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Home My WebLink About20231393.tiffC8r +Vac4- lm °i17s9I Department of Human Services 970-352-1551 315 North 11th Avenue Greeley, CO 80631 July 21, 2025 To: Board of County Commissioners Re: Professional Services Agreement Amendment #3 with Aspen Counseling, LLC Request Board approval and Chair signature for the Department's Professional Services Agreement Amendment #3 with Aspen Counseling, LLC. This amendment is to update Paragraph 13. Notices, as follows: CMS ID Tyler ID Provider Name Term 9789 2023-1393 Aspen Counseling, LLC 1217 East Elizabeth Street, Suite 6A, Room 4 Fort Collins, Colorado 80524 June 1, 2023 through May 31, 2026 Sincerely, Jamie Ulrich, Director constn+HVI �i 3b/25 cC-Orkca( 1S) -7i o/ z5 zo?3 ^ 1393 01120095 AGREEMENT AMENDMENT BETWEEN WELD COUNTY AND ASPEN COUNSELING, LLC This Agreement Amendment made and entered into this 3e day of 2025 by and between the Board of Weld County Commissioners, on behalf of the Wel County Department of Human Services, hereinafter referred to as the "Department", and Aspen Counseling, LLC, hereinafter referred to as the "Contractor". WHEREAS the parties entered into an Agreement for Domestic Violence Intervention and Sexual Abuse Treatment Services, (the "Original Agreement") identified by the Weld County Clerk to the Board of County Commissioners as document No. 2023-1393, approved on May 17, 2023. 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, 2024. The Original Agreement was amended on: • May 15, 2024, to extend the term date through May 31, 2026. • August 19, 2024, to amend Exhibit B, Rate Schedule. • The Amendments are identified by the Weld County Clerk to the Board of County Commissioners as document number 2023-1393. • 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, 2025: 1. Paragraph 18. Notices, is hereby amended as follows: TO CONTRACTOR: Name: Yumil Jimenez Position: Clinical Director Address: 1217 East Elizabeth Street, Suite 6A, Room 4 Address: Fort Collins, Colorado 80524 E-mail: aspencounseling2bllc(a�gmail.com Phone: (720) 280-9379 • 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: °" BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO BY: Clerk to the Board Deputy Clerk to the B and P Y uck, Chair JUL 3 0 2025 TRACTOR: en Counseling, LLC 17 East Elizabeth Street, Suite 6A, Room 4 Fort Collins, Colorado 80524 By. Yumirenez Jul 24, 2025 10:30:38 MDT) Yumil Jimenez, Clinical Director 07/19/2025 Date: z 3-'3q 3 /� ® A v CERTIFICATE OF LIABILITY ATE M/DD/YYYY) INSURANCE gp22024 TNIS 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. TINS CERTHTCATE 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 ENSURED, the policy,. 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 [o the certificate holder in Ileu of such endonement(s),If this certificate is being prepared for a party who has ao insurable interest in [he property, do not use this form. Use ACORD 27 or ACORD 28. PRODUCER CPH Insurance 711 S Dearborn St. Suite 205 Chicago, IL 60605 CONTACT NAME: C. Philip Hodson PHONE (A/C, No, Eat): 312 987 9823 IFAX (A/C, No): 312 987 0902 E-MAIL ADDRESS: inf..cphins.com ENSURED Yumil J Jimenea 110 W Harvard St Fort Collins, CO 80525 INSURERS) AFFORDING COVERAGE NAIL# INSURER A : Philadelphia Indemnity Insurance Company 18058 INSURER B. ENSURER C: INSURER D : INSURER E : INSURER F : COVERAGES 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 CONDIT ONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LNSR LTR TYPE OF INSURANCE ADDL INSR SUER W VD POLICY NUMBER POLICY EFF �(MM/DD/YYYV(MM/DD/YYYY) POLICY EXP LIMITS l'cncrel Liability COMMERCIAL GENERAL LIABILITY' CLAIMS -MADE O OCCUR EACH OCCURRENCE S DAMAGE TO RENTED PREMISES (Ea occurrence) S GENE AGGREGATE LIMIT APPLIES PER: :1dF.D F.XP (Any ...person) S PERSONAL & ADV INJURY S GENERAL AGGREGATE S PRODUCTS — COMP/OP AGG S S AUTOMOBILEAUTOI.IABH.ITY ANY ALL OWNED AUTOS SCHEDULED AUTOB AUTOSNON- -OWN1:D COMBINED SINGLE LIMIT (Ea accident) S BODILY INJURY (Per person) BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Pcr accident) $ S UMBRELLA LIAR OCCUR EXCESS LIAR CLAIMS —MADE EACH OCCURRENCE $ AGGREGATE S DED RETENTION$ $ WORKERS COMPENSATION AND EMI,P.I S' LIABILITY YM1 ANV PAMEMB OR/PARTNER/EXECUTR'E OFFICE/MEMBER EXCLUDED? (.Mandatory fa NH) If yes, describe under DESCRIPTION OF OPERATIONS below I iunrs T Toar I I OTHER F..L. EACH ACCIDENIT $ E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT S PeX OCCUR rofessional Liability CLAIMS -MADE 077403 08/27/2024 0827/2025 Each Occurrence $1,000,000 Aggregate $3,000,000 CERTIFICATE NUMBER: REVISION NUMBER: DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional RemarW Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION Weld 315 N 11th County Avenue Bldg A 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 C. Philip Hodson ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 1988-2010 ACORD CORPORATION. All rights reserved ACORD® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYI'Y) 07/17/2025 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 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 Matthew Ditzen berger Agency, Inc. 5750 DTC Pkwy Ste 130 Greenwood Village, CO 80111 (303) 756-8038 CONTACT g Matthew Ditzenber er NAME: SIXES ExO: 3037568038 I (AItC, No 8554258218 ADD&MAIREL SS: mditzenb@amfam.com INSURER(S) AFFORDING COVERAGE NAIL # INSURER A: American Family Mutual Insurance Company, SI 473 INSURED Aspen Counseling, LLC 1217 E. Elizabeth St Site 6A Lower Level Room 4 Fort Collins, CO 80524 INSURER B : Midvale Indemnity Company 27138 INSURER C: INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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. ILTR THE OF INSURANCE AINSD I POLICY NUMBER POLICY EFF =ON, POLICY EXP (MM/DDIYYYY) LIMITS B COMMERCIAL GENERAL LIABILITY J CLAIMS -MADE ✓ OCCUR X 8P00007179 05/25/2025 05/25/2026 EACH OCCURRENCE $ 2000000 DAMAGE TO RENTED 08510100a occurrence) 1 50000 MED EXP (Any one person) $ 5000 558SONAL & ADV :52880 I 1000000 GEN'L AGGREGATE LIMIT APPLIES PER: ✓ POLICY DPRO JECT LOC OTHER: GENERAL AGGREGATE $ 2000000 PRODUCTS $ 2000000 AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS CNLY HIRED AUTOS ONLY SCHEDULED _ A NON-CUTOS NVNED AUTOS ONLY COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ I DED I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY y / N ANYPROPRIETOR/PARTNER/EXECUT85 ❑ H)EXCLUDED? (Mandatory in NH) (Mandatory describe under DMA= DESCRIPTION OF OPERATIONS below N/A I STATUTE I I ERH E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ B Cyber Liability X BP00007179 05/25/2025 05/25/2026 Occurrence Aeere5ate S50.000 5100.000 DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Additional Insured: Board of Weld County Commissioners and its Officers/Employees CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Weld County 315 N 11th Avenue, Bldg A ACCORDANCE WITH THE POLICY PROVISIONS. Greeley, CO 80631 AUTHORIZED REPRESENTATIVE HS-ContractManagement@weld.gov Matthew Ditzenberger I ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SIGNATURE REQUESTED: Weld/Aspen Counseling, LLC Amendment #3 (Address Change) Final Audit Report 2025-07-24 Created: 2025-07-18 By: Windy Luna (wluna@weld.gov) Status: Signed Transaction ID: CBJCHBCAABAAjNzNeuheT33RR9w9ypZgE9M5UcW8hZIX "SIGNATURE REQUESTED: Weld/Aspen Counseling, LLC Ame ndment #3 (Address Change)" History 5 Document created by Windy Luna (wluna@weld.gov) 2025-07-18 - 10:19:57 PM GMT- IP address: 204.133.39.9 C' -r Document emailed to Yumil Jimenez (aspencounseling2bllc@gmail.com) for signature 2025-07-18 - 10:21:15 PM GMT ▪ Email viewed by Yumil Jimenez (aspencounseling2bllc@gmail.com) 2025-07-20 - 1:31:57 AM GMT- IP address: 66.102.6.228 ,t Email viewed by Yumil Jimenez (aspencounseling2bllc@gmail.com) 2025-07-24 - 4:18:14 PM GMT- IP address: 66.102.6.230 4 Document e -signed by Yumil Jimenez (aspencounseling2bllc@gmail.com) Signature Date: 2025-07-24 - 4:30:38 PM GMT - Time Source: server- IP address: 65.131.50.130 O Agreement completed. 2025-07-24 - 4:30:38 PM GMT Powered by Adobe Acrobat Sign ntr.ct Entity Information Entity Name * ASPEN COUNSELING LLC Entity ID* @00046351 New Entity? Contract Name * Contract ID ASPEN COUNSELING, LLC (PROFESSIONAL SERVICES 9789 AGREEMENT AMENDMENT #3) Contract Status CTB REVIEW Contract Lead * WLUNA Contract Lead Email wluna@weld.gov;cobbxxl k@weld.gov Parent Contract ID 20231393 Requires Board Approval YES Department Project # Contract Description * (CONSENT) ASPEN COUNSELING, LLC - PROFESSIONAL SERVICES AGREEMENT AMENDMENT #3 TO UPDATE THE ADDRESS. TERM: 6/1 /23 THROUGH 5/31 /26. Contract Description 2 CONSENT - THIS WILL BE WITH A MEMO Contract Type * Department Requested BOCC Agenda Due Date AMENDMENT HUMAN SERVICES Date* 07/26/2025 07/30/2025 Amount* Department Email $0.00 CM- Will a work session with BOCC be required?* HumanServices@weld.gov NO Renewable* NO Department Head Email Does Contract require Purchasing Dept. to be CM-HumanServices- included? Automatic Renewal DeptHead@weld.gov Grant County Attorney GENERAL COUNTY ATTORNEY EMAIL IGA County Attorney Email CM- COUNTYATTORNEY@WEL D.GOV 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 Contact Info Review Date 03/31/2026 Committed Delivery Date Renewal Date Expiration Date* 05/31/2026 Contact Name Contact Type Contact Email Contact Phone 1 Contact Phone 2 Purchasing Purchasing Approver Purchasing Approved Date Approval Process Department Head JAMIE ULRICH DH Approved Date 07/24/2025 Final Approval BOCC Approved BOCC Signed Date BOCC Agenda Date 07/30/2025 Finance Approver CHERYL PATTELLI Legal Counsel BYRON HOWELL Finance Approved Date Legal Counsel Approved Date 07/25/2025 07/25/2025 Tyler Ref* AG 073025 Originator WLUNA Corrivac+i35° 1 BOARD OF COUNTY COMMISSIONERS PASS -AROUND REVIEW PASS -AROUND TITLE: Professional Services Agreement Amendment #2 with Aspen Counseling, LLC DEPARTMENT: Human Services DATE: August 6, 2024 PERSON REQUESTING: Jamie Ulrich, Director, Human Services Brief description of the problem/issue: The Department entered into a Professional Services Agreement (PSA) with Intervention, Inc. on May 17, 2023, known to the Board as Tyler ID# 2023-1393, for Domestic Violence Intervention and Sexual Abuse Treatment Services. The Department is now requesting approval for Amendment #2 to revise the rates as reflected below in the fees for services. This is related to Bid #B2300040. What options exist for the Board? Approval of the Amendment #2 with Aspen Counseling, LLC. Deny approval of Amendment #2 with Aspen Counseling, LLC. Consequences: The Department will not have a revised agreement with Aspen Counseling, LLC. Impacts: Weld County will not have current rates for this Vendor to provide Core/Non-Core services. Costs (Current Fiscal Year / Ongoing or Subsequent Fiscal Years): Term: August 1, 2024 through May 31, 2026. Funded through: Core/Non-Core Child Welfare Funding. Fees for Services: Program Area Rate Unit Type Service Name Domestic Violence Intervention Services $ 50.00 Hour Domestic Violence $ 350.00 Episode Domestic Violence: Intake Fee $ 25.00 Each Parenting Skills: DVI Group $ 40.00 Each Parenting Skills: DVI Individual Sex Abuse Treatment $ 100.00 Hour Adult Informed Supervision Training: In- Office/Video $ 40.00 Hour Adult Psychosexual Education class: In- Office/Video $ 80.00 Hour Boundaries Education Session: Group Class $ 125.00 Hour Boundaries Education Session: Individual $ 100.00 Each Parenting Skills: Intake $ 30.00 Each Parenting Skills: SAT Group Pass -Around Memorandum; August 6, 2024 - CMS ID 8591 ion -1393 -1V-DD°15 coin .,11++ IPA 8/ /24 9/..2 Program Area Rate Unit Type Service Name Sex Abuse Treatment $ 40.00 Each Parenting Skills: SAT Individual Sexual Abuse Treatment: Team Meeting $ 100.00 Hour (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $ 150.00 Hour Sexual Abuse Treatment: In -Home or Community $ 150.00 Hour Sexual Abuse Treatment: In -Office w/Transportation $ 125.00 Hour Sexual Abuse Treatment: In-Office/Video $ 350.00 Episode Sexual Abuse Treatment: Intake Fee $ 40.00 Each No Show: (Max of 2 no shows or 2 hours/month/client) Recommendation: • Approval of the Amendment #2 and authorize the Chair to sign. Support Recommendation Schedule Place on BOCC Agenda Work Session Other/Comments: Perry L. Buck, Pro -Tern Mike Freeman Scott K. James Kevin D. Ross, Chair Lori Saine Pass -Around Memorandum; August 6, 2024 - CMS ID 8591 Karla Ford From: Sent: To: Subject: Mike Freeman Wednesday, August 7, 2024 10:57 AM Karla Ford Re: Please Reply - PA FOR ROUTING: CW Aspen Counseling, LLC Amendment #2 (CMS 8591) Approve Sent from my iPhone On Aug 7, 2024, at 8:55 AM, Karla Ford <kford@weld.gov>wrote: Please advise if you support recommendation and to have department place on the agenda. Karla Ford X Office Manager, Board of Weld County Commissioners 1150 0 Street, P.Q. Box 758, Greeley, Colorado 80632 :: 970.336-7204 :: kford@weld.gov :: www.weldgov.com :: **Please note my working hours are Monday -Thursday 7:00a.m.-4:00p.m.** <image002.jpg> Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. From: Windy Luna <wluna@weld.gov> Sent: Tuesday, August 6, 2024 4:O1 PM To: Karla Ford <kford@weld.gov> Cc: HS -Contract Management <HS-ContractManagement@co.weld.co.us>; Bruce Barker <bbarker@weld.gov>; Cheryl Pattelli <cpattelli@weld.gov>; Chris D'Ovidio <cdovidio@weld.gov>; Esther Gesick <egesick@weld.gov>; HS -Contract Management <HS-ContractManagement@co.weld.co.us>; Jill Scott <jscott@weld.gov>; Karla Ford <kford@weld.gov>; Lennie Bottorff <bottorll@weld.gov>; Tanya Geiser <tgeiser@weld.gov> Subject: PA FOR ROUTING: CW Aspen Counseling, LLC Amendment #2 (CMS 8591) Good afternoon Karla, Attached please find the PA approved for routing to all five (5) Commissioners: CW Aspen Counseling, LLC Amendment #2 (CMS 8591). Thank you, Windy Luna 1 AGREEMENT AMENDMENT BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND ASPEN COUNSELING, LLC This Agreement Amendment made and entered into i lday of 2024 by and between the Board of Weld County Commissioners, on behalf of t e Weld County Department of Human Services, hereinafter referred to as the "Department", and Aspen Counseling, LLC, hereinafter referred to as the "Contractor". WHEREAS the parties entered into an Agreement for Domestic Violence Intervention and Sexual Abuse Treatment Services, (the "Original Agreement") identified by the Weld County Clerk to the Board of County Commissioners as document No. 2023-1393, approved on May 17, 2023. 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, 2024. • The Original Agreement was amended on: • May 15, 2024 to extend the term date through May 31, 2026. • The Amendments are identified by the Weld County Clerk to the Board of County Commissioners as document number 2023-1393. • 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 August 1, 2024: 1. Exhibit B, Rate Schedule, is hereby amended as attached. • All other terms and conditions of the Original Agreement remain unchanged. oZootl-b-5?3 IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. COUNTY: ATTEST: Clerk to the B and Deputy l• er BOARD OF COUNTY COMMISSIONERS WELD COUNTY. COLORADO Kevin D. Ross, Chair AUG 1 9 2024 ONTRACTOR: Aspen Counseling, LLC 6795 East Tennessee Avenue, Suite 417 Denver, Colorado 80224 (720) 447-7577 By: Yumil Jimknez(ug 13, 202413:48 MDT) Yumil Jimenez, Clinical Director Date: Aug 13, 2024 02"c:2,3 —L393 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 $ 50.00 Unit Type Hour Service Name Domestic Violence $ 350.00 Episode Domestic Violence: Intake Fee $ 25.00 Each Parenting Skills: DVI Group $ 40.00 Each Parenting Skills: DVI Individual Sex Abuse Treatment $ 100.00 ' Hour Adult Informed Supervision Training: In- Office/Video $ 40.00 Hour Adult Psychosexual Education class: In- Office/Video $ 80.00 Hour Boundaries Education Session: Group Class $ 125.00 Hour Boundaries Education Session: Individual Program Area Sex aAbusri Treatment Rate $ 100.00 Unit Type Each Service Name Parenting Skills: Intake $ 30.00 Each Parenting Skills: SAT Group $ 40.00 Each - Parenting Skills: SAT Individual $ 100.00 Hour Sexual Abuse Treatment: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $ 150.00 Hour Sexual Abuse Treatment: In -Home or Community $ 150.00 Hour Sexual Abuse Treatment: In -Office w/Transportation $ 125.00 Hour Sexual Abuse Treatment: In-Office/Video $ 350.00 Episode Sexual Abuse Treatment: Intake Fee $ 40.00 Each No Show: (Max of 2 no shows or 2 hours/month/client) 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. Contract Form Entity Information Entity Name * ASPEN COUNSELING LLC Entity ID* @00046351 Contract Name * Contract ID ASPEN COUNSELING, LLC AMENDMENT #2 RELATED 8591 TO BID #B2300040. Contract Status CTB REVIEW Contract Lead * WLUNA O New Entity? Parent Contract ID 20231393 Requires Board Approval YES Contract Lead Email Department Project # wluna@weld.gov;cobbxxl k@weld.gov Contract Description ASPEN COUNSELING, LLC PROFESSIONAL SERVICES AGREEMENT AMENDMENT #2. RELATED TO BID #B2300040. TERM; 08/01 /2024 THROUGH 05/31/2026. Contract Description 2 PA ROUTING WITH THIS CMS/ONBASE ENTRY. Contract Type" AMENDMENT Amount* $0.00 Renewable YES 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 D.GOV Requested BOCC Agenda Date * 08/21/2024 Due Date 08/17/2024 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* 04/30/2025 Renewal Date* 06/01/2025 Committed Delivery Date Expiration Date Contact Info Contact Name Contact Type Contact Email Contact Phone 1 Contact Phone 2 Purchasing Purchasing Approver Purchasing Approved Date Approval Process Department Head Finance Approver Legal Counsel JAMIE ULRICH CHERYL PATTELLI BYRON HOWELL DH Approved Date Finance Approved Date Legal Counsel Approved Date 08/13/2024 08/14/2024 08/14/2024 Final Approval BOCC Approved Tyler Ref # AG 081924 BOCC Signed Date Originator WLUNA BOCC Agenda Date 08/19/2024 Cun+vG CftUaI4 AGREEMENT AMENDMENT BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND ASPEN COUNSELING, LLC This Agreement Amendment made and entered into I Sfihday of , 2024 by and between the Board of Weld County Commissioners, on behalf of the Weld Co Department Department of Human Services, hereinafter referred to as the "Department", and Aspen Counseling, LLC hereinafter referred to as the "Contractor". WHEREAS the parties entered into an Agreement for Domestic Violence Intervention and Sexual Abuse Treatment Services, (the "Original Agreement") identified by the Weld County Clerk to the Board of County Commissioners as document No. 2023-1393, approved on May 17, 2023. 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, 2024. • This Amendment, 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. Paragraph 3. — Term. The term of this Agreement shall be from June 1, 2024, through May 31, 2026, unless sooner terminated as provided herein, and is subject to continued budget appropriations. • All other terms and conditions of the Original Agreement remain unchanged. Cohsen�'PtopendiiL- 5/v24 2023-1393 R\200 .5 IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. COUNTY; ATTEST: ' -. " "gidt4;41 BOARD OF COUNTY COMMISSIONERS erk to the Boar. WELD CO BY: Deputy Cl Kevin D. Ross, Chair MAY 1 5 2024 ONTRACTOR: spen Counseling, LLC 6795 East Tennessee Avenue, Suite 417 Denver, Colorado 80224 (720) 447-7577 By: Yumil rr-n nez( ay 1,202412:40 MDT) Yumil Jimenez, Clinical Director Date: May 1, 2024 2023-1393 SIGNATURE REQUESTED: Weld/Aspen Counseling, LLC (Yumil Jimenez) Amendment #1 Final Audit Report 2024-05-01 Created: 2024-05-01 By: Windy Luna (wluna@weld.gov) Status: Signed Transaction ID: CBJCHBCAABAAIIetgaSRP2O3T66J5ap4cFKV3Q9IDO1W "SIGNATURE REQUESTED: Weld/Aspen Counseling, LLC (Yu mil Jimenez) Amendment #1" History .5 Document created by Windy Luna (wluna@weld.gov) 2024-05-01 - 3:46:25 PM GMT- IP address: 204.133.39.9 Et, Document emailed to Yumil Jimenez (aspencounseling2bllc@gmail.com) for signature 2024-05-01 - 3:47:00 PM GMT t Email viewed by Yumil Jimenez (aspencounseling2bllc@gmail.com) 2024-05-01 - 3:47:04 PM GMT- IP address: 74.125.215.68 dS® Document e -signed by Yumil Jimenez (aspencounseling2bllc@gmail.com) Signature Date: 2024-05-01 - 6:40:55 PM GMT - Time Source: server- IP address: 65.131.60.81 © Agreement completed. 2024-05-01 - 6:40:55 PM GMT Powered by Adobe Acrobat Sign Contract Form Entity Information Entity Name * ASPEN COUNSELING LLC Entity ID* @00046351 Contract Name* ASPEN COUNSELING, LLC (PROFESSIONAL SERVICES AGREEMENT AMENDMENT #1 RELATED TO BID #B2300040) Contract Status CTB REVIEW Contract ID 8141 Contract Lead * WLUNA Q New Entity? Parent Contract ID 20231393 Requires Board Approval YES Contract Lead Email Department Project # wluna@weldgov.com;cob bxxlk@weldgov.com Contract Description * (CONSENT) ASPEN COUNSELING, LLC (PROFESSIONAL SERVICES AGREEMENT AMENDMENT, #1 RELATED TO BID #B2300040(. TERM: 6/1 /24 THROUGH 5/31/26. Contract Description 2 PROVIDER WAS LISTED ON APPROVED VENDOR LIST PRESENTED TO THE BOCC ON 04/10/24. Contract Type * Department Requested BOCC Agenda Due Date AMENDMENT HUMAN SERVICES Date* 05/11/2024 05/15/2024 Amount* Department Email $0.00 CM- Will a work session with BOCC be required?* HumanServices@weldgov. NO Renewable * corn YES Does Contract require Purchasing Dept. to be Automatic Renewal Grant IGA Department Head Email CM-HumanServices- DeptHead@weldgov.com County Attorney GENERAL COUNTY ATTORNEY EMAIL County Attorney Email CM- COUNTYATTORNEY@WEL DGOV.COM 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 Renewal Date* 06/01/2025 Committed Delivery Date Expiration Date Contact Info Contact Name Contact Type Contact Email Contact Phone 1 Contact Phone 2 Purchasing Purchasing Approver Purchasing Approved Date CONSENT 05/09/2024 Approval Process Department Head Finance Approver Legal Counsel JAMIE ULRICH CONSENT CONSENT DH Approved Date Finance Approved Date Legal Counsel Approved Date 05/09/2024 05/09/2024 05/09/2024 Final Approval BOCC Approved Tyler Ref # AG 051524 BOCC Signed Date Originator WLUNA BOCC Agenda Date 05/15/2024 CU QCih IDf# c0c(B PROFESSIONAL SERVICE AGREEMENT BETWEEN WELD COUNTY AND ASPEN COUNSELING, LLC � THIS AGREEMENT is made and entered into this 1 IIday of , 2023, by and between the Board of Weld County Commissioners, on behalf of the Weld Cou Department of Human Services, hereinafter referred to as "County," and Aspen Counseling, LLC, hereinafter referred to as "Contractor". WHEREAS, County desires to retain Contractor to perform services as required by County and set forth in the attached Exhibits; and WHEREAS, Contractor is willing and has the specific ability, qualifications, and time to perform the required services according to the terms of this Agreement; and WHEREAS, Contractor is authorized to do business in the State of Colorado and has the time, skill, expertise, and experience necessary to provide the services as set forth below; and WHEREAS, the Colorado Department of Human Services has provided Core and Non - Core or other funding to the Department for Domestic Violence Intervention and Sexual Abuse Treatment Services. NOW, THEREFORE, in consideration of the mutual promises and covenants contained herein, the parties hereto agree as follows: 1. Introduction. The terms of this Agreement are contained in the terms recited in this document and in the attached Exhibits, each of which forms an integral part of this Agreement and are incorporated herein. The parties each acknowledge and agree that this Agreement, including the attached Exhibits, define the performance obligations of Contractor and Contractor's willingness and ability to meet those requirements (the "Work"). If a conflict occurs between this Agreement and any Exhibit or other attached document, the terms of this Agreement shall control, and the remaining order of precedence shall based upon order of attachment. Exhibit A consists of the Scope of Services. Exhibit B consist of the Rate Schedule. Exhibit C consists of County's Request for Proposal (RFP) as set forth in Bid Package No. B2300040 which is incorporated into this agreement by reference and will be provided upon request to the Department. Exhibit D consists of Contractor's Response to County's Request. 2. Service or Work. Contractor agrees to diligently provide all services, labor, personnel and materials necessary to perform and complete the Work described in the attached Exhibits. Services shall be provided by the Contractor to any person(s) eligible for services in compliance with Exhibits A, Scope of Services, and Exhibit D, Contractor's Response to Request for Proposal. .119exidx cam: Ote-ka-ea-15-D 1,51/7/.2 3 2023-1393 tiIP-uSl5 Contractor shall further be responsible for the timely completion and acknowledges that a failure to comply with the standards and requirements of Work within the time limits prescribed by County may result in County's decision to withhold payment or to terminate this Agreement. 3. Term. The term of this Agreement shall be from June 1, 2023, through May 31, 2024, unless sooner terminated as provided herein. Both of the parties to this Agreement understand and agree that the laws of the State of Colorado prohibit County from entering into Agreements which bind County for periods longer than one year. This Agreement may be renewed for 2 (two) additional one-year terms upon mutual written agreement of the Parties. 4. Termination; Breach; Cure. County may terminate this Agreement for its own convenience upon thirty (30) days written notice to Contractor. Either Party may immediately terminate this Agreement upon material breach of the other party, however the breaching party shall have fifteen (15) days after receiving such notice to cure such breach. If this Agreement is terminated by County, Contractor shall be compensated for, and such compensation shall be limited to, (1) the sum of the amounts contained in invoices which it has submitted and which have been approved by the County; (2) the reasonable value to County of the services which Contractor provided prior to the date of the termination notice, but which had not yet been approved for payment; and (3) the cost of any work which the County approves in writing which it determines is needed to accomplish an orderly termination of the work. County shall be entitled to the use of all material generated pursuant to this Agreement upon termination. Upon termination of this Agreement by County, Contractor shall have no claim of any kind whatsoever against the County by reason of sach termination or by reason of any act incidental thereto, except for compensation for work satisfactorily performed and/or materials described herein properly delivered. 5. Extension or Amendment. Any amendments or modifications to this agreement shall be in writing signed by both parties. No additional services or work performed by Contractor shall be the basis for additional compensation unless and until Contractor has obtained written authorization and acknowledgement by County for such additional services. Accordingly, no claim that the County has been unjustly enriched by any additional services, whether or not there is in fact any such unjust enrichment, shall be the basis of any increase in the compensation payable hereunder. In the event that written authorization and acknowledgment by the County for such additional services is not timely executed and issued in strict accordance with this Agreement, Contractor's rights with respect to such additional services shall be deemed waived and such failure shall result in non-payment for such additional services or work performed. Any claims by the Contractorfor adjustment hereunder must be made in writing prior to performance of any work covered in the anticipated Amendment, unless approved and documented otherwise by the County Representative. Any change in work made without such prior Amendment shall be deemed covered in the compensation and time provisions of this Agreement, unless approved and documented otherwise by the County Representative. 6. Compensation. County agrees to pay Contractor through an invoice process during the course of this Agreement in accordance with the Rate Schedule as described as Exhibit B. Contractor agrees to submit invoices which detail the work completed by Contractor. The County will review each invoice and if it agrees Contractor has completed the invoiced items to the County's satisfaction, it will remit payment to the Contractor. No payment in excess of that set 2 forth in the Exhibits will be made by County unless an Amendment authorizing such additional payment has been specifically approved by Weld County as required pursuant to the Weld County Code. If, at any time during the term or after termination or expiration of this Agreement, County reasonably determines that any payment made by County to Contractor was improper because the service for which payment was made did not perform as set forth in this Agreement, then upon written notice of such determination and request for reimbursement from County, Contractor shall forthwith return such payment(s) to County. Upon termination or expiration of this Agreement, unexpended funds advanced by County, if any, shall forthwith be returned to County. County will not withhold any taxes from monies paid to the Contractor hereunder and Contractor agrees to be solely responsible for the accurate reporting and payment of any taxes related to payments made pursuant to the terms of this Agreement. Unless expressly enumerated in the attached Exhibits, Contractor shall not be entitled to be paid for any other expenses (e.g. mileage). Notwithstanding anything to the contrary contained in this Agreement, County shall have no obligations under this Agreement after, nor shall any payments be made to Contractor in respect of any period after December 31 of any year, without an appropriation therefore by County in accordance with a budget adopted by the Board of County Commissioners in compliance with Article 25, Title 30 of the Colorado Revised Statutes, the Local Government Budget Law (C.R.S. 29-1-101 et. seq.) and the TABOR Amendment (Colorado Constitution, Article X, Sec. 20). 7. Independent Contractor. Contractor agrees that it is an independent contractor and that Contractor's officers, agents or employees will not become employees of County, nor entitled to any employee benefits (including unemployment insurance or workers' compensation benefits) from County as a result of the execution of this Agreement. Contractor shall be solely responsible for its acts and those of its agents and employees for all acts performed pursuant to this Agreement. Contractor, its employees and agents are not entitled to unemployment insurance or workers' compensation benefits through County and County shall not pay for or otherwise provide such coverage for Contractor or any of its agents or employees. Unemployment insurance benefits will be available to Contractor and its employees and agents only if such coverage is made available by Contractor or a third party. Contractor shall pay when due all applicable employment taxes and income taxes and local head taxes (if applicable) incurred pursuant to this Agreement. 8. Subcontractors. Contractor acknowledges that County has entered into this Agreement in reliance upon the particular reputation and expertise of Contractor. Contractor shall not enter into any subcontractor agreements for the completion of the Work without County's prior written consent, which may be withheld in County's sole discretion. County shall have the right in its reasonable discretion to approve all personnel assigned to the Work during the performance of this Agreement and no personnel to whom County has an objection, in its reasonable discretion, shall be assigned to the Work. Contractor shall require each subcontractor, as approved by County and to the extent of the Work to be performed by the subcontractor, to be bound to Contractor by the terms of this Agreement, and to assume toward Contractor all the obligations and responsibilities which Contractor, by this Agreement, assumes toward County. County shall have the right (but not the obligation) to enforce the provisions of this Agreement against any subcontractor hired by Contractor and Contractor shall cooperate in such process. The Contractor shall be responsible for the acts and omissions of its agents, employees and subcontractors. 3 9. Ownership. All work and information obtained by Contractor under this Agreement or individual work order shall become or remain (as applicable), the property of County. In addition, all reports, documents, data, plans, drawings, records and computer files generated by Contractor in relation to this Agreement and all reports, test results and all other tangible materials obtained and/or produced in connection with the performance of this Agreement, whether or not such materials are in completed form, shall at all times be considered the property of the County. Contractor shall not make use of such material for purposes other than in connection with this Agreement without prior written approval of County. 10. Confidentiality. Confidential information of the Contractor should be transmitted separately from non -confidential information, clearly denoting in red on the relevant document at the top the word, "CONFIDENTIAL." However, Contractor is advised that as a public entity, Weld County must comply with the provisions of the Colorado Open Records Act (CORA), C.R.S. 24-72-201, et seq., with regard to public records, and cannot guarantee the confidentiality of all documents. Contractor agrees to keep confidential all of County's confidential information. Contractor agrees not to sell, assign, distribute, or disclose any such confidential information to any other person or entity without seeking written permission from the County. Contractor agrees to advise its employees, agents, and consultants, of the confidential and proprietary nature of this confidential information and of the restrictions imposed by this Agreement. 11. Warranty. Contractor warrants that the Work performed under this Agreement will be performed in a manner consistent with the standards governing such services and the provisions of this Agreement. Contractor further represents and warrants that all Work shall be performed by qualified personnel in a professional manner, consistent with industry standards, and that all services will conform to applicable specifications. 12. Acceptance of Services Not a Waiver. Upon completion of the Work, Contractor shall submit to County originals of all test results, reports, etc., generated during completion of this work. Acceptance by County of reports and incidental material(s) furnished under this Agreement shall not in any way relieve Contractor of responsibility for the quality and accuracy of the project. In no event shall any action by County hereunder constitute or be construed to be a waiver by County of any breach of this Agreement or default which may then exist on the part of Contractor, and County's action or inaction when any such breach or default exists shall not impair or prejudice any right or remedy available to County with respect to such breach or default. No assent, expressed or implied, to any breach of any one or more covenants, provisions or conditions of the Agreement shall be deemed or taken to be a waiver of any other breach. Acceptance by the County of, or payment for, the Work completed under this Agreement shall not be construed as a waiver of any of the County's rights under this Agreement or under the law generally. 13. Insurance. Contractor must secure, before the commencement of the Work, the following insurance covering all operations, goods, and services provided pursuant to this Agreement, and shall keep the required insurance coverage in force at all times during the term of the Agreement, or any extension thereof, and during any warranty period. For all coverages, Contractor's insurer shall waive subrogation rights against County. 4 a. Types of Insurance. Workers' Compensation / Employer's Liability Insurance as required by state statute, covering all of the Contractor's employees acting within the course and scope of their employment. The policy shall contain a waiver of subrogation against the County. This requirement shall not apply when a Contractor or subcontractor is exempt under Colorado Workers' Compensation Act., AND when such Contractor or subcontractor executes the appropriate sole proprietor waiver form. Commercial General Liability Insurance including public liability and property damage, covering all operations required by the Work. Such policy shall include minimum limits as follows: $1,000,000 each occurrence; $1,000,000 general aggregate; $1,000,000 Personal injury; $5,000 Medical payment per person. Automobile Liability Insurance: Contractor shall maintain limits of $1,000,000 for bodily injury per person, $1,000,000 for bodily injury for each accident, and $1,000,000 for property damage applicable to all vehicles operating both on County property and elsewhere, for vehicles owned, hired, and non -owned vehicles used in the performance of this Contract. Professional Liability (Errors and Omissions Liability). The policy shall cover professional misconduct or lack of ordinary skill for those positions defined in the Scope of Services of this contract. Contractor shall maintain limits for all claims covering wrongful acts, errors and/or omissions, including design errors, if applicable, for damage sustained by reason of or in the course of operations under this Contract resulting from professional services. In the event that the professional liability insurance required by this Contract is written on a claims -made basis, Contractor warrants that any retroactive date under the policy shall precede the effective date of this Contract; and that either continuous coverage will be maintained or an extended discovery period will be exercised for a period of two (2) years beginning at the time work under this Contract is completed. Minimum Limits: $1,000,000 Per Loss; $2,000,000 Aggregate. b. Proof of Insurance. Upon County's request, Contractor shall provide to County a certificate of insurance, a policy, or other proof of insurance as determined in County's sole discretion. County may require Contractor to provide a certificate of insurance naming Weld County, Colorado, its elected officials, and its employees as an additional named insured. c. Subcontractor Insurance. Contractor hereby warrants that all subcontractors providing services under this Agreement have or will have the above described insurance prior to their commencement of the Work, or otherwise that they are covered by the Contractor's policies to the minimum limits as required herein. Contractor agrees to provide proof of insurance for all such subcontractors upon request by the County. d. No limitation of Liability. The insurance coverages specified in this Agreement are the minimum requirements, and these requirements do not decrease or limit the liability of Contractor. The County in no way warrants that the minimum limits contained herein are 5 sufficient to protect the Contractor from liabilities that might arise out of the performance of the Work under by the Contractor, its agents, representatives, employees, or subcontractors. The Contractor shall assess its own risks and if it deems appropriate and/or prudent, maintain higher limits and/or broader coverages. The Contractor is not relieved of any liability or other obligations assumed or pursuant to the Contract by reason of its failure to obtain or maintain insurance in sufficient amounts, duration, or types. The Contractor shall maintain, at its own expense, any additional kinds or amounts of insurance that it may deem necessary to cover its obligations and liabilities under this Agreement. e. Certification of Compliance with Insurance Requirements. The Contractor stipulates that it has met the insurance requirements identified herein. The Contractor shall be responsible for the professional quality, technical accuracy, and quantity of all services provided, the timely delivery of said services, and the coordination of all services rendered by the Contractor and shall, without additional compensation, promptly remedy and correct any errors, omissions, or other deficiencies. 14. Indemnity. The Contractor shall defend, indemnify and hold harmless County, its officers, agents, and employees, from and against any and all injury, loss, damage, liability, suits, actions, claims, or willful acts or omissions of any type or character arising out of the Work done in fulfillment of the terms of this Agreement or on account of any act, claim or amount arising or recovered under workers' compensation law or arising out of the failure of the Contractor to conform to any statutes, ordinances, regulation, judicial decision, or other law or court decree. The Contractor shall be fully responsible and liable for any and all injuries or damage received or sustained by any person, persons, or property on account of its performance under this Agreement or its failure to comply with the provisions of the Agreement. It is agreed that the Contractor will be responsible for primary loss investigation, defense and judgment costs where this contract of indemnity applies. In consideration of the award of this contract, the Contractor agrees to waive all rights of subrogation against the County its associated and/or affiliated entities, successors, or assigns, its elected officials, trustees, employees, agents, and volunteers for losses arising from the work performed by the Contractor for the County. A failure to comply with this provision shall result in County's right to immediately terminate this Agreement. 15. Non -Assignment. Contractor may not assign or transfer this Agreement or any interest therein or claim thereunder, without the prior written approval of County. Any attempts by Contractor to assign or transfer its rights hereunder without such prior approval by County shall, at the option of County, automatically terminate this Agreement and all rights of Contractor hereunder. Such consent may be granted or denied at the sole and absolute discretion of County. 16. Examination of Records. To the extent required by law, the Contractor agrees that an duly authorized representative of County, including the County Auditor, shall have access to and the right to examine and audit any books, documents, papers and records of Contractor, involving all matters and/or transactions related to this Agreement. Contractor agrees to maintain these documents for three years from the date of the last payment received. 17. Interruptions. Neither party to this Agreement shall be liable to the other for delays in delivery or failure to deliver or otherwise to perform any obligation under this Agreement, where 6 such failure is due to any cause beyond its reasonable control, including but not limited to Acts of God, fires, strikes, war, flood, earthquakes or Governmental actions. 18. Notices. County may designate, prior to commencement of Work, its project representative ("County Representative") who shall make, within the scope of his or her authority, all necessary and proper decisions with reference to the project. All requests for contract interpretations, change orders, and other clarification or instruction shall be directed to County Representative. All notices or other communications made by one party to the other concerning the terms and conditions of this contract shall be deemed delivered under the following circumstances: (a) personal service by a reputable courier service requiring signature for receipt; or (b) five (5) days following delivery to the United States Postal Service, postage prepaid addressed to a party at the address set forth in this contract; or (c) electronic transmission via email at the address set forth below, where a receipt or acknowledgment is required and received by the sending party; or Either party may change its notice address(es) by written notice to the other. Notice may be sent to: TO CONTRACTOR: Name: Yumil Jimenez Position: Clinical Director Address: 2580 East Harmony Road, Suite 201-15 Address: Fort Collins, Colorado 80528 E-mail: aspencounseling2b11c(d,gmail.com Phone: (303) 593-2751 TO COUNTY: Name: Jamie Ulrich Position: Director Address: P.O. Box A Address: Greeley, Colorado 80632 E-mail: julrich(aftweld.gov Phone: (970) 400-6510 19. Compliance with Law. Contractor shall strictly comply with all applicable federal and State laws, rules and regulations in effect or hereafter established, including without limitation, laws applicable to discrimination and unfair employment practices. 20. Non -Exclusive Agreement. This Agreement is nonexclusive and County may engage or use other Contractors or persons to perform services of the same or similar nature. 21. Entire Agreement/Modifications. This Agreement including the Exhibits attached hereto and incorporated herein, contains the entire agreement between the parties with respect to the subject matter contained in this Agreement. This instrument supersedes all prior negotiations, representations, and understandings or agreements with respect to the subject matter contained in 7 this Agreement. This Agreement may be changed or supplemented only by a written instrument signed by both parties. 22. Fund Availability. Financial obligations of the County payable after the current fiscal year are contingent upon funds for that purpose being appropriated, budgeted and otherwise made available. Execution of this Agreement by County does not create an obligation on the part of County to expend funds not otherwise appropriated in each succeeding year. 23. Employee Financial Interest/Conflict of Interest — C.R.S. §§24-18-201 et seq. and §24- 50-507. The signatories to this Agreement state that to their knowledge, no employee of Weld County has any personal or beneficial interest whatsoever in the service or property which is the subject matter of this Agreement. 24. Survival of Termination. The obligations of the parties under this Agreement that by their nature would continue beyond expiration or termination of this Agreement (including, without limitation, the warranties, indemnification obligations, confidentiality and record keeping requirements) shall survive any such expiration or termination. 25. Severability. If any term or condition of this Agreement shall be held to be invalid, illegal, or unenforceable by a court of competent jurisdiction, this Agreement shall be construed and enforced without such provision, to the extent that this Agreement is then capable of execution within the original intent of the parties. 26. Governmental Immunity. No term or condition of this Agreement shall be construed or interpreted as a waiver, express or implied, of any of the immunities, rights, benefits, protections or other provisions, of the Colorado Governmental Immunity Act §§24-10-101 et seq., as applicable now or hereafter amended. 27. No Third Party Beneficiary. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 28. Board of County Commissioners of Weld County Approval. This Agreement shall not be valid until it has been approved by the Board of County Commissioners of Weld County, Colorado or its designee. 29. Choice of Law/Jurisdiction. Colorado law, and rules and regulations established pursuant thereto, shall be applied in the interpretation, execution, and enforcement of this Agreement. Any provision included or incorporated herein by reference which conflicts with said laws, rules and/or regulations shall be null and void. In the event of a legal dispute between the parties, Contractor agrees that the Weld County District Court shall have exclusive jurisdiction to resolve said dispute. 8 30. Attorney's Fees/Legal Costs. In the event of a dispute between County and Contractor concerning this Agreement, the parties agree that each party shall be responsible for the payment of attorney fees and/or legal costs incurred by or on its own behalf. 31. Binding Arbitration Prohibited. Weld County does not agree to binding arbitration by any extra judicial body or person. Any provision to the contrary in this Agreement or incorporated herein by reference shall be null and void. 32. Acknowledgment. County and Contractor acknowledge that each has read this Agreement, understands it and agrees to be bound by its terms. Both parties further agree that this Agreement, with the attached Exhibits, is the complete and exclusive statement of agreement between the parties and supersedes all proposals or prior agreements, oral or written, and any other communications between the parties relating to the subject matter of this Agreement. IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. COUNTY: ATTEST: ''"IVI J&O;ci t 11erk to the Boar / EL �/.... BY: /...'_ %ice. V ,..1 �'; l r Deputy Clr t• t e ' �.• �� /� BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO Mike Freeman, Chair MAY 1 7 2323 TRACTOR: Aspen Counseling, LLC 6795 East Tennessee Avenue, Suite 417 Denver, Colorado 80224 (720) 447-7577 By: Vumil Jl nez May 10, 202312:00 MDT) •77 Yumil Jimenez, Clinical Director Date: May 10, 2023 9 ,70a&-/395 EXHIBIT A SCOPE OF SERVICES Contractor will provide Domestic Violence Intervention and Sexual Abuse Treatment Services, as referred by the Department. Program Area: Domestic Violence Intervention Services 1. Domestic Violence Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Individual or group sessions. ii. Domestic Violence Curriculum. iii. Role-play. iv. Reading materials. v. Discussion. b. Anticipated Frequency of Services: i. Level A - one (1) contact per week, ninety (90) minutes per contact. ii. Level B — five (5) contacts per month, ninety (90) minutes per contact. iii. Level C — eight (8) contacts per month, ninety (90) minutes per contact. c. Anticipated Duration of Services: i. Duration is dependent upon which service level, A, B, or C, is selected by the Department, as well as reviews and progress. d. Goals of Services: i. Provide understanding of the impact of Domestic Violence. ii. Learn techniques to control behavior. iii. Knowledge of Colorado Law. e. Outcomes of Services: i. Stop Domestic Violence. ii. Learn tools to control behaviors. iii. Protect victims and the community. f. Target Population: i. Youth. ii. Adults. iii. Males and females. iv. Any sexual orientation. g. Language: i. English. ii. Spanish. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In office located at 6795 East Tennessee Avenue, Suite 417, Denver, Colorado 80224. ii. Telehealth. 2. Parenting Skills for Domestic Violence — Individual and Group a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Curriculum from Caring Dads. b. Anticipated Frequency of Services: i. Weekly for one (I) hour. c. Anticipated Duration of Services: i. Four (4) months and one (1) week. ii. Seventeen group meetings. d. Goals of Services: i. Education of how to avoid arguments in front of children. ii. Education to avoid violence in the home and gain skills and improve relationships with children and their mothers. iii. Education to learn where and how to get help to avoid resolving personal problems in front of the children. e. Outcomes of Services: i. Use new skills, learn about healthy relationships/behavior/communication. £ Target Population: i. Males with domestic violence cases. ii. Eighteen (18) and older. g. Language: i. English. ii. Spanish. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. Telehealth. ii. In person if there is a group of six (6) or more. 3. Non -offending Parenting Skills for sexual offenses a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Curriculum base on Sex Offender Management Board (SOMB). b. Anticipated Frequency of Services: i. One (1), two (2) or three (3) times per'week. ii. Dependent upon group or individual sessions. c. Anticipated Duration of Services: i. Twelve (12) weeks. d. Goals of Services: i. Parenting to learn the consequences of sexual abuse on their child. ii. Learn how to supervise their children to avoid sexual abuse. iii. Teach children boundaries and sexual abuse behaviors and how they can avoid it from happening, protecting themselves. e. Outcomes of Services: i. Caregivers will be equipped with the information and skills needed to support the youth in their care. ii. Knowledge how to access the resources available to them to manage future challenges. f Target Population: i. Non -offending parents. g. Language: i. English. ii. Spanish. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In office located at 6795 East Tennessee Avenue, Suite 417, Denver, Colorado 80224. ii. Telehealth. Program Area: Sexual Abuse Treatment 1. Adult Informed Supervision Training. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Cognitive Behavior Therapy (CBT). ii. Sex Offender Management Board (SOMB) curriculum. iii. Parenting skills topics. b. Anticipated Frequency of Services: i. One (1) or two (2) day class for a total of two (2) hours. c. Anticipated Duration of Services: i. Two (2) days. d. Goals of Services: i. Education of sexual abuse. ii. Education of Colorado Law. iii. Education to provide skills to stop behavior. e. Outcomes of Services: i. Community safety. ii. Boundaries education. iii. Learn tools to avoid inappropriate sexual behaviors. f Target Population: i. Adults. g. Language: i. English. ii. Spanish. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In office located at 6795 East Tennessee Avenue, Suite 417, Denver, Colorado 80224. ii. Telehealth. 2. Adult Psychosexual Education Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Individual education. ii. Group education. b. Anticipated Frequency of Services: i. Once or twice a week for sixty (60) minute sessions. c. Anticipated Duration of Services: i. Twelve (12) weeks, one (1) time per week. ii. Six (6) weeks, two (2) times per week. d. Goals of Services: i. Teach non -offender parents the tools to educate children. ii. Educate non -offender parents to provide better supervision at home and out in the community. e. Outcomes of Services: i. Reduce sexual behavior. ii. Increase education of non -offender parents. iii. Educate non -offender parents regarding safety. f. Target Population: i. Non -offender parents. g. Language: i. English. ii. Spanish. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. Telehealth. 3. Boundaries Education a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Cognitive Behavioral Therapy (CBT). ii. Agency curriculum reinforced with other materials. b. Anticipated Frequency of Services: i. One (1) hour, weekly. c. Anticipated Duration of Services: i. Twenty-four (24) weeks. d. Goals of Services: i. Education of boundaries. ii. Education in using the skills to avoid crossing their own and other's boundaries. e. Outcomes of Services: i. Safety education. ii. Learn skills to avoid crossing boundaries. iii. Use skills to avoid crossing boundaries. iv. Educating others about boundaries. f. Target Population: i. Adolescents. ii. Adults. g. Language: i. English. ii. Spanish. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In office located at 6795 East Tennessee Avenue, Suite 417, Denver, Colorado 80224. ii. Telehealth. 4. Sexual Abuse Treatment a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Individual Sexual Offense Specific (SOS) Therapy. ii. Group Sexual Offense Specific (SOS) Therapy. iii. Cognitive Behavior Therapy (CBT) curriculum. b. Anticipated Frequency of Services: i. High level - one (1) hour session, three (3) times per week. ii. Medium level - one (1) hour session, two (2) times per week. iii. Low level - one (1) hour session, one (1) time per week. c. Anticipated Duration of Services: i. Eighteen (18) to twenty-four (24) months, dependent on the client's progress. d. Goals of Services: i. Educate the client on sexual offenses. ii. Provide clients with tools to avoid future sexual abuse. iii. Educate the family for better supervision of the client. e. Outcomes of Services: i. Client will stop sexual abuse. ii. Client will learn about victims. iii. Client will learn healthy sexuality. f. Target Population: i. Youth ages twelve (12) to seventeen (17). g. Language: i. English. ii. Spanish. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In office located at 6795 East Tennessee Avenue, Suite 417, Denver, Colorado 80224. ii. Telehealth. Terms 1. Contractor understands and will comply with all aspects of the referral authorization, billing and tracking requirements as set forth by the Department. Failure to comply with all aspects may result in a forfeiture of payment. 2. Contractor agrees to receive referrals for services through e-mail and will provide an identified e-mail address prior to the start of this Agreement. Contractor acknowledges that services are not authorized until the Contractor has received an authorized referral form from the Department. Contractor further acknowledges that services provided prior to the authorized start date or outside the scope of services on the referral form will not be eligible for reimbursement. 3. Contractor will respond to the Mental Health and Support Services Team CWServiceReferral5l/weldgov.com) within three (3) business days regarding the ability to accept the received referral. 4. Upon acceptance of a referral, Contractor will offer an initial appointment within seven (7) days of receiving the referral. The first attempt to contact the client will occur within 24 hours of receiving the referral (excluding weekends and holidays). Contractor will document efforts to engage client in referred services. If the client does not respond after three (3) attempts in the first seven (7) days of the referral period, the Contractor will notify the caseworker and the Mental Health and Support Services Team HS- CWServiceReferral(u,weldgov.com. 5. Contractor acknowledges that any and all modifications to an existing referral must be approved through the Mental Health and Support Services Team HS-CWServiceReferral(a2weldgov.com. No other Department staff or other party to the case may authorize services or modifications to services. 6. Contractor understands that "no shows" are defined as unexcused and unplanned/uncommunicated 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", or up to two (2) hours, on the part of case participants who cancel without 24 hour notice. After three (3) "no-shows", Contractor will place client on a behavioral plan requiring attendance or discharge the client from services. Contractor must inform the caseworker and the Mental Health and Support Services Team HS- CWServiceReferral(a,weldgov.com 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 (excluditg 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(a/weldgov.com immediately via email, to discuss service continuation. 8. Contractor will identify, in detail, areas of continued concern and make recommendations to the caseworker in a monthly report regarding continuation of services and/or the need for additional services. 9. Contractor will submit reports on a monthly basis for each active referral for ongoing services. Reports will be subtr_itted per the online format required by the Department, unless otherwise directed by the Department. 10. Contractor will document in detail any and all observed or verbalized concerns regarding any child whom the Contractor is working with under an active referral. Areas of concern may include, but are not limited to, any physical, emotional, educational or behavioral issues. Areas of concern should be reported to the caseworker and the Mental Health and Support Services Team HS-CWServiceReferral(&weldgov.com immediately AND on the required monthly report. 11. Contractor agrees any change to an existing referral must be pre -approved through the Child Welfare Core Service Coordinator or my member of the Mental Health and Support Services Team. Any changes to visitation referrals will be approved by a new referral signed by the Child Welfare Supervisor. A change is defined as anything outside of the approved documented service on the initial authorized referral form. This may indude 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 Decisioi 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 docummits 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/d/weldnov.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. 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. Paymen: 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 Pro_ram Area Domestic Violence Intervention Services Rate $ 40.00 Unit T. pe Hour Service Name Domestic Violence $ 350.00 Episode Domestic Violence: Intake Fee $ 25.00 Each Parenting, Skills: DVI Group $ 40.00 Each Parenting Skills: DVI Individual Sex Abuse Treatment $ 75.00 Hour Adult Informed Supervision Training: In - OfficeNideo $ 40.00 Hour Adult Psychosexual Education class: In- OfficeNideo 80.00 Hour Boundaries Education Session: Group Class $ 100.00 Hour Boundaries Education Session: Individual $ 100.00 Each Parenting Skills: Intake $ 30.00 Each Parenting Skills: SAT Group $ 40.00 Each Parenting Skills: SAT Individual $ 75.00 Hour Sexual Abuse Treatment: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $ 150.00 Hour Sexual Abuse Treatment: In -Home or Community $ 100.00 Hour Sexual Abuse Treatment: In -Office w/Transportation $ 100.00 Hour Sexual Abuse Treatment: In-Office/Video Program Area Rate Sex Abuse Treatment $ 350.00 Unit Type Episode 40.00 12111 Service Name Sexual Abuse Treatment: Intake Fee Sexual Abuse Treatment: No Show (Max of 2 no shows or 2 hours/month/client 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. £ 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 Service, 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 betweer the Department and Contractor, or by the Department as a debt due to the Department or otherwise as provided by law. 6. Financial Management At all times from the effective date of the Agreement until completion of the Agreement, Contractor shall comply with the administrative requirements, cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under this Agreement must conform to the Single Audit Act of 1984 and OMB Circular A-133. Exhibit C WELD COUNTY'S REQUEST FOR PROPOSAL (Weld County's Request for Proposal is incorporated into this agreement by reference and will be provided upon request to the Department.) This page is intentionally left blank Exhibit D Contractor's response to the Request for Proposal Exhibit D contains the following documents: • Attachment B — Provider Information Form (PIF) • Attachment C — Proposal • Attachment D — Staff Data Sheet • Certificate of Insurance (COI) ATTACHMENT B WELD COUNTY DEPARTMENT OF HUMAN SERVICES — PROVIDER INFORMATION FORM (PIF) AGENCY INFORMATION Aspen Counseling, LLC Agency Y Name: Yumil JimenezProvider Contact Full Name: Primary Phone Number (10 -digit): 720-447-7577 Trails Provider ID (if known): Clinical Director Title: Ext.: Fax Number (10 -digit): aspencounseling2bllc@gmail.com Primary Contact Email: Agency Location Address (Street, city, state, zip): Agency Mailing Address (Street, city, state, zip): Web Address: 6795 E Tennessee Ave Suite 417 - Denver, CO 80224 2580 E Harmony Rd. Suite 201-15 Fort Collins, CO 80528 Agency Type (pick one): Public Company ri Private Non -Profit Private for Profit Send Referrals for Service to: Yumil Jimenez Referral Contact Name: Referral Phone Number (10 -digit): 720-447-7577 Ext. Clinical Director Title: Email: aspencounseling2bllc@gmail.com Billing Contact Name: Billing Contact Yumil Jimenez Billing Phone Number (10 -digit): 303-593-2751 Clinical Director Title: Ext.: Email: aspencounseling2bllc@gmail.com F.. • I certify that the services proposed for intended use by the Weld County Department of Human Services will meet all the specifications it I has so indicated in this bid form. I further affirm intention to enter into an agreement with Weld County, on behalf of the Weld County _ . • • • _ • • _ • • _ • • _ • • _ . • _ • • S • • _ • • . • _ • • _ • • _ • • _ • • _ • • —m • • _ . • S linens CERTIFICATION _ _•• _ S • • S . • SI • S • I • Department of Human Services, and comply with all requirements of the contract, if awarded. • The Board of Weld County Commissioners reserve the right to reject any or all bids, to waive any informality in the bids, and to accept Ithe bid, or part of a bid, that, in the opinion of the Board, is in the best interests of the Board and of the County of Weld, State of : 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 It98-03551-0000. I • • Authorized Rep. Full Name: I Yumil Jimenez Clinical Director Title: i aspencounseling2bllc@gmail.com 303-593-2751 • Authorized Rep. Email: Phone (10 -digit): I i 6795 E Tennessee Ave Suite 417 Denver, CO 80224 • Authorized Rep. Address (street, city, state, zip): I / • Signature of Authorized Rep.. Silt Date: I• • • • �- • • r• • I. • • • • _ • S%• • • • al • • a • • •/ e • • a • • • • .s • • _ • • _ • • _ • • _ • • _ • • a • _ • • • • • • • • �• • • I / • Ext.. • • • • REV. DECEMBER 2021 I i I I I I I I I I • 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: Aspen Counseling, LLC Program Area: Anger Management/Domestic Violence Program Areas are listed in columr 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. 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: Parenting Skills for Domestic violence 2.1a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Curriculum from Caring Dads 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: Weekly 1 hour 2.1c Anticipated duration of service (i.e., 3-4 months): 4 months and 1 vc-wek - 17 Group Meetings 2.1d Three (3), or more, specific goals of the service (DO use bullet points): Participants will learn how to avoid arguments in front of the children. Participants will learn skills to improve their relationship with -heir children a the mother of their children to avoid violence at the home. Participants will learn where and how tc get help to avoid resolving personal problems in front of the children. 2.1e Three (3), or more., specific outcomes of service: 2.1f _ Target populatior of the service, including age and gender: Male with domesic violence cases 18 and older 2.1g Languages service is available in (please list proficiency and if interpreter services are available): English and Spanish 2.1h Medicaid eligibilit , — list whether the service is eligible for Medicaid in whole or in part: None 2.1i Service location — ist where the service will take place (i.e., client's home, in -office, other) Via Telehealth — Person if there is a group of 6 or more Service #2 Name: Non -offending Parenting Skills for Sexual offenses 2.2a Modalities, curricul. m, tools used in delivery of service (DO NOT list company history; DO use bullet points): Curriculum base on 30MB 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, or 3 times/wee( depend on group or individual sessions 2.2c Anticipated duration of service (i.e., 3-4 months): 12 weeks 2.2d Three (3), or more, specific goals of the service (DO use bullet points): 2.2e Parenting to learn the consequences of sexual abuse on their child. Learn how to supervise their children to avoid sexual abuse. Teach children boundaries and sexual abuse behaviors and how they can avoid it for happening, protecting themselves. Three (3), or more, wecific outcomes of service: 2.2f Target population o the service: No offending parents 2.2g Languages service is available in (please list proficiency and if interpreter services are available): English and Spanish 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): 1 2.3e Three (3), or more, specific outcomes of service: 2.3f Target population of the service: 2.3g Languages service is available in (please list proficiency and if interpreter services are available): 2.3h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.3i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #4 Name: 2.4a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.4b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.4c Anticipated duration of service (i.e. 3-4 months): 2.4d Three (3), or more, specific goals of the service (DO use bullet points): 2.4e Three (3), or more, specific outcomes of service: 2.4f Target population of the service: 2.4g Languages service is available in (please list proficiency and if interpreter services are available): 2.4h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.4i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #5 Name: 2.5a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.5b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.5c Anticipated duration of service (i.e. 3-4 months): 2.5d Three (3), or more, specific goals of the service (DO use bullet points): REV. OCT 2021 2 ATTACHMENT C - PROPOSAL 2.5e Three (3), or more, 5 pecific outcomes of service: 2.5f Target population o: the service: 1 2.5g Languages service is available in (please list proficiency and if interpreter services are available): 2.5h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part 2.6i Service location — list where the service will take place (i.e. client's home, in -office, other) Section 3 — Service Access and Transportation 3.1 Will you charge Weld County for transporting clients or mileage? Check one: 3.2 Will you conduct se vices in a client's home or in the community? Check one: 3.3 Will you transport c ients to and/or from services? Check one: ■ ■ ■ YES ■ NO YES ■ NO YES ■ NO 3.4 How many miles arc 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 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: Parenting Skills for Domestic Violence (DV Program area) 4.1a In-Office/Video: 4.1b In -Home or Community: 4.1c Ir-Office/Video, In -Home, or Community with Transportation: 4.1d FTM, TDM, Prof. Staffing: 4.1e No show: 4.1f Mileage rate: $ Amount See below Unit Type Select Unit Type. Select Unit Type. Select Unit Type. 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 Parenting Skills for Sexual offenses (Sex abuse treatment program area) In-Office/Video: 4.2b In -Home or Community: 4.2c Ir -Office/Video, In -Home, or Community with Transportation: 4.2d FTM, TDM, Prof. Staffing: $ Amount See below Unit Type Select Unit Type. Select Unit Type. Select Unit Type. 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: 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: Select Unit Type. 4.3b In -Home or Community: Select Unit Type. No. included of roundtrip in rate: miles miles 4.3c In-Office/Video, Community Transportation: In -Home, or with Select Unit Type. No. included of roundtrip in rate: miles 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: Select Unit Type. No. of roundtrip miles 4.4b In -Home or Community: Select Unit Type. included in rate: miles No. of roundtrip miles 4.4c In-Office/Video, In -Home, or Select Unit Type. included in rate: miles Community Transportation: with 4.4d FTM, TDM, Prof. Staffing: per Hour 4.4e No show: per No Show 4.4f 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: Select Unit Type. No. of roundtrip miles 4.5b In -Home or Community: Select Unit Type. included in rate: miles No. of roundtrip miles 4.5c In-Office/Video, In -Home, or Select Unit Type. included in rate: miles Community Transportation: with 4.5d FTM, TDM, Prof. Staffing: per Hour 4.5e No show: per No Show 4.5f Mileage rate: per Mile above. This is paid after the miles listed 4.6 Monthly Service Rates (each level must be listed): Service Name with Level Rate Month per Minimum Service: Hours of 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. REV. OCT 2021 4 ATTACHMENT C - PROPOSAL Minimum 4.8 Monitored Sobriety Providers — List your rates in the box below. Provider special notes: Parenting Skills for Domestic violence clients 17 group meeting $25/group no intake fee. Individual if there is no group $40 Parenting Skills for Sexual offenses no offender parents Intake $100 12 group meeting $30/group Individual if there 6 no group $40 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: Aspen Counseling, LLC Sexual Abuse Treatment 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. 4 SECTION 2 - Service Name(s) Information If the service is a monthly state a specific package, minimum please offer number different and of direct levels. service All monthly hours. packages must Service #1 Name: Sexual Abuse Treatment 2.1a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Individual or group SOS therapy Cognitive Behavior Therapy curriculum 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: High level 1/hour 3/times/week — Medium Level 2/times/week and Low Level 1/time/week 2.1c Anticipated duration of service (i.e. 3-4 months): Depend on client's progress and the Level of Care — Normally between 18 to 24 months — 60 minutes 2.1d Three (3), or more, specific goals of the service (DO use bullet points): To family educate for the better client supervision on sexual offenses. To provide the clients with tools to avoid future sexual abuse. To educate the 2.1e Three (3), or more, specific outcomes of service: The client will stop sexual abuse. The client will learn about victims. The client will learn healthy sexuality 2.1f Target population of the service, including age and gender: Youth ages 12 to 17 2.1g Languages service is available in (please list proficiency and if interpreter services are available): English and Spanish 2.1h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: No 2.1i Service location — list where the service will take place (i.e. client's home, in -office, other) Office and other Telehealth Service #2 Name: Adult Psychosexual Education class 2.2a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 12 sessions group or individual one/twice week 2.2b administrative Anticipated frequency of time, overhead, direct service or travel time with time (i.e. the 4 client/family hours/week). If per the week, service not including has levels, professional be specific for staffing each level: time, 12 weeks (once/week) or 6 weeks (twice/week) 60 minutes 2.2c Anticipated duration of service (i.e. 3-4 months): 3 months or 6 weeks 2.2d Three (3), or more, specific goals of the service (DO use bullet points): community Education to no offender parents. Teaching the tools to educate children. Better supervision at home and out in the 2.2e Three (3), or more, specific outcomes of service: Reduce sexual behavior, education and safety 2.2f Target population of the service: No offender parents 2.2g Languages service is available in (please list proficiency and if interpreter services are available): Spanish, English 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) REV. OCT 2021 1 ATTACHMENT C - PROPOSAL Telehealth Service #3 Name: Adult Inform Supervision Training 2.3a Modalities, curriculLm, tools used in delivery of service (DO NOT list company history; DO use bullet points): CBT, SOMB curriculum and parenting skills topics 2.3b Anticipated frequen:y 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- or two -days class 2 hours total 2.3c Anticipated duratior of service (i.e. 3-4 months): 2 days 2.3d Three (3), or more, specific goals of the service (DO use bullet points): Learned about sexua I abuse, Colorado Law, skills to stop the behavior 2.3e Three (3), or more, specific outcomes of service: Community safety, koundaries and educate and learn tools to avoid inappropriate sexual behaviors 2.3f Target population of the service: Adults 2.3g Languages service is available in (please list proficiency and if interpreter services are available): English and Spanish 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) Office and Teleheal:h Service #4 Name: Domestic Violence 2.4a Modalities, curriculLm, tools used in delivery of service (DO NOT list company history; DO use bullet points): Individual or group, Domestic violence curriculum, role-play, reading materials, discussions. 2.4b Anticipated frequen:y 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: _ Depend on the Leve s: A once week; B 5 contacts during the month, Level C 8 contacts during the month - 90 minutes 2.4c Anticipated duratior of service (i.e. 3-4 months): Depend on the Leve A, B, C, reviews, and progress 2.4d Three (3), or more, specific goals of the service (DO use bullet points): To understand the impact of domestic violence, to learn techniques to control behavior, to know the law 2.4e Three (3), or more, specific outcomes of service: _ To Stop Domestic Vi blence, To learn tools to control behaviors, And Protect victims and Community. 2.4f 2.4g 2.4h Target population of the service: Youth, Adults. male and female, Guys, lesbian, etc. Languages service is available in (please list proficiency and if interpreter services are available): English - Spanish 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) Office and o/Telehealth Service #5 Name: Boundaries 2.5a Modalities, curricula m, tools used in delivery of service (DO NOT list company history; DO use bullet points): CBT, Agency Curricu um reinforce with other materials 2.5b Anticipated frequen :y 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 time/week 1 hour 2.5c Anticipated duration of service (i.e. 3-4 months): 24 weeks — 60 minutes 2.5d Three (3), or more, specific goals of the service (DO use bullet points): Learn about boundaries, using the kills to avoid crossing others and their own boundaries 2.5e Three (3), or more, specific outcomes of service: Safety, learn and use skills to avoid crossing boundaries, educating others about boundaries REV. OCT 2021 2 ATTACHMENT C - PROPOSAL 2.5f 2.5g 2.5h 2.6i Target population of the service: Adolescents and adults Languages service is available in (please list proficiency and if interpreter services are available): English & Spanish I 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) Office, telehealth Section 3 — Service Access and Transportation 3.1 Will you charge Weld County for transporting clients or mileage? Check one: 3.2 Will you conduct services in a client's home or in the community? Check one: 3.3 Will you transport clients to and/or from services? Check one: ■ YES 3.4 How many miles are you willing to travel round trip? List a specific number of miles. 3.5 When you calculate mileage, what is your starting point address? ■ YES YES NO ■ Miles NO NO 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: SOS- Sexual Abuse 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 $100 $100 $150 $75 $40 U nit 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: Adult Psychosexual Education class 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 $40 U nit 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: Adult Inform Supervision Training 4.3a In-Office/Video: 4.3b In -Office with Transportation: 4.3c In -Home or Community: $ Amount $75 U nit 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 4.3d 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: Domestic Violence $ Amount Unit Type 4.4a In-Office/Video: 40 per Hour 4.4b In -Office w-th Transportation: per Hour No. of roundtrip miles included in rate: miles No. included in rate: In -Home or Community: per Hour of roundtrip miles 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: Boundaries $ Amount Unit Type 4.5a In-Office/Video: per Hour 4.5b In -Office %iith Transportation: per Hour No. of roundtrip miles included in rate: miles 4.5c In-Hpme 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. Do not provide this service 4.8 Monitored Sobriety Providers — List your rates in the box below. Do not provide this service Provider special notes: Intake (one time) fo- SOS is $350, Domestic Violence $350 for Parenting Classes $100 — No Intake fees for the Inform Supervision Training and the fee is $75/per person. 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: Yumil Jimenez Aspen Counseling, LLC PHONE NUMBER: 720_447-7577 EMAIL: aspencounseling2bllc©gmail.com PROPOSED SERVICE(S): Training and Sexual Juveniles) Offense (Parents, Treatment adults who (Adults will and be supervising), Juveniles), Boundaries Psychosexual Class Class (Adults (No Offender & Juveniles), Parents), Domestic Inform Violence Supervision (Adults Legal Last Name Initial Middle Name Previous (If applicable) Legal Last Legal First Name Service Type Credentials Licensure/ DORA # (If applicable) Jimenez J Yumil All Professional Counselor LPC.0004846 above I Certified Addiction Sp ACC.0006613 SOMB • DVOMB I Love & Logic Insttructor CHILD WELFARE REQUEST FOR PROPOSAL 2022-23 - VARIOUS SERVICES ACORL7 DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 05/01/2023 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 PROD JCER, 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 policy, certain policies may require an endorsement. A statement on this certificate does not confe- rights to the certificate holder in lieu of such endorsement(s). PRODUCER Matthew Ditzenberger Agency, Inc. 1485 S Colorado Blvd Ste 200 Denver, CO 80222 (303) 756-8038 INSURED Aspen Counseling, L_C 6789 E Tennessee AN__e Ste 417, Denver, CO 802042 COVERAGES CERTIFICATE NUMBER: CON NAME: Matthew Ditzenberger PHONE 3037568038 (A/C., No, Ext): E-MAIL ADDRESS: mditzenb@amfam.com FAX (NC 8554258218 INSURER(S) AFFORDING COVERAGE INSURER A : American Family Mutual Insurance Company, SI INSURER B : Midvale Indemnity Company INSURER C : INSURER D : INSURER E : INSURER F : REVISION NUMBER: NAIC # 473 27138 THIS IS INDICATED. CERTIFICATE EXCLUSIONS TO CERTIFY THAT NOTWITHSTANDIN MAY BE ISSUED AND CONDITIONS THE POLICIES OF INSURANCE . ANY REQUIREMENT, DR MAY PERTAIN, DF SUCH POLICIES. LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A COMMERCIAL GENERAL CLAIMS -MADE LIABLITY OC�UR X 05-XW8873-01 05/25/2023 05/25/2024 EACH OCCURRENCE $ 2000000 K MIS TO RENTED PREMISES (Ea occurrence) $ 50000 MED EXP (Any one person) $ 5000 PERSONAL & ADV INJURY $ 1000000 GEN'L AGGREGATE POLICY OTHER: LIMIT APPLIES PRO- JECT 'ER. OC GENERAL AGGREGATE $ 2000000 K L PRODUCTS - COMP/OP AGG $ 2000000 $ AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY SCHEE ULED AUTOS NON-CA/NED AUTOE ONLY . COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB I OCUR CLAIMS -MADE I EACH OCCURRENCE $ AGGREGATE $ DED RETENTION S $ WORKERS COMPENSATION AND EMPLOYERS' ANYPROPRIETOR/PARTNER/EXECU- OFFICER/MEMBEREXCLUDED? (Mandatory If yes. describe DESCRIPTION LIABILITY VE NH) under OF OPERATIONS belc- v YEN N/A PER STATUTE OTH- ER E.L. EACH ACCIDENT $ in LE.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT S DESCRIPTION Additional OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Insured: Board of Count • Commissioners of Weld Additional Remarks Schedule, may County and its Officers/Employees be attached if more space is required) CERTIFICATE HOLDER CANCELLATION Weld County 1150O 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 Matthew Ditzenberger ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SIGNATURE REQUESTED: Weld/Aspen Counseling PSA Final Audit Report 2023-05-10 Created: 2023-05-10 By: Windy Luna (wluna@co.weld.co.us) Status: Signed Transaction ID: CBJCHBCAABAAwGoa57UOxTPVVVT7da3gA_Bot43GkizE "SIGNATURE REQUESTED: Weld/Aspen Counseling PSA" Hist ory t Document created by Windy Luna (wluna@co.weld.co.us) 2023-05-10 - 5:51:30 PM GMT Dt Document emailed to Yumil Jimenez (aspencounseling2bllc@gmail.com) for signature 2023-05-10 - 5:52:45 PM GMT t Email viewed by Yumil Jimenez (aspencounseling2bllc@gmail.com) 2023-05-10 - 5:52:50 PM GMT yt0 Document e -signed by Yumil Jimenez (aspencounseling2bllc@gmail.com) Signature Date: 2023-05-10 - 6:00:09 PM GMT - Time Source: server Agreement completed. 2023-05-10 - 6:00:09 PM GMT Powered by Adobe Acrobat Sign Contract Form New Contract Request Entity Information Entity Name" ASPEN COUNSELING LLC Entity ID. 0©46351 ❑ New Entity? Contract Name. Contract ID ASPEN COUNSELING LLC (NEW PROFESSIONAL SERVICES 6983 AGREEMENT) (BID #82300040) Contract Status CTB REVIEW Contract Lead. WLIJNA Contract Lead Email wluna:Tweldgov.com,c©bbx xlkvtweldgov.com Contract Description * CONSENT BID n62300040. TERM06101,'2023 THROUGH 05 31 2024. Parent Contract ID Requires Board Approval YES Department Project # Contract Description 2 PROVIDER WAS LISTED ON APPROVED VENDOR LIST PRESENTED TO THE BOCC ON 03 29 2023 AND AS A COMMUNICATION ITEM; PA SENT TO CTB ON 03;` 30 2023. Contract Type. AGREEMENT Amount * $0.00 Renewable. YES Automatic Renewal Grant ICA Department HUMAN SERVICES Department Email CM- HurnanServices@weldgov.co rn Department Head Email CM-HumanSen/ices- DeptHeadgWeldgov.corn County Attorney GENERAL COUNTY ATTORNEY EMAIL County Attorney Email CM- COUNTYATTORNEY)zWELDG OV.COM Requested BOCC Agenda Date. 05:24.2023 Due Date 05x'20'2023 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 OnBase Contract Dates Effective Date Review Date* 03; 29 -2024 Renewal Date* 05 31 2024 Termination Notice Period Contact Information Contact Info Contact Name Purchasing Committed Delivery Date Expiration Date Contact Type Contact Email Contact Phone I Contact Phone 2 Purchasing Approver Purchasing Approved Date Approval Process Department Head JAMIE ULRICH DH Approved Date 05:11+2023 Final Approval BOCC Approved BOCC Signed Date BOCC Agenda Date 05'17,2023 Originator WLUNA Finance Approver CHRIS D'OVIDIO Legal Counsel BRUCE BARKER Finance Approved Date Legal Counsel Approved Date ,+2023 05; 12,F2023 Tyler Ref # AG 051723 Houstan Aragon From: Sent: To: Subject: noreply@weldgov.com Friday, April 4, 2025 1:31 PM CM-ClerktoBoard; Windy Luna; Lesley Cobb; CM-HumanServices-DeptHead Fast Tracked Contract ID (9291) Contract # 9291 has been Fast Tracked to CM -Contract Maintenance. You will be notified in the future based on the Contract information below: Entity Name: ASPEN COUNSELING LLC Contract Name: ASPEN COUNSELING, LLC (PROFESSIONAL SERVICES AGREEMENT AMENDMENT#1 RELATED TO BID #B2300040) Contract Amount: $0.00 Contract ID: 9291 Contract Lead: WLUNA Department: HUMAN SERVICES Review Date: 3/31/2026 Renewable Contract: NO Renew Date: Expiration Date:5/31/2026 Tyler Ref #: Thank -you ccc cvO& - V --e z o23-133 \\V.O10ct5 ASPEN COUNSELING, LLC Houstan Aragon From: Sent: To: Cc: Subject: Sara Adams Friday, April 4, 2025 1:15 PM CTB HS -Contract Management FAST TRACK - Various Core Agreements (Tyler# Various) Good afternoon CTB, FAST TRACK ITEM: The below list will be Fast Track items in CMS for tracking purposes only to correct the expiration date. 290 8141 2023-1393 9291 8165 , 2314 0 9292 CASA OF LARIMER COUNTY 8176 2024-1270 9293 8 CREATIVE NURSING, LLC CQA{SX'QQ_I 8151 2024-1221 8171: '0 4-1268 9297 2 CRUX COUNSELING, LLC 8132 2023-1396 9300 8 4-1 101 KEEP SWIMMING,LLC 8750 2023-1438 9302 8 MAISHA BORA LLC 8163 2024-1265 9304 NOCO SPEECH & DIAGNOSTICS 1 8156 2023-1439 1 9306 POLARIS PARTNERS LLC 8148 2023-1401 9308 REACHING HOPE RHEGNUMI CONSULTING, LLC 8190 2024-1321 9310 8168 2024-1267 9312 SENSITIVE SOLUTIONS BEHAVIORAL HEALTH, LLC 8182 2024-1271 9314 SIMPLE ASSENT, LLC 8215 2024-1416 9323 SPECIALTY COUNSELING & CONSULTING LLC 8263 2024-1474 9317 UNIVERSITY OF NORTHERN COLORADO 8219 2024-1327 9319 WILLOW COLLECTIVE PLLC 8192 2024-1323 9321 9015 2023-1397 9322 Thank you, Sara COUNTY, CO Sara Adams Contract Administrative Coordinator Department of Human Services Desk: 970-400-6603 P.O. 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