HomeMy WebLinkAbout20241386.tiffRESOLUTION
RE: APPROVE STANDARD FORM, RATES, AND PROVIDER LIST FOR INDIVIDUAL
PROVIDER CONTRACTS FOR PURCHASE OF FOSTER CARE SERVICES IN A
FOSTER CARE HOME BETWEEN DEPARTMENT OF HUMAN SERVICES AND
VARIOUS PROVIDERS, AND AUTHORIZE CHAIR TO SIGN CONTRACTS
CONSISTENT WITH SAID FORM
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board has been presented with a Standard Form, Rates, and Provider
List for Individual Provider Contracts for Purchase of Foster Care Services in a Foster Care Home
between the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County, on behalf of the Department of Human Services, and the various
providers as shown on the attached provider list, with further terms and conditions being as stated
in said standard form, and
WHEREAS, after review, the Board deems it advisable to approve said standard form,
rates, and provider list, copies of which are attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of
Weld County, Colorado, that the Standard Form, Rates, and Provider List for Individual Provider
Contracts for Purchase of Foster Care Services in a Foster Care Home between the County of
Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on
behalf of the Department of Human Services, and the various providers as shown on the attached
provider list, be, and hereby are, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign contracts consistent with said form.
cc: HSA, c1i3(FG), CR(KM%ACT(crfcu)
06 /25 ay
2024-1386
HR0096
STANDARD FORM, RATES, AND PROVIDER LIST FOR INDIVIDUAL PROVIDER
CONTRACTS FOR PURCHASE OF FOSTER CARE SERVICES IN A FOSTER CARE HOME
BETWEEN DEPARTMENT OF HUMAN SERVICES AND VARIOUS PROVIDERS
PAGE 2
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 3rd day of June, A.D., 2024.
ATTEST: ..�
Weld County Clerk to the Board
er.C -idi . tcittiU1-ci&
Deputy Clerk to the Board
APP;eVED
my A' : rney ' l
Date of signature:/0IZ I
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY
Kevin ! oss, Chair
Perry L. Bu j Pro-Tem
Mike Fr-eman
ames
Saine
2024-1386
HR0096
BOARD OF COUNTY COMMISSIONERS
PASS -AROUND REVIEW
PASS -AROUND TITLE: Weld County Department of Human Services' Child Welfare SFY 2024-25 Out -of -Home
Foster and Kinship Care Provider Contract Template, Provider List, and Associated
Rates
DEPARTMENT: Human Services DATE: May 21, 2024
PERSON REQUESTING: Jamie Ulrich, Director, Human Services
Brief description of the problem/issue: The Department is requesting approval of the Child Welfare SFY 2024-
25 Out -of -Home (OOH) Foster and Kinship Care Provider Contract Template, Provider List, and associated
rates. The State requires Counties to enter into agreements with providers for the purchase of OOH services
and has established the CWS-7A as the State prescribed agreement for County certified foster and kinship care
services. The State CWS-7A agreement and Exhibit A had no changes from the 2023-24 template and has
been reviewed by Legal (Byron Howell) and approved for use for the 2024-25 contract year.
The term of these contracts will be based on the certification/recertification date of each provider and is valid
for one year. The following information is attached for your review:
1. CWS-7A Individual Provider Contract template with Exhibit A.
2. List of out -of -home providers for SFY 2024-25.
The service rate will be the State approved base anchor rate as outlined by the Colorado Office of Children,
Youth & Families Division of Child Welfare, unless the Provider and County agree to utilize the Medically
Fragile Tool and associated rates due to intensive medical/physical needs, or limitations that interfere with
daily life functioning. The Medically Fragile Tool will be completed every six months as long as the child
remains in care with the provider.
What options exist for the Board?
Approval of the Child Welfare SFY 2024-25 Out -of -Home (OOH) Foster and Kinship Care Provider
Contract Template, Provider List, and associated rates.
Deny approval of the Child Welfare SFY 2024-25 Out -of -Home (OOH) Foster and Kinship Care Provider
Contract Template, Provider List, and associated rates.
Consequences: The Department will not have current contracts with Foster Care and Kinship Providers.
Impacts: The Department will not be able to place children in County certified Foster and Kinship homes.
Costs (Current Fiscal Year/ Ongoing or Subsequent Fiscal Years):
Total cost = State approved rates
Funded through CW Block Grant
Pass -Around Memorandum; May 21, 2024 - NOT IN CMS 2024-1386
U/3 i-kiz00.9L0
•
Recommendation:
• Approval of the Child Welfare SFY 2024-25 Out -of -Home (OOH) Foster and Kinship Care Provider
Contract Template, Provider List, and associated rates and authorize the Chair to sign the subsequent
agreements.
Support Recommendation Schedule
Place on BOCC Agenda Work Session Other/Comments:
Perry L. Buck, Pro-Tem
Mike Freeman mV -
Scott K. James frb
Kevin D. Ross, Chair
Lori Saine
Pass -Around Memorandum; May 21, 2024 — NOT IN CMS
a
CONS
COLORADO
Office of Children,
Youth S Families
Division of Child Welfare
INDIVIDUAL PROVIDER CONTRACT
FOR PURCHASE OF FOSTER CARE SERVICES IN A FOSTER CARE HOME
1. THIS CONTRACT AND AGREEMENT, made this date by and between Weld
County Department of Human or Social Services, 315 North 11th Avenue, Greeley, Colorado hereinafter
called "County Department" and hereinafter called "Provider", Provider Name at Address. Otv. State. Zip
Code.
2. This Contract and Agreement shall be effective from Begin Date and continue in force until End Date or
until the facility certificate is revoked or surrendered. This contract and agreement may be renewed at
any time during the term of the valid facility certificate. This contract and agreement is in lieu of and
supersedes all prior purchase contracts between the parties hereto and relating to the services herein
described.
3. The Provider holds a valid certificate as a: ❑ Foster Care Home or ❑ Therapeutic Foster Care Home or
❑ Kinship Foster Care Home -(check applicable blank). Such certification standards shall be maintained
during the term hereof. The provider has read and is fully familiar with the "Rules Regulating Foster Care
Homes" issued by the Colorado Department of Human Services.
4. The County Department may but shall not be obligated to purchase foster care home services. The County
Department or any duly authorized agent may request such services to be provided to any child or youth
at any time within the limits of the certificate and without prior notice. At such time or as soon as possible
after the acceptance of a child or youth for services, the County Department and the Provider shall verify
foster care placement of each child or youth in writing on the required form, which shall become an
addendum to this contract, subject to all the terms and conditions hereof.
5. The terms of this Agreement are contained in the terms recited in this document and in Exhibit A and
Addendum 1, which form integral parts of this Agreement. Exhibit A and Addendum 1 are specifically
incorporated herein by this reference.
The Provider agrees:
1. To the rates for child placement as set for by the State of Colorado apply to the services contemplated by
this Agreement and that such rates may be negotiated with the Provider individually in cases with
exceptional circumstances as determined by the County Department;
2. To safely provide the 24 -hour physical care and supervision of each child or youth until removed or until
the agreement is renewed;
3. To accept a child or youth, only with the approval of the certifying agency;
4. To cooperate fully with the County Department or its representatives, and participate in the development
of the Family Service Plans for a child or youth in placement, including visits with their parents, siblings,
relatives, or to transition to another foster care facility;
5. To maintain approved standards of care as set by the Colorado Department of Human Services;
6. To maintain the confidentiality of information shared about the child or youth and his/her family;
7. Not to accept money from parents or guardians;
8. Not to make any independent agreement with parents or guardians;
9. Not to release the child or youth to anyone without prior authorization from the County Department ;
CWS-7A Revised 08/2022 1
10. To allow representatives of the County Department to visit the foster care home and to meet with the
child or youth at any reasonable time, including scheduled and unscheduled visits; and,
11. To give the County Department a 30 -day notice, except in an emergency, to remove a child or youth for
placement elsewhere, and to work with the County Department as requested to prepare the child or youth
for another placement.
12. To provide transportation to the child or youth. Transportation to be provided will be agreed upon at
placement and may be changed upon mutual agreement of the provider and the County Department, as
recorded in the Family Service Plan. Transportation must be provided or arranged:
a. For professional services and/or for school attendance when necessary; and,
b. For youth to participate in age or developmentally appropriate extracurricular, enrichment, cultural,
and social activities.
13. To report promptly to the County Department:
a. Any unplanned absence of the child or youth from provider's care;
b. Any major illness of the child or youth;
c. Any serious injury to the child or youth;
d. Any significant change in the sleeping arrangement for the child or youth;
e. Any contemplated change of address or change of household members;
f. Any conflict the child or youth may have with law enforcement, school/school district staff, or other
persons in authority;
g. Any emergency;
h. Any pertinent discussion with parents or guardians about the child or youth or supervising agency; and,
i. Any information received regarding a change of address of the parents or guardians.
14. To comply with the Civil Rights Act of 1964, Section 504, Rehabilitation Act of 1973, and the ADA of 1990,
concerning discrimination on the basis of race, color, sex, age, sexual orientation, expression, or gender
identity, religion, political beliefs, national origin, or handicapping condition.
Pursuant to §19-1-130, C.R.S., a service provider means the state department of human services, a
county department of human or social services, or a child placement agency. This includes a
contractor or subcontractor that provides placement -related services on a service provider's behalf.
A service provider shall provide placement -related services in a manner that is culturally responsive to the
complex social identity of the individual receiving such services. complex social identities include but are
not limited to race, ethnicity, nationality, age, religion, sex, sexual orientation, gender identity, gender
expression, socioeconomic status, physical or cognitive ability, language, beliefs, values, behavior
patterns, and customs.
Subjecting a child or youth in foster care or an individual, family, or other service provider to
discrimination or harassment on the basis of actual or perceived disability, race, creed, religion, color, sex,
sexual orientation, gender identity, gender expression, marital status, national origin, ancestry, or any
communicable disease, including HIV, when providing any placement -related service is prohibited.
15. To complete pre -service training prior to the placement of a child or youth.
16. To annually:
a. Update the Training Development Plan with the County Department;
b. Complete ongoing, quality, and relevant training that will build competencies to meet the needs of the
children and youth served in the foster care home as required by the Colorado Department of Human
Services regulations including ongoing training required to use and apply the reasonable and prudent
parent standard for each child or youth served in the foster care home.
17. To attend semi-annual Administrative Reviews for a child or youth in placement.
CWS-7A Revised 08/2022 2
18. To be knowledgeable of, and comply with the "Rules Regulating Foster Care Homes" and the "General
Rules for Child Care Facilities;
19. Not to enter into any subordinate subcontract hereunder;
20. To keep required and necessary records for audit/review purposes by state and federal personnel. These
records shall document the type of care and dates that care is provided for each child or youth. In
addition, medical, educational, and progress summary records shall be maintained for each child or youth
as required pursuant to the Colorado Department of Human Services' Rules Regulating Foster Care Homes.
21. To complete or schedule a medical examination for the child or youth within 14 days of initial placement
and complete a dental examination within eight weeks of initial placement.
The County Department agrees:
1. To share all available information about the child or youth, including relevant social, medical and
educational history, behavior problems, court involvement, parental, sibling and relative visitation plans,
and other specific characteristics of the child or youth, with the provider before placement and to share
additional information when obtained while the child or youth is in placement.
2. To inform the provider of expectations regarding the care of the child or youth, such as meeting medical
needs, visitation, special psychological needs, trauma and other grief/loss issues, and the child's or youth's
identification with his/her family;
3. To give the provider the written admission record of the child or youth to the foster care home at the time
of placement;
4. To give the provider a written procedure or authorization for obtaining medical care for the child or youth;
5. To involve the provider in family service planning for the child or youth as a member of treatment team;
6. To give the provider a copy of the Family Service Plan, as it pertains to their expectations for meeting the
needs of the child or youth in the foster care home, at the time of placement or when it is completed
following placement;
7. To give at least a 30 -day notice of plans to remove a child or youth from the foster care home. The 30 -day
notice may be waived by mutual consent to allow and permit immediate removal of a child or youth for
placement elsewhere, or without such waiver in the event of an emergency. An emergency is defined as
any situation in which a provider's inability to provide services threatens the health, safety or welfare of a
child or youth.
8. To pay the provider at the rates established by the Colorado Department of Human Services or as
authorized and negotiated between the provider and the County Department:
a. Payment shall be made by electronic banking transfers (EBT) drawn by the duly authorized county
officer; and,
b. Provider shall notify the County Department of any payment or billing dispute within 60 days of the
month when service was provided. Failure to do so will result in forfeiture of the payment. The
Provider understands that, pursuant to the Colorado Department of Human Services' Rules for the
General Reimbursement for Child Welfare Services, when reimbursement is warranted the State
reimburses for retroactive payments not greater than the current and (2) preceding months.
9. To provide or arrange through statewide contracted training, a minimum of twelve hours of core pre -
service training for foster care homes and 15 hours of pre -service training directed at the needs of the
child or youth to be served in the foster care home.
10. To annually complete the following:
a. Update the Training Development Plan with the provider;
b. Provide or make available quality and relevant training for each foster parent that will build
competencies to meet the needs of the children and youth served in the foster care home;
c. Provide training that prepares each foster parent to use and apply the reasonable and prudent parent
standard; and,
CWS-7A Revised 08/2022 3
d. Pursuant to the Colorado Department of Human Services' Rules Regulating Family Foster Care Homes,
document that the provider is trained in and can use and apply the reasonable and prudent parent
standard for each child or youth placed in the foster care home.
11. The County Department is responsible for providing information on county specific procedures.
12. To invite the provider to Administrative Reviews for each child or youth in placement.
13. To incorporate provider information in planning for the child or youth placed in the foster care home.
14. To assure that the service described herein has been accomplished and a record made thereof on a case
by case basis.
15. To provide notice of court hearings for each child or youth placed in the foster care home.
WHEREFORE, the parties have herein set their hands and affixed their seals the day and date first written
above.
COUNTY:
Jamie Ulrich
Weld County Department
of Human Services
Signature Date
ATTEST: BOARD OF COUNTY COMMISSIONERS
Clerk to the Board WELD COUNTY, COLORADO
BY:
Deputy Clerk to the Board Kevin D. Ross, Chair Date
PROVIDER:
Provider name
Provider
Provider name
Provider
Signature Date
Signature Date
CWS-7A Revised 08/2022 4
EXHIBIT A to the CWS-7A,
Additional Provisions for the Agreement to Purchase Foster Care
Services and Foster Care FacilityAgreement CWS-7A
The following additional provisions in this Exhibit A and Addendum 1 apply to the agreement entitled,
"Individual Provider Contract for Purpose of Foster Care Services and Foster Care Facility Agreement," by and
between the Weld County Department of Human Services, hereinafter referred to as, "County," and <First
Name> <Last Name>, Provider ID# <Provider Number>, hereinafter referred to as, "Provider."
GENERAL PROVISIONS
1. Each party shall have the right to terminate this Agreement by giving the other party written notice
received at least thirty (30) days prior to the intended date of termination. If notice is so given, this
Agreement shall terminate upon the expiration of thirty (30) days, or until the eligible child(ren) may
be placed elsewhere, whichever occurs first, and the liability of the parties hereunder for further
performance of the terms of this Agreement shall thereupon cease; however, the parties shall not be
released from the duty to perform their obligations up to the date of termination. This provision does
not affect removal of a child in an emergencysituation.
2. Provider agrees that Provider is an independent contractor and that neither Provider nor Provider's
agents or employees are, or shall be deemed to be, agents or employees of the County for any
purpose. Provider shall have no authorization, express or implied, to bind the County to any
agreement, liability, or understanding. The parties agree that Provider will not become an employee of
County. Provider shall be solely and entirely responsible for its acts or of any agent, employee, servants
and sub -Providers during the performance of this Agreement. Provider is not entitled to
unemployment insurance or workers' compensation benefits through Weld County and Weld County
shall not pay for or otherwise provide such coverage for Provider. Unemployment insurance benefits
will not be available to Provider for services provided under this Agreement. Provider shall pay when
due any/all applicable employment taxes and income taxes and local head taxes (if applicable)
incurred as a result of the services provided under this Agreement.
3. Payment pursuant to this Agreement, if in State of Colorado, county, or federal funds, whether in
whole or in part, is subject to and contingent upon the continuing availability of State of Colorado,
county, and federal funds for the purposethereof.
4. This Exhibit A is intended to be applied in conjunction with the attached Agreement as the complete
integration of all understandings between the parties. No prior or contemporaneous addition, deletion
or other amendment hereto shall have any force or affect whatsoever, unless embodied herein in
writing. No subsequent notation, renewal, addition, deletion, or other amendment hereto shall have
any force or effect unless embodied as a part of this written Agreement. This section shall not be
construed as prohibiting the periodic amending of this Agreement in writing, if agreed to by both
parties. The Agreement, this Exhibit A and the rate Addendums are intended to be in lieu of and
supersede all prior agreements between the parties hereto and relating to the care and services herein
described.
5. The State of Colorado Department of Human Services and the County shall be and hereby is permitted
to monitor the service program, fiscal and other records sufficiently to assure the purchase of services
in this Agreement are carried out for the benefit of the aforementioned child or youth. Monitoring
may occur through review of program reports, on -site visits where applicable and other Agreements as
Exhibit A to the CWS-7A 5 Revised 11/2022
deemed necessary. Provider understands that the State Department and the County may provide
consultation to Provider to assure satisfactory performance in the provision of purchased services
under this Agreement.
6. County shall have access to Provider's service program, financial and other records, which will
sufficiently and properly reflect all direct and indirect costs of any nature incurred in the performance
of this Agreement for purposes of audit. Such records shall be complete and available for audit 90 days
after final payment hereunder and shall be retained and available for audit purposes for at least five
years after final paymenthereunder.
7. Time is of the essence in each and all of the provisions of this Agreement.
8. Neither party to this Agreement shall be liable to the other for delays in delivery or failureto 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.
9. Any notice required to be given under this Agreement shall be in writing and shall be mailed or
delivered to the other party at that party's address as stated in this Agreement.
10. This Agreement is nonexclusive and County may engage or use other Providers or persons to perform
services of the same or similar nature.
11. Provider assures and certifies that it and its principals:
a. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or
voluntarily excluded from covered transactions by a federal department or agency.
b. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil
judgment rendered against them for commission of fraud or a criminaloffense in connection with
obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or
contract under a public transaction; violation of federal or state antitrust statutes or commission
of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false
statements, or receiving stolen property;
c. Are not presently indicted for or otherwise criminally or civilly charged by agovernment entity
(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B)
above.
d. Have not within a three-year period preceding this Agreement, had one or more public
transactions (federal, state, and local) terminated for cause ordefault.
12. In addition to terminating this Agreement in accordance with the provisions herein, County may
exercise the following remedial actions if the County finds and determines that the Provider has
substantially failed to satisfy the duties found in this Agreement and Exhibit A Substantial failure to
satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the
Provider. These remedial actions include, but are not limited to, any one or more of the following:
Exhibit A to the CWS-7A
6 Revised 11/2022
a. Withhold payment to Provider until the necessary services or correctionsin performance are
satisfactorily completed.
b. Deny payment or recover reimbursement for those services or deliverables which have not been
performed and which due to circumstances caused by Provider cannot be performed or if
performed would be of no value to County. Denial of the amount of payment shall be reasonably
related to the amount of work or deliverables lost to County.
c. Recover from Provider any incorrect payment to Provider due to omission, error, fraud, and/or
defalcation by deducting from subsequent payments under this Agreement, or other agreements
between County and Provider, or as a debt to County, or otherwise as provided bylaw.
13. It is expressly understood and agreed that the enforcement of the terms and conditions of this
Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the
undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any
claim or right of action whatsoever by any other person not included in this Agreement. It is the express
intention of the undersigned parties that any entity other than the undersigned parties or their
assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only.
14. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or
their officers or employees may possess, nor shall any portion of this Agreement be deemedto have
created a duty of care that did not previously exist with respect to any person not a party to this
Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to
circumvent or replace such immunities.
15. Provider shall promptly notify County in the event in which it is a party defendant or respondent in a
case, which involves services provided under the agreement. The Provider, 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 County Director.
The term "litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy,
reorganizations and/orforeclosure.
16. This Agreement and the provision of services hereunder shall be subject to the laws ofColorado and be
in accordance with the policies, procedures, and practices of County. Provider shall strictly comply with
all applicable federal and State laws, rules and regulations in effect or hereafter established.
17. Financial obligations of the County payable after the current fiscal year are contingent upon funds for
that purpose being appropriated, budgeted and otherwise made available. Execution of this
Agreement by County does not create an obligation on the part of County to expend funds not
otherwise appropriated in each succeedingyear.
18. County agrees to purchase, and Provider agrees to provide the care and services, which are listed in
this Agreement. The State approved rate for Child Maintenance/Respite will be paid for any child
placed with the Provider unless the Medically Fragile Tool has been completed due to intensive
medical/physical needs, or limitations that interfere with daily life functioning. The Medically Fragile
Tool will be completed every six months as long as the child remains in care with the Provider. The
rate will be adjusted if the Medically Fragile Tool indicates a change in the level of care. The Medically
Exhibit A to the CWS-7A
7 Revised 11/2022
Fragile Tool will determine the reimbursement rate as specified in Addendum 1.
19. All bed hold authorizations and payments are subject to a 7 -day maximum for a child's temporary
absence from a facility; however, if the absence is a result of hospitalization the maximum bed hold
authorization may be up to 14 days. Bed hold requests must have prior written authorization from the
Department Administrator or Designee before payment will be release to Provider.
20. Any additional costs for specialized services, which may include but are not limited to; Co -pays,
deductibles, or services not covered by Medicaid, will need to be authorized, In writing by the
Department Administrator, prior to the service being performed. Any payment for specialized services
not authorized in writing may be denied.
21. All reimbursement requests shall:
a. Be submitted in a format approved by the County. If submitted in an unapproved format or
inadequate documentation is provided, the County reserves the right to deny payment.
b. Be submitted by the 4th of each month following the month of service. If the reimbursement
request is not submitted within twenty-five (25) calendar days ofthe month following service, it
may result in forfeiture ofpayment.
c. Placement service reimbursement shall be paid from the date of placement up to, but not
including the day of discharge.
d. Transportation reimbursement shall be for visitation purposes or transportation to school if out of
county and with prior approval only If medical transportation is needed, Provider will arrange
reimbursement through Medicaid. Any other special requests for transportation reimbursement
shall require prior approval by the Resource Manager or the DepartmentAdministrator.
e. Clothing allowance reimbursement shall be approved and reimbursed as indicated on the clothing
allowance form provided by the Foster Care Coordinator.
22. It is agreed that if, after investigation, it is shown that reasonable care was given to guard and protect
personal items brought to Provider by the children, Provider shall be released from responsibility for
loss or damage to such personal items.
PROVIDER SHALL:
1. Conform with and abide by all rules and regulations of the Colorado Department of Human Services,
the Colorado Department of Health Care Policy and Financing (if appropriate), the State of Colorado
and any applicable federal laws and regulations, as such, which may be amended from time to time,
and shall be binding on Provider and control any disputes in this Agreement.
2. Not charge any fees to children or families of children referred by County for any services provided
under this Agreement.
3. Not assign the obligations under this Agreement nor enter into any sub -Agreement without the
express written approval of the Director of the County Department or his/her appointed designee.
Exhibit A to the CWS-7A
8 Revised 11/2022
4. Maintain at all times during the term of this Agreement a liability insurance policy of at least $25,000
for property damage liability, $150,000 for injury and/or damage to any one person, and $500,000 for
total injuries arising from any one accident. Provider shall provide a certificate of insurance provided
by its insurer upon request by County.
5. Indemnify the County against any and loss against all claims and actions based upon or arising out of
damage or injury, including death, to persons or property caused or sustained in connection with the
performance of this Agreement or by conditions created thereby, or based upon any violations of any
statute, ordinance, or regulation and the defense of any such claims or actions.
6. Attend or participate in Ice Breaker, Family Engagement or Team Decision making meetings,if
requested by the Department. County staff shall notify the Provider of the dates and times attendance
is requested.
7. Request a staffing if considering giving notice to remove a child, except in emergency situations. These
requests shall be made through the child's caseworker and/or the Provider's Foster Care Coordinator.
8. Actively participate in achieving the child's permanency goal, cooperate with any contractors hired by
the Weld County Department of Human Services to preserve placement in the least restrictive
placement appropriate, comply with the treatment plan of the child, and attendcourt hearings as
requested.
9. Have physical examinations completed within 14 days and dental examinations completed within 8
weeks of the child being placed with Provider. All documentation of these examinations will be placed
in the foster child's placement binder.
10. Attend all necessary school meetings and support any plan that is developed regarding the child in
order to promote educational success.
11. Immediately report to the County Department and/or local law enforcement any known or suspected
child abuse or neglect as set forth in Section 19-3-304,C.R.S.
12. Maintain, access and review information monthly on Binti.
13. Maintain/update information in the foster child's binder, either hard copy or in Binti. The binder will be
reviewed on a monthly basis and signed off by child's caseworker and/or the Provider's Foster Care
Coordinator.
14. Maintain/update medication logs on a daily basis, if child is taking medications.
15. Comply with all County and State certification requirements as set forth in the State Department rules,
Staff Manual Volume VII and the Weld County Department of Human Services Policy and Procedure
manual.
Exhibit A to the CWS-7A
9 Revised 11/2022
ADDENDUM 1
Medically Fragile Tool Rates
Child Maintenance
Daily Rate
Medically Fragile
Level 1
$57.73
Level 2
$115.82
Level 3
$174.17
Level 4
Negotiate up to $210
Addendum 1 to Exhibit A CWS-7A 10 Revised 07/2023
Weld County Foster and Kinship Provider
SFY 2025-2025
Provider Last Name
1 Aikens
Provider First
Name
Carly
CoProvider Last
Name
Aikens
Co Provider
First Name
George
Street Address
22250 County Road 62
City
Greeley
State
Colorado
Zip
80631
ID Number
1718610
Family
Type
Foster
2 Austin
Elizabeth
775 Saddleback Drive
Milliken
Colorado
80543
1772053
Foster
3 Banks
Daniel
Banks
Kayleigh
1507 New Season Drive
Windsor
Colorado
80550
1763395
Foster
4 Barraza
Josefina
4126 Mesquite Lane
Evans
Colorado
80620
1760240
Kinship
5 Bergman
Madison
Bergman
Bennett
6157 Taylor Street
Frederick
Colorado
80530
1779604
Kinship
6 Berrelez
Yvette
Berrelez
Matthew
247 63rd Avenue
Greeley
Colorado
80634
1728772
Foster
7 Bieber
Dana
Conner
Wade
13611 Wrangler Way
Mead
Colorado
80542
1758807
Kinship
8 Bloomfield
Diane
1117 11th Avenue, Unit 7
Greeley
Colorado
80634
1771550
Kinship
9 Braunagel
Karen
1775 Laurus Lane
Johnstown
Colorado
80534
1714402
Foster
10 Brinkerhoff
Samantha
Brinkerhoff
Zaquri
1968 Sweet Pea Drive
Windsor
Colorado
80550
1739843
Foster
11 Brown
Dorian
22690 East Ida Circle
Aurora
Colorado
80015
1770274
Foster
12 Bryner
Windy
Zabel
Mark
323 North 60th Avenue
Greeley
Colorado
80634
1542672
Foster
13 Bushaw
Kristen
Kiefer
Jodi Lynn
1100 Bellaire Street
Broomfield
Colorado
80020
1775654
Kinship
Foster
14 Call
Paula
Call
Shaun
533 East 28th Street Road
Greeley
Colorado
80631
1737209
15 Carloni
Simone
Carloni
Tony
937 Mount Andrew Drive
Severance
Colorado
80550
1769514
Foster
16 Castaneda
Natalie
Castaneda
Freddy
2837 Avocado Avenue
Greeley
Colorado
80631
1678403
Foster
17 Clark
Arnold
Clark
Deborah
3156 Hawthorne Lane
Dacono
Colorado
80514
1697927
Foster
18 Cook
Jamie
Cook
Jeffrey
48 Coyote Trail
Greeley
Colorado
80634
1756217
Foster
19 Cox
Rebeca
Cox
Matthew
452 3rd Street
Severance
Colorado
80550
1763013
Foster
20 Cram
LaDonna
Velasco
Ashley
300 East Stuart Street
Fort Collins
Colorado
80525
1776340
Kinship
Foster
21 Cross
Hannah
Cross
Taylor
22975 County Road 40
LaSalle
Colorado
80645
1739954
22 Cunliffe
Anne
Cunliffe
Levi
2277 Pineywoods Street
Mead
Colorado
80542
1740368
Foster
23 Del Carmen Gutierrez -Benitez
Daysi
1765 30th Street, Unit 1
Greeley
Colorado
80631
1767465
Kinship
24 Dennis
Esther
Grigsby
Michael
5502 West 3rd Street
Greeley
Colorado
80634
1687385
Foster
25 Ditter
Kerri Ann
Ditter
Stacy
33818 County Road 53
Gill
Colorado
80624
1772641
Foster
26 Dunn
James
Dunn
Gail
111 McIntyre Street
Kersey
Colorado
80644
1714413
Foster
27 Ervin
Angela
Ervin
Jason
4609 Prairie River Court
Firestone
Colorado
80504
1752752
Foster
28 Fretwell
Crystal
Fretwell
Steven
4121 West 4th Street Road
Greeley
Colorado
80634
1749771
Foster
29 Giles
Daniel
Giles
Elizabeth
331 Heidie Lane
Milliken
Colorado
80543
1777458
Foster
30 Glasmann
Tierra
Montoya
Joseph
8441 DeSoto Drive
Thornton
Colorado
80229
1769108
Kinship
31 Graham
Latrice
Graham
Roland
5129 South Tibet Street
Aurora
Colorado
80015
1775285
Foster
32 Guildner
Courtney
Guildner
Jacob
9353 Pike Way
Arvada
Colorado
80007
1764734
Kinship
Foster
33 Hagen
Jason
3165 Elizabeth Avenue
Platteville
Colorado
80651
1769586
34 Hansen
Natalie
Betting
Derrick
2813 Steeple Rock Drive
Frederick
Colorado
80516
1753111
Foster
35 Haskett
Nicole
1430 12th Street, Apartment A
Greeley
Colorado
80631
1770380
Foster
36 Hays
Izzabella
Hays
Andrew
12124 County Road 32.5
Platteville
Colorado
80651
1757924
Foster
37 Helton
Bradley
Molyneau
Devon
8150 W. 12th Street, Unit H3
Greeley
Colorado
80634
1780430
Kinship
Kinship
38 Hernandez
Shelby
Hernandez II
Matthew
8823 15th Street
Greeley
Colorado
80634
1750326
39 Hildebrand
Sandy
Hildebrand
John
1704 Morning Drive
Loveland
Colorado
80538
1779798
Kinship
40 Horta
Margarito
Dos Santos
Marlene
8687 Yuba Road
Phelan
California
92371
1773575
Kinship
Foster
41 Ibarra
Eric
Gomez
Maira
200 North 35th Avenue #219
Greeley
Colorado
80634
1707673
42 Irizarry
Marizol
1739 Rowan Lane
Evans
Colorado
80620
1768019
Kinship
43 Jasper
Rachel
Jasper
Brandon
4907 West 23rd Street Road
Greeley
Colorado
80634
1712735
Foster
44 Jauken
Michael
Jauken
Kristi
1730 Ruddlesway Drive #R-4
Windsor
Colorado
80550
1763790
Foster
45 Johnson
Alana
Johnson
Joshua
9981 Bountiful Street
Firestone
Colorado
80504
1625365
Foster
46 Johnson
Rhonda
10400 Universe Blvd
Albuquerque
New Mexico
87114
1782159
Foster
47 Jolly
Marcia
5222 Warrior Street
Frederick
Colorado
80504
1771925
Foster
48 Kelly
Sheila
Kelly
Richard
37125 County Road 63
Galeton
Colorado
80622
1757028
Foster
49 King
Bradley
King
Hilary
2051 Zlaten Drive #E209
Longmont
Colorado
80504
1779607
Foster
50 Klein -Troyer
Cynthia
Troyer
Rodney
2625 28th Avenue
Greeley
Colorado
80634
98370
Foster
51 Leary
Amber
Leary
Christopher
3426 Mountainwood Street
Johnstown
Colorado
80534
1770955
Foster
52 LeRoy
Daniel
LeRoy
Susie
2692 Wrenwood Avenue
Clovis
California
93611
1774746
Kinship
53 Major
Ruby
Major
Jim
6916 Silverleaf Avenue
Firestone
Colorado
80504
1766605
Foster
54 Markworth
Rubyann
Markworth
Johnathon
3903 West 30th Street Road
Greeley
Colorado
80634
1764307
Foster
55 Maronek
Patricia
2929 56th Avenue
Greeley
Colorado
80634
1520627
Foster
56 Martin
Sherry
Martin
Nicholas
2304 Talon Parkway
Greeley
Colorado
80634
1746250
Foster
57 Mehl
Kiersten
Mehl
John
1671 Green River Drive
Windsor
Colorado
80550
1764078
Foster
58 Mendias
Alberta
5881 Sparrow Avenue
Firestone
Colorado
80504
1612747
Kinship
59 Meza
Norma
Meza-Cordero
Martin
4601 Yellowstone Drive
Greeley
Colorado
80634
1768809
Kinship
60 Montoya Gonzalez
Diana
Aguilar
Juan
11440 Ebony Street
Firestone
Colorado
80504
1753481
Foster
61 Moore
Toni
Moore
Patrick
10221 Fercrest
Longmont
Colorado
80504
1770958
Kinship
62 Muth
Rachel
Muth
Bryan
2306 Sunset Lane
Greeley
Colorado
80634
1742038
Foster
63 Neuenberger
Lidia
Neuenberger
Ryan
317149th Avenue
Greeley
Colorado
80634
1759082
Foster
64 Nguyen
Nguyet
Cook
James
2880 Beau Beth Drive
Humboldt
Tennessee
38343
1781507
Kinship
65 Nix
Amanda
Nix
Randall
2124 Village Drive
Milliken
Colorado
80543
1747311
Foster
66 Norris
Emily
Norris
Jason
135 Sunflower Drive
Windsor
Colorado
80550
1758526
Foster
67 0akleaf
Catherine
708 Moonglow Drive
Windsor
Colorado
80550
1756923
Foster
68 Padilla
Daniel
Padilla
MaryLou
9405 Sunburst Road
Albuquerque
New Mexico
87121
1780122
Kinship
69 Patterson
Mary
Patterson
Alton
2225 Kent Road
Las Cruces
New Mexico
88001
1771530
Kinship
70 Pribble
Kelly
2000 80th Avenue Court
Greeley
Colorado
80634
1659978
Foster
71 Purtell
Nicole
Purtell
Christopher
2391 Tate Avenue
Fort Lupton
Colorado
80620
1708813
Foster
72 Ramirez
Nicole
Mervelt
Jennifer
571 Dowdentown Road
Pottsville
Pennsylvania
17901
1781960
Kinship
73 Raulston
Tiffany
Raulston
Seth
25503 Highway 392
Greeley
Colorado
80631
1754590
Foster
74 Rausch
Cameron
Rausch
Alicia
702 Elm Street
Milliken
Colorado
80543
1761890
Kinship
75 Redding
Ashley
Coleman-Droel
Tresten
5323 Warrior Street
Frederick
Colorado
80530
1777916
Kinship
76 Rickard
Carmen
Rickard
Jeff
5938 East Conservation Drive
Frederick
Colorado
80504
1751416
Foster
77 Rivera
Maria
Lagos
Jarol
573 East 19th Street Road
Greeley
Colorado
80631
1716690
Foster
78 Robles
Delfina
Robles
Armand
65299 County Road 135
New Raymer
Colorado
80742
1774240
Kinship
79 Rodriquez
Sarah
Rodriquez
Rebecca
5119 West 5th Street
Greeley
Colorado
80634
1777813
Kinship
80 Scudder
Mistie
Scudder
Nathan
747 Rock Road
Eaton
Colorado
80615
1521113
Foster
81 Sedlacek
Roger
Sedlacek
Allison
4428 West 14th Street Drive
Greeley
Colorado
80634
1761333
Foster
82 Serra
Kim
Serra
Peter
420 Lilac Avenue
Eaton
Colorado
80615
1772995
Foster
83 Shultzaberger
Angela
Shultzaberger
Shawn
1571 Red Tail Road
Eaton
Colorado
80615
1725981
Foster
84 Sill
Carmen
2017 Proneer Drive
Milliken
Colorado
80543
1780291
Foster
85 Sinden
Andrea
5753 Wild Lane
Loveland
Colorado
80538
1543956
Kinship
86 Snow
Nichole
Snow
Austin
1706 Bounty Drive
Windsor
Colorado
80550
1745854
Foster
87 Square
Linsey
Square
Alexander
610 Cimarron Trail
Ault
Colorado
80610
1776135
Foster
88 Taylor
Tommie
5428 South Valdai Street
Aurora
Colorado
80015
1507199
Foster
89 Thurman
Lauren
Thurman
Joel
4138 West 31st Street
Greeley
Colorado
80634
1708802
Foster
90 Trzcinski
Morgan
Trzcinski
Brandon
705 7th Street
Kersey
Colorado
80644
1764220
Foster
91 Vance
Morgan
Kindvall
Brandon
500 Campbell Street
Kersey
Colorado
80644
1703052
Foster
92 Vandenelzen
Dawn
5819 West 16th Street Lane
Greeley
Colorado
80634
44282
Foster
93 Vega
Ignacia
3102 17th Avenue #8
Greeley
Colorado
80631
1769679
Kinship
94 Veit -Williams
Krisstine
Williams
Dallas
2160 Country Club Parkway
Milliken
Colorado
80543
1775395
Foster
95 Wiench
Stephen
Oneill
Amber
12091 West Dakota Drive
Lakewood
Colorado
80228
1779956
Kinship
96 Wilson
Andrew
Romero
Bianca
648 Larkbunting Drive
Fort Collins
Colorado
80526
1772754
Kinship
97 Wolf
Michael James
Burciaga
Selen
232 Swallow Road
Johnstown
Colorado
80534
1774656
Foster
98 Zeitlow
Andrew
Zeitlow
Ellery
4908 North Saker Street
Wichita
Kansas
67219
1782073
Foster
99 Zetye
Rebecca
Zetye
Kenneth
2350 Black Duck Avenue
Johnstown
Colorado
80534
1750254
Foster
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