. Types of Insurance: Contractor shall obtain, and maintain at all times during the term of any Agreement, insurance in the following kinds and amounts: i.Workers' Compensation Insurance as required by state statute, and Employer's Liability Insurance covering all of Contractor's employees acting within the course and scope of their employment. If Contractor is an Independent Contractor, as defined by the Colorado Worker's Compensation Act, this requirement shall not apply. Contractor must submit to the Department a Declaration of Independent Contractor Status Form prior to the start of this agreement. ii.Commercial General Liability Insurance written on ISO occurrence form CG 00 01 10/93 or equivalent, covering premises operations, fire damage, independent Contractors, products and completed operations, blanket contractual liability, personal injury, and advertising liability with minimum limits as follows: - $1,000,000 each occurrence; - $2,000,000 general aggregate; - $50,000 any one fire; and - $500,000 errors and omissions. iii.Automobile Liability: Contractor shall maintain limits of $1,000,000 for bodily injury per person, $1,000,000 for bodily injury for each accident, and $1,000,000 for property damage applicable to all vehicles operating both on County property and elsewhere. iv.Additional Provisions: Policies for all general liability, excess/umbrella liability, liquor liability and pollution liability must provide the following: - If any aggregate limit is reduced by twenty-five percent (25%) or more by paid or reserved claims, Contractor shall notify the Department within ten (10) days and reinstate the aggregates required; - Unlimited defense costs in excess of policy limits; - Contractual liability covering the indemnification provisions of this Agreement; - A severability of interests provision; 6 - Waiver of exclusion for lawsuits by one insured against another; - A provision that coverage is primary; and - A provision that coverage is non-contributory with other coverage or self-insurance provided by the Department. v.For all general liability, excess/umbrella liability, liquor liability, pollution liability and professional liability policies, if the policy is a claims -made policy, the retroactive date must be on or before the contract date or the first date when any goods or services were provided to the Department, whichever is earlier. c. Contractors shall secure and deliver to County's Risk Administrator ("Administrator") at or before the time of execution of this Agreement, and shall keep in force at all times during the term of the Agreement as the same may be extended as herein provided, a commercial general liability insurance policy, including public liability and property damage, in form and company acceptable to and approved by said Administrator, covering all operations hereunder set forth in the related Bid or Request for Proposal. d. Proof of Insurance: Contractor shall provide a copy of this information to its insurance agent or broker and shall have its agent or broker provide proof of Contractor's required insurance. The Department reserves the right to require Contractor to provide a certificate of insurance, a policy, or other proof of insurance as required by the County's Risk Administrator in his sole discretion. e. Additional Insureds: For general liability, excess/umbrella liability, pollution legal liability, liquor liability, and inland marine, Contractor's insurer shall name County as an additional insured. f. Waiver of Subrogation: For all coverages, Contractor's insurer shall waive subrogation rights against County. g. Subcontractors: All subcontractors, independent contractors, sub -vendors, suppliers or other entities providing goods or services required by this Agreement shall be subject to all of the requirements herein and shall procure and maintain the same coverages required of Contractor. Contractor shall include all such subcontractors, independent contractors, sub -vendors, suppliers or other entities as insureds under its policies or shall ensure that all subcontractors maintain the required coverages. Contractor agrees to provide proof of insurance for all such subcontractors, independent contractors, sub -vendors, suppliers or other entities upon request by the Department. A provider of Professional Services shall provide the following coverage: Professional Liability: Contractor shall maintain limits of $1,000,000 for each claim, and $2,000,000 aggregate limit for all claims. 10. Certification Contractor certifies that, at the time of entering into this Agreement, it has currently in effect all necessary licenses, approvals, insurance, etc., required to properly provide the services and/or supplies covered by this Agreement. Copies of all necessary licenses shall be provided to the Department by the Contractor prior to the start of any Agreement. 11. Training Contractor may be required to attend training at the request of the Department specific to services provided under this Agreement. The Department will not compensate the Contractor for said training in the form of registration fees, time spent traveling to and from training, attending the training or any other associated costs unless otherwise agreed to by the Department. 7 12. Subpoenas Contractor will, on behalf of its employees and/or officers, accept any subpoena for testimony from the Weld County Attorney's Office by e-mail and will return a waiver of services within 72 business hours. For this purpose, Contractor will designate an e-mail address prior to the start of this Agreement. If the Contractor receives a subpoena via e-mail but will only accept personal service, the Contractor will contact the Weld County Attorney's Office immediately at (970) 336-7235 and advise that the subpoena must be personally served. 13. Monitoring and Evaluation Contractor and the Department agree that monitoring and evaluation of the performance of this Agreement shall be conducted by the Contractor and the Department. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners, the Department and the Contractor. Contractor will collaborate in a timely manner with the Department to resolve issues pertaining to service delivery, service quality, documentation, and invoicing during referral period and after services have concluded. The Contractor will require clients sign releases of information. Contractor understands that the Department will not reimburse for services rendered to Department clients until releases of information are obtained. Contractor shall permit the Department, and any other duly authorized agent or governmental agency, to monitor all activities conducted by the Contractor pursuant to the terms of this Agreement. The monitoring agency may, if in its sole discretion deems necessary or appropriate, have access to any program data, special analyses, on -site checking, formal audit examinations, or any other reasonable procedures for purposes of monitoring. All such monitoring shall be performed in a manner that will not unduly interfere with the work conducted under this Agreement. 14. Modification of Agreement All modifications to this Agreement shall be in writing and signed by both parties. 15. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor 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 the Contractor. These remedial actions are as follows: - Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed. - Deny payment or recover reimbursement for those services or deliverables, which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Department. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to the Department. - Incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation shall be recovered from Contractor by deduction from subsequent payments under this Agreement or other agreements between the Department and Contractor, or by the Department as a debt due to the Department or otherwise as provided by law. 16. Representatives 8 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 Department: For Contractor: Heather Walker, Child Welfare Division Head Jodi Walters, Chief Executive Officer 17. 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. For Department: Jamie Ulrich, Director P.O. Box A Greeley, CO 80632 (970) 400-6510 18. Litigation For Contractor: Jodi Walters, Chief Executive Officer P.O. Box 271168 Louisville, Colorado 80027 (303) 482-7041 Contractor shall promptly notify the Department in the event that Contractor learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement. Contractor, 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 Director of Human Services. The term "litigation" includes an assignment for the benefit of creditors, and filings of bankruptcy, reorganization and/or foreclosure. 19. Termination This Agreement may be terminated at any time by either party giving thirty (30) days written notice to the individuals identified in paragraph 17. No portion of this Agreement 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, as this Agreement is subject to the availability of funding. Therefore, the Department may terminate this Agreement at any time if the source of funding for the services made available to the Contractor is no longer available to the Department, or for any other reason. Contractor reserves the right to suspend services to clients if funding is no longer available. 20. No Third -Party Beneficiary Enforcement It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 21. Governmental Immunity No term or condition of this contract shall be construed or interpreted as a waiver, express or implied, of any of the immunities, rights, benefits, protections or other provisions, of the Colorado Governmental Immunity Act of §§24-10-101 et. seq., as applicable now or hereafter amended. 22. Partial Invalidity of Agreement If any section, subsection, paragraph, sentence, clause, or phrase of this Agreement is for any reason held 9 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 Agreement 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. 23. Improprieties/Conflict of Interest 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. The Appearance of Conflict of Interest applies to the relationship of a Contractor with the Department 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 Agreement, Contractor shall not enter into 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, Contractor shall submit to the Department, 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 the Department's termination, for cause, of its Agreement with the Contractor. A conflict of interest or appearance of a conflict of interest may also apply to personal relationships between providers and clients. If a provider has a personal relationship with a client to whom the Contractor may provide services for, the Contractor must disclose that relationship to the Department. Contractor certifies that Federal appropriated funds have not been paid or will be paid, by or on behalf of Contractor, 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 an Federal contract, loan, grant, or cooperative agreement. 24. Storage, Availability and Retention of Records Contractor agrees that authorized local, Federal, and State auditors and representatives shall, during business hours, have access to inspect and copy records, and shall be allowed to monitor and review through on -site visits, all activities related to this Agreement, supported with funds under this Agreement, 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. All such records, documents, communications, and other materials created pursuant or related to this Agreement shall be maintained by the Contractor in a central location and shall be made available to the Department upon its request, for a period of seven (7) years from the date of final payment under this Agreement, 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 seven (7) year period, or if audit findings have not been resolved after a seven (7) period, the materials shall be retained until the resolution of the audit finding. 25. Confidentiality of Records Contractor shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Agreement except for purposes directly connected with the administration of Child 10 Protection. No information about or obtained from any applicant/recipient in possession of Contractor shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with the Contractor's written policy governing access to, duplication and dissemination of, all such information, in any form, including social networks. Contractor shall advise its employees, agents, and subcontractor, if any, that they are subject to these confidentiality requirements. Contractor 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. Contractor shall have its employees, agents, and subcontractors, if any, sign a written confidentiality agreement and shall provide a copy of such agreement to the Department, if requested. 26. Proprietary Information Proprietary information for the purposes of this Agreement 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 Agreement. Any proprietary information removed from the Department's site by the Contractor in the course of providing services under this Agreement will be accorded at least the same precautions as are employed by the Contractor for similar information in the course of its own business. 27. Independence of Contractor: Not an Employee of Weld County Contractor agrees that it is an independent Contractor and that Contractor's officers, agents or employees will not become employees of County, nor entitled to any employee benefits from County as a result of the execution of this Agreement. Contractor shall perform its duties hereunder as an independent Contractor. Contractor shall be solely responsible for its acts and those of its agents and employees for all acts performed pursuant to this Agreement. Contractor, its employees and agents are not entitled to unemployment insurance or workers' compensation benefits through County and County shall not pay for or otherwise provide such coverage for Contractor or any of its agents or employees. Unemployment insurance benefits will be available to Contractor and its employees and agents only if such coverage is made available by Contractor or a third party. Contractor shall pay when due all applicable employment taxes and income taxes and local head taxes (if applicable) incurred pursuant to this Agreement. Contractor shall not have authorization, express or implied, to bind County to any agreement, liability or understanding, except as expressly set forth in this Agreement. Contractor shall have the following responsibilities with regard to workers' compensation and unemployment compensation insurance matters: (a) provide and keep in force workers' compensation and unemployment compensation insurance in the amounts required by law, and as set forth in Exhibit C, provide proof thereof when requested to do so by County. 28. 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 state in Paragraph 14 herein. This Agreement shall be binding upon the parties hereto, their successors, heirs, legal representatives, and assigns. The Contractor and the Department may not assign any of its rights or obligations hereunder without the prior consent of both parties. 29. Agreement Nonexclusive This Agreement does not guarantee any work nor does it create an exclusive agreement for services. 30. Warranty 11 The Contractor warrants that services performed under this Agreement will be performed in a manner consistent with the professional standards governing such services and the provisions of this Agreement. The Contractor shall faithfully perform the work in accordance with the standards of care, skill, training, diligence and judgment provided by highly competent individuals and entities that perform services of a similar nature to those described in this Agreement including Exhibits A, B, C, and D. 31. Acceptance of Services Not a Waiver Upon completion of the work, the Contractor shall submit to the Department originals of all tests and results, reports, and other similar items, generated during completion of this work. Acceptance by the Department of reports and incidental material(s) furnished under this Agreement shall not in any way relieve the Contractor of responsibility for the quality and accuracy of the services. In no event shall any action by the Department hereunder constitute or be construed to be a waiver by the Department of any breach of covenant or default which may then exist on the part of the Contractor, and the Department's action or inaction when any such breach or default shall exist shall not impair or prejudice any right or remedy available to the Department with respect to such breach or default; and no assent, expressed or implied, to any breach of any one or more covenants, provisions or conditions of the Agreement shall be deemed or taken to be a waiver of any other breach. Acceptance by the Department of, or payment for, any services performed under this Agreement shall not be construed as a waiver of any of the Department's rights under this Agreement or under the law generally. 32. Employee Financial Interest/Conflict of Interest. C.R.S. §§24-18-201 et seq. and §24-50-507 The signatories to this Agreement aver that to their knowledge, no employee of Weld County has any personal or beneficial interest whatsoever in the service or property which is the subject matter of this Agreement. The Contractor has no interest and shall not acquire any interest direct or indirect, which would in any manner or degree with the performance of the Contractor's services and the Contractor, shall not employ any person having such known interests. During the term of this Agreement, the Contractor shall not engage in any in any business or personal activities or practices or maintain any relationships which actually conflicts with or in any way appear to conflict with the full performance of its obligations under this Agreement. Failure by the Contractor to ensure compliance with this provision may result, in the Department's sole discretion, in immediate termination of this Agreement. No employee of the Contractor nor any member of the Contractor's family shall serve on a County Board, committee or hold any such position which either by rule, practice or action nominates, recommends, supervises Contractor's operations, or authorizes funding to the Contractor. 33. Board of County Commissioners of Weld County Approval This Agreement shall not be valid until it has been approved by the Board of County Commissioners of Weld County, Colorado. 34. Choice of Law/Jurisdiction Colorado law, and rules and regulations established pursuant thereto, shall be applied in the interpretation, execution, and enforcement of this Agreement. Any provision included or incorporated herein by reference which conflicts with said laws, rules and/or regulations shall be null and void. In the event of a legal dispute between the parties, Contractor agrees that the Weld County District Court shall have exclusive jurisdiction to resolve said dispute. 35. Subcontractors Contractor acknowledges that the Department has entered into this Agreement in reliance upon the particular reputation and expertise of Contractor. Contractor shall not enter into any subcontractor agreements for the completion of this project without the Department's prior written consent, which may be withheld in the Department's sole discretion. 36. Attorney's Fees/Legal Costs 12 In the event of a dispute between the Department and Contractor, concerning this Agreement, the parties agree that each party shall be responsible for the payment of attorney fees and/or legal costs incurred by or on its own behalf. 37. Ownership All work and information obtained by Contractor under this Agreement or individual work order shall become or remain (as applicable), the property of the Department. In addition, all reports, documents, data, plans, drawings, records and computer files generated by Contractor in relation to this Agreement and all reports, test results and all other tangible materials obtained and/or produced in connection with the performance of this Agreement, whether or not such materials are in completed form, shall at all times be considered the property of the Department. Contractor shall not make use of such material for purposes other than in connection with this Agreement without prior written approval of the Department. 38. Interruptions Neither party to this Agreement shall be liable to the other for delays in delivery or failure to deliver or otherwise to perform any obligation under this Agreement, where such failure is due to any cause beyond its reasonable control, including but not limited to Acts of God, fires, strikes, war, flood, earthquakes or Governmental actions. 39. Severability If any term or condition of this Agreement shall be held to be invalid, illegal, or unenforceable by a court of competent jurisdiction, this Agreement shall be construed and enforced without such provision, to the extent that this Agreement is then capable of execution within the original intent of the parties. IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. COUNTY: ATTEST: .4.0(44) M' 1';lk' By: BOARD OF COUNTY COMMISSIONERS W . County Clerk to the ' oard WELD COUNTY, COLORADO Deputy Clerk to 13 Mike Freeman, Pro-Tem JUL 0 6 2022 CONTRACTOR: Parker Personal Care Homes, Inc., dba David Kalis P.O. Box 271168 Louisville, Colorado 80027 (303) 482-7041 ate Vevle` By: Kate Veeder (Jun 23, 2022 1432 MDT) Kate Veeder, Director of Psychological & Behavioral Services Date: J u n 23, 2022 EXHIBIT A SCOPE OF SERVICES Contractor will provide Aftercare Services, Anger Management/Domestic Violence, Foster Parent Consultation, Foster Parent Training, Home -Based Intervention, Kinship Services (Therapeutic), Life Skills, Mediation, Mental Health Services, Relinquishment Counseling, Sexual Abuse Treatment, Substance Abuse Treatment, Functional Family Therapy, and Multisystemic Therapy, as referred by the Department. Aftercare Services 1. Aftercare Therapy and Consultation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Consultation and individual and family therapy to foster bonding and attachment, support reunification or other permanent placement, support permanency, and prevent out -of -home placement when possible. ii. Behavioral management intervention, provision of psycho -educational information on bonding and attachment, and assistance with navigation of care systems. iii. Cognitive behavioral strategies, educational strategies, and applied behavioral analysis are utilized, as well as assistance to help families understand such disorders as ADHD, trauma, and autism specific disorders. b. Anticipated Frequency of Services: i. One (1) or two (2) times per week, depending on the needs of the client. c. Anticipated Duration of Services: i. Service may range from three (3) months to two (2) years, typically it is more short-term. d. Goals of Services: i. Align treatment goals with goals identified in the Family Service Plan (FSP). ii. Utilize behavioral management strategies to improve behavioral regulation and the stability of the individual/family. iii. Provide psycho -educational information on bonding and attachment, including supporting the client(s) as needed with their comprehension of the educational material and with specific ways to implement strategies provided. iv. Assist and support clients in navigating the network of applicable community -based services and supports. v. Through individual and/or family therapy, foster bonding and attachment to prevent out -of -home placement when possible, support reunification, or facilitate the transition to other permanent placement when necessary. vi. Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. vii. Engage families with outcome -based treatment modalities with proven efficacy. viii. Maintain frequent and thorough communication with Child Welfare Social Case Workers and provide written reporting on at least a monthly basis. ix. In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. e. Outcomes of Services: i. Families are strengthened and, when possible, kept intact or reunited. ii. 2. Individual and family functioning is improved. iii. 3. Client(s) have improved ability to regulate emotions. iv. 4. Client(s) are better able to meet treatment goals. 1 v. 5. Increased safety and welfare of children by working with parents to understand what is best for and act in the long-term interest of their child(ren). f. Target Population: i. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits. g. Language: i. English. ii. Interpreters may also be utilized. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. Services can be provided in -home. ii. In -community within Weld County. iii. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South McCaslin Boulevard, Suite 200 in Louisville. 3. 14001 East Iliff Avenue, Suite 204 in Aurora. iv. Telehealth services can also be provided as necessary due to Covid-19. Anger Management/Domestic Violence 2. Anger Management/Domestic Violence Prevention a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Diagnostic and therapeutic services to help prevent future violence, improve family communication, increase relationship functioning, and aid in the development of the Family Services Plans when necessary. ii. Client's clinicians are trained to work with victims, offenders, as well as family members, and are able to provide these services in alignment with Domestic Violence Offender Management Board (DVOMB) criteria. b. Anticipated Frequency of Services: i. One (1) or two (2) times per week, depending on the needs of the client. c. Anticipated Duration of Services: i. Service may range three (3) months to two (2) years, typically it is more short-term. d. Goals of Services: i. Improve client(s) anger management skills and prevent further incidents of violence. ii. Improve family communication and functioning, and strengthen family relationships. iii. Provide support to the whole family system to ensure safety and stability. iv. Support multidisciplinary professionals by providing input and guidance on safety planning, recommendations, and progress. v. Align treatment goals with goals identified in the Family Service Plan (FSP). vi. Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. vii. Engage families with outcome -based treatment modalities with proven efficacy. viii. Maintain frequent and thorough communication with Child Welfare Social Case Workers and provide written reporting on at least a monthly basis. 2 ix. In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. e. Outcomes of Services: i. Client(s) have improved ability to regulate emotions. ii. Family members are safer, and the family unit is more stable. iii. Client(s) are better able to meet treatment goals. iv. Increased safety and welfare of children by working with parents to understand what is best for and act in the long-term interest of their child(ren). v. Improved individual and/or family functioning to maintain the welfare of clients. f. Target Population: i. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits. g. Language: i. English. ii. Interpreters may also be utilized. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. Services can be provided in -home. ii. In -community within Weld County. iii. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South McCaslin Boulevard, Suite 200 in Louisville. 3. 14001 East Iliff Avenue, Suite 204 in Aurora. iv. Telehealth services can also be provided as necessary due to Covid-19. Foster Parent Consultation 3. Foster Parent Consultation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Observation of family functioning to identify individual and family strengths and weaknesses. ii. Development of strategies to decrease conflict, build resiliency, and strengthen relationships. iii. Provision of psycho -educational information concerning trauma, abuse, and/or neglect. iv. Ability to work with child welfare clients and/or caseworkers and department personnel to evaluate and address specific cognitive, mental health, and/or developmental issues. v. Can be provided remotely, in -person, and/or at Family Service Plan (FSP) meetings. vi. Provision of trauma -informed care that also includes behavioral interventions to support the child/family. b. Anticipated Frequency of Services: 3 i. Frequency will depend on the case. c. Anticipated Duration of Services: i. Duration will depend on the case. d. Goals of Services: i. Support caseworkers and clients to meet the treatment goals outlined in the FSP. ii. Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. iii. Engage families with outcome -based treatment modalities with proven efficacy. iv. Maintain frequent and thorough communication with Child Welfare Social Case Workers, and provide written reporting on at least a monthly basis. v. In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. e. Outcomes of Services: i. Caseworkers are supported in addressing treatment recommendations. ii. Client(s) have improved ability to regulate emotions. iii. Client(s) are better able to meet treatment goals. iv. Increased safety and welfare of children by working with foster parents to understand what is best for and act in the long-term interest of the child(ren). v. Improved individual and/or family functioning to maintain the welfare of clients. f. Target Population: i. Caseworkers or clients. ii. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. iii. Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits. g. Language: i. English. ii. Interpreters may also be utilized. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. Services can be provided in -home. ii. In -community within Weld County. iii. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South McCaslin Boulevard, Suite 200 in Louisville. 3. 14001 East Iliff Avenue, Suite 204 in Aurora. iv. Telehealth services can also be provided as necessary due to Covid-19. Foster Parent Training 4. Foster Parent Training a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Training for foster parents provided in group or individual sessions concerning the effects of trauma, abuse, neglect, transitions, system of care navigation, and reunification. 4 ii. Contractor's expertise in developmental issues will ensure thorough training for providers on appropriate expectations for and behaviors of children being served by the foster care system. iii. Contractor has extensive experience working with foster and adoptive families on issues related to attachment and in helping preserve family structures. Contractor offers foster/adoptive parent consultation services including observation of family functioning, strategies to decrease conflict, build resiliency, and strengthen relationships, and, when appropriate, provision of psycho -educational information concerning trauma, abuse, and/or neglect. Contractor also offers therapeutic kinship services, including observation of kinship family dynamics and individual functioning as well as provision of psycho - educational information and therapeutic services to ensure positive relationships and decreased conflict. Our adoption preservation services include behavioral management consultation, assistance with the navigation of care systems, provision of psycho - educational information, and family/individual therapy to foster bonding and attachment with the goal of supporting permanency and preventing out -of -home placement when possible. iv. Working with child welfare clients and/or caseworkers and department personnel to identify cognitive, mental health, and/or developmental issues to be addressed during training sessions. b. Anticipated Frequency of Services: i. Frequency will depend on the case. c. Anticipated Duration of Services: i. Duration will depend on the case. d. Goals of Services: i. Based on observation of family functioning, develop and communicate strategies to decrease conflict, build resiliency, and strengthen relationships. ii. Educate foster parents regarding treatment goals outlined in the FSP, especially in regard to specific cognitive, mental health, and/or developmental issues of the foster child(ren). iii. Provide training regarding specific diagnoses/behaviors to support children in the foster placement without disruption. iv. Work with the foster parents to understand the child's current functioning, trauma, and diagnoses to build a behavioral support plan. v. Provide psycho -educational information concerning trauma, abuse, and/or neglect. vi. Work with the family to understand the dynamics between the foster child, foster parents, and others in the home to help them establish a positive routine and daily interventions that reduce negative behaviors. vii. Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. viii. Maintain frequent and thorough communication with Child Welfare Social Case Workers and provide written reporting on at least a monthly basis. ix. In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. e. Outcomes of Services: i. Caseworkers are supported in addressing treatment recommendations. ii. Foster parents have an improved ability to help child(ren) regulate emotions and meet treatment goals. iii. Increased safety and welfare of children by working with foster parents to understand child -welfare -specific concerns such as abuse, neglect, loss, and grief. iv. Improved individual and/or family functioning to maintain the welfare of clients. f. Target Population: i. Caseworkers or clients. 5 ii. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. iii. Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits. g. Language: i. English. ii. Interpreters may also be utilized. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. Services can be provided in -home. ii. In -community within Weld County. iii. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South McCaslin Boulevard, Suite 200 in Louisville. 3. 14001 East Iliff Avenue, Suite 204 in Aurora. iv. Telehealth services can also be provided as necessary due to Covid-19. Home Based Intervention 5. Home Based Intervention a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Preservation & Removal Prevention Services — Contractor is able assess individual and family needs and provide short-term intensive services in the home. Contractor offers conflict resolution, case management consultation, behavioral and parenting skills modeling/coaching, parenting skill development, bonding/attachment and adoption preservation services, transition support, systems of care navigation, individual and family therapy, and help in developing structure and life skills. ii. Adoption preservation services — including behavioral management consultation, assistance with the navigation of care systems, provision of psycho -educational information, and family/individual therapy to foster bonding and attachment with the goal of supporting permanency and preventing out -of -home placement when possible. iii. Therapeutic Visitation — including services to ensure child safety, improve parent/child(ren) interactions, teach parenting techniques, enable clients to access appropriate community resources, minimize family conflict, and enable household management. Contractor is able to provide therapeutic visitation in the home, office, and/or community settings. iv. Evidence -based services provided by contractor's service team include: multi -systemic therapy, cognitive behavioral therapy and trauma -focused Cognitive Behavioral Therapy (CBT), Applied Behavior Analysis (ABA) therapy, therapeutic visitation services, dialectical behavioral therapy, Eye Movement Desensitization and Reprocessing (EMDR), psychological and cognitive evaluations, and family therapy. b. Anticipated Frequency of Services: One (1) or two (2) times per week, depending on the needs of the client. c. Anticipated Duration of Services: i. Service may range from three (3) months to two (2) years, typically it is more short-term. d. Goals of Services: i. Align treatment goals with goals identified in the FSP. 6 ii. Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. iii. Engage families with outcome -based treatment modalities with proven efficacy. iv. Maintain frequent and thorough communication with Child Welfare Social Case Workers and provide written reporting on at least a monthly basis. v. In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. e. Outcomes of Services: i. Client(s) have improved ability to regulate emotions. ii. Client(s) are better able to meet treatment goals. iii. Increased safety and welfare of children by working with parents to understand what is best for and act in the long-term interest of their child(ren). iv. Improved individual and/or family functioning to maintain the welfare of clients. f. Target Population: i. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits. g. Language: i. English. ii. Interpreters may also be utilized. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. Services can be provided in -home. ii. In -community within Weld County. iii. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South McCaslin Boulevard, Suite 200 in Louisville. 3. 14001 East Iliff Avenue, Suite 204 in Aurora. iv. Telehealth services can also be provided as necessary due to Covid-19. Kinship Services (Therapeutic) 6. Therapeutic Kinship Services a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Observation of kinship family dynamics and individual functioning as well as provision of psycho -educational information and therapeutic services to ensure positive relationships and decreased conflict. ii. Child -welfare -specific concerns such as coping with past abuse/neglect and loss/grief are addressed. iii. Evidence -based services provided by contractor's service team include: multi -systemic therapy, cognitive behavioral therapy and trauma -focused Cognitive Behavioral Therapy (CBT), Applied Behavior Analysis (ABA) therapy, therapeutic visitation services, dialectical behavioral therapy, Eye Movement Desensitization and Reprocessing (EMDR), psychological and cognitive evaluations, and family therapy. iv. When applicable, services are tailored for individuals with limited cognitive abilities. 7 v. Behavioral Services/Coaching are also available, which can include assessment, evaluation, counseling, coaching, consultation, and line services to individuals, as well as coaching and consultation for family members and other professionals supporting them. vi. Trauma -Based Relational Intervention (TBRI) coaching is also available to family members. b. Anticipated Frequency of Services: One (1) or two (2) times per week, depending on the needs of the client. c. Anticipated Duration of Services: i. Service may range from three (3) months to two (2) years, typically it is more short-term. d. Goals of Services: i. Align treatment goals with goals identified in the FSP. ii. Enrich and improve the quality of kinship services. iii. Improve family dynamics and functioning, including decreasing conflict in the home and strengthening resiliency. iv. Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. v. Engage families with outcome -based treatment modalities with proven efficacy. vi. Maintain frequent and thorough communication with Child Welfare Social Case Workers and provide written reporting on at least a monthly basis. vii. In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. e. Outcomes of Services: i. Client(s) have improved ability to regulate emotions. ii. Client(s) are better able to meet treatment goals. iii. Increased safety and welfare of children by working with kinship providers to understand what is best for and act in the long-term interest of the child(ren). iv. Improved individual and/or family functioning to maintain the welfare of clients. E Target Population: i. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits. g. Language: i. English. ii. Interpreters may also be utilized. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. Services can be provided in -home. ii. In -community within Weld County. iii. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South McCaslin Boulevard, Suite 200 in Louisville. 3. 14001 East Iliff Avenue, Suite 204 in Aurora. iv. Telehealth services can also be provided as necessary due to Covid-19. Life Skills 8 7. Therapeutic Visitation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Therapeutic Visitation — include active therapeutic coaching strategies employed to ensure child safety, improve parent/child(ren) interactions, teach parenting techniques, enable clients to access appropriate community resources, minimize family conflict, and enable household management. Contractor is able to provide therapeutic visitation in the home, office, and/or community settings. ii. Child -welfare -specific concerns such as coping with past abuse/neglect and loss/grief are addressed. iii. When applicable, services are tailored for individuals with limited cognitive abilities. Curriculum is developed to meet the individual needs of the parent(s) and utilizes modeling, repetition, and specific teaching techniques/methods to help clients develop skills to mastery to alleviate current and future child protection concerns. iv. Services are tailored to clients' current levels of functioning and enable clients to build upon their current skill set. Skill development techniques and strategies are based upon theories developed by leaders in the field such as Lev Vygotsky. v. All life skills therapists are Masters -level therapists who can utilize various therapeutic techniques such as: cognitive behavioral therapy, behavioral, and trauma -focused Cognitive Behavioral Therapy (CBT), Applied Behavior Analysis (ABA) therapy, and dialectical behavioral therapy to further skill development. Many individuals who experience cognitive and/or developmental issues have difficulty with learning, which impedes the skill development process from both a cognitive standpoint but also an emotional one, as learning has always been difficult for that individual. Our approach is to not only address the practical skill development but also emotional skills in order to remove barriers to learning and help provide supports for success in the home. b. Anticipated Frequency of Services: One (1) or two (2) times per week, depending on the needs of the client. c. Anticipated Duration of Services: i. Service may range from three (3) months to two (2) years, typically it is more short-term. d. Goals of Services: i. Align treatment goals with goals identified in the FSP. ii. Address specific child -welfare concerns through intervention, parent education, modeling, and feedback to deal with past abuse/neglect and loss/grief, reestablish parent/child connection after lengthy separations, repair bonding, address dysfunctional dynamics including parentification of child(ren), and address inappropriate and/or unsafe behaviors. Specific physical and/or sexual abuse and/or substance abuse concerns will also be addressed. iii. Foster safe and age -appropriate parent/child interactions. iv. Strengthen family bonding and promote nurturing interactions. v. Engage families with outcome -based treatment modalities with proven efficacy. vi. Maintain frequent and thorough communication with Child Welfare Social Case Workers and provide written reporting on at least a monthly basis. vii. In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. e. Outcomes of Services: i. Client(s) have improved ability to regulate emotions. ii. Client(s) are better able to meet treatment goals. iii. Increased safety and welfare of children by working with parents to understand what is best for and act in the long-term interest of their child(ren). iv. Improved individual and/or family functioning to maintain the welfare of clients. v. Specific learning needs of the client(s) are met, as well as their emotional needs. 9 f. Target Population: i. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits. g. Language: i. English. ii. Interpreters may also be utilized. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. Services can be provided in -home. ii. In -community within Weld County. iii. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South McCaslin Boulevard, Suite 200 in Louisville. 3. 14001 East Iliff Avenue, Suite 204 in Aurora. iv. Telehealth services can also be provided as necessary due to Covid-19. 8. Parent Coaching a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Parent Coaching — include therapeutic and frequent intervention, education, modeling, and feedback. Utilizes a structured parent education curriculum to foster bonding/attachment, teach appropriate discipline, develop empathy, provide education on developmental stages, and communicate safe and healthy parenting techniques. Specific criteria utilized to measure parenting education progress. ii. Child -welfare -specific concerns such as coping with past abuse/neglect and loss/grief are addressed. iii. When applicable, services are tailored for individuals with limited cognitive abilities. Curriculum is developed to meet the individual needs of the parent(s) and utilizes modeling, repetition, and specific teaching techniques/methods to help clients develop skills to mastery to alleviate current and future child protection concerns. iv. Services are tailored to clients' current levels of functioning and enable clients to build upon their current skill set. Skill development techniques and strategies are based upon theories developed by leaders in the field such as Lev Vygotsky. v. All life skills therapists are Masters -level therapists who can utilize various therapeutic techniques such as: cognitive behavioral therapy, behavioral, and trauma -focused Cognitive Behavioral Therapy (CBT), Applied Behavior Analysis (ABA) therapy, and dialectical behavioral therapy to further skill development. Many individuals who experience cognitive and/or developmental issues have difficulty with learning, which impedes the skill development process from both a cognitive standpoint but also an emotional one, as learning has always been difficult for that individual. Our approach is to not only address the practical skill development but also emotional skills in order to remove barriers to learning and help provide supports for success in the home. b. Anticipated Frequency of Services: One (1) or two (2) times per week, depending on the needs of the client. c. Anticipated Duration of Services: i. Service may range from three (3) months to two (2) years, typically it is more short-term. 10 d. Goals of Services: i. Align treatment goals with goals identified in the FSP. ii. Address specific child -welfare concerns through intervention, parent education, modeling, and feedback to deal with past abuse/neglect and loss/grief, reestablish parent/child connection after lengthy separations, repair bonding, address dysfunctional dynamics including parentification of child(ren), and address inappropriate and/or unsafe behaviors. Specific physical and/or sexual abuse and/or substance abuse concerns will also be addressed. iii. Foster safe and age -appropriate parent/child interactions. iv. Strengthen family bonding and promote nurturing interactions. v. Engage families with outcome -based treatment modalities with proven efficacy. vi. Maintain frequent and thorough communication with Child Welfare Social Case Workers and provide written reporting on at least a monthly basis. vii. In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. e. Outcomes of Services: i. Client(s) have improved ability to regulate emotions. ii. Client(s) are better able to meet treatment goals. iii. Increased safety and welfare of children by working with parents to understand what is best for and act in the long-term interest of their child(ren). iv. Improved individual and/or family functioning to maintain the welfare of clients. v. Specific learning needs of the client(s) are met, as well as their emotional needs. f. Target Population: i. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits. g. Language: i. English. ii. Interpreters may also be utilized. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. Services can be provided in -home. ii. In -community within Weld County. iii. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South McCaslin Boulevard, Suite 200 in Louisville. 3. 14001 East Iliff Avenue, Suite 204 in Aurora. iv. Telehealth services can also be provided as necessary due to Covid-19. 9. Supervised Visitation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Supervised Visitation - active interventions, education, and coaching to promote positive behavioral change in parent/child relationships. Appropriate parent -child interactions are modeled, and feedback is provided to parents after each visit. ii. Child -welfare -specific concerns such as coping with past abuse/neglect and loss/grief are addressed. 11 iii. When applicable, services are tailored for individuals with limited cognitive abilities. Curriculum is developed to meet the individual needs of the parent(s) and utilizes modeling, repetition, and specific teaching techniques/methods to help clients develop skills to mastery to alleviate current and future child protection concerns. iv. Services are tailored to clients' current levels of functioning and enable clients to build upon their current skill set. Skill development techniques and strategies are based upon theories developed by leaders in the field such as Lev Vygotsky. v. All life skills therapists are Masters -level therapists who can utilize various therapeutic techniques such as: cognitive behavioral therapy, behavioral, and trauma -focused Cognitive Behavioral Therapy (CBT), Applied Behavior Analysis (ABA) therapy, and dialectical behavioral therapy to further skill development. Many individuals who experience cognitive and/or developmental issues have difficulty with learning, which impedes the skill development process from both a cognitive standpoint but also an emotional one, as learning has always been difficult for that individual. Our approach is to not only address the practical skill development but also emotional skills in order to remove barriers to learning and help provide supports for success in the home. b. Anticipated Frequency of Services: One (1) or two (2) times per week, depending on the needs of the client. c. Anticipated Duration of Services: i. Service may range from three (3) months to two (2) years, typically it is more short-term. d. Goals of Services: i. Align treatment goals with goals identified in the FSP. ii. Address specific child -welfare concerns through intervention, parent education, modeling, and feedback to deal with past abuse/neglect and loss/grief, reestablish parent/child connection after lengthy separations, repair bonding, address dysfunctional dynamics including parentification of child(ren), and address inappropriate and/or unsafe behaviors. Specific physical and/or sexual abuse and/or substance abuse concerns will also be addressed. iii. Foster safe and age -appropriate parent/child interactions. iv. Strengthen family bonding and promote nurturing interactions. v. Engage families with outcome -based treatment modalities with proven efficacy. vi. Maintain frequent and thorough communication with Child Welfare Social Case Workers and provide written reporting on at least a monthly basis. vii. In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. e. Outcomes of Services: i. Client(s) have improved ability to regulate emotions. ii. Client(s) are better able to meet treatment goals. iii. Increased safety and welfare of children by working with parents to understand what is best for and act in the long-term interest of their child(ren). iv. Improved individual and/or family functioning to maintain the welfare of clients. v. Specific learning needs of the client(s) are met, as well as their emotional needs. f. Target Population: i. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits. g. Language: i. English. ii. Interpreters may also be utilized. 12 h. Medicaid Eligibility: i. This service is Medicaid eligible. Service Access and Transportation: i. Services can be provided in -home. ii. In -community within Weld County. iii. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South McCaslin Boulevard, Suite 200 in Louisville. 3. 14001 East Iliff Avenue, Suite 204 in Aurora. iv. Telehealth services can also be provided as necessary due to Covid-19. Mediation 10. Mediation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Attendance of court -ordered meetings to facilitate resolution of treatment plan issues for Dependency and Neglect (D&N) cases. ii. Assisting professionals in addressing the cognitive, mental health, and/or developmental issues experienced by the client(s). iii. Services will be provided by individuals on staff that are certified in mediation training, specifically in domestic cases. b. Anticipated Frequency of Services: i. Frequency will be case dependent. c. Anticipated Duration of Services: i. Duration will be case dependent. d. Goals of Services: i. Support case professionals to resolve issues related to adjudication and treatment plan issues. ii. Provide insight into child -welfare -specific concerns with specific focus on addressing clients' cognitive, mental health, and/or developmental issues. iii. Facilitate resolution for families and professionals to ensure progress in the case. iv. Help develop a thorough plan moving forward to support the safety and well-being and reunification of children when possible. e. Outcomes of Services: i. Case -specific issues are addressed and resolved in a timely manner. ii. Client(s) specific needs are met, allowing them to work towards successful resolution of their case. iii. All case professionals are informed of unique needs of clients in D&N cases. iv. Increased safety and welfare of children by facilitating progress on the case. f. Target Population: i. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits. g. Language: 13 i. English. ii. Interpreters may also be utilized. h. Medicaid Eligibility: i. This service is Medicaid eligible. Service Access and Transportation: i. Services can be provided in -home. ii. In -community within Weld County. iii. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South McCaslin Boulevard, Suite 200 in Louisville. 3. 14001 East Iliff Avenue, Suite 204 in Aurora. iv. Telehealth services can also be provided as necessary due to Covid-19. Mental Health Services 11. Counseling/Psychotherapy a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Child -welfare -specific concerns such as coping with past abuse/neglect and loss/grief are addressed. ii. Evidence -based services provided by contractor's service team include: multi -systemic therapy, cognitive behavioral therapy and trauma -focused Cognitive Behavioral Therapy (CBT), Applied Behavior Analysis (ABA), therapeutic visitation services, dialectical behavioral therapy, Eye Movement Desensitization and Reprocessing (EMDR), psychological and cognitive evaluations, and family therapy. iii. When applicable, services are tailored for individuals with limited cognitive abilities. iv. Behavioral Services/Coaching are also available, which can include assessment, evaluation, counseling, coaching, consultation, and line services to individuals, as well as coaching and consultation for family members and other professionals supporting them. v. Trauma -Based Relational Intervention (TBRI) coaching is also available to family members. b. Anticipated Frequency of Services: One (1) or two (2) times per week, depending on the needs of the client. c. Anticipated Duration of Services: i. Service may range from three (3) months to two (2) years, typically it is more short-term. d. Goals of Services: i. Align treatment goals with goals identified in the FSP. ii. Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. iii. Engage families with outcome -based treatment modalities with proven efficacy. iv. Maintain frequent and thorough communication with Child Welfare Social Case Workers and provide written reporting on at least a monthly basis. v. In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. e. Outcomes of Services: i. Client(s) have improved ability to regulate emotions. ii. Client(s) are better able to meet treatment goals. iii. Increased safety and welfare of children by working with parents to understand what is best for and act in the long-term interest of their child(ren). iv. Improved individual and/or family functioning to maintain the welfare of clients. 14 f. Target Population: i. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits. g. Language: i. English. ii. Interpreters may also be utilized. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. Services can be provided in -home. ii. In -community within Weld County. iii. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South McCaslin Boulevard, Suite 200 in Louisville. 3. 14001 East Iliff Avenue, Suite 204 in Aurora. iv. Telehealth services can also be provided as necessary due to Covid-19. 12. Consultation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Working with child welfare clients and/or caseworkers and department personnel to address cognitive, mental health, and/or developmental issues. ii. Providing support to clients and/or caseworkers to address issues identified by psychological evaluations and to ensure progress on recommendations made in the evaluations. iii. Can be provided remotely, in -person, and/or at FSP meetings. iv. Expert -level court testimony can also be provided. b. Anticipated Frequency of Services: i. Frequency will depend on the case. c. Anticipated Duration of Services: i. Duration will depend on the case. d. Goals of Services: i. Support caseworkers and clients to meet the treatment goals outlined in the FSP. ii. Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. iii. Engage families with outcome -based treatment modalities with proven efficacy. iv. Maintain frequent and thorough communication with Child Welfare Social Case Workers and provide written reporting on at least a monthly basis. v. In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. e. Outcomes of Services: i. Caseworkers are supported in addressing treatment recommendations. ii. Client(s) have improved ability to regulate emotions. iii. Client(s) are better able to meet treatment goals. 15 iv. Increased safety and welfare of children by working with parents to understand what is best for and act in the long-term interest of their child(ren). v. Improved individual and/or family functioning to maintain the welfare of clients. f. Target Population: i. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits. g. Language: i. English. ii. Interpreters may also be utilized. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. Services can be provided in -home. ii. In -community within Weld County. iii. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South McCaslin Boulevard, Suite 200 in Louisville. 3. 14001 East Iliff Avenue, Suite 204 in Aurora. iv. Telehealth services can also be provided as necessary due to Covid-19. 13. Psychological Evaluation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Evaluations include a thorough assessment of mental health concerns, cognitive abilities, and academic skills. ii. Evaluations are tailored specifically to the referral question at hand, including evaluating for developmental issues such as autism spectrum disorder, learning disabilities, attention-deficit/hyperactivity disorder, behavioral concerns (including observations, review of records, identification of target behaviors, and recommendations for behavioral modification), and/or adaptive behavior (to investigate skills/abilities versus current daily performance). b. Anticipated Frequency of Services: i. One (1) to four (4) appointments. c. Anticipated Duration of Services: i. One (1) to two (2) months. d. Goals of Services: i. To schedule with the client as quickly as possible once the referral is received. ii. To conduct a thorough evaluation with the client, including addressing all of the referral questions. iii. To complete the evaluation in a timely manner while making client -specific and thorough recommendations on validated treatments with proven efficacy. iv. To address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and v. loss/grief. 16 vi. To maintain frequent and thorough communication with Child Welfare Social Case Workers throughout the evaluation process and to provide written reporting on at least a monthly basis. vii. In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. e. Outcomes of Services: i. Client's specific needs for support in meeting treatment goals have been identified, improving the likelihood that treatment goals can be met. ii. Client -specific outcome -based treatment modalities with proven efficacy have been recommended. iii. Increased safety and welfare of children by providing recommendations to ensure parents understand what is best for and act in the long-term interest of their child(ren). iv. Improved individual and/or family functioning to maintain the welfare of clients. f. Target Population: i. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits. g. Language: i. English. ii. Interpreters may also be utilized. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. Services can be provided in -home. ii. In -community within Weld County. iii. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South McCaslin Boulevard, Suite 200 in Louisville. 3. 14001 East Iliff Avenue, Suite 204 in Aurora. iv. Telehealth services can also be provided as necessary due to Covid-19. 14. Trauma Assessment a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Includes psychological and cognitive testing as needed in addition to a full trauma assessment. ii. Recommendations will be geared toward helping the individual understand how trauma affects emotions and behaviors, how the individual can be supported in the appropriate environment, and what interventions will lead to increased resilience, skill development, emotional regulation, and ultimately success for the individual. iii. Dr. Kalis has attended Center for Trauma and Resilience at CSU (CTRAC) Trauma Assessment Training as well as trauma assessment training through Dr. James Henry with the Western Michigan University Children's Trauma Assessment Center. He is skilled at assessing for and diagnosing posttraumatic stress disorder in children, adolescents, and adults, and he and his clinical staff are well versed in providing the following trauma -related therapeutic services: Neurosequential Model of Therapeutics, Adolescent Dialectical Behavioral Therapy (DBT), Trauma Focused Cognitive Behavioral Therapy (TF-CBT), Sensory Integration, Trauma -Focused Child/Parent Interactional Therapy, Acceptance and Commitment Therapy (ACT), and EMDR. 17 b. Anticipated Frequency of Services: i. One (1) to four (4) appointments. c. Anticipated Duration of Services: i. One (1) to two (2) months. d. Goals of Services: i. To schedule with the client as quickly as possible once the referral is received. ii. To conduct a thorough trauma assessment with the client, including addressing all of the referral questions. iii. To complete the evaluation in a timely manner while making client -specific and thorough recommendations on validated treatments with proven efficacy. iv. To help the client understand how trauma affects emotions and behaviors. v. To identify how the individual can best be supported in the appropriate environment. vi. To identify what interventions will lead to increased resilience, skill development, emotional regulation, and ultimately individual and family success. vii. To address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and viii. loss/grief. ix. To maintain frequent and thorough communication with Child Welfare Social Case Workers throughout the evaluation process and to provide written reporting on at least a monthly basis. x. In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. e. Outcomes of Services: i. Specific trauma -focused evidenced -based interventions with proven efficacy have been identified in recommendations to meet the client's specific needs. ii. Increased safety and welfare of children by providing recommendations to ensure parents understand what is best for and act in the long-term interest of their child(ren). iii. Improved individual and/or family functioning to maintain the welfare of clients. f. Target Population: i. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits. g. Language: i. English. ii. Interpreters may also be utilized. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. Services can be provided in -home. ii. In -community within Weld County. iii. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South McCaslin Boulevard, Suite 200 in Louisville. 3. 14001 East Iliff Avenue, Suite 204 in Aurora. iv. Telehealth services can also be provided as necessary due to Covid-19. 18 15. Parent -Child Interactional (PCI) Evaluation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Dr. Kalis has twenty (20) years of experience conducting PCIs, and employs an observational measure of parenting. ii. Dr. Kalis has extensive experience with family dynamics, including abuse/neglect/trauma dynamics as well as Intellectual and Developmental Disabilities (I/DD) concerns, enables him to assess strengths and challenges as they relate to parenting success. iii. Interviews with parents and other collateral sources. b. Anticipated Frequency of Services: i. One (1) or two (2) observational appointments. c. Anticipated Duration of Services: i. One (1) to two (2) months. d. Goals of Services: i. To schedule with the client as quickly as possible once the referral is received. ii. To conduct a thorough observation(s) of the family members, with special focus on referral questions. iii. To complete the observation(s) and recommendations in a timely manner. iv. To identify strengths and weaknesses in parenting. v. To identify next steps in treatment to inform treatment plans. vi. To identify how the family can best be supported in the appropriate environment. vii. To identify what interventions will lead to increased resilience, skill development, emotional regulation, and ultimately individual and family success. viii. To address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and ix. loss/grief. x. To maintain frequent and thorough communication with Child Welfare Social Case Workers throughout the evaluation process and to provide written reporting on at least a monthly basis. xi. In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. e. Outcomes of Services: i. Parenting strengths and weaknesses have been identified and articulated. ii. Next steps in treatment plan goals have been identified. iii. Interventions have been identified to improve individual and family functioning. iv. Family preservation/reunification has been facilitated whenever possible. f. Target Population: i. Individuals with intellectuaUdevelopmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits. g. Language: i. English. ii. Interpreters are not able to be used for this service. h. Medicaid Eligibility: i. This service is Medicaid eligible. 19 i. Service Access and Transportation: i. Services can be provided in -home. ii. In -community within Weld County. iii. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South McCaslin Boulevard, Suite 200 in Louisville. 3. 14001 East Iliff Avenue, Suite 204 in Aurora. iv. Telehealth services can also be provided as necessary due to Covid-19. Relinquishment Counseling 16. Relinquishment Counseling a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. When a parent(s) is/are considering the legal relinquishment of their child(ren), Contractor can provide relinquishment counseling services for both parents and their children, ages twelve (12) and older. ii. Additional related services include attachment/bonding therapy, therapeutic visitation, life skills, and aftercare services. b. Anticipated Frequency of Services: i. Frequency will be dependent on each case. c. Anticipated Duration of Services: i. Duration will be dependent on each case. d. Goals of Services: i. Ensure the parent(s) has considered all aspects of the relinquishment and is making an informed choice. ii. Ensure that the child(ren)'s best interests are kept in mind and that parent(s) fully understand these best interests. iii. Align treatment goals with goals identified in the Family Service Plan (FSP). iv. Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. v. Engage families with outcome -based treatment modalities with proven efficacy. vi. Maintain frequent and thorough communication with Child Welfare Case Workers and provide written reporting on at least a monthly basis. vii. In keeping with the Family First Prevention Services Act, Contractor's ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. e. Outcomes of Services: i. Parent(s) are able to make a fully informed decision whether or not to relinquish their parental rights. ii. Child(ren)'s best interests are kept in mind. iii. Increased safety and welfare of children by working with parents to understand child - welfare -specific concerns such as abuse, neglect, loss, and grief. iv. Improved individual and/or family functioning to maintain the welfare of clients. f. Target Population: i. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits. g. Language: 20 i. English. ii. Interpreters may also be utilized. h. Medicaid Eligibility: i. This service is Medicaid eligible. Service Access and Transportation: i. Services can be provided in -home. ii. In -community within Weld County. iii. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South McCaslin Boulevard, Suite 200 in Louisville. 3. 14001 East Iliff Avenue, Suite 204 in Aurora. iv. Telehealth services can also be provided as necessary due to Covid-19. Sexual Abuse Treatment 17. Sexual Abuse Treatment Therapy and Consultation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Contractor's clinical team includes a Master's level Sex Offender Management Board (SOMB) therapist who has extensive experience working with SOMB standards, treating sexual abuse victims, and working with sexually abusive individuals. Therefore, Contractor is able to provide the following sex -offense -specific therapy and consultation services: 1. Therapeutic Sexual Abuse Treatment for Victims. 2. Offense -Specific Treatment for Sexual Offenders. 3. Informed Supervision Training for Caregivers. 4. Multi -Systemic Therapy for Problem Sexual Behaviors (MST-PSB). 5. Attending Multi -Disciplinary Team meetings to provide consultation, guidance, and support, and to assist in safety planning and development of next steps. 6. Providing psycho -educational information for those impacted by sexual abuse, including for education for parents on clarification/reunification, informed supervision, family therapy, and safety planning. b. Anticipated Frequency of Services: One (1) or two (2) times per week, depending on the needs of the client. c. Anticipated Duration of Services: i. Duration can span three (3) months to two (2) years. ii. Contractor is committed to accomplishing treatment goals within court -mandated timeframes. d. Goals of Services: i. To provide therapeutic interventions specific to behaviors related to sexual abuse victimization, sexual dysfunction, and sexual abuse perpetration. ii. To prevent further sexual abuse and victimization. iii. To support multidisciplinary team members at meetings by offering expert -level guidance into treatment planning, safety planning, and next steps. iv. To provide education to team members and clients regarding sexual abuse specific concerns, including clarification, reunification, family therapy, informed supervision, boundary establishment, safety planning. e. Outcomes of Services: i. Assistance is provided in outlining sex -offense -specific treatment goals. ii. Therapy and education are provided to decrease problem behaviors and avoid abuse and victimization. 21 iii. Client(s) are better able to meet treatment goals. f. Target Population: i. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits. g. Language: i. English. ii. Interpreters may also be utilized. h. Medicaid Eligibility: i. This service is Medicaid eligible. Service Access and Transportation: i. Services can be provided in -home. ii. In -community within Weld County. iii. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South McCaslin Boulevard, Suite 200 in Louisville. 3. 14001 East Iliff Avenue, Suite 204 in Aurora. iv. Telehealth services can also be provided as necessary due to Covid-19. 18. Psychosexual Evaluations/Sex-Offender-Specific Evaluation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Thorough psychosexual evaluations/sex-offender-specific evaluation completed by a Master's level SOMB therapist. b. Anticipated Frequency of Services: i. One (1) to four (4) appointments. c. Anticipated Duration of Services: i. One (2) to two (2) months. d. Goals of Services: i. To schedule with the client as quickly as possible once the referral is received. ii. To conduct a thorough evaluation with the client, including addressing all of the referral questions. iii. To complete the evaluation in a timely manner while making client -specific and thorough recommendations on validated treatments with proven efficacy. iv. To determine issues and behaviors related to sexual abuse, dysfunction, and perpetration. v. To determine whether co-occurring conditions exist. vi. To develop thorough evidence -based treatment plan recommendations to assist with treatment, including addressing safety needs and needs for family therapy. vii. To prevent further sexual abuse victimization. viii. To address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. ix. To maintain frequent and thorough communication with Child Welfare Social Case Workers throughout the evaluation process and to provide written reporting on at least a monthly basis. x. In keeping with the Family First Prevention Services Act, Contractor's ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. 22 e. Outcomes of Services: i. Client's specific needs for support in meeting treatment goals have been identified, improving the likelihood that treatment goals can be met. ii. Client -specific outcome -based treatment modalities with proven efficacy have been recommended. iii. Increased safety and welfare of children by providing recommendations to ensure parents understand what is best for and act in the long-term interest of their child(ren). iv. Improved individual and/or family functioning to maintain the welfare of clients. v. Team members are supported in the development of safety planning and FSP goals. f. Target Population: i. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits. g. Language: i. English. ii. Interpreters may also be utilized. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. Services can be provided in -home. ii. In -community within Weld County. iii. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South McCaslin Boulevard, Suite 200 in Louisville. 3. 14001 East Iliff Avenue, Suite 204 in Aurora. iv. Telehealth services can also be provided as necessary due to Covid-19. Substance Abuse Treatment 19. Substance Abuse Treatment Therapy and Consultation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Contractor's clinical team includes a Licensed Addiction Counselor. Contractor is able to provide the following substance abuse treatment services to improve family functioning and support future sobriety and, ultimately, work towards preserving or reuniting the family whenever possible: 1. Individual and family therapeutic services. 2. Consultation to aid in Family Service Plan (FSP) development. 3. Provision of psycho -educational information for those impacted by substance abuse. b. Anticipated Frequency of Services: One (1) or two (2) times per week, depending on the needs of the client. c. Anticipated Duration of Services: i. Duration can span three (3) months to two (2) years. ii. Contractor is committed to accomplishing treatment goals within court -mandated timeframes. d. Goals of Services: 23 i. To provide therapeutic interventions specific to reducing substance abuse and treating underlying issues. ii. To assist in crafting a Family Service Plan that addresses the substance abuse issues at hand. iii. To improve family functioning and relationships by addressing substance abuse issues. iv. To prevent further substance abuse. v. To support team members at meetings by offering expert -level guidance into treatment planning, safety planning, and next steps. vi. To provide education to team members and clients regarding substance abuse specific concerns. e. Outcomes of Services: i. Assistance is provided in outlining substance -abuse -specific treatment goals. ii. Therapy and education are provided to prevent further substance abuse and its negative impacts on the family. iii. Client(s) are better able to meet treatment goals. iv. Family functioning is improved. v. Safety of family members is improved. f. Target Population: i. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits. g. Language: i. English. ii. Interpreters may also be utilized. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. Services can be provided in -home. ii. In -community within Weld County. iii. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South McCaslin Boulevard, Suite 200 in Louisville. 3. 14001 East Iliff Avenue, Suite 204 in Aurora. iv. Telehealth services can also be provided as necessary due to Covid-19. 20. Substance Abuse Evaluations a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Contractor's licensed Addiction Counselor, will conduct a thorough substance abuse evaluation, including assessing the level of drug, alcohol, or polysubstance addiction. ii. Recommendations are made that are tailored specifically to the referral question at hand. b. Anticipated Frequency of Services: i. One (1) to four (4) appointments. c. Anticipated Duration of Services: i. One (1) to two (2) months. 24 d. Goals of Services: i. To determine the extent/level of drug or alcohol addiction. ii. To determine whether co-occurring conditions exist. iii. To develop thorough evidence -based treatment plan recommendations to assist with recovery. iv. To prevent further abuse of substances. e. Outcomes of Services: i. Client's specific needs for support in meeting treatment goals have been identified, improving the likelihood that treatment goals can be met. ii. Client -specific outcome -based treatment modalities with proven efficacy have been recommended. iii. Increased safety and welfare of children by providing recommendations to ensure parents understand what is best for and act in the long-term interest of their child(ren). iv. Improved individual and/or family functioning to maintain the welfare of clients. v. Prevention of further substance abuse. f. Target Population: i. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits. g. Language: i. English. ii. Interpreters may also be utilized. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. Services can be provided in -home. ii. In -community within Weld County. iii. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South McCaslin Boulevard, Suite 200 in Louisville. 3. 14001 East Iliff Avenue, Suite 204 in Aurora. iv. Telehealth services can also be provided as necessary due to Covid-19. Functional Family Therapy 21. Functional Family Therapy a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Contractor is highly experienced in providing functional family therapy, including intensive treatment services in the home or community to decrease family dysfunction and improve familial outcomes. Contractor has served numerous children, adolescents, adults, and family units dealing with challenges related to trauma, attachment difficulties, legal involvement, and other difficult issues. It is the Contractor's Chief Officer of Development and Culture, Dr. Kalis', philosophy that providing the appropriate therapy, support, and education allows families to remain intact while providing a healthy and safe environment for the children. Contractor is dedicated to strengthening families and, whenever possible, helping to avoid out -of -home placement. ii. Evidence -based services provided by the Contractor's service team includes: multi - systemic therapy, cognitive behavioral therapy and trauma -focused Cognitive Behavioral 25 Therapy (CBT), Applied Behavior Analysis (ABA) therapy, therapeutic visitation services, dialectical behavioral therapy, Eye Movement Desensitization and Reprocessing (EMDR), psychological and cognitive evaluations, and family therapy. b. Anticipated Frequency of Services: One (1) or two (2) times per week, depending on the needs of the client. c. Anticipated Duration of Services: i. Duration can span three (3) months to two (2) years. ii. Contractor is committed to accomplishing treatment goals within court -mandated timeframes. d. Goals of Services: i. Align treatment goals with goals identified in the Family Service Plan (FSP). ii. Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. iii. Engage families with outcome -based treatment modalities with proven efficacy. iv. Maintain frequent and thorough communication with Child Welfare Social Case Workers and provide written reporting on at least a monthly basis. v. In keeping with the Family First Prevention Services Act, Contractor's ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. e. Outcomes of Services: i. Client(s) have improved ability to regulate their emotions. ii. Client(s) are better able to meet their treatment goals. iii. The safety and welfare of children is increased by working with parents to understand what is best for, and act in the long-term interest of their child(ren). iv. Improved individual and/or family functioning to maintain the welfare of clients. f. Target Population: i. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits. g. Language: i. English. ii. Interpreters may also be utilized. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. Services can be provided in -home. ii. In -community within Weld County. iii. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South McCaslin Boulevard, Suite 200 in Louisville. 3. 14001 East Iliff Avenue, Suite 204 in Aurora. iv. Telehealth services can also be provided as necessary due to Covid-19. Multisystemic Therapy 22. Multisystemic Therapy 26 a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Contractor is highly experienced in providing intensive multi -systemic therapy to foster positive change across the home, school, and community environments. ii. Serious behavioral issues are addressed through interventions designed to avoid out -of - home placement. b. Anticipated Frequency of Services: One (1) or two (2) times per week, depending on the needs of the client. c. Anticipated Duration of Services: i. Duration can span three (3) months to two (2) years. ii. Contractor is committed to accomplishing treatment goals within court -mandated timeframes. d. Goals of Services: i. Align treatment goals with goals identified in the Family Service Plan (FSP). ii. Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. iii. Engage families with outcome -based treatment modalities with proven efficacy. iv. Maintain frequent and thorough communication with Child Welfare Social Case Workers, and provide written reporting on at least a monthly basis. v. In keeping with the Family First Prevention Services Act, Contractor's ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. e. Outcomes of Services: i. Client(s) have improved ability to regulate their emotions. ii. Problematic behaviors are reduced, and coping skills are improved. iii. Client(s) are better able to meet their treatment goals. iv. There is increased safety and welfare of clients through behavioral improvement. v. There is improved individual and/or family functioning to maintain the welfare of clients. f. Target Population: i. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits. g. Language: i. English. ii. Interpreters may also be utilized. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. Services can be provided in -home. ii. In -community within Weld County. iii. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South McCaslin Boulevard, Suite 200 in Louisville. 3. 14001 East Iliff Avenue, Suite 204 in Aurora. iv. Telehealth services can also be provided as necessary due to Covid-19. 27 Terms 1. Contractor will respond to the Quality Assurance Team (HS-CWQualitvAssurance(a,weldgov.com within three (3) business days regarding the ability to accept the received referral. 2. Upon acceptance of a referral, Contractor will offer an initial appointment within seven (7) days of receiving the referral. The first attempt to contact the client will occur within 24 hours of receiving the referral (excluding weekends and holidays). Contractor will document efforts to engage client in referred services. If the client does not respond after three (3) attempts in the first seven (7) days of the referral period, the Contractor will notify the caseworker and the Quality Assurance Team HS- CWQualityAssurance(a weldgov.com. 3. Contractor understands that "no shows" are defined as unexcused and unplanned/uncommunicated absences for services. If a rate for "no shows" is not specifically stated in Exhibit D, Rate Schedule, then Contractor understands that the Department will not reimburse for "no shows". Contractor understands that the Department will only reimburse Contractor for up to two (2) "no-shows", or up to two (2) hours, on the part of case participants who cancel without 24 hour notice. After three (3) "no-shows", Contractor will place client on a behavioral plan requiring attendance or discharge the client from services. Contractor must inform the caseworker and the Quality Assurance Team HS-CWQualitvAssurance(a,weldgov.com within three (3) days of when the client is placed on a behavioral plan or discharged. 4. Contractor understands that the Department will not reimburse Contractor for cancelled appointments either on the part of the client or the Contractor. If the cancellation is generated from the Contractor, a "makeup" session/episode, to occur within 30 days of the cancellation, will be offered to the client (excluding session/episodes that fall on holidays). If the cancellation is generated from the client, the Contractor must request a makeup session from the Department prior to the makeup session occurring (excluding session/episodes that fall on holidays). After three (3) cancellations, Contractor will inform the caseworker and the Quality Assurance Team HS-CWQualitvAssurance(& weldgov.com immediately via email, to discuss service continuation. 5. Contractor will identify, in detail, areas of continued concern and make recommendations to the caseworker in a monthly report regarding continuation of services and/or the need for additional services. 6. Contractor will document in detail any and all observed or verbalized concerns regarding any child whom the Contractor is working with under an active referral. Areas of concern may include, but are not limited to, any physical, emotional, educational or behavioral issues. Areas of concern should be reported to the caseworker and the Quality Assurance Team HS-CWQualityAssuranceAweldgov.com immediately AND on the required monthly report. 7. Contractor will submit reports on a monthly basis for each active referral for ongoing services. Reports will be submitted per the online format required by the Department, unless otherwise directed by the Department. 8. Contractor agrees any change to an existing referral must be pre -approved through the Child Welfare Core Service Coordinator or any member of the Quality Assurance Team. Any changes to visitation referrals will be approved by a new referral signed by the Child Welfare Supervisor. A change is defined as anything outside of the approved documented service on the initial authorized referral form. This may include an increase or decrease in services hours, change in frequency, change in location of services, transportation needs, or any change to the initial referral or subsequent authorizations. 28 9. Contractor agrees to attend meetings when available and as requested by the Department. Such meetings include Court Facilitations, Bid Meetings, Professional Staffings, Family Team Meetings and/or Team Decision Making meetings. The Department will reimburse for actual participation in the meeting only so long as there is written authorization from the Quality Assurance Team, and the facilitator documents in the meeting notes the timeframe that the provider attended and when participation in the meeting is deemed appropriate and necessary by the Department. The Facilitator will be responsible for filling out the time attended on the meeting notes. Staffings and/or meetings other than those listed above are not considered reimbursable unless otherwise approved by the Child Welfare Contract and Services Coordinator. Contractor may participate by phone or virtually, if approved by the Department. 10. On a monthly basis, the Contractor will notify the Quality Assurance Team HS- CWOualitvAssurance(a�weldeov.com of new staff who will manage and/or administer the services with the following information: a. Staff member name and contact information b. Education level/degree (if applicable) c. Licensure/credentials (if applicable) d. Department of Regulatory Authority (DORA) number (if applicable) e. Supervisor name and contact information The Department reserves the right to decline the new staff members managing and/or administering services to Department clients. 29 EXHIBIT B RATE SCHEDULE 1. Funding and Method of Payment The Department agrees to reimburse the Contractor in consideration of the work and services performed under this Agreement at the rate specific in Paragraph 2, below. Expenses incurred by the Contractor prior to the term of this Agreement are not eligible Department expenditures and shall not be reimbursed by the Department. Payment pursuant to this Agreement, whether in whole or in part, is subject to and contingent upon the continuing availability of said funds for the purposes hereof. In the event that said funds, or any part thereof, become unavailable as determined by the Department, the Department may immediately terminate the Agreement or amend it accordingly. 2. Fees for Services Aftercare Therapy and Consultation Rate Unit Type Service Name $125.00 Hour In-officeNideo — Master's level $150.00 Hour In-officeNideo — Ph.D. level $125.00 Hour In -Home or Community — Master's level $150.00 Hour In -Home or Community — PhD. level $125.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing — Master's level $150.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing — Ph.D. $125.00 Each No Show — Master's level $150.00 Each No Show — Ph.D. level $0.50 Mile For distances exceeding 25 roundtrip miles from the location of the assigned therapist. Anger Management/Domestic Violence Prevention Rate Unit Type Service Name $125.00 Hour In-officeNideo — Master's level $150.00 Hour In-office/Video — Ph.D. level $125.00 Hour In -Home or Community — Master's level $150.00 Hour In -Home or Community — Ph.D. level $125.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing — Master's level $150.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing — Ph.D. $125.00 Each No Show — Master's level $150.00 Each No Show — Ph.D. level $0.50 Mile For distances exceeding 25 roundtrip miles from the location of the assigned therapist. Foster Parent Consultation Rate Unit Type Service Name $125.00 Hour In-office/Video — Master's level $150.00 Hour In-office/Video — Ph.D. level $125.00 Hour In -Home or Community — Master's level $150.00 Hour In -Home or Community — Ph.D. level $125.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing — Master's level $150.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing — Ph.D. $125.00 Each No Show — Master's level $150.00 Each No Show — Ph.D. level $0.50 Mile For distances exceeding 25 roundtrip miles from the location of the assigned therapist. Foster Parent Training Rate Unit Type Service Name $125.00 Hour In-officeNideo — Master's level $150.00 Hour In-officeNideo — Ph.D. level $125.00 Hour In -Home or Community — Master's level $150.00 Hour In -Home or Community — Ph.D. level $125.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing — Master's level $150.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing — Ph.D. $125.00 Each No Show — Master's level $150.00 Each No Show — Ph.D. level $0.50 Mile For distances exceeding 25 roundtrip miles from the location of the assigned therapist. Home -Based Intervention Rate Unit Type Service Name $125.00 Hour In-officeNideo — Master's level $150.00 Hour In-officeNideo — Ph.D. level $125.00 Hour In -Home or Community — Master's level $150.00 Hour In -Home or Community — Ph.D. level $125.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing — Master's level $150.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing — Ph.D. $125.00 Each No Show — Master's level $150.00 Each No Show — Ph.D. level $0.50 Mile For distances exceeding 25 roundtrip miles from the location of the assigned therapist. Therapeutic Kinship Services Rate Unit Type Service Name $125.00 Hour In-officeNideo — Master's level $150.00 Hour In-officeNideo — Ph.D. level $125.00 Hour In -Home or Community — Master's level $150.00 Hour In -Home or Community — Ph.D. level $125.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing — Master's level $150.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing — Ph.D. $125.00 Each No Show — Master's level $150.00 Each No Show — Ph.D. level $0.50 Mile For distances exceeding 25 roundtrip miles from the location of the assigned therapist. Life Skills Therapeutic Visitation Rate Unit Type Service Name $125.00 Hour In-officeNideo — Master's level $150.00 Hour In-office/Video — Ph.D. level $125.00 Hour In -Home or Community — Master's level $150.00 Hour In -Home or Community — Ph.D. level $125.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing — Master's level $150.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing — Ph.D. $125.00 Each No Show — Master's level $150.00 Each No Show — Ph.D. level $0.50 Mile For distances exceeding 25 roundtrip miles from the location of the assigned therapist. Parent Coaching Rate Unit Type Service Name $125.00 Hour In-office/Video — Master's level $150.00 Hour In-officeNideo — Ph.D. level $125.00 Hour In -Home or Community — Master's level $150.00 Hour In -Home or Community — Ph.D. level $125.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing — Master's level $150.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing — Ph.D. $125.00 Each No Show — Master's level $150.00 Each No Show — Ph.D. level $0.50 Mile For distances exceeding 25 roundtrip miles from the location of the assigned therapist. Supervised Visitation Rate Unit Type Service Name $125.00 Hour In-office/Video — Master's level $150.00 Hour In-office/Video — Ph.D. level $125.00 Hour In -Home or Community — Master's level $150.00 Hour In -Home or Community — Ph.D. level $125.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing — Master's level $150.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing — Ph.D. $125.00 Each No Show — Master's level $150.00 Each No Show — Ph.D. level $0.50 Mile For distances exceeding 25 roundtrip miles from the location of the assigned therapist. Mediation Rate Unit Type Service Name $125.00 Hour In-office/Video — Master's level $150.00 Hour In-officeNideo — Ph.D. level $125.00 Hour In -Home or Community — Master's level $150.00 Hour In -Home or Community — Ph.D. level $125.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing — Master's level _ $150.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing — Ph.D. $125.00 Each No Show — Master's level $150.00 Each No Show — Ph.D. level $0.50 Mile For distances exceeding 25 roundtrip miles from the location of the assigned therapist. Mental Health Services Functional Family Therapy Rate Unit Type Service Name $125.00 Hour In-officeNideo — Master's level $150.00 Hour In-officeNideo — Ph.D. level $125.00 Hour In -Home or Community — Master's level $150.00 Hour In -Home or Community — Ph.D. level $125.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing — Master's level $150.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing — Ph.D. $125.00 Each No Show — Master's level $150.00 Each No Show — Ph.D. level $0.50 Mile For distances exceeding 25 roundtrip miles from the location of the assigned therapist. Multisystemic Therapy Rate Unit Type Service Name $125.00 Hour In-officeNideo — Master's level $150.00 Hour In-officeNideo — Ph.D. level $125.00 Hour In -Home or Community — Master's level $150.00 Hour In -Home or Community — Ph.D. level $125.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing — Master's level $150.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing — Ph.D. $125.00 Each No Show — Master's level $150.00 Each No Show — Ph.D. level $0.50 Mile For distances exceeding 25 roundtrip miles from the location of the assigned therapist. Counseling/Psychotherapy Rate Unit Type Service Name $125.00 Hour In-officeNideo — Master's level $150.00 Hour In-officeNideo — Ph.D. level $125.00 Hour In -Home or Community — Master's level $150.00 Hour In -Home or Community — Ph.D. level $125.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing — Master's level $150.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing — Ph.D. $125.00 Each No Show — Master's level $150.00 Each No Show — Ph.D. level $0.50 Mile For distances exceeding 25 roundtrip miles from the location of the assigned therapist. Consultation Rate Unit Type Service Name $125.00 Hour In-officeNideo — Master's level $150.00 Hour In-officeNideo — Ph.D. level $125.00 Hour In -Home or Community — Master's level $150.00 Hour In -Home or Community — Ph.D. level $125.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing — Master's level $150.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing — Ph.D. $125.00 Each No Show — Master's level $150.00 Each No Show — Ph.D. level $0.50 Mile For distances exceeding 25 roundtrip miles from the location of the assigned therapist. Psychological Evaluation Rate Unit Type Service Name $350.00 Hour In-officeNideo $350.00 Hour In -Home or Community $150.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing Trauma Assessment Rate Unit Type Service Name $350.00 Hour In-officeNideo $350.00 Hour In -Home or Community $150.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing Parent -Child Interactional Evaluation Rate Unit Type Service Name $350.00 Hour In-officeNideo $350.00 Hour In -Home or Community $150.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing Relinquishment Counseling Rate Unit Type Service Name $125.00 Hour In-officeNideo — Master's level $150.00 Hour In-officeNideo — Ph.D. level $125.00 Hour In -Home or Community — Master's level $150.00 Hour In -Home or Community — Ph.D. level $125.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing — Master's level $150.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing — Ph.D. $125.00 Each No Show — Master's level $150.00 Each No Show — Ph.D. level $0.50 Mile For distances exceeding 25 roundtrip miles from the location of the assigned therapist. Substance Abuse Treatment Therapy and Consultation Rate Unit Type Service Name $125.00 Hour In-officeNideo — Master's level $125.00 Hour In -Home or Community — Master's level $125.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing — Master's level $125.00 Each No Show — Master's level $0.50 Mile For distances exceeding 25 roundtrip miles from the location of the assigned therapist. Substance Abuse Evaluations Rate Unit Type Service Name $350.00 Hour In-officeNideo $350.00 Hour In -Home or Community $125.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing Sexual Abuse Treatment Therapy and Consultation Rate Unit Type Service Name $125.00 Hour In-officeNideo $125.00 Hour In -Home or Community $125.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing — Master's level $125.00 Each No Show $0.50 Mile For distances exceeding 25 roundtrip miles from the location of the assigned therapist. Psychosexual Evaluations/Sex-Offender-Specific Evaluations Rate Unit Type Service Name $1,100.00 Each In-officeNideo $125.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing — Master's level 3. Submittal of Vouchers Contractor shall prepare and submit monthly a Request for Reimbursement and monthly report including other supporting documentation, if applicable, certifying that services authorized were provided on the date(s) indicated and the charges were made pursuant to the terms and conditions of Paragraph 3 of this Agreement . Contractor shall submit all Requests for Reimbursement and supporting documentation to the Department by the 7th day of the month following the month of service, but no later than 45 days from the date of service. Requests for Reimbursement and/or supporting documentation received after 45 days from the date of service may result in delay or forfeiture of payment. Consistent failure to meet the 45 -day deadline may result in termination of the Agreement. For ongoing services, proof of services rendered shall be a monthly report submitted in accordance with Paragraph 3(d) of this Agreement. When submitting a request for payment for a one-time service, the contractor shall submit the first and last page of the evaluation/report to confirm proof of services rendered. The full evaluation/report should be submitted by the contractor to the caseworker. For Monitored Sobriety services, proof of services rendered shall be the test result. Exhibit C WELD COUNTY'S REQUEST FOR PROPOSAL (Weld County's Request for Proposal is incorporated into this agreement by reference and will be provided upon request to the Department.) This page is intentionally left blank Exhibit D Contractor's response to the Request for Proposal Exhibit D contains the following documents: • Attachment B — Provider Information Form (PIF) • Attachment C — Proposal • Attachment D — Staff Data Sheet • Certificate of Insurance (COI) ATTACHMENT B WELD COUNTY DEPARTMENT OF HUMAN SERVICES — PROVIDER INFORMATION FORM (PIF) AGENCY INFORMATION Agency Name: Parker Personal Care Homes, Inc. dba David Kalis Trails Provider ID (if known): 1606668 Provider Contact Full Name: Kate Veeder Primary Phone Number (10 -digit): 720.471.9973 Title: Director of Psychological & Behavioral Services Ext.: Fax Number (10 -digit): Primary Contact Email: kate@kalisandassociateS.net Web Address: (303) 416-4356 www.kalisandassociates.net and www.parkerpch.com Agency Location Address (Street, city, state, zip): 357 S. M cCasli n Blvd., Louisville, CO 80027 Agency Mailing Address (street, city, state, zip): 1597 Cole Boulevard, Suite 250, Lakewood, CO Agency Type (pick one): Public Company Private Non -Profit Private for Profit Referral Contact Name: Send Referrals for Service to: Jenna Rampi Referral Phone Number (10 -digit): 303.548.8766 Ext.: Behavioral Administrative Assistant Title: admin@kalisandassociates.net Email: Billing Contact Name: Billing Phone Number (10 -digit): 303.424.6078 Billing Contact Misti Jones Ext.: Title: Director of Billing Services 119 Email: mjones@parkerpch.com r CERTIFICATION I certify that the services proposed for intended use by the Weld County Department of Human Services will meet all the specifications it I has so indicated in this bid form. I further affirm intention to enter into an agreement with Weld County, on behalf of the Weld County Department of Human Services, and comply with all requirements of the contract, if awarded. The Board of Weld County Commissioners reserve the right to reject any or all bids, to waive any informality in the bids, and to accept Ithe bid, or part of a bid, that, in the opinion of the Board, is in the best interests of the Board and of the County of Weld, State of Colorado. The Board of Weld County Commissioners shall give preference to resident Weld County bidders in all cases where the bids are I competitive in price and quality. I I WELD COUNTY IS EXEMPT FROM COLORADO SALES TAXES. THE CERTIFICATE OF EXEMPTION NUMBER IS #98-03551-0000. I Authorized Rep. Full Name: Jodi Walters Title: Chief Executive Officer I i jwalters@parkerpch.com 303.424.6078 108 i I Authorized Rep. Email: rl N Phone (10 -digit): Ext.: 1597 Cole Blvd., Ste 250, Lakewood, CO 80401 Authorized Rep. Address (Street, city, state, zip): I Signature of Authorized Rep.: Date: 6.23.2023 i REV. DECEMBER 2021 ATTACHMENT C - PROPOSAL Please type your answers in the boxes below or check the appropriate box. SECTION 1— Provider and Program Area Information Bidder's Legal Name: Program Area: Program Areas are listed in column 1 of the table located in Item XI of the You may complete another Attachment C if you have more than 5. Request for Proposal starting on page 13. Parker Personal Care Homes, Inc. dba David Kalis Aftercare Services Number of services offered on this Attachment C (max 5): SECTION 2 - Service Name(s) and Information If the service is a monthly package, please offer different levels. All monthly packages must state a specific minimum number of direct service hours. Service #1 Name: Aftercare Therapy and Consultation 2.1a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): • Consultation and individual and family therapy to foster bonding and attachment, support reunification or other permanent placement, support permanency, and prevent out -of -home placement when possible. • Services include: behavioral management intervention, provision of psycho -educational information on bonding and attachment, and assistance with navigation of care systems. • Cognitive behavioral strategies, educational strategies, and applied behavioral analysis are utilized, as well as assistance to help families understand such disorders as ADHD, trauma, and autism specific disorders. • Attendance of FTMs to support client(s)/team is also available. 2.1b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Once weekly or bi-weekly, depending on the needs of the client 2.1c Anticipated duration of service (i.e. 3-4 months): 3 months to 2 years, generally; the lengthofservices is dependent not only upon the types of services we are asked to provide but also upon the stage of the case in which we are asked to begin services. Typically this service is more short- term. 2.1d Three (3), or more, specific goals of the service (DO use bullet points): 1. Align treatment goals with goals identified in the FSP. 2. Utilize behavioral management strategies to improve behavioral regulation and the stability of the individual/family.. 3 Provide psycho -educational information on bonding and attachment, including supporting the client(s) as needed with their comprehension of the educational material and with specific ways to implement strategies provided. 4. Assist and support clients in navigating the network of applicable community -based services and supports. 5. Through individual and/or family therapy, foster bonding and attachment to prevent out -of -home placement when possible, support reunification, or facilitate the transition to other permanent placement when necessary. 6. Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief._ 7. Engage families with outcome -based treatment modalities with proven efficacy. 8. Maintain frequent and thorough communication with Child Welfare Social Case Workers, and provide written reporting on at least a monthly basis. 9. In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. 2.1e Three (3), or more, specific outcomes of service: 1. Families are strengthened and, when possible, kept intact or reunited. 2. Individual and family functioning is improved. 3. Client(s) have improved ability to regulate emotions. 4. Client(s) are better able to meet treatment goals. 5. Increased safety and welfare of children by working with parents to understand what is best for and act in the long- term interest of their child(ren), 2.1f Target population of the service, including age and gender: Our clinical specialty is working with individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. We are proud of our commitment to inclusivity and our history of working with individuals regardless of age, gender, or other characteristics/traits. REV. OCT 2021 1 ATTACHMENT C - PROPOSAL 2.1g Languages service is available in (please list proficiency and if interpreter services are available): All services are available in English. When appropriate, interpreters can be utilized. 2.1h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: We are able to bill services either in whole or in part through Medicaid. We are currently providing services through Health First Colorado, including the following RAEs: Colorado Access, Colorado Community Health Alliance, Health Colorado, Inc., Northeast Health Partners, Rocky Mountain Health Plans, Denver Health Medicaid Choice, as well as various health insurance organizations and developmental disability waiver services. We are committed to ensuring affordable services: We also are a Program Approved Service Agency for Long Term Care Medicaid Waivers as a behavioral service provider conducting behavioral evaluations and ongoing services for individuals with developmental disabilities. 2.1i Service location — list where the service will take place (i.e. client's home, in -office, other) Services can be provided in -home, in -community within Weld County, or in any of our offices, which include: 1597 Cole Blvd., Suite 250 in Lakewood, 357 S. McCaslin S. McCaslin Blvd:, Suite 200 in Louisville;and 14001 E. Iliff Ave. Suite 204 in Aurora. All of our offices are ADA compliant and are located on bus lines. Telehealth services can also be provided as necessary due to Covid-19. Service #2 Name: 2.2a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.2b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.2c Anticipated duration of service (i.e. 3-4 months): 2.2d Three (3), or more, specific goals of the service (DO use bullet points): 2.2e Three (3), or more, specific outcomes of service: 2.2f Target population of the service: 2.2g Languages service is available in (please list proficiency and if interpreter services are available): 2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #3 Name: 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.3b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.3c Anticipated duration of service (i.e. 3-4 months): 2.3d Three (3), or more, specific goals of the service (DO use bullet points): 2.3e Three (3), or more, specific outcomes of service: 2.3f Target population of the service: 2.3g Languages service is available in (please list proficiency and if interpreter services are available): 2.3h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.3i Service location — list where the service will take place (i.e. client's home, in -office, other) REV. OCT 2021 2 ATTACHMENT C - PROPOSAL Service 2.4a #4 Name: Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.4b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.4c Anticipated duration of service (i.e. 3-4 months): 2.4d Three (3), or more, specific goals of the service (DO use bullet points): 2.4e Three (3), or more, specific outcomes of service: 2.4f Target population of the service: 2.4g Languages service is available in (please list proficiency and if interpreter services are available): 2.4h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.4i Service 2.5a Service location — list where the service will take place (i.e. client's home, in -office, other) #5 Name: Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.5b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.5c Anticipated duration of service (i.e. 3-4 months): 2.5d Three (3), or more, specific goals of the service (DO use bullet points): 2.5e Three (3), or more, specific outcomes of service: 2.5f Target population of the service: 2.5g Languages service is available in (please list proficiency and if interpreter services are available): 2.5h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part 2.6i Service location — list where the service will take place (i.e. client's home, in -office, other) Section 3 — Service Access and Transportation 3.1 Will you charge Weld County for transporting clients or mileage? Check ® YES one: 3.2 Will you conduct services in a client's home or in the community? Check ® YES one: 3.3 Will you transport clients to and/or from services? Check O YES ® NO one: 3.4 How many miles are you willing to travel round trip? List a specific number of miles. Determined based on service and made on a ❑ NO ❑ NO Miles REV. OCT 2021 3 ATTACHMENT C - PROPOSAL 3.5 When you calculate mileage, what is your starting point address? case -by - case basis This is dependent upon which therapist is providing the service. SECTION 4 - SERVICE RATES All rates need to include administrative work (i.e. scheduling or report writing) and overhead. Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly or monthly rates will be accepted for services, except for those listed above. • For hourly rates complete section(s) 4.1-4.5. • For monthly rates complete section 4.6. • For Home study providers complete section 4.7. • For monitored sobriety testing providers complete section 4.8. 4.1 Hourly Service #1 Name: Aftercare Therapy and Consultation 4.1a In-Office/Video: 4.1b In -Office with Transportation: In -Home or Community: 4.1c FTM, TDM, Prof. Staffing: 4.1d No show: 4.1e Mileage rate: $ Amount Unit Type $125 for Master's level; $150 for Ph.D. level N/A $125 for Master's level; $150 for Ph.D. level $125 for Master's level; $150 for Ph.D. level $125 for Master's level; $150 for Ph.D. level $0.50 per Hour per Hour per Hour per Hour per No Show No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: N/A 25 per Mile This is paid after the miles listed above. miles miles 4.2 Hourly Service #2 Name: 4.2a In-Office/Video: 4.2b In -Office with Transportation: 4.2c In -Home or Community: 4.2d FTM, TDM, Prof. Staffing: 4.2e No show: 4.2f Mileage rate: $ Amount Unit Type per Hour per Hour per Hour per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: This is paid after the miles listed above. miles miles REV. OCT 2021 4 ATTACHMENT C - PROPOSAL 4.3 Hourly Service #3 Name: $ Amount Unit Type 4.3a In-Office/Video: per Hour 4.3b In Transportation: -Office with per Hour No. of roundtrip miles included in rate: miles 4.3c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.3d FTM, TDM, Prof. Staffing: per Hour 4.3e No show: per No Show 4.3f Mileage rate: per Mile This is paid after the miles listed above. 4.4 Hourly Service #4 Name: $ Amount Unit Type 4.4a In-Office/Video: per Hour 4.4b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.4c FTM, TDM, Prof. Staffing: per Hour 4.4d No show: per No Show 4.4e Mileage rate: per Mile This is paid after the miles listed above. 4.5 Hourly Service #5 Name: $ Amount Unit Type 4.5a In-Office/Video: per Hour 4.5b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.5c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.5d FTM, TDM, Prof. Staffing: per Hour 4.5e No show: per No Show 4.5f Mileage rate: per Mile This is paid after the miles listed above. 4.6 Monthly Service Rates (each level must be listed): Service Name with Level Rate per Month No. of Direct Service Hours: 4.6a N/A N/A N/A 4.6b 4.6c 4.6d 4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers — List your rates in the box below. N/A 4.8 Monitored Sobriety Providers — List your rates in the box below. N/A REV. OCT 2021 5 ATTACHMENT C - PROPOSAL Provider special notes: Kalis and Associates has a long history of service to children, adolescents, and adults in the intellectual and developmental disability (I/DD) community, as well as a long history of partnership with Departments of Human Services throughout the Front Range and beyond. Kalis and Associates has truly enjoyed our partnership with Weld County, and we look forward to continuing to meet the unique needs of Weld County's child welfare clients. REV. OCT 2021 6 ATTACHMENT C - PROPOSAL Please type your answers in the boxes below or check the appropriate box. SECTION 1— Provider and Program Area Information Bidder's Legal Name: Program Area: Parker Personal Care Homes, Inc. dba David Kalis Anger Management/Domestic Violence Number of services offered on this Attachment C (max 5): Program Areas are listed in column 1 of the table located in Item XI of the You may complete another Attachment C if you have more than 5. Request for Proposal starting on page 13. 1 If Service 2.1a 2.1b 2.1c 2.1d 2.1e 2.1f 2.1g SECTION 2 - Service Name(s) and Information the service is a monthly package, please offer different levels. All monthly packages must state a specific minimum number of direct service hours. #1 Name: Anger Management/Domestic Violence Prevention Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): • Diagnostic and therapeutic services to help prevent future violence, improve family communication, increase relationship functioning, and aid in the development of the Family Services Plans when necessary.. • Attendance at MDT meetings can occur, and guidance can be provided regarding safety planning, recommendations, and progress made. • Our clinicians are trained to work with victims, offenders, as well as family members, and we are able to provide these services in alignment with DVOMB criteria: Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Once weekly or bi-weekly, depending on the needs of the client Anticipated duration of service (i.e. 3-4 months): 3 months to 2 years, generally; thelength of services is dependent not only upon the types of services we are asked to provide but also upon the stage of the case in which we are asked to begin services. We are committed to accomplishing treatment goals within court -mandated timeframes. Three (3), or more, specific goals of the service (DO use bullet points): 1. Improve client(s) anger management skills and prevent further incidents of violence., 2. Improve family communication and functioning, and strengthen family relationships. 3. Provide support to the whole family system to ensure safety and stability. 4. Support MDT professionals by providing input and guidance on safety planning, recommendations, and progress. 5. Align treatment goals with goals identified in the FSP. 6. Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. 7. Engage families with outcome -based treatment modalities with proven efficacy. 8. Maintain frequent and thorough communication with Child Welfare Social Case Workers, and provide written reporting on at least a monthly basis. 9, In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. Three (3), or more, specific outcomes of service: 1. Client(s) have improved ability to regulate emotions. 2. Family members are safer, and the family unit is more stable. 3. Client(s) are better able to meet treatment goals. 4. Increased safety and welfare of children by working with parents to understand what is best for and act in the long- term interest of their child(ren). 5. Improved individual and/or family functioning to maintain the welfare of clients. Target population of the service, including age and gender: Our clinical specialty is working with individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. We are proud of our commitment to inclusivity and our history of working with individuals regardless of age, gender, or other characteristics/traits. Languages service is available in (please list proficiency and if interpreter services are available): L All services are available in English. When appropriate, interpreters can be utilized. REV. OCT 2021 1 ATTACHMENT C - PROPOSAL 2.1h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: We are able to bill services either in whole or in part through Medicaid. We are currently providing services through Health First Colorado, including the following RAEs: Colorado Access, Colorado Community Health Alliance, Health Colorado, Inc., Northeast Health Partners, Rocky Mountain Health Plans, Denver Health Medicaid Choice, as well as various health insurance organizations and developmental disability waiver services. We are committed to ensuring affordable services. We also are a Program Approved Service Agency for Long Term Care Medicaid Waivers as a behavioral service provider conducting behavioral evaluations and ongoing services for individuals with developmental disabilities. 2.1i Service location — list where the service will take place (i.e. client's home, in -office, other) Services can be provided in -home, in -community within Weld County; or in any of our offices, which include: 1597 Cole Blvd., Suite 250 in Lakewood, 357 S. McCaslin S. McCaslin Blvd., Suite 200 in Louisville; and 14001 E. Iliff Ave, Suite 204 in Aurora. All of our offices are ADA compliant and are located on bus lines. Telehealth services can also be provided as necessary due to Covid-19. Service #2 Name: 2.2a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.2b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.2c Anticipated duration of service (i.e. 3-4 months): 2.2d Three (3), or more, specific goals of the service (DO use bullet points): 2.2e Three (3), or more, specific outcomes of service: 2.2f Target population of the service: 2.2g Languages service is available in (please list proficiency and if interpreter services are available): 2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #3 Name: 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.3b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.3c Anticipated duration of service (i.e. 3-4 months): 2.3d Three (3), or more, specific goals of the service (DO use bullet points): 2.3e Three (3), or more, specific outcomes of service: 2.3f Target population of the service: 2.3g Languages service is available in (please list proficiency and if interpreter services are available): 2.3h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.3i Service location — list where the service will take place (i.e. client's home, in -office, other) REV. OCT 2021 2 ATTACHMENT C - PROPOSAL Service 2.4a #4 Name: Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.4b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.4c Anticipated duration of service (i.e. 3-4 months): 2.4d Three (3), or more, specific goals of the service (DO use bullet points): 2.4e Three (3), or more, specific outcomes of service: 2.4f Target population of the service: 2.4g Languages service is available in (please list proficiency and if interpreter services are available): 2.4h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.4i Service 2.5a Service location — list where the service will take place (i.e. client's home, in -office, other) #5 Name: Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.5b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.5c Anticipated duration of service (i.e. 3-4 months): 2.5d Three (3), or more, specific goals of the service (DO use bullet points): 2.5e Three (3), or more, specific outcomes of service: 2.5f Target population of the service: 2.5g Languages service is available in (please list proficiency and if interpreter services are available): 2.5h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part 2.6i Service location — list where the service will take place (i.e. client's home, in -office, other) 3.1 3.2 3.3 3.4 Section 3 — Service Access and Transportation YES YES NO NO NO Will you charge Weld County for transporting clients or mileage? Check ■ one: Will you conduct services in a client's home or in the community? Check @ ■ one: Miles Will you transport clients to and/or from services? Check ■ YES 0 one: How many miles are you willing to travel round trip? List a specific number of miles. Determined based on service and made on a REV. OCT 2021 3 ATTACHMENT C - PROPOSAL 3.5 When you calculate mileage, what is your starting point address? case -by - case basis This is dependent upon which therapist is providing the service. SECTION 4 - SERVICE RATES All rates need to include administrative work (i.e. scheduling or report writing) and overhead. Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly or monthly rates will be accepted for services, except for those listed above. • For hourly rates complete section(s) 4.1-4.5. • For monthly rates complete section 4.6. • For Home study providers complete section 4.7. • For monitored sobriety testing providers complete section 4.8. 4.1 Hourly Service #1 Name: Anger Management/Domestic Violence Prevention 4.1a In-Office/Video: 4.1b In -Office with Transportation: In -Home or Community: 4.1c FTM, TDM, Prof. Staffing: 4.1d No show: 4.1e Mileage rate: $ Amount Unit Type $125 for Master's level; $150 for Ph.D. level N/A $125 for Master's level; $150 for Ph.D. level $125 for Master's level; $150 for Ph.D. level $125 for Master's level; $150 for Ph.D. level $0.50 per Hour per Hour per Hour per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: N/A 25 This is paid after the miles listed above. miles miles 4.2 Hourly Service #2 Name: 4.2a In-Office/Video: 4.2b In -Office with Transportation: 4.2c In -Home or Community: 4.2d FTM, TDM, Prof. Staffing: 4.2e No show: 4.2f Mileage rate: $ Amount Unit Type per Hour per Hour per Hour per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: This is paid after the miles listed above. miles miles REV. OCT 2021 4 ATTACHMENT C - PROPOSAL 4.3 Hourly Service #3 Name: $ Amount Unit Type 4.3a In-Office/Video: per Hour 4.3b In Transportation: -Office with per Hour No. of roundtrip miles included in rate: miles 4.3c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.3d FTM, TDM, Prof. Staffing: per Hour 4.3e No show: per No Show 4.3f Mileage rate: per Mile This is paid after the miles listed above. 4.4 Hourly Service #4 Name: $ Amount Unit Type 4.4a In-Office/Video: per Hour 4.4b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.4c FTM, TDM, Prof. Staffing: per Hour 4.4d No show: per No Show 4.4e Mileage rate: per Mile This is paid after the miles listed above. 4.5 Hourly Service #5 Name: $ Amount Unit Type 4.5a In-Office/Video: per Hour 4.5b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.5c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.5d FTM, TDM, Prof. Staffing: per Hour 4.5e No show: per No Show 4.5f Mileage rate: per Mile This is paid after the miles listed above. 4.6 Monthly Service Rates (each level must be listed): Service Name with Level Rate per Month No. of Direct Service Hours: 4.6a N/A N/A N/A 4.6b 4.6c 4.6d 4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers — List your rates in the box below. N/A 4.8 Monitored Sobriety Providers — List your rates in the box below. N/A REV. OCT 2021 5 ATTACHMENT C - PROPOSAL Provider special notes: Kalis and Associates has a long history of service to children, adolescents, and adults in the intellectual and developmental disability (I/DD) community, as well as a long history of partnership with Departments of Human Services throughout the Front Range and beyond. Kalis and Associates has truly enjoyed our partnership with Weld County, and we look forward to continuing to meet the unique needs of Weld County's child welfare clients. REV. OCT 2021 6 ATTACHMENT C - PROPOSAL Please type your answers in the boxes below or check the appropriate box. SECTION 1— Provider and Program Area Information Bidder's Legal Name: Program Area: Program Areas are listed in column I of the table located in Item XI of the You may complete another Attachment C if you have more than 5. Request for Proposal starting on page 13. Parker Personal Care Homes, Inc. dba David Kalis Foster Parent Consultation Number of services offered on this Attachment C (max 5): If 2.1a 2.1b 2.1c 2.1d 2.1e 2.1f 2.1g 2.1h SECTION 2 - Service Name(s) and Information the service is a monthly package, please offer different levels. All monthly packages must state a specific minimum number of direct service hours. Foster Parent Consultation Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): • Observation of family functioning to identify individual and family strengths and weaknesses. • Development of strategies to decrease conflict, build resiliency, and strengthen relationships. • Provision of psycho -educational information concerning trauma, abuse, and/or neglect. • Ability to work with child welfare clients and/or caseworkers and department personnel to evaluate and address specific cognitive, mental health, and/or developmental issues. • Can be provided remotely, in -person, and/or at FSP meetings. • Provision of trauma -informed care that also includes behavioral interventions to support the child/family Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Variable, depending upon the needs of the case Anticipated duration of service (i.e. 3-4 months): Variable, depending upon the needs of the case Three (3), or more, specific goals of the service (DO use bullet points): 1. Support caseworkers and clients to meet the treatment goals outlined in the FSP. 2. Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. 3.- Engage families with outcome -based treatment modalities with proven efficacy. 4. Maintain frequent and thorough communication with Child Welfare Social Case Workers, and provide written reporting on at least _ a monthly basis. 5. In keeping with the Family First Prevention Services Act our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. Three (3), or more, specific outcomes of service: 1. Caseworkers are supported in addressing treatment recommendations. 2. Client(s) have improved ability to regulate emotions. 3. Client(s) are better able to meet treatment goals. 4. Increased safety and welfare of children by working with foster parents to understand what is best for and act in the long-term interest of the child(ren). 5. Improved individual and/or family functioning to maintain the welfare of clients. Target population of the service, including age and gender: Consultation can be provided to caseworkers or clients. Our clinical specialty is working with individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. We are proud of our commitment to inclusivity and our history of working with individuals regardless of age, gender, or other characteristics/traits. Languages service is available in (please list proficiency and if interpreter services are available): All services are available in English. When appropriate, interpreters can be utilized. Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: We are able to bill services either in whole or in part through Medicaid. We are currently providing services through Health First Colorado, including the following RAEs: Colorado Access, Colorado Community Health Alliance, Health Colorado, Inc., Northeast. Health Partners, Rocky Mountain Health Plans, Denver Health Medicaid Choice, as well as various health insurance organizations and developmental disability waiver services. We are committed to ensuring affordable services. We also are a Program Approved Service Agency for Long Term Care Medicaid Waivers as a REV. OCT 2021 1 ATTACHMENT C - PROPOSAL behavioral service provider conducting behavioral evaluations and ongoing services for individuals with developmental disabilities. 2.1i Service location — list where the service will take place (i.e. client's home, in -office, other) Services can be provided in -home, in -community within Weld County, or in any of our offices, which include: 1597 Cole Blvd., Suite 250 in Lakewood, 3575. McCaslin S. McCaslin Blvd., Suite 200 in Louisville; and 14001 E. Iliff Ave. Suite 204 in Aurora. All of our offices are ADA compliant and are located on bus lines. Telehealth services can also be provided as necessary due to Covid-19. Service #2 Name: 2.2a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.2b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.2c Anticipated duration of service (i.e. 3-4 months): 2.2d Three (3), or more, specific goals of the service (DO use bullet points): 2.2e Three (3), or more, specific outcomes of service: 2.2f Target population of the service: 2.2g Languages service is available in (please list proficiency and if interpreter services are available): 2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #3 Name: 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.3b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.3c Anticipated duration of service (i.e. 3-4 months): 2.3d Three (3), or more, specific goals of the service (DO use bullet points): 2.3e Three (3), or more, specific outcomes of service: 2.3f Target population of the service: 2.3g Languages service is available in (please list proficiency and if interpreter services are available): 2.3h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.3i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #4 Name: 2.4a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.4b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: REV. OCT 2021 2 ATTACHMENT C - PROPOSAL 2.4c Anticipated duration of service (i.e. 3-4 months): 2.4d Three (3), or more, specific goals of the service (DO use bullet points): 2.4e Three (3), or more, specific outcomes of service: 2.4f Target population of the service: 2.4g Languages service is available in (please list proficiency and if interpreter services are available): 2.4h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.4i Service 2.5a Service location — list where the service will take place (i.e. client's home, in -office, other) #5 Name: Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.5b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.5c Anticipated duration of service (i.e. 3-4 months): 2.5d Three (3), or more, specific goals of the service (DO use bullet points): 2.5e Three (3), or more, specific outcomes of service: 2.5f Target population of the service: 2.5g Languages service is available in (please list proficiency and if interpreter services are available): 2.5h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part 2.6i Service location — list where the service will take place (i.e. client's home, in -office, other) 3.1 3.2 3.3 3.4 3.5 Section 3 — Service Access Will you charge Weld County for transporting clients or mileage? one: Will you conduct services in a client's home or in the community? one: and Transportation YES YES NO Check 0 • NO Check 0 ■ NO Miles Will you transport clients to and/or from services? Check • YES 0 one: How many miles are you willing to travel round trip? List a specific miles. When you calculate mileage, what is your starting point address? number of Determined based on service and made on a case -by - case basis This is dependent upon which therapist is providing the service. SECTION 4 - SERVICE RATES REV. OCT 2021 3 ATTACHMENT C - PROPOSAL All rates need to include administrative work (i.e. scheduling or report writing) and overhead. Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly or monthly rates will be accepted for services, except for those listed above. • For hourly rates complete section(s) 4.1-4.5. • For monthly rates complete section 4.6. • For Home study providers complete section 4.7. • For monitored sobriety testing providers complete section 4.8. 4.1 Hourly Service #1 Name: Foster Parent Consultation Modalities, curriculum, tools $ Amount Unit Type used in delivery of service (DO NOT list company history; DO use bullet points): 4.1a In-Office/Video: per Hour 4.1b In -Office with Transportation: In -Home or Community: 4.1c FTM, TDM, Prof. Staffing: 4.1d No show: 4.1e Mileage rate: $125 for Master's level; $150 for Ph.D. level N/A $125 for Master's level; $150 for Ph.D. level $125 for Master's level; $150 for Ph.D. level $125 for Master's level; $150 for Ph.D. level $0.50 per Hour per Hour per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: N/A 25 This is paid after the miles listed above. miles miles 4.2 Hourly Service #2 Name: 4.2a In-Office/Video: 4.2b In -Office with Transportation: 4.2c In -Home or Community: 4.2d FTM, TDM, Prof. Staffing: 4.2e No show: 4.2f Mileage rate: $ Amount Unit Type per Hour per Hour per Hour per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: This is paid after the miles listed above. miles miles 4.3 Hourly Service #3 Name: 4.3a REV. OCT 2021 In-Office/Video: $ Amount Unit Type per Hour 4 ATTACHMENT C - PROPOSAL 4.3b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.3c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.3d FTM, TDM, Prof. Staffing: per Hour 4.3e No show: per No Show 4.3f Mileage rate: per Mile This is paid after the miles listed above. 4.4 Hourly Service #4 Name: $ Amount Unit Type 4.4a In-Office/Video: per Hour 4.4b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles In -Home or Community: - per Hour No. of roundtrip miles included in rate: miles 4.4c FTM, TDM, Prof. Staffing: per Hour 4.4d No show: per No Show 4.4e Mileage rate: per Mile This is paid after the miles listed above. 4.5 Hourly Service #5 Name: $ Amount Unit Type 4.5a In-Office/Video: per Hour 4.5b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.5c In -Home or Community: per Hour No. of roundtrip miles included in rate: - miles 4.5d FTM, TDM, Prof. Staffing: per Hour 4.5e No show: per No Show 4.5f Mileage rate: per Mile This is paid after the miles listed above. 4.6 Monthly Service Rates (each level must be listed): Service Name with Level Rate per Month No. of Direct Service Hours: 4.6a N/A N/A N/A 4.6b 4.6c 4.6d 4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers — List your rates in the box below. N/A 4.8 Monitored Sobriety Providers — List your rates in the box below. N/A Provider special notes: Kalis and Associates has a long history of service to children, adolescents, and adults in the intellectual and developmental disability (I/DD) community, as well as a long history of partnership with Departments of Human Services throughout the Front Range and beyond. Kalis and Associates has truly enjoyed our partnership with Weld County, and we look forward to continuing to meet the unique needs of Weld County's child welfare clients. REV. OCT 2021 s ATTACHMENT C - PROPOSAL Please type your answers in the boxes below or check the appropriate box. SECTION 1— Provider and Program Area Information Bidder's Legal Name: Program Area: Program Areas are listed in column 1 of the table located in Item XI of the Request for Proposal starting on page 13. Parker Personal Care Homes, Inc. dba David Kalis Foster Parent Training Number of services offered on this Attachment C (max 5): You may complete another Attachment C if you have more than S. 1 If 2.1a 2.1b 2.1c 2.1d SECTION 2 - Service Name(s) and Information the service is a monthly package, please offer different levels. All monthly packages must state a specific minimum number of direct service hours. Foster Parent Training Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): • Training for foster parents provided in group or individual sessions concerning the effects of trauma, abuse, neglect, transitions, system of care navigation, and reunification. Our expertise in developmental issues will ensure thorough training for providers on appropriate expectations for and behaviors of children being served by the foster care system. • Kalis and Associates has extensive experience working with foster and adoptive families on issues related to attachment and in helping preserve family structures. We offer foster/adoptive parent consultation services including observation of family functioning, strategies to decrease conflict, build resiliency, and strengthen relationships, and, when appropriate, provision of psycho -educational information concerning trauma, abuse, and/or neglect. We also offer therapeutic kinship services, including observation of kinship family dynamics and individual functioning as well as provision of psycho -educational information and therapeutic services to ensure positive relationships and decreased conflict. Our adoption preservation services include behavioral management consultation, assistance with the navigation of care systems, provision of psycho -educational information, and family/individual therapy to foster bonding and attachment with the goal of supporting permanency and preventing out -of -home placement when possible. • Working with child welfare clients and/or caseworkers and department personnel to identify cognitive, mental health, and/or developmental issues to be addressed during training sessions. • Can be provided remotely or in -person. Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Variable, depending upon the needs of the case Anticipated duration of service (i.e. 3-4 months): Variable, depending upon the needs of the case Three (3), or more, specific goals of the service (DO use bullet points): 1. Based on observation of family functioning, develop and communicate strategies to decrease conflict, build resiliency, and strengthen relationships. 2. Educate foster parents regarding treatment goals outlined in the FSP, especially in regard to specific cognitive, mental health, and/or developmental issues of the foster child(ren). 3. Provide training regarding specific diagnoses/behaviors to support children in the foster placement without disruption. 4. Work with the foster parents to understand the child's current functioning, trauma, and diagnoses to build a behavioral support plan. 5. Provide psycho -educational information concerning trauma, abuse, and/or neglect. 6. Work with the family to understand the dynamics between the foster child, foster parents, and others in the home to help them establish a positive routine and daily interventions that reduce negative behaviors. 7. Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. 8. Maintain frequent and thorough communication with Child Welfare Social Case Workers, and provide written reporting on at least a monthly basis, 9. In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. REV. OCT 2021 1 ATTACHMENT C - PROPOSAL 2.1e Three (3), or more, specific outcomes of service: 1. Caseworkers are supported in addressing treatment recommendations. 2. Foster parents have an improved ability to help child(ren) regulate emotions and meet treatment goals. 3. Increased safety and welfare of children by working with foster parents to understand child -welfare -specific concerns such as abuse, neglect, loss, and grief. 4. Improved individual and/or family functioning to maintain the welfare of clients. 2.1f Target population of the service, including age and gender: Training can be provided to caseworkers or clients. Our clinical specialty is working with individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. We are proud of our commitment to inclusivity and our history of working with individuals regardless of age, gender, or other characteristics/traits. 2.1g Languages service is available in (please list proficiency and if interpreter services are available): All services are available in English. When appropriate, interpreters can be utilized. 2.1h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: We are able to bill services either in whole or in part through Medicaid. We are currently providing services through Health First Colorado, including the following RAEs: Colorado Access, Colorado Community Health Alliance, Health Colorado, Inc., Northeast Health Partners, Rocky Mountain Health Plans, Denver Health Medicaid Choice, as well as various health insurance organizations and developmental disability waiver services. We are committed to ensuring affordable services. We also are a Program Approved Service Agency for Long Term Care Medicaid Waivers as a behavioral service provider conducting behavioral evaluations and ongoing services for individuals with developmental disabilities. 2.1i Service location — list where the service will take place (i.e. client's home, in -office, other) Services can be provided in -home, in -community within Weld County, or in any of our offices, which include: 1597 Cole Blvd., Suite 250 in Lakewood, 357 S. McCaslin S. McCaslin Blvd., Suite 200 in Louisville; and 14001 E. Riff Ave. Suite 204 in Aurora. All of our offices are ADA compliant and are located on bus lines. Telehealth services can also be provided as necessary due to Covid-19. Service #2 Name: 2.2a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.2b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.2c Anticipated duration of service (i.e. 3-4 months): 2.2d Three (3), or more, specific goals of the service (DO use bullet points): 2.2e Three (3), or more, specific outcomes of service: 2.2f Target population of the service: 2.2g Languages service is available in (please list proficiency and if interpreter services are available): 2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #3 Name: 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.3b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.3c Anticipated duration of service (i.e. 3-4 months): REV. OCT 2021 2 ATTACHMENT C - PROPOSAL 2.3d Three (3), or more, specific goals of the service (DO use bullet points): 2.3e 2.3f 2.3g 2.3h 2.3i Service 2.4a 2.4b 2.4c 2.4d 2.4e 2.4f 2.4g 2.4h 2.4i Service 2.5a 2.5b Three (3), or more, specific outcomes of service: Target population of the service: Languages service is available in (please list proficiency and if interpreter services are available): Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Service location — list where the service will take place (i.e. client's home, in -office, other) #4 Name: Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Anticipated duration of service (i.e. 3-4 months): Three (3), or more, specific goals of the service (DO use bullet points): Three (3), or more, specific outcomes of service: Target population of the service: Languages service is available in (please list proficiency and if interpreter services are available): Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Service location — list where the service will take place (i.e. client's home, in -office, other) #5 Name: Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.5c Anticipated duration of service (i.e. 3-4 months): 2.5d Three (3), or more, specific goals of the service (DO use bullet points): 2.5e Three (3), or more, specific outcomes of service: 2.5f Target population of the service: 2.5g Languages service is available in (please list proficiency and if interpreter services are available): 25h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part 2.6i Service location — list where the service will take place (i.e. client's home, in -office, other) REV. OCT 2021 3 ATTACHMENT C - PROPOSAL Section 3 — Service Access and Transportation 3.1 Will you charge Weld County for transporting clients or mileage? Check ® YES one: 3.2 Will you conduct services in a client's home or in the community? Check ® YES one: 3.3 Will you transport clients to and/or from services? Check ❑ YES ® NO one: 3.4 How many miles are you willing to travel round trip? List a specific number of miles. 3.5 When you calculate mileage, what is your starting point address? Determined based on service and made on a case -by - case basis ❑ NO ❑ NO Miles This is dependent upon which therapist is providing the service. SECTION 4 - SERVICE RATES All rates need to include administrative work (i.e. scheduling or report writing) and overhead. Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly or monthly rates will be accepted for services, except for those listed above. • For hourly rates complete section(s) 4.1-4.5. • For monthly rates complete section 4.6. • For Home study providers complete section 4.7. • For monitored sobriety testing providers complete section 4.8. 4.1 Hourly Service #1 Name: Foster Parent Training Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 4.1a In-Office/Video: 4.1b In -Office with Transportation: In -Home or Community: 4.1c FTM, TDM, Prof. Staffing: $ Amount $125 for Master's level; $150 for Ph.D. level N/A $125 for Master's level; $150 for Ph.D. level $125 for Master's level; $150 for Ph.D. level Unit Type per Hour per Hour per Hour per Hour No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: N/A 25 miles miles REV. OCT 2021 4 ATTACHMENT C - PROPOSAL 4.1d No show: $125 for Master's level; $150 for Ph.D. level per No Show 4.1e Mileage rate: $030 per Mile This is paid after the miles listed above. 4.2 Hourly Service #2 Name: $ Amount Unit Type 4.2a In-Office/Video: per Hour 4.2b In Transportation: -Office with per Hour No. of roundtrip miles included in rate: miles 4.2c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.2d FTM, TDM, Prof. Staffing: per Hour 4.2e No show: per No Show 4.2f Mileage rate: per Mile This is paid after the miles listed above. 4.3 Hourly Service #3 Name: $ Amount Unit Type 4.3a In-Office/Video: per Hour 4.3b In Transportation: -Office with - per Hour No. of roundtrip miles included in rate: miles 4.3c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.3d FTM, TDM, Prof. Staffing: per Hour 4.3e No show: per No Show 4.3f Mileage rate: per Mile This is paid after the miles listed above. 4.4 Hourly Service #4 Name: $ Amount Unit Type 4.4a In-Office/Video: per Hour 4.4b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.4c FTM, TDM, Prof. Staffing: per Hour 4.4d No show: per No Show 4.4e Mileage rate: per Mile This is paid after the miles listed above. 4.5 Hourly Service #5 Name: $ Amount Unit Type 4.5a In-Office/Video: per Hour 4.5b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.5c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.5d FTM, TDM, Prof. Staffing: per Hour 4.5e No show: per No Show 4.5f Mileage rate: per Mile This is paid after the miles listed above. 4.6 Monthly Service Rates (each level must be listed): Service Name with Level Rate per Month No. of Direct Service Hours: 4.6a N/A N/A N/A 4.6b REV. OCT 2021 5 ATTACHMENT C - PROPOSAL 4.6c 4.6d 4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers — List your rates in the box below. N/A 4.8 Monitored Sobriety Providers — List your rates in the box below. N/A Provider special notes: Kalis and Associates has a long history of service to children, adolescents, and adults in the intellectual and developmental disability (1/DD) community, as well as a long history of partnership with Departments of. Human Services throughout the Front Range and beyond. Kalis and Associates has truly enjoyed our partnership with Weld County, and we look forward to continuing to meet the unique needs of Weld County's child welfare clients. REV. OCT 2021 6 ATTACHMENT C - PROPOSAL Please type your answers in the boxes below or check the appropriate box. SECTION 1— Provider and Program Area Information Bidder's Legal Name: Program Area: Program Areas are listed in column 1 of the table located in Item Xl of the you may complete another Attachment C if you have more than 5. Request for Proposal starting on page 13. Parker Personal Care Homes, Inc. dba David Kalis Functional Family Therapy Number of services offered on this Attachment C (max 5): If Service 2.1a 2.1b 2.1c 2.1d 2.1e 2.1f 2.1g SECTION 2 - Service Name(s) and Information the service is a monthly package, please offer different levels. All monthly packages must state a specific minimum number of direct service hours. #1 Name: Functional Family Therapy Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): • Kalis and Associates is highly experienced in providing functional family therapy, including intensive treatment services in the home or community to decrease family dysfunction and improve familial outcomes. We have served numerous children, adolescents, adults, and family units dealing with challenges related to trauma, attachment difficulties, legal involvement, and other difficult issues. It has always been Dr. Kalis' philosophy that providing the appropriate therapy, support, and education allows families to remain intact while providing a healthy and safe environment for the children. We are dedicated to strengthening families and, whenever possible, helping to avoid out -of -home placement. • Evidence -based services provided by our service team include: multi -systemic therapy, cognitive behavioral therapy and trauma -focused CBT, ABA therapy, therapeutic visitation services, dialectical behavioral therapy, EMDR, psychological and cognitive evaluations, and family therapy. Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Once weekly or bi-weekly, depending on the needs of the client Anticipated duration of service (i.e. 3-4 months): 3 months to 2 years, generally; the length of services is dependent not only upon the types of services we are asked to provide but also upon the stage of the case in which we are asked to begin services. We are committed to accomplishing treatment goals within court -mandated timeframes. Three (3), or more, specific goals of the service (DO use bullet points): 1. Align treatment goals with goals identified in the FSP. 2. Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. 3. Engage families with outcome -based treatment modalities with proven efficacy. 4. Maintain frequent and thorough communication with Child Welfare Social Case Workers, and provide written reporting on at least a monthly basis. 5. In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. Three (3), or more, specific outcomes of service: 1. Client(s) have improved ability to regulate emotions. 2. Client(s) are better able to meet treatment goals. 3. Increased safety and welfare of children by working with parents to understand what is best for and act in the long- term interest of their child(ren). 4. Improved individual and/or family functioning to maintain the welfare of clients. Target population of the service, including age and gender: Our clinical specialty is working withindividuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. We are proud of our commitment to inclusivity and our history of working with individuals regardless of age, gender, or other characteristics/traits. Languages service is available in (please list proficiency and if interpreter services are available): All services are available in English. When appropriate, interpreters can be utilized. REV. OCT 2021 1 ATTACHMENT C - PROPOSAL 2.1h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: We are able to bill services either in whole or in part through Medicaid. We are currently providing services through Health First Colorado, including the following RAEs: Colorado Access, Colorado Community Health Alliance, Health Colorado, Inc., Northeast Health Partners, Rocky Mountain Health Plans, Denver Health Medicaid Choice, as well as various health insurance organizations and developmental disability waiver services. We are committed to ensuring affordable services. We also are a Program Approved Service Agency for Long Term Care Medicaid Waivers as a behavioral service provider conducting behavioral evaluations and ongoing services for individuals with developmental disabilities. 2.1i Service location — list where the service will take place (i.e. client's home, in -office, other) Services can be provided in -home, in -community within Weld County, or in any of our offices, which include: 1597 Cole Blvd., Suite 250 in Lakewood, 357 S. McCaslin S. McCaslin Blvd., Suite 200 in Louisville; and 14001 E. Iliff Ave. Suite 204 in Aurora. All of our offices are ADA compliant and are located on bus lines. Telehealth services can also be provided as necessary due to Covid-19. Service #2 Name: 2.2a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.2b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.2c Anticipated duration of service (i.e. 3-4 months): 2.2d Three (3), or more, specific goals of the service (DO use bullet points): 2.2e Three (3), or more, specific outcomes of service: 2.2f Target population of the service: 2.2g Languages service is available in (please list proficiency and if interpreter services are available): 2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #3 Name: 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.3b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.3c Anticipated duration of service (i.e. 3-4 months): 2.3d Three (3), or more, specific goals of the service (DO use bullet points): 2.3e Three (3), or more, specific outcomes of service: 2.3f Target population of the service: 2.3g Languages service is available in (please list proficiency and if interpreter services are available): 2.3h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.3i Service location — list where the service will take place (i.e. client's home, in -office, other) REV. OCT 2021 2 ATTACHMENT C - PROPOSAL Service #4 Name: 2.4a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.4b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.4c Anticipated duration of service (i.e. 3-4 months): 2.4d Three (3), or more, specific goals of the service (DO use bullet points): 2.4e Three (3), or more, specific outcomes of service: 2.4f Target population of the service: 2.4g Languages service is available in (please list proficiency and if interpreter services are available): 2.4h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.4i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #5 Name: 2.5a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.5b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.5c Anticipated duration of service (i.e. 3-4 months): 2.5d Three (3), or more, specific goals of the service (DO use bullet points): 2.5e Three (3), or more, specific outcomes of service: 2.5f Target population of the service: 2.5g Languages service is available in (please list proficiency and if interpreter services are available): 2.5h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part 2.6i Service location — list where the service will take place (i.e. client's home, in -office, other) Section 3 — Service Access 3.1 Will you charge Weld County for transporting clients or mileage? one: 3.2 Will you conduct services in a client's home or in the community? one: 3.3 Will you transport clients to and/or from services? Check one: and Transportation Check Check ■ YES @ 0 YES YES 0 NO ■ ■ NO NO 3.4 How many miles are you willing to travel round trip? List a specific number of miles. Determined based on service and made on a Miles REV. OCT 2021 3 ATTACHMENT C - PROPOSAL 3.5 When you calculate mileage, what is your starting point address? case -by - case basis This is dependent upon which therapist is providing the service. SECTION 4 - SERVICE RATES All rates need to include administrative work (i.e. scheduling or report writing) and overhead. Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly or monthly rates will be accepted for services, except for those listed above. • For hourly rates complete section(s) 4.1-4.5. • For monthly rates complete section 4.6. • For Home study providers complete section 4.7. • For monitored sobriety testing providers complete section 4.8. 4.1 Hourly Service #1 Name: Functional Family Therapy 4.1a In-Office/Video: 4.1b In -Office with Transportation: In -Home or Community: 4.1c FTM, TDM, Prof. Staffing: 4.1d No show: 4.1e Mileage rate: $ Amount Unit Type $125 for Master's level; $150 for Ph.D. level N/A $125 for Master's level; $150 for Ph.D. level $125 for Master's level; $150 for Ph.D. level $125 for Master's level; $150 for Ph.D. level $0.50 per Hour per Hour per Hour per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: N/A 25 This is paid after the miles listed above. miles miles 4.2 Hourly Service #2 Name: 4.2a In-Office/Video: 4.2b In -Office with Transportation: 4.2c In -Home or Community: 4.2d FTM, TDM, Prof. Staffing: 4.2e No show: 4.2f Mileage rate: $ Amount Unit Type per Hour per Hour per Hour per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: This is paid after the miles listed above. miles miles REV. OCT 2021 4 ATTACHMENT C - PROPOSAL 4.3 Hourly Service #3 Name: $ Amount Unit Type 4.3a In-Office/Video: per Hour 4.3b In Transportation: -Office with per Hour No. of roundtrip miles included in rate: miles 4.3c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.3d FTM, TDM, Prof. Staffing: per Hour 4.3e No show: per No Show 4.3f Mileage rate: per Mile This is paid after the miles listed above. 4.4 Hourly Service #4 Name: $ Amount Unit Type 4.4a In-Office/Video: per Hour 4.4b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.4c FTM, TDM, Prof. Staffing: per Hour 4.4d No show: per No Show 4.4e Mileage rate: per Mile This is paid after the miles listed above. 4.5 Hourly Service #5 Name: $ Amount Unit Type 4.5a In-Office/Video: per Hour 4.5b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.5c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.5d FTM, TDM, Prof. Staffing: per Hour 4.5e No show: per No Show 4.5f Mileage rate: per Mile This is paid after the miles listed above. 4.6 Monthly Service Rates (each level must be listed): Service Name with Level Rate per Month No. of Direct Service Hours: 4.6a N/A N/A N/A 4.6b 4.6c 4.6d 4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers — List your rates in the box below. N/A 4.8 Monitored Sobriety Providers — List your rates in the box below. N/A REV. OCT 2021 5 ATTACHMENT C - PROPOSAL Provider special notes: Kalis and Associates has a long history of service to children, adolescents, and adults in the intellectual and developmental disability (I/DD) community, as well as a long history of partnership with Departments of Human Services throughout the Front Range and beyond. Kalis and Associates has truly enjoyed our partnership with Weld County, and we look forward to continuing to meet the unique needs of Weld County's child welfare clients. REV. OCT 2021 6 ATTACHMENT C - PROPOSAL Please type your answers in the boxes below or check the appropriate box. SECTION 1— Provider and Program Area Information Bidder's Legal Name: Program Area: Program Areas are listed in column 1 of the table located in Item XI of the You may complete another Attachment C if you have more than 5. Request for Proposal starting on page 13. Parker Personal Care Homes, Inc. dba David Kalis Home -Based Intervention Number of services offered on this Attachment C (max 5): SECTION 2 - Service Name(s) and Information If the service is a monthly package, please offer different levels. All monthly packages must state a specific minimum number of direct service hours. Service #1 Name: Home -Based Intervention 2.1a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Kalis and Associates is highly experienced in providing home -based intervention services to decrease family dysfunction and improve familial outcomes. We have served numerous children, adolescents, adults, and family units dealing with challenges related to trauma, attachment difficulties, legal involvement, and other difficult issues. It has always been Dr. Kalis' philosophy that providing the appropriate therapy, support, and education allows families to remain intact while providing a healthy and safe environment for the children. Weare dedicated to strengthening families and, whenever possible, helping to avoid out -of -home placement.We believe the whole family system requires support to ensure safety and stability. To that end, we offer the following home -based intervention services: • Preservation & Removal Prevention Services — We are able assess individual and family needs and provide short-term intensive services in the home. We offer conflict resolution, case management consultation, behavioral and parenting skills modeling/coaching, parenting skill development, bonding/attachment and adoption preservation services, transition support, systems of care navigation, individual and family therapy, and help in developing structure and life skills. • Adoption preservation services - including behavioral management consultation, assistance with the navigation of care systems, provision of psycho -educational information, and family/individual therapy to foster bonding and attachment with the goal of supporting permanency and preventing out -of -home placement when possible. • Therapeutic Visitation — including services to ensure child safety, improve parent/child(ren) interactions, teach parenting techniques, enable clients to access appropriate community resources, minimize family conflict, and enable household management. We are able to provide therapeutic visitation in the home, office, and/or community settings. • Evidence -based services provided by our service team include: multi -systemic therapy, cognitive behavioral therapy and trauma -focused CBT, ABA therapy, therapeutic visitation services, dialectical behavioral therapy, EMDR, psychological and cognitive evaluations, and family therapy. 2.1b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Once weekly or bi-weekly, depending on the needs of the client 2.1c Anticipated duration of service (i.e. 3-4 months): 3 months to 2 years, generally; the length of services is dependent not only upon the types of services we are asked to provide but also upon the stage of the case in which we are asked to begin services. We are committed to accomplishing treatment goals within court -mandated timeframes. 2.1d Three (3), or more, specific goals of the service (DO use bullet points): 1. Align treatment goals with goals identified in the FSP. 2. Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. 3. Engage families with outcome -based treatment modalities with proven efficacy. 4. Maintain frequent and thorough communication with Child Welfare Social Case Workers, and provide written reporting on at least a monthly basis. 5. In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. 2.1e Three (3), or more, specific outcomes of service: 1. Client(s) have improved ability to regulate emotions. 2. Client(s) are better able to meet treatment goals. 3. Increased safety and welfare of children by working with parents to understand what is best for and act in the long- term interest of their child(ren). REV. OCT 2021 1 ATTACHMENT C - PROPOSAL 4. Improved individual and/or family functioning to maintain the welfare of clients. 2.1f Target population of the service, including age and gender: Our clinical specialty is working with individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. We are proud of our commitment to inclusivity and our history of working with individuals regardless of age, gender, or other characteristics/traits. 2.1g Languages service is available in (please list proficiency and if interpreter services are available): All services are available in English. When appropriate, interpreters can be utilized. 2.1h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: We are able to bill services either, in whole or in part through Medicaid. We are currently providing services through Health First Colorado, including the following RAEs: Colorado Access, Colorado Community Health Alliance, Health Colorado, Inc., Northeast Health Partners, Rocky Mountain Health Plans, Denver Health Medicaid Choice, as well as various health insurance organizations and developmental disability waiver services. We are committed to ensuring affordable services. We also are a Program. Approved Service Agency for Long Term Care Medicaid Waivers as a behavioral service provider conducting behavioral evaluations and ongoing services for individuals with developmental disabilities. 2.1i Service location — list where the service will take place (i.e. client's home, in -office, other) Services to be provided in the home unless in -community or in -office locations are requested Our office locations include: 1597 Cole Blvd., Suite 250 in Lakewood, 357 5. McCaslin S. McCaslin Blvd., Suite 200 in Louisville; and 14001 E. Riff Ave. Suite 204 in Aurora. All of our offices are ADA compliant and are located on bus lines. Telehealth services can also be provided as necessary due to Covid-19. Service #2 Name: 2.2a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.2b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.2c Anticipated duration of service (i.e. 3-4 months): 2.2d Three (3), or more, specific goals of the service (DO use bullet points): 2.2e Three (3), or more, specific outcomes of service: 2.2f Target population of the service: 2.2g Languages service is available in (please list proficiency and if interpreter services are available): 2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #3 Name: 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.3b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.3c Anticipated duration of service (i.e. 3-4 months): 2.3d Three (3), or more, specific goals of the service (DO use bullet points): 2.3e Three (3), or more, specific outcomes of service: 2.3f Target population of the service: REV. OCT 2021 2 ATTACHMENT C - PROPOSAL 2.3g 2.3h 2.3i Service 2.4a 2.4b 2.4c 2.4d 2.4e 2.4f 2.4g 2.4h 2.4i Service 2.5a 2.5b 2.5c Languages service is available in (please list proficiency and if interpreter services are available): Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Service location — list where the service will take place (i.e. client's home, in -office, other) #4 Name: Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Anticipated duration of service (i.e. 3-4 months): Three (3), or more, specific goals of the service (DO use bullet points): Three (3), or more, specific outcomes of service: Target population of the service: Languages service is available in (please list proficiency and if interpreter services are available): Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Service location — list where the service will take place (i.e. client's home, in -office, other) #5 Name: Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Anticipated duration of service (i.e. 3-4 months): 2.5d Three (3), or more, specific goals of the service (DO use bullet points): 2.5e Three (3), or more, specific outcomes of service: 2.5f Target population of the service: 2.5g Languages service is available in (please list proficiency and if interpreter services are available): 2.5h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part 2.6i Service location — list where the service will take place (i.e. client's home, in -office, other) Section 3 — Service Access and Transportation 3.1 Will you charge Weld County for transporting clients or mileage? Check one: 3.2 Will you conduct services in a client's home or in the community? Check one: REV. OCT 2021 ® YES ❑ NO ® YES ❑ NO 3 ATTACHMENT C - PROPOSAL 3.3 Will you transport clients to and/or from services? Check one: ❑ YES 3.4 How many miles are you willing to travel round trip? List a specific number of miles. 3.5 When you calculate mileage, what is your starting point address? NO Determined based on service and made on a case -by - case basis Miles This is dependent upon which therapist is providing the service. SECTION 4 - SERVICE RATES All rates need to include administrative work (i.e. scheduling or report writing) and overhead. Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly or monthly rates will be accepted for services, except for those listed above. • For hourly rates complete section(s) 4.1-4.5. • For monthly rates complete section 4.6. • For Home study providers complete section 4.7. • For monitored sobriety testing providers complete section 4.8. 4.1 Hourly Service #1 Name: Home -Based Intervention 4.1a In-Office/Video: 4.1b In -Office with Transportation: In -Home or Community: 4.1c FTM, TDM, Prof. Staffing: 4.1d No show: 4.1e Mileage rate: $ Amount Unit Type $125 for Master's level; $150 for Ph.D. level N/A $125 for Master's level; $150 for Ph.D. level $125 for Master's level; $150 for Ph.D. level $125 for Master's level; $150 for Ph.D. level $0.50 per Hour per Hour per Hour per Hour per No Show No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: N/A 25 per Mile This is paid after the miles listed above. miles miles 4.2 Hourly Service #2 Name: 4.2a In-Office/Video: $ Amount Unit Type per Hour REV. OCT 2021 4 ATTACHMENT C - PROPOSAL 4.2b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.2c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.2d FTM, TDM, Prof. Staffing: per Hour 4.2e No show: per No Show 4.2f Mileage rate: per Mile This is paid after the miles listed above. 4.3 Hourly Service #3 Name: $ Amount Unit Type 4.3a In-Office/Video: per Hour 4.3b In Transportation: -Office with per Hour No. of roundtrip miles included in rate: miles 4.3c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.3d FTM, TDM, Prof. Staffing: per Hour 4.3e No show: per No Show 4.3f Mileage rate: per Mile This is paid after the miles listed above. 4.4 Hourly Service #4 Name: $ Amount Unit Type 4.4a In-Office/Video: per Hour 4.4b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.4c FTM, TDM, Prof. Staffing: per Hour 4.4d No show: per No Show 4.4e Mileage rate: per Mile This is paid after the miles listed above. 4.5 Hourly Service #5 Name: $ Amount Unit Type 4.5a In-Office/Video: per Hour 4.5b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.5c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.5d FTM, TDM, Prof. Staffing: per Hour 4.5e No show: per No Show 4.5f Mileage rate: per Mile This is paid after the miles listed above. 4.6 Monthly Service Rates (each level must be listed): Service Name with Level Rate per Month No. of Direct Service Hours: 4.6a N/A N/A N/A 4.6b 4.6c 4.6d 4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers — List your rates in the box below. N/A REV. OCT 2021 5 ATTACHMENT C - PROPOSAL 4.8 Monitored Sobriety Providers — List your rates in the box below. N/A Provider special notes: Kalis and Associates has a long history of service to children, adolescents, and adults in the intellectual and developmental disability (l/DD) community, as well as a long history of partnership with Departments of Human Services throughout the Front Range and beyond. Kalis and Associates has truly enjoyed our partnership with Weld County, and we look forward to continuing to meet the unique needs. of Weld County's child welfare clients. REV. OCT 2021 6 ATTACHMENT C - PROPOSAL Please type your answers in the boxes below or check the appropriate box. SECTION 1— Provider and Program Area Information Bidder's Legal Name: Program Area: Program Areas are listed in column 1 of the table located in Item Xl of the You may complete another Attachment C if you have more than 5. Request for Proposal starting on page 13. Parker Personal Care Homes, Inc. dba David Kalis Kinship Services (Therapeutic) Number of services offered on this Attachment C (max 5): If Service 2.1a 2.1b 2.1c 2.1d 2.1e 2.1f SECTION 2 - Service Name(s) and Information the service is a monthly package, please offer different levels. All monthly packages must state a specific minimum number of direct service hours. #1 Name: Therapeutic Kinships Services Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): • Observation of kinship family dynamics and individual functioning as well as provision of psycho -educational information and therapeutic services to ensure positive relationships and decreased conflict. • Child -welfare -specific concerns such as coping with past abuse/neglect and loss/grief are addressed. • Evidence -based services provided by our service team include: multi -systemic therapy, cognitive behavioral therapy and trauma -focused CBT, ABA therapy, therapeutic visitation services, dialectical behavioral therapy, EMDR, psychological and cognitive evaluations, and family therapy. • When applicable, services are tailored for individuals with limited cognitive abilities. Behavioral Services/Coaching are also available, which can include assessment, evaluation, counseling, coaching, consultation, and line services to individuals, as well as coaching and consultation for family members and other professionals supporting them. • Trauma -Based Relational Intervention (TBRI) coaching is also available to family members. Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Once weekly or bi-weekly, depending on the needs of the client Anticipated duration of service (i.e. 3-4 months): 3 months to 2 years, generally; the length of services is dependent not only upon the types of services we are asked to provide but also upon the stage of the case in which we are asked to begin services. We are committed to accomplishing treatment goals within court -mandated timeframes. Three (3), or more, specific goals of the service (DO use bullet points): 1. Align treatment goals with goals identified in the FSP: 2. Enrich and improve the quality of kinship services. 3. Improve family dynamics and functioning, including decreasing conflict in the home and strengthening resiliency. 4. Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. 5. Engage families with outcome -based treatment modalities with proven efficacy. 6. Maintain frequent and thorough communication with Child Welfare Social Case Workers, and provide written reporting on at least a monthly basis. 7. In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. Three (3), or more, specific outcomes of service: i. Client(s) have improved ability to regulate emotions. 2. Client(s) are better able to meet treatment goals. 3. Increased safety and welfare of children by working with kinship providers to understand what is best for and act in the long-term interest of the child(ren). 4. Improved individual and/or family functioning to maintain the welfare of clients. Target population of the service, including age and gender: Our clinical specialty is working with individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. We are proud of our commitment to inclusivity and our history of working with individuals regardless of age, gender, or other characteristics/traits. REV. OCT 2021 1 ATTACHMENT C - PROPOSAL 2.1g Languages service is available in (please list proficiency and if interpreter services are available): All services are available in English. When appropriate, interpreters can be utilized. 2.1h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: We are able to bill services either in whole or in part through Medicaid. We are currently providing services through Health First Colorado, including the following RAEs: Colorado Access, Colorado Community Health Alliance, Health Colorado, Inc., Northeast Health Partners, Rocky Mountain Health Plans, Denver Health Medicaid Choice, as well as various health insurance organizations and developmental disability waiver services. We are committed to ensuring affordable services. We also are a Program Approved Service Agency for Long Term Care Medicaid Waivers as a behavioral service provider conducting behavioral evaluations and ongoing services for individuals with developmental disabilities. 2.1i Service location — list where the service will take place (i.e. client's home, in -office, other) Services can be provided in -home, in -community within Weld County, or in any of our offices, which include: 1597 Cole Blvd., Suite 250 in Lakewood, 357 S. McCaslin S. McCaslin Blvd., Suite 200 in Louisville; and 14001 E. Riff Ave. Suite 204 in Aurora. All of our offices are ADA compliant and are located on bus lines. Telehealth services can also be provided as necessary due to Covid-19. Service #2 Name: 2.2a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.2b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.2c Anticipated duration of service (i.e. 3-4 months): 2.2d Three (3), or more, specific goals of the service (DO use bullet points): 2.2e Three (3), or more, specific outcomes of service: 2.2f Target population of the service: 2.2g Languages service is available in (please list proficiency and if interpreter services are available): 2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #3 Name: 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.3b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.3c Anticipated duration of service (i.e. 3-4 months): 2.3d Three (3), or more, specific goals of the service (DO use bullet points): 2.3e Three (3), or more, specific outcomes of service: 2.3f Target population of the service: 2.3g Languages service is available in (please list proficiency and if interpreter services are available): 2.3h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: REV. OCT 2021 2 ATTACHMENT C - PROPOSAL 2.3i Service location — list where the service will take place (i.e. client's home, in -office, other) Service 2.4a 2.4b 2.4c 2.4d 2.4e 2.4f 2.4g 2.4h 2.4i Service 2.5a 2.5b 2.5c #4 Name: Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Anticipated duration of service (i.e. 3-4 months): Three (3), or more, specific goals of the service (DO use bullet points): Three (3), or more, specific outcomes of service: Target population of the service: Languages service is available in (please list proficiency and if interpreter services are available): Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Service location — list where the service will take place (i.e. client's home, in -office, other) #5 Name: Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Anticipated duration of service (i.e. 3-4 months): 2.5d Three (3), or more, specific goals of the service (DO use bullet points): 2.5e Three (3), or more, specific outcomes of service: 2.5f Target population of the service: 2.5g Languages service is available in (please list proficiency and if interpreter services are available): 2.5h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part 2.6i Service location — list where the service will take place (i.e. client's home, in -office, other) Section 3 — Service Access and Transportation 3.1 Will you charge Weld County for transporting clients or mileage? Check ® YES one: 3.2 Will you conduct services in a client's home or in the community? Check E YES 0 NO one: 3.3 Will you transport clients to and/or from services? Check 0 YES ® NO one: ❑ NO REV. OCT 2021 3 ATTACHMENT C - PROPOSAL 3.4 How many miles are you willing to travel round trip? List a specific number of miles. 3.5 When you calculate mileage, what is your starting point address? Determined based on service and made on a case -by - case basis Miles This is dependent upon which therapist is providing the service. SECTION 4 - SERVICE RATES All rates need to include administrative work (i.e. scheduling or report writing) and overhead. Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly or monthly rates will be accepted for services, except for those listed above. • For hourly rates complete section(s) 4.1-4.5. • For monthly rates complete section 4.6. • For Home study providers complete section 4.7. • For monitored sobriety testing providers complete section 4.8. 4.1 Hourly Service #1 Name: Therapeutic Kinships Services 4.1a In-Office/Video: 4.1b In -Office with Transportation: In -Home or Community: 4.1c FTM, TDM, Prof. Staffing: 4.1d No show: 4.1e Mileage rate: $ Amount Unit Type $125 for Master's level; $150 for Ph.D. level N/A $125 for Master's level; $150 for Ph.D. level $125 for Master's level; $150 for Ph.D. level $125 for Master's level; $150 for Ph.D. level $0.50 per Hour per Hour per Hour per Hour per No Show No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: N/A per Mile This is paid after the miles listed above. 25 miles miles 4.2 Hourly Service #2 Name: 4.2a In-Office/Video: 4.2b In -Office with Transportation: 4.2c In -Home or Community: 4.2d FTM, TDM, Prof. Staffing: $ Amount Unit Type per Hour per Hour per Hour per Hour No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: miles miles REV. OCT 2021 4 ATTACHMENT C - PROPOSAL 4.2e No show: per No Show 4.2f Mileage rate: per Mile This is paid after the miles listed above. 4.3 Hourly Service #3 Name: $ Amount Unit Type 4.3a In-Office/Video: per Hour 4.3b In Transportation: -Office with per Hour No. of roundtrip miles included in rate: miles 4.3c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.3d FTM, TDM, Prof. Staffing: per Hour 4.3e No show: per No Show 4.3f Mileage rate: per Mile This is paid after the miles listed above. 4.4 Hourly Service #4 Name: $ Amount Unit Type 4.4a In-Office/Video: per Hour 4.4b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.4c FTM, TDM, Prof. Staffing: per Hour 4.4d No show: per No Show 4.4e Mileage rate: per Mile This is paid after the miles listed above. 4.5 $ Amount Unit Type 4.5a In-Office/Video: per Hour 4.5b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.5c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.5d FTM, TDM, Prof. Staffing: per Hour 4.5e No show: per No Show 4.5f Mileage rate: per Mile This is paid after the miles listed above. 4.6 Monthly Service Rates (each level must be listed): Service Name with Level Rate per Month No. of Direct Service Hours: 4.6a N/A N/A N/A 4.6b 4.6c 4.6d 4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers - List your rates in the box below. N/A 4.8 Monitored Sobriety Providers - List your rates in the box below. N/A REV. OCT 2021 5 ATTACHMENT C - PROPOSAL Provider special notes: Kalis and Associates has a long history of service to children, adolescents, and adults in the intellectual and developmental disability (l/DD) community, as well as a long history of partnership with Departments of Human Services throughout the Front Range and beyond. Kalis and Associates has truly enjoyed our partnership with Weld County, and we look forward to continuing to meet the unique needs of Weld County's child welfare clients. REV. OCT 2021 6 ATTACHMENT C - PROPOSAL Please type your answers in the boxes below or check the appropriate box. SECTION 1— Provider and Program Area Information Bidder's Legal Name: Program Area: Program Areas are listed in column 1 of the table located in Item XI of the You may complete another Attachment C if you have more than 5. Request for Proposal starting on page 13. Parker Personal Care Homes, Inc. dba David Kalis Life Skills Number of services offered on this Attachment C (max 5): SECTION 2 — Service Name(s) and Information If the service is a monthly package, please offer different levels. All monthly packages must state a specific minimum number of direct service hours. Service #1 Name: Life Skills 2.1a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): • Therapeutic Visitation — including active therapeutic coaching strategies employed to ensure child safety, improve parent/child(ren) interactions, teach parenting techniques, enable clients to access appropriate community resources, minimize family conflict, and enable household management We are able to provide therapeutic visitation in the home, office, and/or community settings. •. Parent Coaching — including therapeutic and frequent intervention, education, modeling, and feedback. Utilizes a structured parent education curriculum to foster bonding/attachment, teach appropriate discipline, develop empathy, provide education on developmental stages, and communicate safe and healthy parenting techniques. Specific criteria utilized to measure parenting education progress. • Supervised Visitation active interventions, education, and coaching to promote positive behavioral change in parent/child relationships. Appropriate parent -child interactions are modeled, and feedback is provided to parents after each visit, • Child -welfare -specific concerns such as coping with past abuse/neglect and loss/grief are addressed. • When applicable, services are tailored for individuals with limited cognitive abilities. Curriculum is developed to meet the individual needs of the parent(s) and utilizes modeling, repetition, and specific teaching techniques/methods to help clients develop skills to mastery to alleviate current and future child protection concerns. • Services are tailored to clients' current levels of functioning and enable clients to build upon their current skill set. Skill development techniques and strategies are based upon theories developed by leaders in the field such as Lev Vygotsky. • All of our life skills therapists are also Masters -level therapists who can utilize various therapeutic techniques such as: cognitive behavioral therapy, behavioral, and trauma -focused CBT, ABA therapy, and dialectical behavioral therapy to further skill development. As we know, many individuals who experience cognitive and/or developmental issues have difficulty with learning, which impedes the skill development process from both a cognitive standpoint but also an emotional one, as learning has always been difficult for that individual. Our approach is to not only address the practical skill development but also emotional skills in order to remove barriers to learning and help provide supports for success in the home. 2.1b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Once weekly or bi-weekly, depending on the needs of the client 2.1c Anticipated duration of service (i.e. 3-4 months): 3 months to 2 years, generally; the length of services is dependent not only upon the types of services we are asked to provide but also upon the stage of the case in which we are asked to begin services. We are committed to accomplishing treatment goals within court -mandated timeframes: 2.1d Three (3), or more, specific goals of the service (DO use bullet points): 1. Align treatment goals with goals identified in the FSP. 2. Address specific child -welfare concerns through intervention, parent education, modeling, and feedback to deal with past abuse/neglect and loss/grief, reestablish parent/child connection after lengthy separations, repair bonding, address dysfunctional dynamics including parentification of child(ren), and address inappropriate and/or unsafe behaviors. Specific physical and/or sexual abuse and/or substance abuse concerns will also be addressed. 3. Foster safe and age -appropriate parent/child interactions. 4. Strengthen family bonding and promote nurturing interactions. 5. Engage families with outcome -based treatment modalities with proven efficacy. REV. OCT 2021 1 ATTACHMENT C - PROPOSAL 6. Maintain frequent and thorough communication with Child Welfare Social Case Workers, and provide written reporting on at least a monthly basis. 7. In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible._ 2.1e Three (3), or more, specific outcomes of service: 1. Client(s) have improved ability to regulate emotions. 2. Client(s) are better able to meet treatment goals. 3. Increased safety and welfare of children by working with parents to understand what is best for and act in the long- term interest of their child(ren). 4. Improved individual and/or family functioning to maintain the welfare of clients. 5. Specific learning needs of the client(s) are met, as well as their emotional needs. 2.1f Target population of the service, including age and gender: Our clinical specialty is working with individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. We are proud of our commitment to inclusivity and our history of working with individuals regardless of age, gender, or other characteristics/traits. 2.1g Languages service is available in (please list proficiency and if interpreter services are available): All services are available in English. When appropriate, interpreters can be utilized. 2.1h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: We are able to bill services either in whole or in part through Medicaid. We are currently providing services through Health First Colorado, including the following RAEs: Colorado Access, Colorado Community Health Alliance, Health Colorado, Inc., Northeast Health Partners, Rocky Mountain Health Plans, Denver Health Medicaid Choice, as well as various health insurance organizations and developmental disability waiver services. We are committed to ensuring affordable services. We also are a Program Approved Service Agency for Long Term Care Medicaid Waivers as a behavioral service provider conducting behavioral evaluations and ongoing services for individuals with developmental disabilities. 2.1i Service location — list where the service will take place (i.e. client's home, in -office, other) Services can be provided in -home, in -community within Weld County, or in any of our offices, which include: 1597 Cole Blvd., Suite 250 in Lakewood, 357 S. McCaslin S. McCaslin Blvd., Suite 200 in Louisville; and 14001 E. Iliff Ave. Suite 204 in Aurora. All of our offices are ADA compliant and are located on bus lines. Telehealth services can also be provided as necessary due to Covid-19. Service #2 Name: 2.2a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.2b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.2c Anticipated duration of service (i.e. 3-4 months): 2.2d Three (3), or more, specific goals of the service (DO use bullet points): 2.2e Three (3), or more, specific outcomes of service: 2.2f Target population of the service: 2.2g Languages service is available in (please list proficiency and if interpreter services are available): 2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #3 Name: 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): REV. OCT 2021 2 ATTACHMENT C - PROPOSAL 2.3b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.3c Anticipated duration of service (i.e. 3-4 months): 2.3d Three (3), or more, specific goals of the service (DO use bullet points): 2.3e Three (3), or more, specific outcomes of service: 2.3f Target population of the service: 2.3g Languages service is available in (please list proficiency and if interpreter services are available): 2.3h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.3i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #4 Name: 2.4a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.4b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.4c Anticipated duration of service (i.e. 3-4 months): 2.4d Three (3), or more, specific goals of the service (DO use bullet points): 2.4e Three (3), or more, specific outcomes of service: 2.4f Target population of the service: 2.4g Languages service is available in (please list proficiency and if interpreter services are available): 2.4h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.4i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #5 Name: 2.5a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.5b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.5c Anticipated duration of service (i.e. 3-4 months): 2.5d Three (3), or more, specific goals of the service (DO use bullet points): 2.5e Three (3), or more, specific outcomes of service: 2.5f Target population of the service: 2.5g Languages service is available in (please list proficiency and if interpreter services are available): REV. OCT 2021 3 ATTACHMENT C - PROPOSAL 2.5h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part 2.6i Service location — list where the service will take place (i.e. client's home, in -office, other) 3.1 3.2 3.3 3.4 3.5 Section 3 — Service Access Will you charge Weld County for transporting clients or mileage? one: Will you conduct services in a client's home or in the community? one: Will you transport clients to and/or from services? Check one: How many miles are you willing to travel round trip? List a specific miles. When you calculate mileage, what is your starting point address? and Transportation YES YES NO NO NO Check ►Zt ■ Check ►5 ■ Miles • YES ►i number of Determined based on service and made on a case -by - case basis This is dependent upon which therapist is providing the service. SECTION 4 - SERVICE RATES All rates need to include administrative work (i.e. scheduling or report writing) and overhead. Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly or monthly rates will be accepted for services, except for those listed above. • For hourly rates complete section(s) 4.1-4.5. • For monthly rates complete section 4.6. • For Home study providers complete section 4.7. • For monitored sobriety testing providers complete section 4.8. 4.1 Hourly Service #1 Name: Life Skills 4.1a In-Office/Video: 4.1b In -Office with Transportation: In -Home or Community: 4.1c FTM, TDM, Prof. Staffing: $ Amount Unit Type $125 for Master's level; $150 for Ph.D. level N/A $125 for Master's level; $150 for Ph.D. level $125 for Master's level; $150 for Ph.D. level per Hour per Hour per Hour per Hour No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: N/A 25 miles miles REV. OCT 2021 4 ATTACHMENT C - PROPOSAL 4.1d No show: $125 for Master's level; $150 for Ph.D. level per No Show 4.1e Mileage rate: $0.50 per Mile This is paid after the miles listed above. 4.2 Hourly Service #2 Name: $ Amount Unit Type 4.2a In-Office/Video: per Hour 4.2b In Transportation: -Office with per Hour No. of roundtrip miles included in rate: miles 4.2c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.2d FTM, TDM, Prof. Staffing: per Hour 4.2e No show: per No Show 4.2f Mileage rate: per Mile This is paid after the miles listed above. 4.3 Hourly Service #3 Name: $ Amount Unit Type 4.3a In-Office/Video: per Hour 4.3b In Transportation: -Office with per Hour No. of roundtrip miles included in rate: miles 4.3c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.3d FTM, TDM, Prof. Staffing: per Hour 4.3e No show: per No Show 4.3f Mileage rate: per Mile This is paid after the miles listed above. 4.4 Hourly Service #4 Name: $ Amount Unit Type 4.4a In-Office/Video: per Hour 4.4b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.4c FTM, TDM, Prof. Staffing: per Hour 4.4d No show: per No Show 4.4e Mileage rate: per Mile This is paid after the miles listed above. 4.5 $ Amount Unit Type 4.5a In-Office/Video: per Hour 4.5b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.5c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.5d FTM, TDM, Prof. Staffing: per Hour 4.5e No show: per No Show 4.5f Mileage rate: per Mile This is paid after the miles listed above. 4.6 Monthly Service Rates (each level must be listed): Service Name with Level Rate per Month No. of Direct Service Hours: 4.6a N/A N/A N/A 4.6b 4.6c REV. OCT 2021 5 ATTACHMENT C - PROPOSAL 4.6d 4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers — List your rates in the box below. N/A 4.8 Monitored Sobriety Providers — List your rates in the box below. N/A Provider special notes: Kalis and Associates has a long history of service to children, adolescents, and adults in the intellectual and developmental disability (I/DD) community, as well as a long history of partnership with Departments of Human Services throughout the Front Range and beyond. Kalis and Associates has truly enjoyed our partnership with Weld County, and we look forward to continuing to meet the unique needs of Weld County's child welfare clients. REV. OCT 2021 6 ATTACHMENT C - PROPOSAL Please type your answers in the boxes below or check the appropriate box. SECTION 1— Provider and Program Area Information Bidder's Legal Name: Program Area: Program Areas are listed in column 1 of the table located in Item XI of the You may complete another Attachment C you have more than 5. Request for Proposal starting on page 13. Parker Personal Care Homes, Inc. dba David Kalis Mediation Number of services offered on this Attachment C (max 5): If Service 2.1a 2.1b 2.1c 2.1d 2.1e 2.1f 2.1g 2.1h SECTION 2 — Service Name(s) and Information the service is a monthly package, please offer different levels. All monthly packages must state a specific minimum number of direct service hours. #1 Name: Mediation Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): • Attendance of court -ordered meetings to facilitate resolution of treatment plan issues for D&N cases. • Assisting professionals in addressing the cognitive, mental health, and/or developmental issues experienced by the client(s). Services will be provided by individuals on staff that are certified in mediation training, specifically in domestic cases. Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Variable, depending upon the needs of the case Anticipated duration of service (i.e. 3-4 months): Variable, depending upon the needs of the case Three (3), or more, specific goals of the service (DO use bullet points): 1. Support case professionals to resolve issues related to adjudication and treatment plan issues. 2. Provide insight into child -welfare -specific concerns with specific focus on addressing clients' cognitive, mental health, and/or developmental issues. 3. Facilitate resolution for families and professionals to ensure progress in the case. 4. Help develop a thorough plan moving forward to support the safety and well-being and reunification of children when possible. Three (3), or more, specific outcomes of service: 1. Case -specific issues are addressed and resolved in a timely manner 2. Client(s) specific needs are met, allowing them to work towards successful resolution of their case. 3. Allcase professionals are informed of unique needs of clients in D&N cases. 4. Increased safety and welfare of children by facilitating progress on the case. Target population of the service, including age and gender: Our clinical specialty is working with individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. We are proud of our commitment to inclusivity and our history of working with individuals regardless of age, gender, or other characteristics/traits. Languages service is available in (please list proficiency and if interpreter services are available): All services are available in English. When appropriate, interpreters can be utilized. Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: We are able to bill services either in whole or in part through Medicaid. We are currently providing services through Health First Colorado, including the following RAEs: Colorado Access, Colorado Community Health Alliance, Health Colorado, Inc., Northeast Health Partners, Rocky Mountain Health Plans, Denver Health Medicaid Choice, as well as various health insurance organizations and developmental disability waiver services. We are committed to ensuring affordable services. We also area Program Approved Service Agency for Long Term Care Medicaid Waivers as a behavioral service provider conducting behavioral evaluations and ongoing services for individuals with developmental disabilities. REV. OCT 2021 1 ATTACHMENT C - PROPOSAL 2.1i Service location — list where the service will take place (i.e. client's home, in -office, other) Services can be provided in -home, in -community within Weld County, or in any of our offices, which include: 1597 Cole Blvd., Suite 250 in Lakewood, 357 S. McCaslin S. McCaslin Blvd., Suite 200 in Louisville; and 14001 E. Iliff Ave. Suite 204 in Aurora. All of our offices are ADA compliant and are located on bus lines. Telehealth services can also be provided as necessary due to Covid-19. Service #2 Name: 2.2a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.2b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.2c Anticipated duration of service (i.e. 3-4 months): 2.2d Three (3), or more, specific goals of the service (DO use bullet points): 2.2e Three (3), or more, specific outcomes of service: 2.2f Target population of the service: 2.2g Languages service is available in (please list proficiency and if interpreter services are available): 2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #3 Name: 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.3b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.3c Anticipated duration of service (i.e. 3-4 months): 2.3d Three (3), or more, specific goals of the service (DO use bullet points): 2.3e Three (3), or more, specific outcomes of service: 2.3f Target population of the service: 2.3g Languages service is available in (please list proficiency and if interpreter services are available): 2.3h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.3i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #4 Name: 2.4a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.4b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.4c Anticipated duration of service (i.e. 3-4 months): REV. OCT 2021 2 ATTACHMENT C - PROPOSAL 2.4d 2.4e 2.4f 2.4g 2.4h 2.4i Service 2.5a Three (3), or more, specific goals of the service (DO use bullet points): Three (3), or more, specific outcomes of service: Target population of the service: Languages service is available in (please list proficiency and if interpreter services are available): Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Service location — list where the service will take place (i.e. client's home, in -office, other) #5 Name: Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.5b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.5c Anticipated duration of service (i.e. 3-4 months): 2.5d Three (3), or more, specific goals of the service (DO use bullet points): 2.5e Three (3), or more, specific outcomes of service: 2.5f Target population of the service: 2.5g languages service is available in (please list proficiency and if interpreter services are available): 2.5h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part 2.6i Service location — list where the service will take place (i.e. client's home, in -office, other) 3.1 3.2 3.3 3.4 3.5 Section 3 — Service Access Will you charge Weld County for transporting clients or mileage? one: Will you conduct services in a client's home or in the community? one: Will you transport clients to and/or from services? Check one: How many miles are you willing to travel round trip? List a specific miles. When you calculate mileage, what is your starting point address? and Transportation YES YES NO Check @ • NO Check 0 • NO Miles ■ YES 0 number of Determined based on service and made on a case -by - case basis This is dependent upon which therapist is providing the service. SECTION 4 - SERVICE RATES All rates need to include administrative work (i.e. scheduling or report writing) and overhead. REV. OCT 2021 3 ATTACHMENT C - PROPOSAL Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly or monthly rates will be accepted for services, except for those listed above. • For hourly rates complete section(s) 4.1-4.5. • For monthly rates complete section 4.6. • For Home study providers complete section 4.7. • For monitored sobriety testing providers complete section 4.8. 4.1 Hourly Service #1 Name: Mediation 4.1a In-Office/Video: 4.1b In -Office with Transportation: In -Home or Community: 4.1c FTM, TDM, Prof. Staffing: 4.1d No show: 4.1e Mileage rate: $ Amount Unit Type $125 for Master's level; $150 for Ph.D. level N/A $125 for Master's level; $150 for Ph.D. level $125 for Master's level; $150 for Ph.D. level $125 for Master's level; $150 for Ph.D. level $0.50 per Hour per Hour per Hour per Hour per No Show No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: N/A 25 per Mile This is paid after the miles listed above. miles miles 4.2 Hourly Service #2 Name: 4.2a In-Office/Video: 4.2b In -Office with Transportation: 4.2c In -Home or Community: 4.2d FTM, TDM, Prof. Staffing: 4.2e No show: 4.2f Mileage rate: $ Amount Unit Type per Hour per Hour per Hour per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: This is paid after the miles listed above. miles miles 4.3 Hourly Service #3 Name: 4.3a 4.3b 4.3c 4.3d 4.3e 4.3f REV. OCT 2021 In-Office/Video: In -Office with Transportation: In -Home or Community: FTM, TDM, Prof. Staffing: No show: Mileage rate: $ Amount Unit Type per Hour per Hour per Hour per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: This is paid after the miles listed above. miles miles 4 ATTACHMENT C - PROPOSAL 4.4 Hourly Service #4 Name: $ Amount Unit Type 4.4a In-Office/Video: per Hour 4.4b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.4c FTM, TDM, Prof. Staffing: per Hour 4.4d No show: per No Show 4.4e Mileage rate: per Mile This is paid after the miles listed above. 4.5 Hourly Service #5 Name: $ Amount Unit Type 4.5a In-Office/Video: per Hour 4.5b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.5c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.5d FTM, TDM, Prof. Staffing: per Hour 4.5e No show: per No Show 4.5f Mileage rate: per Mile This is paid after the miles listed above. 4.6 Monthly Service Rates (each level must be listed): Service Name with Level Rate per Month No. of Direct Service Hours: 4.6a N/A N/A N/A 4.6b 4.6c 4.6d 4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers — List your rates in the box below. N/A 4.8 Monitored Sobriety Providers — List your rates in the box below. N/A Provider special notes: Kalis and Associates has a long history of service to children, adolescents, and adults in the intellectual and developmental disability (I/DD) community, as well as a long history of partnership with Departments of Human Services throughout the Front Range and beyond. Kalis and Associates has truly enjoyed our partnership with Weld County, and we look forward to continuing to meet the unique needs of Weld County's child welfare clients. REV. OCT 2021 s ATTACHMENT C - PROPOSAL Please type your answers in the boxes below or check the appropriate box. SECTION 1— Provider and Program Area Information Bidder's Legal Name: Program Area: Program Areas are listed in column 1 of the table located in Item XI of the You may complete another Attachment C if you have more than 5. Request for Proposal starting on page 13. Parker Personal Care Homes, Inc. dba David Kalis Mental Health Services Number of services offered on this Attachment C (max 5): 5 If Service 2.1a 2.1b 2.1c 2.1d 2.1e 2.1f 2.1g SECTION 2 - Service Name(s) and Information the service is a monthly package, please offer different levels. All monthly packages must state a specific minimum number of direct service hours. #1 Name: Counseling/Psychotherapy Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): • Child -welfare -specific concerns such as coping with past abuse/neglect and loss/grief are addressed. • Evidence -based services provided by our service team include: multi -systemic therapy, cognitive behavioral therapy and trauma -focused CBT, ABA therapy, therapeutic visitation services, dialectical behavioral therapy, EMDR, psychological and cognitive evaluations, and family therapy. • When applicable, services are tailored for individuals with limited cognitive abilities. • Behavioral Services/Coaching are also available, which can include assessment, evaluation, counseling, coaching, consultation, and line services to individuals, as well as coaching and consultation for family members and other professionals supporting them. • Trauma -Based Relational Intervention (TBRI) coaching is also available to family members. Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Once weekly or bi-weekly, depending on the needs of the client Anticipated duration of service (i.e. 3-4 months): 3 months to 2 years, generally; the length of services is dependent not only upon the types of services we are asked to provide but also upon the stage of the case in which we are asked to begin services. We are committed to accomplishing treatment goals within court -mandated timeframes. Three (3), or more, specific goals of the service (DO use bullet points): 1. Align treatment goals with goals identified in the FSP. 2. Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. 3. Engage families with outcome -based treatment modalities with proven efficacy. 4. Maintain frequent and thorough communication with Child Welfare Social Case Workers, and provide written reporting on at least a monthly basis. 5. In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. Three (3), or more, specific outcomes of service: 1. Client(s) have improved ability to regulate emotions. 2. Client(s) are better able to meet treatment goals. 3. Increased safety and welfare of children by working with parents to understand what is best for and act in the long- term interest of their child(ren). 4. Improved individual and/or family functioning to maintain the welfare of clients. Target population of the service, including age and gender: Our clinical specialty is working with individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. We are proud of our commitment to inclusivity and our history of working with individuals regardless of age, gender, or other characteristics/traits. Languages service is available in (please list proficiency and if interpreter services are available): All services are available in English. When appropriate, interpreters can be utilized. REV. OCT 2021 1 ATTACHMENT C - PROPOSAL 2.1h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: We are able to bill services either in whole or in part through Medicaid. We are currently providing services through Health First Colorado, including the following RAEs: Colorado Access, Colorado Community Health Alliance, Health Colorado, Inc., Northeast Health Partners, Rocky Mountain Health Plans, Denver Health Medicaid Choice, as well as various health insurance organizations and developmental disability waiver services. We are committed to ensuring affordable services. We also are a Program Approved Service Agency for Long Term Care Medicaid Waivers as a behavioral service provider conducting behavioral evaluations and ongoing services for individuals with developmental disabilities. 2.1i Service location — list where the service will take place (i.e. client's home, in -office, other) Services can be provided in -home, in -community within Weld County, or in any of our offices, which include: 1597 Cole Blvd., Suite 250 in Lakewood, 357 S. McCaslin S. McCaslin Blvd., Suite 200 in Louisville; and 14001 E. Iliff Ave. Suite 204 in Aurora. All of our offices are ADA compliant and are located on bus lines. Telehealth services can also be provided as necessary due to Covid-19. Service #2 Name: Consultation 2.2a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): • Working with child welfare clients and/or caseworkers and department personnel to address cognitive, mental health, and/or developmental issues. • Providing support to clients and/or caseworkers to address issues identified by psychological evaluations and to ensure progress on recommendations made in the evaluations. Can be provided remotely, in -person, and/or at FSP meetings. • Expert -level court testimony can also be provided. 2.2b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Variable, depending upon the needs of the case 2.2c Anticipated duration of service (i.e. 3-4 months): Variable, depending upon the needs of the case 2.2d Three (3), or more, specific goals of the service (DO use bullet points): 1. Support caseworkers and clients to meet the treatment goals outlined in the FSP. 2. Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. 3. Engage families with outcome -based treatment modalities with proven efficacy. 4. Maintain frequent and thorough communication with Child Welfare Social Case Workers, and provide written reporting on at least a monthly basis. 5. In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. 2.2e Three (3), or more, specific outcomes of service: 1. Caseworkers are supported in addressing treatment recommendations. 2. Client(s) have improved ability to regulate emotions. 3. Client(s) are better able to meet treatment goals. 4. Increased safety and welfare of children by working with parents to understand what is best for and act in the long- term interest of their child(ren). 5. Improved individual and/or family functioning to maintain the welfare of clients. 2.2f Target population of the service: Consultation can be provided to caseworkers or clients. Our clinical specialty is working with individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. We are proud of our commitment to inclusivity and our history of working with individuals regardless of age, gender, or other characteristics/traits. 2.2g Languages service is available in (please list proficiency and if interpreter services are available): All services are available in English. When appropriate, interpreters can be utilized. 2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: We are able to bill services either in whole or in part through Medicaid. We are currently providing services through Health First Colorado, including the following RAEs: Colorado Access, Colorado Community Health Alliance, Health Colorado, Inc., Northeast Health Partners, Rocky Mountain Health Plans, Denver Health Medicaid Choice, as well as various health insurance organizations and developmental disability waiver services. We are committed to ensuring affordable services. We also are a Program Approved Service Agency for Long Term Care Medicaid Waivers as a behavioral service provider conducting behavioral evaluations and ongoing services for individuals with developmental disabilities. REV. OCT 2021 2 ATTACHMENT C - PROPOSAL 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) Services can be provided in -home, in -community within Weld County, or in any of our offices, which include: 1597 Cole Blvd., Suite 250 in Lakewood, 357 S. McCaslin S. McCaslin Blvd., Suite 200 in Louisville; and 14001 E. Iliff Ave. Suite 204 in Aurora. All of our offices are ADA compliant and are located on bus lines. Telehealth services can also be provided as necessary due to Covid-19. Service #3 Name: Psychological Evaluation 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): • Evaluations include a thorough assessment of mental health concerns, cognitive abilities, and academic skills. • Evaluations are tailored specifically to the referral question at hand, including evaluating for developmental issues such as autism spectrum disorder, learning disabilities, attention-deficit/hyperactivity disorder, behavioral concerns (including observations, review of records, identification of target behaviors, and recommendations for behavioral modification), and/or adaptive behavior (to investigate skills/abilities versus current daily performance). 2.3b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: One to four appointments will be held with the client over the course of one to two months from the date the referral is received. 2.3c Anticipated duration of service (i.e. 3-4 months): One to four appointments will be held with the client over the course of one to two months from the date the referral is received. 2.3d Three (3), or more, specific goals of the service (DO use bullet points): 2.3e 1. To schedule with the client as quickly as possible once the referral is received. 2. To conduct a thorough evaluation with the client, including addressing all of the referral questions. 3. To complete the evaluation in a timely manner while making client -specific and thorough recommendations on validated treatments with proven efficacy. 4 To address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. 5. To maintain frequent and thorough communication with Child Welfare Social Case Workers throughout the evaluation process and to provide written reporting on at least a monthly basis. 6. In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. Three (3), or more, specific outcomes of service: 1. Client's specific needs for support in meeting treatment goals have been identified, improving the likelihood that treatment goals can be met. 2. Client -specific outcome -based. treatment modalities with proven efficacy have been recommended. 3. Increased safety and welfare of children by providing recommendations to ensure parents understand what is best for and act in the long-term interest of their child(ren). 4. Improved individual and/or family functioning to maintain the welfare of clients. 2.3f Target population of the service: Our clinical specialty is working with individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. We are proud of our commitment to inclusivity and our history of working with individuals regardless of age, gender, or other characteristics/traits. 2.3g Languages service is available in (please list proficiency and if interpreter services are available): All services are available in English. When appropriate, interpreters can be utilized. 2.3h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: We are able to bill services either in whole or in part through Medicaid. We are currently providing services through Health First Colorado, including the following RAEs: Colorado Access, Colorado Community Health Alliance, Health Colorado, Inc., Northeast Health Partners, Rocky Mountain Health Plans, Denver Health Medicaid Choice, as well as various health insurance organizations and developmental disability waiver services. We are committed to ensuring affordable services. We also are a Program Approved Service Agency for Long Term Care Medicaid Waivers as a behavioral service provider conducting behavioral evaluations and ongoing services for individuals with developmental disabilities. 2.3i Service location — list where the service will take place (i.e. client's home, in -office, other) Services can be provided in -home, in -community within Weld County, or in any of our offices, which include: 1597 Cole Blvd., Suite 250 in Lakewood, 357 S. McCaslin S. McCaslin Blvd., Suite 200 in Louisville; and 14001 E. Iliff Ave. Suite 204 in Aurora. All of our offices are ADA compliant and are located on bus lines. REV. OCT 2021 3 ATTACHMENT C - PROPOSAL Service #4 Name: Trauma Assessment 2.4a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Includes psychological and cognitive testing as needed in addition to a full trauma assessment. Recommendations will be geared toward helping the individual understand how trauma affects emotions and behaviors, how the individual can be supported in the appropriate environment, and what interventions will lead to increased resilience, skill development, emotional regulation, and ultimately success for the individual. Dr. Kalis has attended CTRAC Trauma Assessment Training as well as trauma assessment training through Dr. James Henry with the Western Michigan University Children's Trauma Assessment Center. He is skilled at assessing for and diagnosing posttraumatic stress disorder in children, adolescents, and adults, and he and his clinical staff are well versed in providing the following trauma -related therapeutic services: Neurosequential Model of Therapeutics, Adolescent Dialectical Behavioral Therapy (DBT), Trauma Focused Cognitive Behavioral Therapy (TF-CBT), Sensory Integration, Trauma -Focused Child/Parent Interactional Therapy, Acceptance and Commitment Therapy (ACT), and EMDR. 2.4b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: One to four appointments will be held with the client over the course of one to two months from the date the referral is received. 2.4c Anticipated duration of service (i.e. 3-4 months): One to four appointments will be held with the client over the course of one to two months from the date the referral is received. 2.4d Three (3), or more, specific goals of the service (DO use bullet points): 1 To schedule with the client as quickly as possible once the referral is received. 2. To conduct a thorough trauma assessment with the client, including addressing all of the referral questions. 3. To complete the evaluation in a timely manner while making client -specific and thorough recommendations on validated treatments with proven efficacy. 4. To help the client understand how trauma affects emotions and behaviors. 5. To identify how the individual can best be supported in the appropriate environment. 6: To identify what interventions will lead to increased resilience, skill development, emotional regulation, and ultimately individual and family success. 7. To address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. 8 To maintain frequent and thorough communication with Child Welfare Social Case Workers throughout the evaluation process and to provide written reporting on at least a monthly basis. 9. In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. 2.4e Three (3), or more, specific outcomes of service: 1. Specific trauma -focused evidenced -based interventions with proven efficacy have been identified in recommendations to meet the client's specific needs. 2 Increased safety and welfare of children by providing recommendations to ensure parents understand what is best for and act in the long-term interest of their child(ren). 3. Improved individual and/or family functioning to maintain the welfare of clients. 2.4f Target population of the service: Our clinical specialty is working with individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. We are proud of our commitment to inclusivity and our history of working with individuals regardless of age, gender, or other characteristics/traits. 2.4g Languages service is available in (please list proficiency and if interpreter services are available): All services are available in English. When appropriate, interpreters can be utilized. 2.4h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: We are able to bill services either in whole or in part through Medicaid. We are currently providing services through Health First Colorado, including the following RAEs: Colorado Access, Colorado Community Health Alliance, Health Colorado, Inc., Northeast. Health Partners, Rocky Mountain Health Plans, Denver Health Medicaid Choice, as well as various health insurance organizations and developmental disability waiver services. We are committed to ensuring affordable services. We also are a Program Approved Service Agency for Long Term Care Medicaid Waivers as a behavioral service provider conducting behavioral evaluations and ongoing services for individuals with developmental disabilities. REV. OCT 2021 4 ATTACHMENT C - PROPOSAL 2.4i Service location — list where the service will take place (i.e. client's home, in -office, other) Services can be provided in -home, in -community within Weld County, or in any of our offices, which include: 1597 Cole Blvd:, Suite 250 in Lakewood, 357 S. McCaslin S. McCaslin Blvd., Suite 200 in Louisville; and 14001 E. Iliff Ave. Suite 204 in Aurora. All of our offices are ADA compliant and are located on bus lines. Service #5 Name: Parent -Child Interactional Evaluation 2.5a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): • Dr. Kalis, who has 20 years of experience conducting PCIs, employs an observational measure of parenting. • His extensive experience with family dynamics, including abuse/neglect/trauma dynamics as well as I/DD concerns, enables him to assess strengths and challenges as they relate to parenting success. 2.5b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: One to two observational appointments will be held with the client over the course of one to two months from the date the referral is received. Interviews with collateral sources and with parent(s) will also occur. 2.5c Anticipated duration of service (i.e. 3-4 months): One to two observational appointments will be held with the client over the course of one to two months from the date the referral is received. Interviews with collateral sources and with parent(s) will also occur. 2.5d Three (3), or more, specific goals of the service (DO use bullet points): 1. To schedule with the client as quickly as possible once the referral is received. 2. To conduct a thorough observation(s) of the family members, with special focus on referral questions. 3. To complete the observation(s) and recommendations in a timely manner. 4. To identify strengths and weaknesses in parenting. 5. To identify next steps in treatment to inform treatment plans. 6. To identify how the family can best be supported in the appropriate environment. 7. To identify what interventions will lead to increased resilience, skill development, emotional regulation, and ultimately individual and family success. 8. To address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. 9. To maintain frequent and thorough communication with Child Welfare Social Case Workers throughout the evaluation process and to provide written reporting on at least a monthly basis. 10. In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. 2.5e Three (3), or more, specific outcomes of service: 1. Parenting strengths and weaknesses have been identified and articulated. 2. Next steps in treatment plan goals have been identified. 3. Interventions have been identified to improve individual and family functioning. 4. Family preservation/reunification has been facilitated whenever possible. 2.5f Target population of the service: Our clinical specialty is working with individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. We are proud of our commitment to inclusivity and our history of working with individuals regardless of age, gender, or other characteristics/traits. 2.5g Languages service is available in (please list proficiency and if interpreter services are available): All services are available in English. For PCIs, interpreters cannot be utilized. 2.5h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part We are able to bill services either in whole or in part through Medicaid. We are currently providing services through Health First Colorado, including the following RAEs: Colorado Access, Colorado Community Health Alliance, Health Colorado, Inc., Northeast Health Partners, Rocky Mountain Health Plans, Denver Health Medicaid Choice, as well as various health insurance organizations and developmental disability waiver services. We are committed to ensuring affordable services. We also are a Program Approved Service Agency for Long Term Care Medicaid Waivers as a behavioral service provider conducting behavioral evaluations and ongoing services for individuals with developmental disabilities. 2.6i Service location — list where the service will take place (i.e. client's home, in -office, other) Services can be provided in -home, in -community within Weld County, or in any of our offices, which include: 1597 Cole Blvd., Suite 250 in Lakewood, 357 S. McCaslin S. McCaslin Blvd., Suite 200 in Louisville; and 14001 E. Iliff Ave. Suite 204 in Aurora. All of our offices are ADA compliant and are located on bus lines. REV. OCT 2021 s ATTACHMENT C - PROPOSAL Section 3 — Service Access and Transportation 3.1 Will you charge Weld County for transporting clients or mileage? Check ® YES ❑ NO one: 3.2 Will you conduct services in a client's home or in the community? Check ® YES ❑ NO one: 3.3 Will you transport clients to and/or from services? Check ❑ YES ® NO one: 3.4 How many miles are you willing to travel round trip? List a specific number of miles. 3.5 When you calculate mileage, what is your starting point address? Determined based on service and made on a case -by - case basis Miles This is dependent upon which therapist is providing the service. SECTION 4 - SERVICE RATES All rates need to include administrative work (i.e. scheduling or report writing) and overhead. Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly or monthly rates will be accepted for services, except for those listed above. • For hourly rates complete section(s) 4.1-4.5. • For monthly rates complete section 4.6. • For Home study providers complete section 4.7. • For monitored sobriety testing providers complete section 4.8. 4.1 Hourly Service #1 Name: Counseling/Psychotherapy 4.1a In-Office/Video: 4.1b In -Office with Transportation: In -Home or Community: 4.1c FTM, TDM, Prof. Staffing: 4.1d No show: $ Amount Unit Type $125 for Master's level; $150 for Ph.D. level N/A $125 for Master's level; $150 for Ph.D. level $125 for Master's level; $150 for Ph.D. level $125 for Master's level; $150 for Ph.D. level per Hour per Hour per Hour per Hour per No Show No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: N/A 25 miles miles REV. OCT 2021 6 ATTACHMENT C - PROPOSAL 4.1e Mileage rate: $0.50 per Mile This is paid after the miles listed above. 4.2 Hourly Service #2 Name: Consultation 4.2a In-Office/Video: 4.2b In -Office with Transportation: 4.2c In -Home or Community: 4.2d FTM, TDM, Prof. Staffing: 4.2e No show: 4.2f Mileage rate: $ Amount Unit Type $125 for Master's level; $150 for Ph.D. level N/A $125 for Master's level; $150 for Ph.D. level $125 for Master's level; $150 for Ph.D. level $125 for Master's level; $150 for Ph.D. level $0.50 per Hour per Hour per Hour per Hour per No Show No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: N/A 25 per Mile This is paid after the miles listed above. miles miles 4.3 Hourly Service #3 Name: Psychological Evaluation 4.3a In-Office/Video: 4.3b In -Office with Transportation: 4.3c In -Home or Community: 4.3d FTM, TDM, Prof. Staffing: 4.3e No show: 4.3f Mileage rate: $ Amount Unit Type $350 for face-to- face time only N/A $350 for face-to- face time only $150/hour N/A No charge per Hour per Hour per Hour per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: N/A No charge This is paid after the miles listed above. miles miles 4.4 Hourly Service #4 Name: Trauma Assessment 4.4a In-Office/Video: 4.4b In -Office with Transportation: $ Amount Unit Type $350 for face-to- face time only N/A per Hour per Hour No. of roundtrip miles included in rate: N/A miles REV. OCT 2021 ATTACHMENT C - PROPOSAL In -Home or Community: $350 for face-to- face time only per Hour No. of roundtrip miles included in rate: No charge miles 4.4c FTM, TDM, Prof. Staffing: $150/hour per Hour 4.4d No show: N/A per No Show 4.4e Mileage rate: No charge per Mile This is paid after the miles listed above. 4.5 Hourly Service #5 Name: Parent -Child Interactional Evaluation $ Amount Unit Type 4.5a In-Office/Video: $350 for face-to- face time only per Hour 4.5b In -Office with Transportation: N/A per Hour No. of roundtrip miles included in rate: N/A miles 4.5c In -Home or Community: $350 for face-to- face time only per Hour No. of roundtrip miles included in rate: No charge miles 4.5d FTM, TDM, Prof. Staffing: $150/hour per Hour 4.5e No show: N/A per No Show 4.5f Mileage rate: $350 for face-to- face time only per Mile This is paid after the miles listed above. 4.6 Monthly Service Rates (each level must be listed): Service Name with Level Rate per Month No. of Direct Service Hours: 4.6a N/A N/A N/A 4.6b 4.6c 4.6d 4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers — List your rates in the box below. N/A 4.8 Monitored Sobriety Providers — List your rates in the box below. N/A Provider special notes: Kalis and Associates has a long history of service to children, adolescents, and adults in the intellectual and developmental disability (l/DD) community, as well as a long history of partnership with Departments of Human Services throughout the Front Range and beyond. Kalis and Associates has truly enjoyed our partnership with Weld County, and we look forward to continuing to meet the unique needs of Weld County's child welfare clients. REV. OCT 2021 8 ATTACHMENT C - PROPOSAL Please type your answers in the boxes below or check the appropriate box. SECTION 1— Provider and Program Area Information Bidder's Legal Name: Program Area: Program Areas are listed in column 1 of the table located in Item XI of the You may complete another Attachment C if you have more than 5. Request for Proposal starting on page 13. Parker Personal Care Homes, Inc. dba David Kalis Multisystemic Therapy Number of services offered on this Attachment C (max 5): 1 If the Service 2.1a 2.1b 2.1c 2.1d 2.1e 2.1f 2.1g 2.1h SECTION 2 - Service Name(s) and Information service is a monthly package, please offer different levels. All monthly packages must state a specific minimum number of direct service hours. #1 Name: Multisystemic Therapy Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): • Kalis and Associates is highly experienced in providing intensive multi -systemic therapy to foster positive change across the home, school, and community environments. • Serious behavioral issues are addressed through interventions designed to avoid out -of -home placement. Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Once weekly or bi-weekly, depending on the needs of the client Anticipated duration of service (i.e. 3-4 months): 3 months to 2 years, generally; the length of services is dependent not only upon the types of services we are asked to provide but also upon the stage of the case in which we are asked to begin services. We are committed to accomplishing treatment goals within court -mandated timeframes. Three (3), or more, specific goals of the service (DO use bullet points): 1. Align treatment goals with goals identified in the FSP. 2. Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. 3. Engage individuals/families with outcome -based treatment modalities with proven efficacy. 4. Maintain frequent and thorough communication with Child Welfare Social Case Workers, and provide written reporting on at least a monthly basis. 5. In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. Three (3), or more, specific outcomes of service: 1. Client(s) have improved ability to regulate emotions. 2. Problematic behaviors are reduced, and coping skills are improved. 3. Client(s) are better able to meet treatment goals. 4. Increased safety and welfare of clients through behavioral improvement. 5. Improved individual and/or family functioning to maintain the welfare of clients. Target population of the service, including age and gender: Our clinical specialty is working with individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. We are proud of our commitment to inclusivity and our history of working with individuals regardless of age, gender, or other characteristics/traits. Languages service is available in (please list proficiency and if interpreter services are available): All services are available in English. When appropriate, interpreters can be utilized. Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: We are able to bill services either in whole or in part through Medicaid. We are currently providing services through Health First Colorado, including the following RAEs: Colorado Access, Colorado Community Health Alliance, Health Colorado, Inc., Northeast Health Partners, Rocky Mountain Health Plans, Denver Health Medicaid Choice, as well as various health insurance organizations and developmental disability waiver services. We are committed to ensuring affordable services. We also are a Program Approved Service Agency for Long Term Care Medicaid Waivers as a behavioral service provider conducting behavioral evaluations and ongoing services for individuals with developmental disabilities. REV. OCT 2021 1 ATTACHMENT C - PROPOSAL 2.11 Service location — list where the service will take place (i.e. client's home, in -office, other) Services can be provided in -home, in -community within Weld County, or in any of our offices, which include: 1597 Cole Blvd., Suite 250 in Lakewood, 357 S. McCaslin S. McCaslin Blvd., Suite 200 in Louisville; and 14001 E. Iliff Ave. Suite 204 in Aurora. All of our offices are ADA compliant and are located on bus lines. Telehealth services can also be provided as necessary due to Covid-19. Service #2 Name: 2.2a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.2b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.2c Anticipated duration of service (i.e. 3-4 months): 2.2d Three (3), or more, specific goals of the service (DO use bullet points): 2.2e Three (3), or more, specific outcomes of service: 2.2f Target population of the service: 2.2g Languages service is available in (please list proficiency and if interpreter services are available): 2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #3 Name: 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.3b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.3c Anticipated duration of service (i.e. 3-4 months): 2.3d Three (3), or more, specific goals of the service (DO use bullet points): 2.3e Three (3), or more, specific outcomes of service: 2.3f Target population of the service: 2.3g Languages service is available in (please list proficiency and if interpreter services are available): 2.3h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.3i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #4 Name: 2.4a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.4b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.4c Anticipated duration of service (i.e. 3-4 months): REV. OCT 2021 2 ATTACHMENT C - PROPOSAL 2.4d 2.4e 2.4f 2.4g 2.4h 2.4i Service 2.5a Three (3), or more, specific goals of the service (DO use bullet points): Three (3), or more, specific outcomes of service: Target population of the service: Languages service is available in (please list proficiency and if interpreter services are available): Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Service location — list where the service will take place (i.e. client's home, in -office, other) #5 Name: Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.5b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.5c Anticipated duration of service (i.e. 3-4 months): 2.5d Three (3), or more, specific goals of the service (DO use bullet points): 2.5e Three (3), or more, specific outcomes of service: 2.5f Target population of the service: 2.5g Languages service is available in (please list proficiency and if interpreter services are available): 2.5h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part 2.6i Service location — list where the service will take place (i.e. client's home, in -office, other) 3.1 3.2 3.3 3.4 3.5 Section 3 — Service Access Will you charge Weld County for transporting clients or mileage? one: Will you conduct services in a client's home or in the community? one: and Transportation YES YES NO Check @ IN NO Check @ ■ NO Miles Will you transport clients to and/or from services? Check ■ YES @ one: How many miles are you willing to travel round trip? List a specific miles. When you calculate mileage, what is your starting point address? number of Determined based on service and made on a case -by - case basis This is dependent upon which therapist is providing the service. SECTION 4 - SERVICE RATES All rates need to include administrative work (i.e. scheduling or report writing) and overhead. REV. OCT 2021 3 ATTACHMENT C - PROPOSAL Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly or monthly rates will be accepted for services, except for those listed above. • For hourly rates complete section(s) 4.1-4.5. • For monthly rates complete section 4.6. • For Home study providers complete section 4.7. • For monitored sobriety testing providers complete section 4.8. 4.1 Hourly Service #1 Name: Multisystemic Therapy 4.1a In-Office/Video: 4.1b In -Office with Transportation: In -Home or Community: 4.1c FTM, TDM, Prof. Staffing: 4.1d No show: 4.1e Mileage rate: $ Amount Unit Type $125 for Master's level; $150 for Ph.D. level N/A $125 for Master's level; $150 for Ph.D. level $125 for Master's level; $150 for Ph.D. level $125 for Master's level; $150 for Ph.D. level $0.50 per Hour per Hour per Hour per Hour per No Show No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: N/A 25 per Mile This is paid after the miles listed above. miles miles 4.2 Hourly Service #2 Name: 4.2a In-Office/Video: 4.2b In -Office with Transportation: 4.2c In -Home or Community: 4.2d FTM, TDM, Prof. Staffing: 4.2e No show: 4.2f Mileage rate: $ Amount Unit Type per Hour per Hour per Hour per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: This is paid after the miles listed above. miles miles 4.3 Hourly Service #3 Name: 4.3a 4.3b 4.3c 4.3d 4.3e 4.3f REV. OCT 2021 In-Office/Video: In -Office with Transportation: In -Home or Community: FTM, TDM, Prof. Staffing: No show: Mileage rate: $ Amount Unit Type per Hour per Hour per Hour per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: This is paid after the miles listed above. miles miles 4 ATTACHMENT C - PROPOSAL 4.4 Hourly Service #4 Name: $ Amount Unit Type 4.4a In-Office/Video: per Hour 4.4b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.4c FTM, TDM, Prof. Staffing: per Hour 4.4d No show: per No Show 4.4e Mileage rate: per Mile This is paid after the miles listed above. 4.5 Hourly Service #5 Name: $ Amount Unit Type 4.5a In-Office/Video: per Hour 4.5b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.5c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.5d FTM, TDM, Prof. Staffing: per Hour 4.5e No show: per No Show 4.5f Mileage rate: per Mile This is paid after the miles listed above. 4.6 Monthly Service Rates (each level must be listed): Service Name with Level Rate per Month No. of Direct Service Hours: 4.6a N/A N/A N/A 4.6b 4.6c 4.6d 4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers — List your rates in the box below. N/A 4.8 Monitored Sobriety Providers — List your rates in the box below. N/A Provider special notes: Kalis and Associates has a long history of service to children, adolescents, and adults in the intellectual and developmental disability (I/DD) community, as well as a long history of partnership with Departments of Human Services throughout the Front Range and beyond. Kalis and Associates has truly enjoyed our partnership with Weld County, and we look forward to continuing to meet the unique needs of Weld County's child welfare clients. REV. OCT 2021 5 ATTACHMENT C - PROPOSAL Please type your answers in the boxes below or check the appropriate box. SECTION 1— Provider and Program Area Information Bidder's Legal Name: Program Area: Program Areas are listed in column 1 of the table located in Item XI of the Request for Proposal starting on page 13. Parker Personal Care Homes, Inc. dba David Kalis Relinquishment Counseling Number of services offered on this Attachment C (max 5): You may complete another Attachment C if you have more than 5. 1 If Service 2.1a 2.1b 2.1c 2.1d 2.1e 2.1f 2.1g 2.1h SECTION 2 - Service Name(s) and Information the service is a monthly package, please offer different levels. All monthly packages must state a specific minimum number of direct service hours. #1 Name: Relinquishment Counseling Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): • When a parent(s) is/are considering the legal relinquishment of their child(ren), Kalis and Associates can provide relinquishment counseling services for both parents and their children (age 12 and older). • Additional related services include attachment/bonding therapy, therapeutic visitation, life skills, and aftercare services. Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Variable, depending upon the needs of the case Anticipated duration of service (i.e. 3-4 months): Variable, depending upon the needs of the case Three (3), or more, specific goals of the service (DO use bullet points): 1. Ensure the parent(s) has considered all aspects of the relinquishment and is making an informed choice. 2. Ensure that the child(ren)'s best interests are kept in mind and that parent(s) fully understand these best interests. 3. Align treatment goals with goals identified in the FSP. 4. Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. 5. Engage families with outcome -based treatment modalities with proven efficacy. 6. Maintain frequent and thorough communication with Child Welfare Social Case Workers, and provide written reporting on at least a monthly basis. 7. In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. Three (3), or more, specific outcomes of service: 1. Parent(s) are able to make a fully informed decision about their decision to relinquish their parental rights or not. 2. Child(ren)'s best interests are kept in mind. 3. Increased safety and welfare of children by working with parents to understand child -welfare -specific concerns such as abuse, neglect, loss, and grief. 4. Improved individual and/or family functioning to maintain the welfare of clients. Target population of the service, including age and gender: Our clinical specialty is working with individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. We are proud of our commitment to inclusivity and our history of working with individuals regardless of age, gender, or other characteristics/traits. Languages service is available in (please list proficiency and if interpreter services are available): All services are available in English. When appropriate, interpreters can be utilized. Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: We are able to bill services either in whole or in part through Medicaid. We are currently providing services through Health First Colorado, including the followingRAEs: Colorado Access, Colorado Community Health Alliance, Health Colorado, Inc., Northeast Health Partners, Rocky Mountain Health Plans, Denver Health Medicaid Choice, as well as various health insurance organizations and developmental disability waiver services. We are committed to ensuring affordable services. We also are a Program Approved Service Agency for Long Term Care Medicaid Waivers as a behavioral service provider conducting behavioral evaluations and ongoing services for individuals with developmental disabilities. REV. OCT 2021 1 ATTACHMENT C - PROPOSAL 2.1i Service location — list where the service will take place (i.e. client's home, in -office, other) Services can be provided in -home, in -community within Weld County, or in any of our offices, which include: 1597 Cole Blvd., Suite 250 in Lakewood, 357 S. McCaslin S. McCaslin Blvd., Suite 200 in Louisville; and 14001 E. Iliff Ave. Suite 204 in Aurora. All of our offices are ADA compliant and are located on bus lines. Telehealth services can also be provided as necessary due to Covid-19. Service #2 Name: 2.2a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.2b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.2c Anticipated duration of service (i.e. 3-4 months): 2.2d Three (3), or more, specific goals of the service (DO use bullet points): 2.2e Three (3), or more, specific outcomes of service: 2.2f Target population of the service: 2.2g Languages service is available in (please list proficiency and if interpreter services are available): 2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #3 Name: 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.3b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.3c Anticipated duration of service (i.e. 3-4 months): 2.3d Three (3), or more, specific goals of the service (DO use bullet points): 2.3e Three (3), or more, specific outcomes of service: 2.3f Target population of the service: 2.3g Languages service is available in (please list proficiency and if interpreter services are available): 2.3h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.3i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #4 Name: 2.4a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.4b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.4c Anticipated duration of service (i.e. 3-4 months): REV. OCT 2021 2 ATTACHMENT C - PROPOSAL 2.4d Three (3), or more, specific goals of the service (DO use bullet points): 2.4e Three (3), or more, specific outcomes of service: 2.4f Target population of the service: 2.4g Languages service is available in (please list proficiency and if interpreter services are available): 2.4h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.4i Service 2.5a Service location — list where the service will take place (i.e. client's home, in -office, other) #5 Name: Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.5b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.5c Anticipated duration of service (i.e. 3-4 months): 2.5d Three (3), or more, specific goals of the service (DO use bullet points): 2.5e Three (3), or more, specific outcomes of service: 2.5f Target population of the service: 2.5g Languages service is available in (please list proficiency and if interpreter services are available): 2.5h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part 2.6i Service location — list where the service will take place (i.e. client's home, in -office, other) 3.1 3.2 3.3 3.4 3.5 Section 3 — Service Access Will you charge Weld County for transporting clients or mileage? one: Will you conduct services in a client's home or in the community? one: and Transportation YES YES NO Check O ■ NO Check e ■ NO Miles Will you transport clients to and/or from services? Check • YES ►5 one: How many miles are you willing to travel round trip? List a specific miles. When you calculate mileage, what is your starting point address? number of Determined based on service and made on a case -by - case basis This is dependent upon which therapist is providing the service. SECTION 4 - SERVICE RATES All rates need to include administrative work (i.e. scheduling or report writing) and overhead. REV. OCT 2021 3 ATTACHMENT C - PROPOSAL Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly or monthly rates will be accepted for services, except for those listed above. • For hourly rates complete section(s) 4.1-4.5. • For monthly rates complete section 4.6. • For Home study providers complete section 4.7. • For monitored sobriety testing providers complete section 4.8. 4.1 Hourly Service #1 Name: Relinquishment Counseling 4.1a In-Office/Video: 4.1b In -Office with Transportation: In -Home or Community: 4.1c FTM, TDM, Prof. Staffing: 4.1d No show: 4.1e Mileage rate: $ Amount Unit Type $125 for Master's level; $150 for Ph.D. level N/A $125 for Master's level; $150 for Ph.D. level $125 for Master's level; $150 for Ph.D. level $125 for Master's level; $150 for Ph.D. level $0.50 per Hour per Hour per Hour per Hour per No Show No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: N/A 25 per Mile This is paid after the miles listed above. miles miles 4.2 Hourly Service #2 Name: 4.2a In-Office/Video: 4.2b In -Office with Transportation: 4.2c In -Home or Community: 4.2d FTM, TDM, Prof. Staffing: 4.2e No show: 4.2f Mileage rate: $ Amount Unit Type per Hour per Hour per Hour per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: This is paid after the miles listed above. miles miles 4.3 Hourly Service #3 Name: 4.3a 4.3b 4.3c 4.3d 4.3e 4.3f REV. OCT 2021 In-Office/Video: In -Office with Transportation: In -Home or Community: FTM, TDM, Prof. Staffing: No show: Mileage rate: $ Amount Unit Type per Hour per Hour per Hour per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: This is paid after the miles listed above. miles miles 4 ATTACHMENT C - PROPOSAL 4.4 Hourly Service #4 Name: $ Amount Unit Type 4.4a In-Office/Video: per Hour 4.4b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.4c FTM, TDM, Prof. Staffing: per Hour 4.4d No show: per No Show 4.4e Mileage rate: per Mile This is paid after the miles listed above. 4.5 Hourly Service #5 Name: $ Amount Unit Type 4.5a In-Office/Video: per Hour 4.5b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.5c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.5d FTM, TDM, Prof. Staffing: per Hour 4.5e No show: per No Show 4.5f Mileage rate: per Mile This is paid after the miles listed above. 4.6 Monthly Service Rates (each level must be listed): Service Name with Level Rate per Month No. of Direct Service Hours: 4.6a N/A N/A N/A 4.6b 4.6c 4.6d 4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers — List your rates in the box below. N/A 4.8 Monitored Sobriety Providers — list your rates in the box below. N/A Provider special notes: Kalis and Associates has a long history of service to children, adolescents, and adults in the intellectual and developmental disability (I/DD) community, as well as a long history of partnership with Departments of Human Services throughout the Front Range and beyond. Kalis and Associates has truly enjoyed our partnership with Weld County, and we look forward to continuing to meet the unique needs of Weld County's child welfare clients. REV. OCT 2021 5 ATTACHMENT C - PROPOSAL Please type your answers in the boxes below or check the appropriate box. SECTION 1— Provider and Program Area Information Bidder's Legal Name: Program Area: Program Areas are listed in column 1 of the table located in Item XI of the You may complete another Attachment C if you have more than 5. Request for Proposal starting on page 13. Parker Personal Care Homes, Inc. dba David Kalis Sexual Abuse Treatment Number of services offered on this Attachment C (max 5): 2 If Service 2.1a 2.1b 2.1c 2.1d 2.1e 2.1f 2.1g SECTION 2 — Service Name(s) and Information the service is a monthly package, please offer different levels. All monthly packages must state a specific minimum number of direct service hours. #1 Name: Sexual Abuse Treatment Therapy and Consultation Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Kalis and Associates is proud that our clinical team includes Ms. Jolene Pagnotta, a Master's level SOMB therapist. Ms. Pagnotta is a licensed full operating -level SOMB professional who has extensive experience working with SOMB standards, treating sexual abuse victims, and working with sexually abusive individuals. As such, she is able to provide the following sex -offense -specific therapy and consultation services: • Therapeutic Sexual Abuse Treatment for Victims • Offense -Specific Treatment for Sexual Offenders • Informed Supervision Training for Caregivers • Multi -Systemic Therapy for Problem Sexual Behaviors (MST-PSB) • Attending Multi -Disciplinary Team meetings to provide consultation, guidance, and support, and to assist in safety planning and development of next steps • Providing psycho -educational information for those impacted by sexual abuse, including for education for parents on clarification/reunification, informed supervision, family therapy, and safety planning Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Once weekly or bi-weekly, depending on the needs of the client Anticipated duration of service (i.e. 3-4 months): 3 months to 2 years, generally; the length of services is dependent not only upon the types of services we are asked to provide but also upon the stage of the case in which we are asked to begin services. We are committed to accomplishing treatment goals within court -mandated timeframes. Three (3), or more, specific goals of the service (DO use bullet points): 1. To provide therapeutic interventions specific to behaviors related to sexual abuse victimization, sexual dysfunction, and sexual abuse perpetration. 2. To prevent further sexual abuse and victimization. 3. To support MDT members at meetings by offering expert -level guidance into treatment planning, safety planning, and next steps. 4. To provide education to team members and clients regarding sexual abuse specific concerns, including clarification, reunification, family therapy, informed supervision, boundary establishment, safety planning. Three (3), or more, specific outcomes of service: 1. Assistance is provided in outlining sex -offense -specific treatment goals. 2. Therapy and education are provided to decrease problem behaviors and avoid abuse and victimization. 3. Client(s) are better able to meet treatment goals. Target population of the service, including age and gender: Our clinical specialty is working with individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. We are proud of our commitment to inclusivity and our history of working with individuals regardless of age, gender, or other characteristics/traits. Languages service is available in (please list proficiency and if interpreter services are available): All services are available in English. When appropriate, interpreters can be utilized. REV. OCT 2021 1 ATTACHMENT C - PROPOSAL 2.1h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: We are able to bill services either in whole or in part through Medicaid. We are currently providing services through Health First Colorado, including the following RAEs: Colorado Access, Colorado Community Health Alliance, Health Colorado, Inc., Northeast Health Partners, Rocky Mountain Health Plans, Denver Health Medicaid Choice, as well as various health insurance organizations and developmental disability waiver services. We are committed to ensuring affordable services. We also are a Program Approved Service Agency for Long Term Care Medicaid. Waivers as a behavioral service provider conducting behavioral evaluations and ongoing services for individuals with developmental disabilities.. 2.1i Service location — list where the service will take place (i.e. client's home, in -office, other) Services can be provided in -home, in -community within Weld County, or in any of our offices, which include: 1597 Cole Blvd., Suite 250 in Lakewood, 357 S. McCaslin S. McCaslin Blvd., Suite 200 in Louisville; and 14001 E. Riff Ave. Suite 204 in Aurora. All of our offices are ADA compliant and are located on bus lines. Telehealth services can also be provided as necessary due to Covid-19. Service #2 Name: Psychosexual Evaluations/Sex-Offender-Specific Evaluation 2.2a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Our Master's -level and full operating -level SOMB therapist, Ms. Pagnotta, will conduct a thorough psychosexual/sex- offender-specific evaluation. 2.2b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: One to four appointments will be held with the client over the course of one to two months from the date the referral is received. 2.2c Anticipated duration of service (i.e. 3-4 months): One to four appointments will be held with the client over the course of one to two months from the date the referral is received. 2.2d Three (3), or more, specific goals of the service (DO use bullet points): 1. To schedule with the client as quickly as possible once the referral is received 2. To conduct a thorough evaluation with the client, including addressing all of the referral questions 3. To complete the evaluation in a timely manner while making client -specific and thorough recommendations on validated treatments with proven efficacy. 4. To determine issues and behaviors related to sexual abuse, dysfunction, and perpetration. 5. To determine whether co-occurring conditions exist. 6 To develop thorough evidence -based treatment plan recommendations to assist with treatment, including addressing safety needs and needs for family therapy. 7 To prevent further sexual abuse victimization. 8 To address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. 8 To maintain frequent and thorough communication with Child Welfare Social Case Workers throughout the evaluation process and to provide written reporting on at least a monthly basis. 10. In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. 2.2e Three (3), or more, specific outcomes of service: 1. 3. 4. Client's specific needs for support in meeting treatment goals have been identified, improving the likelihood that treatment goals can be met. Client -specific outcome -based treatment modalities with proven efficacy have been recommended. Increased safety and welfare of children by providing recommendations to ensure parents understand what is best for and act in the long-term interest of their child(ren). Improved individual and/or family functioning to maintain the welfare of clients. Team members are supported in the development of safety planning and FSP goals. 2.2f Target population of the service: Our clinical specialty is working with individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. We are proud of our commitment to inclusivity and our history of working with individuals regardless of age, gender, or other characteristics/traits. 2.2g Languages service is available in (please list proficiency and if interpreter services are available): All services are available in English. When appropriate, interpreters can be utilized. REV. OCT 2021 2 ATTACHMENT C - PROPOSAL 2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: We are able to bill services either in whole or in part through Medicaid. We are currently providing services through Health First Colorado, including the following RAEs: Colorado Access, Colorado Community Health Alliance, Health Colorado, Inc., Northeast Health Partners, Rocky Mountain Health Plans, Denver Health Medicaid Choice, as well as various health insurance organizations and developmental disability waiver services. We are committed to ensuring affordable services. We also are a Program. Approved Service Agency for Long Term Care Medicaid Waivers as a behavioral service provider conducting behavioral evaluations and ongoing services for individuals with developmental disabilities. 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) Services can be provided in -home, in -community within Weld County, or in any of our offices, which include: 1597 Cole Blvd., Suite 250 in Lakewood, 357 S. McCaslin S. McCaslin Blvd., Suite 200 in Louisville; and 14001 E. Iliff Ave. Suite 204 in Aurora. All of our offices are ADA compliant and are located on bus lines. Service #3 Name: 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.3b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.3c Anticipated duration of service (i.e. 3-4 months): 2.3d Three (3), or more, specific goals of the service (DO use bullet points): 2.3e Three (3), or more, specific outcomes of service: 2.3f Target population of the service: 2.3g Languages service is available in (please list proficiency and if interpreter services are available): 2.3h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.3i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #4 Name: 2.4a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.4b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.4c Anticipated duration of service (i.e. 3-4 months): 2.4d Three (3), or more, specific goals of the service (DO use bullet points): 2.4e Three (3), or more, specific outcomes of service: 2.4f Target population of the service: 2.4g Languages service is available in (please list proficiency and if interpreter services are available): 2.4h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.4i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #5 Name: 2.5a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): REV. OCT 2021 3 ATTACHMENT C - PROPOSAL 2.5b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.5c Anticipated duration of service (i.e. 3-4 months): 2.5d Three (3), or more, specific goals of the service (DO use bullet points): 2.5e Three (3), or more, specific outcomes of service: 2.5f Target population of the service: 2.5g Languages service is available in (please list proficiency and if interpreter services are available): 2.5h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part 2.6i Service location — list where the service will take place (i.e. client's home, in -office, other) 3.1 3.2 3.3 3.4 3.5 Section 3 — Service Access Will you charge Weld County for transporting clients or mileage? one: Will you conduct services in a client's home or in the community? one: Will you transport clients to and/or from services? Check one: How many miles are you willing to travel round trip? List a specific miles. When you calculate mileage, what is your starting point address? and Transportation YES YES NO Check 0 • NO Check 0 • NO Miles ■ YES ►5 number of Determined based on service and made on a case -by - case basis This is dependent upon which therapist is providing the service. SECTION 4 - SERVICE RATES All rates need to include administrative work (i.e. scheduling or report writing) and overhead. Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly or monthly rates will be accepted for services, except for those listed above. • For hourly rates complete section(s) 4.1-4.5. • For monthly rates complete section 4.6. • For Home study providers complete section 4.7. • For monitored sobriety testing providers complete section 4.8. 4.1 Hourly Service #1 Name: Sexual Abuse Treatment Therapy and Consultation 4.1a In-Office/Video: 4.1b In -Office with Transportation: In -Home or Community: $ Amount $125 N/A $125 Unit Type per Hour per Hour per Hour No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: N/A 25 miles miles REV. OCT 2021 4 ATTACHMENT C - PROPOSAL 4.1c FTM, TDM, Prof. Staffing: $125 per Hour 4.1d No show: $125 per No Show 4.1e Mileage rate: $0.50 per Mile This is paid after the miles listed above. 4.2 Hourly Service #2 Name: Psychosexual Evaluations/Sex-Offender-Specific Evaluations $ Amount Unit Type 4.2a In-Office/Video: $1100 per eval per Hour 4.2b In Transportation: -Office with per Hour No. of roundtrip miles included in rate: N/A miles 4.2c In -Home or Community: per Hour No. of roundtrip miles included in rate: No charge miles 4.2d FTM, TDM, Prof. Staffing: $125/hour per Hour 4.2e No show: N/A per No Show 4.2f Mileage rate: No charge per Mile This is paid after the miles listed above. 4.3 Hourly Service #3 Name: $ Amount Unit Type 4.3a In-Office/Video: per Hour 4.3b In Transportation: -Office with per Hour No. of roundtrip miles included in rate: miles 4.3c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.3d FTM, TDM, Prof. Staffing: per Hour 4.3e No show: per No Show 4.3f Mileage rate: per Mile This is paid after the miles listed above. 4.4 Hourly Service #4 Name: $ Amount Unit Type 4.4a In-Office/Video: per Hour 4.4b In Transportation: -Office with per Hour No. of roundtrip miles included in rate: miles In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.4c FTM, TDM, Prof. Staffing: per Hour 4.4d No show: per No Show 4.4e Mileage rate: per Mile This is paid after the miles listed above. 4.5 Hourly Service #5 Name: $ Amount Unit Type 4.5a In-Office/Video: per Hour 4.5b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.5c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.5d FTM, TDM, Prof. Staffing: per Hour 4.5e No show: per No Show 4.5f Mileage rate: per Mile This is paid after the miles listed above. 4.6 Monthly Service Rates (each level must be listed): REV. OCT 2021 5 ATTACHMENT C - PROPOSAL Service Name with Level Rate per Month No. of Direct Service Hours: 4.6a N/A N/A N/A 4.6b 4.6c 4.6d 4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers — List your rates in the box below. N/A 4.8 Monitored Sobriety Providers — List your rates in the box below. N/A Provider special notes: Kalis and Associates has a long history of service to children, adolescents, and adults in the intellectual and developmental disability (I/DD) community, as well as a long history of partnership with Departments of Human Services throughout the Front Range and beyond. Kalis and Associates has truly enjoyed our partnership with Weld County, and we look forward to continuing to meet the unique needs of Weld County's child welfare clients. REV. OCT 2021 6 ATTACHMENT D - STAFF DATA SHEET Bidder Must List All Staff Who Will Administer the Proposed Service(s) BIDDER'S LEGAL NAME (As it appears on the W-9): AGENCY CONTACT: Kate Veeder, LCSW Parker Personal Care Homes PHONE NUMBER: 720.471.9973 EMAIL: kate@kalisandassociates.net PROPOSED SERVICE(S): Aftercare Functional Services, Family Therapy, Anger Management/Domestic Violence, Foster Parent Consultation, Foster Parent Training, Home -Based Intervention, Kinship Services (Therapeutic), Life Skills, Mediation, Mental Treatment Health Services, Services Multisystemic Therapy, Relinquishment Counseling, Sexual Abuse Treatment, Substance Abuse Legal Last Name Initial Middle Previous Name (If applicable) Legal Last Legal First Name Service Type Credentials Licensure/ DORA # (If applicable) Ka David I Family Therapy, Home -Based Intervention, Kinship LCSW, PhD CO LCSW License #077, CO Psychologist License # 3755 I i s H. N/A Veeder E. N/A Kate I Family Therapy, Home -Based Intervention, Kinship LCSW Colorado License # 9925648 Montano N/A Tiffany l FamiyTherapy, Home -Based Intervenion, Kinship LCSW Colorado License # 9922785 Read G. N/A Gretchen IFamiyTherapy. Home -Based Interven ton, Kinship LCSW Colorado License # 09924196 Pagnotta I. Martorano Jolene i itervention, Kinship Services (Therapeutic), Lite Skil LAC, SOMB LAC License #0000842 Echelberry N/A Emily I Fami Thera y ply, Hornc-Based Intervention. Kinship MA Ca m a rote N/A Rachel I Family Therapy, Home -Based Intervention, Kinship MS Switzer N/A Suzanne I Family Therapy, Home -Based Intervention, Kinship MS CHILD WELFARE REQUEST FOR PROPOSAL 2022-23 - VARIOUS SERVICES ACoRI$ CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 12/6/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER IMA, Inc. - Colorado 1705 17th Street, Suite 100 Denver CO 80202 CONTACT NAME: IMA Denver Team PHONE I FAX (A/C, No. Ext): 303-534-4567 (A/C, No): ADDRESS: DenAccountTechs@imacorp.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: *Pinnacol Assurance 41190 INSURED PARKPER-02 David Kalis, Inc, dba: Parker Personal Care Homes, Inc 357 S McCaslin Blvd #200 Lakewood CO 80401 INSURER a : Berkshire Hathaway Specialty Insurance Company 22276 INSURERC: INSURER D: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 1765847646 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR VD POLICY NUMBER POLICY EFF IMMIDD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS B X COMMERCIAL GENERAL LIABILITY 47SPK25819805 7/31/2021 7/31/2022 EACH OCCURRENCE $1,000,000 PREMISESO(Ea occurrence) $ 100,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PRO- JECT X PER: LOC PRODUCTS - COMP/OP AGG $ 3,000,000 $ B AUTOMOBILE X X LIABILITY ANY AUTO OWNED X SCHEDULED AUTOS NON -OWNED AUTOS ONLY L 47RWS25819905 7/31/2021 7/31/2022 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 47SUM25820005 7/31/2021 7/31/2022 EACH OCCURRENCE $3,000,000 AGGREGATE $ 3,000,000 DED X RETENTION $ infirm $ A WORKERS COMPENSATION EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N N / A 4007978 12/1/2021 12/1/2022 X MUTE STATUTE ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500,000 B Professional Liability Including Abuse 8 Molestation 47SPK25819805 7/31/2021 7/31/2022 Per Occurrence Aggregate $1,000,000 $3,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Cyber/Network Security and Privacy Liability Coverage: Policy #PHSD1648178 Effective Dates: 07/31/21-07/31/22 Insurer: Philadelphia Indemnity Insurance Company $1,000,000 Per Occurrence; $2,000,000 Aggregate; $10,000 Deductible Continuity Date/Prior/Pending Litigation Dates: 06/06/2013 Crime/Employee Dishonesty Coverage: Policy #47SPK258 19805 Effective Dates: 07/31/21-07/31/22 Insurer B: See Above $250,000 Limit; $1,000 Deductible See Attached... CERTIFICATE HOLDER CANCELLATION Weld County Department of Human Services 1150 O STREET GREELEY CO 80634 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 31111(41214;t64+ ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: PARKPER-02 LOC #: ACOR©® ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY IMA, Inc. - Colorado NAMED INSURED David Kalis, Inc, dba: Parker Personal Care Homes, Inc 357 S McCaslin Blvd #200 Lakewood CO 80401 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Weld County is included as Additional Insured on the General and Umbrella Liability Policies if required by written contract or agreement subject to the policy terms and conditions. A Waiver of Subrogation is provided in favor of Additional Insured on the General Liability and Workers Compensation Policies if required by written contract or agreement subject to the policy terms and conditions. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD This endorsement, effective 12:01AM: 7/31/2021 Forms a part of Policy No.: 47SPK25819805 Issued to: Parker Personal Care Homes, dba: David Kalis, Inc. By: C L S ACES GE L LIB LI T V C SE EST V THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM It is understood and agreed that the following extensions only apply in the event that no other specific coverage for the indicated loss exposure is provided under this policy. If such specific coverage applies, the terms, conditions and limits of that coverage are the sole and exclusive coverage applicable under this policy, unless otherwise noted on this endorsement. The following is a summary of the Limits of Insurance and additional coverages provided by this endorsement. For complete details on specific coverages, consult the policy contract wording. Coverage Applicable Limit of Insurance Limited Rental Lease Agreement Contractual Liability _ $50,000 limit Damage to Property You Own, Rent, or Occupy $30,000 limit Damage to Premises Rented to You $1,000,000 HIPAA Clarification Medical Payments $20,000 Medical Payments — Extended Reporting Period 3 years Athletic Activities Amended Employee Defense Coverage $25,000 limit Key and Lock Replacement — Janitorial Services Client Coverage $10,000 limit Additional Insured — Newly Acquired Time Period Amended Additional Insured - Medical Directors and Administrators Included Additional Insured — Managers and Supervisors (with Fellow Employee Coveragel Included Additional Insured — Broadened Named Insured Included Additional Insured — Funding Source Included Page 1 I BH-GL-O11-O2/2O15 Additional Insured — Home Care Providers Included Additional Insured — Managers, Landlords, or Lessors of Premises Included Additional Insured - Lessor of Leased Equipment Included Additional Insured — Grantor of Permits Included Additional Insured - Vendor Included Additional Insured — When Required by Contract Included Additional Insured — Owners, Lessees, or Contractors Included Additional Insured — State or Political Subdivisions Included Duties in the Event of Occurrence, Claim or Suit Included Transfer of Rights of Recovery Against Others To Us Clarification Bodily Injury— includes Mental Anguish Included Personal and Advertising Injury— includes Abuse of Process, Discrimination Included Amendment of Liquor Liability Exclusion for Fundraising Events Included Definitions Amended I. Limited Rental Lease Agreement Contractual Liability Section I — COVERAGES, COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Exclusion 2.b. Contractual Liability is amended to include the following: (3) Assumed in rental lease agreement on behalf of a "client". This coverage extension requires the Named Insured to request this coverage at the time of claim, and will provide the coverage only on an indemnity basis, and up to a $50,000 aggregate limit. This limit is in addition to the limits provided by this policy. For the purpose of this Coverage Extension, "client" means a person who is under your direct care and supervision, including but not limited to a "resident". For the purpose of this Coverage Extension, "resident" means a person who is residing in and receiving care services provided by your operation. II. Damage to Property You Own, Rent or Occupy Section I — COVERAGES, COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Exclusion 2.j. Damage to Property, Paragraph (1) is deleted and replaced with the following: (1) Property you own, rent, or occupy, including any costs or expenses incurred by you, or any other person, organization or entity, for repair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to another's property. However, if the "property damage" is caused by your "client", we will pay up to a $30,000 aggregate limit for such damage. This limit is in addition to the limits provided by this policy; For the purpose of this Coverage Extension, "client" means a person who is under your direct care and supervision, including but not limited to a "residents. For the purpose of this Coverage Extension, "resident" means a person who is residing in and receiving care services provided by your operation. BH-GL-011-02/2015 Damage to Premises Rented to You 1. The last paragraph of Section I — COVERAGES, COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions; is deleted and replaced with the following: Exclusions c. through n. do not apply to: a. Damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems; and b. Damage caused by a "resident"; to premises rented to you or temporarily occupied by you with the permission of the owner. A separate limit of insurance applies to this coverage as described in Section III — LIMITS OF INSURANCE. 2. Section III - LIMITS OF INSURANCE, Paragraph 6. is deleted and replaced with the following. 6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under COVERAGE A for damages because of "property damage": a. Resulting from fire, lightning, explosion, smoke, or leakage from automatic fire protective systems, or any combination thereof; and b. Caused by a "resident"; to any one premises, rented to you or temporarily occupied by you with the permission of the owner. The Damage to Premises Rented to You Limit is the greater of: a. $1,000,000 for damages due to fire, lightning, explosion, smoke or leakage from automatic fire protective systems, or any combination thereof; or b. The amount shown in the Declarations as the Damage to Premises Rented to You Limit; and c. $25,000 for all other damages caused by a "resident". 3. Section IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 4.b. Excess Insurance, Subparagraph (1) (iii) is deleted and replaced with the following: (iii) That is property insurance for premises rented to you or temporarily occupied by you with the permission of the owner. 4. Section V — DEFINITIONS, Definition 9. "insured Contract", Paragraph a. is deleted and replaced with the following: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, smoke, or leaks from sprinklers to premises while rented to you or temporarily occupied by you with the permission of the owner is not an "insured contract". BH-GL-011-02/2015 5. For the purpose of this For the purpose of this Coverage Extension, "resident" means a person who is residing in and receiving care services provided by your operation. 1V. HIPAA 1. Section I — COVERAGES, COVERAGE B — PERSONAL AND ADVERTISING INJURY LIABILITY, Paragraph 1. Insuring Agreement is amended to include the following: a. We will pay those sums that the insured becomes legally obligated to pay as "damages" because of a "violation(s)" of the following regulations: (1) General Administrative Requirements (45 CFR § 160 et seq.); (2) Administrative Requirements (45 CFR § 162 et seq.); or (3) Security and Privacy (45 CFR § 164 et seq.) as promulgated by the Department of Health and Human Services ("HHS") pursuant to the authority given to HHS under the Health Insurance Portability and Accountability Act ("HIPAA") as may be amended from time to time and to which this insurance applies. We will have the right and duty to defend you against any "suit", "investigation" or "civil proceeding" by HHS to which this insurance applies. However, we will have no duty to defend you against any "suit", "investigation" or "civil proceeding" to which this insurance does not apply. We may, at our discretion, investigate any "violation(s)" and settle any "damages" arising out of such "violation(s)". But, the amount we will pay for "damages" and "defense costs" is limited as described in Paragraph 3 - HIPAA LIMITS OF INSURANCE of this section of the Human Service General Liability Endorsement below. b. This insurance applies only if HHS notifies you in writing during the policy period of the "investigation" or the "civil proceeding". 2. The following exclusions are added to Section I — COVERAGES, COVERAGE B — PERSONAL AND ADVERTISING INJURY LIABILITY, Paragraph 2. Exclusions: This insurance does not apply to: a. Intentional, Willful, or Deliberate Violations Any willful, intentional, or deliberate "violation(s)" by any insured. b. Criminal Acts Any "violation" which results in any criminal penalties under the HIPAA and any amendments thereto. c. Other Remedies Any remedy other than monetary damages for penalties assessed pursuant to HIPAA and any amendments thereto. BH-GL-011-02/2015 d. Compliance Reviews or Audits Any compliance reviews by HHS pursuant to HIPAA, and any amendments thereto, or any audits, whether or not requested by HHS. 3. HIPAA LIMITS OF INSURANCE With respect to the coverage provided by Section IV — HIPAA of this endorsement only, Section III — LIMITS OF INSURANCE is deleted and replaced with the following: a. The Aggregate Limit of $100,000 is the most we will pay for all "damages" and/or "defense costs" regardless of the number of: (1) Insureds; (2) "Civil proceedings" brought against you by the HHS; (3) "Suits" brought against you by the HHS; (4) "Investigations" conducted by HHS, or (5) "Violations" cited in such "civil proceedings" or "investigation." 4. With respect to the coverage provided by this Section IV — HIPAA only, Section V — DEFINITIONS is amended to include the following additional definitions: a. "Civil proceeding" means an action by HHS arising out of actual or alleged "violations" pursuant to HIPAA and any amendments thereto. b. "Damages" means civil penalties imposed by HI -IS pursuant to HIPAA and any amendments thereto. c. "Defense costs" means the costs incurred in connection with the defense of any "civil proceeding" or "investigation" or "suit" pursuant to HIPAA and any amendments thereto, including, but not limited to, legal fees and other defense costs. d. "Investigation" means an examination by HHS of an actual or alleged "violation(s)" of HIPAA and any amendments thereto. However, "investigation" does not include a compliance review. e. "Violation" means the actual or alleged failure to comply with the regulations included in the HIPAA and any amendment thereto. V. Medical Payments If COVERAGE C— MEDICAL PAYMENTS is not otherwise excluded from this Coverage Part: 1. The Medical Expense Limit is changed subject to all other terms of Section III - LIMITS OF INSURANCE to the greater of: a. $20,000; or BH-GL-a11-02/2015 b. The Medical Expense Limit shown in the Declarations of this Coverage Part. 2. COVERAGE C - MEDICAL PAYMENTS, Subsection 1.a.(3)(b) is deleted and replaced with the following. (b) The expenses are incurred and reported to us within three years of the date of the accident; and VI. Athletic Activities If COVERAGE C — MEDICAL PAYMENTS Is not otherwise excluded from this Coverage Part: COVERAGE C — MEDICAL PAYMENTS, Exclusion 2.e. Athletic Activities is deleted and replaced with the following: e. Athletic Activities To a person injured while taking part in organized athletic events, not including practices for such events. VII. Employee Defense Coverage The following is added to COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Exclusion 2.a. Expected or Intended Injury, and COVERAGE B — PERSONAL AND ADVERTISING INJURY LIABILITY, Exclusion 2.a. Knowing Violation of Rights of Another: However, we will reimburse you for the sums that you voluntarily reimburse to your "employee" for the reasonable and necessary defense costs that the "employee" incurs in order to defend himself or herself against criminal charges made against him or her, but this insurance only applies if: 1. The alleged acts out of which such criminal charges arise are alleged to have: a. Arisen out of and in the course of your employment of the "employee"; and b. Been committed by your "employee" against a "client"; and c. Taken place during that period of time that the "employee" was employed by you; and d. Taken place during the policy period and in the "coverage territory"; and 2. All the criminal charges are either dismissed without prejudice or your "employee" is found not guilty of all criminal charges by a court of law. This exception does not apply to any reimbursement of sums that you voluntarily reimburse to your "employee" for the reasonable and necessary defense costs that he or she incurs in order to defend himself or herself against criminal charges made against him or her: 1. For any criminal charge(s) arising out of the ownership, maintenance, use or entrustment to others of any aircraft, "auto" or watercraft; or 2. For any criminal charge(s) where your "employee" receives anything less than either a complete dismissal with prejudice or a not guilty verdict on all charges, including without limitation, any deferred adjudication or similar finding of guilt that is held in abeyance for any reason, pending the completion of any remedial activity such as community service or counseling; or BH-G 1.-011-02/2015 3. For any type of civil charge(s) whatsoever. For the purpose of this Coverage Extension, "client" means a person who is under your direct care and supervision, including but not limited to a "resident. The most we will pay under this defense extension is $25,000 aggregate limit. VIII. Key and Lock Replacement — Janitorial Services Client Coverage SUPPLEMENTARY PAYMENTS — COVERAGES A AND B is amended to include the following: We will pay for the cost to replace keys and locks at the "business client's" premises due to theft or other loss to keys entrusted to you by your "business client". The most we will pay under this additional coverage for all loss or damage in any one "occurrence" and in the aggregate is $10,000. We will not pay for loss or damage resulting from any dishonest or criminal act committed (including theft) by you, any of your partners, members, officers, "employees", managers, directors, trustees, authorized representatives or anyone to whom you entrust the keys of a "business client" for any purpose, whether acting alone or in collusion with other persons. The following term, when used on this coverage only, is defined as follows: "Business client" means an individual, company or organization with whom you have a written contract or work order for your services for a described premises and have billed for your services. IX. Additional Insureds Section II — WHO IS AN INSURED is amended as follows. 1. If coverage for newly acquired or formed organizations is not otherwise excluded from this Coverage Part, Paragraph 3.a. is deleted and replaced with the following. a. Coverage under this provision is afforded from when you acquire or form the organization until the end of the policy period. 2. Each of the following is also an insured: a. Medical Directors and Administrators - Your medical directors and administrators, but only while acting within the scope of and during the course of their duties as such. Such duties do not include the furnishing or failure to furnish professional services of any physician or psychiatrist in the treatment of a patient. b. Managers and Supervisors —Your managers and supervisors, but only with respect to their duties as your managers and supervisors. Managers and supervisors who are your "employees" are also insureds for "bodily injury" to another "employee" while in the course of his or her employment by you or performing duties related to the conduct of your business. c. Broadened Named Insured - Any organization and subsidiary thereof which you control and actively BH-GL-O11-O2/2O15 manage on the effective date of this Coverage Part. However, if other valid and collectible insurance is available to such organization or subsidiary, any coverage obligation will be limited as provided in Section IV. COMMERCIAL GENERAL LIABILITY CONDITIONS, 4. Other Insurance. d. Funding Source - Any person or organization with respect to their liability arising out of: (1) Their financial control of you; or (2) Premises they own, maintain or control while you tease or occupy these premises. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. a. Home Care Providers - Any person or organization under your direct supervision and control while providing for you private home respite or foster home care for the developmentally disabled. 1. Managers, Landlords, or Lessors of Premises - Any person or organization with respect to their liability arising out of the ownership, maintenance or use of that part of the premises leased or rented to you subject to the following additional exclusions: This insurance does not apply to: (1) Any "occurrence" which takes place after you cease to be a tenant in that premises. (2) Structural alterations, new construction or demolition operations performed by or on behalf of that person or organization. Lessor of Leased Equipment — Automatic Status When Required in Lease Agreement With You — Any person or organization from whom you lease equipment when you and such person or organization have agreed in a written contract or agreement that such person or organization is to be added as an additional insured on your policy. Such person or organization is an insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person or organization. A person's or organization's status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. h. Grantors of Permits — Any state, governmental agency or subdivision, or political subdivision granting you a permit in connection with premises you own, rent or control and to which this insurance applies, but only with respect to the following hazards: (1) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners or decorations and similar exposures; or (2) The construction, erection, or removal of elevators; or BH GL 011-02/2015 (3) The ownership, maintenance, or use of any elevators covered by this insurance. i. Vendors — Only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business, subject to the following additional exclusions: (1) The insurance afforded the vendor does not apply to: (a) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; (b) Any express warranty unauthorized by you; (c) Any physical or chemical change in the product made intentionally by the vendor; (d) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; (e) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; j• (f) (9) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or (h) "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (i) (i) The exceptions contained in Sub=paragraphs (d) or (f); or Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. (2) This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. As Required by Contract - Any person or organization where required by a written contract executed prior to the occurrence of a loss. Such person or organization is an additional insured for "bodily injury," "property damage" or "personal and advertising injury" but only for liability arising out of the negligence of the Named Insured. The limits of insurance applicable to these additional insureds are the lesser of the policy limits or those limits specified in a contract or agreement. These limits are BH-GL-011-02/2015 included within and not in addition to the limits of insurance shown in the Declarations k. Owners, Lessees or Contractors - Any person or organization, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: (1) Your acts or omissions; or (2) The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured; or (3) When required by a contract. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. 1. State or Municipality — any state or municipality as required, subject to the following provisions: (1) This insurance applies only with respect to operations performed by you or on your behalf for which the state or municipality has issued a permit, and is required by contract. (2) This insurance does not apply to: (a) "Bodily injury," "property damage" or "personal and advertising injury" arising out of operations performed for the state or municipality; or (b) "Bodily injury" or "property damage" included within the "products -completed operations hazard". Duties in the Event of Occurrence, Claim or Suit Section IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 2. is amended as follows. 1. Subparagraph a. is amended to include the following: This condition applies only when the "occurrence" or offense is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; or (3) An executive officer or insurance manager, if you are a corporation. BH-GL-011-02/2015 2. Subparagraph b. is amended to include: This condition will not be considered breached unless the breach occurs after such claim or "suit" is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; or (3) An executive officer or insurance manager, if you are a corporation. XL Transfer of Rights of Recovery Against Others To Us Section IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 8. Transfer of Rights of Recovery Against Others To Us is deleted and replaced with the following: If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. Therefore, the insured can waive the €nsurer's Rights of Recovery prior to an "occurrence", provided the waiver is made in a written contract. XII. Bodily injury - Mental Anguish Section V— DEFINITIONS, Paragraph 3. is deleted and replaced with the following: 3. "Bodily injury" means bodily injury, sickness or disease sustained by a person, including death, mental anguish, mental injury, shock or humiliation resulting from any of these at any time. XIII. Personal and Advertising Injury — Abuse of Process, Discrimination If COVERAGE B — PERSONAL AND ADVERTISING INJURY LIABILITY COVERAGE is not otherwise excluded from this Coverage Part, Section V — DEFINITIONS, Paragraph 14. "Personal and advertising injury" is amended as follows: 1. Subparagraph b. is deleted and replaced with the following: a. Malicious prosecution or abuse of process; 2. Subparagraph e. is deleted and replaced with the following: e. Oral or written publication, in any manner, of material that violates a person's right to privacy. As used in this subparagraph, publication includes the unauthorized release of your client's or your customer's individually identifiable medical information. 3. Section V — DEFINITIONS, Paragraph 14. is amended to include the following: h. Discrimination or humiliation against any third -party on account of religion, age, sex, handicap, appearance, health, mental disorder, marital status, race, color, creed or national origin, except when such discrimination or humiliation is: BH-G1x011 02/2015 (1) Committed by, at the direction of, or with the knowledge of, you or any of your executives, officers or directors; or (2) Related, directly or indirectly, to your employment of any person or persons, or (3) Directly or indirectly related to the sale, rental, lease or sub -lease or prospective sales, rental, lease or sub -lease of any room, dwelling or premises by or at the direction of any insured; or (4) Insurance for such discrimination is prohibited by or held in violation of law, public policy, legislation, court decision or administrative hearing. The above does not apply to fines or penalties imposed because of discrimination. XIV. Amendment — Liquor Liability Exclusion — Exception for Fundraising events Section I — COVERAGES, COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Exclusion 2. c. Liquor Liability is amended by adding the following subparagraph: This exclusion does not apply to "bodily injury" or "property damage" arising out of the selling, serving or furnishing of alcoholic beverages at any fundraising events. BH-GL-O11.O2/2O15 Contract Form New Contract Request Entity Information Entity Name* Entity ID * PARKER PERSONAL CARE HOMES INC Q°00042447 New Entity? Contract Name* Contract ID PARKER PERSONAL CARE HOMES INC. DBA DAVID KALIS 6073 (NEW CHILD PROTECTION AGREEMENT) Contract Status CTB REVIEW Contract Lead* APEGG Contract Lead Email apegg�weldgov.corn;cobbx xlkTweldgov.com Contract Description* CONSENT BID B2200040 TERM: JUNE'', 2022 THROUGH MAY 31. 2023 Parent Contract ID 20220410 Requires Board Approval YES Department Project # Contract Description 2 PROVIDER WAS LISTED ON APPROVED VENDOR LIST PRESNETED TO THE BOCC ON 04 06 22 AND AS A COMMUNICATION ITEM/PA SENT TO CTB ON 05,' 10r 2022. Contract Type* AGREEMENT Amount .t $0.00 Renewable* YES Automatic Renewal Grant IGA Department HUMAN SERVICES Department Email CM- HumanServicesC eldgov.co m Department Head Email CM-HumanServices- DeptHeadgweldgov.com County Attorney GENERAL COUNTY ATTORNEY EMAIL County Attorney Email CM- COUNTYATTORNEY@WELDG RN EY@'WELDG OV.COM Requested BOCC Agenda Date* 07.06'2022 Due Date 07 02 2022 Will a work session with BOCC be required?* NO Does Contract require Purchasing Dept. to be included? If this is a renewal enter previous Contract ID If this is part of a MSA enter MSA Contract ID Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in On Base Contract Dates Effective Date Termination Notice Period Contact Information Contact Info Contact Name Purchasing Purchasing Approver CONSENT Approval Process Department Head JAMIE ULRICH DH Approved Date 06,'27/2022 Final Approval BOCC Approved BOCC Signed Date BOCC Agenda Date 07 06 2022 Originator APEGG Review Date* 03 31 :2023 Committed Delivery Date Contact Type Contact Email Finance Approver CONSENT Renewal Date* 05/31/2023 Expiration Date Contact Phone 1 Purchasing Approved Date 0627;2022 Finance Approved Date 06/27,2022 Tyler Ref # AG 070622 Legal Counsel CONSENT Contact Phone 2 Legal Counsel Approved Date 06/27/2022 Hello