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Home My WebLink About20221594.tiffCor vac+ IIDM(olQ 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 IDVariytus 0/,..9COY1-- 5/20/24 4:20/, 2'� 4-00q4 2o22-ISG4 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 '1, nA.F Via. Inn,, 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: IsaineWweldgov.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/NonL.Core 2022-23 Mirior Changes.(GMS 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> 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 if you support recommendation and to have department place on the agenda. Karla Ford A __� Minor a ml In ` _ Core Bid Services Year 2022-23 Providers for 2024-25 Changes Centers, Inc Griffith Program Area ---re WI Service Name Rate _) ' Uni 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 Staffing Services: TDM, $ 75.00 Hour Address Change FTM, 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 $ 105.00 Hour Address Change Life Skills Parenting Skills: with Transportation $ 110.00 Hour Address Change Life Skills Parenting Skills: In-Office/Video 5, 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 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 Mentoring/Behavior Home 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 $ 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/AdoptiorI Relinquishment Counseling: Mileage $ 0.65 A 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 111 Unit Type Other Home -Based Services Engagement Aftercare 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): Teens Imminent and Risk Youth in Home $ 4,000.00 Month Name Address Change Change & 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 S 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: In Transportation -Home or S 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 Family AND 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, Tim dba Assurance TM Therapeutic is Program Area dal 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 Offense Without Specific Abel Juvenile Assessment Evaluation $ 1,000.00 Episode Sex Abuse Treatment Offense Therapy Specific Treatment: Family $ 100.00 Hour Rate Change Sex Abuse Treatment Therapy Offense Specific Treatment: Individual $ 100.00 Hour Rate Change Sex Abuse Treatment Sex Professional Abuse Treatment: Staffing FTM, TDM, $ 75.00 Hour Sex Abuse Treatment Sex Abuse Treatment: Mileage $ 0.33 Mile Northern Colorado Youth for Christ dba Rebalance Program Area Service Name _. Rate Unit Type Other Mental Health Services Rebalance $ 45.00 Hour Mental Health Services Rebalance: No Show $ 20.00 Each Mentoring I Mentoring $ 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 $ 200.00 Hour Rate Change Foster Support Care/Adoption Foster Office/Video Community Parent AND Training 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 - $ 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, $ 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 Time In -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 - PhD: or 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 In-Office/Video Functional 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- $ 250.00 Hour Rate Change Mental Health Services Mental FTM, TDM, Health Professional Services - Staffing Masters: $ 200.00 Hour Rate Change Program Area Service Name Rate Unit Type Other Mental Health Services Show Mental 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 AND Evaluation: 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, Block Professional 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 $ 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 Treatment Professional - 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 In- Therapy 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 revel 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 - $ 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 Program Area Service Name Rate Unit Type Other Foster Support Care/Adoption Foster In -Home Parent or Community Consultation 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 Therapy: $ 95.00 Hour 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 In Aftercare Transportation -Home or Individual/Family Community AND Therapy: with $ 115.00 Hour Home -Based Services In-Office/Video Aftercare Individual/Family Therapy: $ 85.00 Hour Home -Based Services Aftercare No Show Individual/Family Therapy: $ 75.00 Each Home -Based Services Aftercare Based TDM, Family Professional In -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 In Family -Home Support and Services: Community 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 or Transportation $ 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 I $ 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 Family AND with Time: In Transportation -Home or $ 120.00 Hour Name Change lifr Program Area Service Name Rate Unit Type Other r. 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: Based Problematic AND with Treatment In -Home Sexual Transportation or for $ 130.00 Hour Sex Abuse Treatment Community Youth Conduct with Coaching: Problematic Based Treatment In-Office/Video 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 Professional Abuse 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 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 $ 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 In -Home Transportation Home Family or Community Prevention AND Program: with $ 188.00 Hour Rate Change Life Skills In In -Home 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 Life 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, I $ 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 GRIFFITH CENTERS, INC. This Agreement Amendment made and entered into ZOday of MaAA 2024 by and between the Board of Weld County Commissioners, on behalf of the Welounty Department of Human Services, hereinafter referred to as the "Department", and Griffith Centers, Inc., hereinafter referred to as the "Contractor". WHEREAS the parties entered into an Agreement for Day Treatment, Foster Care/Adoption Support, Home -Based Intervention, Life Skills, and Mental Health Services, (the "Original Agreement") identified by the Weld County Clerk to the Board of County Commissioners as document No. 2022-1594, approved on June 8, 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 8, 2023 to extend the term date through May 31, 2024, to amend Exhibit A, Scope of Services, and Exhibit B, Rate Schedule. June 14, 2023 to reflect contractor's legal name change from Griffith Centers for Children, Inc. to Griffith Centers, Inc. November 20, 2023 to amend Exhibit A, Scope of Services, and Exhibit B, Rate Schedule. The Amendments are identified by the Weld County Clerk to the Board of County Commissioners as document number 2022-1594. • These Amendments, 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 Services, 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: ATTEST: f..", 6W ''' Je144'ei Clerk to the Board tab Deputy Clerk to BOARD OF COUNTY COMMISSIONERS WELD COUNTY O O Kevin D. Ross, Chair MAY 2 0 2024 CONTRACTOR: Griffith Centers, Inc. 10190 Bannock Street, Suite 120 Northglenn, Colorado 80260 (303) 237-6865 Utthei- To`iez Esther Torrez, Controller May 3, 2024 Date: �02�- ISq l EXHIBIT A SCOPE OF SERVICES Contractor will provide Day Treatment, Foster Care/Adoption Support, Home -Based Intervention, Life Skills, Relinquishment Counseling, and Mental Health Services as referred by the Department. Program Area: Day Treatment 1. Day Treatment a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Day Treatment. ii. Individual Therapy. iii. Family Therapy. iv. Education Services. b. Anticipated Frequency of Services: i. As needed/daily. c. Anticipated Duration of Services: i. As needed. d. Goals of Services: i. Increase independent living skills. ii. Increase social skills. iii. Manage mental health. iv. Goals can be adjusted and individualized to each client. e. Outcomes of Services: i. Increase independent living skills. ii. Increase social skills. iii. Manage mental health. f. Target Population: i. Grades three (3) to twelve (12). g. Language: i. English. h. Medicaid Eligibility: i. This service is partially Medicaid eligible. 1 i. Service Access and Transportation: i. Colorado Springs Day Treatment Program located at 10 Farragut Avenue, Colorado Springs, Colorado 80909. Program Area: Foster Care/Adoption Support 1. Foster Parent Education a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psychoeducation. ii. Modeling. iii. In -vivo feedback. iv. Nurturing Parenting Program. v. Therapeutic interventions. b. Anticipated Frequency of Services: i. As needed. c. Anticipated Duration of Services: i. As needed. d. Goals of Services: i. Increased knowledge of parenting skills. ii. Increased knowledge of child mental health and wellness. iii. Increase knowledge of attachment. iv. Increase knowledge of trauma. e. Outcomes of Services: i. Increased use of learned parenting skills. ii. Increased ability of foster parent to provide emotionally for child. iii. Increased ability of foster parent to address behavioral or mental health concerns of foster children. f. Target Population: i. Foster Parents. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. 2 i. Service Access and Transportation: i. In contractor's office located at 3400 West 16th Street, Building B, Suite S, Greeley, Colorado 80634-6872. i. In -Home. ii. In -community. Program Area: Home -Based Intervention 1. Mentoring/Behavior Coaching a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psychoeducation. ii. Modeling. iii. In -vivo feedback. iv. Mentoring. b. Anticipated Frequency of Services: i. Two (2) to four (4) hours per week. c. Anticipated Duration of Services: i. Four (4) to six (6) months. d. Goals of Services: i. Increased social skills. ii. Address truancy or school/education concerns. iii. Increase job readiness. iv. Overcome barriers to other treatment. v. Community Integration. e. Outcomes of Services: i. Increased use of social skills. ii. Increased use of community resources. iii. Obtaining employment (if appropriate). iv. Increased school attendance. v. Increased participation in other mental health or social services. f. Target Population: i. Youth ages six (6) and older, young adults, and adults. g. Language: i. English. h. Medicaid Eligibility: 3 i. This service is Medicaid eligible. i. Service Access and Transportation: i. In contractor's office at 3400 West 16th Street, Building B, Suite S, Greeley, Colorado 80634-6872. ii. In -Home. iii. In -community. 2. Family Preservation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Individual therapy. ii. Family therapy. iii. Behavior coaching/mentoring. iv. Life skills. v. Parenting skills. vi. A combination of services designed to maintain placement, prevent removal, and/or assist with family cohesion post -reunification. b. Anticipated Frequency of Services: i. One (1) to four (4) hours per week. c. Anticipated Duration of Services: i. Six (6) to twelve (12) months. d. Goals of Services: i. Increase family skills such as coping and communication. ii. Increase understanding and awareness of community resources. iii. Address concerns around safety. iv. Address concerns in family functioning. v. Goals can be adjusted to meet family needs. e. Outcomes of Services: i. Increase use of learned skills to decrease concerns in family functioning. ii. Decrease safety concerns. iii. Increase use of appropriate community supports. f. Target Population: i. Families who have active Department involvement and are at risk of having children removed, have had children removed, or have children who have recently reunified with the family. g. Language: 4 i. English. h. Medicaid Eligibility: i. Medicaid eligible, up to a specific number of hours per week. i. Service Access and Transportation: i. In contractor's office located at 3400 West 1655 Street, Building B, Suite S, Greeley, Colorado 80634-6872. ii. In -Home. iii. In -community. Program Area: Life Skills 1. Therapeutic Visitation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psychoeducation. ii. Modeling. iii. In -vivo feedback. iv. Nurturing Parenting Program. v. Therapeutic interventions. vi. Service provided by a master's level intern or above. b. Anticipated Frequency of Services: i. As ordered by court order or Department requirements. c. Anticipated Duration of Services: i. As ordered by court order or Department requirements. d. Goals of Services: i. Increased knowledge of parenting skills. ii. Increased ability of parent to provide emotionally for child. iii. Increased ability of parent to provide physically for child. iv. Increased observed markers of healthy attachment. e. Outcomes of Services: i. Increased use of learned parenting skills. ii. Increased ability of parent to provide emotionally for child. iii. Increased ability of parent to provide physically for child. iv. Increased observed markers of healthy attachment. f. Target Population: i. Parents and children who have been removed from their parent's care. 5 g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In contractor's office at 3400 West 16th Street, Building B, Suite S, Greeley, Colorado 80634-6872. ii. In -Home. iii. In -community. 2. Supervised Visitation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psychoeducation. ii. Modeling. iii. In -vivo feedback. iv. Nurturing Parenting Program. v. Service provided by a bachelor's level intern or above. b. Anticipated Frequency of Services: i. As ordered by court order or Department requirements. c. Anticipated Duration of Services: i. As ordered by court order or Department requirements. d. Goals of Services: i. Increased knowledge of parenting skills. ii. Increased ability of parent to provide emotionally for child. iii. Increased ability of parent to provide physically for child. iv. Increased observed markers of healthy attachment. e. Outcomes of Services: i. Increased use of learned parenting skills. ii. Increased ability of parent to provide emotionally for child. iii. Increased ability of parent to provide physically for child. iv. Increased observed markers of healthy attachment. f. Target Population: i. Parents and children who have been removed from their parent's care. 6 g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In contractor's office at 3400 West 16th Street, Building B, Suite S, Greeley, Colorado 80634-6872. ii. In -Home. iii. In -community. 3. Life Skills — Parenting Skills (LSPS) a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psychoeducation. ii. Modeling. iii. In -vivo feedback. iv. Nurturing Parenting Program. b. Anticipated Frequency of Services: i. Three (3) hours per week. c. Anticipated Duration of Services: i. Three (3) to four (4) months. d. Goals of Services: i. Increased knowledge of parenting skills. ii. Increased use of parenting skills. iii. Increased understanding of child development. e. Outcomes of Services: i. Increased knowledge of parenting skills. ii. Increased use of parenting skills. iii. Increased understanding of child development. f. Target Population: i. Parents. g. Language: i. English. h. Medicaid Eligibility: 7 i. Some parent education can be completed through Medicaid funded parenting groups or family therapy if available. Service Access and Transportation: i. In contractor's office at 3400 West 16th Street, Building B, Suite S, Greeley, Colorado 80634-6872. ii. In -community. Program Area: Relinquishment Counseling 1. Relinquishment Counseling a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Contractor's staff will use relevant court documents to complete the paperwork. ii. Contractor's staff will meet with each client to ensure the client understands the finality of his/her decision to relinquish parental rights. iii. Contractor's staff will assess for sobriety or competence of client through observation and conversation at the beginning of the session, and reschedule the session if client is perceived to be under the influence of any substance. iv. Contractor's staff will provide the Department with all completed and signed documents. b. Anticipated Frequency of Services: i. One (1), one (1) hour in -office visit or out of office visit for a relinquishment counseling session and follow up with the client to read and sign all documents. c. Anticipated Duration of Services: i. Service will be completed within sixty (60) days of receipt of referral from the Department. d. Goals of Services: i. Contractor's staff will thoroughly explain the meaning of "Relinquishment of Parental Rights" to client(s). ii. Ensure client is not under the influence of any substance. iii. Ensure client understands the finality of relinquishing their parental rights. iv. Ensure client understands all their options regarding custody of the child(ren). 8 e. Outcomes of Services: i. Client will have a complete understanding of the relinquishment process. ii. Client will understand that there are community resources for support should they decide not to relinquish parental rights. iii. Client will understand that once the Court accepts the Petition to Relinquish Parental Rights, the client will no longer have any personal or legal right to contact their child(ren). iv. The Department will receive the required relinquishment counseling paperwork within sixty (60) days of receipt of the referral. f. Target Population: i. Parents. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: ii. In contractor's office located at 3400 West 16th Street, Building B, Suite S, Greeley, Colorado 80634-6872. iv. In -Home. v. In -community. Program Area: Mental Health Services 1. Individual Therapy a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psychoeducation. ii. Cognitive Behavioral Therapy. iii. Trauma -Focused Cognitive Behavioral Therapy (TF-CBT). iv. Motivational Interviewing. v. Reboot Educational Learning Opportunities Affecting Direction (RELOAD)/Truancy Services vi. Other miscellaneous evidenced based therapeutic interventions. b. Anticipated Frequency of Services: i. One (1) to two (2) hours per week. c. Anticipated Duration of Services: i. Six (6) to twelve (12) months. 9 d. Goals of Services: i. Increase emotional awareness. ii. Increase emotion regulation skills. iii. Increase mental wellness and functioning. iv. Increased coping skills. v. Process trauma. e. Outcomes of Services: i. Clients will report increased self-awareness. ii. Clients will utilize skills learned. iii. Clients will increase in positive functioning. iv. Client's will increase school attendance. f. Target Population: i. Children aged four (4) and older, youth, and adults. g. Language: i. English. ii. Spanish may be available in some cases. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: iii. In contractor's office located at 3400 West 16th Street, Building B, Suite 5, Greeley, Colorado 80634-6872. vi. In -Home. vii. In -community. viii. Telehealth. 2. Family Therapy a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psychoeducation. ii. Miscellaneous Therapeutic Interventions. b. Anticipated Frequency of Services: i. One (1) hour per week. c. Anticipated Duration of Services: i. Six (6) to twelve (12) months. 10 d. Goals of Services: i. Increased communication skills. ii. Increased family functioning. iii. Increased understanding and awareness of family patterns and impact of patterns on system. e. Outcomes of Services: i. Clients and family members will increase ability to positively communicate. ii. Clients and family members will utilize learned skills to address any deficits in family functioning. iii. Clients and family members will utilize skills to create positive change in family system. f. Target Population: i. Siblings, couples, and families. g. Language: i. English. ii. Spanish may be available in some cases. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. In contractor's office located at 3400 West 16th Street, Building B, Suite S, Greeley, Colorado 80634-6872. i. In -Home. ii. In -community. iii. Telehealth. 3. Group Therapy a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psychoeducation. ii. Cognitive Behavioral Therapy. iii. Miscellaneous Group Therapy Interventions. b. Anticipated Frequency of Services: i. One and a half (1.5) to two (2) hours per week. c. Anticipated Duration of Services: i. Three (3) to four (4) months. 11 d. Goals of Services: i. Increased knowledge of information specific to group. ii. Increased coping skills. iii. Increased feelings of support. e. Outcomes of Services: i. Clients will utilize knowledge learned and apply to specific areas of life. ii. Clients will increase their coping skills. iii. Clients will report increased feelings of support. f. Target Population: i. Dependent on the type of group: children, youth, adults, or parents. g. Language: i. English. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. In contractor's office located at 3400 West 16th Street, Building B, Suite S, Greeley, Colorado 80634-6872. ii. Telehealth. 4. Therapeutic Intake a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Service is required for all Core -funded therapy clients. b. Anticipated Frequency of Services: i. Two (2) hours. c. Anticipated Duration of Services: i. One (1) time only. d. Goals of Services: i. Assess mental health needs. ii. Create a treatment plan. iii. Assess for other social needs. e. Outcomes of Services: i. Creation of a treatment plan. 12 ii. Signature of legally required documentation for mental health services. iii. Recommendations for treatment. f. Target Population: i. Ages four (4) and older who intend on enrolling in therapy services. g. Language: i. English. ii. Spanish may be available in some cases. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. In contractor's office located at 3400 West 16th Street, Building B, Suite S, Greeley, Colorado 80634-6872. ii. In -Home. iii. In -community. iv. Telehealth. Terms 1. 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. 2. 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. 3. Contractor will respond to the Mental Health and Support Services Team CWServiceReferral@weld.gov1115, within three (3) business days regarding the ability to accept the received referral. 4. 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 13 will notify the caseworker and the Mental Health and Support Services Team (HS- CWServiceReferral@weld.gov). 5. Contractor acknowledges that any and all modifications to an existing referral must be approved through the Mental Health and Support Services Team (HS- CWServiceReferral@weld.gov). No other Department staff or other party to the case may authorize services or modifications to services. 6. 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 Mental Health and Support Services Team (HS- CWServiceReferral@weld.gov) within three (3) days of when the client is placed on a behavioral plan or discharged 7. 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 Mental Health and Support Services Team (HS-CWServiceReferral@weld.gov) immediately via email, to discuss service continuation. S. 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. 9. 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. 10. 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 14 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 Mental Health and Support Services Team (HS-CWServiceReferral@weld.gov) immediately AND on the required monthly report. 11. Contractor agrees any change to an existing referral must be pre -approved through the Child Welfare Core Service Coordinator or any member of the Mental Health and Support Services 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. 12. 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 Mental Health and Support Services 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. 13. On a monthly basis, the Contractor will notify the Mental Health and Support Services Team (HS-CWServiceReferral@weld.gov) 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. 14. Compliance with Child and Family Services Review 15 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 9 of this Exhibit. 15. 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. 16. Trainin 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. 17. 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. 18. Monitoring and Evaluation 16 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 to 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. 17 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(s) specified below in Paragraph 2, Fees for Services. 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. For services funded through Core Services, Contractor agrees to accept reimbursement through ACH direct deposit one time per month. 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, deposit slip or bank letter. Failure to complete and submit this form and voided check in a timely and accurate manner may result in a delay of payment. For services not funded through Core Services; Contractor agrees to accept payment through County Warrant when funding source does not allow for direct deposit. 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 Program Area Day Treatment Services Rate $ 1,648.00 Unit Type Month I Service Name Day Treatment $ 300.00 Month Day Treatment Mileage: Transportation for distances exceeding 60 roundtrip miles from 10 Farragut Avenue, Colorado Springs, Colorado 80909 Foster Care/Adoption Support $ 64.00 Hour Foster Parent Education: In-office/Video $ 30.00 Each Foster Parent Education: No Show (Max of 2 no shows or 2 hours/month/client) $ 92.00 Hour Foster Parent Education: In -Home or Community Program Area Foster Care/Adoption Support Rate $ 35.00 Unit Type Hour Service Name Foster Parent Education Family: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing Home -Based Intervention $ 93.00 Hour Mentoring/Behavior Coaching: In -Home or Community $ 88.00 Hour Mentoring/Behavior Coaching: In- Office/Video $ 120.00 Hour Family Preservation: In -Home or Community $ 105.00 Hour Family Preservation: In-Office/Video Mentoring $ 103.00 Hour Mentoring/Behavior Coaching: In -Office with Transportation* Life Skills $ 105.00 Hour Therapeutic Visitation: In-Office/Video $ 125.00 Hour Therapeutic Visitation: In -Office with Transportation* $ 120.00 Hour Therapeutic Visitation: In -Home or Community $ 110.00 Hour Supervised Visitation: In -Home or Community $ 100.00 Hour Supervised Visitation: In-Office/Video $ 115.00 Hour Supervised Visitation: In -Office with Transportation* $ 105.00 Hour Life Skills - Parenting Skills (LSPS): In- Home or Community $ 90.00 Hour Life Skills - Parenting Skills (LSPS): In- Office/Video $ 110.00 Hour Life Skills - Parenting Skills (LSPS): In- Office with Transportation* Relinquishment Counseling $ 125.00 Hour Relinquishment Counseling: In - office/Video $ 130.00 Hour Relinquishment Counseling: In -Home or Community $ 75.00 Hour Relinquishment Counseling: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $ 55.00 Each No Show (Max of 2 no shows or 2 hours/month/client) Mental Health Services $ 130.00 Hour Individual Therapy: In -Home or Community $ 125.00 Hour Individual Therapy: In-Office/Video $ 130.00 Hour Family Therapy: In -Home or Community Program Area Rate Unit Type Service Name Mental Health Services $ 125.00 Hour Family Therapy: In-Office/Video $ 45.00 Hour Group Therapy: In -home or Community $ 45.00 Hour Group Therapy: In-Office/Video Therapeutic Intake: In -Home or $ 100.00 Hour Community (2 -hour Max) Therapeutic Intake: In-Office/Video (2- $ 90.00 Hour hour Max) $ 75.00 Hour Mental Health Services: FTM, TDM, Professional Staffing All Program Areas $ 0.65 Mile Mileage* * For distances exceeding 60 roundtrip miles from contractor's office located at 3400 West 16th Street, Building B, Suite S, Greeley, Colorado 80634-6872. 3. Request for Reimbursement and Supporting Documentation 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 for each client receiving ongoing services. 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. 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. Time(s) of service (i.e. 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. What interventions were used, recommendations and/or goals discussed, progressions towards goals, and client engagement. e. For mileage reimbursement, if applicable, the mileage accumulated minus roundtrip mileage that is included in the rate, starting location, and ending location. f. Any and all safety concerns. When submitting a Request for Reimbursement 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. Requests for Reimbursement and/or supporting documentation received after the 7t" day of the month may delay payment. 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. 4. Payment 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: The service being provided by the contractor is not a Medicaid eligible service; a. The service is not deemed medically necessary; b. The Court with jurisdiction over the case has ordered that a non -Medicaid provider or service be used; c. A Medicaid provider is not available to provide the needed service; d. Medicaid is exhausted for the needed service; or e. Medicaid denied service. f. The client is not eligible for Medicaid. 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 Human Services shall be final. 5. 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: a. Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed. b. Deny payment or recover reimbursement for those services or deliverables, which have not been performed and which due to circumstances caused by 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. 6. 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. SIGNATURE REQUESTED: Weld/Griffith Centers Amendment #4 Final Audit Report 2024-05-03 Created: 2024-05-02 By: Windy Luna (wluna@weld.gov) Status: Signed Transaction ID: CBJCHBCAABAAdvtrwlq1nKm_Ytbb-WPCOi2PDKZYI-ncaH "SIGNATURE REQUESTED: Weld/Griffith Centers Amendment #4" History t Document created by Windy Luna (wluna@weld.gov) 2024-05-02 - 10:14:14 PM GMT- IP address: 204.133.39.9 W. Document emailed to esther.torrez@griffithcenters.org for signature 2024-05-02 - 10:14:52 PM GMT 'n Email viewed by esther.torrez@griffithcenters.org 2024-05-03 - 4:06:48 PM GMT- IP address: 104,47.70.126 dp Signer esther.torrez@griffithcenters.org entered name at signing as Esther Torrez 2024-05-03 - 4:07:39 PM GMT- IP address: 98.38.116.134 4 Document e -signed by Esther Torrez (esther.torrez@griffithcenters.org) Signature Date: 2024-05-03 - 4:07:41 PM GMT - Time Source: server- IP address: 98.38.116.134 0 Agreement completed. 2024-05-03 - 4:07:41 PM GMT Powered by Adobe Acrobat Sign Contract Form Entity Information Entity Name* Entity ID* GRIFFITH CENTERS INC @00029886 Contract Name* GRIFFITH CENTERS, INC. (PROFESSIONAL SERVICES AGREEMENT AMENDMENT #4. RELATED TO BID #B2200040( Contract Status CTB REVIEW Q New Entity? Contract ID 8166 Contract Lead * WLUNA Contract Lead Email wluna@weldgov.com;cob bxxlk@weldgov.com Parent Contract ID 20221594 Requires Board Approval YES Department Project # Contract Description* (CONSENT) GRIFFITH CENTERS, INC. (PROFESSIONAL SERVICES AGREEMENT AMENDMENT #4. 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 ORIGINALLY ON 04/6/22, AND AMENDED 6/1 3/22. Contract Type" AMENDMENT Amount* $0.00 Renewable* NO Automatic Renewal Grant IGA Department Requested BOCC Agenda Due Date HUMAN SERVICES Date* 05/18/2024 05/22/2024 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 RN EY@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 Termination Notice Period Contact Information Review Date" 03/31/2025 Committed Delivery Date Renewal 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 05/09/2024 Approval Process Department Head Finance Approver Legal Counsel JAMIE ULRICH CONSENT CONSENT DH Approved Date Finance Approved Date Legal Counsel Approved Date 05/09/2024 05/09/2024 05/09/2024 Final Approval BOCC Approved Tyler Ref # AG 052024 BOCC Signed Date Originator WLUNA BOCC Agenda Date 05/20/2024 Con +KA & 1 Dk7lo22 BOARD OF COUNTY COMMISSIONERS PASS -AROUND REVIEW PASS AROUND TITLE: Child Protection Agreement Amendment #3 with Griffith Centers for Children DEPARTMENT: Human Services DATE: November 7, 2023 PERSON REQUESTING: Jamie Ulrich, Director, Human Services Brief description of the problem/Issue: The Department is requesting approval for Amendment #3 of the Child Protection Agreement with Griffith Centers for Children, Inc. for Day Treatment, Foster Care/Adoption Support, Home - Based Intervention, Life Skills, and Mental Health Services. This Amendment will add Relinquishment Counseling Services. What options exist for the Board? • Approval of Griffith Centers for Children, Inc. Amendment #3. • Deny approval of Griffith Centers for Children, Inc. Amendment #3. Consequences: Provider will not provide needed Services to the Department of Human Services clients. Impacts: Provider will not deliver needed services to Department of Human Services clients. Costs (Current Fiscal Year / Ongoing or Subsequent Fiscal Years): Fees for Services: roc) Type Relinquishment Counseling $ 125.00 Hour $ 125.00 $ 75.00 $ 55.00 Hour Hour Each In-officeNideo In -Home or Community Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing No Show (Max of 2 no shows or 2 hours/month/client) • This service will be funded through Core/Non-Core Child Welfare funding. • Term: October 1, 2023 through May 31, 2024. Recommendation: • Approval of this Amendment #3 and authorize the Chair to sign. Support Recommendation Schedule Place on BOCC Agenda Work Session Other/Comments: Perry L. Buck, Pro-Tem Mike Freeman, Chair Scott K. James Kevin D. Ross Lori Saine ‘:451 - Pass -Around Memorandum; November 7, 023 — CMS TBD 6/6...D) Con�c.-1�1i" Rc�.s�- c: � �t/zo/ � �i ao a5 23 / zo22- 1594 H 0094 AGREEMENT AMENDMENT BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND GRIFFITH CENTERS, INC. This Agreement Amendment made and entered into Z0111 day of N werniK 2023 by and between the Board of Weld County Commissioners, on behalf of the Weld County Department of Human Services, hereinafter referred to as the "Department", and Griffith Centers, Inc., hereinafter referred to as the "Contractor". WHEREAS the parties entered into an Agreement for Day Treatment, Foster Care/Adoption Support, Home -Based Intervention, Life Skills, and Mental Health Services (the "Original Agreement") identified by the Weld County Clerk to the Board of County Commissioners as document No. 2022- 1594, approved on June 8, 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: June 14, 2023 for a legal name change from Griffith Centers for Children, Inc. to Griffith Centers, Inc. May 8, 2023 to extend the term date through May 31, 2024, to amend Exhibit A, Scope of Services, and Exhibit B, Rate Schedule. The Amendments are identified by the Weld County Clerk to the Board of County Commissioners as document number 2022-1594. These Amendments, 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 October 1, 2023: 1. Exhibit A, Scope of Services, is hereby amended as attached. 2. 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; ATTEST:-.�c�%we�r� • AG: '‘`— BOARD OF COUNTY COMMISSIONERS Clerk to the Board WELD COUNTY, COLORADO rn Deputy Clerk to the B e Freeman, Chair N0V 2 0 223 TRACTOR: riffith Centers, Inc 10190 Bannock Street, Suite 120 Northglenn, Colorado 80260 (303) 237-6865 CsthieiTDYYez Esther Torrez, Controller Nov 9, 2023 Date: EXHIBIT A SCOPE OF SERVICES Contractor will provide Day Treatment, Foster Care/Adoption Support, Home -Based Intervention, Life Skills, Relinquishment Counseling, and Mental Health Services as referred by the Department. Program Area: Day Treatment 1. Day Treatment a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Day Treatment. ii. Individual Therapy. iii. Family Therapy. iv. Education Services. b. Anticipated Frequency of Services: i. As needed/daily. c. Anticipated Duration of Services: i. As needed. d. Goals of Services: i. Increase independent living skills. ii. Increase social skills. iii. Manage mental health. iv. Goals can be adjusted and individualized to each client. e. Outcomes of Services: i. Increase independent living skills. ii. Increase social skills. iii. Manage mental health. f. Target Population: i. Grades three (3) to twelve (12). g. Language: i. English. h. Medicaid Eligibility: i. This service is partially Medicaid eligible. i. Service Access and Transportation: i. Colorado Springs Day Treatment Program located at 10 Farragut Avenue, Colorado Springs, Colorado 80909. Program Area: Foster Care/Adoption Support 1. Foster Parent Education 1 a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psychoeducation. ii. Modeling. iii. In -vivo feedback. iv. Nurturing Parenting Program. v. Therapeutic interventions. b. Anticipated Frequency of Services: i. As needed. c. Anticipated Duration of Services: i. As needed. d. Goals of Services: i. Increased knowledge of parenting skills. ii. Increased knowledge of child mental health and wellness. iii. Increase knowledge of attachment. iv. Increase knowledge of trauma. e. Outcomes of Services: i. Increased use of learned parenting skills. ii. Increased ability of foster parent to provide emotionally for child. iii. Increased ability of foster parent to address behavioral or mental health concerns of foster children. f. Target Population: i. Foster Parents. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. Service Access and Transportation: i. In contractor's office located at 710 11 v Avenue, #L-46, Greeley, Colorado 80631. i. In -Home. ii. In -community. Program Area: Home -Based Intervention 2. Mentoring/Behavior Coaching a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psychoeducation. ii. Modeling. iii. In -vivo feedback. 2 iv. Mentoring. b. Anticipated Frequency of Services: i. Two (2) to four (4) hours per week. c. Anticipated Duration of Services: i. Four (4) to six (6) months. d. Goals of Services: i. Increased social skills. ii. Address truancy or school/education concerns. iii. Increase job readiness. iv. Overcome barriers to other treatment. v. Community Integration. e. Outcomes of Services: i. Increased use of social skills. ii. Increased use of community resources. iii. Obtaining employment (if appropriate). iv. Increased school attendance. v. Increased participation in other mental health or social services. f. Target Population: i. Youth ages six (6) and older, young adults, and adults. g. Language: i. English. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. In contractor's office at 710 11th Avenue, #L-46, Greeley, Colorado 80631. ii. In -Home. iii. In -community. 3. Family Preservation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Individual therapy. ii. Family therapy. iii. Behavior coaching/mentoring. iv. Life skills. v. Parenting skills. vi. A combination of services designed to maintain placement, prevent removal, and/or assist with family cohesion post -reunification. b. Anticipated Frequency of Services: i. One (1) to four (4) hours per week. 3 c. Anticipated Duration of Services: i. Six (6) to twelve (12) months. d. Goals of Services: i. Increase family skills such as coping and communication. ii. Increase understanding and awareness of community resources. iii. Address concerns around safety. iv. Address concerns in family functioning. v. Goals can be adjusted to meet family needs. e. Outcomes of Services: i. Increase use of learned skills to decrease concerns in family functioning. ii. Decrease safety concerns. iii. Increase use of appropriate community supports. f Target Population: i. Families who have active Department involvement and are at risk of having children removed, have had children removed, or have children who have recently reunified with the family. g. Language: i. English. h. Medicaid Eligibility: i. Medicaid eligible, up to a specific number of hours per week. Service Access and Transportation: ii. In contractor's office located at 710 11th Avenue, #L-46, Greeley, Colorado 80631. i. In -Home. ii. In -community. Program Area: Life Skills 1. Therapeutic Visitation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psychoeducation. ii. Modeling. iii. In -vivo feedback. iv. Nurturing Parenting Program. v. Therapeutic interventions. vi. Service provided by a master's level intern or above. b. Anticipated Frequency of Services: i. As ordered by court order or Department requirements. c. Anticipated Duration of Services: i. As ordered by court order or Department requirements. 4 d. Goals of Services: i. Increased knowledge of parenting skills. ii. Increased ability of parent to provide emotionally for child. iii. Increased ability of parent to provide physically for child. iv. Increased observed markers of healthy attachment. e. Outcomes of Services: i. Increased use of learned parenting skills. ii. Increased ability of parent to provide emotionally for child. iii. Increased ability of parent to provide physically for child. iv. Increased observed markers of healthy attachment. f Target Population: i. Parents and children who have been removed from their parent's care. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In contractor's office at 710 11th Avenue, #L-46, Greeley, Colorado 80631. ii. In -Home. iii. In -community. 2. Supervised Visitation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psychoeducation. ii. Modeling. iii. In -vivo feedback. iv. Nurturing Parenting Program. v. Service provided by a bachelor's level intern or above. b. Anticipated Frequency of Services: i. As ordered by court order or Department requirements. c. Anticipated Duration of Services: i. As ordered by court order or Department requirements. d. Goals of Services: i. Increased knowledge of parenting skills. ii. Increased ability of parent to provide emotionally for child. iii. Increased ability of parent to provide physically for child. iv. Increased observed markers of healthy attachment. e. Outcomes of Services: i. Increased use of learned parenting skills. ii. Increased ability of parent to provide emotionally for child. 5 iii. Increased ability of parent to provide physically for child. iv. Increased observed markers of healthy attachment. f. Target Population: i. Parents and children who have been removed from their parent's care. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In contractor's office at 710 11`h Avenue, #L-46, Greeley, Colorado 80631. ii. In -Home. iii. In -community. 3. Life Skills — Parenting Skills (LSPS) Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psychoeducation. ii. Modeling. iii. In -vivo feedback. iv. Nurturing Parenting Program. b. Anticipated Frequency of Services: i. Three (3) hours per week. c. Anticipated Duration of Services: i. Three (3) to four (4) months. d. Goals of Services: i. Increased knowledge of parenting skills. ii. Increased use of parenting skills. iii. Increased understanding of child development. e. Outcomes of Services: i. Increased knowledge of parenting skills. ii. Increased use of parenting skills. iii. Increased understanding of child development. f. Target Population: i. Parents. g. Language: i. English. h. Medicaid Eligibility: i. Some parent education can be completed through Medicaid funded parenting groups or family therapy if available. 6 i. Service Access and Transportation: i. In contractor's office at 710 11`h Avenue, #L-46, Greeley, Colorado 80631. ii. In -community. Program Area: Relinquishment Counseling 1. Relinquishment Counseling a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Contractor's staff will use relevant court documents to complete the paperwork. ii. Contractor's staff will meet with each client to ensure the client understands the finality of his/her decision to relinquish parental rights. iii. Contractor's staff will assess for sobriety or competence of client through observation and conversation at the beginning of the session, and reschedule the session if client is perceived to be under the influence of any substance. iv. Contractor's staff will provide the Department with all completed and signed documents. b. Anticipated Frequency of Services: i. One (1), one (1) hour in -office visit or out of office visit for a relinquishment counseling session and follow up with the client to read and sign all documents. c. Anticipated Duration of Services: i. Service will be completed within sixty (60) days of receipt of referral from the Department. d. Goals of Services: i. Contractor's staff will thoroughly explain the meaning of "Relinquishment of Parental Rights" to client(s). ii. Ensure client is not under the influence of any substance. iii. Ensure client understands the finality of relinquishing their parental rights. iv. Ensure client understands all their options regarding custody of the child(ren). e. Outcomes of Services: i. Client will have a complete understanding of the relinquishment process. ii. Client will understand that there are community resources for support should they decide not to relinquish parental rights. iii. Client will understand that once the Court accepts the Petition to Relinquish Parental Rights, the client will no longer have any personal or legal right to contact their child(ren). iv. The Department will receive the required relinquishment counseling paperwork within sixty (60) days of receipt of the referral. f. Target Population: i. Parents. g. Language: 7 i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: iii. In contractor's office located at 710 11`"` Avenue, #L-46, Greeley, Colorado 80631. iii. In -Home. iv. In -community. Program Area: Mental Health Services 1. Individual Therapy a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psychoeducation. ii. Cognitive Behavioral Therapy. iii. Trauma -Focused Cognitive Behavioral Therapy (TF-CBT). iv. Motivational Interviewing. v. Reboot Educational Learning Opportunities Affecting Direction (RELOAD)/Truancy Services vi. Other miscellaneous evidenced based therapeutic interventions. b. Anticipated Frequency of Services: i. One (1) to two (2) hours per week. c. Anticipated Duration of Services: i. Six (6) to twelve (12) months. d. Goals of Services: i. Increase emotional awareness. ii. Increase emotion regulation skills. iii. Increase mental wellness and functioning. iv. Increased coping skills. v. Process trauma. e. Outcomes of Services: i. Clients will report increased self-awareness. ii. Clients will utilize skills learned. iii. Clients will increase in positive functioning. iv. Client's will increase school attendance. f Target Population: i. Children aged four (4) and older, youth, and adults. g. Language: i. English. ii. Spanish may be available in some cases. 8 h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: iv. In contractor's office located at 710 11`h Avenue, #L-46, Greeley, Colorado 80631. v. In -Home. vi. In -community. vii. Telehealth. 2. Family Therapy a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psychoeducation. ii. Miscellaneous Therapeutic Interventions. b. Anticipated Frequency of Services: i. One (1) hour per week. c. Anticipated Duration of Services: i. Six (6) to twelve (12) months. d. Goals of Services: i. Increased communication skills. ii. Increased family functioning. iii. Increased understanding and awareness of family patterns and impact of patterns on system. e. Outcomes of Services: i. Clients and family members will increase ability to positively communicate. ii. Clients and family members will utilize learned skills to address any deficits in family functioning. iii. Clients and family members will utilize skills to create positive change in family system. f Target Population: i. Siblings, couples, and families. g. Language: i. English. ii. Spanish may be available in some cases. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: v. In contractor's office located at 710 11`h Avenue, #L-46, Greeley, Colorado 80631. viii. In -Home. 9 ix. In -community. x. Telehealth. 3. Group Therapy a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psychoeducation. ii. Cognitive Behavioral Therapy. iii. Miscellaneous Group Therapy Interventions. b. Anticipated Frequency of Services: i. One and a half (1.5) to two (2) hours per week. c. Anticipated Duration of Services: i. Three (3) to four (4) months. d. Goals of Services: i. Increased knowledge of information specific to group. ii. Increased coping skills. iii. Increased feelings of support. e. Outcomes of Services: i. Clients will utilize knowledge learned and apply to specific areas of life. ii. Clients will increase their coping skills. iii. Clients will report increased feelings of support. f. Target Population: i. Dependent on the type of group: children, youth, adults, or parents. g. Language: i. English. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. In contractor's office located at 710 11`h Avenue, #L-46, Greeley, Colorado 80631. ii. Telehealth. 4. Therapeutic Intake a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Service is required for all Core -funded therapy clients. b. Anticipated Frequency of Services: i. Two (2) hours. c. Anticipated Duration of Services: 10 i. One (1) time only. d. Goals of Services: i. Assess mental health needs. ii. Create a treatment plan. iii. Assess for other social needs. e. Outcomes of Services: i. Creation of a treatment plan. ii. Signature of legally required documentation for mental health services. iii. Recommendations for treatment. f. Target Population: i. Ages four (4) and older who intend on enrolling in therapy services. g. Language: i. English. ii. Spanish may be available in some cases. h. Medicaid Eligibility: i. This service is Medicaid eligible. Service Access and Transportation: i. In contractor's office located at 710 11th Avenue, #L-46, Greeley, Colorado 80631. ii. In -Home. iii. In -community. iv. Telehealth. Terms 1. 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. 2. 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. 3. Contractor will respond to the Mental Health and Support Services Team (j CWServiceReferraldfweld.gov within three (3) business days regarding the ability to accept the received referral. 4. 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 11 first seven (7) days of the referral period, the Contractor will notify the caseworker and the Mental Health and Support Services Team(HS-CWServiceReferral(a,weld.nov). 5. Contractor acknowledges that any and all modifications to an existing referral must be approved through the Mental Health and Support Services Team(HS-CWServiceReferraltweld.gov). No other Department staff or other party to the case may authorize services or modifications to services. 6. 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 Mental Health and Support Services Team (HS- CWServi.ceReferral(a/weld.nov) within three (3) days of when the client is placed on a behavioral plan or discharged 7. 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 Mental Health and Support Services Team(HS-CWServiceReferral(ai/weld.gov) immediately via email, to discuss service continuation. 8. 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. 9. 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. 10. 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 Mental Health and Support Services Team(HS-CWServiceReferral(a/weld.00v) immediately AND on the required monthly report. 11. Contractor agrees any change to an existing referral must be pre -approved through the Child Welfare Core Service Coordinator or any member of the Mental Health and Support Services 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 12 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. 12. 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 Mental Health and Support Services 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. Stuffings 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. 13. On a monthly basis, the Contractor will notify the Mental Health and Support Services Team (HS-CWServiceReferraldf weld.gov) 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. 14. 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 9 of this Exhibit. 15. 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 13 Department by the Contractor prior to the start of any Agreement. 16. 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. 17. 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. 18. 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 to 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 EXHIBIT B RATE SCHEDULE 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(s) specified below in Paragraph 2, Fees for Services. 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. For services funded through Core Services, Contractor agrees to accept reimbursement through ACH direct deposit one time per month. 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, deposit slip or bank letter. Failure to complete and submit this form and voided check in a timely and accurate manner may result in a delay of payment. For services not funded through Core Services; Contractor agrees to accept payment through County Warrant when funding source does not allow for direct deposit. 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 Program Area Da merit Rate 'S i0 Unit Type Service Name Month Da Tr, 300.00 Month Day Treatment Mileage: Transportation for distances exceeding 60 roundtrip miles from 10 Farragut Avenue, Colorado Springs, Colorado 80909 foster Care/Adoption Support 0i 30.00 our Each Foster Parent Education: In-office/ViA Foster Parent Education: No Show (Max of 2 no shows or 2 hours/month/client) Faster Parent Education: In -Home or Common 200 35.00 d Hour Foster Parent Education Family: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing ha or Coaching: In -Home or $ 85.00 Hour Mentoring/Behavior Coaching: In-OfficeNideo Behavior Coaching: In -Off ion*' 115.00 Hour Hour Family Preservation: In -Home or Community s In -Office Life Skills $ 115.00 100.00 Hour Hour Therapeutic Visitation: In -Home or Community Therapeutic Visitation: In-OfficeNideo Program Area Unit Type Service Name Tram $ 105.00 Hour Supervised Visitation: In -Home or Community Supervlsed Visitation- In-OlSIceNideo $ 110.00 0.00 Hour Hour Supervised Visitation: In -Office with Transportation* Life Coin g Skills (LSPS): In -Home' or 85.00 Hour Life Skills - Parenting Skills (LSPS): In - Office Video 5. Life Skills - Parenting Skills (LSPS): with Transportation* Relinquishment Counseling: In -office Video Relinquishment Community Relinquishment Counseling: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing No Show (Maas of 2 no shows or 2 hours/month/client) Individual Therapy: In -Home or Community Relinquishment Counseling $ 125.00 25,00 75.00 Hour Hour -Horne 55.00 Each Mental Health Services $ 125.00 25.00 $ 125.00 Hour Hour Hour sdividual Therapy: In-OfficeNideo Family Therapy: In -Home or Community 25.00 45.00 00 Hour Hour y Therapy: -Office/Video Group Therapy: In -home or Community GroupTherapy:. In-Office/Video All Program Areas * For distances exceeding 60 roundtrip miles from contractor's office located at 71011th Avenue, #L-46, Greeley, Colorado 80631. $ 100.00 0,00 0.65 Hour Mile Therapeutic Intake: In -Home or Community (2 - hour Max) peutie lritakw In-Office/Video (2 -hour^ Mileage* 3. Request for Reimbursement and Supporting Documentation Contractor shall submit all Requests for Reimbursement and supporting documentation to the Department by the 7t° day of the month following the month of service, but no later than 45 days from the date of service for each client receiving ongoing services. 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. 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. Time(s) of service (i.e. 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. What interventions were used, recommendations and/or goals discussed, progressions towards goals, and client engagement. e. For mileage reimbursement, if applicable, the mileage accumulated minus roundtrip mileage that is included in the rate, starting location, and ending location. f. Any and all safety concerns. When submitting a Request for Reimbursement 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. Requests for Reimbursement and/or supporting documentation received after the 7th day of the month may delay payment. 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. 4. Payment 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: The service being provided by the contractor is not a Medicaid eligible service; a. The service is not deemed medically necessary; b. The Court with jurisdiction over the case has ordered that a non -Medicaid provider or service be used; c. A Medicaid provider is not available to provide the needed service; d. Medicaid is exhausted for the needed service; or e. Medicaid denied service. f. The client is not eligible for Medicaid. 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 Human Services shall be final. 5. 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: a. Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed. b. Deny payment or recover reimbursement for those services or deliverables, which have not been performed and which due to circumstances caused by 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. 6. 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. SIGNATURE REQUESTED: Weld/Griffith Centers Amendment #3 Final Audit Report 2023-11-10 Created: 2023-11-09 By: Windy Luna (wluna@co.weld.co.us) Status: Signed Transaction ID: CBJCHBCAABAAh_kgVmKEgNsJBbj-W5T8i9s9fbzcTWXB "SIGNATURE REQUESTED: Weld/Griffith Centers Amendment #3" History in Document created by Windy Luna (wluna@co.weld.co.us) 2023-11-09 - 6:46:08 PM GMT E Document emailed to esther.torrez@griffithcenters.org for signature 2023-11-09 - 6:47:25 PM GMT 5 Email viewed by esther.torrez@griffithcenters.org 2023-11-10 - 0:18:57 AM GMT da Signer esther.torrez@griffithcenters.org entered name at signing as Esther Torrez 2023-11-10 - 0:20:34 AM GMT er. Document e -signed by Esther Torrez (esther.torrez@griffithcenters.org) Signature Date: 2023-11-10 - 0:20:36 AM GMT - Time Source: server O Agreement completed. 2023-11-10 - 0:20:36 AM GMT Powered by Adobe Acrobat Sign tract Entity Information Entity Name" Entity ID" GRIFFITH CENTERS INC @00029886 Contract Name * Contract ID GRIFFITH CENTERS, INC. AMENDMENT #3 TO THE 7622 CHILD PROTECTION AGREEMENT (ADDING * RELINQUISHMENT COUNSELING) Contract Lead WLUNA Contract Status CTB REVIEW Q New Entity? Contract Lead Email wluna@weldgov.com;cob bxxlk@weldgov.com Parent Contract ID 20221594 Requires Board Approval YES Department Project # Contract Description * GRIFFITH CENTERS, INC. AMENDMENT #3 TO THE CHILD PROTECTION AGREEMENT (ADDING RELINQUISHMENT COUNSELING). TERM: NOVEMBER 1, 2023 THROUGH MAY 31 ,2024. Contract Description 2 PA ROUTING THROUGH NORMAL PROCESS ETA TO CTB 1 1 /16/23. Contract Type AMENDMENT Amount* $0.00 Renewable NO Automatic Renewal Grant IGA Department Requested BOCC Agenda Due Date HUMAN SERVICES Date* 11/18/2023 11/22/2023 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 Termination Notice Period Contact Information Review Date 03/29/2024 Committed Delivery Date Renewal Date Expiration Date" 05/31/2024 Contact Info Contact Name Contact Type Contact Email Contact Phone 1 Contact Phone 2 Purchasing Purchasing Approver Purchasing Approved Date Approval Process Department Head Finance Approver Legal Counsel JAMIE ULRICH CHERYL PATTELLI BYRON HOWELL DH Approved Date Finance Approved Date Legal Counsel Approved Date 11/13/2023 11/14/2023 11/14/2023 Final Approval BOCC Approved Tyler Ref # AG 112023 BOCC Signed Date Originator WLUNA BOCC Agenda Date 11/20/2023 Cun�vQCf It 7v4Lt cbn1+ W l'P/ 23 PRIVILEGED AND CONFIDENTIAL MEMORANaUM DATE: June 5, 2023 TO: Board of County Commissioners — Pass -Around FR: Jamie Ulrich, Director, Human Services RE: Amendment #2 with Griffith Centers, Inc. 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 Amendment #2 with Griffith Centers, Inc. The Department entered into an Agreement with Griffith Centers for Children, Inc. for Day Treatment, Foster Care/Adoption Support, Home -Based Intervention, Life Skills, and Mental Health Services. This agreement is known as Tyler ID# 2022-1594. On April 6, 2023, the Griffith Centers for Children, Inc. successfully filed paperwork with the Department of the Treasury, Internal Revenue Service, for a name change to Griffith Centers, Inc. The Department is requesting to amend the current contract to reflect the change from Griffith Centers for Children, Inc. to Griffith Centers, Inc. I do not recommend a Work Session. I recommend approval of this Amendment #2 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; June 5, 2023 � �� Page l , Wrni-A,23 2°22,- t594 FIrzoc4 AGREEMENT AMENDMENT BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND GRIFFITH CENTERS, INC. This Agreement Amendment, made and entered into IRS, day of J(AyILQ.. , 2023 by and between the Board of Weld County Commissioners, on behalf of the Weld County Department of Human Services, hereinafter referred to as the "Department", and Griffith Centers, Inc., hereinafter referred to as the "Contractor". WHEREAS the parties entered into an Agreement for Day Treatment, Foster Care/Adoption Support, Home -Based Intervention, Life Skills, and Mental Health Services, (the "Original Agreement") identified by the Weld County Clerk to the Board of County Commissioners as document No. 2022-1594, approved on June 8. 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: • June 8, 2022 to extend the term date through May 31, 2023, to amend Exhibit A, Scope of Services, and Exhibit B, Rate Schedule. • May 8, 2023 to extend the term date through May 31, 2024, to amend Exhibit A, Scope of Services, and Exhibit B, Rate Schedule. • The Amendments are identified by the Weld County Clerk to the Board of County Commissioners as document number 2022-1594. These Amendments, together with the Original Agreement, constitutes the entire understanding between the parties. The following additional changes are hereby made to the current Agreement 1. On April 6, 2023, Griffith Centers for Children, Inc. successfully filed paperwork with the Internal Revenue Service for a legal name change. This contract is now amended to reflect that change from Griffith Centers for Children, Inc. to Griffith Centers, Inc. The County agrees to issue payment to the Griffith Centers, Inc. for services rendered and Griffith Centers, Inc. agrees to provide updated paperwork reflecting this change including proof of insurance. 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;, ATTEST: BY: BOARD OF COUNTY COMMISSIONERS rk to the Boa WELD COUNTY, COLORADO Deputy Cleft 1861 ike Freeman, Chair JUN 1 4 2023 NTRACTOR: riffith Centers, Inc. 10190 Bannock Street, Suite 120 Northglenn, Colorado 80260 Esther To`-ez By: Esther Torrez tM ay 29, 2023 20:44 MDT) Esther Torrez, Controller May 29, 2023 Date: o2aoza -- /5'94- SIGNATURE REQUESTED: Weld/Griffith Centers Inc. Amend #3 (name change) Final Audit Report 2023-05-30 Created: 2023-05-22 By: Windy Luna (wluna@co.weld.co.us) Status: Signed Transaction ID: CBJCHBCAABAAECdIsSN_DsC7BF68TouVm8DmxNjLTeVH "SIGNATURE REQUESTED: Weld/Griffith Centers Inc. Amend #3 (name change)" History t Document created by Windy Luna (wluna@co.weld.co.us) 2023-05-22 - 8:01:31 PM GMT P. Document emailed to esther.torrez@griffithcenters.org for signature 2023-05-22 - 8:02:11 PM GMT .5 Email viewed by esther.torrez@griffithcenters.org 2023-05-30 - 2:44:02 AM GMT 5p Signer esther.torrez@griffithcenters.org entered name at signing as Esther Torrez 2023-05-30 - 2:44:41 AM GMT Oe Document e -signed by Esther Torrez (esther.torrez@griffithcenters.org) Signature Date: 2023-05-30 - 2:44:43 AM GMT - Time Source: server 0 Agreement completed. 2023-05-30 - 2:44:43 AM GMT Powered by Adobe Acrobat Sign Contract Form New Contract Request Entity Information Entity Name* Entity ID. GRIFFITH CENTERS FOR CHILDREN INC #00029886 Contract Name. GRIFFITH CENTERS, INC. (AMENDMENT Y2 NAME CHANGE) Contract Status CTB REVIEW ❑ New Entity? Contract ID 7044 Contract Lead* WLIJNA Contract Lead Email wluna.0weldgov.com;cobbx xlk#;weldgov.com Parent Contract ID 20221594 Requires Board Approval YES Department Project # Contract Description* GRIFFITH CENTERS, INC. AMENDMENT #2 NAME CHANGE 05:'0812023 THROUGH 05 31 2024. Contract Description 2 PA ROUTING THROUGH NORMAL PROCESS. ETA TO CTB 06 2023. Contract Type* AMENDMENT Amount $0.00 Renewable. YES Automatic Renewal Grant IGA Department HUMAN SERVICES Department Email CM - H u manService soweldgov. co rrr Department Head Email CM-HumanServices- DeptHead@weldgov.com County Attorney GENERAL COUNTY ATTORNEY EMAIL County Attorney Email CM- COUNTYATTORNEY#WELDG OV.COM Requested BOCC Agenda Date 06 1412023 Due Date 06 10 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 Ontase Contract Dates Effective Date Review Date* 03/29/2024 Renewal Date* 0601/2024 Termination Notice Period Contact Information Contact Info Contact Name Purchasing Committed Delivery Date Expiration Date Contact Type Contact Email Contact Phone 1 Contact Phone 2 Purchasing Approver Purchasing Approved Date Approval Process Department Head JAMIE ULRICH DH Approved Date 05,`30'2023 Final Approval ROCC Approved ROCC Signed Date MCC Agenda Date 06114,'2023 Originator WLLRNA Finance Approver CHERYL PATTELLI Legal Counsel BYRON HOWELL Finance Approved Date Legal Counsel Approved Date 05/30/2023 05,'30 '2023 Tyler Ref AG 061423 Con-'vci& 1.1*(Fl I iv PRIVILEGED AND CONFIDENTIAL MEMORANDUM DATE: May 2, 2023 TO: Board of County Commissioners — Pass -Around FR: Jamie Ulrich, Director, Human Services RE: Agreement Amendment #1 with Griffith Centers for Children, Inc. 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 Agreement Amendment #1 with Griffith Centers for Children, Inc. The Department has an Agreement with Griffith Centers for Children, Inc. for Day Treatment, Foster Care/Adoption Support, Home -Base Intervention, Life Skills, and Mental Health Services. This Agreement is known to the Board as Tyler ID# 2022-1594. The agreement is now being amended to renew for a second year, for the period June 1, 2023 through May 31, 2024, and to make changes to the Scope of Services and Rate Schedule as noted below. The Human Services Advisory Commission (HSAC) has reviewed and approved this information. Scope of Services Changes: • Updates to the terms as requested by the Department. Rate Schedule Changes: • Updates to the terms as requested by the Department. • Updates to the rates as requested by the Contractor. Rate changes are noted below. Day Treatment Services $1,648.00 Month Day Treatment $300.00 Month Day Treatment Mileage: Transportation for distances exceeding 60 roundtrip miles born 10 Farragut Avenue, Colorado Springs, Colorado 80909 Foster Care/Adoption Support $64.00 Hour Foster Parent Education: In-office/Video $30.00 Each Foster Parent Education: No Show (Max of 2 no shows or 2 hours/month/client) $92.00 Hour Foster Parent Education: In -Home or Community $35.00 Hour Foster Parent Education Family: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing Home -Based Intervention $90.00 Hour Mentoring/Behavior Coaching: In -Home or Community $85.00 Hour Mentoring/Behavior Coaching: In- Office/Video $100.00 Hour Mentoring/Behavior Coaching: In -Office with Transportation' Pass -Around Memorandum; May 2, 2023MS I��„� CbnV" PICPriCk 05/ 01VM Page 1 7,022.-1594 PRIVILEGED AND CONFIDENTIAL Home -Based Intervention $115.00 unit Hour Family Preservation: In -Home or Community $100.00 Hour Family Preservation: In-OfficeNideo Life Skills $115.00 Hour Therapeutic Visitation: In -Home or Community $100.00 Hour Therapeutic Visitation: In-Office/Video $120.00 Hour Therapeutic Visitation: In -Office with Transportation* $105.00 Hour Supervised Visitation: In -Home or Community $95.00 Hour Supervised Visitation: In-OffrceNideo $110.00 Hour Supervised Visitation: In -Office with Transportation $100.00 Hour Life Skills - Parenting Skills (LSPS): In - Home or Community $85.00 Hour Life Skills - Parenting Skills (LSPS): In- Office/Video $105.00 Hour Life Skills - Parenting Skills (LSPS): In - Office with Transportation. Mental Health Services $125.00 Hour Individual Therapy: In -Home or Community $125.00 Hour Individual Therapy: In-OffrceNideo $ I25.00 Hour Family Therapy: In -Home or Community $125.00 Hour Family Therapy: In-OfficeNideo $45.00 Hour Group Therapy: In -home or Community $45.00 Hour Group Therapy: In-OfficeNideo $100.00 Hour Therapeutic Intake: In -Home or Community (2 hour ax) $90.00 Hour Therapeutic Intake: In-Office/Video (2 hour Max) AL Program Areas $75.00 Hour Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $55.00 Each No Show (Max of 2 no shows or 2 hours/month/client) 50.65 Mile Mileage' I do not recommend a Work Session. I recommend approval of this Agreement Amendment #I and authorize the Chair to sign. Aonrove Perry L. Buck Pm-Tem Mike Freeman, Chair Scott K. James Kevin Ross Lori Saine chedule. Work Session Other/Comments: Pass -Around Memorandum; May 2, 2023 — CMS ID 6916 Page 2 AGREEMENT AMENDMENT BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND GRIFFITH CENTERS FOR CHILDREN, INC. p This Agreement Amendment, made and entered into O A41 day of , 2023, by and between the Board of Weld County Commissioners, on behalf of the Weld County Department of Human Services, hereirter referred to as the "Department", and Griffith Centers for Children, Inc., hereinafter referred to as the "Contractor". WHEREAS the parties entered into an Agreement for Day Treatment, Foster Care/Adoption Support, Home -Based Intervention, Life Skills, and Mental Health Services, (the "Original Agreement") identified by the Weld County Clerk to the Board of County Commissioners as document No. 2022-1594, approved on June 8, 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 Child Protection Agreement as of June 1, 2023: 1. Term This Agreement is being renewed for the second year, for the period of June 1, 2023 through May 31, 2024. 2. Exhibit A, Scope of Services, 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: BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO MAY 0 8 2323 fah Centers for Children, Inc. 0190 Bannock Street, Suite 120 Northglenn, Colorado 80260 (303) 237- 865 ust ei-Ton-ez By: Esther Torrez (Apr 21, 202314:36 MDT) Esther Torrez, Controller Date: Apr 21, 2023 oLOpW - /.5#- EXHIBIT A SCOPE OF SERVICES Contractor wi I provide Day Treatment, Foster Care/Adoption Support, Home -Based Intervention, Life Skills, and Mental Health Services, as referred by the Department. Program Area thy Treatment 1. Day Treatment a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Day Treatment. ii. Individual Therapy. iii. Family Therapy. iv. Education Services. b. Anticipated Frequency of Services: i. As needed/daily. Anticipated Duration of Services: i. As needed. d. Goals of Services: i. Increase independent living skills. ii. Increase social skills. iii. Manage mental health. iv. Goals can be adjusted and individualized to each client. Outcomes of Services: i. Increase independent living skills. ii. Increase social skills. iii. Manage mental health. f. Target Population: i. Grades three (3) to twelve (12). g. Language: i. English. b. Medicaid Eligibility: i. This service is partially Medicaid eligible. it Service Access and Transportation: i. Colorado Springs Day Treatment Program located at 10 Farragut Avenue, Colorado Springs, Colorado 80909. Program Area: Foster Care/Adoption Support 1. Foster Parent Education a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psychoeducation. ii. Modeling. iii. In -vivo feedback. 1 iv. Nurturing Parenting Program. v. Therapeutic interventions. b. Anticipated Frequency of Services: i. As needed. c. Anticipated Duration of Services: i. As needed. d. Goals of Services: i. Increased knowledge of parenting skills. ii. Increased knowledge of child mental health and wellness. iii. Increase knowledge of attachment. iv. Increase knowledge of trauma. e. Outcomes of Services: i. Increased use of learned parenting skills. ii. Increased ability of foster parent to provide emotionally for child. iii. Increased ability of foster parent to address behavioral or mental health concerns of foster children. £ Target Population: i. Foster Parents. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In contractor's office at 710 11th Avenue, #L-46, Greeley, Colorado 80631, in - community, or in -home. Program Area: Home -Based Intervention 1. Mentoring/Behavior Coaching a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psychoeducation. ii. Modeling. iii. In -vivo feedback. iv. Mentoring. b. Anticipated Frequency of Services: i. Two (2) to four (4) hours per week. c. Anticipated Duration of Services: i. Four (4) to six (6) months. d. Goals of Services: i. Increased social skills. ii. Address truancy or school/education concerns. iii. Increase job readiness. iv. Overcome barriers to other treatment. 2 v. Community Integration. e. Outcomes of Services: i. Increased use of social skills. ii. Increased use of community resources. iii. Obtaining employment (if appropriate). iv. Increased school attendance. v. Increased participation in other mental health or social services. f. Target Population: i. Youth ages six (6) and older, young adults, and adults. g. Language: i. English. I. Medicaid Eligibility: i. This service is Medicaid eligible. I. Service Access and Transportation: i. In contractor's office at 710 11`h Avenue, #L-46, Greeley, Colorado 80631, in - community, or in -home. 2. Famly ?reservation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Individual therapy. ii. Family therapy. iii. Behavior coaching/mentoring. iv. Life skills. v. Parenting skills. vi. A combination of services designed to maintain placement, prevent removal, and/or assist with family cohesion post -reunification. b. Anticipated Frequency of Services: i. One (1) to four (4) hours per week. c. Anticipated Duration of Services: i. Six (6) to twelve (12) months. d. Goals of Services: i. Increase family skills such as coping and communication. ii. Increase understanding and awareness of community resources. iii. Address concerns around safety. iv. Address concerns in family functioning. v. Goals can be adjusted to meet family needs. a. Outcomes of Services: i. Increase use of learned skills to decrease concerns in family functioning. ii. Decrease safety concerns. iii. Increase use of appropriate community supports. Target Population: i. Families who have active Department involvement and are at risk of having children removed, have had children removed, or have children who have recently reunified with the family. 3 g. Language: i. English. h. Medicaid Eligibility: i. Medicaid eligible, up to a specific number of hours per week. Service Access and Transportation: i. In contractor's office at 710 11'h Avenue, #L-46, Greeley, Colorado 80631, in - community, or in -home. Program Area: Life Skills 1. Therapeutic Visitation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psychoeducation. ii. Modeling. iii. In -vivo feedback. iv. Nurturing Parenting Program. v. Therapeutic interventions. vi. Service provided by a master's level intern or above. b. Anticipated Frequency of Services: i. As ordered by court order or Department requirements. c. Anticipated Duration of Services: i. As ordered by court order or Department requirements. d. Goals of Services: i. Increased knowledge of parenting skills. ii. Increased ability of parent to provide emotionally for child. iii. Increased ability of parent to provide physically for child. iv. Increased observed markers of healthy attachment. e. Outcomes of Services: i. Increased use of learned parenting skills. ii. Increased ability of parent to provide emotionally for child. iii. Increased ability of parent to provide physically for child. iv. Increased observed markers of healthy attachment. Target Population: i. Parents and children who have been removed from their parent's care. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In contractor's office at 710 11:h Avenue, #L-46, Greeley, Colorado 80631, in - community, or in -home. 4 2. Supe-vised Visitation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psychoeducation. ii. Modeling. iii. In -vivo feedback. iv. Nurturing Parenting Program. v. Service provided by a Bachelor's level intern or above. h Anticipated Frequency of Services: i. As ordered by court order or Department requirements. e. Anticipated Duration of Services: i. As ordered by court order or Department requirements. 1 Goals of Services: i. Increased knowledge of parenting skills. ii. Increased ability of parent to provide emotionally for child. iii. Increased ability of parent to provide physically for child. iv. Increased observed markers of healthy attachment. c Outcomes of Services: i. Increased use of learned parenting skills. ii. Increased ability of parent to provide emotionally for child. iii. Increased ability of parent to provide physically for child. iv. Increased observed markers of healthy attachment. f. Target Population: i. Parents and children who have been removed from their parent's care. g. Language: i. English. k. Medicaid Eligibility: i. This service is not Medicaid eligible. i Service Access and Transportation: i. In contractor's office at 710 1 1 th Avenue, #L-46, Greeley, Colorado 80631, in - community, or in -home. 3. Life Skills — Parenting Skills (LSPS) z Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psychoeducation. ii. Modeling. iii. In -vivo feedback. iv. Nurturing Parenting Program. b. Anticipated Frequency of Services: i. Three (3) hours per week. c- Anticipated Duration of Services: i. Three (3) to four (4) months. d. Goals of Services: 5 i. Increased knowledge of parenting skills. ii. Increased use of parenting skills. iii. Increased understanding of child development. e. Outcomes of Services: i. Increased knowledge of parenting skills. ii. Increased use of parenting skills. iii. Increased understanding of child development. f. Target Population: i. Parents. g. Language: i. English. h. Medicaid Eligibility: i. Some parent education can be completed through Medicaid funded parenting groups or family therapy if available. i. Service Access and Transportation: i. In contractor's office at 710 11th Avenue, #L-46, Greeley, Colorado 80631 or in - community. Program Area: Mental Health Services 1. Individual Therapy a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psychoeducation. ii. Cognitive Behavioral Therapy. iii. Trauma -Focused Cognitive Behavioral Therapy (TF-CBT). iv. Motivational Interviewing. v. Reboot Educational Learning Opportunities Affecting Direction (RELOAD)/Truancy Services vi. Other miscellaneous evidenced based therapeutic interventions. b. Anticipated Frequency of Services: i. One (1) to two (2) hours per week. c. Anticipated Duration of Services: i. Six (6) to twelve (12) months. d. Goals of Services: i. Increase emotional awareness. ii. Increase emotion regulation skills. iii. Increase mental wellness and functioning. iv. Increased coping skills. v. Process trauma. e. Outcomes of Services: i. Clients will report increased self-awareness. ii. Clients will utilize skills learned. iii. Clients will increase in positive functioning. iv. Client's will increase school attendance. 6 f. Target Population: i. Children ages four (4) and older, youth, and adults. g. Language: i. English. ii. Spanish may be available in some cases. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. In contractor's office at 710 11`h Avenue, #L-46, Greeley, Colorado 80631, in - community, telehealth, or in -home. 2. Family Therapy a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psychoeducation. ii. Miscellaneous Therapeutic Interventions. b. Anticipated Frequency of Services: i. One (1) hour per week. c. Anticipated Duration of Services: i. Six (6) to twelve (12) months. d. Goals of Services: i. Increased communication skills. ii. Increased family functioning. iii. Increased understanding and awareness of family patterns and impact of patterns on system. e. Outcomes of Services: i. Clients and family members will increase ability to positively communicate. ii. Clients and family members will utilize learned skills to address any deficits in family functioning. iii. Clients and family members will utilize skills to create positive change in family system. L Target Population: i. Siblings, couples, and families. g. Language: i. English. ii. Spanish may be available in some cases. 1. Medicaid Eligibility: i. This service is Medicaid eligible. it. Service Access and Transportation: i. In contractor's office at 710 11`h Avenue, #L-46, Greeley, Colorado 80631, in - community, telehealth, or in -home. 3. Group 'Therapy a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: 7 i. Psychoeducation. ii. Cognitive Behavioral Therapy. iii. Miscellaneous Group Therapy Interventions. b. Anticipated Frequency of Services: i. One and a half (1.5) to two (2) hours per week. c. Anticipated Duration of Services: i. Three (3) to four (4) months. d. Goals of Services: i. Increased knowledge of information specific to group. ii. Increased coping skills. iii. Increased feelings of support. e. Outcomes of Services: i. Clients will utilize knowledge learned and apply to specific areas of life. ii. Clients will increase their coping skills. iii. Clients will report increased feelings of support. f. Target Population: i. Dependent on the type of group: children, youth, adults, or parents. g. Language: i. English. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. In contractor's office at 710 11th Avenue, #L-46, Greeley, Colorado 80631 or telehealth. 4. Therapeutic Intake a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Service is required for all Core -funded therapy clients. b. Anticipated Frequency of Services: i. Two (2) hours. c. Anticipated Duration of Services: i. One (1) time only. d. Goals of Services: i. Assess mental health needs. ii. Create a treatment plan. iii. Assess for other social needs. e. Outcomes of Services: i. Creation of a treatment plan. ii. Signature of legally required documentation for mental health services. iii. Recommendations for treatment. f. Target Population: i. Ages four (4) and older who intend on enrolling in therapy services. 8 g. Language: i. English. ii. Spanish may be available in some cases. h_ Medicaid Eligibility: i. This service is Medicaid eligible. Service Access and Transportation: i. In contractor's office at 710 11° Avenue, #L-46, Greeley, Colorado 80631, in - community, telehealth, or in -home. Terms 1. 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 2. 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. 3. Contractor will respond to the Mental Health and Support Services Team CWSerwriceReferral(afweldgov.com within three (3) business days regarding the ability to accept the received referral. 4. Upor 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, Ile Contractor will notify the caseworker and the Mental Health and Support Services Team (HS- CW SeririceReferral(a,weldgov.com). 5. Contractor acknowledges that any and all modifications to an existing referral must be approved through the Mental Health and Support Services Team (HS-CWServiceReferral(aweldgov.com). No other Department staff or other party to the case may authorize services or modifications to services. 6. Contractor understands that "no shows" are defined as unexcused and unplanned/uncommunicated abseaces 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 mustinfcrm the caseworker and the Mental Health and Support Services Team (HS- CW4erviceReferral(u,weldgov.com) within three (3) days of when the client is placed on a behavioral plan Dr discharged 7. Contractor understands that the Department will not reimburse Contractor for cancelled appointments eithe on the part of the client or the Contractor. If the cancellation is generated from the Contractor, a 9 "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 Mental Health and Support Services Tents (HS-CWServiceReferral(&weldgov.com) immediately via email, to discuss service continuation. 8. 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. 9. 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. 10. 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 Mental Health and Support Services Team (HS-CWServiceReferral(arweldgov.com) immediately AND on the required monthly report. 11. Contractor agrees any change to an existing referral must be pre -approved through the Child Welfare Core Service Coordinator or any member of the Mental Health and Support Services 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. 12. Contractor agrees to attend meetings when available and as requested by the Department. Such meetings include Court Facilitations, Bid Meetings, Professional Staffmgs, 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 Mental Health and Support Services 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. Stuffings 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. 13. On a monthly basis, the Contractor will notify the Mental Health and Support Services Team (HS- CWServiceReferral(&,,weldgov.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. 14. Compliance with Child and Family Services Review The Child and Family Services Review (CFSR) examines child welfare service outcomes in three areas; 10 Safety, Permanency and Well Being of families. For each outcome, data and performance indicators measu re:each state's performance according to national standards and monitor progress over time. Followits the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance services o families. Contacto 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 Cai11 and Family Services Review (CFSR), and will address the aforementioned three areas when compietmg monthly reports as required by Paragraph 9 of this Exhibit. 15. Certiicaion Contnctr 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 flgrnement. Copies of all necessary licenses shall be provided to the Department by the Contractor prior to fie start of any Agreement. 16. Trairii€ Contractor may be required to attend training at the request of the Department specific to services provided under thr s Agreement. The Department will not compensate the Contractor for said training in the form of registraton fees, time spent traveling to and from training, attending the training or any other associated costs uness otherwise agreed to by the Department. 17. Subpoenas Contractor will, on behalf of its employees and/or officers, accept any subpoena for testimony from the Weld Cr unty Attorney's Office by e-mail and will return a waiver of services within 72 business hours. For this Jurpose, 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 Wel. County Attorney's Office immediately at (970) 336-7235 and advise that the subpoena must be personaly served. 18. Monhorng 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. Contrarcar will collaborate in a timely manner with the Department to resolve issues pertaining to service delivnryF service quality, documentation, and invoicing during referral period and after services have conckrd rd. The Contractor will require clients to sign releases of information. Contractor understands that the Ccpc.rtment will not reimburse for services rendered to Department clients until releases of information are o 'tared. Contracar 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 nay, 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 purpose' of monitoring. All such monitoring shall be performed in a manner that will not unduly interfere with the work conducted under this Agreement 11 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(s) specified below in Paragraph 2, Fees for Services. 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. For services funded through Core Services, Contractor agrees to accept reimbursement through ACH direct deposit one time per month. 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, deposit slip or bank letter. Failure to complete and submit this form and voided check in a timely and accurate manner may result in a delay of payment. For services not funded through Core Services; Contractor agrees to accept payment through County Warrant when funding source does not allow for direct deposit. 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 Program Area Day Treatment Services Rate $1,648.00 Knit Type Month ,err ice Name Day Treatment $300.00 Month Day Treatment Mileage: Transportation for distances exceeding 60 roundtrip miles from 10 Farragut Avenue, Colorado Springs, Colorado 80909 Foster Care/Adoption Support $64.00 Hour Foster Parent Education: In-officeNideo $30.00 Each Foster Parent Education: No Show (Max of 2 no shows or 2 hours/month/client) $92.00 Hour Foster Parent Education: In -Home or Community $35.00 Hour Foster Parent Education Family: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing Home -Based Intervention $90.00 Hour MentoringBehavior Coaching: In -Home or Community $85.00 Hour Mentoring/Behavior Coaching: In- Office/Video $100:00 Hour MentoringBehavior Coaching: In -Office with Transportation* $115.00 Hour Family Preservation: In -Home or Community $100.00 Hour Family Preservation: In-OfficeNideo Life Skills $115.00 Hour Therapeutic Visitation: In -Home or Community Program Area Life Wills Rate $100.00 lnit Ty pe Hour Service Name Therapeutic Visitation: In-OfficeNideo $120.00 Hour Therapeutic Visitation: In -Office with Transportation* $105.00 Hour Supervised Visitation: In -Home or Community $95.00 Hour Supervised Visitation: In-OfficeNideo $110.00 Hour Supervised Visitation: In -Office with Transportation* $100.00 Hour Life Skills - Parenting Skills (LSPS): In - Home or Community $85.00 Hour Life Skills - Parenting Skills (LSPS): In- OfficeNideo $105.00 Hour Life Skills - Parenting Skills (LSPS): In - Office with Transportation* Mental Health Services $125.00 Hour Individual Therapy: In -Home or Community $125.00 Hour Individual Therapy: In-OfficeNideo $125.00 Hour Family Therapy: In -Home or Community $125.00 Hour Family Therapy: In-OfficeNideo $45.00 Hour Group Therapy: In -home or Community $45.00 Hour Group Therapy: In-Office/Video $100.00 Hour Therapeutic Intake: In -Home or Community (2 hour Max) $90.00 Hour Therapeutic Intake: In-OfficeNideo (2 hour Max) AN Pagram Areas $75.00 Hour Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional; Staffing $55.00 Each No Show (Max of 2 no shows or 2 hours/month/client) $0.65 Mile Mileage* * For distances exceeding 60 roundtrip miles from 710 11th Avenue, #L-46, Greeley, Colorado 80631 3. Request for Reimbursement and Supporting Documentation Contractor shall submit all Requests for Reimbursement and supporting documentation to the Department by the 7' day of the month following the month of service, but no later than 45 days from the date of service For each client receiving ongoing services. 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. 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 dam of service: a. Time(s) of service (i.e. 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. What interventions were used, recommendations and/or goals discussed, progressions towards goals, and client engagement. e. For mileage reimbursement, if applicable, the mileage accumulated minus roundtrip mileage that is included in the rate, starting location, and ending location. f. Any and all safety concerns. When submitting a Request for Reimbursement 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. Requests for Reimbursement and/or supporting documentation received after the 7`h day of the month may delay payment. 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. 4. Payment 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: The service being provided by the contractor is not a Medicaid eligible service; a. The service is not deemed medically necessary; b. The Court with jurisdiction over the case has ordered that a non -Medicaid provider or service be used; c. A Medicaid provider is not available to provide the needed service; d. Medicaid is exhausted for the needed service; or e. Medicaid denied service. f. The client is not eligible for Medicaid. 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 Human Services shall be final. 5. 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: a. Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed. b. Deny payment or recover reimbursement for those services or deliverables, which have not been performed and which due to circumstances caused by 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 betweerrthe Department and Contractor, or by the Department as a debt due to the Department or otherwise as praveled by law. 6. Finarcim Management At all tines from the effective date of the Agreement until completion of the Agreement, Contractor shall comply avith the administrative requirements, cost principles and other requirements set forth in the Finarcid Management Manual adopted by the State of Colorado. The required annual audit of all funds expe.det under this Agreement must conform to the Single Audit Act of 1984 and OMB Circular A-133. SIGNATURE REQUESTED: Weld/Griffith Centers Amendment #1 - 2023-24 Final Audit Report 2023-04-21 Created: 2023-04-21 By: Lesley Cobb (cobbxxlk@co.weid.co.us) Status: Signed Transaction ID: CBJCHBCAABAAXSAsgVuyv26riWWGvPEwhWD-cCis_pBN "SIGNATURE REQUESTED: Weld/Griffith Centers Amendment #1 - 2023-24" History t Document created by Lesley Cobb (cobbxxlk@co.weld.co.us) 2023-04-21 - 5:44:47 PM GMT- IP address: 204.133.39.9 2. Document emailed to esther.torrez@griffithcenters.org for signature 2023-04-21 - 5:45:37 PM GMT 5 Email viewed by esther.torrez@griffithcenters.org 2023-04-21 - 8:35:57 PM GMT- IP address: 98.53.190.32 a© Signer esther.torrez@griffithcenters.org entered name at signing as Esther Torrez 2023-04-21 - 8:36:48 PM GMT- IP address: 98.53.190.32 d© Document e -signed by Esther Torrez (esther.torrez@griffithcenters.org) Signature Date: 2023-04-21 - 8:36:50 PM GMT - Time Source: server- IP address: 98.53.190.32 Agreement completed. 2023-04-21 - 8:36:50 PM GMT Names and email addresses are entered into the Acrobat Sign service by Acrobat Sign users and are unverified unless otherwise noted. Dowered by Adobe Acrobat Sign Contract Form New Contract Request Entity Information ❑ New Entity? Entity Name* Entity ID* GRIFFITH CENTERS FOR CHILDREN INC A00029886 Contract Name* GRIFFITH CENTERS FOR CHILDREN, INC (AGREEMENT AMENDMENT #1 PY 2023-24) Contract Status CTB REVIEW Contract ID 6916 Contract Lead* COBBXXLK Parent Contract ID 20221594 Requires Board Approval YES Contract Lead Email Department Project I cobbxxlkotco.weld.co.us Contract Description * BID# 8220©040. MINOR SCOPE, RATE AND TERM CHANGES. TERM 6 1 23-5 31 24. Contract Description 2 CONSENT: PA ROUTING THROUGH NORMAL APPROVAL PROCESS. ETA TO CTB 05 04 2023. Contract Type* AMENDMENT Amount* $0.00 Renewable* NO Automatic Renewal Grant Department HUMAN SERVICES Department Email CM- HumanServices.Yweldgov.co m Department Head Email CM-HumanServices- DeptHead roeldgov.com County Attorney GENERAL COUNTY ATTORNEY EMAIL County Attorney Email CM- COU NTYATTORN EYWWELDG OV.COM Requested BOCC Agenda Date* 05 10, 2023 Due Date 05?06:2023 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 FSA 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,'29,`2024 Termination Notice Period Committed Delivery Date Expiration Date r 05'31x'2024 Contact Information Contact Info Contact Name Purchasing Purchasing Approver CONSENT Approval Process Department Head JAMIE ULRICH DH Approved Date 04'28;2023 Final Approval BOCC Approved BOCC Signed Date BOCC Agenda Date 05 08 2023 Originator CO08XXLK Contact Type Contact Email Finance Approver CONSENT Contact Phone 1 Contact Phone 2 Purchasing Approved Date 04 28 2023 Legal Counsel CONSENT Finance Approved Date Legal Counsel Approved Date 04128. 2023 Tyler Ref # AG 050823 04 28.2023 e�4'vacf 119.0 5927 CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND GRIFFITH CENTERS FOR CHILDREN, INC Q This Agreement, made and entered into the Oril day of J(,(.,` to , 2022, by and between the Board of Weld County Commissioners, on behalf of the Weld County Department of Human Services, hereinafter referred to as the "Department" and Griffith Centers for Children, Inc, 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 C is 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 Day Treatment, Foster Care/Adoption Support, Home -Based Intervention, Life Skills, and Mental Health Services. 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(a weldgov.com). No other Department staff or other party to the case may authorize services or modifications to services. 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 Conte+of.r)c19, own/ z2. ec:a6,44-€4/5-9 6/1lza 2022-1594 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 Human Services shall be final. 2 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. sec ., and its implementing regulation, 45 C.F.R. Part 80 et. se�C .; 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. sec . 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 and the Department within three (3) days that Contractor has actual knowledge that a subcontractor is 4 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 Contractor's business, at its own expense, and maintain for the duration of the work, insurance coverage 5 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 my 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; Waiver of exclusion for lawsuits by one insured against another; 6 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 For the purpose of this Agreement, the individuals identified below are hereby designated representatives 8 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 Lisa Lamoreaux, Director of Community Programs 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: Lisa Lamoreaux, Director of Community Programs 10190 Bannock Street, Suite 120 Northglenn, Colorado 80260 (303) 237-6865 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. sea. 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 or decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The 9 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 Protection. No information about or obtained from any applicant/recipient in possession of Contractor shall 10 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 The Contractor warrants that services performed under this Agreement will be performed in a manner 11 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. $524-18-201 et seq. and X24-50-507 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: daft& v• "Cf�� By: BOARD OF COUNTY COMMISSIONERS County Clerk to the oard WELD COUNTY, COLORADO Deputy Clerk/ the B. and �9 I 13 rov1/4s411,,17. Mike Freeman, Pro-Tem JUN 0 8 2022 .ONTRACTOR: Griffith Centers for Children, Inc 10190 Bannock Street, Suite 120 Northglenn, Colorado 80260 (303) 237-6865 .Aria zda. Daum 7114 Liae By: Amanda Dunn, Northern Program Supervisor Date: May 27, 2022 EXHIBIT A SCOPE OF SERVICES Contractor will provide Day Treatment, Foster Care/Adoption Support, Home -Based Intervention, Life Skills, and Mental Health Services, as referred by the Department. Program Area: Day Treatment 1. Day Treatment a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Day Treatment ii. Individual Therapy iii. Family Therapy iv. Education Services b. Anticipated Frequency of Services: i. As needed/daily. c. Anticipated Duration of Services: i. As needed. d. Goals of Services: i. Increase independent living skills. ii. Increase social skills. iii. Manage mental health. iv. Goals can be adjusted and individualized to each client. e. Outcomes of Services: i. Increase independent living skills. ii. Increase social skills. iii. Manage mental health. f. Target Population: i. Grades three (3) to twelve (12). g. Language: i. English. h. Medicaid Eligibility: i. This service is partially Medicaid eligible. i. Service Access and Transportation: i. Colorado Springs Day Treatment Program located at 10 Farragut Avenue, Colorado Springs, Colorado 80909 Program Area: Foster Care/Adoption Support 1. Foster Parent Education a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psycho -education ii. Modeling iii. In -vivo feedback 1 iv. Nurturing Parenting Program v. Therapeutic interventions b. Anticipated Frequency of Services: i. As needed. c. Anticipated Duration of Services: i. As needed. d. Goals of Services: i. Increased knowledge of parenting skills. ii. Increased knowledge of child mental health and wellness. iii. Increase knowledge of attachment. iv. Increase knowledge of trauma. e. Outcomes of Services: i. Increased use of learned parenting skills. ii. Increased ability of foster parent to provide emotionally for child. iii. Increased ability of foster parent to address behavioral or mental health concerns of foster children. f. Target Population: i. Foster Parents. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In contractor's office at 710 11. Avenue, #L-46, Greeley, Colorado 80631, in - community, or in -home. Program Area: Home -Based Intervention 1. Mentoring/Behavior Coaching a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psycho -education. ii. Modeling. iii. In -vivo feedback. iv. Mentoring. b. Anticipated Frequency of Services: i. Two (2) to four (4) hours per week. c. Anticipated Duration of Services: i. Four (4) to six (6) months. d. Goals of Services: i. Increased social skills. ii. Address truancy or school/education concerns. iii. Increase job readiness. iv. Overcome barriers to other treatment. 2 v. Community Integration. e. Outcomes of Services: i. Increased use of social skills. ii. Increased use of community resources. iii. Obtaining employment (if appropriate). iv. Increased school attendance. v. Increased participation in other mental health or social services. f. Target Population: i. Youth ages six (6) and older, young adults, and adults. g. Language: i. English. h. Medicaid Eligibility: i. This service is Medicaid eligible. Service Access and Transportation: i. In contractor's office at 710 11. Avenue, #L-46, Greeley, Colorado 80631, in - community, or in -home. 2. Family Preservation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Individual therapy. ii. Family therapy. iii. Behavior coaching/mentoring. iv. Life skills. v. Parenting skills. vi. A combination of services designed to maintain placement, prevent removal, and/or assist with family cohesion post -reunification. b. Anticipated Frequency of Services: i. One (1) to four (4) hours per week. c. Anticipated Duration of Services: i. Six (6) to twelve (12) months. d. Goals of Services: i. Increase family skills such as coping and communication. ii. Increase understanding and awareness of community resources. iii. Address concerns around safety. iv. Address concerns in family functioning. v. Goals can be adjusted to meet family needs. e. Outcomes of Services: i. Increase use of learned skills to decrease concerns in family functioning. ii. Decrease safety concerns. iii. Increase use of appropriate community supports. f. Target Population: i. Families who have active Department involvement and are at risk of having children removed, have had children removed, or have children who have recently reunified with the family. 3 g. Language: i. English. h. Medicaid Eligibility: i. Medicaid eligible, up to a specific number of hours per week. Service Access and Transportation: i. In contractor's office at 710 11. Avenue, #L-46, Greeley, Colorado 80631, in - community, or in -home. Program Area: Life Skills 1. Therapeutic Visitation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psycho -education. ii. Modeling. iii. In -vivo feedback. iv. Nurturing Parenting Program. v. Therapeutic interventions. vi. Service provided by a master's level intern or above. b. Anticipated Frequency of Services: i. As ordered by court order or Department requirements. c. Anticipated Duration of Services: i. As ordered by court order or Department requirements. d. Goals of Services: i. Increased knowledge of parenting skills. ii. Increased ability of parent to provide emotionally for child. iii. Increased ability of parent to provide physically for child. iv. Increased observed markers of healthy attachment. e. Outcomes of Services: i. Increased use of learned parenting skills. ii. Increased ability of parent to provide emotionally for child. iii. Increased ability of parent to provide physically for child. iv. Increased observed markers of healthy attachment. f. Target Population: i. Parents and children who have been removed from their parent's care. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In contractor's office at 710 11. Avenue, #L-46, Greeley, Colorado 80631, in - community, or in -home. 4 2. Supervised Visitation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psycho -education. ii. Modeling. iii. In -vivo feedback. iv. Nurturing Parenting Program. v. Service provided by a Bachelor's level intern or above. b. Anticipated Frequency of Services: i. As ordered by court order or Department requirements. c. Anticipated Duration of Services: i. As ordered by court order or Department requirements. d. Goals of Services: i. Increased knowledge of parenting skills. ii. Increased ability of parent to provide emotionally for child. iii. Increased ability of parent to provide physically for child. iv. Increased observed markers of healthy attachment. e. Outcomes of Services: i. Increased use of learned parenting skills. ii. Increased ability of parent to provide emotionally for child. iii. Increased ability of parent to provide physically for child. iv. Increased observed markers of healthy attachment. f. Target Population: i. Parents and children who have been removed from their parent's care. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In contractor's office at 710 11. Avenue, #L-46, Greeley, Colorado 80631, in - community, or in -home. 3. Life Skills — Parenting Skills (LSPS) a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psycho -education ii. Modeling iii. In -vivo feedback iv. Nurturing Parenting Program b. Anticipated Frequency of Services: i. Three (3) hours per week. c. Anticipated Duration of Services: i. Three (3) to four (4) months. d. Goals of Services: 5 i. Increased knowledge of parenting skills. ii. Increased use of parenting skills. iii. Increased understanding of child development. e. Outcomes of Services: i. Increased knowledge of parenting skills. ii. Increased use of parenting skills. iii. Increased understanding of child development. f. Target Population: i. Parents. g. Language: i. English. h. Medicaid Eligibility: i. Some parent education can be completed through Medicaid funded parenting groups or family therapy if available. i. Service Access and Transportation: i. In contractor's office at 710 I lth Avenue, #L-46, Greeley, Colorado 80631 or in - community. Program Area: Mental Health Services 1. Individual Therapy a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psycho -education. ii. Cognitive Behavioral Therapy. iii. Trauma -Focused Cognitive Behavioral Therapy (TF-CBT). iv. Motivational Interviewing. v. Reboot Educational Learning Opportunities Affecting Direction (RELOAD)/Truancy Services vi. Other miscellaneous evidenced based therapeutic interventions. b. Anticipated Frequency of Services: i. One (1) to two (2) hours per week. c. Anticipated Duration of Services: i. Six (6) to twelve (12) months. d. Goals of Services: i. Increase emotional awareness. ii. Increase emotion regulation skills. iii. Increase mental wellness and functioning. iv. Increased coping skills. v. Process trauma. e. Outcomes of Services: i. Clients will report increased self-awareness. ii. Clients will utilize skills learned. iii. Clients will increase in positive functioning. iv. Client's will increase school attendance. 6 f. Target Population: i. Children ages four (4) and older, youth, and adults. g. Language: i. English. ii. Spanish may be available in some cases. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. In contractor's office at 710 11. Avenue, #L-46, Greeley, Colorado 80631, in - community, telehealth, or in -home. 2. Family Therapy a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psycho -education. ii. Miscellaneous Therapeutic Interventions. b. Anticipated Frequency of Services: i. One (1) hour per week. c. Anticipated Duration of Services: i. Six (6) to twelve (12) months. d. Goals of Services: i. Increased communication skills. ii. Increased family functioning. iii. Increased understanding and awareness of family patterns and impact of patterns on system. e. Outcomes of Services: i. Clients and family members will increase ability to positively communicate. ii. Clients and family members will utilize learned skills to address any deficits in family functioning. iii. Clients and family members will utilize skills to create positive change in family system. f. Target Population: i. Siblings, couples, and families. g. Language: i. English. ii. Spanish may be available in some cases. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. In contractor's office at 710 11. Avenue, #L-46, Greeley, Colorado 80631, in - community, telehealth, or in -home. 3. Group Therapy 7 a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psycho -education. ii. Cognitive Behavioral Therapy. iii. Miscellaneous Group Therapy Interventions. b. Anticipated Frequency of Services: i. One and a half (1.5) to two (2) hours per week. c. Anticipated Duration of Services: i. Three (3) to four (4) months. d. Goals of Services: i. Increased knowledge of information specific to group. ii. Increased coping skills. iii. Increased feelings of support. e. Outcomes of Services: i. Clients will utilize knowledge learned and apply to specific areas of life. ii. Clients will increase their coping skills. iii. Clients will report increased feelings of support. f. Target Population: i. Dependent on the type of group: children, youth, adults, or parents. g. Language: i. English. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. In contractor's office at 710 11. Avenue, #L-46, Greeley, Colorado 80631 or telehealth. 4. Therapeutic Intake a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Service is required for all Core -funded therapy clients. b. Anticipated Frequency of Services: i. Two (2) hours. c. Anticipated Duration of Services: i. One (1) time only. d. Goals of Services: i. Assess mental health needs. ii. Create a treatment plan. iii. Assess for other social needs. e. Outcomes of Services: i. Creation of a treatment plan. ii. Signature of legally required documentation for mental health services. iii. Recommendations for treatment. 8 f. Target Population: i. Ages four (4) and older who intend on enrolling in therapy services. g. Language: i. English. ii. Spanish may be available in some cases. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. In contractor's office at 710 11th Avenue, #L-46, Greeley, Colorado 80631, in - community, telehealth, or in -home. Terms 1. Contractor will respond to the Quality Assurance Team (HS-CWOualitvAssurance(ai/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 - C W QualitvAssu rance(afiweldgov.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(niweldgov.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 9 caseworker and the Quality Assurance Team HS-CWOualitvAssurance(&,weldgov.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. 9. Contractor agrees to attend meetings when available and as requested by the Department. Such meetings include Court Facilitations, Bid Meetings, Professional Stuffings, 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. Stuffings 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(&,,weldgov.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. 1O 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 Day Treatm Rate $1,648.00 ent Unit Type Month Service Name Day Treatment Transportation for distances exceeding 60 roundtrip miles from 10 Farragut Avenue, Colorado Springs, Colorado 80909 $300.00 Month Foster Parent Education Rate $64.00 $92.00 Unit Type Hour Service Name In-officeNideo Hour In -Home or Community Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing No Show $35.00 $30.00 Hour Each Mentoring/Behavior Coaching Rate Unit Type Service Name $75.00 Hour In-officeNideo $75.00 Hour In -Office with Transportation $75.00 Hour In -Home or Community $50.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $40.00 Each No Show $0.59 Mile For distances exceeding 60 roundtrip miles from 710 11. Avenue, #L-46, Greeley, Colorado 80631 Family Preservation Rate $90.00 $106.00 Unit Type Hour Service Name In-office/Video Hour In -Home or Community Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing No Show $50.00 $40.00 Hour Each Supervised Rate $66.00 Visitation Unit Type Hour Service Name In-officeNideo $94.00 Hour In -Office with Transportation $94.00 Hour In -Home or Community $50.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $40.00 Each No Show $0.59 Mile For distances exceeding 60 roundtrip miles from 710 11. Avenue, #L-46, Greeley, Colorado 80631 Therapeutic Visitation Rate Unit Type Service Name $70.00 Hour In-officeNideo $100.00 Hour In -Office with Transportation $100.00 Hour In -Home or Community $50.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $40.00 Each No Show $0.59 Mile For distances exceeding 60 roundtrip miles from 710 11. Avenue, #L-46, Greeley, Colorado 80631 Life Skills Parenting Skil s (LSPS) Rate Unit Type Service Name $75.00 Hour In-officeNideo $92.00 Hour In -Office with Transportation $92.00 Hour In -Home or Community $50.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $40.00 Each No Show $0.59 Mile For distances exceeding 60 roundtrip miles from 710 11. Avenue, #L-46, Greeley, Colorado 80631 Individual Therapy Rate Unit Type Hour Service Name $120.00 $120.00 In-officeNideo Hour In -Home or Community Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing No Show Hour $50.00 $40.00 Each Family Therapy Rate Unit Type Hour Service Name $120.00 $120.00 In-officeNideo Hour In -Home or Community Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing No Show Hour $50.00 $40.00 Each Group Therapy Rate Unit Type Hour Service Name $40.00 $40.00 In-officeNideo $50.00 $40.00 Hour Hour Each In -Home or Community Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing No Show Therapeutic Intake (Two (2) Hours Maximum) Rate Unit Type Service Name $75.00 Hour In-officeNideo $75.00 Hour In -Home or Community $50.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $40.00 Each No Show 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 7. 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: Griffith Centers for Children Trails Provider ID (if known): Provider Contact Full Name: Amanda Dunn Title: Northern Program Supervisor Primary Phone Number (10 -digit): 970-888-3550 Eon.: Fax Number (10 -digit): Primary Contact Email: amanda•dunn@griffithcenters.org Web Address: griffithcenters.org Agency Location Address (street, city, state, zip): 710 11th Ave., Ste. L-46 Agency Mailing Address (street, city, state, zip): Greeley, CO 80631 Agency Type (pick one): ® Public Company12:1 Private Non -Profit El Private for Profit Send Referrals for Service to: Referral Contact Name: Referrals Staff Title: Referrals Staff Referral Phone Number (10 digit): 970-888-3550 Ext.: Email: referrals@griffithcenters.org Billing Contact Billing Contact Name: Esther Torrez rrez Billing Phone Number (10 -digit): 303-237-6865 Title: Accounting/Accounts Receivable Manager 1115 esther.torrez@griffithcenters.org Ext.: Email: ' 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 I iDepartment of Human Services, and comply with all requirements of the contract, if awarded. f 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 I 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 #9H-03551-0000. I I Lisa Lamoreaux Director of Community Programs i Authorized Rep. Full Name: Title: 1 Authorized Rep. Email: Lisa.Lamoreaux@griffithcenters.org Phone (10 -digit): 303-237-6865 Ext., 1114 i 10190 Bannock St. Suite 120 Northglenn, CO 80260 i I Authorized Rep. Address (Street, city, state, zip): Signature of Authorized Rep.: 701.4 LioC Date: 01/20/22 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: Griffith Centers for Children Program Area: I Day Treatment I Number of services offered on this Attachment C (max 5): Program Areas are listed in column 1 of the table located in Item Xl of the Request You may complete another Attachment C if you have more than 5. for Proposal starting on page 13. If Service 2.1a 2.1b 2.1c 2.1d 2.1e 2.1f 2.1g 2.1h 2.1i Service 2.2a 2.2b 2.2c 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: Day Treatment Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): - Day Treatment - Individual Therapy Family Therapy - Education Services Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (Le. 4 hours/week). If the service has levels, be specific for each level: As needed/daily Anticipated duration of service (i.e. 3-4 months): As needed Three (3), or more, specific goals of the service (DO use bullet points): 1. Increase independent living skills 2. Increase social skills 3. Manage mental health 4. Goals can be adjusted and individualized to each client Three (3), or more, specific outcomes of service: 1. Increase independent living skills 2. Increase social skills 3. Manage mental health Target population of the service, including age and gender: Grades 3 —12 Languages service is available in (please list proficiency and if interpreter services are available): English Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Partially covered by Medicaid Service location — list where the service will take place (i.e. client's home, in -office, other) Colorado Springs Day Treatment Program only #2 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): 2.2d Three (3), or more, specific goals of the service (DO use bullet points): 2.2e Three (3), or more, specific outcomes of service: REV. OCT 2021 ATTACHMENT C - PROPOSAL 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): 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 #S 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: REV. OCT 2021 ATTACHMENT C - PROPOSAL 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 one: ® YES 3.2 Will you conduct services in a client's home or in the community? Check one: ❑ YES 3.3 Will you transport clients to and/or from services? Check one: ® YES ❑ NO 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? 60 Miles NO NO 10 Farragut Ave Colorado Springs, CO 80909 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: 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 per Hour per Hour No. of roundtrip miles included in rate: per Hour No. of roundtrip miles included in rate: per Hour per No Show 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: $ 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 ATTACHMENT C - PROPOSAL 4.2e 4.2f No show: Mileage rate: per No Show per Mile This is paid after the miles listed above. 4.3 Hourly Service #3 Name: 4.3a In-Office/Video: 4.3b In -Office with Transportation: 4.3c In -Home or Community: 4.3d 4.3e 4.3f FTM, TDM, Prof. Staffing: No show: Mileage rate: $ Amount Unit Type per Hour per Hour No. of roundtrip miles included in rate: per Hour No. of roundtrip miles included in rate: per Hour per No Show per Mile This is paid after the miles listed above. miles miles 4.4 Hourly Service #4 Name: 4.4a In-Office/Video: 4.4b In -Office with Transportation: In -Home or Community: 4.4c FTM, TDM, Prof. Staffing: 4.4d No show: 4.4e Mileage rate: $ Amount Unit Type per Hour per Hour No. of roundtrip miles included in rate: per Hour No. of roundtrip miles included in rate: per Hour per No Show per Mile This is paid after the miles listed above. miles miles 4.5 Hourly Service #5 Name: 4.5a In-Office/Video: 4.5b In -Office with Transportation: 4.5c In -Home or Community: 4.5d FTM, TDM, Prof. Staffing: 4.5e No show: 4.5f Mileage rate: $ Amount Unit Type per Hour per Hour No. of roundtrip miles included in rate: per Hour No. of roundtrip miles included in rate: per Hour per No Show per Mile This is paid after the miles listed above. miles miles 4.6 Monthly Service Rates (each level must be listed): Service Name with Level Rate per Month No. of Direct Service Hours: 4.6a Day Treatment $1648.00 1, month day treatment, 4.6b Transportation outside of 60 miles round trip $300.00 1 month transportation 4.6c 4.6d4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers — List your rates in the box below. 4.8 Monitored Sobriety Providers — List your rates in the box below. Provider special notes: Day treatment only provided in Colorado Springs; prorated rates if not a full month. REV. OCT 2021 4 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: Griffith Centers for Children Program Area: Foster Parent Training Number of services offered on this Attachment C (max 5): Program Areas are listed in column 1 of the table located in Item Xl of the Request You may complete another Attachment C if you have more than 5. for Proposal starting on page 13. If Service 2.1a 2.1b 2.1c 2.1d 2.1e 2.1f 2.1g 2.1h 2.1i Service 2.2a 2.2b 2.2c 2.2d 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: Foster Parent Education Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Psycho -education - Modeling - In -vivo feedback - Nurturing Parenting Program Therapeutic interventions 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: Adjustable by need Anticipated duration of service (i.e. 3-4 months): Adjustable by need Three (3), or more, specific goals of the service (DO use bullet points): 1. Increased knowledge of parenting skills 2. Increased knowledge of child mental health and wellness 3. Increase knowledge of attachment 4. Increase knowledge of trauma Three (3), or more, specific outcomes of service: 1. Increased use of learned parenting skills 2. Increased ability of foster parent to provide emotionally for child 3. Increased ability of foster parent to address behavioral or mental health concerns of foster children Target population of the service, including age and gender: Foster parents Languages service is available in (please list proficiency and if interpreter services are available): English Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Not Medicaid eligible. Service location — list where the service will take place (i.e. client's home, in -office, other) In -office, in -community, or in -home #2 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): 2.2e Three (3), or more, specific outcomes of service: REV. OCT 2021 ATTACHMENT C - PROPOSAL 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): 1. 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 (Le. 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 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) Section 3 — Service Access and Transportation 3.1 Will you charge Weld County for transporting clients or mileage? Check one: ❑ YES ® NO 3.2 Will you conduct services in a client's home or in the community? Check one: ® YES ❑ NO 3.3 Will you transport clients to and/or from services? Check one: O YES ® NO 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? n/a Miles 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 Education 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 64 n/a 92 35 30 n/a Unit Type per Hour per Hour No. of roundtrip miles included in rate: per Hour No. of roundtrip miles included in rate: per Hour per No Show per Mile This is paid after the miles listed above. n/a n/a 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: $ Amount Unit Type 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 3 ATTACHMENT C - PROPOSAL 4.2d FTM, TDM, Prof. Staffing: 4.2e No show: 4.2f Mileage rate: per Hour per No Show per Mile This is paid after the miles listed above. 4.3 Hourly Service #3 Name: 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 per Hour per Hour No. of roundtrip miles included in rate: per Hour No. of roundtrip miles included in rate: per Hour per No Show per Mile This is paid after the miles listed above. miles miles 4.4 Hourly Service #4 Name: 4.4a In-Office/Video: 4.4b In -Office with Transportation: In -Home or Community: 4.4c FTM, TDM, Prof. Staffing: 4.4d No show: 4.4e Mileage rate: $ Amount Unit Type per Hour per Hour No. of roundtrip miles included in rate: per Hour No. of roundtrip miles included in rate: per Hour per No Show per Mile This is paid after the miles listed above. miles miles 4.5 Hourly Service #5 Name: 4.5a In-Office/Video: 4.5b In -Office with Transportation: 4.5c In -Home or Community: 4.5d FTM, TDM, Prof. Staffing: 4.5e No show: 4.5f Mileage rate: $ Amount Unit Type per Hour per Hour No. of roundtrip miles included in rate: per Hour No. of roundtrip miles included in rate: per Hour per No Show per Mile This is paid after the miles listed above. miles miles 4.6 Monthly Service Rates (each level must be listed): Service Name with Level Rate per Month No. of Direct Service Hours: 4.6a 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. 4.8 Monitored Sobriety Providers — List your rates in the box below. Provider special notes: REV. OCT 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: Griffith Centers for Children Program Area: Home -Based Intervention I 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 Request You may complete another Attachment C if you have more than 5. for Proposal starting on page 13. If Service 2.1a 2.1b 2.1c 2.1d 2.1e 2.1f 2.1g 2.1h 2.1i Service 2.2a 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: Mentoring/Behavior Coaching Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): - Psycho -education - Modeling In -vivo feedback Mentoring 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: 2-4 hours/week Anticipated duration of service (i.e. 3-4 months): 4-6 months Three (3), or more, specific goals of the service (DO use bullet points): 1. Increased social skills 2. Address truancy or school/education concerns 3. Increase job readiness 4. Overcome barriers to other treatment 5. Community Integration Three (3), or more, specific outcomes of service: 1. Increased use of social skills 2. Increased use of community resources 3. Obtaining employment (if appropriate) 4. Increased school attendance 5. Increased participation in other mental health or social services Target population of the service, including age and gender: Youth ages 6 and up, young adults, adults Languages service is available in (please list proficiency and if interpreter services are available): English Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Medicaid Eligible. Service location — list where the service will take place (i.e. client's home, in -office, other) In -office, in -community, or in -home #2 Name: Family Preservation Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Individual therapy Family therapy - Behavior coaching/mentoring - Life skills Parenting skills A combination of services designed to maintain placement, prevent removal, and/or assist with family cohesion post -reunification. REV. OCT 2021 ATTACHMENT C - PROPOSAL 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: 1-4 hours/week 2.2c Anticipated duration of service (i.e. 3-4 months): 6-12 months 2.2d Three (3), or more, specific goals of the service (DO use bullet points): Increase family skills (coping, communication, etc.) 2. Increase understanding and awareness of community resources 3. Address concerns around safety 4. Address concerns in family functioning 5. ' Goals can be adjusted to meet family needs 2.2e Three (3), or more, specific outcomes of service: 1. Increase use of learned skills to decrease concerns in family functioning 2. Decrease safety concerns 3. Increase use of appropriate community supports 2.2f Target population of the service: Families who have active DHS involvementand are at risk of having children removed, have had children removed, or have children recently reunifying with the family 2.2g Languages service is available in (please list proficiency and if interpreter services are available): English 2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Medicaid eligible; up to a specific number of hours per week 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) In -office, in -community, or in -home 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 fist 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): 1. REV. OCT 2021 ATTACHMENT C - PROPOSAL 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 and Transportation 3.1 Will you charge Weld County for transporting clients or mileage? Check one: ® YES 3.2 Will you conduct services in a client's home or in the community? Check one: 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 ® YES ❑ NO ❑ NO 60 Miles 71011cn Ave. # L-46 Greeley CO 80631 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: Mentoring/Behavior Coaching REV. OCT 2021 3 ATTACHMENT C - PROPOSAL 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 75 75 75 50 40 0.59 Unit Type per Hour per Hour No. of roundtrip miles included in rate: per Hour No. of roundtrip miles included in rate: per Hour per No Show per Mile This is paid after the miles listed above. 60 60 miles miles 4.2 Hourly Service #2 Name: Family Preservation 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 90 n/a 106 50 40 n/a. Unit Type per Hour per Hour No. of roundtrip miles included in rate: n/a miles per Hour No. of roundtrip miles included in rate: n/a miles per Hour per No Show per Mile This is paid after the miles listed above. 4.3 Hourly Service #3 Name: 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 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 4.4 Hourly Service #4 Name: 4.4a In-Office/Video: 4.4b In -Office with Transportation: In -Home or Community: 4.4c FTM, TDM, Prof. Staffing: 4.4d No show: 4.4e Mileage rate: $ Amount Unit Type per Hour per Hour No. of roundtrip miles included in rate: per Hour No. of roundtrip miles included in rate: per Hour per No Show per Mile This is paid after the miles listed above. miles miles 4.5 Hourly Service #5 Name: 4.5a In-Office/Video: 4.Sb In -Office with Transportation: 4.5c In -Home or Community: 4.5d FTM, TDM, Prof. Staffing: 4.5e No show: 4.5f Mileage rate: $ Amount Unit Type per Hour per Hour No. of roundtrip miles included in rate: per Hour No. of roundtrip miles included in rate: per Hour per No Show per Mile This is paid after the miles listed above. miles miles 4.6 Monthly Service Rates (each level must be listed): Service Name with Level Rate per Month No. of Direct Service Hours: 4.6a 4.6b 4.6c 4.6d 4.6e 4.6f 4.6g 4.6h 4.6i REV. OCT 2021 4 ATTACHMENT C - PROPOSAL 4.6j I 4.7 Home Study Providers — List your rates in the box below. 4.8 Monitored Sobriety Providers — List your rates in the box below. Provider special notes: 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: Griffith Centers for Children Program Area: Life Skills 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 Request You may complete another Attachment C if you have more than 5. for Proposal starting on page 13. 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: Therapeutic Visitation 2.1a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Psycho -education Modeling In -vivo feedback Nurturing Parenting Program Therapeutic interventions Service provided by a master's level intern or above staff only. 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: As ordered by court order or OHS requirements. 2.1c Anticipated duration of service (i.e. 3-4 months): As ordered by court order or DHS requirements. 2.1d Three (3), or more, specific goals of the service (DO use bullet points): 1. Increased knowledge of parenting skills 2. Increased ability of parent to provide emotionally for child 3. Increased ability of parent to provide physically for child 4. Increased observed markers of healthy attachment 2.1e Three (3), or more, specific outcomes of service: 1. Increased use of learned parenting skills 2. Increased ability of parent to provide emotionally for child 3. Increased ability of parent to provide physically for child 4. Increased observed markers of healthy attachment 2.1f Target population of the service, including age and gender: Parents and: children who have been removed from their parent's care 2.1g Languages service is available in (please list proficiency and if interpreter services are available): English' 2.1h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Not Medicaid eligible. 2.1i Service location — list where the service will take place (i.e. client's home, in -office, other) In -office, in -community, or in -home Service #2 Name: Supervised Visitation 2.2a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Psycho -education Modeling In -vivo feedback - Nurturing Parenting Program Service provided by a Bachelor's level intern or above only. 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: As ordered by court order or DHS requirements. REV. OCT 2021 ATTACHMENT C - PROPOSAL 2.2c 2.2d 2.2e 2.2f 2.2g 2.2h 2.2i Service 2.3a 2.3b 2.3c 2.3d 2.3e Anticipated duration of service (i.e. 3-4 months): As ordered by court order or OHS requirements. Three (3), or more, specific goals of the service (DO use bullet points): 1. Increased knowledge of parenting skills 2. Increased ability of parent to provide emotionally for child 3. Increased ability of parent to provide physically for child 4. Increased observed markers of healthy attachment Three (3), or more, specific outcomes of service: 1. Increased use of learned parenting skills 2. Increased ability of parent to provide emotionally for child 3. Increased ability of parent to provide physically for child 4. Increased observed markers of healthy attachment Target population of the service: Parents and children who have been removed from their parent's care. Languages service is available in (please list proficiency and if interpreter services are available): English Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Not eligible for Medicaid funding. Service location — list where the service will take place (i.e. client's home, in -office, other) In -office, in -community, or in -home #3 Name: Life Skills — Parenting Skills (LSPS) Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Psycho -education Modeling In -vivo feedback Nurturing Parenting Program 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: 3 hours per week Anticipated duration of service (i.e. 3-4 months): 3-4 months Three (3), or more, specific goals of the service (DO use bullet points): 1. Increased knowledge of parenting skills 2. Increased use of parenting skills 3. Increased understanding of child development. Three (3), or more, specific outcomes of service: 1. Increased knowledge of parenting skills 2. Increased use of parenting skills 3. Increased understanding of child development. 2.3f 2.3g 2.3h 2.3i Service 2.4a 2.4b Target population of the service: Parents Languages service is available in (please list proficiency and if interpreter services are available): English Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Some parent education can be completed through Medicaid funded parenting groups or family therapy if available. Service location — list where the service will take place (i.e. client's home, in -office, other) In -office, In -Home #4 Name: Modalities, curriculum, tools used in delivery of service (DO NOT fist 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: REV. OCT 2021 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 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 (Le. 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 3.2 Will you conduct services in a client's home or in the community? Check one: 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? Will you charge Weld County for transporting clients or mileage? Check one: ® YES ❑ NO ® YES ❑ NO ❑ NO 60 Miles 71011. Ave. # L-46 Greeley CO 80631 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. REV. OCT 2021 ATTACHMENT C - PROPOSAL • For Home study providers complete section 4.7. • For monitored sobriety testing providers complete section 4.8. 4.1 Hourly Service #1 Name: Supervised Visitation 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 66 94 94 50 40 0.59 Unit Type per Hour per Hour No. of roundtrip miles included in rate: per Hour No. of roundtrip miles included in rate: per Hour per No Show per Mile This is paid after the miles listed above. 60 60 miles miles 4.2 Hourly Service #2 Name: Therapeutic Visitation 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 70 100 100 50 40 039 Unit Type per Hour per Hour No. of roundtrip miles included in rate: per Hour No. of roundtrip miles included in rate: per Hour per No Show per Mile This is paid after the miles listed above. 60 60 miles miles 4.3 Hourly Service #3 Name: Life Skills Parenting Skills (LSPS) 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 75 92 92 50 40 0.59 Unit Type per Hour per Hour No. of roundtrip miles included in rate: per Hour No. of roundtrip miles included in rate: per Hour per No Show per Mile This is paid after the miles listed above. 60 60 miles miles 4.4 Hourly Service #4 Name: 4.4a In-Office/Video: 4.4b In -Office with Transportation: In -Home or Community: 4.4c FTM, TDM, Prof. Staffing: 4.4d No show: 4.4e Mileage rate: $ Amount Unit Type per Hour per Hour No. of roundtrip miles included in rate: per Hour No. of roundtrip miles included in rate: per Hour per No Show per Mile This is paid after the miles listed above. miles miles 4.5 Hourly Service #5 Name: 4.5a In-Office/Video: 4.5b In -Office with Transportation: 4.5c In -Home or Community: 4.5d FTM, TDM, Prof. Staffing: 4.5e No show: 4.5f Mileage rate: $ Amount Unit Type per Hour per Hour No. of roundtrip miles included in rate: per Hour No. of roundtrip miles included in rate: per Hour per No Show per Mile This is paid after the miles listed above. miles miles 4.6 Monthly Service Rates (each level must be listed): Service Name with Level Rate per Month No. of Direct Service Hours: 4.6a 4.6b 4.6c 4.6d REV. OCT 2021 4 ATTACHMENT C - PROPOSAL 4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers — List your rates in the box below. 4.8 Monitored Sobriety Providers — List your rates in the box below. Provider special notes: REV. OCT 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: Griffith Centers for Children Program Area: Mental Health Services Number of services offered on this Attachment C (max 5): Program Areas are listed in column 1 of the table located in Item Xl of the Request You may complete another Attachment C if you have more than 5. for Proposal starting on page 13. If the Service 2.1a 2.1b 2.1c 2.1d 2.1e 2.1f 2.1g 2.1h 2.1i Service 2.2a 2.2b 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: Individual Therapy Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): - Psycho -education - Cognitive Behavioral Therapy - TF-C8T Motivational Interviewing - RELOAD/Truancy Services - Misc. other evidenced based therapeutic interventions. 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: 1-2 hours/week Anticipated duration of service (i.e. 3-4 months): 6 -12 months Three (3), or more, specific goals of the service (DO use bullet points): 1. Increase emotional awareness 2. Increase emotion regulation skills 3. Increase mental wellness and functioning 4. Increased coping skills 5. Process trauma Three (3), or more, specific outcomes of service: 1. Clients will report increased self-awareness 2. Clients will utilize skills learned 3. Clients will increase in positive functioning 4. Client's will increase school attendance Target population of the service, including age and gender: Children 4 years and older, youth, adults Languages service is available in (please list proficiency and if interpreter services are available): English, Spanish when available Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Medicaid eligible Service location — list where the service will take place (i.e. client's home, in -office, other) In -office, in -community, telehealth, or in -home #2 Name: Family Therapy Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Psycho -education Misc. Therapeutic Interventions 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: 1 hour/week 2.2c Anticipated duration of service (i.e. 3-4 months): 6-12 months REV. OCT 2021 ATTACHMENT C - PROPOSAL 2.2d Three (3), or more, specific goals of the service (DO use bullet points): 1. Increased communication skills 2. Increased family functioning 3. Increased understanding and awareness of family patterns and impact of patterns on system 2.2e Three (3), or more, specific outcomes of service: 1. Clients and family members will increase ability to positively communicate 2. Clients and family members will utilize learned skills to address any deficits in family functioning.: 3. Clients and family members will utilize skills to create positive change in family system. 2.2f Target population of the service: Siblings, couples, families 2.2g Languages service is available in (please list proficiency and if interpreter services are available): English Spanish when available 2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Medicaid Eligible 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) In -office, in -community, telehealth, or in -home Service #3 Name: Group Therapy 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Psycho -education Cognitive Behavioral Therapy Misc. Group Therapy Interventions 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: 1.5 2 hours/week 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): 1. Increased knowledge of information specific to group 2. ' Increased coping skills 3. Increased feelings of support 2.3e Three (3), or more, specific outcomes of service: . Clients will utilize knowledge learned and apply to specific areas of fife Clients will increase their coping skills ▪ Clients will report increased feelings of support 2.3f Target population of the service: Depends on type of group; children, youth,adults, parents 2.3g Languages service is available in (please list proficiency and if interpreter services are available): English 2.3h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Medicaid Eligible 2.3i Service location — list where the service will take place (i.e. client's home, in -office, other) In -Office, Telehealth Service #4 Name: Therapeutic Intake* required for all CORE -funded therapy clients 2.4a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Intake assessment Misc. Evidenced -Based assessments to determine direction of treatment, needs, and estimated duration of treatment. 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 hours, once time only 2.4c Anticipated duration of service (i.e. 3-4 months): One time only 2.4d Three (3), or more, specific goals of the service (DO use bullet points): 1. Assess mental health needs - REV. OCT 2021 2 ATTACHMENT C - PROPOSAL 2. Create a treatment plan 3. Assess for other social needs 2.4e Three (3), or more, specific outcomes of service: 1. Creation of a treatment plan 2. Signature of legally required documentation for mental health services 3. Recommendations for treatment. 2.4f Target population of the service: Ages 4+ who intend on enrolling in therapy services 2.4g Languages service is available in (please list proficiency and if interpreter services are available): English, Spanish when available 2.4h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Medicaid Eligible 2.4i Service locaion — list where the service will take place (i.e. client's home, in -office, other) In -office, telehealth, in -community, in -home 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 locaion — 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: ❑ YES ® NO 3.2 Will you conduct services in a client's home or in the community? Check one: ® YES 0 NO 3.3 Will you transport clients to and/or from services? Check one: 0 YES 0 NO 3.4 How many miles are you willing to travel round trip? List a specific number of miles. 0 Miles 3.5 When you caiculate mileage, what is your starting point address? n/a 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. REV. OCT 2021 3 ATTACHMENT C - PROPOSAL • For Home study providers complete section 4.7. • For monitored sobriety testing providers complete section 4.8. 4.1 Hourly Service #1 Name: Individual 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 120 n/a 120 50 40 n/a Unit Type per Hour per Hour No. of roundtrip miles included in rate: per Hour No. of roundtrip miles included in rate: per Hour per No Show per Mile This is paid after the miles listed above. n/a n/a. miles miles 4.2 Hourly Service #2 Name: Family Therapy 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 120 n/a 120 50 40 n/a Unit Type per Hour per Hour No. of roundtrip miles included in rate: per Hour No. of roundtrip miles included in rate: per Hour per No Show per Mile This is paid after the miles listed above. n/a n/a miles miles 4.3 Hourly Service #3 Name: Group Therapy 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 40 n/a 40 50. 40 n/a . Unit Type per Hour per Hour No. of roundtrip miles included in rate: per Hour No. of roundtrip miles included in rate: per Hour per No Show per Mile This is paid after the miles listed above. n/a n/a miles miles 4.4 Hourly Service #4 Name: Therapeutic Intake 4.4a In-Office/Video: 4.4b In -Office with Transportation: In -Home or Community: 4.4c FTM, TDM, Prof. Staffing: 4.4d No show: 4.4e Mileage rate: $ Amount 75 n/a 75 50 40 n/a Unit Type per Hour per Hour No. of roundtrip miles included in rate: per Hour No. of roundtrip miles included in rate: per Hour per No Show per Mile This is paid after the miles listed above. n/a miles miles 4.5 Hourly Service #5 Name: 4.5a In-Office/Video: 4.5b In -Office with Transportation: 4.5c In -Home or Community: 4.5d FTM, TDM, Prof. Staffing: 4.5e No show: 4.5f Mileage rate: $ Amount Unit Type per Hour per Hour No. of roundtrip miles included in rate: per Hour No. of roundtrip miles included in rate: per Hour per No Show per Mile This is paid after the miles listed above. miles miles 4.6 Monthly Service Rates (each level must be listed): Service Name with Level Rate per Month No. of Direct Service Hours: 4.6a 4.6b 4.6c 4.6d REV. OCT 2021 4 ATTACHMENT C - PROPOSAL 4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers — List your rates in the box below. 4.8 Monitored Sobriety Providers — List your rates in the box below. Provider special notes: REV. OCT 2021 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): Griffith Centers for Children, Inc AGENCY CONTACT: Amanda Dunn, MA LPC PHONE NUMBER: 970-888-3550 EMAIL: amandadunn@griffithcenters.org PROPOSED SERVICE(S): Life Skills Parenting Skills, Visitation, Behavior Coaching/Mentoring, Mental Health, Day Treatment, Foster Parent Training dd cur Booth Sarah Any LCSW CSW.09925849 Dunn Amanda Any LPC LPC.0015789 Felhauer Vanessa Any LPC LPC.0014491 Bauer Caitlin Any MSW pending Clang Renee Visitation, LSPS, Behavior Coaching MA n/a Critchfield Sarah Any LSW LSW.0009923946 Hererra Elena Any MFT Intern n/a Hummer Alli Any MFT-C MFTC.0014236 Larsen Adriana Any LPCC LPCC.0018586 Reid. Alison Any CSWC SWC.0000000487 Sullivan Kailyn Visitation, LSPS, Behavior Coaching BA n/a Gonzalez Danna Visitation, LSPS, Behavior Coaching BA n/a Corrall Natalia Visitation, LSPS BA -Intern n/a Lamoreaux Lisa Any LPC LPC.0013802 CHILD WELFARE REQUEST FOR PROPOSAL 2022-23 - VARIOUS SERVICES ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 4/11 /2022 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 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 BOKF Insurance CO Risk Management 1600 Broadway,9th Floor Denver CO 80202 CONTACT PHONE FAX MIL E.: 303-988-0446 I No): 303-988-0804 (A/C, aootcss: insurancecertificates@bokf.com INSURER(S) AFFORDING COVERAGE NAIL # INSURER A: Philadelphia Indemnity Insurance Company 18058 INSURED GRIFCEN. Griffith Centers for Children, Inc. 10190 Bannock St Ste 120 Northglenn CO 80260 INSURER B : Capitol Specialty Insurance Corporation 10328 INSURER C : Pinnacol Assurance Company 41190 INSURER D : HSB Specialty Insurance Company 14438 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 603722531 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 LTR TYPE OF INSURANCE TV ADDL SUER INSD WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP Actic/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY ICLAIMS -MADE El OCCUR Y PHPK2253470 4/1/2022 4/1/2023 EACH OCCURRENCE $ 1,000,000 PREM SES (EaEoccu ante) $ 100000 MED EXP (Any one person) $ 20,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER: POLICY EI PRCOT- LOC OTHER: PRODUCTS - COMP/OP AGG $5000,000 A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED _ AUTOS NON-0WNED AUTOS PHPK2253470 4/1/2022 4/1/2023 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $1,000,000 PROPERTY DAMAGE (Per PROPERTY $ B X UMBRELLA LAB EXCESS LIAB X OCCUR CLAIMS -MADE HS2021223701 4/12022 4/1/2023 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 $ DED I X I RETENTIONS 10.000 C WORKERS COMPENSATION AND EMPLOYERS' LIABILrrY Y / N OFFICER/MEM ER EXCLUDED? ECUTIVE El (Mandatory In NH) If yes, descdbe under DESCRIPTION OF OPERATIONS below N / A 864142 1/1/2022 1/1/2023 X STATUTE 1 sc. E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 A Professional Liability A Sexual Abuse/Malestation Liab D CyberLiahility N N N N PHPK2253470 PHPK2253470 660424502 4/1/2022 4/1 f2022 4/1/2022 4/1/2023 4/1/2023 4/1/2023 Ea IncidenVAggregate $1m / $3m Ea Occur/Aggregate $1,OO E Limit $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Crime/Fidelity - written with Travelers Casualty and Surety Company, Policy #105579952 effective 04/01/2020 to 04/01/2023 - $250,000 Limit subject to $2,500 Deductible. Board of County Commissioners of Weld County and its Officers/Employees are additional insured per attached endorsement CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Weld County 1150 O Street Greeley CO 80631 AUTHORIZED REPRESENTATIVE i ACORD 25 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD PI-GLD-HS (10/11) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY DELUXE ENDORSEMENT: HUMAN SERVICES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE 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 Page # Extended Property Damage Included 2 Limited Rental Lease Agreement Contractual Liability $50,000 limit 2 Non -Owned Watercraft Less than 58 feet 2 Damage to Property You Own, Rent, or Occupy $30,000 limit 2 Damage to Premises Rented to You $1,000,000 3 HIPAA Clarification 4 Medical Payments $20,000 5 Medical Payments — Extended Reporting Period 3 years 5 Athletic Activities Amended 5 Supplementary Payments — Bail Bonds $5,000 5 Supplementary Payment — Loss of Earnings $1,000 per day 5 Employee Indemnification Defense Coverage $25,000 5 Key and Lock Replacement — Janitorial Services Client Coverage $10,000 limit 6 Additional Insured — Newly Acquired Time Period Amended 6 Additional Insured — Medical Directors and Administrators Included 7 Additional Insured — Managers and Supervisors (with Fellow Employee Coverage) Included 7 Additional Insured — Broadened Named Insured Included 7 Additional Insured — Funding Source Included 7 Additional Insured — Home Care Providers Included 7 Additional Insured — Managers, Landlords, or Lessors of Premises Included 7 Additional Insured — Lessor of Leased Equipment Included 7 Additional Insured — Grantor of Permits Included 8 Additional Insured — Vendor Included 8 Additional Insured — Franchisor Included 9 Additional Insured —When Required by Contract Included 9 Additional Insured — Owners, Lessees, or Contractors Included 9 Additional Insured — State or Political Subdivisions Included 10 Page 1 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company PI-GLD-HS (10/11) Duties in the Event of Occurrence, Claim or Suit Included 10 Unintentional Failure to Disclose Hazards Included 10 Transfer of Rights of Recovery Against Others To Us Clarification 10 Liberalization Included 11 Bodily Injury — includes Mental Anguish Included 11 Personal and Advertising Injury — includes Abuse of Process, Discrimination Included 11 A. Extended Property Damage SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph a. is deleted in its entirety and replaced by the following: a. Expected or Intended Injury "Bodily injury" or property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. B. Limited Rental Lease Agreement Contractual Liability SECTION I - COVERAGES, COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph b. Contractual Liability is amended to include the following: (3) Based on the named insured's request at the time of claim, we agree to indemnify the named insured for their liability assumed in a contract or agreement regarding the rental or lease of a premises on behalf of their client, up to $50,000. This coverage extension only applies to rental lease agreements. This coverage is excess over any renter's liability insurance of the client. C. Non -Owned Watercraft SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph g. (2) is deleted in its entirety and replaced by the following: (2) A watercraft you do not own that is: (a) Less than 58 feet long; and (b) Not being used to carry persons or property for a charge; This provision applies to any person, who with your consent, either uses or is responsible for the use of a watercraft. This insurance is excess over any other valid and collectible insurance available to the insured whether primary, excess or contingent. D. Damage to Property You Own, Rent or Occupy SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE Page 2 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company PI-GLD-HS (10/11) LIABILITY, Subsection 2. Exclusions, Paragraph j. Damage to Property, Item (1) is deleted in its entirety 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, unless the damage to property is caused by your client, up to a $30,000 limit. A client is defined as a person under your direct care and supervision. E. Damage to Premises Rented to You 1. If damage by fire to premises rented to you is not otherwise excluded from this Coverage Part, the word "fire" is changed to "fire, lightning, explosion, smoke, or leakage from automatic fire protective systems" where it appears in: a. The last paragraph of SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions; is deleted in its entirety and replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in SECTION III - LIMITS OF INSURANCE. b. SECTION III - LIMITS OF INSURANCE, Paragraph 6. is deleted in its entirety and replaced by the following: 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" to any one premises, while rented to you, or in the case of damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems while rented to you or temporarily occupied by you with permission of the owner. c. SECTION V - DEFINITIONS, Paragraph 9.a., is deleted in its entirety and replaced by the following: 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, lightning, explosion, smoke, or leakage from automatic fire protective systems to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract"; 2. SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. Other Insurance, Paragraph b. Excess Insurance, (1) (a) (ii) is deleted in its entirety and replaced by the following: That is insurance for fire, lightning, explosion, smoke, or leakage from automatic fire protective systems for premises rented to you or temporarily occupied by you with permission of the owner; 3. The Damage To Premises Rented To You Limit section of the Declarations is amended to the greater of: Page 3 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company PI-GLD-HS (10/11) a. $1,000,000; or b. The amount shown in the Declarations as the Damage to Premises Rented to You Limit. This is the most we will pay for all damage proximately caused by the same event, whether such damage results from fire, lightning, explosion, smoke, or leaks from automatic fire protective systems or any combination thereof. F. HIPAA SECTION I - COVERAGES, COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY, is amended as follows: 1. Paragraph 1. Insuring Agreement is amended to include the following: We will pay those sums that the insured becomes legally obligated to pay as damages because of a "violation(s)" of the Health Insurance Portability and Accountability Act (HIPAA). We have the right and the duty to defend the insured against any "suit," "investigation," or "civil proceeding" seeking these damages. However, we will have no duty to defend the insured against any "suit" seeking damages, "investigation," or "civil proceeding" to which this insurance does not apply. 2. Paragraph 2. Exclusions is amended to include the following additional 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. c. Other Remedies Any remedy other than monetary damages for penalties assessed. d. Compliance Reviews or Audits Any compliance reviews by the Department of Health and Human Services. 3. SECTION V - DEFINITIONS is amended to include the following additional definitions: a. "Civil proceeding" means an action by the Department of Health and Human Services (HHS) arising out of "violations." b. "Investigation" means an examination of an actual or alleged "violation(s)" by HHS. However, "investigation" does not include a Compliance Review. c. "Violation" means the actual or alleged failure to comply with the regulations included in the H I PAA. Page 4 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company PI-GLD-HS (10/11) G. Medical Payments — Limit Increased to $20,000, Extended Reporting Period If COVERAGE C MEDICAL PAYMENTS is not otherwise excluded from this Coverage Part: 1. The Medical Expense Limit is changed subject to all of the terms of SECTION III - LIMITS OF INSURANCE to the greater of: a. $20,000; or b. The Medical Expense Limit shown in the Declarations of this Coverage Part. 2. SECTION I - COVERAGE, COVERAGE C MEDICAL PAYMENTS, Subsection 1. Insuring Agreement, a. (3) (b) is deleted in its entirety and replaced by the following: (b) The expenses are incurred and reported to us within three years of the date of the accident. H. Athletic Activities SECTION I - COVERAGES, COVERAGE C MEDICAL PAYMENTS, Subsection 2. Exclusions, Paragraph e. Athletic Activities is deleted in its entirety and replaced with the following: e. Athletic Activities To a person injured while taking part in athletics. I. Supplementary Payments SECTION I - COVERAGES, SUPPLEMENTARY PAYMENTS - COVERAGE A AND B are amended as follows: 1. b. is deleted in its entirety and replaced by the following: 1. b. Up to $5000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these. 1.d. is deleted in its entirety and replaced by the following: 1. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $1,000 a day because of time off from work. J. Employee Indemnification Defense Coverage SECTION I - COVERAGES, SUPPLEMENTARY PAYMENTS - COVERAGES A AND B the following is added: We will pay, on your behalf, defense costs incurred by an "employee" in a criminal proceeding occurring in the course of employment. The most we will pay for any "employee" who is alleged to be directly involved in a criminal proceeding is $25,000 regardless of the numbers of "employees," claims or "suits" brought or persons or organizations making claims or bringing "suits. Page 5 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company PI-GLD-HS (10/11) K. Key and Lock Replacement — Janitorial Services Client Coverage SECTION I - COVERAGES, 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 "clients" premises due to theft or other loss to keys entrusted to you by your "client," up to a $10,000 limit per occurrence and $10,000 policy aggregate. We will not pay for loss or damage resulting from theft or any other dishonest or criminal act that you or any of your partners, members, officers, "employees", "managers", directors, trustees, authorized representatives or any one to whom you entrust the keys of a "client" for any purpose commit, whether acting alone or in collusion with other persons. The following, when used on this coverage, are defined as follows: "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. b. "Employee" means: (1) Any natural person: (a) While in your service or for 30 days after termination of service; (b) Who you compensate directly by salary, wages or commissions; and (c) Who you have the right to direct and control while performing services for you; or (2) Any natural person who is furnished temporarily to you: (a) To substitute for a permanent "employee" as defined in Paragraph (1) above, who is on leave; or (b) To meet seasonal or short-term workload conditions; while that person is subject to your direction and control and performing services for you. (3) "Employee" does not mean: (a) Any agent, broker, person leased to you by a labor leasing firm, factor, commission merchant, consignee, independent contractor or representative of the same general character; or (b) Any "manager," director or trustee except while performing acts coming within the scope of the usual duties of an "employee." "Manager" means a person serving in a directorial capacity for a limited liability company. L. 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 Page 6 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company PI-GLD-HS (10/11) Coverage Part, Paragraph 3.a. is deleted in its entirely and replaced by the following: a. Coverage under this provision is afforded 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 are also insureds, 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 a co - "employee" while in the course of his or her employment by you or performing duties related to the conduct of your business. This provision does not change Item 2.a.(1)(a) as it applies to managers of a limited liability company. c. Broadened Named Insured — Any organization and subsidiary thereof which you control and actively manage on the effective date of this Coverage Part. However, coverage does not apply to any organization or subsidiary not named in the Declarations as Named Insured, if they are also insured under another similar policy, but for its termination or the exhaustion of its limits of 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 lease 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. e. Home Care Providers — At the first Named Insured's option, 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. f. 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; or (2) Structural alterations, new construction or demolition operations performed by or on behalf of that person or organization. g. 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 writing in a contract or agreement that such person or organization is to be added as an additional insured on your policy. Such person or Page 7 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company PI-GLD-HS (10/11) 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 or political subdivision granting you a permit in connection with your premises subject to the following additional provision: (1) This insurance applies only with respect to the following hazards for which the state or political subdivision has issued a permit in connection with the premises you own, rent or control and to which this insurance applies: (a) 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; (b) The construction, erection, or removal of elevators; or (c) 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; (f) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; Page 8 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company PI-GLD-HS (10/11) (g) 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) The exceptions contained in Sub -paragraphs (d) or (f); or (ii) 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. j. Franchisor —Any person or organization with respect to their liability as the grantor of a franchise to you. k. 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 included within and not in addition to the limits of insurance shown in the Declarations I. 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 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: (a) 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 (b) 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. Page 9 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company PI-GLD-HS (10/11) m. State or Political Subdivisions — Any state or political subdivision 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 political subdivision 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." M. Duties in the Event of Occurrence, Claim or Suit SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 2. is amended as follows: a. is amended to include: 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. 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. N. Unintentional Failure To Disclose Hazards SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 6. Representations is amended to include the following: It is agreed that, based on our reliance on your representations as to existing hazards, if you should unintentionally fail to disclose all such hazards prior to the beginning of the policy period of this Coverage Part, we shall not deny coverage under this Coverage Part because of such failure. O. Transfer of Rights of Recovery Against Others To Us SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 8. Transfer of Rights of Page 10 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company PI-GLD-HS (10/11) Recovery Against Others To Us is deleted in its entirety and replaced by 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 insurer's rights of recovery prior to the occurrence of a loss, provided the waiver is made in a written contract. P. Liberalization SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, is amended to include the following: If we revise this endorsement to provide more coverage without additional premium charge, we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state. Q. Bodily Injury — Mental Anguish SECTION V - DEFINITIONS, Paragraph 3. Is deleted in its entirety and replaced by the following: "Bodily injury" means: a. Bodily injury, sickness or disease sustained by a person, and includes mental anguish resulting from any of these; and b. Except for mental anguish, includes death resulting from the foregoing (Item a. above) at any time. R. 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, the definition of "personal and advertising injury" is amended as follows: 1. SECTION V - DEFINITIONS, Paragraph 14.b. is deleted in its entirety and replaced by the following: b. Malicious prosecution or abuse of process; 2. SECTION V - DEFINITIONS, Paragraph 14. is amended by adding the following: Discrimination based on race, color, religion, sex, age or national origin, except when: a. Done intentionally by or at the direction of, or with the knowledge or consent of: (1) Any insured; or (2) Any executive officer, director, stockholder, partner or member of the insured; b. Directly or indirectly related to the employment, former or prospective employment, termination of employment, or application for employment of any person or persons by an insured; Page 11 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company PI-GLD-HS (10/11) c. Directly or indirectly related to the sale, rental, lease or sublease or prospective sales, rental, lease or sub -lease of any room, dwelling or premises by or at the direction of any insured; or d. Insurance for such discrimination is prohibited by or held in violation of law, public policy, legislation, court decision or administrative ruling. The above does not apply to fines or penalties imposed because of discrimination. Page 12 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company Contract Form New Contract Request Entity Information New Entity? Entity Name* Entity ID* GRIFFITH CENTERS FOR CHILDREN INC A.00029886 Contract Name* GRIFFITH CENTERS FOR CHILDREN INC (NEW CHILD PROTECTION AGREEMENT) Contract Status CTB REVIEW Contract ID 5927 Contract Lead* APEGG Contract Lead Email apegg @weldgov.com, co bbx xlkOweldgov.com Contract Description* CONSENT BID# B2200040 TERM: JUNE 1, 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 05/10/2022. Contract Type* AGREEMENT Amount* 30.00 Renewable* YES Automatic Renewal Grant IGA Department HUMAN SERVICES Department Email CM- HumanServices@weldgov.co m Department Head Email CM-HumanServices- DeptHead@weIdgov.com County Attorney GENERAL COUNTY ATTORNEY EMAIL County Attorney Email CM- 000NTYATTORNEYAWELDG OV.COM Requested BOCC Agenda Date* 06/08/2022 Due Date 06/04/2022 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 RSA 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* 031.31;2023 Renewal Date* 05/31/2023 Termination Notice Period Contact Information Contact Info Contact Name Purchasing Committed Delivery Date Expiration Date Contact Type Contact Email Contact Phone 1 Contact Phone 2 Purchasing Approver Purchasing Approved Date CONSENT 05:31,2022 Approval Process Department Head JAMIE ULRICH DH Approved Date 05/31/2022 Final Approval BOCC Approved BOCC Signed Date BOCC Agenda Date 06,0812022 Originator APEGG Finance Approver CONSENT Legal Counsel CONSENT Finance Approved Date Legal Counsel Approved Date 05/31/2022 05/31/2022 Tyler Ref it AG 060822 Hello