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COLORADO
Office of Children,
Youth & Families
Department of Human Services
SS -23A Agreement to Purchase
Revised 10/15
AGREEMENT TO PURCHASE
OUT -OF -HOME PLACEMENT SERVICES
SS23A
• CHILD PLACEMENT AGENCY SERVICES (CPA)
❑ CHILD HABILITATION RESIDENTIAL PROGRAM (CHRP)
❑ GROUP HOME/GROUP CENTER CARE
❑ INDEPENDENT LIVING
❑ PSYCHIATRIC RESIDENTIAL TREATMENT FACILITY (PRTF)
❑ RESIDENTIAL CHILD CARE FACILITY (RCCF)
❑ RESIDENTIAL DRUG/ALCOHOL PROGRAM
❑ SHELTER CARE
❑ SUBSIDIZED ADOPTION
❑ TRANSITION/HOME BASED AFTER -CARE (RCCF)
• OTHER (DESCRIBE): TREAMENT FOSTER CARE SERVICES
THIS IS AN AGREEMENT, made this day of J IJLb6 12024,
between Weld County Department of Social/Human Services, PO Box A, Greeley, Colorado,
80632, hereinafter called "County" and Specialized Alternatives For Family And Youth,
1600 Specht Point Rd, Suite 105, Fort Collins, CO 80525, hereinafter called "contractor".
THIS AGREEMENT:
Shall include all children placed by Weld County Department of Social/Human Services and
placed with Specialized Alternatives For Family And Youth.
A child specific addendum, identifying individual service needs, must be completed and
attached to supplement this agreement for each child being served by the facility. If this
is a CPA placement, the child specific addendum should also address how administrative
services will be provided in the event the child is placed for adoption in a foster home
supervised by the CPA.
WHEREAS, the Colorado State Department of Human Services, hereinafter called "State
Department" is authorized to provide social services to individuals and families of
individuals through its agents, County Departments of Social/Human Services, and
WHEREAS, the County is authorized to purchase certain services for eligible children
under State Department rules, and
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Jared Polls, Governor I Michelle Byrne, s, Eotive Director
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WHEREAS, the County wishes to provide these services by purchasing them from
Contractor, and,
WHEREAS, the Contractor is licensed as a Child Placement Agency, Residential Child
Care Facility, certified Psychiatric Residential Treatment Facility, or meets the
requirements for other licensed service types.
NOW THEREFORE, it is hereby agreed that in consideration of the mutual undertakings
the County and the Contractor agree as follows:
1. This Agreement shall be in force from the date of the agreement,
July 1, 2024, until the end of the Colorado fiscal year, June 30, 2025. Any
child may be removed from the facility prior to the end of the fiscal year
by the county department.
2. This Agreement may be renewed only by entering into a new written
Agreement such as this Agreement signed by the authorized
representatives of the parties. Except as otherwise provided above,
either party shall have the right to terminate this contract by giving the
other party thirty (30) days notice by registered mail, return receipt
requested. If notice is so given, this contract shall terminate on the
expiration of the thirty (30) days or until the eligible child(ren) can be
placed elsewhere, whichever occurs first, and the liability of the parties
hereunder for further performance of the terms of this Agreement shall
thereupon cease, but the parties shall not be released from the duty to
perform their obligations up to the date of termination.
3. This Agreement is in lieu of and supersedes all prior agreements
between the parties hereto and relating to the care and services herein
described.
SECTION I: DESCRIPTION OF SERVICES TO BE PURCHASED:
1. The total rate of payment for care and services under this Agreement shall not
exceed: the established rate for the PRTF; for CPA placements, the negotiated rate or
the approved vendor rate; for RCCF placements, the established Fee -for -Service rate
and the negotiated rate or the approved vendor rate; and, for CHRP placements, the
agreed upon service proposal rate. The total rate of payment for care and services for
other service types will be as negotiated between the County and the Contractor.
Medicaid rules shall govern activities to be covered in the daily rate paid to PRTFs.
The amount paid for purchased care and services for less than a full month will be
based upon the daily rate.
2. Payment for a child's temporary absence from the facility, including absence due to
hospitalization, will be made in accordance with State Department rules in Staff
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Jared Potis, Governor I Michelle Barnes, Executive Director
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Manual Volume VII, 7.406.1, F (12 CCR 2509-5).
3. Transportation shall be furnished by County between the child's residence and
Contractor's facility for the initial placement and return after the treatment plan is
completed. If the child runs away from the Contractor's facility, the County shall provide
transportation to either return the child to the facility or to other care as arranged by
the County. The County has responsibility for the decision to return the child to the
facility, with input from the Contractor.
4. All other transportation associated with the Contractor's proposed services will be
provided by Contractor. Any transportation costs not covered or contemplated in the
original treatment plan must be negotiated between County and Contractor and are
not subject to reimbursement under this Agreement. However, provisions for
payment of other transportation may be provided for in the Family Service Plan /
Individual Plan of Care.
5. Any transportation costs to be incurred on behalf of a child in placement, which are to
be borne by persons, or agencies, which are not a party to this contract, shall be specified
in the treatment/service plan, and those persons shall acknowledge their responsibility
by signing the treatment/service plan.
SECTION II: LEGAL STATUS AND AUTHORIZATIONS:
1. Such permission as is held by the County is hereby granted to the Contractor
to authorize routine or emergency medical and dental treatment except that:
a. Medical or dental care shall be provided by personnel duly licensed by law as
required by the State of Colorado. It is mutually understood hereto that hospital
expenses, surgery, ophthalmology services, eyeglasses, orthodontia or other
unusual expenses are not included in the monthly rate. The cost of any items not
covered by Medicaid will be negotiated between County and Contractor.
Medicaid rules shall govern activities to be covered in the daily rate paid to
PRTFs.
2. County and Contractor shall insure that the child(ren) is enrolled in the Early and
Periodic Screening, Diagnosis and Treatment Program.
3. It is agreed and permission is granted for the child(ren) to participate in planned
recreational and social activities of Contractor, including supervised off grounds
excursions and extended trips within the State, provided that Contractor has written
permission from County and legal guardian for any trips out of Colorado for any reason
and any planned absence from the facility of over seven (7) days within a consecutive
30- day period. Such written permission may be in the treatment/service plan. Further,
Contractor and County will also secure, where possible, permission from parents or
guardians of the child placed with the Contractor. Any planned absence of more than
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Jared Polo, Governor I Michelle Barnes. Executive Director
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24 hours for children placed in a PRTF is not Medicaid reimbursable.
4. County and Contractor shall inform each other and the local school district of any
changes in parental residence affecting educational status which comes to their
attention.
SECTION III: REASONS FOR REFERRAL, TREATMENT PLAN, AND PROGRESS REPORTS:
1. County and Contractor agree and understand that the reasons for referral, which
necessitate purchasing services for children are specified in the attached child specific
addendum and Family Services Plan. Any other relevant information concerning these
children that does not necessitate purchasing services is also included in the
addendum.
2. County and Contractor shall develop an initial plan that addresses the immediate
and/or emergency needs of the child within 72 hours of admission for children in RCCFs
or group homes except PRTF. County and Contractor shall formulate an initial individual
plan of care within 14 calendar days after admission for children in RCCFs or group
homes except PRTF. The placement date is that date noted in the attached child specific
addendum included with this contract. The Child's Family Service Plan may be utilized
as an Individual Plan of Care for this purpose for facilities. Modifications to this plan
shall be agreed to in writing on the plan or as a supplemental document.
3. County and Contractor shall formulate an initial individual plan of care for children in
PRTFs within 72 hours. For children in a PRTF a comprehensive individual plan of care
must be completed by the multidisciplinary team within 14 calendar days from the
placement date. The placement date is that date noted in the attached child specific
addendum included with this contract. Modifications to this plan shall be agreed to in
writing on the plan or as a supplemental document.
4. The individual plan of care shall be goal oriented and time -limited and shall:
a. Address all areas listed in Section 7.714.4, C, 2, (12 CCR 2509-8) together with
clinical and other needs including the child's presenting problems, physical
health, emotional status, behavior, support system in the community, available
resources, and discharge plan.
b. Include specific goals and measurable objectives, expected dates of
achievement, specific discharge and transitional/after-care and follow up
services criteria to be met for termination of treatment.
c. Specify the type, frequency, and duration of clinical therapy services,
rehabilitation services, medication management, emergency services, initial
assessment, documented treatment modifications, and other services
determined to be necessary to meet the child's specific goals.
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Jared Polls, Governor I Michelle Barnes. Executive Director
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d. Specify that all therapeutic services are necessary to meet the needs of the
child and to treat the child's current diagnosis.
e. Identify the provision of, or the referral for, services other than RCCF services
and shall document any court ordered treatment including identifying the
agency responsible for providing the court ordered treatment.
f. Anticipated living arrangement for the child at the date of discharge;
g. Anticipated educational arrangement for the child at the time of discharge;
h. Anticipated date for discharge from treatment purchased for the child.
i. A permanency goal for the child.
5. Monthly, Child Placement Agencies, RCCFs and other contractor types other than
PRTF, shall conduct a monthly review of each plan to evaluate whether the short-term
and long-term goals have been achieved or not achieved. These parties shall provide the
County with written reports which address changes to the child's physical condition,
psychological and social functioning, changes in the child's family situation, educational
progress, significant incidents or disciplinary actions, and progress made to achieve
goals specified in the treatment plan. Further, the Contractor agrees to sequence
reports to be received by the County 15 calendar days prior to judicial or administrative
hearings or reviews when provided with 30 calendar days advance notice of such dates
by County.
6. Every 14 days, PRTFs shall provide the County with written reports which address
changes to the child's physical condition, psychological and social functioning, changes
in the child's family situation, educational progress, significant incidents or disciplinary
actions, and progress made to achieve goals specified in the treatment plan.
SECTION IV: CONTRACTOR SHALL:
1. Conform with and abide by all rules and regulations of the Colorado Department of
Human Services, the Colorado Department of Health Care Policy and Financing (if
appropriate), the State of Colorado and any applicable federal laws and regulations,
as
such, which may be amended from time to time, and shall be binding on Contractor and
control any disputes in this Agreement.
2. Maintain a current license and maintain license requirements as specified under State
law and rule.
3. Not charge any fees to children or families of children referred by county for any
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Jared PoUs, Governor I Michelle Barnes, Executive Director
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services provided under this Agreement.
4. Not assign the obligations under this Agreement nor enter into any sub -contract
without the express written approval of the Director of the County Department or
his/her appointed designee.
5. Abide by all applicable provisions of Title VI and VII of the Federal Civil Rights Act of
1964, Section 504 of the Rehabilitation Act of 1973, Title XX of the Social Security Act of
1975 as revised, and provide confidentiality of information concerning the child in
compliance with the Health Insurance Portability and Accountability Act (HIPAA).
6. Maintain during the term of this Agreement a liability insurance policy of at least
$25,000 for CPAs and $400,000 for PRTFs, and RCCFs for property damage liability,
$150,000 for injury and/or damage to any one person, and $600,000 for total injuries
arising from any one accident.
7. Maintain during the terms of this Agreement an insurance policy or a fidelity bond
in an amount deemed sufficient by the county, covering the activities of any of its
officers, agents, or employees responsible for the implementation and/or
administration of this contract in order to make reparations for any wrongful acts,
omissions, or any other defalcations of the Contractor.
8. Indemnify County, Colorado Department of Human Services, Colorado Department of
Health Care Policy & Financing, and the State of Colorado against any and loss against
all claims and actions based upon or arising out of damage or injury, including death, to
persons or property caused or sustained in connection with the performance of this
contract or by conditions created thereby, or based upon any violations of any statute,
ordinance, or regulation and the defense of any such claims or actions.
Paragraphs 6, 7 and 8 do not apply to the University of Colorado contracts with county
departments.
9. In regards to University of Colorado contractors only, the contractor shall be
responsible for its own wrongful or negligent acts or omissions or those of its officers,
agents, or employees while performing their professional duties to the full extent
allowed by law. Notwithstanding the foregoing, nothing in this Agreement is a
limitation or waiver of the application of the Colorado Governmental Immunity Act set
forth in §24-10-101 to §24-10-120, C.R.S., any claims resulting from the performance of
the University of Colorado, its employees or agents under this Agreement.
10. Maintain service program records, fiscal records, documentation and other
records, which will sufficiently and properly reflect all direct and indirect costs of any
nature incurred in the performance of this Agreement. The above shall be subject at
all reasonable times to inspection, review or audit by federal, Colorado Department
of Human Services, Colorado Department of Health Care Policy & Financing, or
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Jared Polls, Governor I Michelle Barnes, Executive Director
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county personnel, and other persons authorized in writing by the Executive Director
of the Colorado Department of Human Services.
11. Contractor shall, in any instance of a potential adoption by a foster parent, provide
the initial home study, the SAFE study update, annual certification updates and related
materials when requested by the County within fourteen working days of the request. At
all other times the Contractor shall make home studies and related materials available to
the County for review, at a location agreed upon by the County and the Contractor,
during regular business hours.
12. Bill the County for services rendered, using the required form. This form is to be
mailed to the County by the last day of the month of care. Billings for PRTFs shall be
made to the MMIS System only. Billings for RCCF fee -for —service and CHRP shall be
made to either the MMIS System or the County. Billings for RCCFs daily rate, CPAs and
other contractor types shall be made to the County only. Contractor will not be paid by
the county when billing is not received by the County within 30 calendar days following
the billing due date.
13. Attend and participate in Administrative Reviews for children in placement with the
Contractor pursuant to two (2) weeks written notice by the County. The Contractor
shall encourage children over the age of twelve to attend their Administrative
Reviews. Participation may be in person or by teleconference.
14. The Contractor shall pay the foster parent the amount agreed upon with the county
as the child maintenance or room and board. Any payment to the foster parent in excess
of the child maintenance or room and board amount shall be treated as income to the
foster parent.
15. The Contractor shall have the on -site presence of at least one (1) official who has
received State training in how to use and apply the reasonable and prudent parent
standard and who, with respect to any child or youth placed at the Contractor's facility,
is designated to be the caregiver authorized to apply the reasonable and prudent
parent standard to decisions involving the participation of the child or youth in age or
developmentally -appropriate activities. In the case of a Foster Care Home certified by a
Child Placement Agency, Contractor agrees that each foster parent has received State
training in how to use and apply the reasonable and prudent parent standard to
decisions
involving the participation of the child or youth in age or developmentally appropriate
activities.
16. Contractor shall ensure that each foster parent or caregiver authorized to apply the
reasonable and prudent parent standard receives sufficient, ongoing training to
continue to use and apply the reasonable and prudent parent standard for each child
or youth placed in the foster home or facility.
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Jared Potis, Governor I Michelle Barnes, Executive Director
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SECTION V: COUNTY SHALL:
1. Determine eligibility of the children under this Agreement for placement and
medical coverage. Medicaid rules and regulations shall govern determination of
Medicaid eligibility.
2. Assess and collect fees in accordance with the rules and regulations of the
Colorado Department of Human Services.
3. Reimburse Contractor by the 15th of the following month in accordance with fiscal
system time frames for services purchased under this Agreement in accordance with
the established rate when billing is submitted as described in Section IV, Number 10
(above).
4. Abide by all the rules and regulations of the Colorado Department of Human Services,
federal rules and regulations and the laws of the State of Colorado, any of which may be
amended from time to time.
5. If this agreement covers an initial placement for a child, the Contractor may receive
a clothing allowance in accordance with State Department rules.
6. Monitor children's progress in accordance with the treatment/family services plan
and the requirements of Colorado Department of Human Services rules and provide
consultation to Contractor in relation to the services purchased under this Agreement.
7. Invite Contractor to Administrative Reviews at least 2 weeks prior to the
scheduled review.
8. Involve Contractor in planning for the child and give the Contractor a copy of the
Family Services Plan at time of placement or as soon as completed and when updated
or revised.
9. The County shall seek recovery from the RCCF, CPA or other contractor type for any
non -Medicaid payment amounts that have been misused as defined in rules. The County
may withhold subsequent payments to recover any funds misused by the RCCF, CPA or
other contractor type. The County shall seek recovery of any remaining funds as a debt
due the County for the benefit of the state. The RCCF or CPA may appeal the decision to
recover or withhold subsequent payments as defined in rules.
10. The County shall identify the amount agreed upon with the Contractor to be paid to
the foster parent for the child's room and board. Such amount will be the same as
shown in Trails for the child's maintenance.
11. Reimbursement rates that are negotiated between the County and the Contractor
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Jared Polis, Governor I Michelle Barnes, Executive Director
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shall be for allowable costs in one or more of four primary components: child
maintenance, administrative services, administrative maintenance, and treatment.
Contractor type will determine which of these four components will be included in the
reimbursement rate.
12. The County shall provide the Contractor with a copy of the policy that identifies
activities that providers trained in the reasonable and prudent parent standard
may approve, and identifies activities that require County department approval.
13. The County shall require that the person(s) authorized to apply the reasonable and
prudent parent standard, including each foster parent, will complete State training
specific to the reasonable and prudent parent standard and will receive ongoing
training as necessary in order., to meet the needs of each child or youth, and to use
and apply the reasonable and prudent parent standard.
SECTION VI: GENERAL PROVISIONS:
1. The Parties to this Agreement intend that the relationship between them,
contemplated by this Agreement is that of employer —independent contractor. No
agent, employee, or servant of Contractor shall be deemed to be an employee, agent,
or servant of the County. Contractor will be solely and entirely responsible for its acts
or of any agent, employee, servants and sub -contractors during the performance of this
Agreement.
2. Payment pursuant to this Agreement, if in State of Colorado, county, or federal funds,
whether in whole or in part, is subject to and contingent upon the continuing availability
of State of Colorado, county, and federal funds for the purpose thereof.
3. It is agreed that if, after investigation, it is shown that reasonable care was given to
guard and protect personal items brought to Contractor by the children, Contractor will
be released from responsibility for loss or damage to such personal items.
4. This Agreement is intended to be applied in conjunction with the child specific
addendum and family services plan as the complete integration of all understandings
between the parties. No prior or contemporaneous addition, deletion or other
amendment hereto shall have any force or affect whatsoever, unless embodied herein
in writing. No subsequent notation, renewal, addition, deletion, or other amendment
hereto shall have any force or effect unless embodied as a part of this written
Agreement. This section shall
not be construed as either prohibiting the periodic amending of the family services
plan or appending a county designed addendum to this agreement.
5. The contract shall permit the State Department to monitor service program, fiscal and
other records sufficiently to assure the purchase of services in this Agreement are
carried out for the benefit of the aforementioned client. Monitoring may occur through
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Jared Polls, Governor I Michelle Barnes, Executive Director
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review of program reports, on -site visits where applicable and other contracts as
deemed necessary. The Contractor understands that the State Department may provide
consultation to Contractor to assure satisfactory performance in the provision of
purchased services under this Agreement.
a. All reimbursement requests shall be submitted to and approved by the
appropriate County staff. Reimbursement for placement services shall be paid
from the date of admission up to, but not including, the day of discharge.
Furthermore, Medicaid payments for PRTF and CHRP placements are permitted
on the day of discharge in compliance with regulations promulgated by the
Colorado Department of Health Care Policy and Finance. Fee for Service will be
reimbursed as per Medicaid regulations. Medicaid funds shall not be limited to
funds encumbered in this contract and shall also include Medicaid funds for PRTF
and RCCF therapeutic services and CHRP services paid by the Department of
Health Care Policy and Financing. Payment for placement services will not be
provided for clients on "runaway" status unless the County has previously
approved it. Reimbursement requests for therapy costs for clients enrolled in
PRTF, RCCF, and CHRP programs shall be submitted to the Medicaid Fiscal Agent
in accordance with instructions provided by such Fiscal Agent. The Contractor
shall forward copies of such billings to the County on a monthly basis.
In the event that a Contractor receives payment for a per diem discharge day,
regardless of funding source, the Contractor shall refund those dollars forthwith.
b. The purpose of these requirements is to provide minimum assurance that the
Contractor has adequate accounting and budgeting information available to
allow management to maintain a financially viable enterprise and to
demonstrate financial accountability to the county departments of
human/social services and Colorado Department of Human Services for the use
of public funds.
(1) The Contractor must have in place a double entry accounting system and all
financial transactions must be posted to this system. Financial statements,
prepared from information provided by this system, shall be presented in
conformity with U.S. generally accepted accounting principles (GAAP). The
Contractor must also have adequate time keeping and cost allocation systems
to allocate salary cost and indirect cost to appropriate cost centers. Books and
records of the Contractor shall be subject, at any reasonable time, to
inspection,
audit or copying by appropriate Federal, State or county personnel, or such
independent auditors or accountants as maybe designated by these personnel.
(2) All billing by the contractor must be in a format approved by the fiscal agent
or county. Contractors must bill the fiscal agent and county at least once a
month. Contractors may bill twice a month, on the 15th and last day of the
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Jared Polis, Governor I Michelle Barnes, Executive Director
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month, for services rendered. Bills will be returned unpaid if the bills do not
conform to the approved format or the documentation is inadequate.
(3) All Contractors whose total annual expenditures are $100,000 or more shall
submit an annual audit of their financial statements by an independent certified
public accountant. Contractors with total annual expenditures less than
$100,000 may submit an audit as described above or may submit compiled or
reviewed financial statements, prepared in accordance with generally accepted
accounting principles. If the Contractor is a government agency that has an
independent audit done by another agency of that government, its audited
financial statements, prepared in accordance with generally accepted accounting
principles for state and local governments meet this requirement. The audited,
compiled or reviewed financial statements of PRTFs, RCCFs, and CPAs must be
completed and a copy provided to the Colorado Department of Human Services
(Attn: Administrator for PRTFs, and RCCFs and Attn: Audit Division Director for
CPAs) within 180 days after the contractor's fiscal year end. The audited financial
statements and supplementary information defined in regulation for various
agencies shall be presented as described in Section VI, B (1), above and must
contain sufficient detail to provide evidence of financial accountability under the
terms of this contract and controlling state regulations. Contractors that are a
subsidiary of a parent organization must submit separate financial statements
for the subsidiary that detail each of the Contractor's facilities and/or programs
that provide services for the Colorado Department of Human Services and also
must provide a reconciliation of these financial statements to the consolidated
financial statements of the organization as a whole. When applicable, the
Contractor must comply with the audit requirements found in the Single Audit
Act of 1984 and the Single Audit Act Amendments of 1996 and U. S. Office of
Management and Budget (OMB) Circular A-133, Audits of States, Local
Governments, and Non- Profit Organizations including subsequent revisions, and
appropriate audit and financial reporting requirements as defined in State laws,
rules, and regulations.
(4) If Contractors do not submit their annual audit or refuse to disclose financial
information regarding the operation of the program in a timely manner, the
Fiscal Agent may withhold payment until the audit and/or requested
information is submitted. If the contractor is a CPA, then sanctions of the
contractor may occur for failure to submit.
(5) In cases where documentation does not exist to support audit information
or services provided, contractor will be required to repay all funds received
for which documentation does not exist.
(6) In cases where audit deficiencies are noted, a plan of corrective action shall
be submitted to the State Department's Audit Division for approval within 4
months of the date of the audit.
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Jared Polls, Governor I Michelle Barnes, Executive Director
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(7) Failure to comply with any of these requirements, including items on the
addendum is justification for the County to impose fiscal sanctions, penalties,
or cancel the contract.
6. In the event this contract is terminated, final payment to the Contractor may be
withheld at the discretion of the County until final audit. Incorrect payments to the
Contractor due to omission, error, fraud, or misuse of funds shall be recovered from
the Contractor either by deduction from subsequent payments under this contract or
other contracts between the County and the Contractor or by the County, as a debt
due to both the State of Colorado, the Colorado Department of Human Services and
the County. The waiver of any violation shall not be construed as a waiver of any other
or subsequent violation of this contract or appropriate statutes and regulations.
WHEREFORE, the parties have herein set their hands and affixed their seals the day and
date first written above.
�/►�� COUNTY:
'-.r/iiZ'#(itt)...
ATTEST: v• e&O ei BOARD OF COUNTY COMMISSIONERS
er to the Board WELD OUNTY, COLORADO
BY:
Deputy Cler,
Perry L. BucChair Pro -Tern
JUL 0 12024
CONTRACTOR:
Specialized Alternatives For Family And Youth
1600 Specht Point Rd, Suite 105
Fort Collins, CO 80525
,]ehha Cotewran, LCSW
By: Jenna Coleman, LCSW (Jun 25. 2023 i'7.31 MDT)
Contractor's (or designee's) Signature
and Date
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Jared Polls, Governor Michelle Bames, Executive Director
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,2009,/-/-797
EXHIBIT A to the SS23A
Additional Provisions for the Agreement to
Purchase Out -of -Home Placement Services SS23A
For the Purchase of
Child Placement Agency Services
The following additional provisions of this Exhibit apply to the agreement entitled,
"Agreement to Purchase Out -of -Home Placement Services SS23A, attached hereto, by and
between the Board of County Commissioners of Weld County, on behalf of the Weld County
Department of Human Services," hereinafter referred to as, "County," and Specialized
Alternatives For Family And Youth, hereinafter referred to as, "Contractor."
1. County agrees to purchase and Contractor agrees to provide the care and services which
are listed in this agreement for Provider ID# 1662183 at the Contractor's base anchor
rate as outlined by the Colorado Office of Children, Youth & Families Division of Child
Welfare, unless the Contractor and County have agreed to utilize the Inventory for
Client and Agency Planning (ICAP) assessment and corresponding rate structure for
children who have significant intellectual or developmental disabilities or intensive
medical or physical needs. These services will be for children who have been deemed
eligible for social services under the statues, rules, and regulations of the State of
Colorado.
2. All bed hold authorizations and payments are subject to a 7 -day maximum for a child's
temporary absence from a facility; however, if the absence is a result of hospitalization,
the maximum bed hold authorization may be up to 14 days. Bed hold requests must
have prior written authorization from County's Department Administrator or Designee
before payment will be release to provider.
3. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be
furnished by the Contractor under this contract for facilities that provide sex offender
treatment.
4. Contractor agrees to have appropriate personnel available to attend or participate in
Family Engagement, Team Decision Making meetings, or court hearings. Contractor shall
be notified by County staff of the dates and times attendance is requested.
5. Contractor agrees to cooperate with any vendors hired by the County to shorten the
duration of placement.
6. Contractor agrees to have physical examinations completed within 14 days and dental
examinations completed within 8 weeks of the child being placed with Contractor. All
documentation of these examinations shall be forward to County.
Exhibit to the 5523A
1 Revised 6/2023
7. Contractor agrees to arrange a full evaluation of an Individualized Educational Plan (IEP)
for youth designated as a Special Education Student every 3 years and coordinate
reviews every year. If the IEP is due while the child is in placement, the Contractor shall
complete or obtain a completed IEP. A copy will then be forwarded to the County.
8. Children in Psychiatric Residential Treatment Facilities, Residential Child Care Facilities
and Child Placement Agencies are generally not eligible to receive clothing allowances as
outlined in the Weld County Department of Human Services Policy Manual. However, a
one-time emergency clothing allowance may be approved in limited circumstances,
prior written authorization from the County's Department Administrator is required
before payment will be released to provider.
9. County shall have access to Contractor's financial records as they relate to this
Agreement for purposes of audit. Such records shall be complete and available for audit
90 days after final payment hereunder and shall be retained and available for audit
purposes for at least five years after final payment hereunder.
10. Time is of the essence in each and all of the provisions of this Agreement.
11. 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.
12. Any notice required to be given under this Agreement shall be in writing and shall be
mailed or delivered to the other party at that party's address as stated above.
13. This Agreement and the provision of services hereunder shall be subject to the laws of
Colorado and be in accordance with the policies, procedures, and practices of County.
14. This Agreement is nonexclusive, and County may engage or use other contractors or
persons to perform services of the same or similar nature.
15. Contract Professional certifies, warrants, and agrees that it does not knowingly employ
or contract with an illegal alien who will perform work under this contract. Contract
Professional 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. Contract Professional 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 Contract Professional that
the subcontractor shall not knowingly employ or contract with an illegal alien to
perform work under this Agreement. Contract Professional shall not use E -Verify
Program or State of Colorado program procedures to undertake pre -employment
Exhibit to the SS23A
2 Revised 6/2023
screening or job applicants while this Agreement is being performed. If Contract
Professional obtains actual knowledge that a subcontractor performing work under the
public contract for services knowingly employs or contracts with an illegal alien Contract
Professional shall notify the subcontractor and County within three (3) days that
Contract Professional has actual knowledge that a subcontractor is employing or
contracting with an illegal alien and shall terminate the subcontract if a subcontractor
does not stop employing or contracting with the illegal alien within three (3) days of
receiving notice. Contract Professional 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. Contract Professional shall
comply with reasonable requests made in the course of an investigation by the Colorado
Department of Labor and Employment. Contract Professional shall, within twenty days
after hiring a new employee to perform work under the contract, affirm that Contract
Professional 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. Contract Professional shall deliver to County, 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 federal or state law. If Contract Professional fails to comply
with any requirement of this provision, County may terminate this Agreement for
breach, and if so terminated, Contract Professional shall be liable for actual and
consequential damages.
Except where exempted by federal law and except as provided in C.R.S. § 24-76.5-
103(3), if Contract Professional receives federal or state funds under the contract,
Contract Professional must confirm that any individual natural person eighteen (18)
years of age or older is lawfully present in the United States, if such individual applies for
public benefits provided under the contract. If Contract Professional operates as a sole
proprietor, it hereby swears or affirms under penalty of perjury that it: 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 federal or state law,
and (c) shall produce one of the forms of identification required by federal law prior to
the effective date of the contract.
16. Contractor assures and certifies that it and its principals:
a. Are not presently debarred, suspended, proposed for debarment, and
declared ineligible or voluntarily excluded from covered transactions by a
federal department or agency;
b. Have not, within a three-year period of preceding this Agreement, been
convicted of or had a civil judgment rendered against them for commission of
fraud or a criminal offense in connection with obtaining, attempting to obtain,
or performing a public (federal, state, or local) transaction or contract under a
public transaction; violation of federal or state antitrust statutes or
Exhibit to the 5523A
3 Revised 6/2023
commission of embezzlement, theft, forgery, bribery, falsification or
destruction of records, making false statements, or receiving stolen property;
c. Are not presently indicted for or otherwise criminally or civilly charged by a
government entity (federal, state, or local) with commission of any of the
offenses enumerated in paragraph (B) above;
d. Have not within a three-year period preceding this Agreement, had one or more
public transactions (federal, state, and local) terminated for cause or default.
17. In addition to terminating this Agreement, in accordance with the provisions of the
attached Agreement, the County may exercise the following remedial actions if the
County finds and determines that the Contractor has substantially failed to satisfy the
scope of work found in the Agreement, any Exhibit, or the child specific addendum
SS23B. 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
include, but are not limited to, any one or more of the following:
a. Withhold payment to 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
Contractor cannot be performed or if performed would be of no value to
County. Denial of the amount of payment shall be reasonably related to the
amount of work or deliverables lost to County.
c. Recover from Contractor any incorrect payment to Contractor due to
omission, error, fraud, and/or defalcation by deducting from subsequent
payments underthis Agreement, or other agreements between County and
Contractor, or as a debt to County, or otherwise as provided by law.
18. It is expressly understood and agreed that the enforcement of the terms and conditions
of this Agreement, and all rights of action relating to such enforcement, shall be strictly
reserved to the undersigned parties or their assignees, and nothing contained in this
Agreement shall give or allow any claim or right of action whatsoever by any other
person not included in this Agreement. It is the express intention of the undersigned
parties that any entity other than the undersigned parties or their assignees receiving
services or benefits under this Agreement shall be an incidental beneficiary only.
19. No portion of this Agreement shall be deemed to constitute a waiver of any immunity
including those provided by the Colorado Governmental Immunity Act §§24-10-101 et
seq., as applicable now or hereafter amended, that the parties or their officers or
employees may possess, nor shall any portion of this Agreement be deemed to have
Exhibit to the 5523A
4 Revised 6/2023
created a duty of care that did not previously exist with respect to any person not a
party to this Agreement. The parties hereto acknowledge and agree that no part of this
Agreement is intended to circumvent or replace such immunities.
20. Contractor shall promptly notify County in the event in which it is a party defendant or
respondent in a case, which involves services provided under the agreement. The
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 County Director. The term
"litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy,
reorganizations and/or foreclosure.
21. Any amendments or modifications to this agreement shall be in writing signed by both
parties.
22. 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.
23. 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 is not entitled to unemployment
insurance or workers' compensation benefits through County and County shall not pay
for or otherwise provide such coverage for Contractor. Unemployment insurance
benefits will not be available to Contractor for services provided under this
Agreement. Contractor shall pay when due any/all applicable employment taxes and
income taxes and local head taxes (if applicable) incurred as a result of the services
provided under this Agreement.
24. County reserves the right to require the Contractor to provide a certificate of insurance,
policy, or other proof of insurance at its sole discretion.
25. Contractor shall ensure all homes are recertified within required timelines and will
follow Colorado Volume 7 Social Services Rules 7.710.35 Renewal or Continuation
Notice and 7.710.36 Recertification.
26. Contractor will notify the County a minimum of 30 days prior to a license expiring if a
home is not going to be recertified within the required timeline. In the event the
County has children placed in the home and the license expires, the County will not be
responsible for any payment to the Contractor during the unlicensed time.
Exhibit to the SS23A
5 Revised 6/2023
27. For Children's Habilitation Residential Program (CHRP) waiver funded placements, the
Contractor and the Community Center Board (CCB) will be responsible for ensuring all
Prior Authorizations (PAR) are current and that there is no gap in reimbursement. The
County will not be responsible for any non -reimbursement to the provider if PARS are
not approved.
Exhibit to the SS23A
6 Revised 6/2023
EXHIBIT B to the SS23A
Additional Provisions for the Agreement to
Purchase Out -of -Home Placement Services SS23A
For the Purchase of
Treatment Foster Care Services
The following additional provisions of this Exhibit apply to the agreement entitled,
"Agreement to Purchase Out -of -Home Placement Services SS23A, attached hereto, by and
between the Board of County Commissioners of Weld County, on behalf of the Weld County
Department of Human Services," hereinafter referred to as, "County," and Specialized
Alternatives For Family And Youth, hereinafter referred to as, "Contractor."
1. County agrees to purchase and Contractor agrees to provide the care and services
which are listed in this agreement for Provider ID# 1662183 at the Contractor's base
anchor rate as outlined by the Colorado Office of Children, Youth & Families Division
of Child Welfare, unless the Contractor and County have agreed to utilize the
Inventory for Client and Agency Planning (ICAP) assessment and corresponding rate
structure for children who have significant intellectual or developmental disabilities
or intensive medical or physical needs. These services will be for children who have
been deemed eligible for social services under the statues, rules, and regulations of
the State of Colorado.
2. All bed hold authorizations and payments are subject to a 7 -day maximum for a
child's temporary absence from a facility; however, if the absence is a result of
hospitalization, the maximum bed hold authorization may be up to 14 days. Bed hold
requests must have prior written authorization from County's Department
Administrator or Designee before payment will be release to provider.
3. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will
be furnished by the Contractor under this contract for facilities that provide sex
offender treatment.
4. Contractor agrees to have appropriate personnel available to attend or participate in
Family Engagement, Team Decision Making meetings, or court hearings. Contractor
shall be notified by County staff of the dates and times attendance is requested.
5. Contractor agrees to cooperate with any vendors hired by the County to shorten the
duration of placement.
6. Contractor agrees to have physical examinations completed within 14 days and
dental examinations completed within 8 weeks of the child being placed with
Contractor. All documentation of these examinations shall be forward to County.
7. Contractor agrees to arrange a full evaluation of an Individualized Educational Plan
(IEP) for youth designated as a Special Education Student every 3 years and
Exhibit to the SS23A
6 Revised 6/2023
coordinate reviews every year. If the IEP is due while the child is in placement, the
Contractor shall complete or obtain a completed IEP. A copy will then be forwarded
to the County.
8. Children in Psychiatric Residential Treatment Facilities, Residential Child Care
Facilities and Child Placement Agencies are generally not eligible to receive clothing
allowances as outlined in the Weld County Department of Human Services Policy
Manual. However, a one-time emergency clothing allowance may be approved in
limited circumstances, prior written authorization from the County's Department
Administrator is required before payment will be released to provider.
9. County shall have access to Contractor's financial records as they relate to this
Agreement for purposes of audit. Such records shall be complete and available for
audit 90 days after final payment hereunder and shall be retained and available for
audit purposes for at least five years after final payment hereunder.
10. Time is of the essence in each and all of the provisions of this Agreement.
11. 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.
12. Any notice required to be given under this Agreement shall be in writing and shall be
mailed or delivered to the other party at that party's address as stated above.
13. This Agreement and the provision of services hereunder shall be subject to the laws
of Colorado and be in accordance with the policies, procedures, and practices of
County.
14. This Agreement is nonexclusive, and County may engage or use other contractors or
persons to perform services of the same or similar nature.
15. Contract Professional certifies, warrants, and agrees that it does not knowingly
employ or contract with an illegal alien who will perform work under this contract.
Contract Professional 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. Contract Professional
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
Contract Professional that the subcontractor shall not knowingly employ or contract
with an illegal alien to perform work under this Agreement. Contract Professional
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 Contract Professional obtains actual knowledge that a subcontractor
performing work under the public contract for services knowingly employs or
Exhibit to the SS23A
7 Revised 6/2023
contracts with an illegal alien Contract Professional shall notify the subcontractor
and County within three (3) days that Contract Professional has actual knowledge
that a subcontractor is employing or contracting with an illegal alien and shall
terminate the subcontract if a subcontractor does not stop employing or contracting
with the illegal alien within three (3) days of receiving notice. Contract Professional
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.
Contract Professional shall comply with reasonable requests made in the course of an
investigation, by the Colorado Department of Labor and Employment. Contract
Professional shall, within twenty days after hiring a new employee to perform work
under the contract, affirm that Contract Professional 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. Contract Professional shall
deliver to County, 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 federal
and state law. If Contract Professional fails to comply with any requirement of this
provision, County may terminate this Agreement for breach, and if so terminated,
Contract Professional shall be liable for actual and consequential damages.
Except where exempted by federal law and except as provided in C.R.S. § 24-76.5-
103(3), if Contract Professional receives federal or state funds under the contract,
Contract Professional must confirm that any individual natural person eighteen (18)
years of age or older is lawfully present in the United States, if such individual applies
for public benefits provided under the contract. If Contract Professional operates as a
sole proprietor, it hereby swears or affirms under penalty of perjury that it:
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
federal or state law, and (c) shall produce one of the forms of identification required by
federal law prior to the effective date of the contract.
16. Contractor assures and certifies that it and its principals:
a. Are not presently debarred, suspended, proposed for debarment, and
declared ineligible or voluntarily excluded from covered transactions by a
federal department or agency;
b. Have not, within a three-year period of preceding this Agreement, been
convicted of or had a civil judgment rendered against them for commission of
fraud or a criminal offense in connection with obtaining, attempting to obtain,
or performing a public (federal, state, or local) transaction or contract under a
public transaction; violation of federal or state antitrust statutes or
commission of embezzlement, theft, forgery, bribery, falsification or
destruction of records, making false statements, or receiving stolen property;
c. Are not presently indicted for or otherwise criminally or civilly charged by a
Exhibit to the SS23A
8 Revised 6/2023
government entity (federal, state, or local) with commission of any of the
offenses enumerated in paragraph (B) above;
d. Have not within a three-year period preceding this Agreement, had one or
more public transactions (federal, state, and local) terminated for cause or
default.
17. In addition to terminating this Agreement, in accordance with the provisions of the
attached Agreement, the County may exercise the following remedial actions if the
County finds and determines that the Contractor has substantially failed to satisfy
the scope of work found in the Agreement, any Exhibit, or the child specific
addendum SS23B. 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 include, but are not limited to, any one or more of the following:
a. Withhold payment to 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
Contractor cannot be performed or if performed would be of no value to
County. Denial of the amount of payment shall be reasonably related to the
amount of work or deliverables lost to County.
c. Recover from Contractor any incorrect payment to Contractor due to
omission, error, fraud, and/or defalcation by deducting from subsequent
payments underthis Agreement, or other agreements between County and
Contractor, or as a debt to County, or otherwise as provided by law.
18. It is expressly understood and agreed that the enforcement of the terms and
conditions of this Agreement, and all rights of action relating to such enforcement,
shall be strictly reserved to the undersigned parties or their assignees, and nothing
contained in this Agreement shall give or allow any claim or right of action
whatsoever by any other person not included in this Agreement. It is the express
intention of the undersigned parties that any entity other than the undersigned
parties or their assignees receiving services or benefits under this Agreement shall be
an incidental beneficiary only.
19. No portion of this Agreement shall be deemed to constitute a waiver of any
immunity including those provided by the Colorado Governmental Immunity Act
§§24-10-101 et seq., as applicable now or hereafter amended, that the parties or
their officers or employees may possess, nor shall any portion of this Agreement be
deemed to have created a duty of care that did not previously exist with respect to
any person not a party to this Agreement. The parties hereto acknowledge and
agree that no part of this Agreement is intended to circumvent or replace such
immunities.
Exhibit to the SS23A
9 Revised 6/2023
20. Contractor shall promptly notify County in the event in which it is a party defendant
or respondent in a case, which involves services provided under the agreement. The
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 County
Director. The term "litigation" includes an assignment for the benefit of creditors,
and filings in bankruptcy, reorganizations and/or foreclosure.
21. Any amendments or modifications to this agreement shall be in writing signed by
both parties.
22. 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.
23. 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 is not
entitled to unemployment insurance or workers' compensation benefits through
County and County shall not pay for or otherwise provide such coverage for
Contractor. Unemployment insurance benefits will not be available to Contractor
for services provided under this Agreement. Contractor shall pay when due any/all
applicable employment taxes and income taxes and local head taxes (if applicable)
incurred as a result of the services provided under this Agreement.
24. County reserves the right to require the Contractor to provide a certificate of
insurance, policy, or other proof of insurance at its sole discretion.
25. Contractor shall ensure all homes are recertified within required timelines and will
follow Colorado Volume 7 Social Services Rules 7.710.35 Renewal or Continuation
Notice and 7.710.36 Recertification.
26. Contractor will notify the County a minimum of 30 days prior to a license expiring if a
home is not going to be recertified within the required timeline. In the event the
County has children placed in the home and the license expires, the County will not
be responsible for any payment to the Contractor during the unlicensed time.
27. For Children's Habilitation Residential Program (CHRP) waiver funded placements, the
Contractor and the Community Center Board (CCB) will be responsible for ensuring all
Prior Authorizations (PAR) are current and that there is no gap in reimbursement. The
County will not be responsible for any non -reimbursement to the provider if PARS are
not approved.
Exhibit to the 5523A
10 Revised 6/2023
SIGNATURE REQUESTED: Weld/SAFY SS23A
with Exhibits
Final Audit Report
2024-06-25
Created: 2024-06-25
By: Lesley Cobb (cobboolk@weld.gov)
Status: Signed
Transaction ID: CBJCHBCAABAA51JbyDCdB7lCg7TGSiRzkXy_ko6rYRRf
"SIGNATURE REQUESTED: Weld/SAFY SS23A with Exhibits"
History
t Document created by Lesley Cobb (cobbxxlk@weld.gov)
2024-06-25 - 3:23:23 PM GMT- IP address: 204.133.39.9
000 Document emailed to colemanj@safy.org for signature
2024-06-25 - 3:24:09 PM GMT
t Email viewed by colemanj@safy.org
2024-06-25 - 11:31:24 PM GMT- IP address: 104.47.56.126
bo Signer colemanj@safy.org entered name at signing as Jenna Coleman, LCSW
2024-06-25 - 11:31:46 PM GMT- IP address: 104.28.221.82
4 Document e -signed by Jenna Coleman, LCSW (colemanj@safy.org)
Signature Date: 2024-06-25 - 11:31:48 PM GMT - Time Source: server- IP address: 104.28.221.82
el Agreement completed.
2024-06-25 - 11:31:48 PM GMT
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Entity Information
Entity Name* Entity ID*
SPECIALIZED ALTERNATIVES FOR @00036903
FAMILIES AND YOUTHS OF CO,
INC
Contract Name* Contract ID
SPECIALIZED ALTERNATIVES FOR FAMILIES AND 8445
YOUTHS OF CO, INC (SS23A AGREEMENT TO
PURCHASE OUT -OF -HOME PLACEMENT SERVICES) Contract Lead*
COBBXXLK
Contract Status
CTB REVIEW
Q New Entity?
Parent Contract ID
20241532
Requires Board Approval
YES
Contract Lead Email Department Project #
cobbxxlk@co.weld.co.us
Contract Description*
CONSENT - 5523A AGREEMENT TO PURCHASE OUT -OF -HOME PLACEMENT SERVICES. TERM: JULY 1, 2024 TO
JUNE 30, 2025.
Contract Description 2
BOCC APPROVED SFY 2024-25 PROVIDER, TEMPLATE AND RATES TYLER ID 2024-1 532.
Contract Type *
AGREEMENT
Amount*
$0.00
Renewable*
NO
Automatic Renewal
Grant
IGA
Department Requested BOCC Agenda Due Date
HUMAN SERVICES Date* 06/29/2024
07/03/2024
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
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*
04/30/2025
Committed Delivery Date
Renewal Date
Expiration Date*
06/30/2025
Contact Info
Contact Name Contact Type Contact Email Contact Phone 1 Contact Phone 2
Purchasing
Purchasing Approver Purchasing Approved Date
CONSENT 06/26/2024
Approval Process
Department Head Finance Approver Legal Counsel
JAMIE ULRICH CONSENT CONSENT
DH Approved Date Finance Approved Date Legal Counsel Approved Date
06/26/2024 06/26/2024 06/26/2024
Final Approval
BOCC Approved Tyler Ref #
AG 070124
BOCC Signed Date Originator
COBBXXLK
BOCC Agenda Date
07/01/2024
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