HomeMy WebLinkAbout20240196.tiffRESOLUTION
RE: APPROVE PROFESSIONAL SERVICE AGREEMENT FOR VARIOUS CORE AND
NON -CORE CHILD WELFARE SERVICES AND AUTHORIZE CHAIR TO SIGN -
BETTER THAN GOOD COUNSELING
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board has been presented with a Professional Service Agreement for
Various Core and Non -Core Child Welfare Services between the County of Weld, State of
Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the
Department of Human Services, and Better Than Good Counseling, commencing December 1,
2023, and ending May 31, 2024, with further terms and conditions being as stated in said
agreement, and
WHEREAS, after review, the Board deems it advisable to approve said agreement, a copy
of which is attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of
Weld County, Colorado, that the Professional Service Agreement for Various Core and Non -Core
Child Welfare Services between the County of Weld, State of Colorado, by and through the Board
of County Commissioners of Weld County, on behalf of the Department of Human Services, and
Better Than Good Counseling, be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said agreement.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 24th day of January, A.D., 2024, nunc pro tune December 1, 2023.
ATTEST: damdadv :,
Weld County Clerk to the Board
B 11( ' t,L-)IM o r..lc_
AP
Deputy Clerk to the Board
County Atto ey�
1 iz
Date of signature: Z 4
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
p,Th
Ross, Chair
o,
erry L. B �' k, Pro-Tem
Mike Freeman
K. James
me
Gc :1-1 SD
02/23/24
2024-0196
HR0096
Can-IvGe-F
BOARD OF COUNTY COMMISSIONERS
PASS -AROUND REVIEW
PASS -AROUND TITLE: Professional Service Agreement with Better Than Good Counseling
DEPARTMENT: Human Services DATE: December 12, 2023
PERSON REQUESTING: Jamie Ulrich, Director, Human Services
Brief description of the problem/issue: The Department is requesting to enter into a Professional Service
Agreement (PSA) for Mental Health Services with Better Than Good Counseling.
What options exist for the Board?
Approval of the Professional Service Agreement with Better Than Good Counseling.
Deny approval of the Professional Service Agreement with Better Than Good Counseling.
Consequences: New Core/Non-Core Service Provider will not be approved.
Impacts: Provider will not provide needed Service to Department of Human Services clients.
Costs (Current Fiscal Year / Ongoing or Subsequent Fiscal Years):
Funded through: Core/Non-Core Child Welfare funding.
Term: December 1, 2023 through May 31, 2024.
Fees for Services:
I'ru<2rani
k rearMental
Services
Rate
$120.00
Unit 1 N Ire
Hour
hen ice Name
Mental Health Intake. In-Office/Video
$75.00
Each
Mental Health Intake - No Show
$120.00
Hour
Mental Health Therapy - Individual: In -
Office/Video
$75.00
Each
Mental Health Therapy -Individual: No Show
$50.00
Hour
Mental Health Therapy — Group: In-OfficeNideo
$75.00
Each
Mental Health Therapy — Group: No Show
Pass -Around Memorandum; December 12, 2023 — CMS ID TBD
2024-0196
l /24
Recommendation:
• Approval of the Professional Service Agreement and authorize the Chair to sign.
Su000rt 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
Pass -Around Memorandum; December 12, 2023 - CMS ID TBD
Cheryl Hoffman
From:
Sent:
To:
Subject:
Cheryl Hoffman
Wednesday, December 13, 2023 12:30 PM
Cheryl Hoffman
8 Passarounds
Today 11:56 AM
Hi mike, I just sent you 8 pass
arounds. Could you please
review? I hope you're having
a wonderful time
Cheryl,
I just reviewed all 8 and I am
good with all of them.
Mike
Thank you mike. That's all I
need.
Delivered
Cheryl L. Hoffman
Deputy Clerk to the Board
1150 O Street/P.O. Box 758
Greeley, CO 80632
Tel: (970) 400.4227
choffman@weld.gov
PROFESSIONAL SERVICE AGREEMENT BETWEEN WELD COUNTY AND
BETTER THAN GOOD COUNSELING
THIS AGREEMENT is made and entered into this ZOlday of , 2024, by and
between the Board of Weld County Commissioners, on behalf of the Weld Count epartment of
Human Services, hereinafter referred to as "County," and Better Than Good Counseling, hereinafter
referred to as "Contractor".
WHEREAS, County desires to retain Contractor to perform services as required by County
and set forth in the attached Exhibits; and
WHEREAS, Contractor is willing and has the specific ability, qualifications, and time to
perform the required services according to the terms of this Agreement; and
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; and
WHEREAS, the Colorado Department of Human Services has provided Core and Non -
Core or other funding to the Department for Mental Health Services.
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 the attached Exhibits, each of which forms an integral part of this Agreement and
are incorporated herein. The parties each acknowledge and agree that this Agreement, including the
attached Exhibits, define the performance obligations of Contractor and Contractor's willingness
and ability to meet those requirements (the "Work"). If a conflict occurs between this Agreement
and any Exhibit or other attached document, the terms of this Agreement shall control, and the
remaining order of precedence shall be based upon order of attachment.
Exhibit A consists of the Scope of Services.
Exhibit B consist of the Rate Schedule.
Exhibit C consists of County's Request for Proposal (RFP) as set forth in Bid Package No.
/32300040 which is incorporated into this agreement by reference and will be provided upon
request to the Department.
Exhibit D consists of Contractor's Response to County's Request.
2. Service or Work. Contractor agrees to diligently provide all services, labor, personnel, and
materials necessary to perform and complete the Work described in the attached Exhibits. Services
shall be provided by the Contractor to any person(s) eligible for services in compliance with Exhibits
A, Scope of Services, and Exhibit D, Contractor's Response to Request for Proposal. 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 December 1.2023, through May 31, 2024,
unless sooner terminated as provided herein. Both of the parties to this Agreement understand and
agree that the laws of the State of Colorado prohibit County from entering into Agreements which
bind County for periods longer than one year. This Agreement may be renewed for 2 (two)
additional one-year terms upon mutual written agreement of the 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 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. tlpon termination of this Agreement by County,
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 Amendment. 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. Accordingly, no claim that the
County has been unjustly enriched by any additional services, whether or not there is in fact any
such unjust enrichment, shall be the basis of any increase in the compensation payable hereunder.
In the event that written authorization and acknowledgment by the County for such additional
services is not timely executed and issued in strict accordance with this Agreement, Contractor's
rights with respect to such additional services shall be deemed waived and such failure shall result
in non-payment for such additional services or work performed. Any claims by the Contractor for
adjustment hereunder must be made in writing prior to performance of any work covered in the
anticipated Amendment, unless approved and documented otherwise by the County Representative.
Any change in work made without such prior Amendment shall be deemed covered in the
compensation and time provisions of this Agreement, unless approved and documented otherwise
by the Coanty Representative.
6. Compensation. County agrees to pay Contractor through an invoice process during the
course of this Agreement in accordance with the Rate Schedule as described as Exhibit B.
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 the Contractor. No payment in excess of that set forth in the
Exhibits will be made by County unless an Amendment authorizing such additional payment has
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been specifically approved by Weld County as required pursuant to the Weld County Code. If, at
any time during the term or after termination or expiration of this Agreement, County reasonably
determines that any payment made by County to Contractor was improper because the service for
which payment was made did not perform as set forth in this Agreement, then upon written notice
of such determination and request for reimbursement from County, Contractor shall forthwith return
such payment(s) to County. Upon termination or expiration of this Agreement, unexpended funds
advanced by County, if any, shall forthwith be returned to County. 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. Unless expressly enumerated in the attached Exhibits,
Contractor shall not be entitled to be paid for any other expenses (e.g. mileage). Notwithstanding
anything to the contrary contained in this Agreement, County shall have no obligations under this
Agreement after, nor shall any payments be made to Contractor in respect of any period after
December 31 of any year, without an appropriation therefore by County in accordance with a budget
adopted by the Board of County Commissioners in compliance with Article 25, Title 30 of the
Colorado Revised Statutes, the Local Government Budget Law (C.R.S. 29-1-101 et. seq.) and the
TABOR Amendment (Colorado Constitution, Article X, Sec. 20).
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 (including unemployment insurance or workers' compensation benefits)
from County as a result of the execution of this Agreement. 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.
S. 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 the Work without County's prior written
consent, which may be withheld in County's sole discretion. County shall have the right in its
reasonable discretion to approve all personnel assigned to the Work during the performance of this
Agreement and no personnel to whom County has an objection, in its reasonable discretion, shall
be assigned to the Work. Contractor shall require each subcontractor, as approved by County and
to the extent of the Work to be performed by the subcontractor, to be bound to Contractor by the
terms of this Agreement, and to assume toward Contractor all the obligations and responsibilities
which Contractor, by this Agreement, assumes toward County. County shall have the right (but not
the obligation) to enforce the provisions of this Agreement against any subcontractor hired by
Contractor and Contractor shall cooperate in such process. The Contractor shall be responsible for
the acts and omissions of its agents, employees, and subcontractors.
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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. 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 County.
Contractor shall not make use of such material for purposes other than in connection with this
Agreement without prior written approval of County.
10. Confidentiality. Confidential information of the Contractor should be transmitted
separately from non -confidential information, clearly denoting in red on the relevant document at
the top the word, "CONFIDENTIAL." However, Contractor is advised that as a public entity, Weld
County must comply with the provisions of the Colorado Open Records Act (CORA), C.R.S. 24-
72-201, et seq., with regard to public records, and cannot guarantee the confidentiality of all
documents. 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.
11. Warranty. Contractor warrants that the Work 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 Work shall be performed by
qualified personnel in a professional manner, consistent with industry standards, and that all services
will conform to applicable specifications.
12. Acceptance of Services Not a Waiver. Upon completion of the Work, Contractor shall
submit to County originals of all test results, reports, etc., generated during completion of this work.
Acceptance by County of reports and incidental material(s) furnished under this Agreement shall
not in any way relieve Contractor of responsibility for the quality and accuracy of the project. 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, and
County's action or inaction when any such breach or default exists shall not impair or prejudice any
right or remedy available to County with respect to such breach or default. 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 County of, or
payment fir, the Work 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. Contractor must secure, before the commencement of the Work, the
following insurance covering all operations, goods, and services provided pursuant to this Agreement,
and shall keep the required insurance coverage in force at all times during the term of the Agreement,
or any extension thereof, and during any warranty period. For all coverages, Contractor's insurer shall
waive subrogation rights against County.
4
a. Types of Insurance.
Workers' Compensation / Employer's Liability Insurance as required by state statute,
covering all of the Contractor's employees acting within the course and scope of their
employment. The policy shall contain a waiver of subrogation against the County. This
requirement shall not apply when a Contractor or subcontractor is exempt under Colorado
Workers' Compensation Act., AND when such Contractor or subcontractor executes the
appropriate sole proprietor waiver form.
Commercial General Liability Insurance including public liability and property damage,
covering all operations required by the Work. Such policy shall include minimum limits as
follows: $1,000,000 each occurrence; $1,000,000 general aggregate; $1,000,000 Personal
injury; $5,000 Medical payment per person.
Automobile Liability Insurance: 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, for
vehicles owned, hired, and non -owned vehicles used in the performance of this Contract.
Professional Liability (Errors and Omissions Liability). The policy shall cover professional
misconduct or lack of ordinary skill for those positions defined in the Scope of Services of
this contract. Contractor shall maintain limits for all claims covering wrongful acts, errors
and/or omissions, including design errors, if applicable, for damage sustained by reason of
or in the course of operations under this Contract resulting from professional services. In
the event that the professional liability insurance required by this Contract is written on a
claims -made basis, Contractor warrants that any retroactive date under the policy shall
precede the effective date of this Contract; and that either continuous coverage will be
maintained, or an extended discovery period will be exercised for a period of two (2) years
beginning at the time work under this Contract is completed. Minimum Limits: $1,000,000
Per Loss; $2,000,000 Aggregate.
b. Proof of Insurance. Upon County's request, Contractor shall provide to County a
certificate of insurance, a policy, or other proof of insurance as determined in County's sole
discretion. County may require Contractor to provide a certificate of insurance naming Weld
County, Colorado, its elected officials, and its employees as an additional named insured.
c. Subcontractor Insurance. Contractor hereby warrants that all subcontractors providing
services under this Agreement have or will have the above -described insurance prior to their
commencement of the Work, or otherwise that they are covered by the Contractor's policies
to the minimum limits as required herein. Contractor agrees to provide proof of insurance
for all such subcontractors upon request by the County.
d. No limitation of Liability. The insurance coverages specified in this Agreement are the
minimum requirements, and these requirements do not decrease or limit the liability of
Contractor. The County in no way warrants that the minimum limits contained herein are
5
sufficient to protect the Contractor from liabilities that might arise out of the performance of
the Work under by the Contractor, its agents, representatives, employees, or subcontractors.
The Contractor shall assess its own risks and if it deems appropriate and/or prudent, maintain
higher limits and/or broader coverages. The Contractor is not relieved of any liability or
other obligations assumed or pursuant to the Contract by reason of its failure to obtain or
maintain insurance in sufficient amounts, duration, or types. The 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.
e. Certification of Compliance with Insurance Requirements. The Contractor stipulates that it
has met the insurance requirements identified herein. The Contractor shall be responsible
for the professional quality, technical accuracy, and quantity of all services provided, the
timely delivery of said services, and the coordination of all services rendered by the
Contractor and shall, without additional compensation, promptly remedy and correct any
errors, omissions, or other deficiencies.
14. Indemnity. The Contractor shall defend, indemnify and hold harmless County, its
officers, agents, and employees, from and against any and all injury, loss, damage, liability, suits,
actions, claims, or willful acts or omissions of any type or character arising out of the Work done in
fulfillment of the terms of this Agreement 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, judicial decision, or other law or court decree. The
Contractor shall be fully responsible and liable for any and all injuries or damage received or
sustained by any person, persons, or property on account of its performance under this Agreement
or its failure to comply with the provisions of the Agreement. It is agreed that the Contractor will
be responsible for primary loss investigation, defense and judgment costs where this contract of
indemnity applies. In consideration of the award of this contract, the Contractor agrees to waive all
rights of subrogation against the County its associated and/or affiliated entities, successors, or
assigns, its elected officials, trustees, employees, agents, and volunteers for losses arising from the
work performed by the Contractor for the County. A failure to comply with this provision shall
result in County's right to immediately terminate this Agreement.
15. Nan -Assignment. Contractor may not assign or transfer this Agreement or any interest
therein or claim thereunder, without the prior written approval of County. Any attempts by
Contractor to assign or transfer its rights hereunder without such prior approval by County shall, at
the optionmf County, automatically terminate this Agreement and all rights of Contractor hereunder.
Such consent may be granted or denied at the sole and absolute discretion of County.
16. Emination of Records. To the extent required by law, the Contractor agrees that an
duly authorized representative of County, including the County Auditor, shall have access to and
the right to examine and audit any books, documents, papers and records of Contractor, involving
all matters and/or transactions related to this Agreement. Contractor agrees to maintain these
document for three years from the date of the last payment received.
17. 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
6
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.
18. Notices. County may designate, prior to commencement of Work, its project representative
("County Representative") who shall make, within the scope of his or her authority, all necessary
and proper decisions with reference to the project. All requests for contract interpretations, change
orders, and other clarification or instruction shall be directed to County Representative. All notices
or other communications made by one party to the other concerning the terms and conditions of this
contract shall be deemed delivered under the following circumstances:
(a) personal service by a reputable courier service requiring signature for receipt; or
(b) five (5) days following delivery to the United States Postal Service, postage prepaid
addressed to a party at the address set forth in this contract; or
(c) electronic transmission via email at the address set forth below, where a receipt or
acknowledgment is required and received by the sending party; or
Either party may change its notice address(es) by written notice to the other. Notice may be sent to:
TO CONTRACTOR:
Name: Holly Gregory
Position: LPC/Owner
Address: 2101 16th Street
Address: Greeley, Colorado 80631
E-mail: support@greeleycocounseling.com
Phone: (970) 590-8094
TO COUNTY:
Name: Jamie Ulrich
Position: Director
Address: P.O. Box A
Address: Greeley, Colorado 80632
E-mail: ulrichij@weld.gov
Phone: (970) 400-6510
19. 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.
20. 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.
21. 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,
7
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.
22. Fund Availability. Financial obligations of the County payable after the current fiscal year
are contir_gent 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. 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.
24. Survival of Termination. The obligations of the parties under this Agreement that by their
nature would continue beyond expiration or termination of this Agreement (including, without
limitation, the warranties, indemnification obligations, confidentiality and record keeping
requirements) shall survive any such expiration or termination.
25. 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.
26. Governmental Immunity. No term or condition of this Agreement shall be construed or
interpretei 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.
27. No Third -Party Beneficiary. It is expressly understood and agreed that the enforcement
of the terns 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.
28. 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.
29. 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.
8
30. Attorney's Fees/Legal Costs. In the event of a dispute between County 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.
31. Binding Arbitration Prohibited. Weld County does not agree to binding arbitration by any
extra judicial body or person. Any provision to the contrary in this Agreement or incorporated herein
by reference shall be null and void.
32. 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 Exhibits, 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.
IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day,
month, and year first above written.
COUNTY:
ATTEST: ddrif46) Jelt0;ti
Jerk to the Board
BY
Deputy CI �T tot a Bo,,
9
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
Kevin D. Ross, Chair
JAN 2 4 2024
CONTRACTOR:
Better Than Good Counseling
2101 16th Street
Greeley, Colorado 80634
(970) 590-8094
14 By. tto6,,G, ory,LPC,J.n O:e 7t Mit)
Holly Gregory, LPC/Owner
Date: Jan 5, 2024
EXHIBIT A
SCOPE OF SERVICES
Contractor will provide Mental Health Services, as referred by the Department.
1. Mental Health Intake
a. Contractor will utilize the following modalities, curriculum, and tools in the
delivery of services under this agreement:
i. Cognitive Behavioral Therapy (CBT).
ii. Dialectical Behavioral Therapy (DBT).
iii. Eye Movement Desensitization and Reprocessing (EMDR) therapy.
iv. Psychotherapy.
b. Anticipated Frequency of Services:
i. One hour each.
c. Anticipated Duration of Services:
i. For the duration of the treatment plan.
d. Goals of Services:
i. To identify problems.
ii. Etiology.
iii. To build rapport.
e. Outcomes of Services:
i. Build a treatment plan.
ii. Identify measurable outcomes.
iii. Identify a discharge goal that is measurable.
f. Target Population:
i. Youth of any gender.
g. Language:
i. English.
h. Medicaid Eligibility:
i. This service is Medicaid eligible.
i. Service Access and Transportation:
i. In -Office located at 2101 16' Street, Greeley, Colorado 80631.
2. Mental Health Therapy- Individual
Contractor will utilize the following modalities, curriculum, and tools in the
delivery of services under this agreement:
i. Cognitive Behavioral Therapy (CBT).
ii. Dialectical Behavioral Therapy (DBT).
iii. Eye Movement Desensitization and Reprocessing (EMDR) therapy.
iv. Psychotherapy.
b. Anticipated Frequency of Services:
i. Forty-five (45) minutes to one (1) hour, per session.
c. Anticipated Duration of Services:
i. Three (3) to four (4) months.
d. Goals of Services:
i. Building the child's self-esteem.
ii. Helping to improve the child's communication skills.
iii. Stimulating healthy, normal development.
iv. Building an appropriate emotional repertoire.
e. Outcomes of Services:
i. To improve mood regulation.
ii. Reduce anxiety levels.
iii. Enhance social skills.
iv. To manage psychotic symptoms.
v. Improve self -care habits.
vi. Enhance self-esteem.
vii. Develop coping mechanisms for stress.
viii. To reduce substance abuse.
f. Target Population:
i. Youth of any gender.
g. Language:
i. English.
h. Medicaid Eligibility:
i. This service is Medicaid eligible.
i. Service Access and Transportation:
i. In -Office located at 2101 le Street, Greeley, Colorado 80631.
3. Mental Health Therapy - Group
a. Contractor will utilize the following modalities, curriculum, and tools in the
delivery of services under this agreement:
i. Cognitive Behavioral Therapy (CBT).
ii. Dialectical Behavioral Therapy (DBT).
iii. Eye Movement Desensitization and Reprocessing (EMDR) therapy.
iv. Psychotherapy.
b. Anticipated Frequency of Services:
i. Forty-five (45) minutes to one (1) hour, per session.
c. Anticipated Duration of Services:
i. For the duration of the treatment plan.
d. Goals of Services:
i. To develop trust with peers and clinicians.
ii. Communicate feelings and experience.
iii. Psychoeducation.
e. Outcomes of Services:
i. To improve mood regulation.
ii. Reduce anxiety levels.
iii. Enhance social skills.
iv. To manage psychotic symptoms.
v. Improve self -care habits.
vi. Enhance self-esteem.
vii. Develop coping mechanisms for stress.
viii. To reduce substance abuse.
f. Target Population:
i. Youth of any gender.
g. Language:
i. English.
h. Medicaid Eligibility:
i. This service is Medicaid eligible.
i. Service Access and Transportation:
i. In -Office located at 2101 le Street, Greeley, Colorado 80631.
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 f
CWServiceReferral(a7,weldaov.com 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 will
notify the caseworker and the Mental Health and Support Services Team (HS-
CWServiceReferral(llweidgov.com) and the Home Study Supervisor.
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(a weldgov.com) and the Home Study Supervisor. 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-CWServiceReferrald weldgov.com)
and the Home Study Supervisor, 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, Home Study Supervisor, and the Mental Health and Support
Services Team(HS-CWServieeReferralAweldaov.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
cencern may include, but are not limited to, any physical, emotional, educational, or
behavioral issues. Areas of concern should be reported to the caseworker, Home Study
Supervisor, and the Mental Health and Support Services Team HS-
CWServiceReferral(atweldsov.com immediately AND on the required monthly report.
11. Contractor agrees any change to an existing referral must be pm -approved through the
Child Welfare Clinical Care Coordinator, Home Study Supervisor, 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. Any changes to
home study referrals will be approved by a new referral signed by the Home Study
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 Stuffings, Family
Team Meetings and/or Team Decision Making meetings. The Department will reimburse
for actual participation in the meeting only so tong 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-CWS►erviceReferrel(a7weldaov.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; 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 wilt address the aforementioned three areas when
completing monthly or home study 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. 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. Sibpoenas
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.
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
Mental Health
Services
IR.lt,
$120.00
1,01 Is;::
Hour
SMic, '.me
Mental Health Intake: In-Office/Video
$75.00
Each
Mental Health Intake - No Show
$75.00
Hour
Mental Health Intake: Team Meeting (FTM), Team
Decision Making (TDM) Meeting, Professional
Staffing
$120.00
Hour
Mental Health Therapy - Individual: In-
Office/Video
$75.00
Each
Mental Health Therapy - Individual: No Show
$75.00
Hour
Mental Health Therapy - Individual: Team Meeting
(FTM), Team Decision Making (TDM) Meeting,
Professional Staffing
$50.00
Hour
Mental Health Therapy — Group: In-Office/Video
$35.00
Each.
Mental Health Therapy — Group: No Shaw
$75.00
Hour
Mental Health Therapy - Group: Team Meeting
(FTM), Team Decision Making (TDM) Meeting,
Professional Staffing
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
subunit monthly a Request for Reimbursement and monthly report including other supporting
documentation, if applicable, certifying that services authorized were provided on the date(s)
indiicated 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
evuation/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"' 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
fording 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.
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: ) t -t ,Yiva(Ln £inod !6UVQ(1Ylif1sProvderIDl1k1:
Provider Contact Full Name:1-A1)1,t 1 GI re et, r9 Title: 0 wtt.16r
Primary Phone Number (10-digit):Q76 Sqa b II (4 Ext.:
Primary Contact Email: nfw 1 @9 ref t aged rp ri&I it e e oddress: f l,)I(,f11x) 9 rej (,9itS� 0,Q (DuL li
Agency Location Address (Street, ally, state, zip): 2101 i ( pt It S+ �2 � j , (D U'-7- I ,J
�
„,,,, a above-.
Agency Mailing Address (street, city, state, zip):
Fax Number (10 -digit►:
Agency Type 1pick one): El Public Company Ej Private Non -Profit Private for Profit
Send Referrals for Service to:
Referral ContactName: \101) 671( () ((1 Title:
Referral Phone Number (10 -digit): q7 -�5qQ. ! Ext.:
0/4.0111
Emaill3u JDT-t ti)giref 11:9Cdet*11544 e y.
Billing Contact
Billing Contact Name: l4'0Uj Uirecjort j Title:
J EmaH:SEGI3190rfre-Q.116 CW'e
Billing Phone Number (10 -digit}; Q -J 5qd cr.tgLI
Ext.:
hOG>iQ
I certify that the services proposed for intended use by the Weld County Department of Human Services will meet all the specifications it
Ihas so indicated le this bid farm. I further affirm intention to enter into an agreement with Weld County, on behalf of the Weld County
IDepartment of Hunan Services, and comply with all requirements of the contract. If awarded.
The Board of Weld County Commissioners reserve the right to reject any or ail bids, to waive any Informality in the blds, and to accept
Ithe bid, or part ofa bid, that, in the opinion of the Board, is in the best interests of the Board and of the County of Weld, State of
Colorado. The goad of Weld County Commissioners shall give preference to resident Weld County bidders In all cases where the bids are
competitive in price and quality.
WELD COUNTY IS EXEMPT FROM COLORADO SALES TAXES. THE CERTIFICATE OF EXEMPTION NUMBER IS fi98-03551.0000.
I rn
Authorized Rep. Full Name:
/b$ Ext.: I
i Authorized Rep.EmaiISIAppUfY'� A 311 C.At�(s7('b�tvSPti��.Cpmne(1o�dlglq: 9o�'�Qy' Authorized Rep. -- 1. ,'-... � .:, l,.,r s4- l.�►, e 111 t it g -01 ,93z/
3 1 ( �
Signature of Authorized Rep. Date: / /
rit 0 r//I Title: Wel0
REV. DECEMBER 2021
ATTACHMENT C - PROPOSAL
Please type your answers in the boxes below or check the appropriate box.
SECTION 1— Provider and Program Area Information
Bidder's Legal Name:
Program Area:
Holly M Gregory
Mental Health Services
Program Areas are listed in column 1 of the table located in Item Xi of the Request for
Proposal starting on page 13.
Number of services offered on this Attachment C
(max 5):
You may complete another Attachment C y you have more than 5.
3
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: Intake
2.ia Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points):
I CBT, DBT, EMDR, Psychotherapy
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:
I. 1 Hour I
2.1c Anticipated duration of service (i.e. 3-4 months):
I For duration of treatment plan
2.1d Three (3), or more, specific goals of the service (DO use bullet points):
- Identify problem.
- Etiology
- Rapport building
2.1e Three (3), or more, specific outcomes of service:
- Build a treatment plan
- Measurable outcomes identified.
- Identify a discharge goal that is measurable
2.1f Target population of the service, including age and gender:
I Youth of any gender
2.ig Languages service is available in (please list proficiency and if interpreter services are available):
English speaking only 1
2.1h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part:
IV I
2.1i Service location — list where the service will take place (i.e. client's home, in -office, other)
1210116th st Greeley CO 80631 1
Service #2 Name: Therapy session
2.2a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points):
I CBT, DBT, EMDR, Psychotherapy 1
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:
45 mins —1 hour
2.2c Anticipated duration of service (i.e. 3-4 months):
3-4 months
2.2d Three (3), or more, specific goals of the service (DO use bullet points):
• Building the child's self-esteem.
• Helping to improve the child's communication skills.
• Stimulating healthy, normal development.
• Building an appropriate emotional repertoire.
REV. OCT 2021
ATTACHMENT C - PROPOSAL
2.2e Three (3), or more, specific outcomes of service:
Improving Mood Regulation....
Reducing Anxiety Levels....
Enhancing Social Skills....
Managing Psychotic Symptoms....
Improving Self -Care Habits....
Enhancing Self -Esteem....
Developing Coping Mechanisms for Stress....
Reducing Substance Use.
2.2f Target population of the servke:
Youth of any gender
2.2g Languages service is available in (please list proficiency and if interpreter services are available):
I English
2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part:
(Y
2.21 Service location — list where the service will take place (i.e. client's home, in -office, other)
210116"' st Greeley CO 80631
Service #3 Name:
2.3a Modalities, cuwiculum, tools used in delivery of service (DO NOT list company history; DO use bullet points):
I CBT, DBT, EM0R, Psychotherapy
23b 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:
145 mins-1 hour
23c Anticipated duration of service (i.e. 3-4 months):
Duration of treatment plan
23d Three (3), or more, specific goals of the service (DO use bullet points):
- Develop Trust with peers and clinicians.
- Communicate feelings and experiences.
- Psychoeducation
2.3e Three (3), or more, specific outcomes of service:
Group
Improving Mood Regulation....
Reducing Anxiety Levels....
Enhancing Social Skills....
Managing Psychotic Symptoms....
Improving Self -Care Habits....
Enhancing Self -Esteem....
Developing Coping Mechanisms for Stress....
Reducing Substance Use.
2.3f Target population of the service:
Youth of any gender
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:
IY
2.3i Service location — list where the service will take place (i.e. client's home, in -office, other)
210116"' st Greeley CO 80631
REV. OCT 2021
ATTACHMENT C - PROPOSAL
Service #4 Name:
2.4a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points):
2.4b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time,
administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level:
2.4c Anticipated duration of service (i.e. 3-4 months):
2.4d Three (3), or more, specific goals of the service (DO use bullet points):
I
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 in eligible for Medicaid in whole or in part:
I
2.4i Service location — list where the service will take place (i.e. client's home, in -office, other)
I
Service #5 Name:
2.5a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points):
I
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):
I
I
2.5e Three (3), or more, specific outcomes of service:
2.Sf Target population of the service:
1
2.5g Languages service is available in (please list proficiency and if interpreter services are available):
I
2.5h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part
I
I
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: O YES ® NO
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. I Miles
3.5 When you calculate mileage, what is your starting point address? 210116th at Greeley CO 80631
SECTION 4 - SERVICE RATES
All rates need to include administrative work (i.e. scheduling or report writing) and overhead.
REV. OCT 2021
3
ATTACHMENT C - PROPOSAL
Rates cannot be per episode, except for home studies and monitored sobriety testing.
Only hourly or monthly rates will be accepted for services, except for those listed above.
• For hourly rates complete section(s) 4.1-4.5.
• For monthly rates complete section 4.6.
• For Home study providers complete section 4.7.
• For monitored sobriety testing providers complete section 4.8.
4.1 Hourly Service#i Name: Intake code 96136
$ Amount
Unit Type
4.1a In-Office/Video:
120.00
Select Unit Type.
4.1b In -Home or Community:
Select Unit Type. No. of roundtrip miles
miles
120.00
Included in rate:
4.1c In-Office/Video, In -Home,
or Community with
Select Unit Type. No. of mundtrip mites
included In rate:
miles
Transportation:
4.1d FTM, TDM, Prof. Staffing:
120.00
per Hour
4.1e No show:
4.1f Mileage rate:
75.00
per No Show
per Mile This is paid after the miles
listed above.
4.2 Hourly Service#2 Name: ( Therapy session
$ Amount
Unit Type
4.2a In-Office/Video:
120.00
Select Unit Type.
4.2b In -Home or Community:
Select Unit Type. No. of roundtrip miles
miles
120.00
Included in rate:
4.2c In-Office/Video, In -Home,
or Community with
Select Unit Type. No. of roundtrip miles
Included In rate:
miles
Transportation:
4.2d FTM, TDM, Prof. Staffing:
120.00
per Hour
4.2e No show:
75.00
per No Show
4.2f Mileage rate:
per Mile This is paid after the miles listed above.
4.3 Hourly Service#3 Name: Group
$ Amount
Unit Type
4.3a In-Office/Video:
50.00
Select Unit Type.
4.3b In -Home or Community:
50.00
Select Unit Type. No. of roundtrip miles
included In rate:
miles
4.3c In-Office/Video, In -Home, or
Select Unit Type. No. of roundtdp miles
miles
Community with
Included in rate:
Transportation:
4.3d FTM, TDM, Prof. Staffing:
50.00
per Hour
4.3e No show:
75.00
per No Show
4.3f Mileage rate:
per Mile This is paid after the miles listed above.
4.4 Hourly Service -#4 Name:
4.4a In-Office/Video:
$ Amount
Unit Type
Select Unit Type.
4.4b In -Home or Community:
Select Unit Type. No. of roundtrip miles
miles
4.4c In-Office/Video, In -Home, or
Included in rote:
Select Unit Type. No. of roundtrlp miles
miles
Community with
Included in rate:
Transportation:
4.4d FTM, TDM, Prof. Staffing:
4.4e No show:
per Hour
per No Show
4.4f Mileage rate:
per Mile This is paid after the miles listed above.
REV. OCT 2021
4
ATTACHMENT C - PROPOSAL
4.5 Hourly Service OS Name: I
$ Amount Unit Type
4.5a In-Office/Video:
Select Unit Type.
4.5b In -Home or Community:
Select Unit Type. No. of roundtrip mites
included in rate:
miles
4.Sc in-Office/Video, In -Home, or
Community with
Transportation:
Select Unit Type. No. of roundtrip miles
lnduded In rate:
miles
4.5d FTM, TDM, Prof. Staffing:
per Hour
4.5e No show:
per No Show
4.5f Mileage rate:
per Mile This is paid after the miles listed
above.
4.6 Monthly Service Rates (each level must be listed):
Service Name with Level
Rate per
Month
Minimum Hours of
Service:
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.
....m
4.8 Monitored Sobriety Providers — List your rates in the box below.
Provider special notes:
ATTACHMENT D - STAFF DATA SHEET
Bidder Must List All Staff Who Will Administer the Proposed Service(s)
BIDDER'S LEGAL NAME (As it appears on the W-9):
AGENCY CONTACT:
'f 01\14 )\A Grjpru
PHONE NUMBER: '-1 7' 0 - 5go- qL/
EMAIL: �k' pirrt [ .P1dc (ZL.d11la'I4.S 2 ja
PROP=OSED SERVICE(S): *f C 40frin
Legal Last Name
Middle
Initial
Previous=LegalLast
Name (If applicable)
Legal First Name
Service Type V
Licensure/
Credentials
DORA # (If applicable)
G)rQG10r
r`n
s,
1 -1 -111(11L
-QC_
LPC-DOI7celt!
-
CHILD WELFARE REQUEST FOR PROPOSAL 2023-24 - VARIOUS SERVICES
Philadelphia Indemnity Insurance Company
PI-PHCP-05 (02/17)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION
(PROFESSIONAL LIABILITY)
This endorsement modifies insurance provided under the following:
ALLIED HEALTHCARE PROVIDER'S PROFESSIONAL AND SUPPLEMENTAL LIABILITY
INSURANCE POLICY
In consideration of the premium paid, this policy is amended as follows:
Board of County Commissioners of Weld County and Its officers Employees is hereby added as an
Additional Insured, for damages arising out of a professional incident covered under this policy, caused in
whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf. The
professional incident must arise out of services provided by the insured, under contract with Board of
County Commissioners of Weld County and Its officers Employees.
However:
1. The insurance afforded to such additional insured only applies to the extent permitted by law; and
2. If coverage provided to the additional insured is required by a contract or agreement, the insurance
afforded to such additional insured will not be broader than that which you are required by contract or
agreement to provide for such additional insured.
With respect to the insurance afforded to this additional insured, the following is added to SECTION III -
LIMITS OF LIABILITY:
If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on
behalf of the additional insured is the amount of insurance:
a. Required by the contract or agreement; or
b. Available under the applicable Limits of Liability shown in the Declarations;
whichever is less.
This endorsement shall not increase the Limits of Liability shown in the Declarations.
All other terms and conditions of the Policy remain unchanged.
Policy #: AR280268
Effective on or after: 07/31/2023
Issued to: Better Than Good Counseling
Expiration date: 07/31/2024
PI-PHCP-05 (02/17)
Page 1 of 1
cphv
Named Insured:
Better Than Good Counseling
Holly Gregory
4315w9th strd,
Greeley, CO 80634
Insurer: Philadelphia Indemnity Insurance Company
One Bala Plaza, Suite 100, Bala Cynwyd, PA 19004
NAIC #: 18058
Contact: CPH Insurance, 800-875-1911, info@cphins.com
Certificate of Liability Insurance
Date issued: 12/28/2023
Policy #: AR280268
Policy Term: 07/31/2023 - 07/31/2024
Covered Locations
Professional Liability: Portable Coverage, not location specific
Coverage Type Limits of Liability
(Occurrence Form) (Per Claim/Total Per Year)
Professional Liability
Supplemental Liability
Licensing Board Defense
Commercial General Liability
Fire/Water Legal Liability NIA
Business Personal Property N/A
Sexual Abuse/Molestation Defense .__..4, Unlimited Defense Coverage (for false allegations)
Cyber Liability (Claims Made Retroactive Date: 07/31/2023) L 15,000
$1,000,000/$5,000,000
$1,000,000/$ 5,000,000
$35,000
Certificate Holder
Board of County Commissioners of Weld County and Its
officers Employees
1150Ost.
Greeley, CO 80631
EJ Certificate holder added as Additional Insured
N/A
Notice of Cancellation will only be provided to the first named
insured in accordance with policy provisions, who shall act on
behalf of all additional insureds with respect to giving notice of
cancellation
f, pip /44 -
Authorized Representative
Disclaimer This certificate Is issued as a matter of information only and confers no rights upon the certificate holder. The Certificate of Insurance does not constitute
a contract between the resuing insurer, authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend, or
alter the coverage afforded by the policies listed thereon.
SIGNATURE REQUESTED: Weld/BTG
Counseling PSA
Final Audit Report
2024-01-05
Created: 2024-01-05
By: Windy Luna (wluna@co.weld.co.us)
Status: Signed
Transaction ID: CBJCHBCAABAALFSuDIeb3KW9oGRm83u-dsCS6uiJrnKQg
"SIGNATURE REQUESTED: Weld/BTG Counseling PSA" Histor
Y
'`,J Document created by Windy Luna (wluna@co.weld.co.us)
2024-01-05 - 9:14:05 PM GMT
C? Document emailed to support@greeleycocounseting.com for signature
2024-01-05 - 9:14:54 PM GMT
fi Email viewed by support@greeleycocounseting.com
2024-01-05 - 9:34:11 PM GMT
64 Signer support@greeleycocounseling.com entered name at signing as Holly M Gregory, LPC
2024-01-05 - 9:34:34 PM GMT
64 Document e -signed by Holly M Gregory, LPC (support@greeleycocounseling.com)
Signature Date: 2024-01-05 - 9:34:36 PM GMT - Time Source: server
Agreement completed.
2024-01-05 - 9:34:36 PM GMT
.MoeadW
,Adobe
Acrobat Sign
Contract F
Entity Information
Entity Name* Entity ID"
BETTER THAN GOOD COUNSELING @00047971
Contract Name* Contract ID
BETTER THAN GOOD COUNSELING (POST -BID 7744
B2300040) (PROFESSIONAL SERVICES AGREEMENT)
Contract Status
CTB REVIEW
Contract Lead *
WLUNA
O New Entity?
Parent Contract ID
Requires Board Approval
YES
Contract Lead Email Department Project #
wluna@weldgov.com;cob
bxxlk@weldgov.com
Contract Description
BETTER THAN GOOD COUNSELING (POST -BID B2300040) (PROFESSIONAL SERVICES AGREEMENT). TERM:
DECEMBER 1 , 2023 THROUGH MAY 31, 2024.
Contract Description 2
PA ROUTING THROUGH NORMAL PROCESS - WILL BE ATTACHED TO THIS CMS SUBMISSION. ETA TO CTB
01/11/2024.
Contract Type*
AGREEMENT
Amount*
$0.00
Renewable*
NO
Automatic Renewal
Grant
IGA
Department Requested BOCC Agenda Due Date
HUMAN SERVICES Date* 01/13/2024
01/17/2024
Department Email
CM-
HumanServices@weldgov.
com
Department Head Email
CM-HumanServices-
DeptHead@weldgov.com
County Attorney
GENERAL COUNTY
ATTORNEY EMAIL
County Attorney Email
CM-
COUNTYATTORNEY@WEL
DGOV.COM
Will a work session with BOCC be required?*
NO
Does Contract require Purchasing Dept. to be
included?
If this is a renewal enter previous Contract ID
If this is part of a MSA enter MSA Contract ID
Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts
are not in OnBase
Contract Dates
Effective Date
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
01/11/2024 01/12/2024 01/12/2024
Final Approval
BOCC Approved Tyler Ref #
AG 012424
BOCC Signed Date Originator
WLUNA
BOCC Agenda Date
01/24/2024
Hello