HomeMy WebLinkAbout20241053.tiffRESOLUTION
RE: APPROVE STANDARD FORM OF AGREEMENT FOR PROFESSIONAL SERVICES
FOR CASE MANAGEMENT AGENCY (CMA) SUPPORTS INTENSITY SCALE (SIS)
ASSESSMENTS, PROVIDER LIST, AND RATES, BETWEEN DEPARTMENT OF
HUMAN SERVICES AND VARIOUS PROVIDERS, AND AUTHORIZE CHAIR TO SIGN
AGREEMENTS CONSISTENT WITH SAID FORM
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board, sitting as the Weld County Board of Human Services, has been
presented with a Standard Form of Agreement for Professional Services for Case Management
Agency (CMA) Supports Intensity Scale (SIS) Assessments, Provider List, and Rates, between
the Department of Human Services and various providers, and
WHEREAS, after review, the Board deems it advisable to approve said standard form of
agreement, provider list, and rates, copies of which are attached hereto and incorporated herein
by reference, and to delegate standing authority to the Chair of the Board of County
Commissioners to execute individual agreements between the Department of Human Services
and various providers.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County, Colorado, sitting as the Weld County Board of Human Services, that the Standard Form
of Agreement for Professional Services for Case Management Agency (CMA) Supports Intensity
Scale (SIS) Assessments, Provider List, and Rates, between the Department of Human Services
and various providers, be, and hereby are, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign agreements consistent with said form.
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2024-1053
HR0096
STANDARD FORM OF AGREEMENT FOR PROFESSIONAL SERVICES FOR CASE
MANAGEMENT AGENCY (CMA) SUPPORTS INTENSITY SCALE (SIS) ASSESSMENTS,
PROVIDER LIST, AND RATES, BETWEEN DEPARTMENT OF HUMAN SERVICES AND
VARIOUS PROVIDERS
PAGE 2
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 1st day of May, A.D., 2024.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST:
Weld County Clerk to the Board
B( . LJtt4 U.) dcr
Deputy Clerk to the Board
RM:
Count rney
S
Date of signature: f I
EXCUSED
Kevin ! -oss, Chair
Perry L. Bu�c, Pro-Tem
Mike Freeman
XCUSED
tt K. James
sine
2024-1053
HR0096
BOARD OF COUNTY COMMISSIONERS
PASS -AROUND REVIEW
PASS -AROUND TITLE: Case Management Agency Supports Intensity Scale (515) Professional Services
Agreement Template and Provider List
DEPARTMENT: Human Services DATE: April 23, 2024
PERSON REQUESTING: Jamie Ulrich, Director, Human Services
Brief description of the problem/issue: On March 1, 2024, the Weld County Department of Human Services
began serving as the region's Case Management Agency (CMA) as a result of an awarded Request for Proposal
(RFP) through the Colorado Department of Health Care Policy & Financing (HCPF). To offer services to clients as
the CMA, a Supports Intensity Scale (SIS) assessment is required to be completed to develop an individualized
service plan to determine the daily supports a person with intellectual or developmental disabilities needs to
live as independently as possible. As a result of this requirement, the Department has developed the SIS
Professional Services Agreement and is requesting approval of this template, along with a list of proposed
vendors.
The Service Agreement and Exhibit A have been approved by Legal (B. Howell) and reflect a term date of May
1, 2024 through April 30, 2025 which may be extended upon written agreement by both parties. The following
information is attached for your reference:
1. Supports Intensity Scale (SIS) Professional Services Agreement Template and Provider List Template
2. Exhibit A — Scope of Services and Rates
3. Vendor List for SFY 2024-25
What options exist for the Board?
• Approval of the SIS Professional Services Agreement Template and Vendor List.
• Deny approval of the SIS Professional Services Agreement Template and Vendor List.
Consequences: WCDHS will not have contracts with providers.
Impacts: WCDHS will not be able to serve the individuals on our caseload.
Costs (Current Fiscal Year / Ongoing or Subsequent Fiscal Years):
• Total cost = $225.00 per fully completed assessment
• Pass-thru funding from the Colorado Department of Health Care Policy & Financing (HCPF).
Pass -Around Memorandum; April 23, 2024 — NOT IN CMS
2024-1053
5/1 ru0ua co
Recommendation:
• Approval of the Supports Intensity Scale (SIS) Professional Services Agreement Template and listed
Vendor List and authorize the Chair to sign subsequent agreements.
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
Pass -Around Memorandum; April 23, 2024 — NOT IN CMS
Weld County Supports Intensity Scale (SIS) Assessment Providers
SFY 2024-2025
CMS#
Supports Intensity Scale Provider
Elise Nowicki
Location
Email
maenowicki21@gmail.com
Language Offered
English
Vikki Disney
vdisnev@rmhumanservices.org
English
8083
Alex Turner
Clifton, Colorado
aturner@mtnvallev.org
English
Sulema Saenz Sanchez
Arvada, Colorado
ssaenz2894@gmail.com
English and Spanish
MickiP (Legal)
Mikii SchEeEh hoech (Preferred)
Boulder, Colorado
msoech@imaginecolorado.org
English
Emilia McGinn
Westminster, Colorado
emiliamcginn@gmail.com
English and Spanish
Ayanna Griffin
Denver, Colorado
Avanna griffin@vahoo.com
English
8084
Stacey Larrabee
Mansfield Center, Connecticut
Staceylarrabee15@gmail.com
Karol Guerrero
Karolguerrero43@gmail.com
WELD COUNTY AGREEMENT FOR PROFESSIONAL SERVICES
BETWEEN WELD COUNTY AND
SUPPORTS INTENSITY SCALE PROVIDER
THIS AGREEMENT is made and entered into this day of , 2024, by and between
the County of Weld, a body corporate and politic of the State of Colorado, by and through its Board of County
Commissioners, whose address is 1150 "O" Street, Greeley, Colorado 80631 hereinafter referred to as "County,"
and Name, who whose address is Address, hereinafter referred to as "Contractor".
WHEREAS, County desires to retain Contractor as an Independent Contractor to perform services as
more particularly set forth below; and
WHEREAS, Contractor has the ability, qualifications, and time available to timely perform the services,
and is willing to perform the services according to the terms of this Agreement.
WHEREAS, Contractor is authorized to do business in the State of Colorado and has the time, skill,
expertise, and experience necessary to provide the services as set forth below;
NOW, THEREFORE, in consideration of the mutual promises and covenants contained herein, the parties
hereto agree as follows:
1. Introduction. The terms of this Agreement are contained in the terms recited in this document and in Exhibit
A, Scope of Services and Rate Schedule, which forms an integral part of this Agreement. Exhibit A is specifically
incorporated herein by this reference.
2. Service or Work. Contractor agrees to provide all services, labor, personnel and materials necessary to
perform and complete the work outlined in the Scope of Work, as set forth in Exhibit A. Contractor shall further
be responsible for the timely completion and acknowledges that a failure to comply with the standards and
requirements of Work within the time limits prescribed by County may result in County's decision to withhold
payment or to terminate this Agreement.
3. Term. The term of this Agreement shall be from Date, through Date, or Contractor's completion of the
responsibilities described in Exhibit A. This Agreement may be extended annually upon written agreement of
both parties.
4. Termination; Breach; Cure. County may terminate this Agreement for its own convenience upon thirty (30)
days written notice to Contractor. Either Party may immediately terminate this Agreement upon material breach
of the other party, however the breaching party shall have fifteen (15) days after receiving such notice to cure
such breach. If cure is timely accomplished to satisfaction of non -breaching party, then agreement will continue
under its current terms and conditions. If this Agreement is terminated by County, Contractor shall be
compensated for, and such compensation shall be limited to, (1) the sum of the amounts contained in invoices
which it has submitted and which have been approved by the County; (2) the reasonable value to County of the
services which Contractor provided prior to the date of the termination notice, but which had not yet been
approved for payment; and (3) the cost of any work which the County approves in writing which it determines
is needed to accomplish an orderly termination of the work. County shall be entitled to the use of all material
generated pursuant to this Agreement upon termination. Upon termination of this Agreement by County,
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Contractor shall have no claim of any kind whatsoever against the County by reason of such termination or by
reason of any act incidental thereto, except for compensation for work satisfactorily performed and/or materials
described herein properly delivered.
5. Extension or Modification. Any amendments or modifications to this agreement shall be in writing signed
by both parties. No additional services or work performed by Contractor shall be the basis for additional
compensation unless and until Contractor has obtained written authorization and acknowledgement by County
for such additional services.
6. Compensation/Contract Amount. County agrees to pay Contractor through an invoice process during the
course of this Agreement in accordance with the Rate Schedule as described in Exhibit A. Contractor agrees to
submit invoices which detail the work completed by Contractor. The County will review each invoice and if it
agrees Contractor has completed the invoiced items to the County's satisfaction, it will remit payment to
Contractor.
Contractor agrees to work within the confines of the Scope of Services and Rate Schedule outlined in Exhibit A.
County will not withhold any taxes from monies paid to the Contractor hereunder and Contractor agrees to
be solely responsible for the accurate reporting and payment of any taxes related to payments made pursuant
to the terms of this Agreement.
7. Independent Contractor. 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.
8. Subcontractors. Contractor acknowledges that County 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 County's prior written consent, which may be withheld in County's
sole discretion.
9. Ownership. All work and information obtained by Contractor under this Agreement or individual work order
shall become or remain (as applicable), the property of County.
10. Confidentiality. Contractor agrees to keep confidential all of County's confidential information. Contractor
agrees not to sell, assign, distribute, or disclose any such confidential information to any other person or entity
without seeking written permission from the County. Contractor agrees to advise its employees, agents, and
consultants, of the confidential and proprietary nature of this confidential information and of the restrictions
imposed by this agreement.
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11. Warranty. Contractor warrants that the services performed under this Agreement will be performed in a
manner consistent with the standards governing such services and the provisions of this Agreement. Contractor
further represents and warrants that all services shall be performed by qualified personnel in a professional and
workmanlike manner, consistent with industry standards, and that all services will conform to applicable
specifications, including all Healthcare Policy and Finance requirements related to SIS Assessment Certification.
12. Acceptance of Services Not a Waiver. In no event shall any action by County hereunder constitute or be
construed to be a waiver by County of any breach of this Agreement or default which may then exist on the part
of Contractor. Acceptance by the County of, or payment for, the services completed under this Agreement shall
not be construed as a waiver of any of the County's rights under this Agreement or under the law generally.
13. Insurance and Indemnification. Contractor shall procure at least the minimum amount of automobile
liability insurance required by the State of Colorado for the use of any personal vehicle. Proof of said automobile
liability insurance shall be provided to County prior to the performance of any services under this Agreement.
14. Indemnity. The Contractor shall defend, indemnify and hold harmless County, its officers, agents, and
employees, from and against injury, loss damage, liability, suits, actions, or claims of any type or character arising
out of the work done in fulfillment of the terms of this Contract or on account of any act, claim or amount arising
or recovered under workers' compensation law or arising out of the failure of the Contractor to conform to any
statutes, ordinances, regulation, law or court decree.
15. Non -Assignment. Contractor may not assign or transfer this Agreement or any interest therein or claim
thereunder, without the prior written approval of County.
16. 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.
17. Compliance with Law. Contractor shall strictly comply with all applicable federal and State laws, rules and
regulations in effect or hereafter established, including without limitation, laws applicable to discrimination and
unfair employment practices.
18. Non -Exclusive Agreement. This Agreement is nonexclusive, and County may engage or use other.
Contractors or persons to perform services of the same or similar nature.
19. Entire Agreement/Modifications. This Agreement including the Exhibits attached hereto and incorporated
herein, contains the entire agreement between the parties with respect to the subject matter contained in this
Agreement. This instrument supersedes all prior negotiations, representations, and understandings or
agreements with respect to the subject matter contained in this Agreement. This Agreement may be changed
or supplemented only by a written instrument signed by both parties.
20. Fund Availability. Financial obligations of the County payable after the current fiscal year are contingent
upon funds for that purpose being appropriated, budgeted and otherwise made available. Execution of this
Agreement by County does not create an obligation on the part of County to expend funds not otherwise
appropriated in each succeeding year.
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21. Employee Financial Interest/Conflict of Interest — C.R.S. §§24-18-201 et seq. and §24-50-507. The
signatories to this Agreement state 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.
22. 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.
23. 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 §§24-10-101 et seq., as applicable now or hereafter amended.
24. Force Majeure. Neither the Contractor nor the County shall be liable for any delay in, or failure of
performance of, any covenant or promise contained in this Agreement, nor shall any delay or failure
constitute default or give rise to any liability for damages if, and only to extent that, such delay or failure is
caused by "force majeure." As used in this Agreement, "force majeure" means acts of God, acts of the public
enemy, unusually severe weather, fires, floods, epidemics, quarantines, strikes, labor disputes and freight
embargoes, to the extent such events were not the result of, or were not aggravated by, the acts or omissions
of the non -performing or delayed party.
25. No Third -Party Beneficiary. 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.
26. 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 or its designee.
27. 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.
28. Acknowledgment. County and Contractor acknowledge that each has read this Agreement, understands it
and agrees to be bound by its terms. Both parties further agree that this Agreement, with the attached Exhibit
A , is the complete and exclusive statement of agreement between the parties and supersedes all proposals or
prior agreements, oral or written, and any other communications between the parties relating to the subject
matter of this Agreement.
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IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year
first above written.
COUNTY:
ATTEST: BOARD OF COUNTY COMMISSIONERS
Clerk to the Board WELD COUNTY, COLORADO
BY:
Deputy Clerk to the Board
Kevin D. Ross, Chair
VENDOR:
Name
Address
City, State Zip
By:
Name, Title
Date:
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EXHIBIT A
SCOPE OF SERVICES AND RATE SCHEDULE
1) The Contractor will need to complete the deliverables listed below:
a. The Support Intensity Scale (SIS) Assessor is obligated to maintain current credentials with the
Department of Health Care Policy & Financing (HCPF) SIS Team.
b. The Assessor shall provide information regarding their availability to conduct SIS assessments,
whether in -person or virtual.
c. When a SIS assessment needs to be scheduled or completed, the Case Management Agency
(CMA) Program Manager will email the Assessor with the following details:
d. Name, date of birth, Medicaid number, address, and phone number of the member.
e. Names, email addresses, and phone numbers of respondents.
f. Any specific days of the week or times of day preferred or to be avoided for scheduling the SIS
assessment.
g. The SIS Assessor will promptly contact the member/respondents to arrange the earliest
possible date for the SIS assessment. If the schedule date is beyond one (1) business day, the
SIS assessor will notify the CMA Program Manager of the date and reason for delay.
h. After scheduling, the Assessor will share the most recent versions of the following forms and
guides with the member and respondents via email:
i. SIS Complaint Process
j. Support Level Review Process
k. Supports Intensity Scale and Support Level Disclosure forms.
I. SIS-A Respondent Guide
m. On the day of the SIS assessment, the Assessor will review each form with the individual and
their guardian, if applicable, and obtain signature(s) on the Disclosure form.
n. Upon completion of the SIS assessment, the Assessor will enter the documentation into SIS
Online within 3 days business days.
o. The Assessor will notify the CMA Program Manager via secure email that the SIS assessment
has been entered. The Assessor will attach the signed Disclosure form and their invoice to the
email. If completing multiple assessments during a calendar month, the Assessor may submit
their invoice listing all assessments at the end of the month.
2) Fees for Services:
a. Services rendered will be reimbursed at $225.00 per completed assessment.
3) Invoice and Payment
a. Monthly Invoicing: The Contractor shall invoice CMA within four (4) working days of the end of the
month in which the services were performed, except at the end of the fiscal year when invoices
are due two (2) working days from the end of the fiscal year.
b. Invoices should be sent via email to wccmabilling@weld.gov
c. Vendor must include the following detail on invoices in order to be paid for services:
i. Name of member/respondent(s) assessed.
ii. Dates of Service.
iii. Total Amount Due.
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d. In order to comply with HCPF State General Funds reporting requirements, no
invoices received from the Contractor after July 3, 2024, for Fiscal Year July 1, 2023
thru June 30, 2024 will be accepted or paid by CMA, the date of July 3, 2024 is subject
to change pending Fiscal Year 24-25 holiday schedule.
e. County shall pay Contractor within thirty (30) days of County's receipt of such
invoice.
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