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Home My WebLink About20221598.tiffCo►i-h'ac+ 1t SZZ3 AGREEMENT AMENDMENT BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND LIFELONG, INC. This Agreement Amendment made and entered into 3Vdday of J1AJ'ZQ, , 2024 by and between the Board of Weld County Commissioners, on behalf of the Weld County Department of Human Services, hereinafter referred to as the "Department", and Lifelong Inc., hereinafter referred to as the "Contractor". WHEREAS the parties entered into an Agreement for Domestic Violence Intervention Services, Foster Parent Training, Home -Based Services, Life Skills, Mental Health Services, Mentoring, Monitored Sobriety Services, Substance Abuse Treatment Services, and Therapeutic Kinship Services, (the "Original Agreement") identified by the Weld County Clerk to the Board of County Commissioners as document No. 2022-1598, approved on June 8, 2022. WHEREAS the parties hereby agree to amend the term of the Original Agreement in accordance with the terms of the Original Agreement and any previously adopted amendment, which is incorporated by reference herein, as well as the terms provided herein. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: • The Original Agreement was set to end on May 31, 2023. • The Original Agreement was amended on: • May 8, 2023, to extend the term date through May 31, 2024, and to amend Exhibit A, Scope of Services, and Exhibit B, Rate Schedule. • These Amendments are identified by the Weld County Clerk to the Board of County Commissioners as document number 2022-1598. • These Amendments, together with the Original Agreement, constitutes the entire understanding between the parties. The following additional changes are hereby made to the current Agreement as of June 1, 2024: 1. Term This agreement is being renewed for the third and final year, for the period June 1, 2024 through May 31, 2025. Con Ic6, (0/ 3/zy 644,,e,a46D) 6&I z-/e/o2 2022-159$ 2. Exhibit A, Scope of Services, is hereby amended as attached. 3. Exhibit B, Rate Schedule, is hereby amended as attached. 4. Section 17 of the Agreement, Contractors Address, is hereby amended. • All other terms and conditions of the Original Agreement remain unchanged. IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. COUNTY: ATTEST: "' jd111 4"' Clerk to the Board Deputy Clerk to the BOARD OF COUNTY COMMISSIONERS WELD COUNT O vin D. Ross, Chair JUN 0 3 2024 NTRACTOR: Lifelong, Inc. 750 West Hampden Avenue, Suite 450 Englewood, Colorado 80110 L1sstfeSpakei- By: Lindsey Spraker May 7, 202409:32 MN, l Lindsey Spraker, Executive Director May 17, 2024 Date: EXHIBIT A SCOPE OF SERVICES Contractor will provide Domestic Violence Intervention Services, Foster Parent Training, Home - Based Services, Life Skills, Mental Health Services, Mentoring, Monitored Sobriety Services, Substance Abuse Treatment Services, and Therapeutic Kinship Services, as referred by the Department. Program Area: Domestic Violence Intervention Services 1. Domestic Violence Evaluation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Clinical Assessment Interview. ii. Domestic Violence Risk and Needs Assessment (DVRNA). iii. Spousal Assault Risk Assessment Guide — 3 (SARA — 3). iv. CAGE -AID (Cut, Annoyed, Guilty, and Eye) Substance Abuse Screening Tool. v. Alcohol Use Disorders Identification Test (AUDIT). vi. Scoring the States of Change Readiness and Treatment Eagerness Scale (SOCRATES 8A/8D). vii. Ohio State University Traumatic Brain Injury Identification Method (OSU- TBI). viii. Mini -Mental State Examination (MMSE). ix. Brief Resiliency Scale (BRS). x. Beck Anxiety Inventory (BAI). xi. Beck Depression Inventory (BDI). xii. Level 2 - Anger —Adult. xiii. Substance Abuse Subtle Screening Inventory (SASSI). xiv. Personality Inventory for Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5) — Brief Form (PID-BF) — Adult. xv. World Health Organization Disability Assessment Schedule (WHODAS) 2.0. xvi. Personality Assessment Screener (PAS). xvii. Adverse Childhood Experiences (ACE) Questionnaire. b. Anticipated Frequency of Services: i. Three (3) to seven (7) hours. c. Anticipated Duration of Services: i. Each evaluation and assessment summary and recommendations will be completed within fifteen (15) to thirty (30) days of the first appointment. d. Goals of Services: i. Assess and identify treatment needs of the client. ii. Determine the level of treatment intensity required for domestic violence services. iii. Establish recommendations for immediate and long-term safety planning. e. Outcomes of Services: i. Completion of evaluation. f. Target Population: i. Persons identified as at risk of or known domestic violence involvement with or without police contact or child welfare involvement. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In-Office/Video. ii. In -Home or Community. 2. Domestic Violence Group Treatment a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Cognitive Behavior Therapy (CBT). ii. Dialectical Behavioral Therapy (DBT). iii. Trauma Focused Cognitive Behavioral Therapy (TF-CBT). iv. Motivational Interviewing (MI). v. Duluth model. vi. Multimodal approaches. b. Anticipated Frequency of Services: i. One (1) group session per week. c. Anticipated Duration of Services: i. Duration will be case specific. d. Goals of Services: i. Reduce and manage mental health triggers. ii. Increase the ability to demonstrate understanding of cycle of violence, power and control. iii. Increase ability to demonstrate self-awareness and identify triggers. iv. Increase ability to reflect on self in the group setting. v. Interact with peers in the group setting, demonstrating accountability, competency achievement, and vulnerability. vi. Identify precursors to violence and engage in preventive strategies to self -regulate and manage impulses. e. Outcomes of Services: i. Successful engagement in the group therapy dynamic. ii. Successful daily practice of self -care and coping skills. iii. Successful use of coping skills during conflict or crisis. iv. Successful reunification or other successful case closure. f. Target Population: i. Clients with various diagnosed for suspected disabilities, age four (4) to one hundred (100). ii. Individuals, dyads, and families. g. Language: i. English and Spanish (proficient) — no interpreter services are available. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In-Office/Video. ii. In -Home or Community. 3. Domestic Violence Individual Treatment a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Cognitive Behavior Therapy (CBT). ii. Dialectical Behavioral Therapy (DBT). iii. Trauma Focused Cognitive Behavioral Therapy (TF-CBT). iv. Motivational Interviewing (MI). v. Duluth model. vi. Multimodal approaches. b. Anticipated Frequency of Services: i. One (1) to two (2) sessions per week, dependent on individual needs. c. Anticipated Duration of Services: i. Duration will be case specific. d. Goals of Services: i. Reduce and manage mental health triggers. ii. Increase the ability to demonstrate understanding of cycle of violence, power and control. iii. Increase ability to demonstrate self-awareness and identify triggers. iv. Increase ability to reflect and self -evaluate, identify precursors to violence, and engage in preventive strategies to self -regulate and manage impulses. v. Increase ability to identify criteria for safe and healthy interactions and relationships. vi. Increase ability to demonstrate protective skills of self and dependents. e. Outcomes of Services: i. Successful engagement in individual therapy process regarding offense specific behavior reduction. ii. Successful daily practice of self -care and coping skills. iii. Successful use of coping skills during conflict or crisis. iv. Successful reunification or other successful case closure. f. Target Population: i. Clients aged four (4) to one hundred (100). g. Language: i. English and Spanish (proficient) — no interpreter services are available. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In-Office/Video. ii. In -Home or Community. 4. Domestic Violence Intake a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Domestic Violence Offender Management Board (DVOMB) approved intake and assessment materials. b. Anticipated Frequency of Services: i. Two (2) to five (5) hours. c. Anticipated Duration of Services: i. One (1) to two (2) sessions. d. Goals of Services: i. Completion of intake. e. Outcomes of Services: i. Completion of intake. f. Target Population: i. Persons identified as at risk of or known domestic violence involvement with or without police contact or child welfare involvement. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In-Office/Video. ii. In -Home or Community. 5. Foundations for Family Safety (FFS) — Group and Individual a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psychoeducation group as part of a Family Violence Reduction Program (FVRP) developed specifically for Human Services, Colorado Works, and child welfare. ii. Upon identifying concerns of (or a documented history of) power and control, behaviors of abuse (including child abuse), family violence, high conflict, neglect, victimization, or suspected intimate partner violence in front of children, and after completing an intake with screening to determine appropriateness for enrollment, parent(s) and caregiver(s) can be enrolled in this group. b. Anticipated Frequency of Services: i. Ninety (90) minutes per week. c. Anticipated Duration of Services: i. Twelve (12) weeks. d. Goals of Services: i. Provide psychoeducation, processing, and support around family violence, intimate partner violence. ii. Address victim and offender issues. iii. Identify developmental neglect and harm, impact on children. iv. Create case planning, continuity of care, connection to resources, safety planning, and repairing harm. e. Outcomes of Services: i. Provide a written document of assessment with recommendation indicating one of the following: completion with no further education or treatment indicated, or recommendation for client to transition to a subsequent therapy or treatment (e.g., substance treatment, mental health therapy groups/individuals, domestic violence treatment, parenting class, victim advocacy, family therapy, psychological evaluation, etc.). ii. Documented reduction and/or extinguishment of family violence. iii. Increased access to support, resources, and safety planning. iv. Increased recognition and internalization of impact of harm on children) as a result of family violence. f. Target Population: i. Clients. ii. Caregivers and/or families with learning developmental or intellectual disabilities, traumatic or acquired brain injuries, autism spectrum. iii. Those who have not had success with previous providers. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In-Office/Video. 6. Victim -Survivor Advocacy Group and Individual a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psychoeducation as part of a Family Violence Reduction Program (FVRP). ii. The first sixty (60) minutes of programming focus on psychoeducation and the final thirty (30) minutes invest in processing and support. iii. Expertise that includes best practice support and education for parents and caregivers impacted by interpersonal and family violence and is provided by an expert professional in victim services, support, and advocacy. b. Anticipated Frequency of Services: i. Ninety (90) minutes per week. c. Anticipated Duration of Services: i. Six (6) weeks. d. Goals of Services: i. Provide education on healthy and unhealthy relationship dynamics. ii. Differentiate between violence, abuse, and control. iii. Understand the cycle of abuse. - iv. Learn the impact of IPV on children. v. Create a self -care and safety plan. e. Outcomes of Services: i. Provide written document of assessment with recommendation indicating one of the following: completion with no further education or treatment indicated, or recommendation for client to transition to a subsequent therapy or treatment (e.g., substance treatment, mental health therapy groups/individuals, domestic violence treatment, parenting class, victim advocacy, family therapy, psychological evaluation, etc.). ii. Victim -Survivor will be informed of domestic violence dynamics through a victim lens with a focus on reduction of risk and safety enhancement. iii. Victim -Survivor will have increased access to support, resources, and safety planning. iv. Victim -Survivor will have enhanced recognition and internalization of impact of harm on children) as a result of family violence. f. Target Population: i. Caregivers. ii. All genders, iii. All abilities. iv. All diagnoses, unless contraindicated. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In-Office/Video. ii. In -Home or Community. 7. Family Violence Reduction Program Intake a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: ii. Biopsychosocial. iii. Identify rule -outs. iv. Determine appropriateness. v. Sign disclosures and Release of Information. vi. Complete screeners. b. Anticipated Frequency of Services: vii. Two (2) to five (5) hours. c. Anticipated Duration of Services: viii. One (1) episode. d. Goals of Services: e. Outcomes of Services: ix. Intake into programming completed. x. Contraindicated clients ruled -out with recommendations. xi. Ongoing programming begins. f. Target Population: xi i. Caregivers. xiii. All genders. xiv. All abilities. xv. All diagnoses — unless contraindicated. g. Language: xvi. English. h. Medicaid Eligibility: xvii. This service is not Medicaid eligible. i. Service Access and Transportation: xviii. In-Office/Video. Program Area: Foster Parent Training 1. Foster Parent Training — Various a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Trauma informed ABA (Applied Behavior Analysis), parent coaching curriculums specialized for parents fostering children, and trauma informed trainings. ii. Attachment/trauma focused therapy and psychoeducation. b. Anticipated Frequency of Services: i. Frequency will depend on the needs as requested by the Department. c. Anticipated Duration of Services: i. Duration will depend on the needs as identified by the Department. d. Goals of Services: i. Provide psychoeducation to foster parents regarding attachment trauma and associated symptoms and behaviors. ii. Provide foster parents with skills and training to support the development and maintenance of strategies that promote safety and prevent or limit the occurrence of behavioral challenges that can lead to additional trauma and /or disruption of the placement. iii. Provide foster parents with a safe and understanding support system in which they can process the challenges of foster parenting and learn self - care and coping skills. e. Outcomes of Services: i. Preservation of placement. ii. Reduction in the number of placement changes a child experiences while in foster care. iii. Reduction in foster parent burn out and stressors associated with foster care. f. Target Population: i. Foster Parents. g. Language: i. English and Spanish (fluent). h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In-Office/Video. ii. In -Home or Community. Program Area: Home -Based Services 1. Home -Based Interventions — High a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Therapeutic life skills, Applied Behavior Analysis, Parent Training and Coaching and a variety of our services provided by master's level clinicians -in -training in the home environment of the individual. Modality for therapeutic interventions determined by clinician and based on clients' individual needs and abilities. b. Anticipated Frequency of Services: i. Three (3) to six (6) hours per week, frequency will be based on individual needs and goals. c. Anticipated Duration of Services: i. Minimum of eight (8) weeks based on individual needs and goals. d. Goals of Services: i. Provide most accessible therapeutic level interventions in client home. ii. Individuals will engage in skill acquisition and therapy with opportunity to demonstrate and maintain skills in their home environment. iii. Individuals will develop and maintain self -care and coping practices. e. Outcomes of Services: i. Increased ability to generalize and maintain learned skills over time in their home environments. , ii. Reduced likelihood of out of home placement and court involvement for child protection concerns. iii. Reduced recidivism for child welfare contact and involvement. f. Target Population: i. Clients with various diagnosed or suspected disabilities, ages twelve (12) to one hundred (100). ii. Individuals, dyads, or families. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In-Office/Video. ii. In -Home or Community. 2. Home -Based Interventions — Intensive a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Individual and/or family therapy, therapeutic life skills, Applied Behavior Analysis, and a variety of our services provided by master level clinicians in the home environment of the individual. Modality for therapeutic interventions determined by clinician and based on clients' individual needs and abilities. Skills assessments may be utilized to determine curriculum and programming. b. Anticipated Frequency of Services: i. Three (3) to eight (8) hours per week, frequency will be based on individual needs and goals. c. Anticipated Duration of Services: i. Minimum of twelve (12) weeks based on individual needs and goals. d. Goals of Services: i. Provide most accessible therapeutic level interventions in client home. ii. Individuals will engage in skill acquisition and therapy with opportunity to demonstrate and maintain skills in their home environment. iii. Individuals will reflect on and process stressors, traumatic experiences, and associated emotions and behaviors. iv. Individuals will develop and maintain self -care and coping practices. e. Outcomes of Services: i. Increased ability to generalize and maintain learned skills over time in their home environments. ii. Reduced likelihood of out of home placement and court involvement for child protection concerns. iii. Reduced recidivism for child welfare contact and involvement. f. Target Population: i. Clients with various diagnosed or suspected disabilities, ages twelve (12) to one hundred (100). ii. Individuals, dyads, and families. g. Language: i. English and Spanish (proficient) — no interpreter services are available. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In-Office/Video. ii. In -Home or Community. Program Area: Life Skills 1. Life Skills a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Approaches are highly individualized and dependent on the specific skill deficits and goals of the individual. May include but are not limited to role play practice of skills, direct support, prompting and prompt fading strategies, and naturalistic in -situation instruction. b. Anticipated Frequency of Services: i. Two (2) hours per week minimum, one (1) to three (3) sessions depending on the client's needs. c. Anticipated Duration of Services: i. Duration will be case specific. d. Goals of Services: i. Provide skill acquisition training to individuals. ii. Individuals will increase their independence to the maximum potential possible for their abilities. iii. Individuals will secure and maintain resources that will allow them to meet their court ordered treatment goals. e. Outcomes of Services: i. Successful reunification or other successful case closure. ii. Increased ability to access home and community resources. iii. Increased independence and ability to establish and maintain meaningful healthy relationships. iv. Increased ability to identify and maintain healthy supports and leisure skills that contribute to stable and predictable parenting. f. Target Population: i. Clients with various diagnosed or suspected disabilities, ages twelve (12) to one hundred (100). ii. Individuals, dyads, or families. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. Service Access and Transportation: i. In-Office/Video. ii. In -Home or Community. 2. Therapeutic Life Skills a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Approaches are highly individualized and dependent on the specific skill deficits and goals of the individual. May include but are not limited to role play practice of skills, direct support, prompting and prompt fading strategies, and naturalistic in -situation instruction. b. Anticipated Frequency of Services: i. Two (2) hours per week at a minimum, taking place over one (1) to three (3) sessions, depending on the client's needs. c. Anticipated Duration of Services: i. Duration will be case specific. d. Goals of Services: i. Provide skill acquisition training to individuals. ii. Provide safe therapeutic support in which clients social/emotional needs are respected and addressed in ways that will allow learning of skills and processing the emotions related to their challenges. iii. Individuals will increase their independence to the maximum potential possible for their abilities. iv. Individuals will secure and maintain resources that will allow them to meet their court ordered treatment goals. v. Individuals will improve the quality of their relationships, develop leisure skills that are healthy and sustainable. vi. Successful mental health management during stressful or triggering life skill activities. e. Outcomes of Services: i. Successful reunification or other successful case closure. ii. Increased ability to access home and community resources. iii. Increased independence and ability to establish and maintain meaningful healthy relationships. iv. Increased ability to identify and maintain healthy supports and leisure skills that contribute to stable and predictable parenting. f. Target Population: i. Clients with various diagnosed or suspected disabilities, ages twelve (12) to one hundred (100). ii. Individuals, dyads, or families. g. Language: i. English and Spanish (proficient) — no interpreter services are available. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In-Office/Video. ii. In -Home or Community. Pro ram Area: Mental Health Services 1. Applied Behavior Analysis (ABA) — Board Certified Behavior Analyst (BCBA) a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Applied Behavior Analysis (ABA) as primary modality. ii. Trauma -informed. iii. Assessments including but not limited to: Functional Behavior Assessment (FBA), Functional Assessment Screening Tools (FAST), Functional Analysis (only when clinically indicated), skills assessments, adaptive functioning scales, Vineland III, developmental assessments, Autism screening tools, Verbal Behavior Milestones Assessment and Placement Program (VBMAPP), Assessment of Basic Language and Living Skills (ABLLS), Assessment of functional living skills (AFLS), Essentials for Living (EFLS). iv. All assessments are used to allocate baseline data, identify skill deficits, and drive curriculum for treatment goals. v. Assessment is ongoing and all treatment decisions are driven by data collected in every session reflecting progress on each goal and behavior. b. Anticipated Frequency of Services: i. ABA is highly dependent on a thorough, individualized assessment. Service recommendations can range from one (1) to forty (40) hours per week of treatment. c. Anticipated Duration of Services: i. ABA services can range from a short-term focused treatment for six (6) months or may extend longer depending on the individual's needs and abilities. d. Goals of Services: i. Identify skill deficits and develop skill acquisition programming to be taught using the principles of ABA. ii. Mediate and reduce the negative effects of challenging behaviors on the individual and caregivers. iii. Develop and implement behavior intervention strategies to reduce behaviors targeted for reduction. iv. Conduct ongoing parent/caregiver required training on skill teaching and behavior intervention strategies using a trauma-informed/preventative approach. e. Outcomes of Services: i. Prevent or reduce behaviors that put individuals or their caregivers/family members at risk of harm. ii. Prevent or reduce behaviors that limit an individual's ability to access their home, school, community, and establish and maintain meaningful relationships. iii. Increase communication and social skills. iv. Increase independence to the highest level possible and establish skills that contribute to mental and physical health and hygiene. f. Target Population: i. Individuals of all ages, genders, abilities and diagnoses, unless clinically contraindicated or a diagnosis for the person or child involves a symptomology that requires medical intervention as the primary treatment. g. Language: i. English and Spanish (proficient) — no interpreter services are available. h. Medicaid Eligibility: i. This service may be Medicaid eligible for qualified individuals through EPSDT with a doctor's referral prescribing ABA as a medically necessary treatment for individuals' specific diagnosis. i. Service Access and Transportation: i. In-Office/Video. ii. In -Home or Community. 2. Applied Behavior Analysis (ABA) — Behavior Technician a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Primary modality being ABA. ii. Behavior Technician's (BT's) work directly with the client, under supervision, to implement the skill teaching program and behavior interventions designed by the Board -Certified Behavior Analyst (BCBA). b. Anticipated Frequency of Services: i. ABA is highly dependent on a thorough individualized assessment. Service recommendations can range from one (1) to forty (40) hours per week. c. Anticipated Duration of Services: i. ABA services can range from a short-term focused treatment for six (6) months or may extend longer depending on the individual's needs and abilities. d. Goals of Services: i. Identify skill deficits and develop skill acquisition programming to be taught using the principles of ABA. ii. Mediate and reduce the negative effects of challenging behaviors on the individual and caregivers. iii. Develop and implement behavior intervention strategies to reduce behaviors targeted for reduction. iv. Conduct ongoing parent/caregiver required training on skill teaching and behavior intervention strategies using a trauma -informed / preventative approach. e. Outcomes of Services: i. Prevent or reduce behaviors that put individuals or their caregivers/family members at risk of harm. ii. Prevent or reduce behaviors that limit an individual's ability to access their home, school, community, and establish and maintain meaningful relationships. iii. Increase communication and social skills. iv. Increase independence to the highest level possible and establish skills that contribute to mental and physical health and hygiene. f. Target Population: i. Individuals of all ages, genders, abilities and diagnoses, unless clinically contraindicated or a diagnosis for the person or child involves a symptomology that requires medical intervention as the primary treatment. g. Language: i. English and Spanish (proficient) — no interpreter services are available. h. Medicaid Eligibility: i. This service may be Medicaid eligible for qualified individuals through EPSDT with a doctor's referral prescribing ABA as a medically necessary treatment for individuals' specific diagnosis. i. Service Access and Transportation: i. In-Office/Video. ii. In -Home or Community. 3. Caring Dads a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. The Caring Dads parenting group is a curriculum driven and facilitated opportunity for men to obtain and practice parenting skills and connect with other men as fathers. b. Anticipated Frequency of Services: i. One (1) time per week. c. Anticipated Duration of Services: i. Seventeen (17) weeks. d. Goals of Services: i. Improve and strengthen the father/child relationship. ii. Learn child centered parenting skills and strategies to manage stress and frustration. iii. Identify and self -reflect on the impact of previous conflictual strategies on familial relationships. e. Outcomes of Services: i. Reduce recidivism of child welfare contact for participating families. ii. Successful case closure via reunification or maintenance of custody or in -home placement. iii. Create community connections and relationships for fathers. f. Target Population: i. Parents with children, fathers who have demonstrated parenting challenges that resulted in child protection concerns, fathers struggling with parenting children with challenging behaviors or special behavioral needs. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In-Office/Video. ii. In -Home or Community. 4. Consultation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Case consult. ii. Document review. b. Anticipated Frequency of Services: i. As needed. c. Anticipated Duration of Services: i. As requested by the Department. d. Goals of Services: i. Identify correct course for client treatment, needs, and dynamics. e. Outcomes of Services: i. Achieve successful direction. f. Target Population: i. Department and Court Professionals. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In-Office/Video. ii. In -Home or Community. 5. Loved Ones of Survivors Intake, Group, and Individual a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psychoeducation as part of a Family Violence Reduction Program (FVRP). The first sixty (60) minutes of programming focus on psychoeducation and the final thirty (30) minutes invest in processing and support. ii. Expertise includes education surrounding best practices in supporting Survivors as well as the complexities of intimate partner violence. iii. Education provided by an expert professional in victim services, support, and advocacy. b. Anticipated Frequency of Services: i. Ninety (90) minutes per week. c. Anticipated Duration of Services: i. Six (6) weeks. d. Goals of Services: i. Provide education on healthy and unhealthy relationship dynamics. ii. Education loved ones on coercive control. iii. Understand the cycle of abuse. iv. Learn the impact of IPV on children. v. Create a victim support and safety plan as the support of a survivor. e. Outcomes of Services: i. Loved One (parent, sibling, support person, etc.) will be informed of domestic violence dynamics through a victim support lens with a focus on reduction of risk and safety enhancement. ii. Increased access to support, resources, and safety planning. iii. Enhanced recognition and internalization of impact of harm on children) as a result of family violence with additional psychoeducation around victim dynamics as a place of support vs. blame. f. Target Population: i. Loved ones of a domestic violence survivor. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In-Office/Video. ii. In -Home or Community. 6. Mental Health Evaluation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Clinical Interview, Adverse Childhood Experience (ACE) Questionnaire, Behavioral Rehabilitation Services (BRS), Ohio State University Traumatic Brain Injury (OSU-TBI), Diagnostic and Statistical Manual of Mental Disorders (DSM-V), Minnesota Multiphasic Personality Inventory (MMPI), Texas Success Initiative program (TSI), mental status exam, or others as determined during the interview. b. Anticipated Frequency of Services: i. Two (2) hours to four (4) hours. c. Anticipated Duration of Services: i. One (1) to two (2) appointments. d. Goals of Services: i. Conduct a thorough assessment of individuals' mental status, social/emotional skills and deficits, and adaptive functioning. ii. Identify individuals' current mental functioning and mental health diagnosis if indicated. iii. Assist individual in identifying areas of strength and need regarding their mental/emotional health. e. Outcomes of Services: i. Provide client and authorized Department service providers with a comprehensive assessment summary. ii. Provide client and authorized Department service providers with specialized treatment recommendations for modalities and treatment options that are most effective for client's abilities and needs. iii. Provide psychoeducation to the client and/or guardian regarding client's mental status, symptomology, and diagnosis. iv. Connect client with resources which can meet their needs. f. Target Population: v. Individuals with various diagnosed or suspected intellectual/developmental disabilities, ages six (6) to one hundred (100), exhibiting challenges. g. Language: i. English and Spanish (proficient) — no interpreter services available. h. Medicaid Eligibility: i. This service may be Medicaid eligible. i. Service Access and Transportation: i. In-Office/Video. ii. In -Home or Community. 7. Mental Health Therapy— Individual. a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), Trauma Focused Cognitive Behavioral Therapy (TF-CBT), Abstinence - Based Treatment (ABT), Animal Assisted Therapy (AAT), Marriage and Family Therapy (MFT), Motivational Interviewing (MI), Parent -Child Interaction Therapy (PCIT). b. Anticipated Frequency of Services: i. Frequency will be case specific depending on the severity of need/trauma/crisis. c. Anticipated Duration of Services: i. Duration will be case specific with recommendations based on assessment, client goals, and abilities, in addition to level of engagement. d. Goals of Services: i. Reduce and manage mental health triggers. ii. Reduce skill deficits within emotional regulation and coping practices. iii. Increase self-awareness and self -management skills. iv. Process traumatic experiences and develop understanding of their impact on current functioning and relationships. v. Increase the ability of the client to identify emotional, mental, and physical needs and advocate for themselves. e. Outcomes of Services: i. Successful use of coping skills during day-to-day interactions, conflict, or crisis. ii. Increased independence in accessing community activities, resources, and services. iii. Increased ability to demonstrate independent engagement in pro -social and safe leisure skills. iv. Ability to establish and maintain healthy and safe relationships. v. Successful achievement of court recommended goals. vi. Successful reunification or other successful case outcome. f. Target Population: i. Ages four (4) to one hundred (100), with various diagnosed or suspected disabilities/developmental disabilities. ii. Individuals, dyads, or families, staff/professionals in need of training. g. Language: i. English and Spanish (proficient) — no interpreter services available. h. Medicaid Eligibility: i. This service is not currently Medicaid eligible. i. Service Access and Transportation: i. In-Office/Video. ii. In -Home or Community. 8. Mental Health Treatment - Groups a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Seeking Safety, Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), High Conflict Co -Parenting, Caring Dads, Strategies for Self -Improvement, and Change (SSC/SSIC), Affective Education and Health Relationships, Veteran Group, Social Skills, Trauma -Processing, Domestic Violence, and others. b. Anticipated Frequency of Services: i. One (1) to two (2) groups per week. c. Anticipated Duration of Services: i. Sixteen (16) to fifty-two (52) weeks, depending on client progress and needs. d. Goals of Services: i. Complete treatment group assigned. e. Outcomes of Services: i. Complete accurate assessment of clients' treatment, strengths, needs, and areas of skill deficits. ii. Complete designated curriculum specialized for the service type. iii. Reduce and/or eliminate concerns of recidivism, relapse, and other risk factors. iv. Increase coping capacity, safety tools, safe relationships, problem - solving, communication, and decision -making. f. Target Population: i. Individuals with various diagnosed or suspected intellectual/developmental disabilities, ages six (6) to one hundred (100). g. Language: i. English and Spanish (proficient) — no interpreter services available. h. Medicaid Eligibility: i. This service is partially Medicaid eligible. i. Service Access and Transportation: i. In-Office/Video. ii. In -Home or Community. 9. Neuropsychological Evaluation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Diagnostic tools, testing, screeners, and assessments as determined by the psychologist. b. Anticipated Frequency of Services: i. Ten (10) to fifteen (15) hours total. c. Anticipated Duration of Services: i. One (1) to three (3) appointments for testing and interview. d. Goals of Services: i. Assess clients' strengths and areas of skill deficits. ii. Conduct neuropsychological testing as prescribed. iii. Accurately test clients' current functioning and gather full history of the whole person. iv. Generate tailored recommendations for specialized services and modalities that will best support the client. e. Outcomes of Services: i. Accurate holistic understanding of client needs, diagnosis, and abilities. ii. Recommendations for specialized services. iii. Individualized and thorough report. f. Target Population: i. Client's aged four (4) to one hundred (100). g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. Service Access and Transportation: i. In-Office/Video. ii. In -Home or Community. 10. Parent Child Interaction Assessment a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Parent child interaction assessment utilizes prescribed evidence -based tools, observation techniques, and structured play scenarios based on the assessors training and current research. b. Anticipated Frequency of Services: i. Two (2) to three (3) hours of direct observation plus interviews and collateral documentation review. c. Anticipated Duration of Services: i. Ten (10) to twelve (12) hours including report preparation and feedback session. d. Goals of Services: i. Gather data about parental attunement, attachment, relationship dynamics between parent and child. ii. Identify harmful or dysfunctional parenting attributes. iii. Present a thorough representation of the parent child relationship. e. Outcomes of Services: i. Generate specialized recommendations for therapeutic supports to improve the quality of the parent/child relationship. ii. Reduce the likelihood of future child welfare contact. iii. Predict likelihood of potential for future abuse and neglect. f. Target Population: i. All individuals including those with various diagnosed or suspected intellectual/developmental disabilities, dyads, and families. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In-Office/Video. ii. In -Home or Community. 11. Pediatric Diagnostic Evaluation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. The pediatric diagnostic evaluation consists of systematic observations, assessments, collateral documentation review, and testing that will yield evidence to support a diagnosis of an Autism Spectrum diagnose or another disorder. b. Anticipated Frequency of Services: i. Ten (10) to fifteen (15) hours of observation, interviewing, testing and collateral review. c. Anticipated Duration of Services: i. One (1) to three (3) appointments. d. Goals of Services: i. Obtain or rule out a diagnosis of a developmental disorder. ii. Procure a thorough assessment of where a child falls along the Autism Spectrum. iii. Gain an understanding of a child's intellectual potential. e. Outcomes of Services: i. Provide a treatment and education plan specifically geared towards the child's needs. ii. Provide education and resources to those providing care for the child. iii. Identify and connect the family with specialized support services and treatment options. f. Target Population: i. Children up to age eighteen (18) with suspected developmental disabilities or autism spectrum disorder. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. Service Access and Transportation: i. In-Office/Video. ii. In -Home. 12. Psychological Evaluation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Diagnostic tools, screeners, and assessments as determined by the psychologist. b. Anticipated Frequency of Services: i. Ten (10) to twelve (12) hours total including report preparation and feedback session. c. Anticipated Duration of Services: i. One (1) to three (3) appointments. d. Goals of Services: i. Generate accurate assessment of clients' diagnosis, strengths, needs, and areas of skill deficits. ii. Generate a complete report of specialized recommendations for treatment and services tailored to the social/emotional, mental health, and learning needs of the individual. iii. Identify and determine course of treatment, treatment goals, and modality that is best suited for the individual. e. Outcomes of Services: i. Evaluation will provide data, summary, and outcome suggestions for client's learning, developmental, and mental health needs. f. Target Population: i. Client's aged four (4) to one hundred (100). g. Language: i. English and Spanish (proficient) — no interpreter services available. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In-Office/Video. ii. In -Home or Community. 13. Therapeutic Peer Support Group and Individual a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Therapeutic Peer Support is part of a Family Violence Reduction Program (FVRP). Upon completion of the six (6) week psychoeducation advocacy group programming, individuals may join a therapeutic peer support group, when recommended. ii. This therapeutic support group will provide further processing of psychoeducation material provided in the previous course along with a supportive setting with peers that allows for shared information, support networking, and additional depth in education surrounding the topic of intimate partner violence. iii. This therapeutic group will be victim centered and facilitated by a mental health therapist trained in victim issues and domestic violence dynamics. b. Anticipated Frequency of Services: i. Ninety (90) minutes per week. c. Anticipated Duration of Services: i. Six (6) to twelve (12) weeks. d. Goals of Services: i. Deepened processing of psychoeducation material. ii. Peer support of shared experiences, support networking, and internalization of education. iii. Victim -centered trauma processing. e. Outcomes of Services: i. Victim -survivor trauma -processing. ii. Victim -survivor community connections strengthening for individual, child(ren), and family. iii. Reduction of Department intervention related to IPV concerns. f. Target Population: i. Caregivers. ii. All genders. iii. All abilities. iv. All diagnosis unless contraindicated. g. Language: i. English. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. In-Office/Video. ii. In -Home or Community. 14. Treatment Group - Social Skills Group a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Social skills checklists are utilized to assess skills and identify pairs or groups of individuals who would work effectively together on mutual goals that are appropriate for their age and development. b. Anticipated Frequency of Services: i. One (1) to two (2) times per week for one (1) or more hours depending on size of group and abilities. c. Anticipated Duration of Services: i. Eight (8) weeks per cohort. d. Goals of Services: i. Identify individuals who could benefit from facilitated social skills practice in a group setting. ii. Provide safe, monitored, and facilitated activities that support individuals' social skills practice in a group setting. iii. Provide peer modeling opportunities for individuals with social skills deficits. iv. Promote the development of necessary social skills and safe ways to connect and interact with peers. e. Outcomes of Services: i. Increase clients' access to safe opportunities to practice social skills and develop meaningful relationships. ii. Increase clients' ability to generalize social skills to new individuals in a new setting. iii. Increase the connections and opportunities to create a community for individuals with intellectual disabilities. f. Target Population: i. Children and adults that have been assessed and identified as a candidate for group processing. g. Language: i. English, Spanish, (proficient) — no interpreter services available h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In-Office/Video. ii. In -Home. Program Area: Mentoring 1. Specialized Mentorship a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Based on the intake assessment, modalities or curriculum may include but are not limited to adventure -based activities, participation and engagement in community activities, modeling, skill acquisition, role playing, and development of hobbies and interests. b. Anticipated Frequency of Services: i. Two (2) hours per week minimum, typically up to three (3) sessions per week. c. Anticipated Duration of Services: i. Six (6) to twelve (12) months. d. Goals of Services: i. Provide a safe, stable, consistent connection to individuals. ii. Individuals will develop and maintain skills that promote stability, independence, and physical/mental wellbeing. iii. Individuals will develop and maintain healthy leisure skills and increase self-worth and self-confidence by reducing risk taking behavior, acting out, substance use, and negative self -statements. e. Outcomes of Services: i. Reduce future police contact or juvenile justice system involvement. ii. Maintain placement in home or current stable living situation. iii. Increase school attendance and completion. iv. Increase awareness of mental health and resources to secure supports necessary to maintain wellbeing. v. Increase social/emotional skills and self -management. vi. Increase ability to advocate for self. vii. Increased communication skills. viii. Reduce symptoms of anxiety and depression. ix. Reduce self -harm. f. Target Population: i. Youth ages eight (8) to twenty-one (21) with or without suspected or diagnosed disability, criminal involvement, or child welfare involvement. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In-Office/Video. ii. In -Home or Community. Program Area: Monitored Sobriety Services 1. Urinalysis and Breathalyzer a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Secure and protected drug panel screening tools. ii. Substances tested for: 1. Amphetamine (AMP) 2. Barbiturates (BAR) 3. Buprenorphine (BUP) 4. Benzodiazepines (BZO) 5. Cocaine (COC), 6. Creatine (CR), 7. Ethyl glucuronide (ETG), 8. Fenfluramine/phentermine (FEN) 9. Methadone (MTD) 10. Opiates (OPI) 11. Oxycodone (OXY) 12. Tetrahydrocannabinol (THC) 13. Tramadol b. Anticipated Frequency of Services: i. As needed or as required by treatment. c. Anticipated Duration of Services: i. Length of Substance Use Disorder (SUD) treatment. d. Goals of Services: i. Complete sobriety testing successfully. e. Outcomes of Services: i. Provide negative sobriety test results when scheduled. f. Target Population: i. Clients in SUD treatment. g. Language: i. English. h. Medicaid Eligibility: i. No. i. Service Access and Transportation: i. In-Office/Video Program Area: Substance Abuse Treatment 1. Substance Abuse Treatment — Group Treatment a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), Trauma Focused Cognitive Behavioral Therapy (TF-CBT), Motivational Interviewing (MI), multimodal approaches. b. Anticipated Frequency of Services: i. One group weekly. c. Anticipated Duration of Services: i. Duration will be case specific. d. Goals of Services: i. Reduce and manage substance use or substance misuse. ii. Reach a goal of being alcohol or substance use free. iii. Maintain abstinence from all substances. e. Outcomes of Services: i. Successful daily practice of self -care and coping skills. ii. Successful establishment and maintenance of pro -social relationships. iii. Successful reunification or other successful case closure. f. Target Population: i. Ages twelve (12) to one hundred (100) with various diagnosed or suspected disabilities. g. Language: i. English. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. In-Office/Video. ii. In -Home. 2. Substance Abuse Treatment - Individual Treatment a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), Trauma Focused Cognitive Behavioral Therapy (TF-CBT), Motivational Interviewing (MI), multimodal approaches. b. Anticipated Frequency of Services: i. One (1) to three (3) sessions per week depending on the client's needs. c. Anticipated Duration of Services: i. Duration will be case specific. d. Goals of Services: i. Reduce and manage substance use or substance misuse. ii. Reach a goal of being alcohol or substance use free. iii. Maintain abstinence from all substances. e. Outcomes of Services: i. Successful daily practice of self -care and coping skills. ii. Successful establishment and maintenance of pro -social relationships. iii. Successful reunification or other successful case closure. f. Target Population: i. Ages twelve (12) to one hundred (100) with various diagnosed or suspected disabilities. g. Language: i. English. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. In-Office/Video. ii. In -Home. 3. Substance Treatment Evaluation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Evaluation Assessment and Screening Tools. b. Anticipated Frequency of Services: i. One (1) to two (2) hours. c. Anticipated Duration of Services: i. Thirty (30) days. d. Goals of Services: i. Complete Substance Use Disorder (SUD) evaluation. e. Outcomes of Services: i. SUD evaluation report generated and released. f. Target Population: Client with various diagnosed or suspected disabilities, ages twelve (12) to one hundred (100). g. Language: i. English. h. Medicaid Eligibility: i. This service is Medicaid eligible. Service Access and Transportation: i. In-Office/Video. 4. Substance Treatment Intake a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Intake Assessment and Screening Tools. b. Anticipated Frequency of Services: i. One (1) to two (2) hours. c. Anticipated Duration of Services: i. Thirty (30) days. d. Goals of Services: i. Complete Substance Use Disorder (SUD) intake. e. Outcomes of Services: i. SUD intake report generated and released. f. Target Population: i. Client with various diagnosed or suspected disabilities, ages twelve (12) to one hundred (100). g. Language: i. English h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: ii. In-Office/Video. Program Area: Therapeutic Kinship Services 1. Kinship Services (Therapeutic) a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Intensive Family Therapy, Applied Behavior Analysis (ABA), Caregiver Consultation, and Caregiver Training. b. Anticipated Frequency of Services: i. Two (2) hours per week minimum. c. Anticipated Duration of Services: i. Twelve (12) weeks minimum. Duration is highly dependent on case specifics, children's needs, and engagement of involved parties. d. Goals of Services: i. Provide supportive and comprehensive services to kinship placement providers. ii. Provide psychoeducation, therapy, skill acquisition, and prevention strategies to mediate challenges presented in kinship care. iii. Provide Kinship caregivers with resources, community connections, and skills to develop coping practices. e. Outcomes of Services: i. Preservation of Kinship placement. ii. Improve quality and stability of relationships within kinship placement. iii. Prevent kinship provider burnout and reduce risk of harm in placement. f. Target Population: i. Clients with various diagnosed or suspected disabilities, ages twelve (12) to one hundred (100). ii. Individuals, dyads, or families. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In-Office/Video. ii. In -Home. Terms 1. Contractor understands and will comply with all aspects of the referral authorization, billing and tracking requirements as set forth by the Department. Failure to comply with all aspects may result in a forfeiture of payment. 2. Contractor agrees to receive referrals for services through e-mail and will provide an identified e-mail address prior to the start of this Agreement. Contractor acknowledges that services are not authorized until the Contractor has received an authorized referral form from the Department. Contractor further acknowledges that services provided prior to the authorized start date or outside the scope of services on the referral form will not be eligible for reimbursement. 3. Contractor will respond to the Mental Health and Support Services Team HS- CWServiceReferral@weld.gov) within three (3) business days regarding the ability to accept the received referral. 4. Upon acceptance of a referral, Contractor will offer an initial appointment within seven (7) days of receiving the referral. The first attempt to contact the client will occur within 24 hours of receiving the referral (excluding weekends and holidays). Contractor will document efforts to engage client in referred services. If the client does not respond after three (3) attempts in the first seven (7) days of the referral period, the Contractor will notify the caseworker and the Mental Health and Support Services Team HS- CWServiceReferral@weld.gov. 5. Contractor acknowledges that any and all modifications to an existing referral must be approved through the Mental Health and Support Services Team HS- CWServiceReferral@weld.gov. No other Department staff or other party to the case may authorize services or modifications to services. 6. Contractor understands that "no shows" are defined as unexcused and unplanned/uncommunicated absences for services. If a rate for "no shows" is not specifically stated in Exhibit B, 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" on the part of case participants who cancel without 24 -hour notice. After three (3) "no-shows", Contractor will place client on a behavioral plan requiring attendance or discharge the client from services. Contractor must inform the caseworker and the Mental Health and Support Services Team HS-CWServiceReferral@weld.gov within three (3) days of when the client is placed on a behavioral plan or discharged. 7. Contractor understands that the Department will not reimburse Contractor for cancelled appointments either on the part of the client or the Contractor. If the cancellation is generated from the Contractor, a "makeup" session/episode, to occur within 30 days of the cancellation, will be offered to the client (excluding session/episodes that fall on holidays). If the cancellation is generated from the client, the Contractor must request a makeup session from the Department prior to the makeup session occurring (excluding session/episodes that fall on holidays). After three (3) cancellations, Contractor will inform the caseworker and the Mental Health and Support Services Team HS-CWServiceReferral@weld.gov immediately via email, to discuss service continuation. 8. Contractor will identify, in detail, areas of continued concern and make recommendations to the caseworker in a monthly report regarding continuation of services and/or the need for additional services. 9. Contractor will submit reports on a monthly basis for each active referral for ongoing services. Reports will be submitted per the online format required by the Department, unless otherwise directed by the Department. 10. Contractor will document in detail any and all observed or verbalized concerns regarding any child whom the Contractor is working with under an active referral. Areas of concern may include, but are not limited to, any physical, emotional, educational, or behavioral issues. Areas of concern should be reported to the caseworker and the Mental Health and Support Services Team HS-CWServsceReferral@weld.gov immediately AND on the required monthly report. 11. Contractor agrees any change to an existing referral must be pre -approved through the Child Welfare Core Service Coordinator or any member of the Mental Health and Support Services Team. Any changes to Family Time referrals will be approved by a new referral signed by the Child Welfare Supervisor. A change is defined as anything outside of the approved documented service on the initial authorized referral form. This may include an increase or decrease in services hours, change in frequency, change in location of services, transportation needs, or any change to the initial referral or subsequent authorizations. 12. Contractor agrees to attend meetings when available and as requested by the Department. Such meetings include Court Facilitations, Bid Meetings, Professional Staffings, Family Team Meetings and/or Team Decision Making meetings. The Department will reimburse for actual participation in the meeting only so long as there is written authorization from the Mental Health and Support Services Team, and the facilitator documents in the meeting notes the timeframe that the provider attended and when participation in the meeting is deemed appropriate and necessary by the Department. The Facilitator will be responsible for filling out the time attended on the meeting notes. Staffings and/or meetings other than those listed above are not considered reimbursable unless otherwise approved by the Mental Health and Support Services Team. Contractor may participate by phone or virtually, if approved by the Department. 13. On a monthly basis, the Contractor will notify the Mental Health and Support Services Team HS-CWServiceReferral@weld.govofnewstaffwhowill manageand/or administer the services with the following information: a. Staff member name and contact information b. Education level/degree (if applicable) c. Licensure/credentials (if applicable) d. Department of Regulatory Authority (DORA) number (if applicable) e. Supervisor name and contact information The Department reserves the right to decline the new staff members managing and/or administering services to Department clients. 14. Compliance with Child and Family Services Review The Child and Family Services Review (CFSR) examines child welfare service outcomes in three areas: Safety, Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's performance according to national standards and monitor progress over time. Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance services to families. Contractor agrees to continually strive for positive outcomes in the areas of Safety, Permanency and Well Being. Contractor will ensure that any employee or subcontractor of Contractor providing services under this Agreement will work towards positive outcomes in the aforementioned three areas as outlined under the Child and Family Services Review (CFSR) and will address the aforementioned three areas when completing monthly reports as required by Paragraph 9 of this Exhibit. 15. Certification Contractor certifies that, at the time of entering into this Agreement, it has currently in effect all necessary licenses, approvals, insurance, etc., required to properly provide the services and/or supplies covered by this Agreement. Copies of all necessary licenses shall be provided to the Department by the Contractor prior to the start of any Agreement. 16. Training Contractor may be required to attend training at the request of the Department specific to services provided under this Agreement. The Department will not compensate the Contractor for said training in the form of registration fees, time spent traveling to and from training, attending the training or any other associated costs unless otherwise agreed to by the Department. 17. Subpoenas Contractor will, on behalf of its employees and/or officers, accept any subpoena for testimony from the Weld County Attorney's Office by e-mail and will return a waiver of services within 72 business hours. For this purpose, Contractor will designate an e-mail address prior to the start of this Agreement. If the Contractor receives a subpoena via e-mail but will only accept personal service, the Contractor will contact the Weld County Attorney's Office immediately at (970) 336-7235 and advise that the subpoena must be personally served. 18. Monitoring and Evaluation Contractor and the Department agree that monitoring and evaluation of the performance of this Agreement shall be conducted by the Contractor and the Department. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners, the Department, and the Contractor. Contractor will collaborate in a timely manner with the Department to resolve issues pertaining to service delivery, service quality, documentation, and invoicing during referral period and after services have concluded. The Contractor will require clients to sign releases of information. Contractor understands that the Department will not reimburse for services rendered to Department clients until releases of information are obtained. Contractor shall permit the Department, and any other duly authorized agent or governmental agency, to monitor all activities conducted by the Contractor pursuant to the terms of this Agreement. The monitoring agency may, if in its sole discretion deems necessary or appropriate, have access to any program data, special analyses, on -site checking, formal audit examinations, or any other reasonable procedures for purposes of monitoring. All such monitoring shall be performed in a manner that will not unduly interfere with the work conducted under this Agreement. EXHIBIT B RATE SCHEDULE 1. Funding and Method of Payment The Department agrees to reimburse the Contractor in consideration of the work and services performed under this Agreement at the rate(s) specified below in Paragraph 2, Fees for Services. Expenses incurred by the Contractor prior to the term of this Agreement are not eligible Department expenditures and shall not be reimbursed by the Department. For services funded through Core Services, Contractor agrees to accept reimbursement through ACH direct deposit one time per month. If Contractor is not currently set up with the State of Colorado to accept direct deposit, Contractor agrees to complete and submit a State of Colorado direct deposit enrollment form, which will be provided by the Department, with a voided check, deposit slip or bank letter. Failure to complete and submit this form and voided check in a timely and accurate manner may result in a delay of payment. For services not funded through Core Services; Contractor agrees to accept payment through County Warrant when funding source does not allow for direct deposit. Payment pursuant to this Agreement, whether in whole or in part, is subject to and contingent upon the continuing availability of said funds for the purposes hereof. In the event that said funds, or any part thereof, become unavailable as determined by the Department, the Department may immediately terminate the Agreement or amend it accordingly. 2. Fees for Services Program Area Domestic Violence Intervention Services Rate $775.00 Unit Type Each Service Name Domestic Violence Evaluation: In-Office/Video $250.00 Each Domestic Violence Evaluation: Bilingual Rate Increase $90.00 Each Domestic Violence Group Treatment: In - Office/Video $45.00 Each Domestic Violence Group Treatment: No Show $195.00 Hour Domestic Violence Individual Treatment: In- Office/Video. $98.00 Each Domestic Violence Individual Treatment: No Show $15.00 Each Domestic Violence Group and Individual Treatment: Bilingual Rate Increase $500.00 Each Domestic Violence Intake: In-Office/Video Program Area Domestic Violence Intervention Services Rate $30.00 Unit Type Each Service Name Domestic Violence Intake: Bilingual Rate Increase $0.67 Mile Domestic Violence Intervention Services: Mileage $195.00 Hour Domestic Violence Masters level: FTM, TDM, Professional Staffing $90.00 Episode Foundations for Family Safety (FFS): Group In - Office/Video $195A0 Hour Foundations for Family Safety (FFS): Individual In - Office/Video $100.00 Episode Victim -Survivor Advocacy Group: In -Home or Community $90.00 Episode Victim -Survivor Advocacy Group: In-Office/Video $200.00 Hour Victim -Survivor Advocacy Individual: In -Home or Community $195.00 Hour Victim -Survivor Advocacy Individual: In-Office/Video $500.00 Each Family Violence Reduction Program Intake: In - Office/Video $100.00 Each Domestic Violence Intervention Evaluation or Family Violence Reduction Program Intake: No Show Foster Parent Training $250.00 Hour Foster Parent Training: In-Office/Video AND In - Home or Community AND with Transportation Home -Based Services $135,00 Hour Home -Based Services - High: In-Office/Video AND In -Home or Community AND with Transportation $195.00 Hour Home -Based Services - Intensive: In-Office/Video AND In -Home or Community AND with Transportation $90.00 Hour Home -Based Services BA level: FTM, TOM, Professional Staffing $195.00 Hour Home -Based Services Masters level: FTM, TOM, Professional Staffing $15.00 Hour Home -Based Services: Bilingual rate increase $0.67 Mile Home -Based Services: Mileage $98.00 Each Home -Based Services: No Show Life Skills $135.00 Hour Life Skills: In-Office/Video AND In -Home or Community AND with Transportation $135.00 Hour Life Skills BA level: FTM, TDM, Professional Staffing $195.00 Hour Life Skills Masters level: FTM, TDM, Professional Staffing $15.00 Hour Life Skills: Bilingual rate increase per service $0.67 Mile Life Skills: Mileage $195.00 Hour Therapeutic Life Skills: In-Office/Video AND In - Home or Community AND with Transportation $98.00 Each Therapeutic Life Skills: No Show Program Area lVlental Health Services Rate $195.0 Unit Type Hour Service Name , BA BCBA. In-Curse/Video ANC In `FrOcrie tlr, community AND with Transportation $135.00 Hour ABA Behavior Technician In-Office/Video AND In - Home or Community AND with Transportation $90.00 Each Caring Dads: In-Office/Video $125.00 Hour Consultation: In-Office/Video $100.00 Episode Loved Ones of Survivors Group: In -Home or Community $90.00 Episode Loved Ones of Survivors Group: In -Office Video $200.00 Hour Loved Ones of Survivors Individual: In -Home or Community $195.00 Hour Loved Ones of Survivors Individual: In -Office Video $200.00 Episode Loved Ones of Survivors Intake $100.00 Each Loved Ones of Survivors Intake: No Show $250.00 Each Mental Health Evaluation: Bilingual Rate Increase $1,200.00 Each Mental Health Evaluation: Full $100.00 Each Mental Health Evaluation: No Show $195.00 Hour Mental Health Therapy Individual: In-Office/Video AND In -Home or Community AND with Transportation $15.00 Hour Mental Health Services Group and Individual Bilingual Rate Increase $45.00 Each Mental Health Services Group: No Show $98.00 Each Mental Health Services Individual: No Show $195.00 Hour Mental Health Services Masters level: FTM, TDM, Professional Staffing $250.00 Hour Mental Health Services PhD level: FTM, TOM, Professional Staffing $0.67 Mile Mental Health Services: Mileage $3,350.00 Each Neuropsychological Evaluation: Full $2,550.00 Each Parent Child Interaction Assessment: Full $3,350.00 ' Each Pediatric Diagnostic Evaluation: Full $2,450.00 Each Psychological Evaluation - Full $1,225.00 Each Psychological Evaluation - Partial $100.00 Episode Therapeutic Peer Support Group: Group In -Home or Community $90.00 Episode Therapeutic Peer Support Group: Group In - Office/Video $200.00 Hour Therapeutic Peer Support Group: Individual In - Home or Community Program Area Mental Health Services Rate $195.00 Unit Type Hour Service Name Therapeutic Peer Support Group, Individual in - Office/Video $90.00 Each TreatmentGroup—Social Skills Group: In- Office/Video Mentoring $135.00 Hour Specialized Mentorship: In-Office/Video AND In- Home or Community AND with Transportation Monitored Sobriety Services $10.00 Each Breath Alcohol (BA) $18.00 Each Confirmation Test $25.00 Each Urinalysis (UA) Substance Abuse Treatment $90.00 Each Substance Abuse Treatment Group: In-Office/Video $45.00 Each Substance Abuse Treatment: Group No Show $150.00 Hour Substance Abuse Treatment: Individual In - Office/Video $98.00 Each Substance Abuse Treatment: Individual No Show $195.00 Hour Substance Abuse Treatment: FTM, TDM, Professional Staffing $575.00 Each Substance Treatment Evaluation $350.00 Each Substance Treatment Intake $100.00 Each Substance Treatment Evaluation OR Intake: No Show Therapeutic Kinship Services $195.00 Hour Therapeutic Kinship Services: In-Office/Video AND In -Home or Community AND with Transportation $15.00 Hour Therapeutic Kinship Services: Bilingual rate increase per service $195.00 Hour Therapeutic Kinship Services: FTM, TDM, Professional Staffing $0.67 Mile Therapeutic Kinship Services: Mileage $98.00 Each Therapeutic Kinship Services: No Show 3. Request for Reimbursement and Supporting Documentation Contractor shall submit all Requests for Reimbursement and supporting documentation to the Department by the 7th day of the month following the month of service, but no later than 45 days from the date of service for each client receiving ongoing services. Contractor shall prepare and submit monthly a Request for Reimbursement and monthly report including other supporting documentation, if applicable, certifying that services authorized were provided on the date(s) indicated and the charges were made pursuant to the terms and conditions of Paragraph 3 of this Agreement. Monthly reports will be submitted through the Department's online reporting system, unless otherwise directed or agreed to by the Department. Monthly reports for ongoing services must include the following information, entered in the "Narrative" box for each date of service: a. Time(s) of service (i.e. 2-4pm) b. Location of where the service took place (i.e. clinician's office, client's home, in the community.) c. Clinician/therapist name d. What interventions were used, recommendations and/or goals discussed, progressions towards goals, and client engagement. e. For mileage reimbursement, if applicable, the mileage accumulated minus roundtrip mileage that is included in the rate, starting location, and ending location. f. Any and all safety concerns. When submitting a Request for Reimbursement for a one-time service, the contractor shall submit the first and last page of the evaluation/report to confirm proof of services rendered. The full evaluation/report should be submitted by the contractor to the caseworker. For Monitored Sobriety services, proof of services rendered shall be the test result. Requests for Reimbursement and/or supporting documentation received after the 7th day of the month may delay payment. Requests for Reimbursement and/or supporting documentation received after 45 days from the date of service may result in delay or forfeiture of payment. Consistent failure to meet the 45 -day deadline may result in termination of the Agreement. 4. Payment The Department and the Contractor agree that all benefits from private insurance and/or other funding sources such as Medicaid (if Contractor is a Medicaid eligible provider) or Victim's Compensation must be exhausted before Core Services or other Department funds can be accessed for services. Exceptions to this Paragraph may include, if approved by the Department, the following: The service being provided by the contractor is not a Medicaid eligible service; a. The service is not deemed medically necessary; b. The Court with jurisdiction over the case has ordered that a non -Medicaid provider or service be used; c. A Medicaid provider is not available to provide the needed service; d. Medicaid is exhausted for the needed service; or e. Medicaid denied service. f. The client is not eligible for Medicaid. The Department may withhold reimbursement if Contractor has failed to comply with any part of the Agreement, including the Financial Management requirements, program objectives, contractual terms, or reporting requirements. In the event of forfeiture of reimbursement, Contractor may appeal such circumstance in writing to the Director of Human Services. The decision of the Director of Human Services shall be final. 5. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: a. Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed. b. Deny payment or recover reimbursement for those services or deliverables, which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Department. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to the Department. Incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation shall be recovered from Contractor by deduction from subsequent payments under this Agreement or other agreements between the Department and Contractor, or by the Department as a debt due to the Department or otherwise as provided by law. 6. Financial Management At all times from the effective date of the Agreement until completion of the Agreement, Contractor shall comply with the administrative requirements, cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under this Agreement must conform to the Single Audit Act of 1984 and OMB Circular A- 133. ACO CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 6/30/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Flood and Peterson PO Box 578 Greeley CO 80632 CONTACT Ally Ingram NAME: In ram PHONE (970)356-0123 FAX (970)330-1967 (A/C. No. Extl: (A/C, No): E-MAIL SS: y All soul@FPINSURANCE.com ADDRE INSURER(S) AFFORDING COVERAGE NAIL # INSURER A: Irwin Siegel Agency Inc. INSURED Lifelong, Inc. 7175 W. Jefferson Ave #4000 Lakewood CO 80235 mswmRB:Pinnacol Assurance wsuRERc:North American Specialty Ins CO 29874 ws0RERo:Philadelphia Insurance INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER:2023-2024 Master REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE ADDL S UBR NSD WVD POLICY NUMBER POLICY EFF „may POLICY EXP iras/VYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY I CLAIMS -MADE ❑X OCCUR X Prof. Liability $111/$311 47SPK2631770/ 7/1/2023 7/1/2024 EACH OCCURRENCE $ 1, 000 , 000 DAMAGETO RENTED PREMISES (Ea occurrence) $ 100,0000 M8D EXP (Any one person) $ 20,000 X Sex Abuse $500K/$11D4 PERSONAL &ADV INJURY $ 1,000,000 GEN, AGGREGATE LIMIT APPLIES PER: X POLICY ❑ Mr ❑ LOC JEC OTHER: GENERAL AGGREGATE $ 3,000,000 PRODUCTS - COMP/OP AGG $ 3,000,000 A AUTOMOBILE LIABILITY _ ANY AUTO _ ALL OWNED _ AUTOS X HIRED AUTOS SCHEDULED AUTOS NON -OWNED X AUTOS 47SPK26317701 7/1/2023 7/1/2024 COMBINED SINGLE LIMIT (Ea accidenU $ 1, 000 , 000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) Terrorism $ UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE DEO I 1 RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 4193499 7/1/2023 7/1/2024 X I STATUTE I I OERH E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYEE $ 100,000 E.L. DISEASE - POLICY LIMIT $ 500,000 C D Cyber Liability Employee Dishonesty C-4116-071907-0]006-2022 PH801789796 1/1/2023 4/17/2023 7/1/2024 4/17/2024 Limit $2,000,000 Limit $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Board of County Commissioners of Weld County and its Officers/Employees are listed as additional insured with regards to Commercial General Liability. CERTIFICATE HOLDER CANCELLATION Weld County 1150 O St Greeley, CO 80631 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Allyson Ingram/AXI ACORD 25 (2014/01) INS025 (201401) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SIGNATURE REQUESTED: Weld/Lifelong Amendment #2 Final Audit Report 2024-05-17 Created: 2024-05-15 By: Windy Luna (wluna@weld.gov) Status: Signed Transaction ID: CBJCHBCAABAA8eJC1o6lRbwwCHsjWZmfxSVhbXfeOKYH "SIGNATURE REQUESTED: Weld/Lifelong Amendment #2" His tory t Document created by Windy Luna (wluna@weld.gov) 2024-05-15 - 10:12:38 PM GMT- IP address: 204.133.39.9 C7+ Document emailed to lindsey@lifelonginc.com for signature 2024-05-15 - 10:13:21 PM GMT 1 Email viewed by lindsey@lifelonginc.com 2024-05-17 - 3:32:27 PM GMT- IP address: 73.34.187.198 O3o Signer lindsey@lifelonginc.com entered name at signing as Lindsey Spraker 2024-05-17 - 3:32:43 PM GMT- IP address: 73.34.187.198 (56 Document e -signed by Lindsey Spraker (lindsey@lifelonginc.com) Signature Date: 2024-05-17 - 3:32:45 PM GMT - Time Source: server- IP address: 73.34.187.198 O Agreement completed. 2024-05-17 - 3:32:45 PM GMT Powered by Adobe Acrobat Sign Contract For Entity Information Entity Name * LIFELONG INC Entity ID* @00045085 Contract Name* Contract ID LIFELONG INC (PROFESSIONAL SERVICES AGREEMENT 8223 AMENDMENT #2) Contract Status CTB REVIEW Contract Lead" WLUNA O New Entity? Parent Contract ID 20221598 Requires Board Approval YES Contract Lead Email Department Project # wluna@weldgov.com;cob bxxlk@weldgov.com Contract Description* (CONSENT) LIFELONG INC - PROFESSIONAL SERVICES AGREEMENT AMENDMENT #2. RELATED TO BID #B2200040. TERM: 06/01 /2024 THROUGH 05/31/2025. Contract Description 2 PROVIDER WAS LISTED ON APPROVED VENDOR LIST PRESENTED TO THE BOCC ON 06/1 3/2022. Contract Type* AMENDMENT Amount* $ 0.00 Renewable* NO Automatic Renewal Grant IGA Department HUMAN SERVICES 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 Requested BOCC Agenda Date * 05/22/2024 Due Date 05/18/2024 Will a work session with BOCC be required?* NO Does Contract require Purchasing Dept. to be included? If this is a renewal enter previous Contract ID If this is part of a MSA enter MSA Contract ID Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in OnBase Contract Dates Effective Date Termination Notice Period Contact Information Review Date" 03/31/2025 Committed Delivery Date Renewal Date Expiration Date* 05/31/2025 Contact Info Contact Name Contact Type Contact Email Contact Phone 1 Contact Phone 2 Purchasing Purchasing Approver Purchasing Approved Date CONSENT 05/17/2024 Approval Process Department Head Finance Approver Legal Counsel JAMIE ULRICH CONSENT CONSENT DH Approved Date Finance Approved Date Legal Counsel Approved Date 05/17/2024 05/17/2024 05/17/2024 Final Approval BOCC Approved Tyler Ref # AG 060324 BOCC Signed Date Originator WLUNA BOCC Agenda Date 06/03/2024 Covmel- t Da vi ly Con5-tallordo•- 5/ 6/23 PRIVILEGED AND CONFIDENTIAL MEMORANDUM DATE: May 2, 2023 TO: Board of County Commissioners — Pass -Around FR: Jamie Ulrich, Director, Human Services RE: Agreement Amendment #1 with Lifelong, Inc. Please review and indicate if you would like a work session prior to placing this item on the Board's agenda. Request Board Approval of the Department's Agreement Amendment #1 with Lifelong, Inc. The Department has an Agreement with Lifelong, Inc. for Anger Management/Domestic Violence, Foster Parent Consultation, Foster Parent Training, Home -Based Intervention, Kinship Services (Therapeutic), Life Skills, Mental Health Services, Monitored Sobriety Services, and Substance Abuse Treatment Services. This Agreement is known to the Board as Tyler ID# 2022-1598. The agreement is now being amended to renew fora second year, for the period June 1, 2023 through May 31, 2024, and to make changes to the Scope of Services and Rate Schedule as noted below. The Human Services Advisory Commission (HSAC) has reviewed and approved this information. Scope of Services Changes: • Updates to the Scope and terms as requested by the Department. Rate Schedule Changes: • Updates to the terms as requested by the Department. • Updates to the rates as requested by the Department and Contractor. Rate changes are noted below. Anger Management/Domestic Violence $75.00 I, lac' Each Caring Dads: In-OfficeNideo $375.00 Each Domestic Violence Intake: In- Office/Video $30.00 Each Domestic Violence Intake: Bilingual Rate increase $575.00 Each Domestic Violence Evaluation: In- Office/Video $250.00 Each Domestic Violence Evaluation: Bilingual Rate increase $100.00 Each Domestic Violence Evaluation or Intake: No Show (Max of 2 no shows or 2 hours/month/client) $145.00 Hour Domestic Violence Individual Treatment: In-Office/Video $15.00 Hour Domestic Violence Individual: Bilingual Rate increase $75.00 Each Domestic Violence Group Treatment: In-OfficeNideo Pass -Around Memorandum; May 2, 2023 — CMS ID 6914 *rM3 Page 1 2022-1591 PRIVILEGED AND CONFIDENTIAL Anger Management/Domestic Violence $15.00 Each Domestic Violence Group: Bilingual Rate increase $35.00 Each Domestic Violence Group: No Show (Max of 2 no shows or 2 hours/month/client) $100.00 Hour Domestic Violence Masters Level: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing FTM, TDM, Prof. Staffing $0.66 Mile Domestic Violence: Mileage" $995.00 Client Family -Violence Psychoeducation Group -Programming: In- Office/Video (12 sessions/ 1 session per week) $1,990.00 Couple Family -Violence Psychoeducation Group-Programming:In- OfficeNideo $75.00 Each High Conflict Co -Parenting: In- Office/Video $595.00 Client Victim -Survivor Advocacy Group Programming: In-OfficeNideo (6 sessions/ 1 session per week) $150.00 Hour Victim -Survivor Advocacy Support: Any Location Fates Parent Consultation $150.00 Hour Foster Parent Consultation - Individual/Family: Any Location $15.00 Hour Foster Parent Consultation Individual: Bilingual rate increase per service $55.00 Hour Foster Parent Consultation Individual: No Show $15.00 Each Foster Parent Consultation Group: Bilingual rate increase per service $35.00 Each Foster Parent Consultation Group: No Show (Max of 2 no shows or 2 hours/month/client) $100.00 Hour Foster Parent Consultation Masters Level: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $75.00 Hour Foster Parent Consultation - Group: In -Office $0.66 Mile Foster Parent Consultation: Mileage* $55.00 Each Foster Parent Consultation Individual/Family: No Show (Max of 2 no shows or 2 hours/month/client) Foster Parent Training $200.00 Hour Foster Parent Training: Any Location Hone Based Intervention $ 100.00 Hour Home -Based Intervention - High: Any Location $150.00 Hour Home -Based Intervention - Intensive: Any Location Pass -Around Memorandum; May 2, 2023 - CMS ID 6914 Page 2 PRIVILEGED AND CONFIDENTIAL Home Based Intervention $15.00 How Home -Based Intervention: Bilingual rate increase $75.00 Hour Home -Based Intervention BA Level: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $100.00 How Home -Based Intervention Masters Level: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $55.00 Each Home -Based Intervention: No Show (Max of 2 no shows or 2 hours/month/client) $0.66 Mile Home -Based Intervention: Mileage• Kinship Services (Therapeutic) $150.00 Hour Therapeutic Kinship Services: Any Location $15.00 How Therapeutic Kinship Services: Bilingual rate increase per service $100.00 Hour Therapeutic Kinship Services: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $55.00 Each Therapeutic Kinship Services: No Show (Max of 2 no shows or 2 hours/month/client) $0.66 Hour Therapeutic Kinship Services: Mileage* Life Skills $100.00 Hour Life Skills: Any Location $75.00 Hour Life Skills BA Level: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $100.00 How Life Skills Masters Level: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffmg $15.00 Hour Life Skills: Bilingual rate increase per service $0.66 Mile Life Skills: Mileage* $150.00 Hour Therapeutic Life Skills: Any Location $55.00 Each Therapeutic Life Skills and Specialized Mentorship: No Show (Max of 2 no shows or 2 hours/month/client) Specialized Mentorship: Any Location $100.00 Hour Mental Health Services $150.00 How Applied Behavior Analysis (ABA) Board Certified Behavior Analyst (BCBA): Any Location $100.00 Hour ABA Behavior Technician: Any Location $125.00 Hour Consultation: In-Office/t/ideo Pass -Around Memorandum; May 2, 2023 — CMS ID 6914 Page 3 PRIVILEGED AND CONFIDENTIAL Mental Health Services $775.00 Each Mental Health Evaluation: Full (2-4 hours) $250.00 Each Mental Health Evaluation: Bilingual rate increase (2-4 hours) $100.00 Each Mental Health Evaluation: No Show (Max of 2 no shows or 2 hours/month/client) $150.00 Hour Mental Health Therapy: Any Location $15.00 Hour Mental Health Individual: Bilingual rate increase ; $55.00 Each Mental Health Individual Therapy: No Show (Max of 2 no shows or 2 hours/month/client) $75.00 Each Mental Health Treatment Groups: In- OfficeNideo $75.00 Each Mental Health Treatment Groups: In- Office/Video $15.00 Each Mental Health Treatment Group: Bilingual rate increase $35.00 Each Mental Health Treatment Group: No Show (Max of 2 no shows or 2 hours/month/client) $ L00.00 Hour Mental Health Services Masters level: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $150.00 Hour Mental Health Services PhD level: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $992.50 Each Psychological Evaluation - Partial $1,985.00 Each Psychological Evaluation - Full (10- 12 Hours) $2,175.00 Each Parent Child Interaction Assessment: Full (I0-12 Hours) $2,755.00 Each Pediatric Diagnostic Evaluation: Full $2,900.00 Each Neuropsychological Evaluation: Full (10-15 Hours) $0.66 Mile Mental Health Services: Mileages Mcnitrred Sobriety Services $8.00 Each Breath Alcohol (13A) $18.00 Each Confirmation Test $22.00 Each Urinalysis (UA) Substatce Abuse Treatment $325.00 Each Substance Treatment Intake $500.00 Each Substance Treatment Evaluation $100.00 Each Substance Treatment Evaluation or Intake: No Show (Max of 2 no shows or 2 hours/month/client) $125.00 Hour Substance Abuse Treatment - Individual: In-Office/Video Pass -Around Memorandum; May 2, 2023 - CMS ID 6914 Page 4 PRIVILEGED AND CONFIDENTIAL V1,41,1111 ACCIl Substance Abuse Treatment RII, $55.00 .'.` 1171 Each .SCI, Il.1 \';111, Substance Abuse Treatment - Individual: No Show (Max of 2 no shows or 2 hours/month/client) $75.00 Each Substance Abuse Treatment - Group: In-Office/Video $35.00 Each Substance Abuse Treatment - Group: No Show (Max of 2 no shows or 2 hours/month/client) $100.00 Hour Substance Abuse Treatment: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing I do not recommend a Work Session. I recommend approval of this Agreement Amendment #1 and authorize the Chair to sign. Aonrove Perry L. Buck, Pro-Tem Mike Freeman, Chair Scott K. James Kevin Ross Lori Saine Schedule Work Session Other/Comments: Pass -Around Memorandum; May 2, 2023 - CMS ID 6914 Page 5 B AGREEMENT AMENDMENT BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND LIFELONG, INC. U This Agreement Amendment, made and entered into 1/h day of M , 2023, by and between the Board of Weld County Commissioners, on behalf of the Weld County Department of Human Services, her it after referred to as the "Departmmt", and Lifelong, Inc., hereinafter referred to as the "Contractor". WHEREAS the parties entered into an Agreement for Anger Management/Domestic Violence, Foster Parent Consultation, Foster Parent Training, Home -Based Intervention, Kinship Services (Therapeutic), Life Skills, Mental Health Services, Monitored Sobriety Services, and Substance Abuse Treatment Services, (the "Original Agreement") identified by the Weld County Clerk to the Board of County Commissioners as document No. 2022-1598, approved on June 8, 2022. WHEREAS the parties hereby agree to amend the term of the Original Agreement in accordance with the terms of the Original Agreement and any previously adopted amendment, which is incorporated by reference herein, as well as the terms provided herein. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: • The Original Agreement will end on May 31, 2023. • This Amendment, together with the Original Agreement, constitutes the entire understanding between the parties. The following additional changes am hereby made to the current Child Protection Agreement m of June 1, 2023: 1. Term This Agreement is being renewed for the second year, for the period of June 1, 2023 through May 31, 2024. 2. Exhibit A, Scope of Services, is hereby amended as attached. 3. Exhibit B, Rate Schedule, is hereby amended as attached. All other terms and conditions of the Original Agreement remain unchanged. IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. COUNTY: ATTES� o+;l �/• K�- BOARD OF COUNTY COMMISSIONERS rk to the B . . WEEL(D�CQUNTY, COLORADO tot a ir�l `' Deputy Cle Mike Freeman, Chair MAY 0 8 2323 ONTRACTOR: Lifelong, Inc. 7175 West Jefferson Avenue, Suite 4000 Lakewood, Colorado 80235 (909)LLfnJ 57,3-0839 re By: Lindsey SpraTter (A r 21, 2023 13:36 MDT) Lindsey Spraker, Executive Director Date: Apr 21, 2023 c� -/5w EXHIBIT A SCOPE OF SERVICES Contractor wit provide Anger Management/Domestic Violence, Foster Parent Consultation, Foster Parent Training, Home -Based Int✓rvention, Kinship Services (Therapeutic), Life Skills, Mental Health Services, Monitored Sobriety Services, and 5wstance Abuse Treatment Services as referred by the Department. Program Area: Anger Management/Domestic Violence 1. Caring Dads Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. The Caring Dads parenting group is a curriculum driven and facilitated opportunity for men to obtain and practice parenting skills and connect with other men as fathers. D. Anticipated Frequency of Services: i. One (1) time per week. Anticipated Duration of Services: i. Seventeen (17) weeks. I. Goals of Services: i. Improve and strengthen the father/child relationship. ii. Learn child centered parenting skills and strategies to manage stress and frustration. iii. Identify and self -reflect on the impact of previous conflictual strategies on familial relationships. a. Outcomes of Services: i. Reduce recidivism of child welfare contact for participating families. ii. Successful case closure via reunification or maintenance of custody or in -home placement iii. Create community connections and relationships for fathers. Target Population: i. Parents with children, fathers who have demonstrated parenting challenges that resulted in child protection concerns, fathers struggling with parenting children with challenging behaviors or special behavioral needs. b. Language: i. English. 1. Medicaid Eligibility: i. This service is not Medicaid eligible. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The provider will not be transporting clients. 2. Donmstc Violence Intake a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: 1 i. Domestic Violence Offender Management Board (DVOMB) approved intake and assessment materials. b. Anticipated Frequency of Services: i. Two (2) to five (5) hours. c. Anticipated Duration of Services: i. One (1) to two (2) sessions. d. Goals of Services: i. Completion of intake. e. Outcomes of Services: i. Completion of intake. f. Target Population: i. Persons identified as at risk of or known domestic violence involvement with or without police contact or child welfare involvement. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The provider will not be transporting clients. 3. Domestic Violence Evaluation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Clinical Assessment Interview. ii. Domestic Violence Risk and Needs Assessment (DVRNA). iii. Spousal Assault Risk Assessment Guide — 3 (SARA - 3). iv. CAGE -AID Substance Abuse Screening Tool. v. Alcohol Use Disorders Identification Test (AUDIT). vi. Scoring the States of Change Readiness and Treatment Eagerness Scale (SOCRATES 8A/8D). vii. Ohio State University Traumatic Brain Injury Identification Method (OSU-TBI). viii. Mini -Mental State Examination (MMSE). ix. Brief Resiliency Scale (BRS). x. Beck Anxiety Inventory (BAI). xi. Beck Depression Inventory (BDI). xii. Level 2 - Anger — Adult. xiii. Substance Abuse Subtle Screening Inventory (SASSI). xiv. Personality Inventory for Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5) — Brief Form (PID-BF) — Adult. xv. World Health Organization Disability Assessment Schedule (WHODAS) 2.0. xvi. Personality Assessment Screener (PAS). xvii. Adverse Childhood Experiences (ACE) Questionnaire. 2 D. Anticipated Frequency of Services: i. Three (3) to seven (7) hours. Anticipated Duration of Services: i. Each evaluation and assessment summary and recommendations will be completed within fifteen (15) to thirty (30) days of the first appointment. 4. Goals of Services: i. Assess and identify treatment needs of the client. ii. Determine the level of treatment intensity required for domestic violence services. iii. Establish recommendations for immediate and long-term safety planning. Outcomes of Services: i. Completion of evaluation. Target Population: i. Persons identified as at risk of or known domestic violence involvement with or without police contact or child welfare involvement. g. Language: i. English. 1. Medicaid Eligibility: i. This service is not Medicaid eligible. . Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The provider will not be transporting clients. 4. Domestic Violence Individual Treatment Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Cognitive Behavior Therapy (CBT). ii. Dialectical Behavioral Therapy (DBT). iii. Trauma Focused Cognitive Behavioral Therapy (TF-CBT). iv. Motivational Interviewing (MI). v. Duluth model. vi. Multimodal approaches. Anticipated Frequency of Services: i. One (1) to two (2) sessions per week, dependent on individual needs. c. Anticipated Duration of Services: i. Duration will be case specific. .1. Goals of Services: i. Reduce and manage mental health triggers. ii. Increase the ability to demonstrate understanding of cycle of violence, power and control. iii. Increase ability to demonstrate self-awareness and identify, triggers. iv. Increase ability to reflect and self -evaluate, identify precursors to violence, and engage in preventive strategies to self -regulate and manage impulses. v. Increase ability to identify, criteria for safe and healthy interactions and relationships. vi. Increase ability to demonstrate protective skills of self and dependents. 3 e. Outcomes of Services: i. Successful engagement in individual therapy process regarding offense specific behavior reduction. ii. Successful daily practice of self -care and coping skills. iii. Successful use of coping skills during conflict or crisis. iv. Successful reunification or other successful case closure. f. Target Population: i. Clients aged four (4) to one hundred (100). g. Language: i. English and Spanish (proficient) — no interpreter services are available. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The provider will not be transporting clients. 5. Domestic Violence Group Treatment Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Cognitive Behavior Therapy (CBT). ii. Dialectical Behavioral Therapy (DBT). iii. Trauma Focused Cognitive Behavioral Therapy (TF-CBT). iv. Motivational Interviewing (MI). v. Duluth model. vi. Multimodal approaches. b. Anticipated Frequency of Services: i. One (1) group per week. c. Anticipated Duration of Services: i. Duration will be case specific. d. Goals of Services: i. Reduce and manage mental health triggers. ii. Increase the ability to demonstrate understanding of cycle of violence, power and control. iii. Increase ability to demonstrate self-awareness and identify triggers. iv. Increase ability to reflect on self in the group setting. v. Interact with peers in the group setting, demonstrating accountability, competency achievement, and vulnerability. vi. Identify precursors to violence and engage in preventive strategies to self -regulate and manage impulses. e. Outcomes of Services: i. Successful engagement in the group therapy dynamic. ii. Successful daily practice of self -care and coping skills. iii. Successful use of coping skills during conflict or crisis. iv. Successful reunification or other successful case closure. 4 f_ Target Population: i. Clients with various diagnosed or suspected disabilities, age four (4) to one hundred (100). ii. Individuals, dyads, and families. g. Language: i. English and Spanish (proficient) — no interpreter services are available. In Medicaid Eligibility: i. This service is not Medicaid eligible. i_ Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The provider will not be transporting clients. 6. Family Tiolence Psychoeducation Group Programming a Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Group psychoeducation, processing, and support. ii. Curriculum driven and skill acquisition focused. iii. Parents assessed as needing family violence focused programming. iv. Skills focused on education attainment, communication skills, resource connection, and protection of involved children. b. Anticipated Frequency of Services: i. One (1) time per week. a. Anticipated Duration of Services: i. Twelve (12) weeks. d. Coals of Services: i. Educate parents and partners on intimate partner violence and the impact on children being raised in homes with domestic violence. ii. Educate parents and partners on victim and offender dynamics, interrupting escalation, accessing safety tools successfully, and development of safe relationship rules. iii. Address system and family impacts, trauma responses in children and adults, and connect to ongoing resources. e:. Outcomes of Services: i. Developed awareness of trauma responses and family impact as it relates to domestic violence. ii. Strengthen relationship between caregivers while focusing on repairing harm and impact to involved children. iii. Understanding and identify elements power and control, coercive control, and intimate partner violence as risk factors to children. iv. Reduce repeat child welfare involvement related to concerns of family or intimate partner violence. E Target Population: i. Individuals, partners, and parents who have had identified or suspected concerns of intimate partner violence, power and control, and/or behaviors or abuse. g Language: 5 i. English h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. Services will take place virtually or in the provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235 (or partner agency office at 3225 South Wadsworth, Unit T, Lakewood CO 80227). ii The provider will not be transporting clients. 7. High Conflict Co -Parenting a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Group therapy. ii. Curriculum driven and skill acquisition focused. iii. Parents in high -conflict separations, child welfare cases, divorces, or requiring mediation attend the groups separately. iv. Skills focused on conflict resolution, communication skills, stress management, and protection of involved children. b. Anticipated Frequency of Services: i. One (1) time per week. c. Anticipated Duration of Services: i. Twelve (12) weeks. d. Goals of Services: i. Provide a safe environment for parents to connect, reflect, and learn ways to manage co -parenting challenges. ii. Parents will develop skills to co -parent and communicate effectively, minimizing conflict. iii. Parents will learn strategies to mediate stress and implement protective strategies to reduce emotional harm to involved children. e. Outcomes of Services: i. Reduce the occurrence of severe conflictual parenting interactions that result in violence, child protection involvement, and/or police contact. ii. Support parents to resolve contentious custody battles and resolve disagreements independently after supports fade. iii. Reduce emotional / physical harm to involved children. f. Target Population: i. Parents who have been identified as having co -parenting conflict that is unable to be resolved without proper supports. g. Language: i. English. j. Medicaid Eligibility: i. This service is not Medicaid eligible. k. Service Access and Transportation: 6 i. Services will take place virtually, in the client's home, or in the provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The provider will not be transporting clients. 8. Vicfm-Survivor Advocacy Group Programming Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Group psychoeducation, processing and support. ii. Curriculum driven and skill acquisition focused. iii. Individual parents assessed as needing victim focused programming. iv. Skills focused on education attainment, communication skills, and protection of involved children and parent survivor. b. Anticipated Frequency of Services: i. One (1) time per week. a. Anticipated Duration of Services: i. Six (6) weeks. d. Goals of Services: i. 1. Educate survivors on the signs, experiences, and signals of domestic violence, power and control, and coercive control. ii. 2. Empower survivors and support language development to enable self -advocacy with reduced need for professional or DHS intervention in the future iii. 3. Access to resources via trained domestic violence advocate concurrent with resources provision and community support development. c. Outcomes of Services: i. Developed awareness of trauma responses as it relates to domestic violence. ii. Strengthen relationship between DHS Caseworker and client relative to the power and control of the system and circumstances through informed and intentional communication. iii. Educate victims on domestic violence impact on children. iv. Reduce traumatic impact to involved children. F. Target Population: i. Individuals who have been identified as survivors or victims of domestic violence/intimate partner violence. g. Language: i. English Is. Medicaid Eligibility: i. This service is not Medicaid eligible. Service Access and Transportation: i. Services will take place virtually or in the provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The provider will not be transporting clients. Program Area: Foster Parent Consultation 1. Fost✓r Parent Consultation — Individuals/Family a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement 7 i. Modality may include trauma informed ABA (Applied Behavior Analysis) or other parent coaching curriculums specialized for parents fostering children. b. Anticipated Frequency of Services: i. Frequency is highly dependent on specific needs and behaviors the family identifies during assessment. c. Anticipated Duration of Services: i. The duration of services depends on the specific needs and behaviors the family identifies during the assessment and if child(ren) are also receiving services. d. Goals of Services: i. Provide foster parents with psychoeducation and resources that will prevent or limit burnout and stress. ii. Work with foster parents to identify preventative and environmental modifications that will enhance structure and predictability in their home. iii. Connect foster parents with other necessary resources or services. e. Outcomes of Services: i. Prevent placement disruptions for involved children. ii. Support the placement to improve health and safety for the family unit. iii. Identify the need for additional or longer -term support and services. f. Target Population: i. Foster parents in need of consultation to address a specific concern or improve the overall placement success of their home. g. Language: i. English and Spanish (fluent). h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The provider will not be transporting clients. 2. Foster Parent Consultation — Group Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Modality may include Trauma Informed ABA (Applied Behavior Analysis) or other parent coaching curriculums specialized for parent groups fostering children. b. Anticipated Frequency of Services: i. Frequency is highly dependent on specific needs and behaviors of the groups of families identified during/after assessment. c. Anticipated Duration of Services: i. The duration of services depends on the specific needs and behaviors of each of the families identified during/after assessment and if child(ren) are also receiving services. d. Goals of Services: i. Provide foster parent groups with psychoeducation and resources that will prevent or limit burnout and stress. 8 ii. Work with foster parent groups to identify preventative and environmental modifications that will enhance structure and predictability in their home. iii. Connect foster parent groups with other necessary resources or services. e. Outcomes of Services: i. Prevent placement disruptions for involved children. ii. Support the placement to improve health and safety for the family unit. iii. Identify the need for additional or longer -term support and services. f Target Population: i. Foster parent groups in need of consultation to address a general concem or improve the overall placement success of their home. g. Language: i. English and Spanish (fluent). in. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. Services will take place virtually or in the provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The provider will not be transporting clients. Program Area Foster Parent Training 1. Foste^ Parent Training — Various a Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Trauma informed ABA (Applied Behavior Analysis), parent coaching curriculums specialized for parents fostering children, and trauma informed trainings. ii. Attachment/trauma focused therapy and psychoeducation. li Anticipated Frequency of Services: i. Frequency will depend on the needs as requested by the Department. e. Anticipated Duration of Services: i. Duration will depend on the needs as identified by the Department. d. Coals of Services: i. Provide psychoeducation to foster parents regarding attachment trauma and associated symptoms and behaviors. ii. Provide foster parents with skills and training to support the development and maintenance of strategies that promote safety and prevent or limit the occurrence of behavioral challenges that can lead to additional trauma and /or disruption of the placement. iii. Provide foster parents with a safe and understanding support system in which they can process the challenges of foster parenting and learn self -care and coping skills. e. Outcomes of Services: i. Preservation of placement. ii. Reduction in the number of placement changes a child experiences while in foster care. iii. Reduction in foster parent bum out and stressors associated with foster care. f Target Population: 9 i. Foster Parents. g. Language: iii. English and Spanish (fluent). h. Medicaid Eligibility: i. This service is not Medicaid eligible. Service Access and Transportation: i. Services will take place virtually, or in the provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The provider will not be transporting clients. Program Area: Home -Based Intervention 1. Home -Based Interventions — High a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Therapeutic life skills, Applied Behavior Analysis, Parent Training and Coaching and a variety of our services provided by master's level clinicians -in -training in the home environment of the individual. Modality for therapeutic interventions determined by clinician and based on clients' individual needs and abilities. b. Anticipated Frequency of Services: i. Three (3) to six (6) hours per week, frequency will be based on individual needs and goals. c. Anticipated Duration of Services: i. Minimum of eight (8) weeks based on individual needs and goals. d. Goals of Services: i. Provide most accessible therapeutic level interventions in client home. ii. Individuals will engage in skill acquisition and therapy with opportunity to demonstrate and maintain skills in their home environment. iii. Individuals will develop and maintain self -care and coping practices. e. Outcomes of Services: i. Increased ability to generalize and maintain learned skills over time in their home environments. ii. Reduced likelihood of out of home placement and court involvement for child protection concerns. iii. Reduced recidivism for child welfare contact and involvement. f. Target Population: i. Clients with various diagnosed or suspected disabilities, ages twelve (12) to one hundred (100). ii. Individuals, dyads, or families. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. 10 Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The provider will not be transporting clients. 2. Howe -Based Interventions — Intensive a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Individual and/or family therapy, therapeutic life skills, Applied Behavior Analysis, and a variety of our services provided by master level clinicians in the home environment of the individual. Modality for therapeutic interventions determined by clinician and based on clients' individual needs and abilities. Skills assessments may be utilized to determine curriculum and programming. J. Anticipated Frequency of Services: i. Three (3) to eight (8) hours per week, frequency will be based on individual needs and goals. Anticipated Duration of Services: i. Minimum of twelve (12) weeks based on individual needs and goals. J. Goals of Services: i. Provide most accessible therapeutic level interventions in client home. ii. Individuals will engage in skill acquisition and therapy with opportunity to demonstrate and maintain skills in their home environment. iii. Individuals will reflect on and process stressors, traumatic experiences, and associated emotions and behaviors. iv. Individuals will develop and maintain self -care and coping practices. r. Outcomes of Services: i. Increased ability to generalize and maintain learned skills over time in their home environments. ii. Reduced likelihood of out of home placement and court involvement for child protection concerns. iii. Reduced recidivism for child welfare contact and involvement. Target Population: i. Clients with various diagnosed or suspected disabilities, ages twelve (12) to one hundred (100). ii. Individuals, dyads, and families. Language: i. English and Spanish (proficient) — no interpreter services are available. Medicaid Eligibility: i. This service is not Medicaid eligible. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The provider will not be transporting clients. Program Arta: Kinship Services (Therapeutic) 1. Kinsaip Services (Therapeutic) 11 a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Intensive Family Therapy, Applied Behavior Analysis (ABA), Caregiver Consultation, and Caregiver Training. b. Anticipated Frequency of Services: i. Two (2) hours per week minimum. c. Anticipated Duration of Services: i. Twelve (12) weeks minimum. Duration is highly dependent on case specifics, children's needs, and engagement of involved parties. d. Goals of Services: i. Provide supportive and comprehensive services to kinship placement providers. ii. Provide psychoeducation, therapy, skill acquisition, and prevention strategies to mediate challenges presented in kinship care. iii. Provide Kinship caregivers with resources, community connections, and skills to develop coping practices. e. Outcomes of Services: i. Preservation of Kinship placement. ii. Improve quality and stability of relationships within kinship placement. iii. Prevent kinship provider burnout and reduce risk of harm in placement. f. Target Population: i. Clients with various diagnosed or suspected disabilities, ages twelve (12) to one hundred (100). ii. Individuals, dyads, or families. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The provider will not be transporting clients. Program Area: Life Skills 1. Life Skills a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Approaches are highly individualized and dependent on the specific skill deficits and goals of the individual. May include but are not limited to role play practice of skills, direct support, prompting and prompt fading strategies, and naturalistic in -situation instruction. b. Anticipated Frequency of Services: i. Two (2) hours per week minimum, one (1) to three (3) sessions depending on the client's needs. c. Anticipated Duration of Services: 12 i. Duration will be case specific. d Goals of Services: i. Provide skill acquisition training to individuals. ii. Individuals will increase their independence to the maximum potential possible for their abilities. iii. Individuals will secure and maintain resources that will allow them to meet their court ordered treatment goals. e. Outcomes of Services: i. Successful reunification or other successful case closure. ii. Increased ability to access home and community resources. iii. Increased independence and ability to establish and maintain meaningful healthy relationships. iv. Increased ability to identify and maintain healthy supports and leisure skills that contribute to stable and predictable parenting. f Target Population: i. Clients with various diagnosed or suspected disabilities, ages twelve (12) to one hundred (100). ii. Individuals, dyads, or families. g. Language: i. English. E. Medicaid Eligibility: i. This service is not Medicaid eligible. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The provider will not be transporting clients. 2. Therapeutic Life Skills a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Approaches are highly individualized and dependent on the specific skill deficits and goals of the individual. May include but are not limited to role play practice of skills, direct support, prompting and prompt fading strategies, and naturalistic in -situation instruction. 1. Anticipated Frequency of Services: i. Two (2) hours per week at a minimum, taking place over one (1) to three (3) sessions, depending on the client's needs. c. Anticipated Duration of Services: i. Duration will be case specific. 1. Goals of Services: i. Provide skill acquisition training to individuals. ii. Provide safe therapeutic support in which clients social/emotional needs are respected and addressed in ways that will allow learning of skills and processing the emotions related to their challenges. iii. Individuals will increase their independence to the maximum potential possible for their abilities. 13 iv. Individuals will secure and maintain resources that will allow them to meet their court ordered treatment goals. v. Individuals will improve the quality of their relationships, develop leisure skills that are healthy and sustainable. vi. Successful mental health management during stressful or triggering life skill activities. e. Outcomes of Services: i. Successful reunification or other successful case closure. ii. Increased ability to access home and community resources. iii. Increased independence and ability to establish and maintain meaningful healthy relationships. iv. Increased ability to identify and maintain healthy supports and leisure skills that contribute to stable and predictable parenting. f. Target Population: i. Clients with various diagnosed or suspected disabilities, ages twelve (12) to one hundred (100). ii. Individuals, dyads, or families. g. Language: i. English and Spanish (proficient) — no interpreter services are available. h. Medicaid Eligibility: i. This service is not Medicaid eligible. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The provider will not be transporting clients. 3. Specialized Mentorship Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Based on the intake assessment, modalities or curriculum may include but are not limited to adventure -based activities, participation and engagement in community activities, modeling, skill acquisition, role playing, and development of hobbies and interests. b. Anticipated Frequency of Services: i. Two (2) hours per week minimum, typically up to three (3) sessions per week. c. Anticipated Duration of Services: i. Six (6) to twelve (12) months. d. Goals of Services: i. Provide a safe, stable, consistent connection to individuals. ii. Individuals will develop and maintain skills that promote stability, independence, and physical/mental wellbeing. iii. Individuals will develop and maintain healthy leisure skills and increase self-worth and self-confidence by reducing risk taking behavior, acting out, substance use, and negative self -statements. e. Outcomes of Services: i. Reduce future police contact or juvenile justice system involvement. ii. Maintain placement in home or current stable living situation. iii. Increase school attendance and completion. 14 iv. Increase awareness of mental health and resources to secure supports necessary to maintain wellbeing. v. Increase social/emotional skills and self -management. vi. Increase ability to advocate for self. vii. Increased communication skills. viii. Reduce symptoms of anxiety and depression. ix. Reduce self -harm. Target Population: i. Youth ages eight (8) to twenty-one (21) with or without suspected or diagnosed disability, criminal involvement, or child welfare involvement. Language: i. English. i. Medicaid Eligibility: i. This service is not Medicaid eligible. . Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The provider may transport clients. Program Arca: Mental Health Services 1. Appiec Behavior Analysis (ABA) — Board Certified Behavior Analyst (BCBA) a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement i. Applied Behavior Analysis (ABA) as primary modality. ii. Trauma -informed. iii. Assessments including but not limited to: Functional Behavior Assessment (FBA), Functional Assessment Screening Tools (FAST), Functional Analysis (only when clinically indicated), skills assessments, adaptive functioning scales, Vineland III, developmental assessments, Autism screening tools, Verbal Behavior Milestones Assessment and Placement Program (VBMAPP), Assessment of Basic Language and Living Skills (ABLLS), Assessment of functional living skills (AFLS), Essentials for Living (EFLS). iv. All assessments are used to allocate baseline data, identify skill deficits, and drive curriculum for treatment goals. v. Assessment is ongoing and all treatment decisions are driven by data collected in every session reflecting progress on each goal and behavior. 1.. Anticipated Frequency of Services: i. ABA is highly dependent on a thorough, individualized assessment. Service recommendations can range from one (1) to forty (40) hours per week of treatment. c. Anticipated Duration of Services: i. ABA services can range from a short-term focused treatment for six (6) months or may extend longer depending on the individual's needs and abilities. 4. Goals of Services: i. Identify skill deficits and develop skill acquisition programming to be taught using the principles of ABA. ii. Mediate and reduce the negative effects of challenging behaviors on the individual and caregivers. 15 iii. Develop and implement behavior intervention strategies to reduce behaviors targeted for reduction. iv. Conduct ongoing parent/caregiver required training on skill teaching and behavior intervention strategies using a trauma-informed/preventative approach. e. Outcomes of Services: i. Prevent or reduce behaviors that put individuals or their caregivers/family members at risk of harm. ii. Prevent or reduce behaviors that limit an individual's ability to access their home, school, community, and establish and maintain meaningful relationships. iii. Increase communication and social skills. iv. Increase independence to the highest level possible and establish skills that contribute to mental and physical health and hygiene. f. Target Population: i. Individuals of all ages, genders, abilities and diagnoses, unless clinically contraindicated or a diagnosis for the person or child involves a symptomology that requires medical intervention as the primary treatment. g. Language: i. English and Spanish (proficient) — no interpreter services are available. h. Medicaid Eligibility: i. This service may be Medicaid eligible for qualified individuals through EPSDT with a doctor's referral prescribing ABA as a medically necessary treatment for individuals' specific diagnosis. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The provider will not be transporting clients. 2. Applied Behavior Analysis (ABA) — Behavior Technician Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Primary modality being ABA. ii. Behavior Technician's (BT's) work directly with the client, under supervision, to implement the skill teaching program and behavior interventions designed by the Board - Certified Behavior Analyst (BCBA). b. Anticipated Frequency of Services: i. ABA is highly dependent on a thorough individualized assessment. Service recommendations can range from one (1) to forty (40) hours per week. c. Anticipated Duration of Services: i. ABA services can range from a short-term focused treatment for six (6) months or may extend longer depending on the individual's needs and abilities. d. Goals of Services: i. Identify skill deficits and develop skill acquisition programming to be taught using the principles of ABA. ii. Mediate and reduce the negative effects of challenging behaviors on the individual and caregivers. iii. Develop and implement behavior intervention strategies to reduce behaviors targeted for reduction. 16 iv. Conduct ongoing parent/caregiver required training on skill teaching and behavior intervention strategies using a trauma -informed / preventative approach. e Outcomes of Services: i. Prevent or reduce behaviors that put individuals or their caregivers/family members at risk of harm. ii. Prevent or reduce behaviors that limit an individual's ability to access their home, school, community, and establish and maintain meaningful relationships. iii. Increase communication and social skills. iv. Increase independence to the highest level possible and establish skills that contribute to mental and physical health and hygiene. f Target Population: i. Individuals of all ages, genders, abilities and diagnoses, unless clinically contraindicated or a diagnosis for the person or child involves a symptomology that requires medical intervention as the primary treatment. g. Language: i. English and Spanish (proficient) — no interpreter services are available. I. Medicaid Eligibility: i. This service may be Medicaid eligible for qualified individuals through EPSDT with a doctor's referral prescribing ABA as a medically necessary treatment for individuals' specific diagnosis. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The provider will not be transporting clients. 3. Consaltdion a Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement i. Case consult. ii. Document review. E. Anticipated Frequency of Services: i. As needed. a Anticipated Duration of Services: i. As requested by the Department. c. Goals of Services: i. Identify correct course for client treatment, needs, and dynamics. c. Outcomes of Services: i. Achieve successful direction. I. Target Population: i. Department and Court Professionals. g. Language: i. English. h. Medicaid Eligibility: 17 i. This service is not Medicaid eligible. i. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. 4. Mental Health Evaluation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Clinical Interview, Adverse Childhood Experience (ACE) Questionnaire, Behavioral Rehabilitation Services (BRS), Ohio State University Traumatic Brain Injury (OSU-TBI), Diagnostic and Statistical Manual of Mental Disorders (DSM-V), Minnesota Multiphasic Personality Inventory (MMPI), Texas Success Initiative program (TSI), mental status exam, or others as determined during the interview. b. Anticipated Frequency of Services: i. Two (2) hours to four (4) hours. c. Anticipated Duration of Services: i. One (1) to two (2) appointments. d. Goals of Services: i. Conduct a thorough assessment of individuals' mental status, social/emotional skills and deficits, and adaptive functioning. ii. Identify individuals' current mental functioning and mental health diagnosis if indicated. iii. Assist individual in identifying areas of strength and need regarding their mental/emotional health. e. Outcomes of Services: i. Provide client and authorized Department service providers with a comprehensive assessment summary. ii. Provide client and authorized Department service providers with specialized treatment recommendations for modalities and treatment options that are most effective for client's abilities and needs. iii. Provide psychoeducation to the client and/or guardian regarding client's mental status, symptomology, and diagnosis. iv. Connect client with resources which can meet their needs. f. Target Population: i. Individuals with various diagnosed or suspected intellectual/developmental disabilities, ages six (6) to one hundred (100), exhibiting challenges. g. Language: i. English and Spanish (proficient) — no interpreter services available. h. Medicaid Eligibility: i. This service may be Medicaid eligible. i. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. 18 5. Treatise Group - Social Skills Group a Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Social skills checklists are utilized to assess skills and identify pairs or groups of individuals who would work effectively together on mutual goals that are appropriate for their age and development. E Anticipated Frequency of Services: i. One (1) to two (2) times per week for one (1) or more hours depending on size of group and abilities. c Anticipated Duration of Services: i. Eight (8) weeks per cohort. c Coals of Services: i. Identify individuals who could benefit from facilitated social skills practice in a group setting. ii. Provide safe, monitored, and facilitated activities that support individuals' social skills practice in a group setting. iii. Provide peer modeling opportunities for individuals with social skills deficits. iv. Promote the development of necessary social skills and safe ways to connect and interact with peers. Outcomes of Services: i. Increase clients' access to safe opportunities to practice social skills and develop meaningful relationships. ii. Increase clients' ability to generalize social skills to new individuals in a new setting. iii. Increase the connections and opportunities to create a community for individuals with intellectual disabilities. i Target Population: i. Children and adults that have been assessed and identified as a candidate for group processing. €• Language: i. English, Spanish, (proficient) — no interpreter services available 1r. Medicaid Eligibility: i. This service is not Medicaid eligible. i Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The provider will not be transporting clients. 6. Treamart Group - Trauma Processing Group L. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Trauma informed approaches and materials, depression and anxiety scales, Post - Traumatic Stress Disorder (PTSD) assessments as prescribed by the group facilitators as needed. I. Anticipated Frequency of Services: i. One (1) time per week for one (1) to two (2) hours. 19 c. Anticipated Duration of Services: i. Three (3) to six (6) months. d. Goals of Services: i. Provide a safe setting for individuals who have been assessed and identified as a candidate for which group processing may be beneficial. ii. Facilitate the development of a supportive working group in which individuals can share, relate to others and process traumatic experiences. iii. Provide psychoeducation to group members to promote skill development for management of symptoms of PTSD and other trauma related behaviors and symptomology. e. Outcomes of Services: i. Individuals access opportunities to process trauma and begin a healing process in a safe and supportive group that is goal oriented and facilitated. ii. Individuals demonstrate the ability to establish and maintain self -care and coping practices while sharing connection and accountability with their group peers. iii. Individuals experience safety and acceptance that allows for integration of skills and mental health treatment. f. Target Population: i. Youth and adults that have been assessed and identified as a candidate for group processing. g. Language: i. English, Spanish, (proficient) — no interpreter services available. h. Medicaid Eligibility: i. This service is not Medicaid eligible. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235, virtually, or in the client's home. ii. The provider will not be transporting clients. 7. Mental Health Therapy a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), Trauma Focused Cognitive Behavioral Therapy (TF-CBT), Abstinence -Based Treatment (ABT), Animal Assisted Therapy (AAT), Marriage and Family Therapy (MFT), Motivational Interviewing (MI), Parent -Child Interaction Therapy (PCIT). b. Anticipated Frequency of Services: i. Frequency will be case specific depending on the severity of need/trauma/crisis. c. Anticipated Duration of Services: i. Duration will be case specific with recommendations based on assessment, client goals, and abilities, in addition to level of engagement. d. Goals of Services: i. Reduce and manage mental health triggers. ii. Reduce skill deficits within emotional regulation and coping practices. 20 iii. Increase self-awareness and self -management skills. iv. Process traumatic experiences and develop understanding of their impact on current functioning and relationships. v. Increase the ability of the client to identify emotional, mental, and physical needs and advocate for themselves. Outcomes of Services: i. Successful use of coping skills during day-to-day interactions, conflict, or crisis. ii. Increased independence in accessing community activities, resources, and services. iii. Increased ability to demonstrate independent engagement in pro -social and safe leisure skills. iv. Ability to establish and maintain healthy and safe relationships. v. Successful achievement of court recommended goals. vi. Successful reunification or other successful case outcome. f. Target Population: i. Ages four (4) to one hundred (100), with various diagnosed or suspected disabilities/developmental disabilities. ii. Individuals, dyads, or families, staff/professionals in need of training. g. Language: i. English and Spanish (proficient) — no interpreter services available. h. Medicaid Eligibility: i. This service is not currently Medicaid eligible. i. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will be able to transport clients for Adventure Based Therapy (ABT) services, only. 8. Medal tealth Treatment Groups Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Seeking Safety, Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), High Conflict Co -Parenting, Caring Dads, Strategies for Self -Improvement, and Change (SSC/SSIC), Affective Education and Health Relationships, Veteran Group, Social Skills, Trauma -Processing, Domestic Violence, and others. b. Anticipated Frequency of Services: i. One (1) to two (2) groups per week. c. Anticipated Duration of Services: i. Sixteen (16) to fifty-two (52) weeks, depending on client progress and needs. J. Goals of Services: i. Complete treatment group assigned. 2. Outcomes of Services: i. Complete accurate assessment of clients' treatment, strengths, needs, and areas of skill deficits. ii. Complete designated curriculum specialized for the service type. iii. Reduce and/or eliminate concerns of recidivism, relapse, and other risk factors. 21 iv. Increase coping capacity, safety tools, safe relationships, problem -solving, communication, and decision -making. f. Target Population: i. Individuals with various diagnosed or suspected intellectual/developmental disabilities, ages six (6) to one hundred (100). g. Language: i. English and Spanish (proficient) — no interpreter services available. h. Medicaid Eligibility: i. This service is partially Medicaid eligible. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. 9. Psychological Evaluation Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Diagnostic tools, screeners, and assessments as determined by the psychologist. b. Anticipated Frequency of Services: i. Ten (10) to twelve (12) hours total including report preparation and feedback session. c. Anticipated Duration of Services: i. One (1) to three (3) appointments. d. Goals of Services: i. Generate accurate assessment of clients' diagnosis, strengths, needs, and areas of skill deficits. ii. Generate a complete report of specialized recommendations for treatment and services tailored to the social/emotional, mental health, and learning needs of the individual. iii. Identify and determine course of treatment, treatment goals, and modality that is best suited for the individual. e. Outcomes of Services: i. Evaluation will provide data, summary, and outcome suggestions for client's learning, developmental, and mental health needs. f. Target Population: i. Client's aged four (4) to one hundred (100). g. Language: i. English and Spanish (proficient) — no interpreter services available. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. 22 10. Parent Child Interaction Assessment Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Parent child interaction assessment utilizes prescribed evidence -based tools, observation techniques, and structured play scenarios based on the assessors training and current research. b. Anticipated Frequency of Services: i. Two (2) to three (3) hours of direct observation plus interviews and collateral documentation review. c. Anticipated Duration of Services: i. Ten (10) to twelve (12) hours including report preparation and feedback session. d. Goals of Services: i. Gather data about parental attunement, attachment, relationship dynamics between parent and child. ii. Identify harmful or dysfunctional parenting attributes. iii. Present a thorough representation of the parent child relationship. e. Outcomes of Services: i. Generate specialized recommendations for therapeutic supports to improve the quality of the parent/child relationship. ii. Reduce the likelihood of future child welfare contact. iii. Predict likelihood of potential for future abuse and neglect. E Target Population: i. All individuals including those with various diagnosed or suspected intellectual/developmental disabilities, dyads, and families. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. 11. Pediatric Diagnostic Evaluation i. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. The pediatric diagnostic evaluation consists of systematic observations, assessments, collateral documentation review, and testing that will yield evidence to support a diagnosis of an Autism Spectrum diagnose or mother disorder. D. Anticipated Frequency of Services: i. Ten (10) to fifteen (15) hours of observation, interviewing, testing and collateral review. Anticipated Duration of Services: i. One (1) to three (3) appointments. 23 d. Goals of Services: i. Obtain or rule out a diagnosis of a developmental disorder. ii. Procure a thorough assessment of where a child falls along the Autism Spectrum. iii. Gain an understanding of a child's intellectual potential. e. Outcomes of Services: i. Provide a treatment and education plan specifically geared towards the child's needs. ii. Provide education and resources to those providing care for the child. iii. Identify and connect the family with specialized support services and treatment options. f Target Population: i. Children up to age eighteen (18) with suspected developmental disabilities or autism spectrum disorder. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. 12. Neuropsychological Evaluation Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Diagnostic tools, testing, screeners, and assessments as determined by the psychologist. b. Anticipated Frequency of Services: i. Ten (10) to fifteen (15) hours total. c. Anticipated Duration of Services: i. One (1) to three (3) appointments for testing and interview. d. Goals of Services: i. Assess clients' strengths and areas of skill deficits. ii. Conduct neuropsychological testing as prescribed. iii. Accurately test clients' current functioning and gather full history of the whole person. iv. Generate tailored recommendations for specialized services and modalities that will best support the client. e. Outcomes of Services: i. Accurate holistic understanding of client needs, diagnosis, and abilities. ii. Recommendations for specialized services. iii. Individualized and thorough report. f Target Population: i. Client's aged four (4) to one hundred (100). g. Language: i. English. 24 h. Medicaid Eligibility: i. This service is not Medicaid eligible. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. Program Area: Monitored Sobriety Services 1. Urinnl}sis and Breathalyzer a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Secure and protected drug panel screening tools. ii. Substances tested for: 1. Amphetamine (AMP) 2. Barbiturates (BAR) 3. Buprenorphine (BUP) 4. Benzodiazepines (BZO) 5. Cocaine (COC), 6. Creatine (CR), 7. Ethyl glucuronide (ETG), 8. Fenfluramine/phentermine (FEN) 9. Methadone (MTD) 10. Opiates (OPI) 11. Oxycodone (OXY) 12. Tetrahydrocannabinol (THC) 13. Tramadol a. Anticipated Frequency of Services: i. As needed or as required by treatment. Anticipated Duration of Services: i. Length of Substance Use Disorder (SUD) treatment. 4. Goals of Services: i. Complete sobriety testing successfully. e. Outcomes of Services: i. Provide negative sobriety test results when scheduled. Target Population: i. Clients in SUD treatment. Language: i. English. Medicaid Eligibility: i. No. Service Access and Transportation: i. Services will take place in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235 ii. The contractor will not be transporting clients. 25 Proeram Area: Substance Abuse Treatment Services 1. Substance Treatment Intake a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Intake Assessment and Screening Tools. b. Anticipated Frequency of Services: i. One (1) to two (2) hours. c. Anticipated Duration of Services: i. Thirty (30) days. d. Goals of Services: i. Complete Substance Use Disorder (SUD) intake. e. Outcomes of Services: i. SUD intake report generated and released. f. Target Population: i. Client with various diagnosed or suspected disabilities, ages twelve (12) to one hundred (100). g. Language: i. English h. Medicaid Eligibility: i. This service is Medicaid eligible. Service Access and Transportation: i. Services will take place virtually or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235 ii. The contractor will not be transporting clients. 2. Substance Treatment Evaluation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Evaluation Assessment and Screening Tools. b. Anticipated Frequency of Services: i. One (1) to two (2) hours. c. Anticipated Duration of Services: i. Thirty (30) days. d. Goals of Services: i. Complete Substance Use Disorder (SUD) evaluation. e. Outcomes of Services: i. SUD evaluation report generated and released. f. Target Population: 26 Client with various diagnosed or suspected disabilities, ages twelve (12) to one hundred (100). g. Language: i. English. 1. Medicaid Eligibility: i. This service is Medicaid eligible. Service Access and Transportation: i. Services will take place virtually or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. 3. Subsanee Abuse Treatment - Individual Treatment L. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), Trauma Focused Cognitive Behavioral Therapy (TF-CBT), Motivational Interviewing (MI), multimodal approaches. I. Anticipated Frequency of Services: i. One (1) to three (3) sessions per week depending on the client's needs. c. Anticipated Duration of Services: i. Duration will be case specific. 1. Goals of Services: i. Reduce and manage substance use or substance misuse. ii. Reach a goal of being alcohol or substance use free. iii. Maintain abstinence from all substances. c. Outcomes of Services: i. Successful daily practice of self -care and coping skills. ii. Successful establishment and maintenance of pro -social relationships. iii. Successful reunification or other successful case closure. Target Population: i. Ages twelve (12) to one hundred (100) with various diagnosed or suspected disabilities. g. Language: i. English. i. Medicaid Eligibility: i. This service is Medicaid eligible. . Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. 27 4. Substance Abuse Treatment — Group Treatment a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), Trauma Focused Cognitive Behavioral Therapy (TF-CBT), Motivational Interviewing (MI), multimodal approaches. b. Anticipated Frequency of Services: i. One group weekly. c. Anticipated Duration of Services: i. Duration will be case specific. d. Goals of Services: i. Reduce and manage substance use or substance misuse. ii. Reach a goal of being alcohol or substance use free. iii. Maintain abstinence from all substances. e. Outcomes of Services: i. Successful daily practice of self -care and coping skills. ii. Successful establishment and maintenance of pro -social relationships. iii. Successful reunification or other successful case closure. f. Target Population: i. Ages twelve (12) to one hundred (100) with various diagnosed or suspected disabilities. g. Language: i. English. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. Terms 1. Contractor understands and will comply with all aspects of the referral authorization, billing and tracking requirements as set forth by the Department. Failure to comply with all aspects may result in a forfeiture of payment. 2. Contractor agrees to receive referrals for services through e-mail and will provide an identified e-mail address prior to the start of this Agreement. Contractor acknowledges that services are not authorized until the Contractor has received an authorized referral form from the Department. Contractor further acknowledges that services provided prior to the authorized start date or outside the scope of services on the referral form will not be eligible for reimbursement. 3. Contractor will respond to the Mental Health and Support Services Team CWServiceReferral(a,weldeov.com within three (3) business days regarding the ability to accept the received referral. 28 4. Upcn acceptance of a referral, Contractor will offer an initial appointment within seven (7) days of recevits the referral. The first attempt to contact the client will occur within 24 hours of receiving the referai(excluding weekends and holidays). Contractor will document efforts to engage client in referred sery cm. If the client does not respond after three (3) attempts in the first seven (7) days of the referral peri.d,the Contractor will notify the caseworker and the Mental Health and Support Services Team HS- CW SeiceReferral@weldgov.com. 5. Conractor acknowledges that any and all modifications to an existing referral must be approved through the Mental Health and Support Services Team mailto:(HS-CWServiceReferral@weldgov.com). No othe- Ii partment staff or other party to the case may authorize services or modifications to services. 6. ConTa for 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 ConTaator understands that the Department will not reimburse for "no-shows". Contractor understands that _heDepartment 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 placo client on a behavioral plan requiring attendance or discharge the client from services. Contractor mus- inform the caseworker and the Mental Health and Support Services Team HS- CW6ew'iceReferral@weldgov.com within three (3) days of when the client is placed on a behavioral plan or discllarged 7. Con-ractor 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 "ma;eyr" session/episode, to occur within 30 days of the cancellation, will be offered to the client (excucing session/episodes that fall on holidays). If the cancellation is generated from the client, the ConTactor must request a makeup session from the Department prior to the makeup session occurring (excucfing session/episodes that fall on holidays). After three (3) cancellations, Contractor will inform the caseworker and the Mental Health and Support Services Team HS-CWServiceReferral@weldgov.com imnidiEately via email, to discuss service continuation. 8. ConTartor 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. Conaaetor will submit reports on a monthly basis for each active referral for ongoing services. Reports will be sabrnitted per the online format required by the Department, unless otherwise directed by the Department. 10. Conaador will document in detail any and all observed or verbalized concerns regarding any child whom the Contractor is working with under an active referral. Areas of concern may include, but are not limited to, al), 3hysical, emotional, educational or behavioral issues. Areas of concern should be reported to the casewwcrker and the Mental Health and Support Services Team HS-CWServiceReferral@weldgov.com immediately AND on the required monthly report. 11. Conaador agrees any change to an existing referral must be pre -approved through the Child Welfare Core ServiceCoordinator or any member of the Mental Health and Support Services Team. Any changes to visitation referrals will be approved by a new referral signed by the Child Welfare Supervisor. A change is defitedlas anything outside of the approved documented service on the initial authorized referral form. This may indude an increase or decrease in services hours, change in frequency, change in location of services, tranixrtation needs, or any change to the initial referral or subsequent authorizations. 29 12. Contractor agrees to attend meetings when available and as requested by the Department. Such meetings include Court Facilitations, Bid Meetings, Professional Staffings, Family Team Meetings and/or Team Decision Making meetings. The Department will reimburse for actual participation in the meeting only so long as there is written authorization from the Mental Health and Support Services Team, and the facilitator documents in the meeting notes the timeframe that the provider attended and when participation in the meeting is deemed appropriate and necessary by the Department. The Facilitator will be responsible for filling out the time attended on the meeting notes. Staffings and/or meetings other than those listed above are not considered reimbursable unless otherwise approved by the Child Welfare Contract and Services Coordinator. Contractor may participate by phone or virtually, if approved by the Department. 13. On a monthly basis, the Contractor will notify the Mental Health and Support Services Team HS- CWServiceReferral@weldgov.com of new staff who will manage and/or administer the services with the following information: a. Staff member name and contact information b. Education level/degree (if applicable) c. Licensure/credentials (if applicable) d. Department of Regulatory Authority (DORA) number (if applicable) e. Supervisor name and contact information The Department reserves the right to decline the new staff members managing and/or administering services to Department clients. 14. Compliance with Child and Family Services Review The Child and Family Services Review (CFSR) examines child welfare service outcomes in three areas; Safety, Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's performance according to national standards and monitor progress over time. Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance services to families. Contractor agrees to continually strive for positive outcomes in the areas of Safety, Permanency and Well Being. Contractor will ensure that any employee or subcontractor of Contractor providing services under this Agreement will work towards positive outcomes in the aforementioned three areas as outlined under the Child and Family Services Review (CFSR), and will address the aforementioned three areas when completing monthly reports as required by Paragraph 9 of this Exhibit. 15. Certification Contractor certifies that, at the time of entering into this Agreement, it has currently in effect all necessary licenses, approvals, insurance, etc., required to properly provide the services and/or supplies covered by this Agreement. Copies of all necessary licenses shall be provided to the Department by the Contractor prior to the start of any Agreement. 16. Training Contractor may be required to attend training at the request of the Department specific to services provided under this Agreement. The Department will not compensate the Contractor for said training in the form of registration fees, time spent traveling to and from training, attending the training or any other associated costs unless otherwise agreed to by the Department. 17. Subpoenas Contractor will, on behalf of its employees and/or officers, accept any subpoena for testimony from the Weld County Attorney's Office by e-mail and will return a waiver of services within 72 business hours. 30 For triapurpose, Contractor will designate an e-mail address prior to the start of this Agreement. If the Contaator 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. Moritodng 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 deliver service quality, documentation, and invoicing during referral period and after services have conducted. 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 obtned. Contactor 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. 31 EXHIBIT B RATE SCHEDULE 1. Funding and Method of Payment The Department agrees to reimburse the Contractor in consideration of the work and services performed under this Agreement at the rate(s) specified below in Paragraph 2, Fees for Services. Expenses incurred by the Contractor prior to the term of this Agreement are not eligible Department expenditures and shall not be reimbursed by the Department. For services funded through Core Services, Contractor agrees to accept reimbursement through ACH direct deposit one time per month. If Contractor is not currently set up with the State of Colorado to accept direct deposit, Contractor agrees to complete and submit a State of Colorado direct deposit enrollment form, which will be provided by the Department, with a voided check, deposit slip or bank letter. Failure to complete and submit this form and voided check in a timely and accurate manner may result in a delay of payment. For services not funded through Core Services; Contractor agrees to accept payment through County Warrant when funding source does not allow for direct deposit. Payment pursuant to this Agreement, whether in whole or in part, is subject to and contingent upon the continuing availability of said funds for the purposes hereof. In the event that said funds, or any part thereof, become unavailable as determined by the Department, the Department may immediately terminate the Agreement or amend it accordingly. 2. Fees for Services Program Area Anger Management/Domestic Violence Rate $75.00 lnit -1-e yl Each Service lame Caring Dads: In-Office/Video $375.00 Each Domestic Violence Intake: In- Office/Video $30.00 Each Domestic Violence Intake: Bilingual Rate increase $575.00 Each Domestic Violence Evaluation: In- Office/Video $250.00 Each Domestic Violence Evaluation: Bilingual Rate increase $100.00 Each Domestic Violence Evaluation or Intake: No Show (Max of 2 no shows or 2 hours/month/client) $145.00 Hour Domestic Violence Individual Treatment: In-Office/Video $15.00 Hour Domestic Violence Individual: Bilingual Rate increase $75.00 Each Domestic Violence Group Treatment: In-Office/Video $15.00 Each Domestic Violence Group: Bilingual Rate increase $35.00 Each Domestic Violence Group: No Show (Max of 2 no shows or 2 hours/month/client) Pri grim :krea Anger Management/Domestic Violence Rate $100.00 lnit Type Hour Service Name Domestic Violence Masters Level: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing FTM, TDM, Prof. Staffing $0.66 Mile Domestic Violence: Mileage* $995.00 Client Family -Violence Psychoeducation Group -Programming: In- OfficeNideo (12 sessions/ 1 session per week) $1,990.00 Couple Family -Violence Psychoeducation Group-Programming:In- OfficeNideo $75.00 Each High Conflict Co -Parenting: In - $595.00 Client Victim -Survivor Advocacy Group Programming: In-OfiiceNideo (6 sessions/ 1 session per week) $150.00 Hour Victim -Survivor Advocacy Support: Any Location Foster Parent Consultation $150.00 Hour Foster Parent Consultation - Individual/Family: Any Location $15.00 Hour Foster Parent Consultation Individual: Bilingual rate increase per service $55.00 Hour Foster Parent Consultation Individual: No Show $15.00 Each Foster Parent Consultation Group: Bilingual rate increase per service $35.00 Each Foster Parent Consultation Group: No Show (Max of 2 no shows or 2 hours/month/client) $100.00 Hour Foster Parent Consultation Masters Level: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $75.00 Hour Foster Parent Consultation - Group: In -Office $0.66 Mile Foster Parent Consultation: Mileage* $55.00 Each Foster Parent Consultation Individual/Family: No Show (Max of 2 no shows or 2 hours/month/client) Foster Parent Training $200.00 Hour Foster Parent Training: Any Location Home Based Intervention $100.00 Hour Home -Based Intervention - High: Any Location $150.00 Hour Home -Based Intervention - Intensive: Any Location $15.00 Hour Home -Based Intervention: Bilingual rate increase Area Home Based Intervention Rate $75.00 UnitProgram Type Hour ',en. ice Name Home -Based Intervention BA Level: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $100 00 © Home -Based Intervention Masters Level: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $55.00 Each Home -Based Intervention: No Show (Max of 2 no shows or 2 hours/month/client) $0.66 Mile Home -Based Intervention: Mileage* Kinship Services (Therapeutic) $150.00 Hour Therapeutic Kinship Services: Any Location $15.00 Hour Therapeutic Kinship Services: Bilingual rate increase per service $100.00 Hour Therapeutic Kinship Services: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $55.00 Each Therapeutic Kinship Services: No Show (Max of 2 no shows or 2 hours/month/client) $0.66 Hour Therapeutic Kinship Services: Mileage* Life Skills $100.00 Hour Life Skills: Any Location $75.00 Hour Life Skills BA Level: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $100.00 Hour Life Skills Masters Level: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $15.00 Hour Life Skills: Bilingual rate increase per service $0.66 Mile ; Life Skills: Mileage* $150.00 Hour Therapeutic Life Skills: Any Location $55.00 Eeli . Therapeutic Life Skills and Specialized Mentorship: No Show (Maxof2noshows or2 hours/month/client) $100.00 Hour Specialized Mentorship: Any Location Mental Health Services $150.00 Hour .; Applied Behavior Analysis (ABA) Board Certified Behavior Analyst r. . (BCBA): Any Location $100.00 Hour ABA Behavior Technician: Any Location $125.00 H to `° " onsu tation: In-Office/Video P -ot ram area Mental Health Services Rate $775.00 Unit Tape Each Ser% ice Name Mental Health Evaluation: Full (2-4 hours) $250.00 Each Mental Health Evaluation: Bilingual rate increase (2-4 hours) $100.00 Each Mental Health Evaluation: No Show (Max of 2 no shows or 2 hours/month/client) $150.00 Hour Mental Health Therapy: Any Location. $15.00 Hour Mental Health Individual: Bilingual rate increase $55.00 Each Mental Health Individual Therapy: No Shaw (Max of 2 no shows or 2 hours/month/client) $75.00 Each Mental Health Treatment Groups: In- Office/Video $75.00 Each Mental Health Treatment Groups: In- OfficeNideo $15.00 Each Mental Health Treatment Group: Bilingual rate increase $35.00 Each Mental Health Treatment Group: No Show (Max of 2 no shows or 2 hours/month/client) $100.00 Hour Mental Health Services Masters level: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $15Q_0Q Hour Mental Health Services PhD level: Team Meeting (Film), Team Decision Making (TOM) Meeting, Professional Staffing $992.50 Each Psychological Evaluation - Partial $1,905.00 , Each Psychological Evaluation - Full (10- 12 Hours) $2,175.00 Each Parent Child Interaction Assessment: Full (10-12 Hours) $2,755.00 Each Pediatric Diagnostic Evaluation: Full $2,900.00 Each Neuropsychological Evaluation: Full (10-15 Hours) $0.66 Mile Mental Health Services: Mileage* Montored Sobriety Services $8.00 Each Breath Alcohol (BA) $18.00 Each , Confirmation Test $22.00 Each Urinalysis (UA) Suh nce Abuse Treatment $325.00 Each Substance Treatment Intake $500.00 Each Substance Treatment Evaluation $100.00 Each ' Substance Treatment Evaluation or Intake: No Shaw(Max of 2 no shows or 2 hours/manth/+client) $125.00 Hour ATm- IndividSubstanceual: In-Ofbuse fice/Vreatideoent Program Area Substance Abuse Treatment Rate $55.00 lnit Type Each Seryice 'Name Substance Abuse Treatment - Individual: No Show (Max of 2 no shows or 2 hours/month/client) $75.00 Each Substance Abuse Treatment - Group: In-Office/Video $35.00 Each Substance Abuse Treatment - Group: No Show (Max of 2 no shows or 2 hours/month/client) $100.00 Hour Substance Abuse Treatment: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing * For distances exceeding 30 miles roundtrip from provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235 or the first appointment location of the day. 3. Request for Reimbursement and Supporting Documentation Contractor shall submit all Requests for Reimbursement and supporting documentation to the Department by the 7th day of the month following the month of service, but no later than 45 days from the date of service for each client receiving ongoing services. Contractor shall prepare and submit monthly a Request for Reimbursement and monthly report including other supporting documentation, if applicable, certifying that services authorized were provided on the date(s) indicated and the charges were made pursuant to the terms and conditions of Paragraph 3 of this Agreement. Monthly reports will be submitted through the Department's online reporting system, unless otherwise directed or agreed to by the Department. Monthly reports for ongoing services must include the following information, entered in the "Narrative" box for each date of service: a. Time(s) of service (i.e. 2-4pm) b. Location of where the service took place (i.e. clinician's office, client's home, in the community.) c. Clinician/therapist name d. What interventions were used, recommendations and/or goals discussed, progressions towards goals, and client engagement. e. For mileage reimbursement, if applicable, the mileage accumulated minus roundtrip mileage that is included in the rate, starting location, and ending location. f. Any and all safety concerns. When submitting a Request for Reimbursement for a one-time service, the contractor shall submit the first and last page of the evaluation/report to confirm proof of services rendered. The full evaluation/report should be submitted by the contractor to the caseworker. For Monitored Sobriety services, proof of services rendered shall be the test result. Requests for Reimbursement and/or supporting documentation received after the 7`h day of the month may delay payment. Requests for Reimbursement and/or supporting documentation received after 45 days from the date of service may result in delay or forfeiture of payment. Consistent failure to meet the 45 -day deadline may result in termination of the Agreement. 4. Payment The Department and the Contractor agree that all benefits from private insurance and/or other funding sourans ouch 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 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 reporfng 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 sa lj the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed. 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. Incoreas payment to the Contractor due to omission, error, fraud, and/or defalcation shall be recovered fromContractor by deduction from subsequent payments under this Agreement or other agreements betw,en the Department and Contractor, or by the Department as a debt due to the Department or otherwise as provided by law. 6. Fina ti6l 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 expeadel under this Agreement must conform to the Single Audit Act of 1984 and OMB Circular A-133. SIGNATURE REQUESTED: Weld/Lifelong Amendment #1 - 2023-24 Final Audit Report 2023-04-21 Created: 2023-04-21 By: Lesley Cobb (cobb)odk@co.weld.co.us) Status: Signed Transaction ID: CBJCHBCAABAAbaSXgKK3WW0Jct-3399_LC9ETwlxzsOy "SIGNATURE REQUESTED: Weld/Lifelong Amendment #1 - 20 23-24" History 5 Document created by Lesley Cobb (cobbxxlk@co.weld.co.us) 2023-04-21 - 5:56:57 PM GMT- IP address: 204.133.39.9 2. Document emailed to lindsey@lifelonginc.com for signature 2023-04-21 - 5:58:10 PM GMT 5 Email viewed by lindsey@lifelonginc.com 2023-04-21 - 6:46:45 PM GMT- IP address: 76.154.11.243 6� Signer lindsey@lifelonginc.com entered name at signing as Lindsey Spraker 2023-04-21 - 7:36:56 PM GMT- IP address: 76.154.11.243 ere Document e -signed by Lindsey Spraker (lindsey@lifelonginc.com) Signature Date: 2023-04-21 - 7:36:58 PM GMT - Time Source: server- IP address: 76.154.11.243 Q Agreement completed. 2023-04-21 - 7:36:58 PM GMT Names and email addresses are entered into the Acrobat Sign service by Acrobat Sign users and are unverified unless otherwise noted. Powered by Adobe Acrobat Sign Contract Form New Contract Request Entity Information Entity Name* LIFELONG INC Entity ID * x'•00045085 Contract Name* LIFELONG, INC (AGREEMENT AMENDMENTU1 PY 202 3-24) Contract Status CTE REVIEW Contract ID 6914 Contract Lead* COBEXXLK New Entity? Parent Contract ID 20221598 Requires Board Approval YES Contract Lead Email Department Project t cobbxxlki co.weld.co.us Contract Description * BID# B2200040. MINOR SCOPE, RATE AND TERM CHANGES. TERM 6 1 2 3-5 31 x 24. Contract Description 2 CONSENT: PA ROUTING THROUGH NORMAL APPROVAL PROCESS. ETA TO C:TB 05 04 2023. Contract Type* AMENDMENT Amount 50.00 Renewable* NO Automatic Renewal Grant iGA Department HUMAN SERVICES Department Email CM- HumanServicesTw•eldgov.co rn Department Head Email CM-HumaoServices- DeptHead0weldgov.com County Attorney GENERAL COUNTY ATTORNEY EMAIL County Attorney Email CM- COU NTYATTO RN EYUWELDG OV.COM Requested ROCC Agenda Date* 05.10 2023 Due Date 05;06;2023 Will a work session with BOCC be required?* NO Does Contract require Purchasing Dept. to be included? If this is a renewal enter previous Contract ID If this is part of a 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 On Base ContractDates Effective Date Review Date* Renewal Date 03,29,2024 Termination Notice Period Committed Delivery Date Expiration Date* 05.,'31/2024 Contact Information Contact Info Contact Name Contact Type Contact Email Contact Phone 1 Contact Phone 2 Purchasing Purchasing Approver Purchasing Approved Date CONSENT 04282020 Approval Process Department Head Finance Approver Legal Counsel JAMIE ULRICH CONSENT CONSENT DH Approved Date Finance Approved Date Legal Counsel Approved Date 04;28x2023 04.28 2023 04 28 2023 Final Approval BOCC Approved Tyler Ref # AG 050823 BOCC Signed Date BOCC Agenda Date 05©8!2023 Originator COBBXXLK Con -Iva cA- t b 5x43 CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND LIFELONG, INC. tt This Agreement, made and entered into the day of V (L4'J_ , 2022, by and between the Board of Weld County Commissioners, on behalf of the Weld County Department of Human Services, hereinafter referred to as the "Department" and Lifelong, Inc., hereinafter referred to as the "Contractor". The parties to this Agreement understand and agree that the provisions of this Agreement specifically include the following documents: Exhibit A, Scope of Services, Exhibit B, Rate Schedule, Exhibit C, Weld County's Request for Proposal, and Exhibit D, Contractor's Response to Request for Proposal. Exhibit A, B, and D are attached hereto and incorporated herein by this reference. Exhibit C is Weld County's Request for Proposal Number B220040 which is incorporated into this agreement by reference and will be provided upon request to the Department. WITNESSETH WHEREAS, required approval, clearance, and coordination have been accomplished from and with appropriate agencies; and WHEREAS, the Colorado Department of Human Services has provided Core Services or other funding to the Department for Aftercare Services, Crisis Intervention and Stabilization Services, Anger Management/Domestic Violence, Foster Parent Consultation, Foster Parent Training, Home -Based Intervention, Kinship Services (Therapeutic), Life Skills, Mental Health Services, and Substance Abuse Treatment Services. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: 1. Term This agreement shall become effective on June 1, 2022, upon proper execution of this Agreement and shall expire May 31, 2023, unless sooner terminated as provided herein. This agreement may be renewed for 2 additional terms by written agreement of both parties. 2. Scope of Services Services shall be provided by the Contractor to any person(s) eligible for services in compliance with Exhibit A Scope of Services, and Exhibit D, Contractor's Response to Request for Proposal. 3. Referrals, Billing and Tracking a. Contractor understands and will comply with all aspects of the referral authorization, billing and tracking requirements as set forth by the Department. Failure to comply with all aspects may result in a forfeiture of payment. b. Contractor agrees to receive referrals for services through e-mail and will provide an identified e- mail address prior to the start of this Agreement. Contractor acknowledges that services are not authorized until the Contractor has received an authorized referral form from the Department. Contractor further acknowledges that services provided prior to the authorized start date or outside the scope of services on the referral form will not be eligible for reimbursement. Contractor acknowledges that any and all modifications to an existing referral must be approved through the Quality Assurance Team (HS-CWOualitvAssurance(a weldgov.com). No other Department staff or other party to the case may authorize services or modifications to services. c. Contractor agrees to submit a complete Request for Reimbursement and supporting documentation by the 7th of the month, following the month of service, utilizing billing forms required by the Conwit 01-59-) oc�ro�l2z° HRoOTy 2022-1598 Department. Requests for Reimbursement Forms received after 45 days from the date of service may result in delay or forfeiture of payment. Consistent failure to meet 45 -day deadline may result in termination of the Agreement. d. Contractor agrees to submit a monthly report by the 7th of the month, following the month of service, for each client receiving ongoing services. Monthly reports will be submitted through the Department's online reporting system, unless otherwise directed or agreed to by the Department. Monthly reports for ongoing services must include the following information, entered in the "Narrative" box for each date of service: a. Date and time(s) of service (i.e. two hours or 2-4pm) b. Location of where the service took place (i.e. clinician's office, client's home, in the community.) c. Clinician/therapist name d. Clients participating e. What interventions were used, recommendations and/or goals discussed f. Any and all safety concerns One-time services will be verified through receipt of the completed product (ex. psychological evaluation, substance abuse evaluation, home study). Verification of Monitored Sobriety Services will be the test result. A completed home study may be a full, partial or denied study, as determined by the Department. Contractor will document in detail any and all observed or verbalized concerns regarding any child whom the Contractor is working with under the Agreement. Areas of concern may include, but are not limited to, any physical, emotional, educational or behavioral issues. Areas of concern should be reported immediately to the caseworker AND on the required monthly report. 4. Payment a. The Department and the Contractor agree that all benefits from private insurance and/or other funding sources such as Medicaid (if Contractor is a Medicaid eligible provider) or Victim's Compensation must be exhausted before Core Services or other Department funds can be accessed for services. Exceptions to this Paragraph may include, if approved by the Department, the following: i. The service being provided by the contractor is not a Medicaid eligible service; ii. The service is not deemed medically necessary; iii. The Court with jurisdiction over the case has ordered that a non -Medicaid provider or service be used; iv. A Medicaid provider is not available to provide the needed service; v. Medicaid is exhausted for the needed service; or vi. Medicaid denied service. vii. The client is not eligible for Medicaid. b. Payment shall be made in accordance with Exhibit A, Scope of Services , Exhibit B, Rate Schedule, Exhibit C, Weld County's Request for Proposal, and Exhibit D, Contractor's Response to Request for Proposal., attached hereto and incorporated herein by reference, so long as services are rendered satisfactorily and in accordance with the Agreement. c. Payment pursuant to this Agreement, whether in whole or in part, is subject to, and contingent upon, the continuing availability of said funds for the purposes hereof. d. The Department may withhold reimbursement if Contractor has failed to comply with any part of the Agreement, including the Financial Management requirements, program objectives, contractual terms, or reporting requirements. In the event of forfeiture of reimbursement, Contractor may appeal such circumstance in writing to the Director of Human Services. The decision of the Director of Human Services shall be final. 2 5. Financial Management At all times from the effective date of the Agreement until completion of the Agreement, Contractor shall comply with the administrative requirements, cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under this Agreement must conform to the Single Audit Act of 1984 and OMB Circular A-133. 6. Payment Method Unless otherwise provided in Exhibit A, Scope of Services, Exhibit B, Rate Schedule, and Exhibit D, Contractor's Proposal: a. If services are funded through Core Services, Contractor agrees to accept reimbursement through ACH direct deposit one time per month. b. If Contractor is not currently set up with the State of Colorado to accept direct deposit, Contractor agrees to complete and submit a State of Colorado direct deposit enrollment form, which will be provided by the Department, with a voided check. Failure to complete and submit this form and voided check in a timely and accurate manner may result in a delay of payment. c. Contractor agrees to accept payment through county warrant when funding source does not allow for direct deposit. 7. Compliance with Applicable Laws a. At all times during the performance of this Agreement, Contractor will strictly adhere to all applicable Federal and State laws, order, and applicable standards, regulations, interpretations and/or guidelines issued pursuant thereto. This includes protection of the confidentiality of all applicant/recipient records, papers, documents, tapes and any other materials that have been or may hereafter be established which relate to the Agreement. Contractor shall abide by all applicable laws and regulations, including, but not limited to the following: - Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d-1 Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d-1 et. seq. and its implementing regulation, 45 C.F.R. Part 80 et. seq.; and - all provisions of the Civil Rights Act of 1986 so that no person shall, on the grounds of race, creed, color, sex, or national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under the approved Agreement. - Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 794, and its implementing regulations, 45 C.F.R. Part 84; and - the Age Discrimination Act of 1975, 42 U.S.C. Section 6101 et. seq. and its implementation regulations, 45 C.F.R. Part 91; and - Title VII of the Civil Rights Act of 1964; and - the Age Discrimination in Employment Act of 1967; and - the Equal Pay Act of 1963; and the Education Amendments of 1972; and - Immigration Reform and Control Act of 1986, P.L. 99-603, 42 C.F.R. Part 2; and 3 - all regulations applicable to these laws prohibiting discrimination because of race, color, national origin, sex, religion, and handicap, including Acquired Immune Deficiency Syndrome (AIDS) or AIDS related conditions covered under Section 504 of the Rehabilitation Act of 1973, as amended, cited above. If necessary, Contractor and the Department will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 C.F.R. Part 2. 45 C.F.R. Part 74, Appendix G 9, which requires that affirmative steps be taken to assure that small and minority businesses are utilized, when possible, as sources of supplies, equipment, construction and services. This assurance is given in consideration of and for the purpose of obtaining any all Federal and/or State financial assistance. - Colorado Revised Statute (C.R.S.) 26-6-104, requiring criminal background record checks for all employees, contractors and sub -contractors. b. Contractor is further charged with the knowledge that any person who feels that s/he has been discriminated against has the right to file a complaint either with the Colorado Department of Human Services or with the United States Department of Health and Human Services, Office for Civil Rights. c. Contractor assures that it will fully comply with all other applicable Federal and State laws which may govern the ability of the Department to comply with the relevant funding requirements. Contractor understands the source of funds to be accessed under the Agreement is determined by the Department. d. Contractor assures and certifies that it and its principals: - Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transaction by a Federal or State department or agency; and - have not, within a three-year period preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or Local) transaction or contract under public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; and - are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state or local) with commission of any of the offenses enumerated in this certification; and - have not, within a three-year period preceding this Agreement, had one or more public transactions (federal, state, or local) terminated for cause or default. e. Public Contracts for Services C.R.S. §8-17.5-101. Contractor certifies, warrants, and agrees that it does not knowingly employ or contract with an illegal alien who will perform work under this contract. Contractor will confirm the employment eligibility of all employees who are newly hired for employment in the United States to perform work under this Agreement, through participation in the E - Verify program or the State of Colorado program established pursuant to C.R.S. §8-17.5- 102(5)(c). Contractor shall not knowingly employ or contract with an illegal alien to perform work under this Agreement or enter into a contract with a subcontractor that fails to certify with Contractor that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this Agreement. Contractor shall not use E -Verify Program or State of Colorado program procedures to undertake pre -employment screening or job applicants while this Agreement is being performed. If Contractor obtains actual knowledge that a subcontractor performing work under the public contract for services knowingly employs or contracts with an illegal alien Contractor shall notify the subcontractor and the Department within three (3) days that Contractor has actual knowledge that a subcontractor is 4 employing or contracting with an illegal alien and shall terminate the subcontract if a subcontractor does not stop employing or contracting with the illegal alien within three (3) days of receiving notice. Contractor shall not terminate the contract if within three days the subcontractor provides information to establish that the subcontractor has not knowingly employed or contracted with an illegal alien. shall comply with reasonable requests made in the course of an investigation, undertaken pursuant to C.R.S. §8-17.5-102(5), by the Colorado Department of Labor and Employment. If Contractor participates in the State of Colorado program, Contractor shall, within twenty days after hiring a new employee to perform work under the contract, affirm that Contractor has examined the legal work status of such employee, retained file copies of the documents, and not altered or falsified the identification documents for such employees. Contractor shall deliver to the Department, a written notarized affirmation that it has examined the legal work status of such employee and shall comply with all of the other requirements of the State of Colorado program. If Contractor fails to comply with any requirement of this provision or of C.R.S. §8-17.5-101 et seq., the Department, may terminate this Agreement for breach, and if so terminated, Contractor shall be liable for actual and consequential damages. f. Except where exempted by federal law and except as provided in C.R.S. § 24-76.5-103(3), if Contractor receives federal or state funds under the contract, Contractor must confirm that any individual natural person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. § 24-76.5-103(4), if such individual applies for public benefits provided under the contract. If Contractor operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it: (a) is a citizen of the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall produce one of the forms of identification required by C.R.S. § 24- 76.5-101, et seq., and (c) shall produce one of the forms of identification required by C.R.S. § 24-76.5- 103 prior to the effective date of the contract. 8. Compliance with Child and Family Services Review The Child and Family Services Review (CFSR) examines child welfare service outcomes in three areas; Safety, Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's performance according to national standards and monitor progress over time. Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance services to families. Contractor agrees to continually strive for positive outcomes in the areas of Safety, Permanency and Well Being. Contractor will ensure that any employee or subcontractor of Contractor providing services under this Agreement will work towards positive outcomes in the aforementioned three areas as outlined under the Child and Family Services Review (CFSR), and will address the aforementioned three areas when completing monthly reports as required by Paragraph 3(d) of this Agreement. 9. Insurance Requirements Contractor and the Department agree that Weld County, the Board of County Commissioners of Weld County, its officers and employees, shall not be held liable for injuries or damages caused by any negligent acts or omissions of the Contractor, it subcontractor, or their employees, volunteers, or agents while performing duties described in this Agreement. Contractor shall indemnify, defend and hold harmless Weld County, the Board of County Commissioners of Weld County, its employees, volunteers and agents. Contractor shall provide the liability insurances (including professional liability insurances where necessary) and worker's compensation insurances for all its employees, volunteers, and agents engaged in the performance of this Agreement which are required under Weld County's Request for Proposal, and required by the Colorado Worker's Compensation Act. Contractor shall provide the Department with the acceptable evidence that such coverage is in effect prior to execution of this Agreement. At a minimum, Contractor shall procure, either personally or through its employer as applicable to the Contractor's business, at its own expense, and maintain for the duration of the work, insurance coverage 5 listed in this agreement. The Board of County Commissioners of Weld County and its Officers/Employees shall be named as additional insured. a. General Requirements: Contractors must secure, at or before the time of execution of any agreement or commencement of any work, the following insurance covering all operations, goods or services provided pursuant to this request. Contractors shall keep the required insurance coverage in force at all times during the term of the Agreement, or any extension thereof, and during any warranty period. The required insurance shall be underwritten by an insurer licensed to do business in Colorado and rated by A.M. Best Company as "A"VIII or better. Each policy shall contain a valid provision or endorsement stating "Should any of the above -described policies by canceled or should any coverage be reduced before the expiration date thereof, the issuing company shall send written notice to the Weld County Director of General Services by certified mail, return receipt requested. Such written notice shall be sent thirty (30) days prior to such cancellation or reduction unless due to non-payment of premiums for which notice shall be sent ten (10) days prior. If any policy is in excess of a deductible or self -insured retention, the Department must be notified by the Contractor. Contractor shall be responsible for the payment of any deductible or self -insured retention. The Department reserves the right to require Contractor to provide a bond, at no cost to the Department, in the amount of the deductible or self -insured retention to guarantee payment of claims. The insurance coverages specified in this Agreement are the minimum requirements, and these requirements do not decrease or limit the liability of Contractor. Contractor shall maintain, at its own expense, any additional kinds or amounts of insurance that it may deem necessary to cover its obligations and liabilities under this Agreement. b. Types of Insurance: Contractor shall obtain, and maintain at all times during the term of any Agreement, insurance in the following kinds and amounts: i.Workers' Compensation Insurance as required by state statute, and Employer's Liability Insurance covering all of Contractor's employees acting within the course and scope of their employment. If Contractor is an Independent Contractor, as defined by the Colorado Worker's Compensation Act, this requirement shall not apply. Contractor must submit to the Department a Declaration of Independent Contractor Status Form prior to the start of this agreement. ii.Commercial General Liability Insurance written on ISO occurrence form CG 00 01 10/93 or equivalent, covering premises operations, fire damage, independent Contractors, products and completed operations, blanket contractual liability, personal injury, and advertising liability with minimum limits as follows: - $1,000,000 each occurrence; - $2,000,000 general aggregate; - $50,000 any one fire; and - $500,000 errors and omissions. iii.Automobile Liability: Contractor shall maintain limits of $1,000,000 for bodily injury per person, $1,000,000 for bodily injury for each accident, and $1,000,000 for property damage applicable to all vehicles operating both on County property and elsewhere. iv.Additional Provisions: Policies for all general liability, excess/umbrella liability, liquor liability and pollution liability must provide the following: If any aggregate limit is reduced by twenty-five percent (25%) or more by paid or reserved claims, Contractor shall notify the Department within ten (10) days and reinstate the aggregates required; Unlimited defense costs in excess of policy limits; Contractual liability covering the indemnification provisions of this Agreement; A severability of interests provision; Waiver of exclusion for lawsuits by one insured against another; 6 - A provision that coverage is primary; and - A provision that coverage is non-contributory with other coverage or self-insurance provided by the Department. v.For all general liability, excess/umbrella liability, liquor liability, pollution liability and professional liability policies, if the policy is a claims -made policy, the retroactive date must be on or before the contract date or the first date when any goods or services were provided to the Department, whichever is earlier. c. Contractors shall secure and deliver to County's Risk Administrator ("Administrator") at or before the time of execution of this Agreement, and shall keep in force at all times during the term of the Agreement as the same may be extended as herein provided, a commercial general liability insurance policy, including public liability and property damage, in form and company acceptable to and approved by said Administrator, covering all operations hereunder set forth in the related Bid or Request for Proposal. d. Proof of Insurance: Contractor shall provide a copy of this information to its insurance agent or broker and shall have its agent or broker provide proof of Contractor's required insurance. The Department reserves the right to require Contractor to provide a certificate of insurance, a policy, or other proof of insurance as required by the County's Risk Administrator in his sole discretion. e. Additional Insureds: For general liability, excess/umbrella liability, pollution legal liability, liquor liability, and inland marine, Contractor's insurer shall name County as an additional insured. f. Waiver of Subrogation: For all coverages, Contractor's insurer shall waive subrogation rights against County. g. Subcontractors: All subcontractors, independent contractors, sub -vendors, suppliers or other entities providing goods or services required by this Agreement shall be subject to all of the requirements herein and shall procure and maintain the same coverages required of Contractor. Contractor shall include all such subcontractors, independent contractors, sub -vendors, suppliers or other entities as insureds under its policies or shall ensure that all subcontractors maintain the required coverages. Contractor agrees to provide proof of insurance for all such subcontractors, independent contractors, sub -vendors, suppliers or other entities upon request by the Department. A provider of Professional Services shall provide the following coverage: Professional Liability: Contractor shall maintain limits of $1,000,000 for each claim, and $2,000,000 aggregate limit for all claims. 10. Certification Contractor certifies that, at the time of entering into this Agreement, it has currently in effect all necessary licenses, approvals, insurance, etc., required to properly provide the services and/or supplies covered by this Agreement. Copies of all necessary licenses shall be provided to the Department by the Contractor prior to the start of any Agreement. 11. Training Contractor may be required to attend training at the request of the Department specific to services provided under this Agreement. The Department will not compensate the Contractor for said training in the form of registration fees, time spent traveling to and from training, attending the training or any other associated costs unless otherwise agreed to by the Department. 7 12. Subpoenas Contractor will, on behalf of its employees and/or officers, accept any subpoena for testimony from the Weld County Attorney's Office by e-mail and will return a waiver of services within 72 business hours. For this purpose, Contractor will designate an e-mail address prior to the start of this Agreement. If the Contractor receives a subpoena via e-mail but will only accept personal service, the Contractor will contact the Weld County Attorney's Office immediately at (970) 336-7235 and advise that the subpoena must be personally served. 13. Monitoring and Evaluation Contractor and the Department agree that monitoring and evaluation of the performance of this Agreement shall be conducted by the Contractor and the Department. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners, the Department and the Contractor. Contractor will collaborate in a timely manner with the Department to resolve issues pertaining to service delivery, service quality, documentation, and invoicing during referral period and after services have concluded. The Contractor will require clients sign releases of information. Contractor understands that the Department will not reimburse for services rendered to Department clients until releases of information are obtained. Contractor shall permit the Department, and any other duly authorized agent or governmental agency, to monitor all activities conducted by the Contractor pursuant to the terms of this Agreement. The monitoring agency may, if in its sole discretion deems necessary or appropriate, have access to any program data, special analyses, on -site checking, formal audit examinations, or any other reasonable procedures for purposes of monitoring. All such monitoring shall be performed in a manner that will not unduly interfere with the work conducted under this Agreement. 14. Modification of Agreement All modifications to this Agreement shall be in writing and signed by both parties. 15. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: - Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed. - Deny payment or recover reimbursement for those services or deliverables, which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Department. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to the Department. - Incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation shall be recovered from Contractor by deduction from subsequent payments under this Agreement or other agreements between the Department and Contractor, or by the Department as a debt due to the Department or otherwise as provided by law. 16. Representatives For the purpose of this Agreement, the individuals identified below are hereby designated representatives 8 of the respective parties. Either party may from time to time designate in writing a new or substitute representative(s). For Department: For Contractor: Heather Walker, Child Welfare Division Head Lindsey Spraker, Executive Director 17. Notice All notices required to be given by the parties hereunder shall be given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing a substitute person(s) or address to whom such notices shall be sent. For Department: Jamie Ulrich, Director P.O. Box A Greeley, CO 80632 (970) 400-6510 18. Litigation For Contractor: Lindsey Spraker, Executive Director 7175 West Jefferson Avenue, Suite 4000 Lakewood, Colorado 80235 (303) 573-0839 Contractor shall promptly notify the Department in the event that Contractor learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement. Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any Federal or State court or administrative agency, shall deliver copies of such document(s) to the Director of Human Services. The term "litigation" includes an assignment for the benefit of creditors, and filings of bankruptcy, reorganization and/or foreclosure. 19. Termination This Agreement may be terminated at any time by either party giving thirty (30) days written notice to the individuals identified in paragraph 17. No portion of this Agreement shall be deemed to create an obligation on the part of the County of Weld, State of Colorado, to expend funds not otherwise appropriated in each succeeding year, as this Agreement is subject to the availability of funding. Therefore, the Department may terminate this Agreement at any time if the source of funding for the services made available to the Contractor is no longer available to the Department, or for any other reason. Contractor reserves the right to suspend services to clients if funding is no longer available. 20. No Third -Party Beneficiary Enforcement It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 21. Governmental Immunity No term or condition of this contract shall be construed or interpreted as a waiver, express or implied, of any of the immunities, rights, benefits, protections or other provisions, of the Colorado Governmental Immunity Act of §§24-10-101 et. seq., as applicable now or hereafter amended. 22. Partial Invalidity of Agreement If any section, subsection, paragraph, sentence, clause, or phrase of this Agreement is for any reason held or decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The 9 parties hereto declare that they would have entered into this Agreement and each and every section, subsection, paragraph, sentence, clause, and phrase thereof irrespective of the fact that any one or more sections, subsections, paragraphs, sentences, clauses, or phrases might be declared to be unconstitutional or invalid. 23. Improprieties/Conflict of Interest No officer, member or employee of Weld County and no member of their governing bodies shall have any pecuniary interest, direct or indirect, in the approved Agreement or the proceeds thereof. The Appearance of Conflict of Interest applies to the relationship of a Contractor with the Department when the Contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest, it is not necessary for the Contractor to gain from knowledge of these opposing interests. It is only necessary that the Contractor know that the two relationships are in opposition. During the term of the Agreement, Contractor shall not enter into any third -party relationship that gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation, Contractor shall submit to the Department, a full disclosure statement setting forth the details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for the Department's termination, for cause, of its Agreement with the Contractor. A conflict of interest or appearance of a conflict of interest may also apply to personal relationships between providers and clients. If a provider has a personal relationship with a client to whom the Contractor may provide services for, the Contractor must disclose that relationship to the Department. Contractor certifies that Federal appropriated funds have not been paid or will be paid, by or on behalf of Contractor, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of an Federal contract, loan, grant, or cooperative agreement. 24. Storage, Availability and Retention of Records Contractor agrees that authorized local, Federal, and State auditors and representatives shall, during business hours, have access to inspect and copy records, and shall be allowed to monitor and review through on -site visits, all activities related to this Agreement, supported with funds under this Agreement, to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. All such records, documents, communications, and other materials created pursuant or related to this Agreement shall be maintained by the Contractor in a central location and shall be made available to the Department upon its request, for a period of seven (7) years from the date of final payment under this Agreement, or for such further period as may be necessary to resolve any matters which may be pending, or until an audit has been completed with the following qualifications: If an audit by or on behalf of the Federal and/or State government has begun but is not completed at the end of the seven (7) year period, or if audit findings have not been resolved after a seven (7) period, the materials shall be retained until the resolution of the audit finding. 25. Confidentiality of Records Contractor shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Agreement except for purposes directly connected with the administration of Child Protection. No information about or obtained from any applicant/recipient in possession of Contractor shall 10 be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with the Contractor's written policy governing access to, duplication and dissemination of, all such information, in any form, including social networks. Contractor shall advise its employees, agents, and subcontractor, if any, that they are subject to these confidentiality requirements. Contractor shall provide its employees, agents, and subcontractors, if any, with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. Contractor shall have its employees, agents, and subcontractors, if any, sign a written confidentiality agreement and shall provide a copy of such agreement to the Department, if requested. 26. Proprietary Information Proprietary information for the purposes of this Agreement is information relating to a party's research, development, trade secrets, business affairs, internal operations and management procedures and those of its customers, clients or affiliates, but does not include information (1) lawfully obtained from third parties, (2) that which is in the public domain, or (3) that which is developed independently. Neither party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of this Agreement. Any proprietary information removed from the Department's site by the Contractor in the course of providing services under this Agreement will be accorded at least the same precautions as are employed by the Contractor for similar information in the course of its own business. 27. Independence of Contractor: Not an Employee of Weld County Contractor agrees that it is an independent Contractor and that Contractor's officers, agents or employees will not become employees of County, nor entitled to any employee benefits from County as a result of the execution of this Agreement. Contractor shall perform its duties hereunder as an independent Contractor. Contractor shall be solely responsible for its acts and those of its agents and employees for all acts performed pursuant to this Agreement. Contractor, its employees and agents are not entitled to unemployment insurance or workers' compensation benefits through County and County shall not pay for or otherwise provide such coverage for Contractor or any of its agents or employees. Unemployment insurance benefits will be available to Contractor and its employees and agents only if such coverage is made available by Contractor or a third party. Contractor shall pay when due all applicable employment taxes and income taxes and local head taxes (if applicable) incurred pursuant to this Agreement. Contractor shall not have authorization, express or implied, to bind County to any agreement, liability or understanding, except as expressly set forth in this Agreement. Contractor shall have the following responsibilities with regard to workers' compensation and unemployment compensation insurance matters: (a) provide and keep in force workers' compensation and unemployment compensation insurance in the amounts required by law, and as set forth in Exhibit C, provide proof thereof when requested to do so by County. 28. Entire Agreement This Agreement, together with all attachments hereto, constitutes the entire understanding between the parties with respect to the subject matter hereof, and may not be changed or modified except as state in Paragraph 14 herein. This Agreement shall be binding upon the parties hereto, their successors, heirs, legal representatives, and assigns. The Contractor and the Department may not assign any of its rights or obligations hereunder without the prior consent of both parties. 29. Agreement Nonexclusive This Agreement does not guarantee any work nor does it create an exclusive agreement for services. 30. Warranty The Contractor warrants that services performed under this Agreement will be performed in a manner 11 consistent with the professional standards governing such services and the provisions of this Agreement. The Contractor shall faithfully perform the work in accordance with the standards of care, skill, training, diligence and judgment provided by highly competent individuals and entities that perform services of a similar nature to those described in this Agreement including Exhibits A, B, C, and D. 31. Acceptance of Services Not a Waiver Upon completion of the work, the Contractor shall submit to the Department originals of all tests and results, reports, and other similar items, generated during completion of this work. Acceptance by the Department of reports and incidental material(s) furnished under this Agreement shall not in any way relieve the Contractor of responsibility for the quality and accuracy of the services. In no event shall any action by the Department hereunder constitute or be construed to be a waiver by the Department of any breach of covenant or default which may then exist on the part of the Contractor, and the Department's action or inaction when any such breach or default shall exist shall not impair or prejudice any right or remedy available to the Department with respect to such breach or default; and no assent, expressed or implied, to any breach of any one or more covenants, provisions or conditions of the Agreement shall be deemed or taken to be a waiver of any other breach. Acceptance by the Department of, or payment for, any services performed under this Agreement shall not be construed as a waiver of any of the Department's rights under this Agreement or under the law generally. 32. Employee Financial Interest/Conflict of Interest. C.R.S. §,$24-18-201 et seq. and $24-50-507 The signatories to this Agreement aver that to their knowledge, no employee of Weld County has any personal or beneficial interest whatsoever in the service or property which is the subject matter of this Agreement. The Contractor has no interest and shall not acquire any interest direct or indirect, which would in any manner or degree with the performance of the Contractor's services and the Contractor, shall not employ any person having such known interests. During the term of this Agreement, the Contractor shall not engage in any in any business or personal activities or practices or maintain any relationships which actually conflicts with or in any way appear to conflict with the full performance of its obligations under this Agreement. Failure by the Contractor to ensure compliance with this provision may result, in the Department's sole discretion, in immediate termination of this Agreement. No employee of the Contractor nor any member of the Contractor's family shall serve on a County Board, committee or hold any such position which either by rule, practice or action nominates, recommends, supervises Contractor's operations, or authorizes funding to the Contractor. 33. Board of County Commissioners of Weld County Approval This Agreement shall not be valid until it has been approved by the Board of County Commissioners of Weld County, Colorado. 34. Choice of Law/Jurisdiction Colorado law, and rules and regulations established pursuant thereto, shall be applied in the interpretation, execution, and enforcement of this Agreement. Any provision included or incorporated herein by reference which conflicts with said laws, rules and/or regulations shall be null and void. In the event of a legal dispute between the parties, Contractor agrees that the Weld County District Court shall have exclusive jurisdiction to resolve said dispute. 35. Subcontractors Contractor acknowledges that the Department has entered into this Agreement in reliance upon the particular reputation and expertise of Contractor. Contractor shall not enter into any subcontractor agreements for the completion of this project without the Department's prior written consent, which may be withheld in the Department's sole discretion. 36. Attorney's Fees/Legal Costs 12 In the event of a dispute between the Department and Contractor, concerning this Agreement, the parties agree that each party shall be responsible for the payment of attorney fees and/or legal costs incurred by or on its own behalf. 37. Ownership All work and information obtained by Contractor under this Agreement or individual work order shall become or remain (as applicable), the property of the Department. In addition, all reports, documents, data, plans, drawings, records and computer files generated by Contractor in relation to this Agreement and all reports, test results and all other tangible materials obtained and/or produced in connection with the performance of this Agreement, whether or not such materials are in completed form, shall at all times be considered the property of the Department. Contractor shall not make use of such material for purposes other than in connection with this Agreement without prior written approval of the Department. 38. Interruptions Neither party to this Agreement shall be liable to the other for delays in delivery or failure to deliver or otherwise to perform any obligation under this Agreement, where such failure is due to any cause beyond its reasonable control, including but not limited to Acts of God, fires, strikes, war, flood, earthquakes or Governmental actions. 39. Severability If any term or condition of this Agreement shall be held to be invalid, illegal, or unenforceable by a court of competent jurisdiction, this Agreement shall be construed and enforced without such provision, to the extent that this Agreement is then capable of execution within the original intent of the parties. IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. COUNTY: ATTEST: a/. ki uC O►t , By: BOARD OF COUNTY COMMISSIONERS W e County Clerk to the Bo rd WELD COUNTY, COLORADO Deputy Clerk t./ he Bo .i d R'� \ i 13 Mike Freeman, Pro—Tem ONTRACTOR: ifelong, Inc. 7175 West Jefferson Avenue, Suite 4000 Lakewood, Colorado 80235 (303) 573-0839 Li rdeer&i-i% i- By: Lindsey Spra ( y 31, 2022 15:09 MDT) Lindsey Spraker, Executive Director Date: May 31, 2022 JUN 0 8 2022 �Oo?o2 -/59 EXHIBIT A SCOPE OF SERVICES Contractor will provide Aftercare Services, Crisis Intervention and Stabilization Services, Anger Management/Domestic Violence, Foster Parent Consultation, Foster Parent Training, Home -Based Intervention, Kinship Services (Therapeutic), Life Skills, Mental Health Services, and Substance Abuse Treatment Services, as referred by the Department. Program Area: Aftercare Services 1. Applied Behavior Analysis (ABA) — Board Certified Behavior Analyst (BCBA) a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Applied Behavior Analysis (ABA) as primary modality ii. Trauma -informed iii. Assessments including but not limited to: Functional Behavior Assessment (FBA), Functional Assessment Screening Tools (FAST), Functional Analysis (only when clinically indicated), skills assessments, adaptive functioning scales, Vineland III, developmental assessments, Autism screening tools, Verbal Behavior Milestones Assessment and Placement Program (VBMAPP), Assessment of Basic Language and Living Skills (ABLLS), Assessment of functional living skills (AFLS), Essentials for Living (EFLS). iv. All assessments are used to allocate baseline data, identify skill deficits, and drive curriculum for treatment goals. v. Assessment is ongoing and all treatment decisions are driven by data collected in every session reflecting progress on each goal and behavior. b. Anticipated Frequency of Services: i. ABA is highly dependent on a thorough, individualized assessment. Service recommendations can range from one (1) to forty (40) hours per week of treatment. c. Anticipated Duration of Services: i. ABA services can range from a short term focused treatment for six (6) months or may extend longer depending on the individual's needs and abilities. d. Goals of Services: i. Identify skill deficits and develop skill acquisition programming to be taught using the principles of ABA. ii. Mediate and reduce the negative effects of challenging behaviors on the individual and caregivers. iii. Develop and implement behavior intervention strategies to reduce behaviors targeted for reduction. iv. Conduct ongoing parent/caregiver required training on skill teaching and behavior intervention strategies using a trauma-informed/preventative approach. e. Outcomes of Services: i. Prevent or reduce behaviors that put individuals or their caregivers/family members at risk of harm. ii. Prevent or reduce behaviors that limit an individual's ability to access their home, school, community, and establish and maintain meaningful relationships. iii. Increase communication and social skills. iv. Increase independence to the highest level possible and establish skills that contribute to mental and physical health and hygiene. 1 f. Target Population: i. Individuals of all ages, genders, abilities and diagnoses, unless clinically contraindicated or a diagnosis for the person or child involves a symptomology that requires medical intervention as the primary treatment. g. Language: i. English and Spanish (proficient) — no interpreter services are available. h. Medicaid Eligibility: i. This service may be Medicaid eligible for qualified individuals through EPSDT with a doctor's referral prescribing ABA as a medically necessary treatment for individuals' specific diagnosis. i. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. 2. Applied Behavior Analysis (ABA) — Behavior Technician a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Primary modality being ABA. ii. Behavior Technician's (BT's) work directly with the client, under supervision, to implement the skill teaching program and behavior interventions designed by the Board - Certified Behavior Analyst (BCBA). b. Anticipated Frequency of Services: i. ABA is highly dependent on a thorough individualized assessment. Service recommendations can range from one (1) to forty (40) hours per week. c. Anticipated Duration of Services: i. ABA services can range from a short term focused treatment for six (6) months or may extend longer depending on the individual's needs and abilities. d. Goals of Services: i. Identify skill deficits and develop skill acquisition programming to be taught using the principles of ABA. ii. Mediate and reduce the negative effects of challenging behaviors on the individual and caregivers. iii. Develop and implement behavior intervention strategies to reduce behaviors targeted for reduction. iv. Conduct ongoing parent/caregiver required training on skill teaching and behavior intervention strategies using a trauma -informed / preventative approach. e. Outcomes of Services: i. Prevent or reduce behaviors that put individuals or their caregivers/family members at risk of harm. ii. Prevent or reduce behaviors that limit an individual's ability to access their home, school, community, and establish and maintain meaningful relationships. iii. Increase communication and social skills. iv. Increase independence to the highest level possible and establish skills that contribute to mental and physical health and hygiene. f. Target Population: 2 i. Individuals of all ages, genders, abilities and diagnoses, unless clinically contraindicated or a diagnosis for the person or child involves a symptomology that requires medical intervention as the primary treatment. g. Language: i. English and Spanish (proficient) — no interpreter services are available. h. Medicaid Eligibility: i. This service may be Medicaid eligible for qualified individuals through EPSDT with a doctor's referral prescribing ABA as a medically necessary treatment for individuals' specific diagnosis. i. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. 3. Social Skills Group a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Social skills checklists are utilized to assess skills and identify pairs or groups of individuals who would work effectively together on mutual goals that are appropriate for their age and development. b. Anticipated Frequency of Services: i. One (1) to two (2) times per week for one (1) or more hours depending on size of group and abilities. c. Anticipated Duration of Services: i. Eight (8) weeks per cohort. d. Goals of Services: i. Identify individuals who could benefit from facilitated social skills practice in a group setting. ii. Provide safe, monitored, and facilitated activities that support individuals' social skills practice in a group setting. iii. Provide peer modeling opportunities for individuals with social skills deficits. iv. Promote the development of necessary social skills and safe ways to connect and interact with peers. e. Outcomes of Services: i. Increase clients' access to safe opportunities to practice social skills and develop meaningful relationships. ii. Increase clients' ability to generalize social skills to new individuals in a new setting. iii. Increase the connections and opportunities to create a community for individuals with intellectual disabilities. f. Target Population: i. Children and adults that have been assessed and identified as a candidate for group processing. g. Language: i. English, Spanish, (proficient) — no interpreter services available h. Medicaid Eligibility: 3 i. This service is not Medicaid eligible. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. 4. Trauma Processing Group a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Trauma informed approaches and materials, depression and anxiety scales, Post - Traumatic Stress Disorder (PTSD) assessments as prescribed by the group facilitators as needed. b. Anticipated Frequency of Services: i. One (1) time per week for one (1) to two (2) hours. c. Anticipated Duration of Services: i. Three (3) to six (6) months. d. Goals of Services: i. Provide a safe setting for individuals who have been assessed and identified as a candidate for which group processing may be beneficial. ii. Facilitate the development of a supportive working group in which individuals can share, relate to others and process traumatic experiences. iii. Provide psychoeducation to group members to promote skill development for management of symptoms of PTSD and other trauma related behaviors and symptomology. e. Outcomes of Services: i. Individuals access opportunities to process trauma and begin a healing process in a safe and supportive group that is goal oriented and facilitated. ii. Individuals demonstrate the ability to establish and maintain self -care and coping practices while sharing connection and accountability with their group peers. iii. Individuals experience safety and acceptance that allows for integration of skills and mental health treatment. f. Target Population: i. Youth and adults that have been assessed and identified as a candidate for group processing. g. Language: i. English, Spanish, (proficient) — no interpreter services available h. Medicaid Eligibility: i. This service is not Medicaid eligible. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235, virtually, or in the client's home. ii. The contractor will not be transporting clients. Program Area: Anger Management 1. Domestic Violence Intake 4 a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Domestic Violence Offender Management Board (DVOMB) approved intake and assessment materials. b. Anticipated Frequency of Services: i. Two (2) to five (5) hours. c. Anticipated Duration of Services: i. One (1) to two (2) sessions. d. Goals of Services: i. Completion of intake. e. Outcomes of Services: i. Completion of intake. f. Target Population: i. Persons identified as at risk of or known domestic violence involvement with or without police contact or child welfare involvement. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. 2. Domestic Violence Evaluation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Clinical Assessment Interview. ii. Domestic Violence Risk and Needs Assessment (DVRNA). iii. Spousal Assault Risk Assessment Guide — 3 (SARA — 3). iv. CAGE -AID Substance Abuse Screening Tool. v. Alcohol Use Disorders Identification Test (AUDIT). vi. Scoring the States of Change Readiness and Treatment Eagerness Scale (SOCRATES 8A/8D). vii. Ohio State University Traumatic Brain Injury Identification Method (OSU-TBI). viii. Mini -Mental State Examination (MMSE). ix. Brief Resiliency Scale (BRS). x. Beck Anxiety Inventory (BAI). xi. Beck Depression Inventory (BDI). xii. Level 2 - Anger — Adult. xiii. Substance Abuse Subtle Screening Inventory (SASSI). xiv. Personality Inventory for Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5) — Brief Form (PID-BF) — Adult. xv. World Health Organization Disability Assessment Schedule (WHODAS) 2.0. xvi. Personality Assessment Screener (PAS). xvii. Adverse Childhood Experiences (ACE) Questionnaire. 5 b. Anticipated Frequency of Services: i. Three (3) to seven (7) hours. c. Anticipated Duration of Services: i. Each evaluation and assessment summary and recommendations will be completed within fifteen (15) to thirty (30) days of the first appointment. d. Goals of Services: i. Assess and identify treatment needs of the client. ii. Determine the level of treatment intensity required for domestic violence services. iii. Establish recommendations for immediate and long-term safety planning. e. Outcomes of Services: i. Completion of evaluation. f. Target Population: i. Persons identified as at risk of or known domestic violence involvement with or without police contact or child welfare involvement. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. 3. Domestic Violence Group Treatment a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Cognitive Behavior Therapy (CBT). ii. Dialectical Behavioral Therapy (DBT). iii. Trauma Focused Cognitive Behavioral Therapy (TF-CBT). iv. Motivational Interviewing (MI). v. Duluth model. vi. Multimodal approaches. b. Anticipated Frequency of Services: i. One (1) group per week. c. Anticipated Duration of Services: i. Duration will be case specific. d. Goals of Services: i. Reduce and manage mental health triggers. ii. Increase the ability to demonstrate understanding of cycle of violence, power and control. iii. Increase ability to demonstrate self-awareness and identify triggers. iv. Increase ability to reflect on self in the group setting. v. Interact with peers in the group setting, demonstrating accountability, competency achievement, and vulnerability. 6 vi. Identify precursors to violence and engage in preventive strategies to self -regulate and manage impulses. e. Outcomes of Services: i. Successful engagement in the group therapy dynamic. ii. Successful daily practice of self -care and coping skills. iii. Successful use of coping skills during conflict or crisis. iv. Successful reunification or other successful case closure. f. Target Population: i. Clients with various diagnosed or suspected disabilities, age four (4) to one hundred (100). ii. Individuals, dyads, and families. g. Language: i. English and Spanish (proficient) — no interpreter services are available. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. 4. Domestic Violence Individual Treatment a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Cognitive Behavior Therapy (CBT). ii. Dialectical Behavioral Therapy (DBT). iii. Trauma Focused Cognitive Behavioral Therapy (TF-CBT). iv. Motivational Interviewing (MI). v. Duluth model. vi. Multimodal approaches . b. Anticipated Frequency of Services: i. One (1) to two (2) sessions per week, dependent on individual needs. c. Anticipated Duration of Services: i. Duration will be case specific. d. Goals of Services: i. Reduce and manage mental health triggers. ii. Increase the ability to demonstrate understanding of cycle of violence, power and control. iii. Increase ability to demonstrate self-awareness and identify triggers. iv. Increase ability to reflect and self -evaluate, identify precursors to violence, and engage in preventive strategies to self -regulate and manage impulses. v. Increase ability to identify criteria for safe and healthy interactions and relationships. vi. Increase ability to demonstrate protective skills of self and dependents. e. Outcomes of Services: i. Successful engagement in individual therapy process regarding offense specific behavior reduction. ii. Successful daily practice of self -care and coping skills. 7 iii. Successful use of coping skills during conflict or crisis. iv. Successful reunification or other successful case closure. f. Target Population: i. Clients age four (4) to one hundred (100). g. Language: i. English and Spanish (proficient) — no interpreter services are available. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. 5. Caring Dads a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. The Caring Dads parenting group is a curriculum driven and facilitated opportunity for men to obtain and practice parenting skills and connect with other men as fathers. b. Anticipated Frequency of Services: i. One (1) time per week. c. Anticipated Duration of Services: i. Seventeen (17) weeks. d. Goals of Services: i. Improve and strengthen the father/child relationship. ii. Learn child centered parenting skills and strategies to manage stress and frustration. iii. Identify and self -reflect on the impact of previous conflictual strategies on familial relationships. e. Outcomes of Services: i. Reduce recidivism of child welfare contact for participating families. ii. Successful case closure via reunification or maintenance of custody or in -home placement. iii. Create community connections and relationships for fathers. f. Target Population: i. Parents with children, fathers who have demonstrated parenting challenges that resulted in child protection concerns, fathers struggling with parenting children with challenging behaviors or special behavioral needs. g. Language: i. English j. Medicaid Eligibility: ii. This service is not Medicaid eligible. k. Service Access and Transportation: iii. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. 8 iv. The contractor will not be transporting clients. 6. High Conflict Co -Parenting a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Group therapy. ii. Curriculum driven and skill acquisition focused. iii. Parents in high -conflict separations, child welfare cases, divorces, or requiring mediation attend the groups separately. iv. Skills focused on conflict resolution, communication skills, stress management, and protection of involved children. b. Anticipated Frequency of Services: i. One (1) time per week. c. Anticipated Duration of Services: i. Twelve (12) weeks. d. Goals of Services: ii. 1. Provide a safe environment for parents to connect, reflect, and learn ways to manage co -parenting challenges. iii. 2. Parents will develop skills to co -parent and communicate effectively, minimizing conflict. iv. 3. Parents will learn strategies to mediate stress and implement protective strategies to reduce emotional harm to involved children. e. Outcomes of Services: i. Reduce the occurrence of severe conflictual parenting interactions that result in violence, child protection involvement, and/or police contact. ii. Support parents to resolve contentious custody battles and resolve disagreements independently after supports fade. iii. Reduce emotional / physical harm to involved children. f. Target Population: i. Parents who have been identified as having co -parenting conflict that is unable to resolved without proper supports. h. Language: ii. English 1. Medicaid Eligibility: iii. This service is not Medicaid eligible. m. Service Access and Transportation: v. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. vi. The contractor will not be transporting clients. Program Area: Foster Parent Consultation 1. Foster Parent Consultation — Individuals/Families a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: 9 i. Modality may include trauma informed ABA (Applied Behavior Analysis) or other parent coaching curriculums specialized for parents fostering children. b. Anticipated Frequency of Services: i. Frequency is highly dependent on specific needs and behaviors the family identifies during assessment. c. Anticipated Duration of Services: i. The duration of services depends on the specific needs and behaviors the family identifies during the assessment and if child(ren) are also receiving services. d. Goals of Services: i. Provide foster parents with psychoeducation and resources that will prevent or limit burnout and stress. ii. Work with foster parents to identify preventative and environmental modifications that will enhance structure and predictability in their home. iii. Connect foster parents with other necessary resources or services. e. Outcomes of Services: i. Prevent placement disruptions for involved children. ii. Support the placement to improve health and safety for the family unit. iii. Identify the need for additional or longer -term support and services. f. Target Population: i. Foster parents in need of consultation to address a specific concern or improve the overall placement success of their home. g. Language: i. English and Spanish (fluent). h. Medicaid Eligibility: i. This service is not Medicaid eligible. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. 2. Foster Parent Consultation — Groups a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Modality may include Trauma Informed ABA (Applied Behavior Analysis) or other parent coaching curriculums specialized for parent groups fostering children. b. Anticipated Frequency of Services: i. Frequency is highly dependent on specific needs and behaviors of the groups of families identified during/after assessment. c. Anticipated Duration of Services: i. The duration of services depends on the specific needs and behaviors of each of the families identified during/after assessment and if child(ren) are also receiving services. d. Goals of Services: i. Provide foster parent groups with psychoeducation and resources that will prevent or limit burnout and stress. 10 ii. Work with foster parent groups to identify preventative and environmental modifications that will enhance structure and predictability in their home. iii. Connect foster parent groups with other necessary resources or services. e. Outcomes of Services: i. Prevent placement disruptions for involved children. ii. Support the placement to improve health and safety for the family unit. iii. Identify the need for additional or longer -term support and services. f. Target Population: i. Foster parent groups in need of consultation to address a general concern or improve the overall placement success of their home. g. Language: i. English and Spanish (fluent). h. Medicaid Eligibility: i. This service is not Medicaid eligible. Service Access and Transportation: i. Services will take place virtually or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. Program Area: Foster Parent Training 1. Foster Parent Training — Various a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Trauma informed ABA (Applied Behavior Analysis), parent coaching curriculums specialized for parents fostering children, and trauma informed trainings. ii. Attachment/trauma focused therapy and psychoeducation. b. Anticipated Frequency of Services: i. Frequency will depend on the needs as requested by the Department. c. Anticipated Duration of Services: i. Duration will depend on the needs as identified by the Department. d. Goals of Services: i. Provide psychoeducation to foster parents regarding attachment trauma and associated symptoms and behaviors. ii. Provide foster parents with skills and training to support the development and maintenance of strategies that promote safety and prevent or limit the occurrence of behavioral challenges that can lead to additional trauma and /or disruption of the placement. iii. Provide foster parents with a safe and understanding support system in which they can process the challenges of foster parenting and learn self -care and coping skills. e. Outcomes of Services: i. Preservation of placement. ii. Reduction in the number of placement changes a child experiences while in foster care. iii. Reduction in foster parent burn out and stressors associated with foster care. f. Target Population: i. Foster Parents. 11 g. Language: iii. English and Spanish (fluent). h. Medicaid Eligibility: i. This service is not Medicaid eligible. Service Access and Transportation: i. Services will take place virtually, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. Program Area: Home -Based Intervention 2. Home -Based Interventions — Intensive a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Individual and/or family therapy, therapeutic life skills, Applied Behavior Analysis, and a variety of our services provided by master level clinicians in the home environment of the individual. Modality for therapeutic interventions determined by clinician and based on clients' individual needs and abilities. Skills assessments may be utilized to determine curriculum and programming. b. Anticipated Frequency of Services: i. Three (3) to eight (8) hours per week, frequency will be based on individual needs and goals. c. Anticipated Duration of Services: i. Minimum of twelve (12) weeks based on individual needs and goals. d. Goals of Services: i. Provide most accessible therapeutic level interventions in client home. ii. Individuals will engage in skill acquisition and therapy with opportunity to demonstrate and maintain skills in their home environment. iii. Individuals will reflect on and process stressors, traumatic experiences, and associated emotions and behaviors. iv. Individuals will develop and maintain self -care and coping practices. e. Outcomes of Services: i. Increased ability to generalize and maintain learned skills over time in their home environments. ii. Reduced likelihood of out of home placement and court involvement for child protection concerns. iii. Reduced recidivism for child welfare contact and involvement. f. Target Population: i. Clients with various diagnosed or suspected disabilities, ages twelve (12) to one hundred (100). ii. Individuals, dyads, and families. g. Language: i. English and Spanish (proficient) — no interpreter services are available. h. Medicaid Eligibility: iv. This service is not Medicaid eligible. 12 i. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. 3. Home -Based Interventions — High a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Therapeutic life skills, Applied Behavior Analysis, Parent Training and Coaching and a variety of our services provided by master's level clinicians -in -training in the home environment of the individual. Modality for therapeutic interventions determined by clinician and based on clients' individual needs and abilities. b. Anticipated Frequency of Services: i. Three (3) to six (6) hours per week, frequency will be based on individual needs and goals. c. Anticipated Duration of Services: i. Minimum of eight (8) weeks based on individual needs and goals. d. Goals of Services: i. Provide most accessible therapeutic level interventions in client home. ii. Individuals will engage in skill acquisition and therapy with opportunity to demonstrate and maintain skills in their home environment. iii. Individuals will develop and maintain self -care and coping practices. e. Outcomes of Services: i. Increased ability to generalize and maintain learned skills over time in their home environments. ii. Reduced likelihood of out of home placement and court involvement for child protection concerns. iii. Reduced recidivism for child welfare contact and involvement. f. Target Population: i. Clients with various diagnosed or suspected disabilities, ages twelve (12) to one hundred (100). ii. Individuals, dyads, or families. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. 7. Home -Based Interventions — Moderate a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Can include life skills coaching, Applied Behavior Analysis, parenting skills, child development psychoeducation, and mentoring provided in the individual's home. 13 b. Anticipated Frequency of Services: iii. Two (2) to six (6) hours per week, based on individual needs and goals. c. Anticipated Duration of Services: i. Eight (8) to twelve (12) weeks, based on individual needs and goals. d. Goals of Services: i. Individuals will engage in skill acquisition opportunity to demonstrate and maintain skills in their home environment. ii. Individuals will develop and maintain self -care and coping practices. iii. Individuals will demonstrate an increased knowledge of safe parenting practices, awareness of child development, and the impact of trauma / abuse and neglect. e. Outcomes of Services: i. Increased ability to generalize and maintain learned skills over time in their home environments. ii. Reduced likelihood of out of home placement and court involvement for child protection concerns. iii. Reduced recidivism for child welfare contact and involvement. f. Target Population: i. Clients with various diagnosed or suspected disabilities, ages twelve (12) to one hundred (100). ii. Individuals, dyads, or families. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. Program Area: Kinship Services (Therapeutic) 1. Kinship Services (Therapeutic) a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Intensive Family Therapy, Applied Behavior Analysis (ABA), Caregiver Consultation, and Caregiver Training. b. Anticipated Frequency of Services: i. Two (2) hours per week minimum. c. Anticipated Duration of Services: i. Twelve (12) weeks minimum. Duration is highly dependent on case specifics, children's needs, and engagement of involved parties. d. Goals of Services: i. Provide supportive and comprehensive services to kinship placement providers. ii. Provide psychoeducation, therapy, skill acquisition, and prevention strategies to mediate challenges presented in kinship care. 14 iii. Provide Kinship caregivers with resources, community connections, and skills to develop coping practices. e. Outcomes of Services: i. Preservation of Kinship placement. ii. Improve quality and stability of relationships within kinship placement. iii. Prevent kinship provider burnout and reduce risk of harm in placement. f. Target Population: i. Clients with various diagnosed or suspected disabilities, ages twelve (12) to one hundred (100). ii. Individuals, dyads, or families. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. Program Area: Life Skills 1. Therapeutic Life Skills a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Approaches are highly individualized and dependent on the specific skill deficits and goals of the individual. May include but are not limited to role play practice of skills, direct support, prompting and prompt fading strategies, and naturalistic in -situation instruction. b. Anticipated Frequency of Services: i. Two (2) hours per week at a minimum, taking place over one (1) to three (3) sessions, depending on the client's needs. c. Anticipated Duration of Services: i. Duration will be case specific. d. Goals of Services: i. Provide skill acquisition training to individuals. ii. Provide safe therapeutic support in which clients social/emotional needs are respected and addressed in ways that will allow learning of skills and processing the emotions related to their challenges. iii. Individuals will increase their independence to the maximum potential possible for their abilities. iv. Individuals will secure and maintain resources that will allow them to meet their court ordered treatment goals. v. Individuals will improve the quality of their relationships, develop leisure skills that are healthy and sustainable. vi. Successful mental health management during stressful or triggering life skill activities. e. Outcomes of Services: i. Successful reunification or other successful case closure. 15 ii. Increased ability to access home and community resources. iii. Increased independence and ability to establish and maintain meaningful healthy relationships. iv. Increased ability to identify and maintain healthy supports and leisure skills that contribute to stable and predictable parenting. f. Target Population: i. Clients with various diagnosed or suspected disabilities, ages twelve (12) to one hundred (100). ii. Individuals, dyads, or families. g. Language: i. English and Spanish (proficient) — no interpreter services are available h. Medicaid Eligibility: i. This service is not Medicaid eligible. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. 2. Life Skills a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Approaches are highly individualized and dependent on the specific skill deficits and goals of the individual. May include but are not limited to role play practice of skills, direct support, prompting and prompt fading strategies, and naturalistic in -situation instruction. b. Anticipated Frequency of Services: i. Two (2) hours per week minimum, one (1) to three (3) sessions depending on the client's needs. c. Anticipated Duration of Services: i. Duration will be case specific. d. Goals of Services: i. Provide skill acquisition training to individuals. ii. Individuals will increase their independence to the maximum potential possible for their abilities. iii. Individuals will secure and maintain resources that will allow them to meet their court ordered treatment goals. e. Outcomes of Services: i. Successful reunification or other successful case closure. ii. Increased ability to access home and community resources. iii. Increased independence and ability to establish and maintain meaningful healthy relationships. iv. Increased ability to identify and maintain healthy supports and leisure skills that contribute to stable and predictable parenting. f. Target Population: i. Clients with various diagnosed or suspected disabilities, ages twelve (12) to one hundred (100). 16 ii. Individuals, dyads, or families. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. 3. Specialized Mentorship a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Based on the intake assessment, modalities or curriculum may include but are not limited to adventure based activities, participation and engagement in community activities, modeling, skill acquisition, role playing, and development of hobbies and interests. b. Anticipated Frequency of Services: i. Two (2) hours per week minimum, typically up to three (3) sessions per week. c. Anticipated Duration of Services: i. Six (6) to twelve (12) months. d. Goals of Services: i. Provide a safe, stable, consistent connection to individuals. ii. Individuals will develop and maintain skills that promote stability, independence, and physical/mental wellbeing. iii. Individuals will develop and maintain healthy leisure skills and increase self-worth and self-confidence by reducing risk taking behavior, acting out, substance use, and negative self -statements. e. Outcomes of Services: i. Reduce future police contact or juvenile justice system involvement. ii. Maintain placement in home or current stable living situation. iii. Increase school attendance and completion. iv. Increase awareness of mental health and resources to secure supports necessary to maintain wellbeing. v. Increase social/emotional skills and self -management. vi. Increase ability to advocate for self. vii. Increased communication skills. viii. Reduce symptoms of anxiety and depression. ix. Reduce self -harm. f. Target Population: i. Youth ages eight (8) to twenty-one (21) with or without suspected or diagnosed disability, criminal involvement, or child welfare involvement. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. 17 i. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor may transport clients. 4. Therapeutic Visitation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Therapeutic visitation will be provided by staff who have obtained higher levels of education or have extended years of experience in performing this service. Staff with this education and/or experience are able to provide higher levels of support during the visit. ii. Contractor is a member of the Supervised Visitation Network. The approach to therapeutic visitation is highly individualized and dependent on the specific skill deficits and goals of the individual regarding parenting needs, trauma responses, triggers, and other evidence -informed assessment and treatment approaches. iii. This service may include but is not limited to role play practice of parenting skills, direct support, prompting and prompt fading strategies, redirection, bonding, abuse intervening, structure, education, and repeat instruction. b. Anticipated Frequency of Services: i. Frequency will be dependent on each case. c. Anticipated Duration of Services: i. Duration will be dependent on each case. d. Goals of Services: i. Strengthen parent -child bond. ii. Assess for trauma responses. iii. Develop a family structure that is predictable, with protective parenting, and safe behaviors. e. Outcomes of Services: i. Increased parenting time for the identified parent. ii. Increased independent parenting. iii. Increased structure during visitation. f. Target Population: i. Clients with various diagnosed or suspected disabilities. ii. All ages. iii. Individuals, dyads, or families. g. Language: i. English and Spanish. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. At the Department, contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235, in the community, in the client's home, or virtually. 18 5. Supportive/Coached Visitation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Contractor is a member of the Supervised Visitation Network. The approach to supportive/coached visitation is highly individualized and dependent on the specific skill deficits and goals of the individual regarding parenting needs, trauma responses, triggers, and other evidence -informed assessment and treatment approaches. ii. This service may include but is not limited to role play practice of parenting skills, direct support, prompting and prompt fading strategies, redirection, bonding, abuse intervening, structure, education, and repeat instruction. b. Anticipated Frequency of Services: i. Frequency will be dependent on each case. c. Anticipated Duration of Services: i. Duration will be dependent on each case. d. Goals of Services: i. Strengthen parent -child bond. ii. Assess for trauma responses. iii. Develop a family structure that is predictable, with protective parenting, and safe behaviors. e. Outcomes of Services: i. Increased parenting time for the identified parent. ii. Increased independent parenting. iii. Increased structure during visitation. f. Target Population: i. Clients with various diagnosed or suspected disabilities. ii. All ages. iii. Individuals, dyads, or families. g. Language: i. English and Spanish. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. At the Department, contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235, in the community, in the client's home, or virtually. Program Area: Mental Health Services 1. Mental Health Therapy a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), Trauma Focused Cognitive Behavioral Therapy (TF-CBT), Abstinence -Based Treatment (ABT), Animal Assisted Therapy (AAT), Marriage and Family Therapy (MFT), Motivational Interviewing (MI), Parent -Child Interaction Therapy (PCIT). b. Anticipated Frequency of Services: 19 i. Frequency will be case specific depending on the severity of need/trauma/crisis. c. Anticipated Duration of Services: i. Duration will be case specific with recommendations based on assessment, client goals, and abilities, in addition to level of engagement. d. Goals of Services: i. Reduce and manage mental health triggers. ii. Reduce skill deficits within emotional regulation and coping practices. iii. Increase self-awareness and self -management skills. iv. Process traumatic experiences and develop understanding of their impact on current functioning and relationships. v. Increase the ability of the client to identify emotional, mental, and physical needs and advocate for themselves. e. Outcomes of Services: i. Successful use of coping skills during day-to-day interactions, conflict, or crisis. ii. Increased independence in accessing community activities, resources, and services. iii. Increased ability to demonstrate independent engagement in pro -social and safe leisure skills. iv. Ability to establish and maintain healthy and safe relationships. v. Successful achievement of court recommended goals. vi. Successful reunification or other successful case outcome. f. Target Population: i. Ages four (4) to one hundred (100), with various diagnosed or suspected disabilities/developmental disabilities. ii. Individuals, dyads, or families, staff/professionals in need of training. g. Language: i. English and Spanish (proficient) — no interpreter services available. h. Medicaid Eligibility: i. This service is not currently Medicaid eligible. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will be able to transport clients for Adventure Based Therapy (ABT) services, only. 2. Psychological Evaluation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Diagnostic tools, screeners, and assessments as determined by the psychologist. b. Anticipated Frequency of Services: i. Ten (10) to twelve (12) hours total including report preparation and feedback session. c. Anticipated Duration of Services: i. One (1) to three (3) appointments. d. Goals of Services: i. Generate accurate assessment of clients' diagnosis, strengths, needs, and areas of skill deficits. 20 ii. Generate a complete report of specialized recommendations for treatment and services tailored to the social/emotional, mental health, and learning needs of the individual. iii. Identify and determine course of treatment, treatment goals, and modality that is best suited for the individual. e. Outcomes of Services: i. Evaluation will provide data, summary, and outcome suggestions for client's learning, developmental, and mental health needs. f. Target Population: i. Client's age four (4) to one hundred (100). g. Language: i. English and Spanish (proficient) — no interpreter services available. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. 3. Neuropsychological Evaluation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Diagnostic tools, testing, screeners, and assessments as determined by the psychologist. b. Anticipated Frequency of Services: i. Ten (10) to fifteen (15) hours total. c. Anticipated Duration of Services: i. One (1) to three (3) appointments for testing and interview. d. Goals of Services: i. Assess clients' strengths and areas of skill deficits. ii. Conduct neuropsychological testing as prescribed. iii. Accurately test clients' current functioning and gather full history of the whole person. iv. Generate tailored recommendations for specialized services and modalities that will best support the client. e. Outcomes of Services: i. Accurate holistic understanding of client needs, diagnosis, and abilities. ii. Recommendations for specialized services. iii. Individualized and thorough report. f. Target Population: i. Client's age four (4) to one hundred (100). g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. 21 i. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. 4. Pediatric Diagnostic Evaluation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. The pediatric diagnostic evaluation consists of systematic observations, assessments, collateral documentation review, and testing that will yield evidence to support a diagnosis of an Autism Spectrum diagnose or another disorder. b. Anticipated Frequency of Services: i. Ten (10) to fifteen (15) hours of observation, interviewing, testing and collateral review. c. Anticipated Duration of Services: i. One (1) to three (3) appointments. d. Goals of Services: i. Obtain or rule out a diagnosis of a developmental disorder. ii. Procure a thorough assessment of where a child falls along the Autism Spectrum. iii. Gain an understanding of a child's intellectual potential. e. Outcomes of Services: i. Provide a treatment and education plan specifically geared towards the child's needs. ii. Provide education and resources to those providing care for the child. iii. Identify and connect the family with specialized support services and treatment options. f. Target Population: i. Children up to age eighteen (18) with suspected developmental disabilities or Autism Spectrum Disorder. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. 5. Parent Child Interaction Assessment a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Parent child interaction assessment utilizes prescribed evidence -based tools, observation techniques, and structured play scenarios based on the assessors training and current research. b. Anticipated Frequency of Services: i. Two (2) to three (3) hours of direct observation plus interviews and collateral documentation review. c. Anticipated Duration of Services: 22 i. Ten (10) to twelve (12) hours including report preparation and feedback session. d. Goals of Services: i. Gather data about parental attunement, attachment, relationship dynamics between parent and child. ii. Identify harmful or dysfunctional parenting attributes. iii. Present a thorough representation of the parent child relationship. e. Outcomes of Services: i. Generate specialized recommendations for therapeutic supports to improve the quality of the parent/child relationship. ii. Reduce the likelihood of future child welfare contact. iii. Predict likelihood of potential for future abuse and neglect. f. Target Population: i. All individuals including those with various diagnosed or suspected intellectual/developmental disabilities, dyads, and families. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. 6. Mental Health Evaluation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Clinical Interview, Adverse Childhood Experience (ACE) Questionnaire, Behavioral Rehabilitation Services (BRS), Ohio State University Traumatic Brain Injury (OSU-TBI), Diagnostic and Statistical Manual of Mental Disorders (DSM-V), Minnesota Multiphasic Personality Inventory (MMPI), Texas Success Initiative program (TSI), mental status exam, or others as determined during the interview. b. Anticipated Frequency of Services: i. Two (2) hours to four (4) hours. c. Anticipated Duration of Services: i. One (1) to two (2) appointments. d. Goals of Services: i. Conduct a thorough assessment of individuals' mental status, social/emotional skills and deficits, and adaptive functioning. ii. Identify individuals' current mental functioning and mental health diagnosis if indicated. iii. Assist individual in identifying areas of strength and need regarding their mental/emotional health. e. Outcomes of Services: i. Provide client and authorized Department service providers with a comprehensive assessment summary. 23 ii. Provide client and authorized Department service providers with specialized treatment recommendations for modalities and treatment options that are most effective for client's abilities and needs. iii. Provide psychoeducation to the client and/or guardian regarding client's mental status, symptomology, and diagnosis. iv. Connect client with resources which can meet their needs. f. Target Population: i. Individuals with various diagnosed or suspected intellectual/developmental disabilities, ages six (6) to one hundred (100), exhibiting challenges. g. Language: i. English and Spanish (proficient) — no interpreter services available. h. Medicaid Eligibility: i. This service may be Medicaid eligible. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. 7. Treatment Groups a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Seeking Safety, Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), High Conflict Co -Parenting, Caring Dads, Strategies for Self -Improvement and Change (SSC/SSIC), Affective Education and Health Relationships, Veteran Group, Social Skills, Trauma -Processing, Domestic Violence, and others. b. Anticipated Frequency of Services: i. One (1) to two (2) groups per week. c. Anticipated Duration of Services: i. Sixteen (16) to fifty-two (52) weeks, depending on client progress and needs. d. Goals of Services: i. Complete treatment group assigned. e. Outcomes of Services: i. Complete accurate assessment of clients' treatment, strengths, needs, and areas of skill deficits. ii. Complete designated curriculum specialized for the service type. iii. Reduce and/or eliminate concerns of recidivism, relapse, and other risk factors. iv. Increase coping capacity, safety tools, safe relationships, problem -solving, communication, and decision -making. f. Target Population: i. Individuals with various diagnosed or suspected intellectual/developmental disabilities, ages six (6) to one hundred (100). g. Language: i. English and Spanish (proficient) — no interpreter services available. h. Medicaid Eligibility: 24 i. This service is partially Medicaid eligible. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. 8. Consultation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Case consult. ii. Document review. b. Anticipated Frequency of Services: i. As needed. c. Anticipated Duration of Services: i. As requested by the Department. d. Goals of Services: i. Identify correct course for client treatment, needs, and dynamics. e. Outcomes of Services: i. Achieve successful direction. f. Target Population: i. Department and Court Professionals. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. Program Area: Substance Abuse Treatment Services 9. Substance Abuse Treatment — Group Treatment (E.g. Relapse Prevention, SSIC/SSC, Seeking Safety) a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), Trauma Focused Cognitive Behavioral Therapy (TF-CBT), Motivational Interviewing (MI), multimodal approaches. b. Anticipated Frequency of Services: i. One group weekly. c. Anticipated Duration of Services: i. Duration will be case specific. d. Goals of Services: 25 i. Reduce and manage substance use or substance misuse. ii. Reach a goal of being alcohol or substance use free. iii. Maintain abstinence from all substances. e. Outcomes of Services: i. Successful daily practice of self -care and coping skills. ii. Successful establishment and maintenance of pro -social relationships. iii. Successful reunification or other successful case closure. f. Target Population: i. Ages twelve (12) to one hundred (100) with various diagnosed or suspected disabilities. g. Language: i. English. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. 10. Substance Abuse Treatment - Individual Treatment a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), Trauma Focused Cognitive Behavioral Therapy (TF-CBT), Motivational Interviewing (MI), multimodal approaches b. Anticipated Frequency of Services: i. One (1) to three (3) sessions per week depending on the client's needs. c. Anticipated Duration of Services: i. Duration will be case specific. d. Goals of Services: i. Reduce and manage substance use or substance misuse. ii. Reach a goal of being alcohol or substance use free. iii. Maintain abstinence from all substances. e. Outcomes of Services: i. Successful daily practice of self -care and coping skills. ii. Successful establishment and maintenance of pro -social relationships. iii. Successful reunification or other successful case closure. f. Target Population: i. Ages twelve (12) to one hundred (100) with various diagnosed or suspected disabilities. g. Language: i. English. h. Medicaid Eligibility: i. This service is Medicaid eligible. 26 Service Access and Transportation: i. Services will take place virtually, in the client's home, or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235. ii. The contractor will not be transporting clients. 11. Urinalysis and Breathalyzer a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Secure and protected drug panel screening tools. ii. Substances tested for: 1. Amphetamine (AMP) 2. Barbiturates (BAR) 3. Buprenorphine (BUP) 4. Benzodiazepines (BZO) 5. Cocaine (COC), 6. Creatine (CR), 7. Ethylglucuronide (ETG), 8. Fenfluramine/phentermine (FEN) 9. Methadone (MTD) 10. Opiates (OPI) 11. Oxycodone (OXY) 12. Tetrahydrocannabinol (THC) 13. Tramadol b. Anticipated Frequency of Services: i. As needed or as required by treatment. c. Anticipated Duration of Services: i. Length of Substance Use Disorder (SUD) treatment. d. Goals of Services: i. Complete sobriety testing successfully. e. Outcomes of Services: i. Provide negative sobriety test results when scheduled. f. Target Population: i. Clients in SUD treatment. g. Language: i. English. h. Medicaid Eligibility: i. No. Service Access and Transportation: i. Services will take place in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235 ii. The contractor will not be transporting clients. 12. Substance Treatment Intake a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Intake Assessment and Screening Tools. 27 b. Anticipated Frequency of Services: i. One (1) to two (2) hours. c. Anticipated Duration of Services: i. Thirty (30) days. d. Goals of Services: i. Complete Substance Use Disorder (SUD) intake. e. Outcomes of Services: i. SUD intake report generated and released. f. Target Population: i. Client with various diagnosed or suspected disabilities, ages twelve (12) to one hundred (100). g. Language: i. English h. Medicaid Eligibility: i. This service is Medicaid eligible. Service Access and Transportation: i. Services will take place virtually or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235 ii. The contractor will not be transporting clients. 13. Substance Treatment Evaluation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Evaluation Assessment and Screening Tools. b. Anticipated Frequency of Services: i. One (1) to two (2) hours. c. Anticipated Duration of Services: i. Thirty (30) days. d. Goals of Services: i. Complete Substance Use Disorder (SUD) evaluation. e. Outcomes of Services: i. SUD evaluation report generated and released. f. Target Population: Client with various diagnosed or suspected disabilities, ages twelve (12) to one hundred (100). g. Language: i. English h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: 28 i. Services will take place virtually or in the contractor's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235 ii. The contractor will not be transporting clients. Terms 1. Contractor will respond to the Quality Assurance Team (HS-CWOualitvAssurance(ii weldgov.com within three (3) business days regarding the ability to accept the received referral. 2. Upon acceptance of a referral, Contractor will offer an initial appointment within seven (7) days of receiving the referral. The first attempt to contact the client will occur within 24 hours of receiving the referral (excluding weekends and holidays). Contractor will document efforts to engage client in referred services. If the client does not respond after three (3) attempts in the first seven (7) days of the referral period, the Contractor will notify the caseworker and the Quality Assurance Team II.S- C WQualitvAssurance(a,weldgov.com. 3. Contractor understands that "no shows" are defined as unexcused and unplanned/uncommunicated absences for services. If a rate for "no shows" is not specifically stated in Exhibit D, Rate Schedule, then Contractor understands that the Department will not reimburse for "no shows". Contractor understands that the Department will only reimburse Contractor for up to two (2) "no-shows", or up to two (2) hours, on the part of case participants who cancel without 24 hour notice. After three (3) "no-shows", Contractor will place client on a behavioral plan requiring attendance or discharge the client from services. Contractor must inform the caseworker and the Quality Assurance Team HS-CWQualitvAssurance(&,weldgov.com within three (3) days of when the client is placed on a behavioral plan or discharged. 4. Contractor understands that the Department will not reimburse Contractor for cancelled appointments either on the part of the client or the Contractor. If the cancellation is generated from the Contractor, a "makeup" session/episode, to occur within 30 days of the cancellation, will be offered to the client (excluding session/episodes that fall on holidays). If the cancellation is generated from the client, the Contractor must request a makeup session from the Department prior to the makeup session occurring (excluding session/episodes that fall on holidays). After three (3) cancellations, Contractor will inform the caseworker and the Quality Assurance Team HS-CWQualitvAssurance(a,weldgov.com immediately via email, to discuss service continuation. 5. Contractor will identify, in detail, areas of continued concern and make recommendations to the caseworker in a monthly report regarding continuation of services and/or the need for additional services. 6. Contractor will document in detail any and all observed or verbalized concerns regarding any child whom the Contractor is working with under an active referral. Areas of concern may include, but are not limited to, any physical, emotional, educational or behavioral issues. Areas of concern should be reported to the caseworker and the Quality Assurance Team HS-CWQualitvAssurance(a)weldgov.com immediately AND on the required monthly report. 7. Contractor will submit reports on a monthly basis for each active referral for ongoing services. Reports will be submitted per the online format required by the Department, unless otherwise directed by the Department. 8. Contractor agrees any change to an existing referral must be pre -approved through the Child Welfare Core Service Coordinator or any member of the Quality Assurance Team. Any changes to visitation referrals 29 will be approved by a new referral signed by the Child Welfare Supervisor. A change is defined as anything outside of the approved documented service on the initial authorized referral form. This may include an increase or decrease in services hours, change in frequency, change in location of services, transportation needs, or any change to the initial referral or subsequent authorizations. 9. Contractor agrees to attend meetings when available and as requested by the Department. Such meetings include Court Facilitations, Bid Meetings, Professional Staffings, Family Team Meetings and/or Team Decision Making meetings. The Department will reimburse for actual participation in the meeting only so long as there is written authorization from the Quality Assurance Team, and the facilitator documents in the meeting notes the timeframe that the provider attended and when participation in the meeting is deemed appropriate and necessary by the Department. The Facilitator will be responsible for filling out the time attended on the meeting notes. 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. 10. On a monthly basis, the Contractor will notify the Quality Assurance Team HS- CWQualitvAssurance(a,weldgov.com of new staff who will manage and/or administer the services with the following information: a. Staff member name and contact information b. Education level/degree (if applicable) c. Licensure/credentials (if applicable) d. Department of Regulatory Authority (DORA) number (if applicable) e. Supervisor name and contact information The Department reserves the right to decline the new staff members managing and/or administering services to Department clients. 30 EXHIBIT B RATE SCHEDULE 1. Funding and Method of Payment The Department agrees to reimburse the Contractor in consideration of the work and services performed under this Agreement at the rate specific in Paragraph 2, below. Expenses incurred by the Contractor prior to the term of this Agreement are not eligible Department expenditures and shall not be reimbursed by the Department. Payment pursuant to this Agreement, whether in whole or in part, is subject to and contingent upon the continuing availability of said funds for the purposes hereof In the event that said funds, or any part thereof, become unavailable as determined by the Department, the Department may immediately terminate the Agreement or amend it accordingly. 2. Fees for Services Rate Unit Type Aftercare Services Service Name Applied Behavior Analysis (ABA) -- Board Certified Behavior Analyst (BCBA) $135.00 Hour In-Office/Video $150.00 Hour In-Office/Video — Spanish $140.00 Hour In -Home or Community $155.00 Hour In -Home or Community — Spanish $100.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $60.00 Each No show — maximum of two (2) no shows or two (2) hours per month per client. $0.56 Mile Mileage — For distances exceeding 30 miles roundtrip from provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235 or the first appointment location of the day Applied Behavior Analysis (ABA) -- Behavior Technician $95.00 Hour In-Office/Video $110.00 Hour In-OfficeNideo — Spanish $100.00 Hour In -Home or Community $115.00 Hour In -Home or Community — Spanish $60.00 Each No show — maximum of two (2) no shows or two (2) hours per month per client. $75.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $0.56 Mile Mileage — For distances exceeding 30 miles roundtrip from provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235 or the first ap ointment location of the da Soci: hills Group $55.00 Hour In-OfficeNideo $70.00 Hour In-OfficeNideo — Spanish $60.00 Hour In -Home or Community $75.00 Hour In -Home or Community — Spanish $100.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $30.00 Each No show — maximum of two (2) no shows or two (2) hours per month per client. $0.56 Mile Mileage — For distances exceeding 30 miles roundtrip from provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235 or the first appointment location of the day $55.00 $70.00 $60.00 $75.00 Hour In-Office/Video Hour Hour Hour In-Office/Video — Spanish In -Home or Community In -Home or Community — Spanish Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing No show — maximum of two (2) no shows or two (2) hours per month per client. $100.00 $30.00 Hour Each $0.56 Mile $300.00 Hour Mileage — For distances exceeding 30 miles roundtrip from provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235 or the first appointment location of the day Anger Management/Domestic Violence Service Name In-office/Video $315.00 Hour In-office/Video — Spanish Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing No show — maximum of two (2) no shows or two (2) hours per month per client. $100.00 $60.00 Dotnea ie, x€6 1N v .It tide $575.00 $600.00 Hour Each Hour In-office/Video Hour In-office/Video — Spanish Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing No show — maximum of two (2) no shows or two (2) hours per month per client. $100.00 $100.00 Hour Each $55.00 $70.00 Hour In-office/Video Hour In-office/Video — Spanish Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing No show — maximum of two (2) no shows or two (2) hours per month per client. $100.00 $30.00 Dor►mestic $135.00 $150.00 Hour Each Hour In-office/Video Hour In-office/Video — Spanish Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing No show — maximum of two (2) no shows or two (2) hours per month per client. $100.00 $60.00 Hour Each $55.00 $70.00 Hour In-office/Video $100.00 $30.00 Hour Hour Each In-office/Video — Spanish Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing No show — maximum of two (2) no shows or two (2) hours per month per client. $55.00 $70.00 etCo-Parep Hour In-office/Video Hour In-office/Video — Spanish $100.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $30.00 Each No show — maximum of two (2) no shows or two (2) hours per month per client. Rate Unit Type Foster Parent Consultation Service Name a ' arent Consultation — Individual/Family $175.00 Hour In-OfficeNideo $190.00 Hour In-Office/Video — Spanish $190.00 Hour In -Home or Community $105.00 Hour In -Home or Community — Spanish $100.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $60.00 Each No show — maximum of two (2) no shows or two (2) hours per month per client. $0.56 Mile Mileage — For distances exceeding 30 miles roundtrip from provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235 or the first appointment location of the day Foster Parent Consultation — Group $55.00 Hour In-Office/Video $70.00 Hour In-OfficeNideo — Spanish $65.00 Hour In -Home or Community $80.00 Hour In -Home or Community — Spanish $100.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $30.00 Each No show — maximum of two (2) no shows or two (2) hours per month per client. $0.56 Mile Mileage — For distances exceeding 30 miles roundtrip from provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235 or the first appointment location of the day Rate Unit Type Foster Parent Training Service Name Foster Parent Training — Various $225.00 Hour In-Office/Video $275.00 Hour In -Home or Community $100.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $60.00 Each No show — maximum of two (2) no shows or two (2) hours per month per client. $0.56 Mile Mileage — For distances exceeding 30 miles roundtrip from provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235 or the first appointment location of the day Rate Unit Type Home -Based Interventions Service Name Home -Based Interventions - Intensive $135.00 Hour In-Office/Video $150.00 Hour In-Office/Video — Spanish $140.00 Hour In -Home or Community $155.00 Hour In -Home or Community — Spanish $100.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $60.00 Each No show — maximum of two (2) no shows or two (2) hours per month per client. $0.56 Mile Mileage — For distances exceeding 30 miles roundtrip from provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235 or the first a. .ointment location of the da $95.00 Hour In-Office/Video $110.00 Hour In-OfficeNideo — Spanish $100.00 Hour In -Home or Community $115.00 Hour In -Home or Community — Spanish $75.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $60.00 Each No show — maximum of two (2) no shows or two (2) hours per month per client. $0.56 Mile Mileage — For distances exceeding 30 miles from provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235 or the first appointment location of the da ased Intervention -- oderate $80.00 Hour In-OfficeNideo $95.00 Hour In-Office/Video — Spanish $85.00 Hour In -Home or Community $100.00 Hour In -Home or Community — Spanish $75.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $60.00 Each No show — maximum of two (2) no shows or two (2) hours per month per client. $0.56 Mile Mileage — For distances exceeding 30 miles roundtrip from provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235 or the first appointment location of the day Kinship Services (Therapeutic) Rate Unit T .e Service Name $135.00 Hour In-Office/Video $150.00 Hour In-OfficeNideo — Spanish $140.00 Hour In -Home or Community $155.00 Hour In -Home or Community — Spanish $100.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $60.00 Each No show — maximum of two (2) no shows or two (2) hours per month per client. $0.56 Mile Mileage — For distances exceeding 30 miles roundtrip from provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235 or the first appointment location of the day Life Skills $135.00 $150.00 $140.00 $155.00 $100.00 Hour Hour Hour Hour Hour In-Office/Video In-OfficeNideo — S . anish In -Home or Communi In -Home or Communi — Spanish Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffin $60.00 Each No show — maximum of two (2) no shows or two (2) hours per month per client. $0.56 Mile Mileage — For distances exceeding 30 miles roundtrip from provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235 or the first appointment location of the day Life Skills $95.00 Hour In-Office/Video $110.00 Hour In-Office/Video — Spanish $100.00 Hour In -Home or Community $115.00 Hour In -Home or Community — Spanish $75.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $60.00 Each No show — maximum of two (2) no shows or two (2) hours per month per client. $0.56 Mile Mileage — For distances exceeding 30 miles roundtrip from provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235 or the first appointment location of the day Specialized Mentorship $95.00 Hour In-Office/Video $110.00 Hour In-Office/Video — Spanish $100.00 Hour In -Home or Community $115.00 Hour In -Home or Community — Spanish $75.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $60.00 Each No show — maximum of two (2) no shows or two (2) hours per month per client. $0.56 Mile Mileage — For distances exceeding 30 miles roundtrip from provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235 or the first appointment location of the day Therapeutic Visitation $135.00 Hour In-Office/Video $140.00 Hour In -Home or Community $100.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $60.00 Each No show — maximum of two (2) no shows or two (2) hours per month per client. $0.56 Mile Mileage — For distances exceeding 30 miles roundtrip from provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235 or the first appointment location of the day Supervised/Coached Visitation $95.00 Hour In-Office/Video $115.00 Hour In -Office with Transportation $100.00 Hour In -Home or Community $75.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $60.00 Each No show — maximum of two (2) no shows or two (2) hours per month per client. $0.56 Mile Mileage — For distances exceeding 30 miles roundtrip from provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235 or the first appointment location of the day Mental Health Services Rate Unit Type Mental Health Therapy Service Name $135.00 $150.00 $145.00 $160.00 $100.00 $60.00 $0.56 $185.00 $200.00 $150.00 $100.00 $0.56 $210.00 Family Team Meeting (FTM), Team Decision Making (TDM) $150.00 Hour Meeting, Professional Staffing Hour In-Office/Video Hour In-Office/Video — Spanish Hour In -Home or Community Hour In -Home or Community — Spanish Family Team Meeting (FTM), Team Decision Making (TDM) Hour Meeting, Professional Staffing No show — maximum of two (2) no shows or two (2) hours per Each month per client. Mileage — For distances exceeding 30 miles roundtrip from provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235 or the first appointment location Mile of the da Hour In-Office/Video Hour In-Office/Video — Spanish Family Team Meeting (FTM), Team Decision Making (TDM) Hour Meeting, Professional Staffing No show — maximum of two (2) no shows or two (2) hours per Each month per client. Mileage — For distances exceeding 30 miles roundtrip from provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235 or the first appointment location Mile of the da Hour In-Office/Video $100.00 OS $210.00 $150.00 $100.00 $160.00 $175.00 $150.00 $100.00 $0.56 Each Hour No show — maximum of two (2) no shows or two (2) hours per month i er client. In-Office/Video Family Team Meeting (FTM), Team Decision Making (TDM) Hour Meeting, Professional Staffmg Each Hour No show — maximum of two (2) no shows or two (2) hours per month i er client. In-Office/Video Hour In -home or community Family Team Meeting (FTM), Team Decision Making (TDM) Hour Meeting, Professional Staffing Each Mile No show — maximum of two (2) no shows or two (2) hours per month per client. Mileage — For distances exceeding 30 miles roundtrip from provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235 or the first appointment location of the da $175.00 $200.00 Hour In-office/Video Hour In -home or community $100.00 $100.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing No show — maximum of two (2) no shows or two (2) hours per Each month per client. $0.56 Mile Mileage — For distances exceeding 30 miles roundtrip from provider's office located at 7175 West Jefferson Avenue, Suite 4000, Lakewood, Colorado, 80235 or the first appointment location of the day Treatment Groups $55.00 Hour In-Office/Video $70.00 Hour In-OfficeNideo — Spanish $100.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $30.00 Each No show — maximum of two (2) no shows or two (2) hours per month per client. Consultation $135.00 Hour In-Office/Video $100.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing Rate Unit Type Substance Abuse Treatment Services Service Name Substance Abuse Treatment — Group Treatment $55.00 Hour In-Office/Video $100.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $30.00 Each No show — maximum of two (2) no shows or two (2) hours per month per client. Substance Abuse Treatment - Individual Treatment $120.00 Hour In-Office/Video $100.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $60.00 Each No show — maximum of two (2) no shows or two (2) hours per month per client. Urinalysis and Breathal zer $21.00 Each Urinalysis (UA) $7.00 Each Breath Alcohol (BA) $15.00 Each Confirmation Test Substance Treatment Intake $250.00 Hour Substance Treatment Intake $100.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $100.00 Each No show — maximum of two (2) no shows or two (2) hours per month per client. Substance Treatment, Evaluation $425.00 Hour Substance Treatment Intake $100.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $100.00 Each No show — maximum of two (2) no shows or two (2) hours per month per client. 3. Submittal of Vouchers Contractor shall prepare and submit monthly a Request for Reimbursement and monthly report including other supporting documentation, if applicable, certifying that services authorized were provided on the date(s) indicated and the charges were made pursuant to the terms and conditions of Paragraph 3 of this Agreement . Contractor shall submit all Requests for Reimbursement and supporting documentation to the Department by the 7th day of the month following the month of service, but no later than 45 days from the date of service. Requests for Reimbursement and/or supporting documentation received after 45 days from the date of service may result in delay or forfeiture of payment. Consistent failure to meet the 45 -day deadline may result in termination of the Agreement. For ongoing services, proof of services rendered shall be a monthly report submitted in accordance with Paragraph 3(d) of this Agreement. When submitting a request for payment for a one-time service, the contractor shall submit the first and last page of the evaluation/report to confirm proof of services rendered. The full evaluation/report should be submitted by the contractor to the caseworker. For Monitored Sobriety services, proof of services rendered shall be the test result. Exhibit C WELD COUNTY'S REQUEST FOR PROPOSAL (Weld County's Request for Proposal is incorporated into this agreement by reference and will be provided upon request to the Department.) This page is intentionally left blank Exhibit D Contractor's response to the Request for Proposal Exhibit D contains the following documents: • Attachment B — Provider Information Form (PIF) • Attachment C — Proposal • Attachment D — Staff Data Sheet • Certificate of Insurance (COI) ATTACHMENT B WELD COUNTY DEPARTMENT OF HUMAN SERVICES - PROVIDER INFORMATION FORM (PIF) AGENCY INFORMATION Agency Name: Lifelong, Inc. Provider Contact Full Name: Lindsey Spraker Trails Provider ID (if known): Title: Executive Director Primary Phone Number (10 -digit): 303.573.0839 Ext: Fax Number (10 -digit): Primary Lindsey@Lifelonginc.com Contact Email: Web Address: 303.573.0849 www.lifelonginc.com 7175 W. Jefferson Avenue, Suite 4000, Lakewood, CO 80235 Agency Location Address (Street, city, state, zip): same Agency Mailing Address (Street, city, state, zip): Agency Type (pick one): Public Company n Private Non -Profit n Private for Profit Send Referrals for Service to: Referral Contact Name: Erika DeLeon Referral Phone Number (10 -digit): 720.660.4549 Ext.: Title: Program Director Erika@Lifelonginc.com Email: Billing Contact Name: Billing Contact Vanessa Pagan Title: Office Manager 303.573.0839 Vanessa@Lifelonginc.com Billing Phone Number (1O -digit): Ext.: Email: r--------------------------------------ERTIFICTION---------------------------------------r I I certify that the services proposed for intended use by the Weld County Department of Human Services will meet all the specifications it i II has so indicated in this bid form. I further affirm intention to enter into an agreement with Weld County, on behalf of the Weld County Department of Human Services, and comply with all requirements of the contract, if awarded. I • The Board of Weld County Commissioners reserve the right to reject any or all bids, to waive any informality in the bids, and to accept i Ithe bid, or part of a bid, that, in the opinion of the Board, is in the best interests of the Board and of the County of Weld, State of Colorado. The Board of Weld County Commissioners shall give preference to resident Weld County bidders in all cases where the bids are i competitive in price and quality. ▪ WELD COUNTY IS EXEMPT FROM COLORADO SALES TAXES. THE CERTIFICATE OF EXEMPTION NUMBER IS #98-03551-0000. I • Authorized Rep. Fu Name. Title: Executive Director I I Full Lindsey Spraker i I Lindsey@Lifelonginc.com Phone (10 digit): 720.582.3086 Ext.: i I ▪ Authorized Rep. Email: I 7175 W. Jefferson Avenue, Suite 4000, kakewood, CO 80235 Authorized Rep. Address (Street, city, state, zip): ▪ Signature of Authorized Rep.: Date: 01/19/2022 • i REV. DECEMBER 2021 ATTACHMENT C - PROPOSAL Please type your answers in the boxes below or check the appropriate box. SECTION 1— Provider and Program Area Information Bidder's Legal Name: Program Area: Program Areas are listed in column 1 of the table located in Item Xl of the Request You may complete another Attachment C if you have more than 5. for Proposal starting on page 13. Lifelong, Inc. Aftercare Services Number of services offered on this Attachment C (max 5): 4 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: Applied Behavior Analysis (ABA) - BCBA 2.1a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): • Applied Behavior Analysis as primary modality • Trauma —informed • Assessments including but not limited to: FBA (Functional Behavior Assessment), FAST (Functional Assessment Screening Tools), Functional Analysis (only when clinically indicated), skills assessments, adaptive functioning scales, Vineland Ill, developmental assessments, Autism screening tools, VBMAPP (Verbal Behavior Milestones Assessment and Placement Program), ABLLS (Assessment of Basic Language and Living Skills), AFLS (Assessment of functional living skills), EFLS (Essentials for Living). • All assessments are used to allocate baseline data, identify skill deficits and drive curriculum for treatment goals. • Assessment is ongoing and all treatment decisions are driven by data collected in every session reflecting progress on each goal and behavior. 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: Applied Behavior Analysis (ABA) is highly depending on a thorough individualized assessment and recommendations can range from 1 to 40 hours per week of treatment. 2.1c Anticipated duration of service (i.e. 3-4 months): ABA services can range from short term focused treatment for 6 months or less, to several years or lifelong supports depending on the individual's needs and abilities. 2.1d Three (3), or more, specific goals of the service (DO use bullet points): 1) Identify skill deficits and develop skill acquisition programming to be taught using the principles of ABA. 2) Mediate and reduce the negative effects of challenging behaviors on the individual and caregivers. 3) Develop and implement behavior intervention strategies to reduce behaviors targeted for reduction. 4) Conduct ongoing parent / caregiver required training on skill teaching and behavior intervention strategies using a trauma -informed / preventative approach. 2.1e Three (3), or more, specific outcomes of service: 1) Prevent or reduce behaviors that put individuals or their caregivers / family members at risk of harm. 2) Prevent or reduce behaviors that limit an individual's ability to access their home, school, community, and establish and maintain meaningful relationships. 3) Increase communication and social skills. 4) Increase independence to the highest level possible and establish skills that contribute to mental and physical health and hygiene. 2.1f Target population of the service, including age and gender: All ages, genders, abilities and diagnoses. Unless clinically contraindicated or involves a symptomology that requires medical intervention as the primary treatment. 2.1g Languages service is available in (please list proficiency and if interpreter services are available): English and Spanish (proficient) — no interpreter services available 2.1h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: YES- qualified individuals may access ABA via Medicaid through EPSDT with a doctor's referral prescribing ABA as a medically necessary treatment for individuals' specific diagnosis. Individuals can only access private insurance for ABA funding if they carry an Autism Spectrum Disorder Diagnosis. 2.1i Service location — list where the service will take place (i.e. client's home, in -office, other) REV. OCT 2021 1 ATTACHMENT C - PROPOSAL Weld County DHS, Lifelong, Inc. offices, community, client's home, virtual Service #2 Name: Applied Behavior Analysis (ABA) — Behavior Technician 2.2a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Primary modality being ABA, Behavior Technicians (BT's) work directly with the client, under supervision, to implement the skill teaching program and behavior interventions designed by the board -certified behavior analyst (BCBA). 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: Applied Behavior Analysis (ABA) is highly depending on a thorough individualized assessment and recommendations can range from 1 to 40 hours per week of treatment. 2.2c Anticipated duration of service (i.e. 3-4 months): ABA services can range from short term focused treatment for 6 months or less, to several years or lifelong supports depending on the individual's needs and abilities. 2.2d Three (3), or more, specific goals of the service (DO use bullet points): 1. Identify skill deficits and develop skill acquisition programming to be taught using the principles of ABA. 2. Mediate and reduce the negative effects of challenging behaviors on the individual and caregivers. 3. Develop and implement behavior intervention strategies to reduce behaviors targeted for reduction. 4. Conduct ongoing parent / caregiver required training on skill teaching and behavior intervention strategies using a trauma -informed / preventative approach. 2.2e Three (3), or more, specific outcomes of service: 1. Prevent or reduce behaviors that put individuals or their caregivers / family members at risk of harm. 2. Prevent or reduce behaviors that limit an individual's ability to access their home, school, community, and establish and maintain meaningful relationships. 3. Increase communication and social skills. 4. Increase independence to the highest level possible and establish skills that contribute to mental and physical health and hygiene. 2.2f Target population of the service: All ages, genders, abilities, and diagnoses. Unless clinically contraindicated or involving symptomology that requires medical intervention as the primary treatment. 2.2g Languages service is available in (please list proficiency and if interpreter services are available): English and Spanish (proficient) — no interpreter services available 2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: YES- qualified individuals may access ABA via Medicaid through EPSDT with a doctor's referral prescribing ABA as a medically necessary treatment for individuals' specific diagnosis. Individuals can only access private insurance for ABA funding if they carry an Autism Spectrum Disorder Diagnosis. 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) Weld County DHS, Lifelong, Inc. offices, community, client's home, virtual Service #3 Name: Social Skills Group 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Social skills checklists are utilized to assess skills and identify pairs of groups of individuals who would work effectively together on mutual goals that are appropriate for their age and development. 2.3b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Social Skills Group held 1-2 times per week for 1 or more hours depending on size of group and abilities. 2.3c Anticipated duration of service (i.e. 3-4 months): 8 weeks per cohort 2.3d Three (3), or more, specific goals of the service (DO use bullet points): 1. Identify individuals who could benefit from facilitated social skills practice in a group setting. 2. Provide safe, monitored, and facilitated activities that support individuals' social skills practice in a group setting. 3. Provide peer modeling opportunities for individuals with social skills deficits. REV. OCT 2021 2 ATTACHMENT C - PROPOSAL 4. Promote the development of necessary social skills and safe ways to connect and interact with peers. 2.3e Three (3), or more, specific outcomes of service: 1. Increase clients' access to safe opportunities to practice social skills and develop meaningful relationships. 2. Increase clients' ability to generalize social skills to new individuals in a setting. 3. Increase the connections and opportunities to create a community for individuals with intellectual disabilities. 2.3f Target population of the service: Children and adults with specialized social needs, on the Autism Spectrum , with intellectual disability or traumatic brain injury. 2.3g Languages service is available in (please list proficiency and if interpreter services are available): English and Spanish (proficient) — no interpreter services available 2.3h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: No. 2.3i Service location — list where the service will take place (i.e. client's home, in -office, other) Weld County DHS, Lifelong, Inc. offices, community, virtual Service #4 Name: Trauma Processing Group 2.4a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Trauma informed approaches and materials, depression and anxiety scales, PTSD assessments as prescribed by the group facilitators as needed. 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: One time per week for 1-2 hours 2.4c Anticipated duration of service (i.e. 3-4 months): 3-6 months 2.4d Three (3), or more, specific goals of the service (DO use bullet points): i Provide a safe setting for individuals who have been assessed and identified as a candidate for which group processing may be beneficial. 2. Facilitate the development of a supportive working group in which individuals can share, relate to others and process traumatic experiences. 3. Provide psychoeducation to group members to promote skill development for management of symptoms of Post- Traumatic Stress Disorder and other trauma related behaviors and symptomology. 2.4e Three (3), or more, specific outcomes of service: 1. 2. 3. Individuals access opportunities to process trauma and begin a healing process in a safe and supportive group that is goal oriented and facilitated. Individuals demonstrate the ability to establish and maintain self -care and coping practices while sharing connection and accountability with their group peers. Individuals experience safety and acceptance that allows for integration of skills and mental health treatment. 2.4f Target population of the service: Youth and adults that have been assessed and identified as a candidate for group processing. 2.4g Languages service is available in (please list proficiency and if interpreter services are available): English and Spanish (proficient) — no interpreter services available 2.4h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: No. 2.4i Service location — list where the service will take place (i.e. client's home, in -office, other) Weld County DHS, Lifelong, Inc. offices, community, virtual Service #5 Name: 2.5a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.5b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.5c Anticipated duration of service (i.e. 3-4 months): 2.5d Three (3), or more, specific goals of the service (DO use bullet points): REV. OCT 2021 3 ATTACHMENT C - PROPOSAL 2.5e Three (3), or more, specific outcomes of service: 2.5f Target population of the service: 2.5g Languages service is available in (please list proficiency and if interpreter services are available): 2.5h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part 2.6i Service location — list where the service will take place (i.e. client's home, in -office, other) 3.1 3.2 3.3 3.4 3.5 Section 3 — Service Access and Transportation YES YES NO Will you charge Weld County for transporting clients or mileage? Check one: @ ■ NO Will you conduct services in a client's home or in the community? Check one: ►5 • NO Miles Will you transport clients to and/or from services? Check one: ■ YES @ How many miles are you willing to travel round trip? List a specific number of miles. When you calculate mileage, what is your starting point address? 7175 W. Jefferson Avenue, Lakewood, CO 80235 SECTION 4 - SERVICE RATES All rates need to include administrative work (i.e. scheduling or report writing) and overhead. Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly or monthly rates will be accepted for services, except for those listed above. • For hourly rates complete section(s) 4.1-4.5. • For monthly rates complete section 4.6. • For Home study providers complete section 4.7. • For monitored sobriety testing providers complete section 4.8. 4.1 Hourly Service #1 Name: Applied Behavior Analysis (ABA) - BCBA 4.1a In-Office/Video: 4.1b In -Office with Transportation: In -Home or Community: 4.1c FTM, TDM, Prof. Staffing: 4.1d No show: 4.1e Mileage rate: $ Amount $135 $140 $100 $60 .56 Unit Type per Hour per Hour per Hour per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: This is paid after the miles listed above. miles miles 4.2 Hourly Service #2 Name: Applied Behavior Analysis (ABA) — Behavior Technician 4.2a In-Office/Video: 4.2b In -Office with Transportation: 4.2c In -Home or Community: 4.2d FTM, TDM, Prof. Staffing: 4.2e No show: 4.2f Mileage rate: $ Amount $95 $100 $75 $60 .56 Unit Type per Hour per Hour per Hour per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: This is paid after the miles listed above. miles miles 4.3 Hourly Service #3 Name: Social Skills Group 4.3a In-Office/Video: $ Amount Unit Type $55 per Hour REV. OCT 2021 4 ATTACHMENT C - PROPOSAL 4.3b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.3c In -Home or Community: $60 per Hour No. of roundtrip miles included in rate: miles 4.3d FTM, TDM, Prof. Staffing: $100 per Hour 4.3e No show: $30 per No Show 4.3f Mileage rate: .56 per Mile This is paid after the miles listed above. 4.4 Hourly Service #4 Name: Trauma Processing Group $ Amount Unit Type 4.4a In-Office/Video: $55 per Hour 4.4b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles In -Home or Community: $60 per Hour No. of roundtrip miles included in rate: miles 4.4c FTM, TDM, Prof. Staffing: $100 per Hour 4.4d No show: $30 per No Show 4.4e Mileage rate: .56 per Mile This is paid after the miles listed above. 4.5 Hourly Service #5 Name: $ Amount Unit Type 4.5a In-Office/Video: per Hour 4.5b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.5c In -Home or Community: per Hour No. of roundtrip miles included 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 No. of Direct Service Hours: 4.6a 4.6b 4.6c 4.6d 4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers — List your rates in the box below. 4.8 Monitored Sobriety Providers — List your rates in the box below. Please see SUD program area attachment. Provider special notes: All bilingual services are +$15/hour. REV. OCT 2021 5 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: Lifelong, Inc. Crisis Intervention and Stabilization Services Number of services offered on this Attachment C (max 5): Program Areas are listed in column 1 of the table located in Item XI of the Request You may complete another Attachment C if you have more than 5. for Proposal starting on page 13. 1 If Service 2.1a 2.1b 2.1c 2.1d 2.1e 2.1f 2.1g 2.1h 2.1i Service 2.2a SECTION 2 - Service Name(s) and Information the service is a monthly package, please offer different levels. All monthly packages must state a specific minimum number of direct service hours. #1 Name: DV/DHS Intersections Consultant and Trainer Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Professional DV 100, Survivor DV 101, Professional DV 200, Survivor DV 201, Professional DV 300, Survivor DV 301, monthly lunch -and -learn 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: Daily Anticipated duration of service (i.e. 3-4 months): Very case specific, some 6 weeks, some longer throughout the year for ongoing consultations and training Three (3), or more, specific goals of the service (DO use bullet points): 1) Tailored education, support, and resources for child welfare staff and domestic violence survivors, to achieve compliance in accordance to HB 21-1099. 2) Case specific consultation for professionals to engage survivors and offenders while managing treatment plans and families impacted by domestic violence/intimate partner violence. 3) Provide effective, evidence based, evidence -informed, and current resources and education from a team of experts in both victim and offender services, to the Weld County community, including current data tracking. Three (3), or more, specific outcomes of service: 1) Successful support, education, and training for domestic violence survivors. 2) Successful support, education, and training for domestic violence professional staff (to include caseworkers, attorneys, judges, and other staff). Target population of the service, including age and gender: Client with various diagnosed or suspected disabilities, ages (any), individuals, dyads, or families, staff/professionals in need of training Languages service is available in (please list proficiency and if interpreter services are available): English Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: No. Service location — list where the service will take place (i.e. client's home, in -office, other) Weld County DHS, Lifelong, Inc. offices, community, virtual #2 Name: Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 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: 2.2c Anticipated duration of service (i.e. 3-4 months): 2.2d Three (3), or more, specific goals of the service (DO use bullet points): 2.2e Three (3), or more, specific outcomes of service: REV. OCT 2021 1 ATTACHMENT C - PROPOSAL 2.2f Target population of the service: 2.2g Languages service is available in (please list proficiency and if interpreter services are available): 2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #3 Name: 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.3b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.3c Anticipated duration of service (i.e. 3-4 months): 2.3d Three (3), or more, specific goals of the service (DO use bullet points): 2.3e Three (3), or more, specific outcomes of service: 2.3f Target population of the service: 2.3g Languages service is available in (please list proficiency and if interpreter services are available): 2.3h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.3i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #4 Name: 2.4a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.4b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.4c Anticipated duration of service (i.e. 3-4 months): 2.4d Three (3), or more, specific goals of the service (DO use bullet points): 2.4e Three (3), or more, specific outcomes of service: 2.4f Target population of the service: 2.4g Languages service is available in (please list proficiency and if interpreter services are available): 2.4h Medicaid eligibility— list whether the service is eligible for Medicaid in whole or in part: 2.4i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #5 Name: 2.5a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): REV. OCT 2021 2 ATTACHMENT C - PROPOSAL 2.5b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.5c Anticipated duration of service (i.e. 3-4 months): 2.5d Three (3), or more, specific goals of the service (DO use bullet points): 2.5e Three (3), or more, specific outcomes of service: 2.5f Target population of the service: 2.5g Languages service is available in (please list proficiency and if interpreter services are available): 2.5h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part 2.6i Service location — list where the service will take place (i.e. client's home, in -office, other) 3.1 3.2 3.3 3.4 3.5 Section 3 — Service Access and Transportation YES YES NO Will you charge Weld County for transporting clients or mileage? Check one: • IN NO Will you conduct services in a client's home or in the community? Check one: ■ • NO Miles Will you transport clients to and/or from services? Check one: • YES • How many miles are you willing to travel round trip? List a specific number of miles. When you calculate mileage, what is your starting point address? SECTION 4 - SERVICE RATES All rates need to include administrative work (i.e. scheduling or report writing) and overhead. Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly or monthly rates will be accepted for services, except for those listed above. • For hourly rates complete section(s) 4.1-4.5. • For monthly rates complete section 4.6. • For Home study providers complete section 4.7. • For monitored sobriety testing providers complete section 4.8. 4.1 Hourly Service #1 Name: DV/DHS Intersections Consultant and Trainer 4.1a In-Office/Video: 4.1b In -Office with Transportation: In -Home or Community: 4.1c FTM, TDM, Prof. Staffing: 4.1d No show: 4.1e Mileage rate: $ Amount 150 175 100 55 .56 Unit Type per Hour per Hour per Hour per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: This is paid after the miles listed above. miles miles 4.2 Hourly Service #2 Name: 4.2a In-Office/Video: 4.2b In -Office with Transportation: 4.2c In -Home or Community: $ Amount Unit Type per Hour per Hour per Hour No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: miles miles REV. OCT 2021 3 ATTACHMENT C - PROPOSAL 4.2d FTM, TDM, Prof. Staffing: per Hour 4.2e No show: per No Show 4.2f Mileage rate: per Mile This is paid after the miles listed above. 4.3 Hourly Service #3 Name: $ Amount Unit Type 4.3a In-Office/Video: per Hour 4.3b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.3c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.3d FTM, TDM, Prof. Staffing: per Hour 4.3e No show: per No Show 4.3f Mileage rate: per Mile This is paid after the miles listed above. 4.4 Hourly Service #4 Name: $ Amount Unit Type 4.4a In-Office/Video: per Hour 4.4b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.4c FTM, TDM, Prof. Staffing: per Hour 4.4d No show: per No Show 4.4e Mileage rate: per Mile This is paid after the miles listed above. 4.5 Hourly Service #5 Name: $ Amount Unit Type 4.5a In-Office/Video: per Hour 4.5b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.5c In -Home or Community: per Hour No. of roundtrip miles included 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 No. of Direct Service Hours: 4.6a DV/DHS Intersections Consultant and Trainer 3333.33 100+ 4.6b 4.6c 4.6d 4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers — List your rates in the box below. 4.8 Monitored Sobriety Providers — List your rates in the box below. Provider special notes: REV. OCT 2021 4 ATTACHMENT C - PROPOSAL Please type your answers in the boxes below or check the appropriate box. SECTION 1— Provider and Program Area Information Bidder's Legal Name: Program Area: Program Areas are listed in column 1 of the table located in Item XI of the Request You may complete another Attachment C if you have more than 5. for Proposal starting on page 13. Lifelong, Inc. Anger Management/Domestic Violence Number of services offered on this Attachment C (max 5): 5 If Service 2.1a 2.1b 2.1c 2.1d 2.1e 2.1f 2.1g 2.1h 2.1i Service 2.2a SECTION 2 - Service Name(s) and Information the service is a monthly package, please offer different levels. All monthly packages must state a specific minimum number of direct service hours. #1 Name: Domestic Violence Group Treatment Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): CBT, DBT, TF-CBT, MI, Duluth model, multimodal approaches 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: One group per week Anticipated duration of service (i.e. 3-4 months): Case specific — ranges for each case needs (i.e., 16 weeks to 52 weeks) Three (3), or more, specific goals of the service (DO use bullet points): 1. Reduce and manage mental health triggers. 2. Increase the ability to demonstrate understanding of cycle of violence, power and control. 3. Increase ability to demonstrate self-awareness and identify triggers. 4. Increase ability to reflect on self in the group setting. 5. Interact with peers in the group setting, demonstrating accountability, competency achievement, and vulnerability. 6. Identify precursors to violence and engage in preventive strategies to self -regulate and manage impulses. Three (3), or more, specific outcomes of service: 1. Successful engagement in the group therapy dynamic. 2. Successful daily practice of self -care and coping skills. 3. Successful use of coping skills during conflict or crisis. 4. Successful reunification or other successful case closure. Target population of the service, including age and gender: Client with various diagnosed or suspected disabilities, ages 12-100, individuals. Languages service is available in (please list proficiency and if interpreter services are available): English — interpreter services not available Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: No. Service location — list where the service will take place (i.e. client's home, in -office, other) Lifelong, Inc. offices, virtual #2 Name: Domestic Violence Individual Treatment Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): CBT, DBT, TF-CBT, MI, Duluth model, multimodal approaches 2.2b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 1-2 sessions/week depending on individual's needs. 2.2c Anticipated duration of service (i.e. 3-4 months): Case specific - ranges for each case needs (i.e., 16 weeks to 52 weeks) 2.2d Three (3), or more, specific goals of the service (DO use bullet points): 1. Reduce and manage mental health triggers. 2. Increase the ability to demonstrate understanding of cycle of violence, power and control. REV. OCT 2021 1 ATTACHMENT C - PROPOSAL 3. Increase ability to demonstrate self-awareness and identify triggers. 4. Increase ability to reflect and self -evaluate, identify precursors to violence, and engage in preventive strategies to self -regulate and manage impulses. 5. Increase ability to identify criteria for safe and healthy interactions and relationships. 6. Increase ability to demonstrate protective skills of self and dependents. 2.2e Three (3), or more, specific outcomes of service: 1. Successful engagement in the group therapy dynamic. 2. Successful daily practice of self -care and coping skills. 3. Successful use of coping skills during conflict or crisis. 4. Successful reunification or other successful case closure. 2.2f Target population of the service: Client with various diagnosed or suspected disabilities, ages 12-100, individuals. 2.2g Languages service is available in (please list proficiency and if interpreter services are available): English — interpreter services not available 2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: No. 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) Lifelong, Inc. offices, virtual Service #3 Name: Caring Dads 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): The Caring Dads parenting group is a curriculum driven and facilitated opportunity for men to obtain and practice parenting skills and connect with other men as fathers. 2.3b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: The Caring Dads group takes place lx per week for 17 weeks. 2.3c Anticipated duration of service (i.e. 3-4 months): 17 weeks 2.3d Three (3), or more, specific goals of the service (DO use bullet points): 2.3e 1. 17 weeks. Improve and strengthen the father / child relationship. 2. Learn child centered parenting skills and strategies to manage stress and frustration. 3. Identify and self -reflect on the impact of previous oonflictual strategies on familial relationships. Three (3), or more, specific outcomes of service: 1. Reduce recidivism of child welfare contact for participating families. 2. Successful case closure via reunification or maintenance of custody or in -home placement. 3. Create community connections and relationships for fathers. 2.3f Target population of the service: Parents with children, fathers who have demonstrated parenting challenges that resulted in child protection concerns, fathers struggling with parenting children with challenging behaviors or special behavioral needs. 2.3g Languages service is available in (please list proficiency and if interpreter services are available): English — interpreter services not available 2.3h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: No. 2.3i Service location — list where the service will take place (i.e. client's home, in -office, other) Lifelong, Inc. offices, virtual Service #4 Name: High Conflict Co -Parenting 2.4a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): • Group therapy • Curriculum driven and skill acquisition focused • Parents in high -conflict separations, child welfare cases, divorces, or requiring mediation attend the groups separately. • Skills focused on conflict resolution, communication skills, stress management, and protection of involved children. REV. OCT 2021 2 ATTACHMENT C - PROPOSAL 2.4b 2.4c 2.4d 2.4e 2.4f 2.4g 2.4h 2.4i Service 2.5a 2.5b 2.5c 2.5d 2.5e 2.5f 2.5g 2.5h 2.6i 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: Groups take place one time per week. Anticipated duration of service (i.e. 3-4 months): 12 weeks Three (3), or more, specific goals of the service (DO use bullet points): 1. Provide a safe environment for parents to connect, reflect, and learn ways to manage co -parenting challenges. 2. Parents will develop skills to co -parent and communicate effectively, minimizing conflict. 3. Parents will learn strategies to mediate stress and implement protective strategies to reduce emotional harm to involved children. Three (3), or more, specific outcomes of service: 1. Reduce the occurrence of severe conflictual parenting interactions that result in violence, child protection involvement, and/or police contact. 2. Support parents to resolve contentious custody battles and resolve disagreements independently after supports fade. 3. Reduce emotional / physical harm to involved children. Target population of the service: Parents identified as having co -parenting conflict that is unable to resolved without proper supports. Languages service is available in (please list proficiency and if interpreter services are available): English — interpreter services not available Medicaid eligibility— list whether the service is eligible for Medicaid in whole or in part: No. Service location — list where the service will take place (i.e. client's home, in -office, other) Lifelong, Inc. offices, virtual #5 Name: Domestic Violence Intake Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): DVOMB Approved intake and assessment materials. 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: 2-5 hours Anticipated duration of service (i.e. 3-4 months): 1-2 sessions Three (3), or more, specific goals of the service (DO use bullet points): Completion of intake. Three (3), or more, specific outcomes of service: Completion of intake. Target population of the service: Persons identified as at risk of or known domestic violence involvement with or without police contact or child welfare involvement. Languages service is available in (please list proficiency and if interpreter services are available): English — interpreter services not available Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part No. Service location — list where the service will take place (i.e. client's home, in -office, other) Lifelong, Inc. offices, virtual 3.1 3.2 3.3 Section 3 — Service Access and Transportation Will you charge Weld County for transporting clients or mileage? Check one: @ YES ■ NO Will you conduct services in a client's home or in the community? Check one: ■ YES 0 NO Will you transport clients to and/or from services? Check one: ■ YES 0 NO REV. OCT 2021 3 ATTACHMENT C - PROPOSAL 3.4 How many miles are you willing to travel round trip? List a specific number of miles. 3.5 When you calculate mileage, what is your starting point address? Miles 7175 W. Jefferson Avenue, Lakewood, CO 80235 SECTION 4 - SERVICE RATES All rates need to include administrative work (i.e. scheduling or report writing) and overhead. Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly or monthly rates will be accepted for services, except for those listed above. • For hourly rates complete section(s) 4.1-4.5. • For monthly rates complete section 4.6. • For Home study providers complete section 4.7. • For monitored sobriety testing providers complete section 4.8. 4.1 Hourly Service #1 Name: Domestic Violence Group Treatment $ Amount Unit Type 4.1a In-Office/Video: $55 per Hour 4.1b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.1c FTM, TDM, Prof. Staffing: $100 per Hour 4.1d No show: $30 per No Show 4.1e Mileage rate: per Mile This is paid after the miles listed above. 4.2 Hourly Service #2 Name: Domestic Violence Individual Treatment $ Amount Unit Type 4.2a In-Office/Video: $135 _ per Hour 4.2b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.2c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.2d FTM, TDM, Prof. Staffing: $100 per Hour 4.2e No show: $60 per No Show 4.2f Mileage rate: per Mile This is paid after the miles listed above. 4.3 Hourly Service #3 Name: Caring Dads $ Amount Unit Type 4.3a In-Office/Video: $55 per Hour 4.3b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.3c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.3d FTM, TDM, Prof. Staffing: $100 per Hour 4.3e No show: $30 per No Show 4.3f Mileage rate: per Mile This is paid after the miles listed above. 4.4 Hourly Service #4 Name: High Conflict Co -Parenting $ Amount Unit Type 4.4a In-Office/Video: $55 per Hour 4.4b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.4c FTM, TDM, Prof. Staffing: $100 per Hour 4.4d No show: $30 per No Show 4.4e Mileage rate: per Mile This is paid after the miles listed above. 4.5 Hourly Service #5 Name: Domestic Violence Intake $ Amount Unit Type 4.5a In-Office/Video: $300 per Hour REV. OCT 2021 4 ATTACHMENT C - PROPOSAL 4.5b In -Office with Transportation: 4.5c In -Home or Community: 4.5d FTM, TDM, Prof. Staffing: 4.5e No show: 4.5f Mileage rate: per Hour No. of roundtrip miles included in rate: per Hour No. of roundtrip miles included in rate: per Hour per No Show per Mile This is paid after the miles listed above. miles miles $100 $60 4.6 Monthly Service Rates (each level must be listed): Service Name with Level Rate per Month No. of Direct Service Hours: 4.6a 4.6b 4.6c 4.6d 4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers — List your rates in the box below. 4.8 Monitored Sobriety Providers — List your rates in the box below. Please see SUD program area attachment. Provider special notes: All bilingual services are +$15/hour. REV. OCT 2021 5 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: Lifelong, Inc. Anger Management/Domestic Violence Number of services offered on this Attachment C (max 5): Program Areas are listed in column 1 of the table located in Item XI of the You may complete another Attachment C if you have more than 5. Request for Proposal starting on page 13. 1 If Service 2.1a 2.1b 2.1c 2.1d 2.1e 2.1f 2.1g 2.1h 2.1i SECTION 2 — Service Name(s) and Information the service is a monthly package, please offer different levels. All monthly packages must state a specific minimum number of direct service hours. #1 Name: Domestic Violence Evaluation Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Clinical Assessment Interview Domestic Violence Risk and Needs Assessment (DVRNA) Spousal Assault Risk Assessment Guide — 3 (SARA - 3) CAGE -AID Substance Abuse Screening Tool Alcohol Use Disorders Identification Test (AUDIT) Scoring the States of Change Readiness and Treatment Eagerness Scale (SOCRATES 8A/8D) Ohio State University Traumatic Brain Injury Identification Method (OSU-TBI) Mini -Mental State Examination (MMSE) Brief Resiliency Scale (BRS) Beck Anxiety Inventory (BAI) Beck Depression Inventory (BDI) Level 2 - Anger — Adult Substance Abuse Subtle Screening Inventory (SASSI) Personality Inventory for DSM-5 — Brief Form (PID-BF) — Adult World Health Organization Disability Assessment Schedule (WHODAS) 2.0 Personality Assessment Screener (PAS) Adverse Childhood Experiences (ACE) Questionnaire Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 3-7 hours Anticipated duration of service (i.e. 3-4 months): Evaluation and assessment summary with treatment recommendations with a 15-30 day turn around for complete report. Three (3), or more, specific goals of the service (DO use bullet points): 1. Assess and identify treatment needs of the client. 2. Determine the level of treatment intensity required for domestic violence services. 3. Establish recommendations for immediate and long-term safety planning. Three (3), or more, specific outcomes of service: 1) Completion of Evaluation Target population of the service, including age and gender: Persons identified as at risk of or known domestic violence involvement with or without police contact or child welfare involvement. Languages service is available in (please list proficiency and if interpreter services are available): English Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: No. Service location — list where the service will take place (i.e. client's home, in -office, other) Lifelong, Inc. offices, virtual (in some circumstances) REV. OCT 2021 1 ATTACHMENT C - PROPOSAL Service #2 Name: 2.2a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 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: 2.2c Anticipated duration of service (i.e. 3-4 months): 2.2d Three (3), or more, specific goals of the service (DO use bullet points): 2.2e Three (3), or more, specific outcomes of service: 2.2f Target population of the service: 2.2g Languages service is available in (please list proficiency and if interpreter services are available): 2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #3 Name: 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.3b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.3c Anticipated duration of service (i.e. 3-4 months): 2.3d Three (3), or more, specific goals of the service (DO use bullet points): 2.3e Three (3), or more, specific outcomes of service: 2.3f Target population of the service: 2.3g Languages service is available in (please list proficiency and if interpreter services are available): 2.3h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.3i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #4 Name: 2.4a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.4b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.4c Anticipated duration of service (i.e. 3-4 months): 2.4d Three (3), or more, specific goals of the service (DO use bullet points): 2.4e Three (3), or more, specific outcomes of service: 2.4f Target population of the service: REV. OCT 2021 2 ATTACHMENT C - PROPOSAL 2.4g Languages service is available in (please list proficiency and if interpreter services are available): 2.4h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.4i Service 2.5a Service location — list where the service will take place (i.e. client's home, in -office, other) #5 Name: Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.5b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.5c Anticipated duration of service (i.e. 3-4 months): 2.5d Three (3), or more, specific goals of the service (DO use bullet points): 2.5e Three (3), or more, specific outcomes of service: 2.5f Target population of the service: 2.5g Languages service is available in (please list proficiency and if interpreter services are available): 2.5h Medicaid eligibility— list whether the service is eligible for Medicaid in whole or in part 2.6i Service location — list where the service will take place (i.e. client's home, in -office, other) 3.1 3.2 3.3 3.4 3.5 Section 3 — Service Access Will you charge Weld County for transporting clients or mileage? one: Will you conduct services in a client's home or in the community? one: Will you transport clients to and/or from services? Check one: How many miles are you willing to travel round trip? List a specific miles. When you calculate mileage, what is your starting point address? and Transportation YES YES NO Check ►I • NO Check IN ►ii NO Miles • YES ►5 number of 7175 W. Jefferson Avenue, Lakewood, CO 80235 SECTION 4 - SERVICE RATES All rates need to include administrative work (i.e. scheduling or report writing) and overhead. Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly or monthly rates will be accepted for services, except for those listed above. • For hourly rates complete section(s) 4.1-4.5. • For monthly rates complete section 4.6. • For Home study providers complete section 4.7. • For monitored sobriety testing providers complete section 4.8. 4.1 Hourly Service #1 Name: REV. OCT 2021 Domestic Violence Evaluation 3 ATTACHMENT C - PROPOSAL $ Amount Unit Type 4.1a In-Office/Video: $575 per Hour 4.1b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.1c FTM, TDM, Prof. Staffing: $100 per Hour 4.1d No show: $100 per No Show 4.1e Mileage rate: per Mile This is paid after the miles listed above. 4.2 Hourly Service #2 Name: $ Amount Unit Type 4.2a In-Office/Video: per Hour 4.2b In Transportation: -Office with per Hour No. of roundtrip miles included in rate: miles 4.2c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.2d FTM, TDM, Prof. Staffing: per Hour 4.2e No show: per No Show 4.2f Mileage rate: per Mile This is paid after the miles listed above. 4.3 Hourly Service #3 Name: $ Amount Unit Type 4.3a In-Office/Video: per Hour 4.3b In Transportation: -Office with per Hour No. of roundtrip miles included in rate: miles 4.3c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.3d FTM, TDM, Prof. Staffing: per Hour 4.3e No show: per No Show 4.3f Mileage rate: per Mile This is paid after the miles listed above. 4.4 Hourly Service #4 Name: $ Amount Unit Type 4.4a In-Office/Video: per Hour 4.4b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.4c FTM, TDM, Prof. Staffing: per Hour 4.4d No show: per No Show 4.4e Mileage rate: per Mile This is paid after the miles listed above. 4.5 Hourly Service #5 Name: $ Amount Unit Type 4.5a In-Office/Video: per Hour 4.5b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.5c In -Home or Community: per Hour No. of roundtrip miles included 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 No. of Direct Service Hours: 4.6a REV. OCT 2021 4 ATTACHMENT C - PROPOSAL 4.6b 4.6c 4.6d 4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers — List your rates in the box below. 4.8 Monitored Sobriety Providers — List your rates in the box below. Please see SUD program area attachment. Provider special notes: All bilingual services are +$15/hour. REV. OCT 2021 5 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: Program Areas are listed in column 1 of the table located in Item XI of the Request You may complete another Attachment C if you have more than 5. for Proposal starting on page 13. Lifelong, Inc. Foster Parent Consultation Number of services offered on this Attachment C (max 5): 2 If Service 2.1a 2.1b 2.1c 2.1d 2.1e 2.1f 2.1g 2.1h 2.1i Service 2.2a SECTION 2 — Service Name(s) and Information the service is a monthly package, please offer different levels. All monthly packages must state a specific minimum number of direct service hours. #1 Name: Foster Parent Consultation — Individuals/Families Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Modality may include Trauma Informed ABA (Applied Behavior Analysis) or other parent coaching curriculums specialized for parents fostering children. 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: Frequency is highly dependent on specific needs and behaviors the family identifies. Anticipated duration of service (i.e. 3-4 months): Duration is highly dependent on specific needs and behaviors the family identifies during assessment and if child(ren) are also receiving services. Three (3), or more, specific goals of the service (DO use bullet points): 1. Provide foster parents with psychoeducation and resources that will prevent or limit burnout and stress. 2. Work with foster parents to identify preventative and environmental modifications that will enhance structure and predictability in their home. 3. Connect foster parents with other necessary resources or services. Three (3), or more, specific outcomes of service: 1. Prevent placement disruptions for involved children. 2. Support the placement to improve health and safety for the family unit. 3. Identify the need for additional or longer -term support and services. Target population of the service, including age and gender: Foster parents in need of consultation to address a specific concern or improve the overall placement success of their home. Languages service is available in (please list proficiency and if interpreter services are available): English or Spanish (fluent) — no interpreter services available Medicaid eligibility— list whether the service is eligible for Medicaid in whole or in part: No. Service location — list where the service will take place (i.e. client's home, in -office, other) Weld County DHS, Lifelong, Inc. offices, community, client's home, virtual #2 Name: Foster Parent Consultation — Groups Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Modality may include Trauma Informed ABA (Applied Behavior Analysis) or other parent coaching curriculums specialized for parents fostering children. 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: Frequency is highly dependent on specific needs and behaviors the family identifies. 2.2c Anticipated duration of service (i.e. 3-4 months): Duration is highly dependent on specific needs and behaviors the family identifies during assessment and if child(ren) are also receiving services. 2.2d Three (3), or more, specific goals of the service (DO use bullet points): 1. Provide foster parents with psychoeducation and resources that will prevent or limit burnout and stress. REV. OCT 2021 1 ATTACHMENT C - PROPOSAL 2. Work with foster parents to identify preventative and environmental modifications that will enhance structure and predictability in their home. Connect foster parents with other necessary resources or services. 2.2e Three (3), or more, specific outcomes of service: 1. Prevent placement disruptions for involved children. 2. Support the placement to improve health and safety for the family unit. 3. Identify the need for additional or longer -term support and services. 2.2f Target population of the service: Foster parents in need of consultation to address a specific concern or improve the overall placement success of their home. 2.2g Languages service is available in (please list proficiency and if interpreter services are available): English or Spanish (fluent) — no interpreter services available 2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: No. 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) Weld County DHS, Lifelong, Inc. offices, community, client's home, virtual Service #3 Name: 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.3b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.3c Anticipated duration of service (i.e. 3-4 months): 2.3d Three (3), or more, specific goals of the service (DO use bullet points): 2.3e Three (3), or more, specific outcomes of service: 2.3f Target population of the service: 2.3g Languages service is available in (please list proficiency and if interpreter services are available): 2.3h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.3i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #4 Name: 2.4a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.4b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.4c Anticipated duration of service (i.e. 3-4 months): 2.4d Three (3), or more, specific goals of the service (DO use bullet points): 2.4e Three (3), or more, specific outcomes of service: 2.4f Target population of the service: 2.4g Languages service is available in (please list proficiency and if interpreter services are available): REV. OCT 2021 2 ATTACHMENT C - PROPOSAL 2.4h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.4i Service 2.5a Service location — list where the service will take place (i.e. client's home, in -office, other) #5 Name: Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.5b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.5c Anticipated duration of service (i.e. 3-4 months): 2.5d Three (3), or more, specific goals of the service (DO use bullet points): 2.5e Three (3), or more, specific outcomes of service: 2.5f Target population of the service: 2.5g Languages service is available in (please list proficiency and if interpreter services are available): 2.5h Medicaid eligibility— list whether the service is eligible for Medicaid in whole or in part 2.6i Service location — list where the service will take place (i.e. client's home, in -office, other) 3.1 3.2 3.3 3.4 3.5 Section 3 — Service Access and Transportation YES YES NO Will you charge Weld County for transporting clients or mileage? Check one: 0 • NO Will you conduct services in a client's home or in the community? Check one: 0 • NO Miles Will you transport clients to and/or from services? Check one: ■ YES e How many miles are you willing to travel round trip? List a specific number of miles. 60 When you calculate mileage, what is your starting point address? 7175 W. Jefferson Avenue, Lakewood, CO 80235 SECTION 4 - SERVICE RATES All rates need to include administrative work (i.e. scheduling or report writing) and overhead. Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly or monthly rates will be accepted for services, except for those listed above. • For hourly rates complete section(s) 4.1-4.5. • For monthly rates complete section 4.6. • For Home study providers complete section 4.7. • For monitored sobriety testing providers complete section 4.8. 4.1 Hourly Service #1 Name: 4.1a 4.1b 4.1c 4.1d REV. OCT 2021 Foster Parent Consultation — Individual/Family In-Office/Video: In -Office with Transportation: In -Home or Community: FTM, TDM, Prof. Staffing: No show: $ Amount $175 $190 $100 $60 Unit Type per Hour per Hour per Hour per Hour per No Show No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: miles miles 3 ATTACHMENT C - PROPOSAL 4.1e Mileage rate: I .56 I per Mile This is paid after the miles listed above. 4.2 Hourly Service #2 Name: Foster Parent Consultation - Group $ Amount Unit Type 4.2a In-Office/Video: $55 per Hour 4.2b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.2c In -Home or Community: $65 per Hour No. of roundtrip miles included in rate: miles 4.2d FTM, TDM, Prof. Staffing: $100 per Hour 4.2e No show: $30 per No Show 4.2f Mileage rate: .56 per Mile This is paid after the miles listed above. 4.3 Hourly Service #3 Name: $ Amount Unit Type 4.3a In-Office/Video: per Hour 4.3b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.3c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.3d FTM, TDM, Prof. Staffing: per Hour 4.3e No show: per No Show 4.3f Mileage rate: per Mile This is paid after the miles listed above. 4.4 Hourly Service #4 Name: $ Amount Unit Type 4.4a In-Office/Video: per Hour 4.4b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.4c FTM, TDM, Prof. Staffing: per Hour 4.4d No show: per No Show 4.4e Mileage rate: per Mile This is paid after the miles listed above. 4.5 Hourly Service #5 Name: $ Amount Unit Type 4.5a In-Office/Video: per Hour 4.5b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.5c In -Home or Community: per Hour No. of roundtrip miles included 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 No. of Direct Service Hours: 4.6a 4.6b 4.6c 4.6d 4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers — List your rates in the box below. 4.8 Monitored Sobriety Providers — List your rates in the box below. REV. OCT 2021 4 ATTACHMENT C - PROPOSAL Please see SUD program area attachment. Provider special notes: All bilingual services are +$15/hour. REV. OCT 2021 5 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: Program Areas are listed in column 1 of the table located in Item Xl of the Request for Proposal starting on page 13. Lifelong, Inc. Foster Parent Training Number of services offered on this Attachment C (max 5): You may complete another Attachment C if you have more than 5. 1 If Service 2.1a 2.1b 2.1c 2.1d 2.1e 2.1f 2.1g 2.1h 2.11 Service 2.2a SECTION 2 - Service Name(s) and Information the service is a monthly package, please offer different levels. All monthly packages must state a specific minimum number of direct service hours. #1 Name: Foster Parent Training - Various Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): • Modality may include Trauma Informed ABA (Applied Behavior Analysis), parent coaching curriculums specialized for parents fostering children, trauma informed trainings, etc. • Attachment / trauma focused therapy and psychoeducation 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: Dependent upon identified needs. Anticipated duration of service (i.e. 3-4 months): Dependent upon identified needs. Three (3), or more, specific goals of the service (DO use bullet points): 1. Provide psychoeducation to foster parents regarding attachment trauma and associated symptoms and behaviors. 2. Provide foster parents with skills and training to support the development and maintenance of strategies that promote safety and prevent or limit the occurrence of behavioral challenges that can lead to additional trauma and / or disruption of the placement. 3. Provide foster parents with a safe and understanding support system in which they can process the challenges of foster parenting and learn self -care and coping skills. Three (3), or more, specific outcomes of service: 1. Preservation of placement 2. Reduce the number of placement changes a child experiences while in foster care. 3. Reduce foster parent burn out and stressors associated with foster care. Target population of the service, including age and gender: Foster Parents Languages service is available in (please list proficiency and if interpreter services are available): English and Spanish (proficient) — no interpreter services available Medicaid eligibility— list whether the service is eligible for Medicaid in whole or in part: No. Service location — list where the service will take place (i.e. client's home, in -office, other) Weld County DHS, Lifelong, Inc. offices, community, client's home, virtual #2 Name: Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 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: 2.2c Anticipated duration of service (i.e. 3-4 months): 2.2d Three (3), or more, specific goals of the service (DO use bullet points): 2.2e Three (3), or more, specific outcomes of service: REV. OCT 2021 1 ATTACHMENT C - PROPOSAL 2.2f Target population of the service: 2.2g Languages service is available in (please list proficiency and if interpreter services are available): 2.2h Medicaid eligibility— list whether the service is eligible for Medicaid in whole or in part: 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #3 Name: 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.3b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.3c Anticipated duration of service (i.e. 3-4 months): 2.3d Three (3), or more, specific goals of the service (DO use bullet points): 2.3e Three (3), or more, specific outcomes of service: 2.3f Target population of the service: 2.3g Languages service is available in (please list proficiency and if interpreter services are available): 2.3h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.3i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #4 Name: 2.4a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.4b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.4c Anticipated duration of service (i.e. 3-4 months): 2.4d Three (3), or more, specific goals of the service (DO use bullet points): 2.4e Three (3), or more, specific outcomes of service: 2.4f Target population of the service: 2.4g Languages service is available in (please list proficiency and if interpreter services are available): 2.4h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.4i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #5 Name: 2.5a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): REV. OCT 2021 2 ATTACHMENT C - PROPOSAL 2.5b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.5c Anticipated duration of service (i.e. 3-4 months): 2.5d Three (3), or more, specific goals of the service (DO use bullet points): 2.5e Three (3), or more, specific outcomes of service: 2.5f Target population of the service: 2.5g Languages service is available in (please list proficiency and if interpreter services are available): 2.5h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part 2.6i Service location — list where the service will take place (i.e. client's home, in -office, other) 3.1 3.2 3.3 3.4 3.5 Section 3 — Service Access and Transportation YES YES NO Will you charge Weld County for transporting clients or mileage? Check one: ►A • NO Will you conduct services in a client's home or in the community? Check one: 0 • NO Miles Will you transport clients to and/or from services? Check one: In YES @ How many miles are you willing to travel round trip? List a specific number of miles. When you calculate mileage, what is your starting point address? 7175 W. Jefferson Avenue, Lakewood, CO 80235 SECTION 4 - SERVICE RATES All rates need to include administrative work (i.e. scheduling or report writing) and overhead. Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly or monthly rates will be accepted for services, except for those listed above. • For hourly rates complete section(s) 4.1-4.5. • For monthly rates complete section 4.6. • For Home study providers complete section 4.7. • For monitored sobriety testing providers complete section 4.8. 4.1 Hourly Service #1 Name: Foster Parent Training 4.1a In-Office/Video: 4.1b In -Office with Transportation: In -Home or Community: 4.1c FTM, TDM, Prof. Staffing: 4.1d No show: 4.1e Mileage rate: $ Amount $225 $275 $100 $60 .56 Unit Type per Hour per Hour per Hour per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: This is paid after the miles listed above. miles miles 4.2 Hourly Service #2 Name: 4.2a In-Office/Video: 4.2b In -Office with Transportation: 4.2c In -Home or Community: $ Amount Unit Type per Hour per Hour per Hour No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: miles miles REV. OCT 2021 3 ATTACHMENT C - PROPOSAL 4.2d FTM, TDM, Prof. Staffing: per Hour 4.2e No show: per No Show 4.2f Mileage rate: per Mile This is paid after the miles listed above. 4.3 Hourly Service #3 Name: $ Amount Unit Type 4.3a In-Office/Video: per Hour 4.3b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.3c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.3d FTM, TDM, Prof. Staffing: per Hour 4.3e No show: per No Show 4.3f Mileage rate: per Mile This is paid after the miles listed above. 4.4 Hourly Service #4 Name: $ Amount Unit Type 4.4a In-Office/Video: per Hour 4.4b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.4c FTM, TDM, Prof. Staffing: per Hour 4.4d No show: per No Show 4.4e Mileage rate: per Mile This is paid after the miles listed above. 4.5 Hourly Service #5 Name: $ Amount Unit Type 4.5a In-Office/Video: per Hour 4.5b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.5c In -Home or Community: per Hour No. of roundtrip miles included 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 No. of Direct Service Hours: 4.6a 4.6b 4.6c 4.6d 4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers — List your rates in the box below. 4.8 Monitored Sobriety Providers — List your rates in the box below. Please see SUD program area attachment. Provider special notes: All bilingual services are +$15/hour. REV. OCT 2021 4 ATTACHMENT C - PROPOSAL Please type your answers in the boxes below or check the appropriate box. SECTION 1— Provider and Program Area Information Bidder's Legal Name: Program Area: Program Areas are listed in column 1 of the table located in Item Xl of the Request You may complete another Attachment C if you have more than 5. for Proposal starting on page 13. Lifelong, Inc. Home -Based Intervention Number of services offered on this Attachment C (max 5): 3 If Service 2.1a 2.1b 2.1c 2.1d 2.1e 2.1f 2.1g 2.1h 2.1i Service 2.2a 2.2b 2.2c SECTION 2 — Service Name(s) and Information the service is a monthly package, please offer different levels. All monthly packages must state a specific minimum number of direct service hours. #1 Name: Home -Based Interventions - Intensive Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Individual and / or family therapy, therapeutic life skills, Applied Behavior Analysis, and a variety of our services provided by masters level clinicians in the home environment of the individual. Modality for therapeutic interventions determined by clinician and based on clients' individual needs and abilities. Skills assessments may be utilized to determine curriculum and programming. Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 3-8 hours per week, based on individual needs and goals. Anticipated duration of service (i.e. 3-4 months): Minimum 12 weeks, based on individual need and goals. Three (3), or more, specific goals of the service (DO use bullet points): 1. Provide most accessible therapeutic level interventions in client home. 2. Individuals will engage in skill acquisition and therapy with opportunity to demonstrate and maintain skills in their home environment. 3. Individuals will reflect on and process stressors, traumatic experiences, and associated emotions and behaviors. 4. Individuals will develop and maintain self -care and coping practices. Three (3), or more, specific outcomes of service: 1. Increased ability to generalize and maintain learned skills over time in their home environments. 2. Reduce likelihood of out of home placement and court involvement for child protection concerns. 3. Reduce recidivism for child welfare contact and involvement. Target population of the service, including age and gender: Client with various diagnosed or suspected disabilities, ages 0-100, individuals, dyads, or families Languages service is available in (please list proficiency and if interpreter services are available): English and Spanish (proficient) - no interpreter services available Medicaid eligibility— list whether the service is eligible for Medicaid in whole or in part: No. Service location — list where the service will take place (i.e. client's home, in -office, other) community, client's home #2 Name: Home -Based Interventions - High Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Individual and / or family therapy, therapeutic life skills, Applied Behavior Analysis, and a variety of our services provided by masters level clinicians in the home environment of the individual. Modality for therapeutic interventions determined by clinician and based on clients' individual needs and abilities. Skills assessments may be utilized to determine curriculum and programming. Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 3-6 hours per week Anticipated duration of service (i.e. 3-4 months): Minimum 8 weeks, based on individual needs and goals. REV. OCT 2021 1 ATTACHMENT C - PROPOSAL 2.2d Three (3), or more, specific goals of the service (DO use bullet points): 1. Provide most accessible therapeutic level interventions in client home. 2. Individuals will engage in skill acquisition and therapy with opportunity to demonstrate and maintain skills in their home environment. 3. Individuals will develop and maintain self -care and coping practices. 2.2e Three (3), or more, specific outcomes of service: 1. Increased ability to generalize and maintain learned skills over time in their home environments. 2. Reduce likelihood of out of home placement and court involvement for child protection concerns. 3. Reduce recidivism for child welfare contact and involvement. 2.2f Target population of the service: Client with various diagnosed or suspected disabilities, ages 0-100, individuals, dyads, or families 2.2g Languages service is available in (please list proficiency and if interpreter services are available): English and Spanish (proficient) — no interpreter services available 2.2h Medicaid eligibility— list whether the service is eligible for Medicaid in whole or in part: No. 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) community, client's home Service #3 Name: Home -Based Interventions - Moderate 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Can include life skills coaching, applied behavior analysis, parenting skills, child development psychoeducation, and mentoring provided in the individual's home. 2.3b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2-6 hours per week, based on individual needs and goals. 2.3c Anticipated duration of service (i.e. 3-4 months): Minimum 8 —12 weeks, based on individual needs and goals. 2.3d Three (3), or more, specific goals of the service (DO use bullet points): 2.3e 1. Individuals will engage in skill acquisition opportunity to demonstrate and maintain skills in their home environment. 2. Individuals will develop and maintain self -care and coping practices. 3. Individuals will demonstrate an increased knowledge of safe parenting practices, awareness of child development, and the impact of trauma/abuse and neglect Three (3), or more, specific outcomes of service: 1. Increased ability to generalize and maintain learned skills over time in their home environments. 2. Reduce likelihood of out of home placement and court involvement for child protection concerns. 3. Reduce recidivism for child welfare contact and involvement. 2.3f Target population of the service: Client with various diagnosed or suspected disabilities, ages 0-100, individuals, dyads, or families 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: No. 2.3i Service location — list where the service will take place (i.e. client's home, in -office, other) community, client's home 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): REV. OCT 2021 2 ATTACHMENT C - PROPOSAL 2.4e Three (3), or more, specific outcomes of service: 2.4f Target population of the service: 2.4g Languages service is available in (please list proficiency and if interpreter services are available): 2.4h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.4i Service 2.5a Service location — list where the service will take place (i.e. client's home, in -office, other) #5 Name: Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.5b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.5c Anticipated duration of service (i.e. 3-4 months): 2.5d Three (3), or more, specific goals of the service (DO use bullet points): 2.5e Three (3), or more, specific outcomes of service: 2.5f Target population of the service: 2.5g Languages service is available in (please list proficiency and if interpreter services are available): 2.5h Medicaid eligibility— list whether the service is eligible for Medicaid in whole or in part 2.6i Service location — list where the service will take place (i.e. client's home, in -office, other) 3.1 3.2 3.3 3.4 3.5 Section 3 — Service Access and Transportation YES YES NO Will you charge Weld County for transporting clients or mileage? Check one: 0 • NO Will you conduct services in a client's home or in the community? Check one: ►5 • NO Miles Will you transport clients to and/or from services? Check one: • YES 0 How many miles are you willing to travel round trip? List a specific number of miles. When you calculate mileage, what is your starting point address? 7175 W. Jefferson Avenue, Lakewood, CO 80235 SECTION 4 - SERVICE RATES All rates need to include administrative work (i.e. scheduling or report writing) and overhead. Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly or monthly rates will be accepted for services, except for those listed above. • For hourly rates complete section(s) 4.1-4.5. • For monthly rates complete section 4.6. • For Home study providers complete section 4.7. • For monitored sobriety testing providers complete section 4.8. 4.1 Hourly Service #1 Name: Home Based Intervention - Intensive REV. OCT 2021 3 ATTACHMENT C - PROPOSAL $ Amount Unit Type 4.1a In-Office/Video: $135 per Hour 4.1b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles In -Home or Community: $140 per Hour No. of roundtrip miles included in rate: miles 4.1c FTM, TDM, Prof. Staffing: $100 per Hour 4.1d No show: $60 per No Show 4.1e Mileage rate: .56 per Mile This is paid after the miles listed above. 4.2 Hourly Service #2 Name: Home Based Intervention - High $ Amount Unit Type 4.2a In-Office/Video: $95 per Hour 4.2b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.2c In -Home or Community: $100 per Hour No. of roundtrip miles included in rate: miles 4.2d FTM, TDM, Prof. Staffing: $75 per Hour 4.2e No show: $60 per No Show 4.2f Mileage rate: .56 per Mile This is paid after the miles listed above. 4.3 Hourly Service #3 Name: Home Based Intervention - Moderate $ Amount Unit Type 4.3a In-Office/Video: $80 per Hour 4.3b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.3c In -Home or Community: $85 per Hour No. of roundtrip miles included in rate: miles 4.3d FTM, TDM, Prof. Staffing: $75 per Hour 4.3e No show: $60 per No Show 4.3f Mileage rate: .56 per Mile This is paid after the miles listed above. 4.4 Hourly Service #4 Name: $ Amount Unit Type 4.4a In-Office/Video: per Hour 4.4b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.4c FTM, TDM, Prof. Staffing: per Hour 4.4d No show: per No Show 4.4e Mileage rate: per Mile This is paid after the miles listed above. 4.5 Hourly Service #5 Name: $ Amount Unit Type 4.5a In-Office/Video: per Hour 4.5b In -Office with Transportation: _ per Hour No. of roundtrip miles included in rate: miles 4.5c In -Home or Community: per Hour No. of roundtrip miles included 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 No. of Direct Service Hours: 4.6a 4.6b 4.6c 4.6d 4.6e 4.6f 4.6g 4.6h 4.6i REV. OCT 2021 4 ATTACHMENT C - PROPOSAL 4.6j 4.7 Home Study Providers — List your rates in the box below. 4.8 Monitored Sobriety Providers — List your rates in the box below. Please see SUD program area attachment. Provider special notes: All bilingual services are +$15/hour. REV. OCT 2021 5 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: Program Areas are listed in column 1 of the table located in Item XI of the Request You may complete another Attachment C if you have more than 5. for Proposal starting on page 13. Lifelong, Inc. Kinship Services (Therapeutic) Number of services offered on this Attachment C (max 5): 1 If Service 2.1a 2.1b 2.1c 2.1d 2.1e 2.1f 2.1g 2.1h 2.1i Service 2.2a SECTION 2 — Service Name(s) and Information the service is a monthly package, please offer different levels. All monthly packages must state a specific minimum number of direct service hours. #1 Name: Kinship Services (Therapeutic) Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Modalities may include Intensive Family Therapy, Applied Behavior Analysis, Caregiver Consultation, Caregiver Training. 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: Typically 2 hours per week at a minimum. Anticipated duration of service (i.e. 3-4 months): Highly dependent on case specifics, children's needs, and engagement of involved parties. Minimum 12 weeks. Three (3), or more, specific goals of the service (DO use bullet points): 1. Provide supportive and comprehensive services to kinship placement providers. 2. Provide psychoeducation, therapy, skill acquisition, and prevention strategies to mediate challenges presented in kinship care. 3. Provide Kinship caregivers with resources, community connections, and skills to develop coping practices. Three (3), or more, specific outcomes of service: 1. Preservation of Kinship placement. 2. Improve quality and stability of relationships within kinship placement. 3. Prevent kinship provider burnout and reduce risk of harm in placement. Target population of the service, including age and gender: Client with various diagnosed or suspected disabilities, ages (any), individuals, dyads, or families. Languages service is available in (please list proficiency and if interpreter services are available): English and Spanish (proficient) — no interpreter services available Medicaid eligibility— list whether the service is eligible for Medicaid in whole or in part: No. Service location — list where the service will take place (i.e. client's home, in -office, other) Weld County DHS, Lifelong, Inc. offices, community, client's home, virtual #2 Name: Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 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: 2.2c Anticipated duration of service (i.e. 3-4 months): 2.2d Three (3), or more, specific goals of the service (DO use bullet points): 2.2e Three (3), or more, specific outcomes of service: 2.2f Target population of the service: 2.2g Languages service is available in (please list proficiency and if interpreter services are available): REV. OCT 2021 1 ATTACHMENT C - PROPOSAL 2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #3 Name: 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.3b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.3c Anticipated duration of service (i.e. 3-4 months): 2.3d Three (3), or more, specific goals of the service (DO use bullet points): 2.3e Three (3), or more, specific outcomes of service: 2.3f Target population of the service: 2.3g Languages service is available in (please list proficiency and if interpreter services are available): 2.3h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.3i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #4 Name: 2.4a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.4b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.4c Anticipated duration of service (i.e. 3-4 months): 2.4d Three (3), or more, specific goals of the service (DO use bullet points): 2.4e Three (3), or more, specific outcomes of service: 2.4f Target population of the service: 2.4g Languages service is available in (please list proficiency and if interpreter services are available): 2.4h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.4i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #5 Name: 2.5a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.5b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.5c Anticipated duration of service (i.e. 3-4 months): REV. OCT 2021 2 ATTACHMENT C - PROPOSAL 2.5d Three (3), or more, specific goals of the service (DO use bullet points): 2.5e Three (3), or more, specific outcomes of service: 2.5f Target population of the service: 2.5g Languages service is available in (please list proficiency and if interpreter services are available): 2.5h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part 2.6i Service location — list where the service will take place (i.e. client's home, in -office, other) 3.1 3.2 3.3 3.4 3.5 Section 3 — Service Access and Transportation YES YES NO Will you charge Weld County for transporting clients or mileage? Check one: e • NO Will you conduct services in a client's home or in the community? Check one: e • NO Miles Will you transport clients to and/or from services? Check one: ■ YES ►5 How many miles are you willing to travel round trip? List a specific number of miles. When you calculate mileage, what is your starting point address? 7175 W. Jefferson Avenue, Lakewood, CO 80235 SECTION 4 - SERVICE RATES All rates need to include administrative work (i.e. scheduling or report writing) and overhead. Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly or monthly rates will be accepted for services, except for those listed above. • For hourly rates complete section(s) 4.1-4.5. • For monthly rates complete section 4.6. • For Home study providers complete section 4.7. • For monitored sobriety testing providers complete section 4.8. 4.1 Hourly Service #1 Name: Kinship Services (Therapeutic) 4.1a In-Office/Video: 4.1b In -Office with Transportation: In -Home or Community: 4.1c FTM, TDM, Prof. Staffing: 4.1d No show: 4.1e Mileage rate: $ Amount $135 $140 $100 $60 .56 Unit Type per Hour per Hour per Hour per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: This is paid after the miles listed above. miles miles 4.2 Hourly Service #2 Name: 4.2a In-Office/Video: 4.2b In -Office with Transportation: 4.2c In -Home or Community: 4.2d FTM, TDM, Prof. Staffing: 4.2e No show: 4.2f Mileage rate: $ Amount Unit Type per Hour per Hour per Hour per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: This is paid after the miles listed above. miles miles 4.3 Hourly Service #3 Name: REV. OCT 2021 3 ATTACHMENT C - PROPOSAL $ Amount Unit Type 4.3a In-Office/Video: per Hour 4.3b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.3c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.3d FTM, TDM, Prof. Staffing: per Hour 4.3e No show: per No Show 4.3f Mileage rate: per Mile This is paid after the miles listed above. 4.4 Hourly Service #4 Name: $ Amount Unit Type 4.4a In-Office/Video: per Hour 4.4b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.4c FTM, TDM, Prof. Staffing: per Hour 4.4d No show: per No Show 4.4e Mileage rate: per Mile This is paid after the miles listed above. 4.5 Hourly Service #5 Name: $ Amount Unit Type 4.5a In-Office/Video: per Hour 4.5b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.5c In -Home or Community: per Hour No. of roundtrip miles included 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 No. of Direct Service Hours: 4.6a 4.6b 4.6c 4.6d 4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers — List your rates in the box below. 4.8 Monitored Sobriety Providers — List your rates in the box below. Please see SUD program area attachment. Provider special notes: All bilingual services are +$15/hour. REV. OCT 2021 4 ATTACHMENT C - PROPOSAL Please type your answers in the boxes below or check the appropriate box. SECTION 1— Provider and Program Area Information Bidder's Legal Name: Program Area: Program Areas are listed in column 1 of the table located in Item XI of the You may complete another Attachment C if you have more than 5. Request for Proposal starting on page 13. Lifelong, Inc. Life Skills Number of services offered on this Attachment C (max 5): 5 If Service 2.1a 2.1b 2.1c 2.1d 2.1e 2.1f 2.1g 2.1h 2.1i Service 2.2a SECTION 2 - Service Name(s) and Information the service is a monthly package, please offer different levels. All monthly packages must state a specific minimum number of direct service hours. #1 Name: Therapeutic Life Skills Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Approaches are highly individualized and dependent on the specific skill deficits and goals of the individual. May include but not limited to role play practice of skills, direct support, prompting and prompt fading strategies, naturalistic in - situation instruction. 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: Minimum 2 hours per week, 1-3 sessions depending on client needs. Anticipated duration of service (i.e. 3-4 months): Case specific — ranges for each case needs (i.e., 16 weeks to 52 weeks) Three (3), or more, specific goals of the service (DO use bullet points): 1. Provide skill acquisition training to individuals. 2. Provide safe therapeutic support in which clients social/ emotional needs are respected and addressed in ways that will allow learning of skills and processing the emotions related to their challenges. 3. Individuals will increase their independence to the maximum potential possible for their abilities. 4. Individuals will secure and maintain resources that will allow them to meet their court ordered treatment goals. 5. Individuals will improve the quality of their relationships, develop leisure skills that are healthy and sustainable. 6. Successful mental health management during stressful or triggering life skill activities. Three (3), or more, specific outcomes of service: 1. Successful reunification or other successful case closure. 2. Increased ability to access home and community resources. 3. Increased independence and ability to establish and maintain meaningful healthy relationships. 4. Increased ability to identify and maintain healthy supports and leisure skills that contribute to stable and predictable parenting. Target population of the service, including age and gender: Clients with various diagnosed or suspected disabilities, ages (any), individuals, dyads, or families. Languages service is available in (please list proficiency and if interpreter services are available): English and Spanish (proficient) — no interpreter services available Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: No. Service location — list where the service will take place (i.e. client's home, in -office, other) Weld County DHS, Lifelong, Inc. offices, community, client's home, virtual #2 Name: Life Skills Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Approaches are highly individualized and dependent on the specific skill deficits and goals of the individual. May include but not limited to role play practice of skills, direct support, prompting and prompt fading strategies, naturalistic in - situation instruction. 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: REV. OCT 2021 1 ATTACHMENT C - PROPOSAL Minimum 2 hours per week, 1-3 sessions depending on client needs. 2.2c Anticipated duration of service (i.e. 3-4 months): Case specific — ranges for each case needs (i.e., 16 weeks to 52 weeks) 2.2d Three (3), or more, specific goals of the service (DO use bullet points): 1. Provide skill acquisition training to individuals. 2. Individuals will increase their independence to the maximum potential possible for their abilities. 3. Individuals will secure and maintain resources that will allow them to meet their court ordered treatment goals. 2.2e Three (3), or more, specific outcomes of service: 1. Successful reunification or other successful case closure. 2. Increased ability to access home and community resources. 3. Increased independence and ability to establish and maintain meaningful healthy relationships. 4. Increased ability to identify and maintain healthy supports and leisure skills that contribute to stable and predictable parenting. 2.2f Target population of the service: Clients with various diagnosed or suspected disabilities, ages (any), individuals, dyads, or families. 2.2g Languages service is available in (please list proficiency and if interpreter services are available): English and Spanish (proficient) — no interpreter services available 2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: No. 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) Weld County DHS, Lifelong, Inc. offices, community, client's home, virtual Service #3 Name: Specialized Mentorship 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Based on intake assessment, modalities or curriculum may include but not limited to adventure based activities, participation and engagement in community activities, modeling, skill acquisition, role playing, and development of hobbies and interests. 2.3b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: At a minimum 2 hours per week. Typically up to 3 times per week. 2.3c Anticipated duration of service (i.e. 3-4 months): 2.3d 2.3e 6-12 months Three (3), or more, specific goals of the service (DO use bullet points): 1. Provide a safe, stable, consistent connection to individuals. 2. Individuals will develop and maintain skills that promote stability, independence, and physical / mental wellbeing. 3. Individuals will develop and maintain healthy leisure skills and increase self-worth and self-confidence by reducing risk taking behavior, acting out, substance use, and negative self -statements. Three (3), or more, specific outcomes of service: 1. Reduce future police contact or juvenile justice system involvement. 2. Maintain placement in home or current stable living situation. 3. Increase school attendance and completion. 4. Increase awareness of mental health and resources to secure supports necessary to maintain wellbeing. 5. Increase social / emotional skills and self -management. 6. Increase ability to advocate for self. 7. Increased communication skills. 8. Reduce symptoms of anxiety and depression. 9. Reduce self harm. 2.3f Target population of the service: Youth ages 8 to 21 with or without suspected or diagnosed disability, criminal involvement, or child welfare involvement. 2.3g Languages service is available in (please list proficiency and if interpreter services are available): English and Spanish (proficient) — no interpreter services available 2.3h Medicaid eligibility— list whether the service is eligible for Medicaid in whole or in part: No. 2.3i Service location — list where the service will take place (i.e. client's home, in -office, other) Weld County DHS, Lifelong, Inc. offices, community, client's home, virtual REV. OCT 2021 2 ATTACHMENT C - PROPOSAL Service #4 Name: Therapeutic Visitation 2.4a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Lifelong is a member of the Supervised Visitation Network. Approaches are highly individualized and dependent on the specific skill deficits and goals of the individual regarding parenting needs, trauma responses, triggers, and other evidence - informed assessment and treatment approaches. May include but not limited to role play practice of parenting skills, direct support, prompting and prompt fading strategies, redirection, bonding, abuse intervening, structure, education, and repeat instruction. 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: As determined by team 2.4c Anticipated duration of service (i.e. 3-4 months): As determined by team 2.4d Three (3), or more, specific goals of the service (DO use bullet points): 1. Strengthen parent -child bond. 2. Assess for trauma responses. 3. Develop a family structure that is predictable, with protective parenting, and safe behaviors. 2.4e Three (3), or more, specific outcomes of service: 1. Increased parenting time for the identified parent. 2. Increased independent parenting. 3. Increased structure during visitation. 2.4f Target population of the service: Clients with various diagnosed or suspected disabilities, ages (any), individuals, dyads, or families. 2.4g Languages service is available in (please list proficiency and if interpreter services are available): English and Spanish (proficient) — no interpreter services available 2.4h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: No. 2.4i Service location — list where the service will take place (i.e. client's home, in -office, other) Weld County DHS, Lifelong, Inc. offices, community, client's home, virtual Service #5 Name: Supportive/Coached Visitation 2.5a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Lifelong is a member of the Supervised Visitation Network. Approaches are highly individualized and dependent on the specific skill deficits and goals of the individual regarding parenting needs, trauma responses, triggers, and other evidence - informed assessment and treatment approaches. May include but not limited to role play practice of parenting skills, direct support, prompting and prompt fading strategies, redirection, bonding, structure, education, and repeat instruction. 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: As determined by team. 2.5c Anticipated duration of service (i.e. 3-4 months): As determined by team. 2.5d Three (3), or more, specific goals of the service (DO use bullet points): 1. Strengthen parent -child bond. 2. Assess for triggers. 3. Develop a family structure that is predictable, with protective parenting, and safe behaviors. 2.5e Three (3), or more, specific outcomes of service: 1. Increased parenting time for the identified parent. 2. Increased independent parenting. 3. Increased structure and initiative during visitation. 2.5f Target population of the service: Clients with various diagnosed or suspected disabilities, ages (any), individuals, dyads, or families. 2.5g Languages service is available in (please list proficiency and if interpreter services are available): English and Spanish (proficient) — no interpreter services available REV. OCT 2021 3 ATTACHMENT C - PROPOSAL 2.5h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part No. 2.6i Service location — list where the service will take place (i.e. client's home, in -office, other) Weld County DHS, Lifelong, Inc. offices, community, client's home, virtual 3.1 3.2 3.3 3.4 3.5 Section 3 — Service Access Will you charge Weld County for transporting clients or mileage? one: Will you conduct services in a client's home or in the community? Will you transport clients to and/or from services? Check one: How many miles are you willing to travel round trip? List a specific When you calculate mileage, what is your starting point address? and Transportation Check 0 YES • NO Check one: 0 YES • NO Miles ►I YES ►5 NO (specialized mentorship and supportive visitation) number of miles. 7175 W. Jefferson Avenue, Lakewood, CO 80235 SECTION 4 - SERVICE RATES All rates need to include administrative work (i.e. scheduling or report writing) and overhead. Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly or monthly rates will be accepted for services, except for those listed above. • For hourly rates complete section(s) 4.1-4.5. • For monthly rates complete section 4.6. • For Home study providers complete section 4.7. • For monitored sobriety testing providers complete section 4.8. 4.1 Hourly Service #1 Name: Therapeutic Life Skills 4.1a In-Office/Video: 4.1b In -Office with Transportation: In -Home or Community: 4.1c FTM, TDM, Prof. Staffing: 4.1d No show: 4.1e Mileage rate: $ Amount $135 $140 $100 $60 . 56 Unit Type per Hour per Hour per Hour per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: This is paid after the miles listed above. miles miles 4.2 Hourly Service #2 Name: Life Skills 4.2a In-Office/Video: 4.2b In -Office with Transportation: 4.2c In -Home or Community: 4.2d FTM, TDM, Prof. Staffing: 4.2e No show: 4.2f Mileage rate: $ Amount $95 $100 $75 $60 . 56 Unit Type per Hour per Hour per Hour per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: This is paid after the miles listed above. miles miles REV. OCT 2021 4 ATTACHMENT C - PROPOSAL 4.3 Hourly Service #3 Name: Specialized Mentorship $ Amount Unit Type 4.3a In-Office/Video: $95 per Hour 4.3b In Transportation: -Office with $100 per Hour No. of roundtrip miles included in rate: miles 4.3c In -Home or Community: $100 per Hour No. of roundtrip miles included in rate: miles 4.3d FTM, TDM, Prof. Staffing: $75 per Hour 4.3e No show: $60 per No Show 4.3f Mileage rate: .56 per Mile This is paid after the miles listed above. 4.4 Hourly Service #4 Name: Therapeutic Visitation $ Amount Unit Type 4.4a In-Office/Video: $135 per Hour 4.4b In Transportation: -Office with per Hour No. of roundtrip miles included in rate: miles In -Home or Community: $140 per Hour No. of roundtrip miles included in rate: miles 4.4c FTM, TDM, Prof. Staffing: $100 per Hour 4.4d No show: $60 per No Show 4.4e Mileage rate: .56 per Mile This is paid after the miles listed above. 4.5 Hourly Service #5 Name: Supportive/Coached Visitation $ Amount Unit Type 4.5a In-Office/Video: $95 per Hour 4.5b In -Office with Transportation: $115 per Hour No. of roundtrip miles included in rate: miles 4.5c In -Home or Community: $100 per Hour No. of roundtrip miles included in rate: miles 4.5d FTM, TDM, Prof. Staffing: $75 per Hour 4.5e No show: $60 per No Show 4.5f Mileage rate: .56 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 No. of Direct Service Hours: 4.6a 4.6b 4.6c 4.6d 4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers — List your rates in the box below. 4.8 Monitored Sobriety Providers — List your rates in the box below. Please see SUD program area attachment. REV. OCT 2021 5 ATTACHMENT C - PROPOSAL Provider special notes: All bilingual services are +$15/hour. REV. OCT 2021 6 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: Program Areas are listed in column 1 of the table located in Item XI of the Request You may complete another Attachment Cif you have more than 5. for Proposal starting on page 13. Lifelong, Inc. Mental Health Services Number of services offered on this Attachment C (max 5): 5 If Service 2.1a 2.1b 2.1c 2.1d 2.1e 2.1f 2.1g 2.1h 2.11 Service 2.2a SECTION 2 - Service Name(s) and Information the service is a monthly package, please offer different levels. All monthly packages must state a specific minimum number of direct service hours. #1 Name: Mental Health Therapy Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): CBT, DBT, TF-CBT, ABT, AAT, MFT, MI, PCIT, etc. 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: Very case specific — some client or families will need 1 hour week, some will need 4, etc., depending on the severity of need/trauma/crisis. Anticipated duration of service (i.e. 3-4 months): Very case specific with recommendations based on assessment, client goals, and abilities in addition to level of engagement. Three (3), or more, specific goals of the service (DO use bullet points): 1. Reduce and manage mental health triggers. 2. Reduce skill deficits within emotional regulation and coping practices. 3. Increase self-awareness and self -management skills. 4. Process traumatic experiences and develop understanding of their impact on current functioning and relationships. 5. Increase the ability of the client to identify emotional, mental, and physical needs and advocate for themselves. Three (3), or more, specific outcomes of service: 1. Successful use of coping skills during day-to-day interactions, conflict or crisis. 2. Increased independence in accessing community activities, resources, and services. 3. Increased ability to demonstrate independent engagement in pro -social and safe leisure skills. 4. Ability to establish and maintain healthy and safe relationships. 5. Successful achievement of court recommended goals. 6. Successful reunification or other successful case outcome. Target population of the service, including age and gender: Client with various diagnosed or suspected disabilities, ages (any), individuals, dyads, or families. Languages service is available in (please list proficiency and if interpreter services are available): English and Spanish (proficient) — no interpreter services available Medicaid eligibility— list whether the service is eligible for Medicaid in whole or in part: Yes, in most instances. Service location — list where the service will take place (i.e. client's home, in -office, other) Weld County DHS, Lifelong, Inc. offices, community, virtual, client's home #2 Name: Psychological Evaluation Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Diagnostic tools, screeners, and assessments as determined by psychologist. 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: 10-12 hours total including report preparation and feedback session. 2.2c Anticipated duration of service (i.e. 3-4 months): 1-3 appointments REV. OCT 2021 1 ATTACHMENT C - PROPOSAL 2.2d Three (3), or more, specific goals of the service (DO use bullet points): 1. Generate accurate assessment of clients' diagnosis, strengths, needs, and areas of skill deficits. 2. Generate a complete report of specialized recommendations for treatment and services tailored to the social/emotional, mental health, and learning needs of the individual. 3. Identify and determine course of treatment, treatment goals, and modality that is best suited for the individual. 2.2e Three (3), or more, specific outcomes of service: Evaluation will provide data, summary, and outcome suggestions for client's learning, developmental, and mental health needs. 2.2f Target population of the service: Clients age 4-100 2.2g Languages service is available in (please list proficiency and if interpreter services are available): English and Spanish (proficient) — no interpreter services available 2.2h Medicaid eligibility— list whether the service is eligible for Medicaid in whole or in part: No. 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) Lifelong Offices Service #3 Name: Neuropsychological Evaluation 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Diagnostic tools, testing, screeners, and assessments as determined by the psychologist. 2.3b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 10-15 hours total for testing and interview 2.3c Anticipated duration of service (i.e. 3-4 months): 1-3 appointments 2.3d Three (3), or more, specific goals of the service (DO use bullet points): 2.3e 1. Assess clients' strengths and areas of skill deficits. 2. Conduct neuropsychological testing as prescribed. 3. Accurately test clients' current functioning and gather full history of the whole person. 4. Generate tailored recommendations for specialized services and modalities that will best support the client. Three (3), or more, specific outcomes of service: 1. Accurate holistic understanding of client needs, diagnosis, and abilities. 2. Recommendations for specialized services. 3. Individualized and thorough report. 2.3f Target population of the service: Clients age 4-100 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: No. 2.3i Service location — list where the service will take place (i.e. client's home, in -office, other) Lifelong Offices. Service #4 Name: Pediatric Diagnostic Evaluation — Autism Evaluation 2.4a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): The pediatric diagnostic evaluation consists of systematic observations, assessments, collateral documentation review, and testing that will yield evidence to support a diagnosis of an autism spectrum diagnose or another disorder. 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: 10-15 hours of observation, interviewing, testing and collateral review. 2.4c Anticipated duration of service (i.e. 3-4 months): 1-3 appointments 2.4d Three (3), or more, specific goals of the service (DO use bullet points): 1. Obtain or rule out a diagnosis of a developmental disorder. REV. OCT 2021 2 ATTACHMENT C - PROPOSAL 2.4e 2.4f 2.4g 2.4h 2.4i Service 2.5a 2.5b 2.5c 2.5d 2.5e 2.5f 2.5g 2.5h 2.6i 2. Procure a thorough assessment of where a child falls along the Autism Spectrum. 3. Gain an understanding of a child's intellectual potential. Three (3), or more, specific outcomes of service: 1. Provide a treatment and education plan specifically geared towards the child's needs. 2. Provide education and resources to those providing care for the child. 3. Identify and connect the family with specialized support services and treatment options. Target population of the service: Children up to age 18 with suspected developmental disabilities or Autism Spectrum Disorder. Languages service is available in (please list proficiency and if interpreter services are available): English Medicaid eligibility— list whether the service is eligible for Medicaid in whole or in part: No. Service location — list where the service will take place (i.e. client's home, in -office, other) Lifelong Offices. #5 Name: Parent Child Interaction Assessment Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Parent child interaction assessment utilizes prescribed evidence based tools, observation techniques, and structured play scenarios based on the assessors training and current research. 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: 2-3 hours of direct observation plus interviews and collateral documentation review Anticipated duration of service (i.e. 3-4 months): 10-12 hours including report preparation and feedback session. Three (3), or more, specific goals of the service (DO use bullet points): 1. Gather data about parental attunement, attachment, relationship dynamics between parent and child. 2. Identify harmful or dysfunctional parenting attributes. 3. Present a thorough representation of the parent child relationship. Three (3), or more, specific outcomes of service: 1. Generate specialized recommendations for therapeutic supports to improve the quality of the parent / child relationship. 2. Reduce the likelihood of future child welfare contact. 3. Predict likelihood of potential for future abuse and neglect. Target population of the service: Individuals with various diagnosed or suspected intellectual/developmental disabilities, individuals, dyads, and families. Languages service is available in (please list proficiency and if interpreter services are available): English. Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part No. Service location — list where the service will take place (i.e. client's home, in -office, other) Lifelong Offices (other locations considered with recording equipment available) 3.1 3.2 3.3 3.4 3.5 Section 3 — Service Access and Transportation YES YES NO Will you charge Weld County for transporting clients or mileage? Check one: @ ■ NO Will you conduct services in a client's home or in the community? Check one: @ • NO Miles Will you transport clients to and/or from services? Check one: • YES ►5 How many miles are you willing to travel round trip? List a specific number of miles. When you calculate mileage, what is your starting point address? 7175 W. Jefferson Avenue, Lakewood, CO 80235 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 #1 Name: Mental Health Therapy $ Amount Unit Type 4.1a In-Office/Video: $135 per Hour 4.1b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles In -Home or Community: $145 per Hour No. of roundtrip miles included in rate: miles 4.1c FTM, TDM, Prof. Staffing: $100 per Hour 4.1d No show: $60 per No Show 4.1e Mileage rate: .56 per Mile This is paid after the miles listed above. 4.2 Hourly Service #2 Name: Psychological Evaluation $ Amount Unit Type 4.2a In-Office/Video: $185 per Hour 4.2b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.2c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.2d FTM, TDM, Prof. Staffing: $150 per Hour 4.2e No show: $100 per No Show 4.2f Mileage rate: per Mile This is paid after the miles listed above. 4.3 Hourly Service #3 Name: Neuropsychological Evaluation $ Amount Unit Type 4.3a In-Office/Video: $210 per Hour 4.3b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.3c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.3d FTM, TDM, Prof. Staffing: $150 per Hour 4.3e No show: $100 per No Show 4.3f Mileage rate: per Mile This is paid after the miles listed above. 4.4 Hourly Service #4 Name: Pediatric Diagnostic Evaluation $ Amount Unit Type 4.4a In-Office/Video: $210 per Hour 4.4b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.4c FTM, TDM, Prof. Staffing: $150 per Hour 4.4d No show: $100 per No Show 4.4e Mileage rate: per Mile This is paid after the miles listed above. 4.5 Hourly Service #5 Name: Parent Child Interaction Assessment $ Amount Unit Type 4.5a In-Office/Video: $160 per Hour 4.5b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.5c In -Home or Community: $175 per Hour No. of roundtrip miles included in rate: miles 4.5d FTM, TDM, Prof. Staffing: $150 per Hour 4.5e No show: $100 per No Show 4.5f Mileage rate: .56 per Mile This is paid after the miles listed above. 4.6 Monthly Service Rates (each level must be listed): REV. OCT 2021 4 ATTACHMENT C - PROPOSAL Service Name with Level Rate per Month No. of Direct Service Hours: 4.6a 4.6b 4.6c 4.6d 4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers — List your rates in the box below. 4.8 Monitored Sobriety Providers — List your rates in the box below. Please see SUD program area attachment. Provider special notes: All bilingual services are +$15/hour. REV. OCT 2021 5 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: Program Areas are listed in column 1 of the table located in Item XI of the Request You may complete another Attachment C if you have more than 5. for Proposal starting on page 13. Lifelong, Inc. Mental Health Services Number of services offered on this Attachment C (max 5): 3 If Service 2.1a 2.1b 2.1c 2.1d 2.1e 2.1f 2.1g 2.1h 2.1i Service 2.2a SECTION 2 - Service Name(s) and Information the service is a monthly package, please offer different levels. All monthly packages must state a specific minimum number of direct service hours. #1 Name: Mental Health Evaluation Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Clinical Interview, ACE, BRS, OSU-TBI, DSM-V, MMPI, TSI, mental status exam, or others as determined during interview. Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 3-5 hours Anticipated duration of service (i.e. 3-4 months): 1-2 appointments Three (3), or more, specific goals of the service (DO use bullet points): 1. Conduct a thorough assessment of individuals' mental status, social / emotional skills and deficits, and adaptive functioning. 2. Identify individuals' current mental functioning and mental health diagnosis if indicated. 3. Assist individual in identifying areas of strength and need with regard to their mental / emotional health. Three (3), or more, specific outcomes of service: 1. Provide client and authorized service providers with a comprehensive assessment summary. 2. Provide client and authorized service providers with specialized treatment recommendations for modalities and treatment options that are most effective for client's abilities and needs. 3. Provide psychoeducation to the client and/ or guardian regarding client's mental status, symptomology, and diagnosis. 4. Connect client with resources which can meet their needs. Target population of the service, including age and gender: Individuals with various diagnosed or suspected intellectual/developmental disabilities, ages 6-100, exhibiting challenges with mental or behavioral health. Languages service is available in (please list proficiency and if interpreter services are available): English and Spanish (proficient) — no interpreter services available Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Possibly, yes. Service location — list where the service will take place (i.e. client's home, in -office, other) Lifelong, Inc. offices or virtual #2 Name: Treatment Groups Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Seeking Safety, CBT, DBT, High Conflict Co -Parenting, Caring Dads, SSC/SSIC, Affective Education and Health Relationships, Veteran Group, Social Skills, Trauma -Processing, and others. 2.2b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 1-2 groups weekly 2.2c Anticipated duration of service (i.e. 3-4 months): 16-52 weeks, depending on client progress and needs 2.2d Three (3), or more, specific goals of the service (DO use bullet points): Complete treatment group assigned. REV. OCT 2021 1 ATTACHMENT C - PROPOSAL 2.2e Three (3), or more, specific outcomes of service: 1. Complete accurate assessment of clients' treatment, strengths, needs, and areas of skill deficits. 2. Complete designated curriculum specialized for the service type. 3. Reduce and/or eliminate concerns of recidivism, relapse, and other risk factors. 4. Increase coping capacity, safety tools, safe relationships, problem -solving, communication, and decision - making. 2.2f Target population of the service: Individuals with various diagnosed or suspected intellectual/developmental disabilities/brain injury, ages 6-100. 2.2g Languages service is available in (please list proficiency and if interpreter services are available): English and Spanish (proficient) — no interpreter services available 2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Some, yes. 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) Lifelong, Inc. offices or virtual Service #3 Name: Case Consultation 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Case consult, document review, etc. 2.3b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: As needed 2.3c Anticipated duration of service (i.e. 3-4 months): As needed 2.3d Three (3), or more, specific goals of the service (DO use bullet points): Identify correct course for client treatment, needs, and dynamics. 2.3e Three (3), or more, specific outcomes of service: Successful direction achieved. 2.3f Target population of the service: Any. 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: No. 2.3i Service location — list where the service will take place (i.e. client's home, in -office, other) Virtual, telephone Service #4 Name: 2.4a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.4b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.4c Anticipated duration of service (i.e. 3-4 months): 2.4d Three (3), or more, specific goals of the service (DO use bullet points): 2.4e Three (3), or more, specific outcomes of service: 2.4f Target population of the service: 2.4g Languages service is available in (please list proficiency and if interpreter services are available): 2.4h Medicaid eligibility— list whether the service is eligible for Medicaid in whole or in part: 2.4i Service location — list where the service will take place (i.e. client's home, in -office, other) REV. OCT 2021 2 ATTACHMENT C - PROPOSAL Service #5 Name: 2.5a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.5b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.5c Anticipated duration of service (i.e. 3-4 months): 2.5d Three (3), or more, specific goals of the service (DO use bullet points): 2.5e Three (3), or more, specific outcomes of service: 2.5f Target population of the service: 2.5g Languages service is available in (please list proficiency and if interpreter services are available): 2.5h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part 2.6i Service location — list where the service will take place (i.e. client's home, in -office, other) Section 3 — Service Access and Transportation YES YES NO 3.1 Will you charge Weld County for transporting clients or mileage? Check one: ►il • NO 3.2 Will you conduct services in a client's home or in the community? Check one: e ■ NO Miles 3.3 Will you transport clients to and/or from services? Check one: • YES @ 3.4 How many miles are you willing to travel round trip? List a specific number of miles. 3.5 When you calculate mileage, what is your starting point address? 7175 W. Jefferson Avenue, Lakewood, CO 80235 SECTION 4 - SERVICE RATES All rates need to include administrative work (i.e. scheduling or report writing) and overhead. Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly or monthly rates will be accepted for services, except for those listed above. • For hourly rates complete section(s) 4.1-4.5. • For monthly rates complete section 4.6. • For Home study providers complete section 4.7. • For monitored sobriety testing providers complete section 4.8. 4.1 Hourly Service #1 Name: Mental Health Evaluation 4.1a In-Office/Video: 4.1b In -Office with Transportation: In -Home or Community: 4.1c FTM, TDM, Prof. Staffing: 4.1d No show: 4.1e Mileage rate: $ Amount $175 $200 $100 $100 .56 Unit Type per Hour per Hour per Hour per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: This is paid after the miles listed above. miles miles 4.2 Hourly Service #2 Name: Treatment Groups $ Amount Unit Type REV. OCT 2021 3 ATTACHMENT C - PROPOSAL 4.2a In-Office/Video: $55 per Hour 4.2b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.2c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.2d FTM, TDM, Prof. Staffing: $100 per Hour 4.2e No show: $30 per No Show 4.2f Mileage rate: per Mile This is paid after the miles listed above. 4.3 Hourly Service #3 Name: Case Consultation $ Amount Unit Type 4.3a In-Office/Video: $135 per Hour 4.3b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.3c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.3d FTM, TDM, Prof. Staffing: $100 per Hour 4.3e No show: per No Show 4.3f Mileage rate: per Mile This is paid after the miles listed above. 4.4 Hourly Service #4 Name: $ Amount Unit Type 4.4a In-Office/Video: per Hour 4.4b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.4c FTM, TDM, Prof. Staffing: per Hour 4.4d No show: per No Show 4.4e Mileage rate: per Mile This is paid after the miles listed above. 4.5 Hourly Service #5 Name: $ Amount Unit Type 4.5a In-Office/Video: per Hour 4.5b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.5c In -Home or Community: per Hour No. of roundtrip miles included 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 No. of Direct Service Hours: 4.6a 4.6b 4.6c 4.6d 4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers — List your rates in the box below. 4.8 Monitored Sobriety Providers — List your rates in the box below. Please see SUD program area attachment. Provider special notes: REV. OCT 2021 4 ATTACHMENT C - PROPOSAL All bilingual services are +$15/hour. REV. OCT 2021 5 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: Lifelong, Inc. Substance Abuse Treatment 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 if you have more than 5. 5 If Service 2.1a 2.1b 2.1c 2.1d 2.1e 2.1f 2.1g 2.1h 2.1i Service 2.2a 2.2b 2.2c 2.2d SECTION 2 — Service Name(s) and Information the service is a monthly package, please offer different levels. All monthly packages must state a specific minimum number of direct service hours. #1 Name: Substance Abuse Treatment — Group Treatment (E.g. Relapse Prevention, SSIC/SSC, Seeking Safety, etc.) Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): CBT, DBT, TF-CBT, MI, curriculum driven, multimodal approaches Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 1-2 groups per week Anticipated duration of service (i.e. 3-4 months): Case specific — ranges for each case needs (i.e., 16 weeks to 52 weeks) Three (3), or more, specific goals of the service (DO use bullet points): 1. Reduce and manage substance use or substance misuse. 2. Reach a goal of being alcohol or substance use free. 3. Maintain abstinence from all substances. Three (3), or more, specific outcomes of service: 1. Successful daily practice of self -care and coping skills. 2. Successful establishment and maintenance of pro -social relationships. 3. Successful reunification or other successful case closure. Target population of the service, including age and gender: Client with various diagnosed or suspected disabilities/brain injury, ages 12-100 Languages service is available in (please list proficiency and if interpreter services are available): English Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Yes, most. Service location — list where the service will take place (i.e. client's home, in -office, other) Lifelong, Inc. offices or virtual #2 Name: Substance Abuse Treatment - Individual Treatment Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): CBT, DBT, TF-CBT, MI, curriculum driven, multimodal approaches Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 1-3 sessions/week depending on individual's needs. Anticipated duration of service (i.e. 34 months): Case specific — ranges for each case needs (i.e., 16 weeks to 52 weeks) Three (3), or more, specific goals of the service (DO use bullet points): 1. Reduce and manage substance use or substance misuse. 2. Reach a goal of being alcohol or substance use free. 3. Maintain abstinence from all substances. 2.2e Three (3), or more, specific outcomes of service: 1. Successful daily practice of self -care and coping skills. 2. Successful establishment and maintenance of pro -social relationships. 3. Successful reunification or other successful case closure. REV. OCT 2021 1 ATTACHMENT C - PROPOSAL 2.2f Target population of the service: Client with various diagnosed or suspected disabilities/brain injury, ages 12-100 2.2g Languages service is available in (please list proficiency and if interpreter services are available): English 2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Yes, most. 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) Lifelong, Inc. offices or virtual Service #3 Name: Urinalysis and Breathalyzer 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Secure and protected drug panel screening tools Substances tested for: AMP,BAR, BUP,BZ0,C0C,CR,ETG,FEN, MTD,0PI,0XY,THC,TRAMAD0L 2.3b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: As needed or required by treatment (i.e., 2x/month, 1/x week, etc.) 2.3c Anticipated duration of service (i.e. 3-4 months): Length of SUD treatment 2.3d Three (3), or more, specific goals of the service (DO use bullet points): Complete sobriety testing successfully. 2.3e Three (3), or more, specific outcomes of service: Provide negative sobriety test results when scheduled. 2.3f Target population of the service: Youth or adults with concerns of substance misuse. 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: No. 2.3i Service location — list where the service will take place (i.e. client's home, in -office, other) Lifelong, Inc. offices Service #4 Name: Substance Treatment Intake 2.4a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Intake Assessment and Screening Tools 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: 1-2 sessions 2.4c Anticipated duration of service (i.e. 3-4 months): 30 days 2.4d Three (3), or more, specific goals of the service (DO use bullet points): Complete SUD intake 2.4e Three (3), or more, specific outcomes of service: SUD intake report generated and released 2.4f Target population of the service: Client with various diagnosed or suspected disabilities, brain injuries, ages 12-100 2.4g Languages service is available in (please list proficiency and if interpreter services are available): English 2.4h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Yes. 2.4i Service location — list where the service will take place (i.e. client's home, in -office, other) Lifelong, Inc. offices or virtual Service #5 Name: Substance Treatment Evaluation 2.5a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Evaluation Assessment and Screening Tools REV. OCT 2021 2 ATTACHMENT C - PROPOSAL 2.5b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 1-2 sessions 2.5c Anticipated duration of service (i.e. 3-4 months): 30 days 2.5d Three (3), or more, specific goals of the service (DO use bullet points): Completed SUD evaluation 2.5e Three (3), or more, specific outcomes of service: SUD evaluation report generated and released. 2.5f Target population of the service: Client with various diagnosed or suspected disabilities, brain injuries, ages 12-100 2.5g Languages service is available in (please list proficiency and if interpreter services are available): English 2.5h Medicaid eligibility— list whether the service is eligible for Medicaid in whole or in part Yes 2.6i Service location — list where the service will take place (i.e. client's home, in -office, other) Lifelong, Inc. offices or virtual 3.1 3.2 3.3 3.4 3.5 Section 3 — Service Access and Transportation Will you charge Weld County for transporting clients or mileage? Check one: @ YES • NO Will you conduct services in a client's home or in the community? Check one: • YES ►5 NO Will you transport clients to and/or from services? Check one: ■ YES 0 NO How many miles are you willing to travel round trip? List a specific number of miles. Miles When you calculate mileage, what is your starting point address? 7175 W. Jefferson Avenue, Lakewood, CO 80235 SECTION 4 - SERVICE RATES All rates need to include administrative work (i.e. scheduling or report writing) and overhead. Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly or monthly rates will be accepted for services, except for those listed above. • For hourly rates complete section(s) 4.1-4.5. • For monthly rates complete section 4.6. • For Home study providers complete section 4.7. • For monitored sobriety testing providers complete section 4.8. 4.1 Hourly Service #1 Name: Substance Abuse Group Treatment 4.1a In-Office/Video: 4.1b In -Office with Transportation: In -Home or Community: 4.1c FTM, TDM, Prof. Staffing: 4.1d No show: 4.1e Mileage rate: $ Amount $55 $100 $30 Unit Type per Hour per Hour per Hour per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: This is paid after the miles listed above. miles miles 4.2 Hourly Service #2 Name: Substance Abuse Individual Treatment 4.2a In-Office/Video: 4.2b In -Office with Transportation: 4.2c In -Home or Community: 4.2d FTM, TDM, Prof. Staffing: $ Amount $120 $100 Unit Type per Hour per Hour per Hour per Hour No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: miles miles REV. OCT 2021 3 ATTACHMENT C - PROPOSAL 4.2e No show: $60 per No Show 4.2f Mileage rate: per Mile This is paid after the miles listed above. 4.3 Hourly Service #3 Name: Urinalysis and Breathalyzer — confirmation test additional ($15) $ Amount Unit Type 4.3a In-Office/Video: UA - $21 BA -$7 Confirmation -$15 per Hour 4.3b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.3c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.3d FTM, TDM, Prof. Staffing: per Hour 4.3e No show: per No Show 4.3f Mileage rate: per Mile This is paid after the miles listed above. 4.4 Hourly Service #4 Name: Substance Treatment Intake $ Amount Unit Type 4.4a In-Office/Video: $250 per Hour 4.4b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.4c FTM, TDM, Prof. Staffing: $100 per Hour 4.4d No show: $100 per No Show 4.4e Mileage rate: per Mile This is paid after the miles listed above. 4.5 Hourly Service #5 Name: Substance Treatment Evaluation $ Amount Unit Type 4.5a In-Office/Video: $425 per Hour 4.5b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.5c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.5d FTM, TDM, Prof. Staffing: $100 per Hour 4.5e No show: $100 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 No. of Direct Service Hours: 4.6a 4.6b 4.6c 4.6d 4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers — List your rates in the box below. 4.8 Monitored Sobriety Providers — List your rates in the box below. $21 UA $7 BA $15 confirmation Provider special notes: All bilingual services are +$15/hour. REV. OCT 2021 4 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: Lindsey Spraker Lifelong, Inc. PHONE NUMBER: (303)573-0839 EMAIL: Lindsey@Lifelonginc.com PROPOSED SERVICE(S): Crisis Intervention and Stabilization, Domestic Violence Services, Foster Parent Consultation, Foster Parent Training, Home Based Intervention, Aftercare Services, Kinship Services (Therapeutic), Life Skills, Mental Health Services, Substance Abuse Treatment Services Spraker Lindsey various LCSW, CTRS 2081 Bickelhaupt Krista various LPC, BCBA 13521 Byrne Camryn various CAS, NLC 21020, 110489 Fann Jess various NLC 105704 Finn Jordyn various BCJ Grajeda Karina various MCJ Greive Elliot various LPC, LAC 17582, 1622 Gutierrez Stephanie various BA Jorden Jeffrey various LPC 13469 McLaughlin Meaghan various MFT Mendez Jose various MA Murphy Brandon various CAT 8148 Pagan Vanessa Office Manager MHCA Schell Kenneth various BA Spraker Erika various LSW, CAT 9923985, 8035 Wilcox Alexa various LPC 14456 Owen Jesse various PhD 4340 Quirk Kelley various PhD 4510 Allen Korrie various PhD 5290 Martinich Matthew various PhD 4951 Barnhart Kristine various MS CHILD WELFARE REQUEST FOR PROPOSAL 2022-23 - VARIOUS SERVICES / 1 ® ACCPR o CERTIFICATE OF LIABILITY INSURANCE DATE (MWDD/YYYY) 01/25/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the po icy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holdef in lieu of such endorsement(s). PRODUCER CenterPoint Insurance Group 8400 E Prentice Ave Suite 735 Greenwood Village CO 80111 CONTACT Allyson Ingram NAME: PHONE . Ext): (303) 333-0375 I FAX No): (303) 333-1391 E-MAIL allyson.ingram@cptins.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Philadelphia Insurance Companies 006 INSURED Lifelong, Inc. 7175 W. Jefferson Ave #4000 Lakewood CO 80235 INSURER B : Pinnacol Assurance Company 20 INSURER C : North American Specialty Insurance INSURER D : INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER: 2021-2022 Master REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR A X X TYPE OF INSURANCE COMMERCIAL GENERAL LIABILITY ICLAIMS -MADE X OCCUR X X Prof. Liability $1MM/$3MM Sex Abuse $1 MM/$2MM GEN'LAGGREGATE LIMIT APPLIES PER: PRO- JECT POLICY OTHER: LOC ADDL INSD SUBR WVD POLICY NUMBER PH PK2293074 POLICY EFF (MMIDD/YYYY) 07/01/2021 POLICY EXP (MMIDD/YYYY) 07/01/2022 EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) LIMITS $ 1,000,000 $ 100,000 $ 5,000 $ 1,000,000 $ 3,000,000 $ 3,000,000 MED EXP (Any one person) PERSONAL&ADV INJURY GENERALAGGREGATE PRODUCTS - COMP/OP AGG A AU X OMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY SCHEDULED AUTOS NON -OWNED X AUTOS ONLY PH PK2293074 07/01/2021 07/01/2022 COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) $ 1,000,000 BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) B UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE DED I I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y/N Y N /A 4193499 07/01/2021 07/01/2022 EACH OCCURRENCE AGGREGATE XI PER I OTH- STATUTE I I ER E.L. EACH ACCIDENT $ 100,000 $ 100,000 $ 500,000 E.L. DISEASE - EA EMPLOYEE E.L. DISEASE- POLICY LIMIT C Cyber Liability C-4MZ6-071907-CY B E R-2021 01/01/2022 01/01/2023 Limit $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if mom space is required) Board of County Commissioners of Weld County and its Officers/Employees are listed as additional insured with regards to Commercial General Liability. CERTIFICATE HOLDER CANCELLATION Weld County 1150 O St Greeley CO 80631 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD contract is Entity Name' LIFELONG INC Entity ID' @00045085 Contract Contract ID LIFELONG INC (NEW CHILD PROTECTION AGREEMENT) 5943 Contract Status CTB REVIEW Contract Lead APEGG Contract Lead Email apegg@weldgov.com,cobbx xlk@weldgov.com Contract Description' CONSENT BID# 62200040 TERM: JUNE'', 2022 THROUGH MAY 31, 2023 Parent Contract ID 20220410 Requires Board Approval YES Department Project # Contract Description 2 PA IS BEING ROUTED THROUGH THE NORMAL PROCESS. ETA TO CTB 6/9/22 PA WILL CORRECT SOME MISTAKES NOTED ON THE APPROVED VENDOR LIST PRESNETED TO THE BOCC ON 04/06/22 AND AS A COMMUNICATION ITEM; PA SENT TO CTB ON 05/10/2022. Contract Type AGREEMENT Amount' $0.00 YES Automatic Renewal 10€` nt HUMAN SERVICES Email CM- HumanServices :eidgov.co m Department Head Email CM-HumanServices- DeptHeadC�weldgov.com County Attorney GENERAL COUNTY ATTORNEY EMAIL County Attorney Email CM- COUNTYATTORNEY@WELDG OV.COM a renewal us Contract ID If this is part of a MSA enter MSA Contract ID Requested BOCC Agenda Date' 06,15/2022 Will a work session NO Due Date 06/11/2022 Does Contract require Purchasing Dept_ to be i Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in On8ase Bat Termination Notice Period BOCC Agenda Date 06/O8/2022 Review Date* 03/31/2023 Committed Delivery Bare Finance Approver CONSENT Renewal Date* 05/31/2023 Expiration flare Contact Phone 1 Contact Phone 2 Purchasing Approved Date 06/02/2022 Legal Counsel CONSENT Finance Approved Date Legal Counsel Approved Date 06/©2/2022 06/02/2022 Tyler Ref # AG 060822 Hello