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Home My WebLink About20242283.tiffConkvock AGREEMENT AMENDMENT BETWEEN WELD COUNTY AND BRITIN, LLC DBA FIRSTLIGHT HOMECARE BOULDER This Agreement Amendment made and entered into I '1'day of HWi, 2025 by and between the Board of Weld County Commissioners, on behalf of the eld County Department of Human Services, hereinafter referred to as the "Department", and Britin, LLC dba FirstLight HomeCare Boulder, hereinafter referred to as the "Contractor". WI-EREAS the parties entered into an Agreement for In -Home Services for Older Adults, (the "Original Agreement") identified by the Weld County Clerk to the Board of County Commissioners as document No. 2024-2283, approved on August 28, 2024. WHEREAS the parties hereby agree to amend the term of the Original Agreement in accordanoe 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 June 30, 2025. • 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 effective July 1, 2025: 1. Paragraph 3. Term. The term of this Agreement shall be from July 1, 2025, through June 30, 2026, or Contractor's completion of the responsibilities described in Exhibit A. This Agreement may be extended annually upon written agreement of both parties. • All other terms and conditions of the Original Agreement remain unchanged. C ()Y1 tO.Se OS) 5A/2_5 20Zc\-22�3 IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. COUNTY: ATTES rj"^) jC,l" Clerk to the Board _ _ ELD COUNTY, COLORADO BY: dal I Lail Artiv • r eputy Clerk o the oard BOARD OF COUNTY COMMISSIONERS uck, Chair ONTRACTOR: MAY 1 9 232 Britin, LLC dba FirstLight HomeCare Boulder 1021 East South Boulder Road, Suite J Louisville, Colorado 80027 By: GREGORY BRA (May 14 May 14 , 202515:05 MDT) Whitney Brown, Agency Manager Date: 05/14/2025 2oZ-1-22$3 SIGNATURE REQUESTED: Weld/Britin LLC dba FirstLight Home Care Boulder Amendment #1 Final Audit Report 2025-05-14 Created: 2025-05-14 By: Sara Adams (sadams©weld.gov) Status: Signed Transaction ID: CBJCHBCAABAA12_PPVIdhXeBwM0GkvkgVMYG-_v9oKtG "SIGNATURE REQUESTED: Weld/Britin LLC dba FirstLight Ho me Care Boulder Amendment #1" History In Document created by Sara Adams (sadams@weld.gov) 2025-05-14 - 1:52:30 PM GMT- IP address: 204.133.39.9 O4 Document emailed to GREGORY BROWN (whbrown@firstlighthomecare.com) for signature 2025-05-14 -1:53:00 PM GMT t Email viewed by GREGORY BROWN (whbrown@firstlighthomecare.com) 2025-05-14 - 1:53:39 PM GMT- IP address: 66.102.6.194 6O Document e -signed by GREGORY BROWN (whbrown@firstlighthomecare.com) Signature Date: 2025-05-14 - 9:05:29 PM GMT - Time Source: server- IP address: 76.154.225.138 Agreement completed. 2025-05-14 - 9:05:29 PM GMT Powered by Adobe Acrobet Sign Contract Form Entity Information Entity Name* BRITIN LLC Entity ID* @00036424 Contract Name* BRITIN LLC DBA FIRSTLIGHT HOMECARE BOULDER PROFESSIONAL SERVICE AGREEMENT AMENDMENT #1 FOR THE OAA IN -HOME VOUCHER PROGRAM. Contract Status CTB REVIEW Contract ID 9422 Contract Lead * SADAMS O New Entity? Parent Contract ID 20242283 Requires Board Approval YES Contract Lead Email Department Project # sadams@weld.gov;cobbx xlk@weld.gov Contract Description * (CONSENT) BRITIN LLC DBA FIRSTLIGHT HOMECARE BOULDER PROFESSIONAL SERVICE AGREEMENT AMENDMENT #1 FOR THE OAA IN -HOME VOUCHER PROGRAM. TERM 7/1/2025 THROUGH 6/30/2026. Contract Description 2 Contract Type* AMENDMENT Amount* $0.00 Renewable* NO Automatic Renewal Grant IGA Department HUMAN SERVICES Department Email CM- HumanServices@weld.gov Department Head Email CM-HumanServices- DeptHead@weld.gov County Attorney GENERAL COUNTY ATTORNEY EMAIL 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 Requested BOCC Agenda Due Date Date * 05/21/2025 05/17/2025 Will a work session with BOCC be required?* NO Does Contract require Purchasing Dept. to be included? 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 04/30/2026 Committed Delivery Date Renewal Date Expiration Date* 06/30/2026 Contact Name Contact Type Contact Email Contact Phone 1 Contact Phone 2 Purchasing Purchasing Approver Purchasing Approved Date CONSENT 05/14/2025 Approval Process Department Head JAMIE ULRICH DH Approved Date 05/14/2025 Final Approval BOCC Approved BOCC Signed Date BOCC Agenda Date 05/19/2025 Finance Approver CONSENT Legal Counsel CONSENT Finance Approved Date Legal Counsel Approved Date 05/14/2025 05/14/2025 Tyler Ref # AG 051925 Originator SADAMS Conkvac>+ t ao0 WELD COUNTY AGREEMENT FOR PROFESSIONAL SERVICES BETWEEN WELD COUNTY AND BRITIN, LLC DBA FIRSTLIGHT HOMECARE BOULDER THIS AGREEMENT is made and entered into th• is ZS day of OtAS 2024, by and between the County of Weld, a body corporate and politic of the State of Colora o, by and through its Board of County Commissioners, whose address is 1150 "O" Street, Greeley, Colorado 80631 hereinafter referred to as "County," and Britin, LLC dba FirstLight HomeCare Boulder, whose address is 1021 East South Boulder Road, Suite J, Louisville, Colorado 80027, hereinafter referred to as "Contractor". WHEREAS, County desires to retain Contractor as an Independent Contractor to perform services as more particularly set forth below; and WHEREAS, Contractor has the ability, qualifications, and time available to timely perform the services, and is willing to perform the services according to the terms of this Agreement. WHEREAS, Contractor is authorized to do business in the State of Colorado and has the time, skill, expertise, and experience necessary to provide the services as set forth below; WHEREAS, In -Home Services for older adults, as defined by the 12 CCR 2510-1, Colorado Older Americans Act, Volume 10, are widely recognized as valued services that assist individuals who experience difficulty performing activities of daily living to remain in their homes and to live independently. WHEREAS, County serves as the advocate and focal point for older persons with the greatest economic and social need, and WHEREAS, Contractor is an organization existing for the purpose of providing homemaker and personal care services to residents of Weld County, and County desires to purchase homemaker and personal care services for low-income seniors from Contractor. NOW, THEREFORE, in consideration of the mutual promises and covenants contained herein, the parties hereto agree as follows: 1. Introduction. The terms of this Agreement are contained in the terms recited in this document and in Exhibit A, Scope of Services and Rate Schedule, Exhibit B, HIPPA Business Associate Agreement, Exhibit C, Voucher Program Instructions and Exhibit D, Consumer Complaints, Appeals and Hearings Procedure which forms an integral part of this Agreement. Exhibit A, Exhibit B, Exhibit C and Exhibit D are specifically incorporated herein by this reference. 2. Service or Work. Contractor agrees to provide the materials, equipment and/or products necessary for the outlined Scope of Work and further agrees to diligently provide all services and labor, as set forth in Exhibit A. 3. Term. The term of this Agreement shall be from July 1, 2024, through June 30, 2025, or Contractor's completion of the responsibilities described in Exhibit A. This Agreement may be extended annually upon written agreement of both parties. 4. Termination. County has the right to terminate this Agreement, with or without cause on thirty (30) days ebrw+ icya 3/26/24 1 cctQnbasc (D*S') 3/13/2.,-1 2024-2283 02-00B ic written notice. Furthermore, this Agreement may be terminated at any time without notice upon a material breach of the terms of the Agreement. 5. Extension or Modification. Any amendments or modifications to this agreement shall be in writing and signed by both parties. No additional services or work performed by Contractor shall be the basis for additional compensation unless and until Contractor has obtained written authorization and acknowledgement by County for such additional services. 6. Compensation/Contract Amount. County agrees to pay an amount no greater than the amount listed in Exhibit A, Scope of Services and Rate Schedule for the term of this Agreement, as set forth in Paragraph 3. County agrees to pay Contractor through an invoice process during the course of this Agreement in accordance with the Rate Schedule as described in Exhibit A. Contractor agrees to submit invoices which detail the work completed by Contractor. The County will review each invoice and if it agrees Contractor has completed the invoiced items to the County's satisfaction, it will remit payment to Contractor. Contractor agrees to work within the confines of the Scope of Services outlined in Exhibit A. County will not withhold any taxes from monies paid to the Contractor hereunder and Contractor agrees to be solely responsible for the accurate reporting and payment of any taxes related to payments made pursuant to the terms of this Agreement. 7. Independent Contractor. Contractor agrees that it is an independent Contractor and that Contractor's officers, agents or employees will not become employees of County, nor entitled to any employee benefits from County as a result of the execution of this Agreement. Contractor shall perform its duties hereunder as an independent Contractor. Contractor shall be solely responsible for its acts and those of its agents and employees for all acts performed pursuant to this Agreement. Contractor, its employees and agents are not entitled to unemployment insurance or workers' compensation benefits through County and County shall not pay for or otherwise provide such coverage for Contractor or any of its agents or employees. Unemployment insurance benefits will be available to Contractor and its employees and agents only if such coverage is made available by Contractor or a third party. Contractor shall pay when due all applicable employment taxes and income taxes and local head taxes (if applicable) incurred pursuant to this Agreement. 8. Subcontractors. Contractor acknowledges that County has entered into this Agreement in reliance upon the particular reputation and expertise of Contractor. Contractor shall not enter into any subcontractor agreements for the completion of this Project without County's prior written consent, which may be withheld in County's sole discretion. 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. 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, 2 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 services performed under this Agreement will be performed in a manner consistent with the standards governing such services and the provisions of this Agreement. Contractor further represents and warrants that all services shall be performed by qualified personnel in a professional and workmanlike manner, consistent with industry standards, and that all services will conform to applicable specifications. 12. Acceptance of Services Not a Waiver. In no event shall any action by County hereunder constitute or be construed to be a waiver by County of any breach of this Agreement or default which may then exist on the part of Contractor. Acceptance by the County of, or payment for, the services completed under this Agreement shall not be construed as a waiver of any of the County's rights under this Agreement or under the law generally. 13. Insurance. 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. 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; $50,000 fire, $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 3 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. Privacy Insurance Liability Insurance covering all loss of County and State Confidential Information, such as Personal Identifiable Information (PII), Protected Health Information (PHI), Payment Card Information (PCI), Tax Information, and Criminal Justice Information (CJI), and claims based on alleged violations of privacy rights through improper use or disclosure of protected information with minimum limits as follows: $1,000,000 each occurrence; and $2,000,000 general aggregate. Notwithstanding if Contractor has Confidential Information for 10 or fewer individuals or revenue of $250,000 or less, Contractor shall maintain limits of not less than $50,000. Notwithstanding if Contractor has Confidential Information for 25 or fewer individuals or revenue of $500,000 or less, Contractor shall maintain limits of not less than $100,000. 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 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 4 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 a 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. Compliance with Law. Contractor shall strictly comply with all applicable federal and State laws, rules and regulations in effect or hereafter established, including without limitation, laws applicable to discrimination and unfair employment practices. 18. Non -Exclusive Agreement. This Agreement is nonexclusive, and County may engage or use other Contractors or persons to perform services of the same or similar nature. 19. Entire Agreement/Modifications. This Agreement including the Exhibits attached hereto and incorporated herein, contains the entire agreement between the parties with respect to the subject matter contained in this Agreement. This instrument supersedes all prior negotiations, representations, and understandings or agreements with respect to the subject matter contained in this Agreement. This Agreement may be changed or supplemented only by a written instrument signed by both parties. 20. Fund Availability. Financial obligations of the County payable after the current fiscal year are contingent upon funds for that purpose being appropriated, budgeted and otherwise made available. Execution of this Agreement by County does not create an obligation on the part of County to expend funds not otherwise appropriated in each succeeding year. 5 21. Employee Financial Interest/Conflict of Interest — C.R.S. §§24-18-201 et seq. and §24-50-507. The signatories to this Agreement state that to their knowledge, no employee of Weld County has any personal or beneficial interest whatsoever in the service or property which is the subject matter of this Agreement. 22. 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. 23. 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. 24. Governmental Immunity. No term or condition of this contract shall be construed or interpreted as a waiver, express or implied, of any of the immunities, rights, benefits, protections or other provisions, of the Colorado Governmental Immunity Act §§24-10-101 et seq., as applicable now or hereafter amended. 25. Force Majeure. Neither the Contractor nor the County shall be liable for any delay in, or failure of performance of, any covenant or promise contained in this Agreement, nor shall any delay or failure constitute default or give rise to any liability for damages if, and only to extent that, such delay or failure is caused by "force majeure." As used in this Agreement, "force majeure" means acts of God, acts of the public enemy, unusually severe weather, fires, floods, epidemics, quarantines, strikes, labor disputes and freight embargoes, to the extent such events were not the result of, or were not aggravated by, the acts or omissions of the non -performing or delayed party. 26. 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. 27. 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. 28. 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. 29. 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. 6 30. 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. 31. 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: BY: artzetito ‘Ideo; Clerk to the 3oard BOARD OF COUNTY COMMISSIONERS ELD COUNTY COLORADO Deputy Clerk to the Bderd� ,�..r.., .evin D. Ross, Chair 7 CONTRACTOR: AUG 2 8 2424 Britin, LLC dba FirstLight HomeCare Boulder 1021 East South Boulder Road, Suite J Louisville, Colorado 80027 kvh,tneii 3'tOWM By: Whitney Brown (ug 22, 2024 11:09 MDT' Whitney Brown, Agency Manager Date: Aug 22, 2024 Z02Lf- zz3 Exhibit A Scope of Services and Rate Schedule Scope of Services a. Definitions (Volume 10 Older Americans Act State Unit on Aging Policy and Procedure Manual 8- 12-2019) i. "Frail" means an older adult who is determined to be functionally impaired due to inability to perform at least two Activities of Daily Living without substantial human assistance, including verbal reminding, physical cueing, or supervision; or, a cognitive or other mental impairment, requiring substantial supervision because the individual behaves in a manner that poses a serious health or safety hazard to self or others. ii. "Homemaker Services" means providing assistance to persons who meet the eligibility requirements for in -home services and who are unable to perform two or more of the following Instrumental Activities of Daily Living: preparing meals, laundry, shopping for personal items, managing money, using the telephone or doing light housework. iii. "Homemaker Eligibility" is restricted to those persons who are unable to perform at least two Instrumental Activities of Daily Living without substantial human assistance, including verbal reminding, physical cueing, or supervision; or due to a cognitive or other mental impairment, requires substantial supervision because the individual behaves in a manner that poses a serious health or safety hazard to the individual or to another individual. 1. Instrumental Activities of Daily Living (IADL) shall include: a. Meal Preparation b. Housework c. Laundry d. Shopping e. Medication Management f. Appointment Management g. Money Management h. Accessing Resources/Transportation i. Telephone iv. "Personal Care" means providing personal assistance, stand-by assistance, supervision or cues for persons who meet the requirements for in -home services. v. "Personal Care Eligibility" is restricted to those persons who fit the definition of "frail" within the Older Americans Act. 1. Activities of Daily Living (ADL) shall include: a. Mobility b. Transfers c. Bladder Care d. Bowel Care e. Bathing f. Dressing g. Eating h. Hygiene vi. All Weld County adults age sixty (60) and older who meet the necessary definitions in this section shall be eligible for services. If resources are not available to serve eligible older adults who require services, preference and priority shall be given to those eligible 8 persons at greatest social and economic need with particular attention to low-income minority, frail, and older adults residing in rural areas. In -home services shall be made available to individuals with Alzheimer's disease and related disorders or with neurological and organic brain dysfunction and their families. b. General Guidelines i. Upon referral to the County recipients will be assessed by the AAA Program Coordinator using the standard Title III NAPIS Intake form at the time of the initial enrollment and each six-month period thereafter. In the event the coordinator is not available, assessments may be completed by authorized County staff. ii. Recipients must be 60 years of age or older and live in Weld County. iii. Recipients must meet the criteria for homemaker/personal care services as outlined in regulations. County will follow Older Americans Act and target populations with greatest economic need; greatest social need: low-income minority; frail; and older individuals residing in rural areas. iv. Vouchers will be prioritized and awarded on a first -come, first -served basis contingent on funding. Funding for this program is based on a fiscal year July 1 through June 30. v. If funding is not available at time of request, the applicant will be placed on a wait list for the next funding cycle or referred to other resources if waiting list is full. vi. Recipients may use a home health care Contractor from the list of agencies contracted with County for in -home services. If the recipient does not indicate a preference, County staff will assign a contractor based on a rotating schedule to assure equal distribution of hours and units of services. If the contractor selected is not able to meet the need, staff will choose next agency on the list. vii. Any homemaker or personal care costs incurred prior to receipt of a voucher or after voucher expires will not be covered by the In -Home Services Voucher Program. viii. Vouchers will be submitted by Contractor to the County for payment (see Exhibit C). ix. Only approved services listed on the award voucher will be honored. Any costs or services incurred above and beyond the authorized services and hours/units will be the responsibility of the recipient. Concerns or complaints about services should be reported to the County. All recipients will be made aware of the County grievance procedures at time of enrollment (see Exhibit C). Please refer to Volume 10 and the State Unit on Aging Policy and Procedures for regulation guidance. xi. If homemaker or personal care services are not used for sixty (60) day period, the voucher may be withdrawn with notice by the County and assigned to another recipient. xii. Any unused hours/units of authorized services cannot be carried over into the next funding cycle. xiii. Assigned Contractors must contact County AAA Program Coordinator listed on the recipient's voucher immediately upon any changes in status of assigned recipients (i.e. fall, hospitalization, move, death) or to request additional hours due to change in recipient status or a termination of services. xiv. Recipients and their assigned Contractor agencies will need to track the hours/units of service they receive to avoid exceeding authorized hours/units of service. xv. Recipients will be given information regarding donations at time of enrollment. All donations for In -Home Services Voucher Program will be sent to County and used by the program for service delivery. xvi. Applicants on Long -Term Care Medicaid are not eligible for the In -Home Services 9 Voucher Program; however, pending applicants may be eligible until approval is granted. xvii. Contractor agency is required to notify the Program Coordinator when a client is without services for more than thirty (30) days. c. Referral, Assessment and Follow-up Guideline i. Referrals may be accepted from other agencies, caseworkers, Contractors, professionals, self -referral, and family members of the applicants. All referrals for the In - Home Services Voucher Program will be processed by the County. The AAA Program Coordinator will obtain basic recipient information such as name, contact information, age, general care needs, housing situation and other programs or agencies involved. As appropriate, the AAA Program Coordinator will schedule a home visit to complete the full assessment using the Title III NAPIS Intake. ii. Upon approval or denial of application, the AAA Program Coordinator will notify applicant via United States Postal Services of the eligibility status and include hours/units of service information, guidelines, and instructions. The AAA Program Coordinator will notify assigned contractor by electronically sending or faxing recipient Assessment, Task Sheet, Release of Information, and Voucher including assigned hours/units. The AAA Program Coordinator will follow-up with agency and/or recipients to assure services begin within one week. AAA Program Coordinator will be available to problem solve as needed. d. Reimbursement for Services i. Reimbursement for services will be monthly. See Exhibit C for complete instructions. All questions and concerns regarding reimbursements will be directed to the AAA Program Coordinator. ii. Only approved services listed on the award voucher will be honored. Any costs or services incurred above and beyond the authorized hours/units will not be reimbursed and will be the responsibility of the recipient or assigned agency. Contractor may not request reimbursement for services unless services have been rendered, if a client is not home at the scheduled time, the cost is not reimbursable. Travel time to the recipient's residence is not a reimbursable service. iii. Contractor may not require a client to pay for private pay hours in order to receive hours provided by the County. iv. Contractor may not require a client to pay for hours the County has agreed to pay. e. Hours/Units of Service i. Applicants qualifying for the In -Home Services Voucher Program will be limited to a maximum number of hours/units of service. County will reimburse the Contractor for services at the rate outlined below under Rate Schedule. County is not guaranteeing a minimum number of units or recipients. Travel will not be reimbursed. The general guidelines for homemaker and/or personal care services are a total of 12 hours/units of service per month based on funding availability and need. Exceptions to these guidelines will be reviewed on a case -by -case basis. f. Changes in Service Hours i. All changes to services or hours/units must be approved by the AAA Program Coordinator and a new voucher will be generated that reflects the changes. ii. Contractor will not be paid for any changes in services or hours/units unless prior approval is received by the AAA Program Coordinator and a new voucher is issued. iii. Payment for any services provided upon the request of the recipient, which are in 10 addition to the services or hours/units approved by the County will be the responsibility of the recipient. g. Withdrawal of Service Request i. A recipient may withdraw a request for homemaker and/or personal care services. A request to end services must be reported by the recipient or their legal representative by contacting County. h. Denial or Termination of a Service Request , i. County makes every effort to be fair to both recipients and service Contractors and meet the needs of older adults who need homemaker or personal care services. The following rules for denial or termination were developed as guidelines for receiving services with the In -Home Services Voucher Program. ii. When the County or Contractor determines that the In -Home Services Voucher Program cannot meet the needs of the recipient requesting homemaker or personal care services, the County must be notified by the Contractor within two (2) business days of the last day of services being offered, if services cannot be provided and why. i. Reasons for Denial or Termination of Services i. The County or Contractor has determined that the recipient no longer meets the program eligibility requirements (Age 60+, deficit in 2 IADLs, or 2 ADLs, with a focus on recipients with greatest economic need, greatest social need, low-income, minority, frail, older individuals residing in rural areas as defined by Volume 10). ii. The recipient is unavailable for scheduled appointments (same day and time) and is requesting a variable schedule that creates undue hardship for service Contractors. iii. The recipient is not home for scheduled appointments on two (2) or more occasions and has failed to notify the Contractor 24 hours in advance. iv. The recipient has cancelled three (3) or more consecutive appointments without due cause (i.e. hospitalization, temporary out -of -home placement, illness). v. The recipient is verbally or physically abusive to Contractor. vi. Contractor has the right to refuse service to recipients when Contractor health safety is deemed to be at risk and the recipient home is unsafe. j. Training for Staff i. Homemaker Contractor agencies shall document that all homemakers have received a minimum of eight hours of training or have passed a skills validation test prior to delivery of services in the provision of Homemaker Services, to include at a minimum the following: 1. Basic techniques in light housecleaning including, but not limited to dusting, vacuuming, mopping, and cleaning of bathroom and kitchen areas. 2. Basic nutritional requirements including shopping, meal preparation, and proper food handling and storage techniques. 3. Dishwashing, bed making, and laundry. 4. Basic techniques of identifying and correcting potential safety hazards in the home. 5. First aid and emergency procedures and basic infection control techniques, including universal precautions. 6. Screening for situations requiring assistance. ii. A person, who at a minimum, has received the eight (8) hours of training listed herein or passed the skills validation test required of homemakers, shall be considered qualified 11 to supervise other employees. Supervision shall include, but not be limited to: 1. Arrangement and documentation of training. 2. Informing staff of policies concerning advance directives and emergency procedures. 3. Oversight of scheduling and notification to clients of changes. 4. Meetings and conferences with staff as necessary. 5. Investigation of complaints. 6. Counseling with staff on difficult cases and potentially dangerous situations. 7. Communication with case managers as necessary. 8. Oversight of record keeping by staff. 9. Supervisory visits shall be made to the participant's home at least every six months or more often as necessary for problem resolution, skills validation of staff, observation of the home's condition, and assessment of participant's satisfaction with services. iii. Personal Care Contractor agencies shall document that all staff rendering personal care services to older adults shall receive at least 20 hours of training or pass a skills validation test prior to service delivery in the following: 1. Basic personal care procedures, including bathing, skin care, hair care, nail care, mouth care, shaving, dressing, and feeding. 2. Assistance with ambulation, exercises, and transfers. 3. Bowel and bladder care. 4. Medication. 5. Homemaking and protective oversight. 6. Basic nutritional requirements, including meal planning, shopping and food storage. 7. Basic first aid, training in infection control, and emergency procedures. 8. Basic techniques of identifying and correcting potential safety hazards in the home. 9. Techniques in lifting. iv. A person who, at a minimum, has received the 20 hours of training listed herein or passed the skills validation test required of personal care staff shall be considered qualified to supervise all employees giving personal care. Supervision shall include, but is not limited to: 1. Orientation of staff to agency policies and procedures. 2. Arrangement and documentation of training. 3. Informing staff of policies concerning advance directives and emergency procedures. 4. Oversight of scheduling, and notification to clients of changes, or close communication with scheduling staff. 5. Written assignment of duties on a client -specific basis. 6. Meetings and conferences with staff as necessary. 7. Investigation of complaints and critical incidents. 8. Counseling with staff on difficult cases, and potentially dangerous situations. 9. Communication with case managers, the physicians, and other Contractors on the service plan, as necessary, to assure appropriate and effective care. 10. Supervisory visits shall be made to the participant's home at least every three months or more often as necessary, for problem resolution, skills validation of 12 staff, participant specific or procedure -specific training of staff, observation of the participant's condition and care, and assessment of satisfaction with services. At least one of the assigned personal staff shall be present at supervisory visits. Rate Schedule Contractor understands and agrees the following provisions: a. The County hereby agrees to reimburse Contractor for services at the rate of $29.00 per unit of service (1 unit of service = 1 hour of personal care and/or homemaker services). b. Contractor agrees to commence services within thirty (30) days after the signing of the Agreement and assure completion of all services within the terms of this contract. c. Contractor will not accept donations related to the services provided in this agreement. All donations received related to the services provided under this agreement must be referred to County. d. Contractor understands that County is required to conduct an on -site evaluation of the activities conducted under this Agreement and to monitor on an ongoing basis the performance of Contractor. The evaluations ensure that the funds made available by this Agreement are expended in keeping with the purposes for which they were awarded. Contractor accordingly agrees to cooperate fully with the County in the conduct of such evaluation and monitoring, including the keeping and supplying of such information, and providing access to documents and records to the County for audit purposes. Contractor further agrees to do all things necessary to enable County to fulfill its obligation to the State of Colorado and the United States Government. e. Any changes, including any increase or decrease in the amount of Contractor's compensation, and including changes in budget allocations, which are mutually agreed upon by and between County and Contractor shall be incorporated in written amendments to this Agreement and in appropriate revisions to the grant proposal. f. This Agreement and the provisions of services hereunder shall be subject to the laws of Colorado and be in accordance with the policies, procedures, and practices of the County, the Older Americans Act, the policies and procedures established by the State Unit on Aging, and the terms and conditions of the project application approved by County. g. This Agreement in no way implies that further funding beyond the initial term is available. Funding for future terms is contingent upon the availability of funds and approval of future project applications. h. Contractor agrees to keep records and make reports on the forms required by the County and in accordance with guidelines issued by the State of Colorado and the Administration on Aging, specifically, i. To submit monthly financial and programmatic reports to the County by the 10th of the following month; ii. To submit other reports to the County as requested; iii. Maintain a computer system that will be able to manage all required County reporting 13 software; iv. Maintain Internet access in order to transfer all required data to the County. i. Agrees to advise the County of needed program and financial changes and await approval from the County prior to change implementation. j. Agrees to have policies and procedures for complaint/appeal tracking, timely disposition of complaints/appeals and documentation of such processes that include all information in Exhibit C. A complaint log shall be kept on file and shall be available for County review as requested. Recipients must also be provided the County complaints and appeal process. k. Agrees to have a client grievance policy, which will address any alleged infractions of any federal state or local laws by Contractor against recipients of or applicants for services. I. Agrees to perform background checks of all employees, volunteers, or subcontractors pursuant to C.R.S. 27-90-111 and in accordance with the policy of County and the State Unit on Aging. m. Agrees to be licensed by the State of Colorado to perform the services provided. n. Agrees to follow all policies of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) regarding privacy of records. o. County reserves the right to conduct an investigation on a complaint received by a consumer. Performance Measures a. As part of the State's Unit on Aging performance -based requirement, the County will survey recipients in the month of February. During this time, Contractor agencies will not be allowed to survey clients. This month is subject to change each fiscal year. 14 Exhibit B HIPAA BUSINESS ASSOCIATE AGREEMENT This Business Associate Agreement ("Agreement") is part of federal and state requirements for purposes of this Agreement, Weld County Department of Human Services is referred to as "Covered Entity" or "CE" and Contractor is referred to as the "Business Associate" or "Associate." The Associate performs, or assists in the performance, of a function or activity, or provides services of a type for Weld County Department of Human Services that makes the Associate a "Business Associate" for purposes of the HIPAA privacy regulations. The CE may disclose protected health information to the Associate in conjunction with the function, activity, or services performed or provided by the Associate. The CE and the Associate desire to enter into an agreement as required by the HIPAA privacy regulations to provide satisfactory assurance to Weld County Department of Human Services that the Associate will appropriately safeguard that protected health information (PHI). RECITALS A. CE and Associate intend to protect the privacy and provide for the security of PHI disclosed to Associate pursuant to this Agreement in compliance with the Health Insurance Portability and Accountability Act of 1996, 42 U.S.C. §1320d — 1320d-8 ("HIPAA"), as amended by the American Recovery and Reinvestment Act of 2009 ("ARRA")/HITECH Act (P.L. 111-005), and its implementing regulations promulgated by the U.S. Department of Health and Human Services, 45 C.F.R. Parts 160, 162 and 164 (the "HIPAA Rules") and other applicable laws, as amended. B. As part of the HIPAA Rules, the CE is required to enter into an agreement containing specific requirements with Associate prior to the disclosure of PHI, as set forth in, but not limited to, Title 45, Sections 160.103, 164.502(e) and 164.504(e) of the Code of Federal Regulations ("C.F.R.") and contained in this Agreement. The parties agree as follows: 1. Term. Except as otherwise provided for herein, this Agreement will continue in full force and effect through the term of any function, activity, or services performed or provided by the Associate. 2. Definitions. a. Except as otherwise defined herein, capitalized terms in this Agreement shall have the definitions set forth in the HIPAA Rules at 45 C.F.R. Parts 160,162 and 164, as amended. In the event of any conflict between the mandatory provisions of the HIPAA Rules and the provisions of this Agreement, the HIPAA Rules shall control. b. "Protected Health Information" or "PHI" means any information, whether oral or recorded in any form or medium: (i) that relates to the past, present, or future physical or mental condition of an individual; the provision of health care to an individual; or the past, present, or future payment for the provision of health care to an individual; and (ii) that identifies the individual or with respect to which there is a reasonable basis to 15 believe the information can be used to identify the individual and shall have the meaning given to such term under the HIPAA Rules, including, but not limited to, 45 C.F.R. Section 164.501. c. "Protected Information" shall mean PHI provided by CE to Associate or created, received, maintained, or transmitted by Associate on CE's behalf. To the extent Associate is a covered entity under HIPAA and creates or obtains its own PHI for treatment, payment, and health care operations, Protected Information under this Agreement does not include any PHI created or obtained by Associate as a covered entity and Associate shall follow its own policies and procedures for accounting, access and amendment of Associate's PHI. 3. Obligations of Associate. a. Permitted Uses. Associate shall not use Protected Information except for the purpose of performing Associate's obligations as permitted under this Agreement. Further, Associate shall not use Protected Information in any manner that would constitute a violation of the HIPAA Rules if so used by CE, except that Associate may use Protected Information: (i) for the proper management and administration of Associate; (ii) to carry out the legal responsibilities of Associate; or (iii) for Data Aggregation purposes for the Health Care Operations of CE. Associate agrees to defend and indemnify the CE against third party claims arising from Associate's breach of this Agreement. b. Permitted Disclosures. Associate shall not disclose Protected Information in any manner that would constitute a violation of the HIPAA Rules if disclosed by CE, except that Associate may disclose Protected Information: (i) in a manner permitted pursuant to this Agreement; (ii) for the proper management and administration of Associate; (iii) as required by law; (iv) for Data Aggregation purposes for the Health Care Operations of CE; or (v) to report violations of law to appropriate federal or state authorities, consistent with 45 C.F.R. Section 164.502(j)(1). c. Appropriate Safeguards. Associate shall implement appropriate safeguards as are necessary to prevent the use or disclosure of Protected Information other than as permitted by this Agreement. Associate shall comply with the requirements of the HIPAA Security Rule at 45 C.F.R. Sections 164.308, 164.310, 164.312, and 164.316. Associate shall maintain a comprehensive written information privacy and security program that includes administrative, technical, and physical safeguards appropriate to the size and complexity of the Associate's operations and the nature and scope of its activities. Associate shall review, modify, and update documentation of its safeguards as needed to ensure continued provision of reasonable and appropriate protection of Protected Information. d. Reporting of Improper Use or Disclosure. Associate shall report to CE in writing any use or disclosure of Protected Information other than as provided for by this Agreement within five (5) business days of becoming aware of such use or disclosure. e. Accounting Rights. Associate and its agents shall make available to CE, within ten (10) business days of notice by CE, the information required to provide an accounting of disclosures to enable CE to fulfill its obligations under the HIPAA Rules, including, but not limited to, 45 C.F.R. Section 164.528. In the event that the request for an accounting is delivered directly to Associate or its agents, Associate shall within five (5) business days of the receipt of the request, forward it to CE in writing. It shall be CE's responsibility to prepare and deliver any such accounting requested. Associate shall not disclose any Protected Information except as set forth in Section 2(b) of this Agreement. f. Governmental Access to Records. Associate shall keep records and make its internal practices, books and records relating to the use and disclosure of Protected Information available to the Secretary of the 16 U.S. Department of Health and Human Services (the "Secretary,") in a time and manner designated by the Secretary, for purposes of determining CE's or Associate's compliance with the HIPAA Rules. Associate shall provide to CE a copy of any Protected Information that Associate provides to the Secretary concurrently with providing such Protected Information to the Secretary when the Secretary is investigating CE. Associate shall cooperate with the Secretary if the Secretary undertakes an investigation or compliance review of Associate's policies, procedures or practices to determine whether Associate is complying with the HIPAA Rules, and permit access by the Secretary during normal business hours to its facilities, books, records, accounts, and other sources of information, including Protected Information, that are pertinent to ascertaining compliance. g. Minimum Necessary. Associate (and its agents) shall only request, use, and disclose the minimum amount of Protected Information necessary to accomplish the purpose of the request, use, or disclosure, in accordance with the Minimum Necessary requirements of the HIPAA Rules, including, but not limited to, 45 C.F.R. Sections 164.502(b( and 164.514(d). h. Data Ownership. Associate acknowledges that Associate has no ownership rights with respect to the Protected Information. i. Retention of Protected Information. Except upon termination of all functions, activities, or services performed or provided by the Associate, Associate or agents shall retain all Protected Information and shall continue to maintain the information for a period of six (6) years. j. Notification of Breach. During the term of this Agreement, Associate shall notify CE within five (5) business days of any suspected or actual breach of security, intrusion or unauthorized use or disclosure of Protected Information and/or any actual or suspected use or disclosure of data in violation of any applicable federal or state laws or regulations. Associate shall not initiate notification to affected individuals per the HIPAA Rules without prior notification and approval of CE. Information provided to CE shall include the identification of each individual whose unsecured PHI has been, or is reasonably believed to have been accessed, acquired or disclosed during the breach. Associate shall take (i) prompt corrective action to cure any such deficiencies and (ii) any action pertaining to such unauthorized disclosure required by applicable federal and state laws and regulations. k. Safeguards During Transmission. Associate shall be responsible for using appropriate safeguards, including encryption of PHI, to maintain and ensure the confidentiality, integrity and security of Protected Information transmitted to CE pursuant to the Agreement, in accordance with the standards and requirements of the HIPAA Rules. I. Restrictions and Confidential Communications. Associate will not respond directly to an individual's requests to restrict the use or disclosure of Protected Information or to send all communication of Protected Information to an alternate address. Associate will refer such requests to the CE so that the CE can coordinate and prepare a timely response to the requesting individual and provide direction to Associate. 4. Obligations of CE. a. Safeguards During Transmission. CE shall be responsible for using appropriate safeguards, including encryption of PHI, to maintain and ensure the confidentiality, integrity and security of Protected Information transmitted pursuant to this Agreement, in accordance with the standards and requirements of the HIPAA Rules. 17 b. Notice of Changes. CE maintains a copy of its Notice of Privacy Practices on its website. CE shall provide Associate with any changes in, or revocation of, permission to use or disclose Protected Information, to the extent that it may affect Associate's permitted or required uses or disclosures. To the extent that it may affect Associate's permitted use or disclosure of PHI, CE shall notify Associate of any restriction on the use or disclosure of Protected Information that CE has agreed to in accordance with 45 C.F.R. Section 164.522. 5. Reasonable Steps to Cure Breach. a. If CE knows of a pattern of activity or practice of Associate that constitutes a material breach or violation of the Associate's obligations under the provisions of this Agreement or another arrangement, then CE shall take reasonable steps to cure such breach or end such violation. If Associate knows of a pattern of activity or practice of an agent that constitutes a material breach or violation of agent's obligations under the written agreement between Associate and the agent, Associate shall take reasonable steps to cure such breach or end such violation, if feasible. 6. Disposition of the PHI upon Termination or Expiration. a. Upon termination or expiration of any agreement for services between the Parties, the Associate will either return or destroy, at CE's sole discretion and in accordance with any instructions by CE, all PHI in the possession or control of the Associate and its agents. However, if the Associate determines that neither the return nor destruction of the PHI is feasible, the Associate may retain the PHI provided that the Associate complies with those reasonable restrictions imposed by the CE. 7. Disclaimer. CE makes no warranty or representation that compliance by Associate with this Agreement or the HIPAA Rules will be adequate or satisfactory for Associate's own purposes. Associate is solely responsible for all decisions made by Associate regarding the safeguarding of PHI. 8. Assistance in Litigation or Administrative Proceedings. Associate shall make itself and any employees or agents assisting Associate in the performance of its obligations under the Agreement, available to CE, at no cost to CE, up to a maximum of thirty (30) hours, to testify as witnesses or otherwise, in the event of litigation or administrative proceedings being commenced against CE, its directors, officers, or employees based upon a claimed violation of the HIPAA Rules or other laws relating to security and privacy or PHI, in which the actions of Associate are at issue, except where Associate or its employee or agent is a named adverse party. 9. Interpretation and Order of Precedence. The provisions of this Agreement shall be interpreted as broadly as necessary to implement and comply with the HIPAA Rules. The parties agree that any ambiguity in this Agreement shall be resolved in favor of a meaning that complies and is consistent with the HIPAA Rules. 10. Survival of Certain Agreement Terms. Notwithstanding anything herein to the contrary, Associate's obligations under this Agreement shall survive termination of this Agreement and shall be enforceable by CE as provided herein in the event of such failure to perform or comply by the Associate. 11. Representatives and Notice. For the purpose of the Agreement, the individuals identified on Page 1 of 4 Pages of this agreement shall be the representatives of the respective parties. All required notices shall be hand delivered or given by certified or registered mail to the representatives at the addresses listed at the top of this form. 18 Exhibit C Weld County Department of Human Services In -Home Services Voucher Program Instructions for completing voucher. 1. When a consumer is awarded units/hours of service, the County will generate a voucher that includes the name and contact information of the consumer, invoice number, date of approval, number of units/hours awarded, and expiration date of the voucher. 2. Vouchers are valid for a six-month period of time unless otherwise indicated. At the end of voucher period, the consumer will be reassessed by the County for the program and if applicable, they will be issued a new voucher for ongoing units of service. 3. Consumers will be notified advising them of the number of units/hours awarded and the expiration date of the voucher. 4. County will confirm with consumers which Contractor they have chosen to provide services. County will contact the Contractor and provide them with a copy of the voucher. The voucher will be used by Contractors for reimbursement during that voucher period (expiring every six months during a fiscal year July 1 -June 30. If consumer is approved in September, the voucher will expire December 31 and may be eligible for another six months beginning January 1 expiring June 30). 5. Contractor is responsible for obtaining and verifying with the County that the consumer has a valid voucher before providing services. 6. The Contractor will complete and submit the voucher each month to be reimbursed for units of service rendered. Vouchers must be received no more than bi-monthly and no less than monthly for processing. For services rendered in the month of June, vouchers and invoices shall be received no later than July 5th of that same year. In addition to individual vouchers, Contractor will submit an invoice for the services delivered for the month. Invoices shall include the Contractor contact information; name of consumer served, date(s) of service; service provided and unit rate for service provided. If Contractor has more than one consumer receiving services through the County In -Home Services Voucher Program, all may be listed on one company invoice with each consumer name, date(s) of service, service provided, unit rate, and number of hours/units provided with corresponding vouchers attached. The submission of the completed voucher and invoice by the Contractor is the request for payment. 7. In the event of a program audit, Contractor must be able to show proof that a visit and services were provided. 8. All information inside the center box of the voucher should be completed by the Contractor each month, and the voucher must be signed by an authorized agency representative in order for the voucher to be processed for payment. 9. Vouchers with missing information or signatures will be returned to Contractor to be completed and returned for payment. 10. Payments will be processed and mailed to Contractor upon receipt of completed voucher(s) and invoice generally within three to four weeks. 11. Contractor must track units/hours of service and will not be reimbursed for any services other than those indicated on the Task Sheet without prior approval from the County. 12. Contractor will not be reimbursed for any units of service provided that exceeds units/hours of service allocated on the voucher without prior approval from the County. 19 13. Only the homemaker/personal care services outlined in the In -Home Services Voucher Program Eligibility Guidelines are reimbursable services. 14. Vouchers may be submitted by email or fax: • Email: mwickstrom@weldgov.com • FAX: (970) 400-6951 Attn: Monica Wickstrom 20 Exhibit D Weld County Area Agency on Aging (Region 2B) Consumer Complaints, Appeals and Hearings Procedure Updated July 2023 Consumer Complaint Any older adult, his/her representative, or caregiver applying or receiving services under the Older Americans Act or State Funding for Senior Services by the Weld County Home and Community Supports (WCHCS), or a contractor of the WCHCS, has the right to submit a complaint. You may file your complaint in person, by telephone, email, or in writing within thirty (30) days of the action or incident. Complaints shall be forwarded to the appropriate agency for follow-up and resolution. Complaints shall be resolved at the lowest possible level. If the complaint cannot be resolved at the local level, it may be appealed. The direct service provider receiving the complaint shall investigate and resolve the complaint. The direct service provider may be the WCHCS or a contractor of the WCHCS. In Writing: In Person: Weld County Home and Community Supports (970) 400-6950 PO Box A Greeley, CO 80632 Weld County Home and Community Supports (970) 400-6950 315 N 11th Ave., Bldg. C Greeley, CO 80631 Written notice of the resolution shall be sent to the complainant within fifteen (15) working days from the time the agency receives the complaint. Consumer Appeal At any time, the complainant may contact that State Unit on Aging or if the complainant is dissatisfied with the complaint resolution, a written appeal may be filed with the State Unit on Aging Director within ten (10) calendar days of receipt of the decision at: Colorado Department of Human Services, State Unit on Aging 1575 Sherman Street, 10th Floor Denver, CO 80203-1702 (888) 866-4243 (Toll Free) The State Unit on Aging Director or designee shall complete a review of the complaint and resolution of that complaint, including all pertinent documentation or new information that may be available. The State Unit on Aging will provide a response, including notification of the complainant's rights to an Administrative Law Judge hearing as described in Section 10.507 if he/she is dissatisfied with the resolution of the appeal, to the complainant. The appeal procedure may be terminated at any time if the individual and service provider negotiate a written agreement that resolves the issue in question. Upon termination, the complainant shall file with the WCAHCS or the State Unit on Aging, whichever is applicable, a written notice stating the reason for the termination. 21 SIGNATURE REQUESTED: Weld/Britin, LLC dba FirstLight HomeCare Boulder PSA - In Home Providers Final Audit Report 2024-08-22 Created: 2024-08-21 By: Sara Adams (sadams@weld.gov) Status: Signed Transaction ID: CBJCHBCAABAA-cOHgNAgErwrmzSwIGBbH-fSrVkSiE_Y "SIGNATURE REQUESTED: Weld/Britin, LLC dba FirstLight Ho meCare Boulder PSA - In Home Providers" History in Document created by Sara Adams (sadams@weld.gov) 2024-08-21 - 2:59:51 PM GMT- IP address: 204.133.39.9 ., Document emailed to GREGORY BROWN (whbrown@firstlighthomecare.com) for signature 2024-08-21 - 3:00:27 PM GMT 'n Email viewed by GREGORY BROWN(whbrown@firstlighthomecare.com) 2024-08-22 - 5:09:11 PM GMT- IP address: 74.125.215.78 43 Signer GREGORY BROWN (whbrown@firstlighthomecare.com) entered name at signing as Whitney Brown 2024-08-22 - 5:09:55 PM GMT- IP address: 76.154.225.138 43 Document e -signed by Whitney Brown (whbrown@firstlighthomecare.com) Signature Date: 2024-08-22 - 5:09:57 PM GMT - Time Source: server- IP address: 76.154.225.138 Agreement completed. 2024-08-22 - 5:09:57 PM GMT Powered by Adobe Acrobat Sign FIRSHOM-06 CERTIFICATE OF LIABILITY INSURANCE EMCCHESNEY DATE (MM/DDIYYYY) 8/19/2024 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 License # 0757776 HUB International Insurance Services (COL) 2000 S. Colorado Blvd Tower 2, Suite 150 Denver, CO 80222 CONTACT Alice O'Rourke -Mills NAME: PHONE (AIc, NcExt) , : (970) 541-6024 (ac, No):(720) 863-2029 n oREss: alice.orourkemills@hubinternational.com INSURER(S) AFFORDING COVERAGE NAIL tt INSURER A: Philadelphia Indemnity Insurance Company 18058 INSURED Britin, LLC dba FirstLight Home Care of Boulder 1300 Plaza Court North, Suite 103 Lafayette, CO 80026 INSURER B : Pinnacol Assurance Company 41190 INSURER c : State National Insurance Company 12831 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 POLIC ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE LTR ADD- SUER INSD WVD POLICY NUMBER POLICY EFF (MM/DDIYYYYI POLICY EXP (MM0)D/YYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY ICLAIMS -MADE X OCCUR X X PHPK2560834-001 6/1/2024 6/1/2025 EACH OCCURRENCE $ 1,000,000 DAMAGETORENTED P' EMISES (Ea occunence) $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEM_ X x AGGREGATE LIMIT APPLIES PER: POLICY ❑ PROT ❑ LOC JEC Employee Benf Liab $1,000,000 OTHER: PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE AHIRED LIABILITY ANY AUTO OWNED AUTOS ONLY AUTOS ONLY SCHEDULED AUTOS X NON -OWNED AUTOS ONLY PHPK2560834-001 6/1/2024 6/1/2025 SINGLE LIMIT cciden (Ea COMBaINEDt) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ A X UMBRELLA LIAR EXCESS LIAR X OCCUR CLAIMS -MADE PHUB866360-001 6/1/2024 6/1/2025 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 $ DED 1 X I RETENTIONS 10,000 B WORKERS COMPENSATION rang ANY PROPRIETOR/PARTNER/EXECUTIVE YNN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A X 4206750 6/1/2024 6/1/2025 X I STATUTE I EORH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000'000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 A Professional Liab. C Cyber Liability PHPK2560834-001 EHJ-ADM00975907 6/1/2024 6/1/2024 6/1/2025 6/1/2025 1,000,000 Limit 2,000,000 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, ma be attached if more space is required Board of County Commissioners of Weld County and it Officers/Employees are ad tonal insureds under Genera Liability. CERTIFICATE HOLDER CANCELLATION Weld County 1150 O Street Greeley, CO 80631 I 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 6172--e ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD PI-GLD-HS (10/11) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY DELUXE ENDORSEMENT: HUMAN SERVICES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE It is understood and agreed that the following extensions only apply in the event that no other specific coverage for the indicated loss exposure is provided under this policy. If such specific coverage applies, the terms, conditions and limits of that coverage are the sole and exclusive coverage applicable under this policy, unless otherwise noted on this endorsement. The following is a summary of the Limits of Insurance and additional coverages provided by this endorsement. For complete details on specific coverages, consult the policy contract wording. Coverage Applicable Limit of Insurance Page # Extended Property Damage Included 2 Limited Rental Lease Agreement Contractual Liability $50,000 limit 2 Non -Owned Watercraft Less than 58 feet 2 Damage to Property You Own, Rent, or Occupy $30,000 limit 2 Damage to Premises Rented to You $1,000,000 3 HIPAA PAA Clarification 4 Medical Payments $20,000 5 Medical Payments — Extended Reporting Period 3 years 5 Athletic Activities Amended 5 Supplementary Payments — Bail Bonds $5,000 5 Supplementary Payment — Loss of Earnings $1,000 per day 5 Employee Indemnification Defense Coverage $25,000 5 Key and Lock Replacement — Janitorial Services Client Coverage $10,000 limit 6 Additional Insured — Newly Acquired Time Period Amended 6 Additional Insured — Medical Directors and Administrators Included 7 Additional Insured — Managers and Supervisors (with Fellow Employee Coverage) Included 7 Additional Insured — Broadened Named Insured Included 7 Additional Insured — Funding Source Included 7 Additional Insured — Home Care Providers Included 7 Additional Insured — Managers, Landlords, or Lessors of Premises Included 7 Additional Insured — Lessor of Leased Equipment Included 7 Additional Insured — Grantor of Permits Included 8 Additional Insured — Vendor Included 8 Additional Insured — Franchisor Included 9 Additional Insured — When Required by Contract Included 9 Additional Insured — Owners, Lessees, or Contractors Included 9 Additional Insured — State or Political Subdivisions Included 10 Page 1 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company PI-GLD-HS (10/11) Duties in the Event of Occurrence, Claim or Suit Included 10 Unintentional Failure to Disclose Hazards Included 10 Transfer of Rights of Recovery Against Others To Us Clarification 10 Liberalization Included 11 Bodily Injury — includes Mental Anguish Included 11 Personal and Advertising Injury — includes Abuse of Process, Discrimination Included 11 A. Extended Property Damage SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph a. is deleted in its entirety and replaced by the following: a. Expected or Intended Injury "Bodily injury" or property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. B. Limited Rental Lease Agreement Contractual Liability SECTION I - COVERAGES, COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph b. Contractual Liability is amended to include the following: (3) Based on the named insured's request at the time of claim, we agree to indemnify the named insured for their liability assumed in a contract or agreement regarding the rental or lease of a premises on behalf of their client, up to $50,000. This coverage extension only applies to rental lease agreements. This coverage is excess over any renter's liability insurance of the client. C. Non -Owned Watercraft SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph g. (2) is deleted in its entirety and replaced by the following: (2) A watercraft you do not own that is: (a) Less than 58 feet long; and (b) Not being used to carry persons or property for a charge; This provision applies to any person, who with your consent, either uses or is responsible for the use of a watercraft. This insurance is excess over any other valid and collectible insurance available to the insured whether primary, excess or contingent. D. Damage to Property You Own, Rent or Occupy SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE Page 2 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company PI-GLD-HS (10/11) LIABILITY, Subsection 2. Exclusions, Paragraph j. Damage to Property, Item (1) is deleted in its entirety and replaced with the following: (1) Property you own, rent, or occupy, including any costs or expenses incurred by you, or any other person, organization or entity, for repair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to another's property, unless the damage to property is caused by your client, up to a $30,000 limit. A client is defined as a person under your direct care and supervision. E. Damage to Premises Rented to You 1. If damage by fire to premises rented to you is not otherwise excluded from this Coverage Part, the word "fire" is changed to "fire, lightning, explosion, smoke, or leakage from automatic fire protective systems" where it appears in: The last paragraph of SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions; is deleted in its entirety and replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in SECTION III - LIMITS OF INSURANCE. b. SECTION III - LIMITS OF INSURANCE, Paragraph 6. is deleted in its entirety and replaced by the following: Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems while rented to you or temporarily occupied by you with permission of the owner. SECTION V - DEFINITIONS, Paragraph 9.a., is deleted in its entirety and replaced by the following: A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract"; 2. SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. Other Insurance, Paragraph b. Excess Insurance, (1) (a) (ii) is deleted in its entirety and replaced by the following: That is insurance for fire, lightning, explosion, smoke, or leakage from automatic fire protective systems for premises rented to you or temporarily occupied by you with permission of the owner; 3. The Damage To Premises Rented To You Limit section of the Declarations is amended to the greater of: Page 3of12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company PI-GLD-HS (10/11) a. $1,000,000; or b. The amount shown in the Declarations as the Damage to Premises Rented to You Limit. This is the most we will pay for all damage proximately caused by the same event, whether such damage results from fire, lightning, explosion, smoke, or leaks from automatic fire protective systems or any combination thereof. F. HIPAA SECTION I - COVERAGES, COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY, is amended as follows: 1. Paragraph 1. Insuring Agreement is amended to include the following: We will pay those sums that the insured becomes legally obligated to pay as damages because of a "violation(s)" of the Health Insurance Portability and Accountability Act (HIPAA). We have the right and the duty to defend the insured against any "suit," "investigation," or "civil proceeding" seeking these damages. However, we will have no duty to defend the insured against any "suit" seeking damages, "investigation," or "civil proceeding" to which this insurance does not apply. 2. Paragraph 2. Exclusions is amended to include the following additional exclusions: This insurance does not apply to: a. Intentional, Willful, or Deliberate Violations Any willful, intentional, or deliberate "violation(s)" by any insured. b. Criminal Acts Any "violation" which results in any criminal penalties under the HIPAA. c. Other Remedies Any remedy other than monetary damages for penalties assessed. d. Compliance Reviews or Audits Any compliance reviews by the Department of Health and Human Services. 3. SECTION V - DEFINITIONS is amended to include the following additional definitions: a. "Civil proceeding" means an action by the Department of Health and Human Services (HHS) arising out of "violations." b. "Investigation" means an examination of an actual or alleged "violation(s)" by HHS. However, "investigation" does not include a Compliance Review. c. "Violation" means the actual or alleged failure to comply with the regulations included in the HIPAA. Page 4 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company PI-GLD-HS (10/11) G. Medical Payments — Limit Increased to $20,000, Extended Reporting Period If COVERAGE C MEDICAL PAYMENTS is not otherwise excluded from this Coverage Part: 1. The Medical Expense Limit is changed subject to all of the terms of SECTION III - LIMITS OF INSURANCE to the greater of: a. $20,000; or b. The Medical Expense Limit shown in the Declarations of this Coverage Part. 2. SECTION I - COVERAGE, COVERAGE C MEDICAL PAYMENTS, Subsection 1. Insuring Agreement, a. (3) (b) is deleted in its entirety and replaced by the following: (b) The expenses are incurred and reported to us within three years of the date of the accident. H. Athletic Activities SECTION I - COVERAGES, COVERAGE C MEDICAL PAYMENTS, Subsection 2. Exclusions, Paragraph e. Athletic Activities is deleted in its entirety and replaced with the following: e. Athletic Activities To a person injured while taking part in athletics. I. Supplementary Payments SECTION I - COVERAGES, SUPPLEMENTARY PAYMENTS - COVERAGE A AND B are amended as follows: 1. b. is deleted in its entirety and replaced by the following: 1. b. Up to $5000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these. 1.d. is deleted in its entirety and replaced by the following: 1. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $1,000 a day because of time off from work. J. Employee Indemnification Defense Coverage SECTION I - COVERAGES, SUPPLEMENTARY PAYMENTS - COVERAGES A AND B the following is added: We will pay, on your behalf, defense costs incurred by an "employee" in a criminal proceeding occurring in the course of employment. The most we will pay for any "employee" who is alleged to be directly involved in a criminal proceeding is $25,000 regardless of the numbers of "employees," claims or "suits" brought or persons or organizations making claims or bringing "suits. Page 5 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company PI-GLD-HS (10/11) K. Key and Lock Replacement — Janitorial Services Client Coverage SECTION I - COVERAGES, SUPPLEMENTARY PAYMENTS - COVERAGES A AND B is amended to include the following: We will pay for the cost to replace keys and locks at the "clients" premises due to theft or other loss to keys entrusted to you by your "client," up to a $10,000 limit per occurrence and $10,000 policy aggregate. We will not pay for loss or damage resulting from theft or any other dishonest or criminal act that you or any of your partners, members, officers, "employees", "managers", directors, trustees, authorized representatives or any one to whom you entrust the keys of a "client" for any purpose commit, whether acting alone or in collusion with other persons. The following, when used on this coverage, are defined as follows: "Client" means an individual, company or organization with whom you have a written contract or work order for your services for a described premises and have billed for your services. b. "Employee" means: (1) Any natural person: (a) While in your service or for 30 days after termination of service; (b) Who you compensate directly by salary, wages or commissions; and (c) Who you have the right to direct and control while performing services for you; or (2) Any natural person who is furnished temporarily to you: (a) To substitute for a permanent "employee" as defined in Paragraph (1) above, who is on leave; or (b) To meet seasonal or short-term workload conditions; while that person is subject to your direction and control and performing services for you. (3) "Employee" does not mean: (a) Any agent, broker, person leased to you by a labor leasing firm, factor, commission merchant, consignee, independent contractor or representative of the same general character; or (b) Any "manager," director or trustee except while performing acts coming within the scope of the usual duties of an "employee." "Manager" means a person serving in a directorial capacity for a limited liability company. L. Additional Insureds SECTION II - WHO IS AN INSURED is amended as follows: 1. If coverage for newly acquired or formed organizations is not otherwise excluded from this Page 6 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company PI-GLD-HS (10/11) Coverage Part, Paragraph 3.a. is deleted in its entirely and replaced by the following: a. Coverage under this provision is afforded until the end of the policy period. 2. Each of the following is also an insured: Medical Directors and Administrators — Your medical directors and administrators, but only while acting within the scope of and during the course of their duties as such. Such duties do not include the furnishing or failure to furnish professional services of any physician or psychiatrist in the treatment of a patient. b. Managers and Supervisors — Your managers and supervisors are also insureds, but only with respect to their duties as your managers and supervisors. Managers and supervisors who are your "employees" are also insureds for "bodily injury" to a co - "employee" while in the course of his or her employment by you or performing duties related to the conduct of your business. This provision does not change Item 2.a.(1)(a) as it applies to managers of a limited liability company. Broadened Named Insured — Any organization and subsidiary thereof which you control and actively manage on the effective date of this Coverage Part. However, coverage does not apply to any organization or subsidiary not named in the Declarations as Named Insured, if they are also insured under another similar policy, but for its termination or the exhaustion of its limits of insurance. d. Funding Source — Any person or organization with respect to their liability arising out of: (1) Their financial control of you; or (2) Premises they own, maintain or control while you lease or occupy these premises. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. Home Care Providers — At the first Named Insured's option, any person or organization under your direct supervision and control while providing for you private home respite or foster home care for the developmentally disabled. f. Managers, Landlords, or Lessors of Premises — Any person or organization with respect to their liability arising out of the ownership, maintenance or use of that part of the premises leased or rented to you subject to the following additional exclusions: This insurance does not apply to: (1) Any "occurrence" which takes place after you cease to be a tenant in that premises; or (2) Structural alterations, new construction or demolition operations performed by or on behalf of that person or organization. g. Lessor of Leased Equipment — Automatic Status When Required in Lease Agreement With You — Any person or organization from whom you lease equipment when you and such person or organization have agreed in writing in a contract or agreement that such person or organization is to be added as an additional insured on your policy. Such person or Page 7 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company PI -GAD -HS (10/11) organization is an insured only with respect to liability for "bodily injury," "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person or organization. A person's or organization's status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. h. Grantors of Permits — Any state or political subdivision granting you a permit in connection with your premises subject to the following additional provision: (1) This insurance applies only with respect to the following hazards for which the state or political subdivision has issued a permit in connection with the premises you own, rent or control and to which this insurance applies: (a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners or decorations and similar exposures; (b) The construction, erection, or removal of elevators; or (c) The ownership, maintenance, or use of any elevators covered by this insurance. Vendors — Only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business, subject to the following additional exclusions: (1) The insurance afforded the vendor does not apply to: (a) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; (b) Any express warranty unauthorized by you; (c) Any physical or chemical change in the product made intentionally by the vendor; (d) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; (e) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; (f) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; Page 8 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company PI-GLD-HS (10/11) (g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or (h) "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (i) The exceptions contained in Sub -paragraphs (d) or (f); or (ii) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. (2) This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing. j. Franchisor — Any person or organization with respect to their liability as the grantor of a franchise to you. k. As Required by Contract — Any person or organization where required by a written contract executed prior to the occurrence of a loss. Such person or organization is an additional insured for "bodily injury," "property damage" or "personal and advertising injury" but only for liability arising out of the negligence of the named insured. The limits of insurance applicable to these additional insureds are the lesser of the policy limits or those limits specified in a contract or agreement. These limits are included within and not in addition to the limits of insurance shown in the Declarations I. Owners, Lessees or Contractors — Any person or organization, but only with respect to liability for "bodily injury," "property damage" or "personal and advertising injury" caused, in whole or in part, by: (1) Your acts or omissions; or (2) The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured when required by a contract. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: -(a) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (b) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. Page 9 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company PI-GLD-HS (10/11) m. State or Political Subdivisions — Any state or political subdivision as required, subject to the following provisions: (1) This insurance applies only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit, and is required by contract. (2) This insurance does not apply to: (a) "Bodily injury," "property damage" or "personal and advertising injury" arising out of operations performed for the state or municipality; or (b) "Bodily injury" or "property damage" included within the "products -completed operations hazard." M. Duties in the Event of Occurrence, Claim or Suit SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 2. is amended as follows: a. is amended to include: This condition applies only when the "occurrence" or offense is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; or (3) An executive officer or insurance manager, if you are a corporation. b. is amended to include: This condition will not be considered breached unless the breach occurs after such claim or "suit" is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; or (3) An executive officer or insurance manager, if you are a corporation. N. Unintentional Failure To Disclose Hazards SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 6. Representations is amended to include the following: It is agreed that, based on our reliance on your representations as to existing hazards, if you should unintentionally fail to disclose all such hazards prior to the beginning of the policy period of this Coverage Part, we shall not deny coverage under this Coverage Part because of such failure. O. Transfer of Rights of Recovery Against Others To Us SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 8. Transfer of Rights of Page 10 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company PI-GLD-HS (10/11) Recovery Against Others To Us is deleted in its entirety and replaced by the following: If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. Therefore, the insured can waive the insurer's rights of recovery prior to the occurrence of a loss, provided the waiver is made in a written contract. P. Liberalization SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, is amended to include the following: If we revise this endorsement to provide more coverage without additional premium charge, we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state. Q. Bodily Injury — Mental Anguish SECTION V - DEFINITIONS, Paragraph 3. Is deleted in its entirety and replaced by the following: "Bodily injury" means: a. Bodily injury, sickness or disease sustained by a person, and includes mental anguish resulting from any of these; and b. Except for mental anguish, includes death resulting from the foregoing (Item a. above) at any time. R. Personal and Advertising Injury — Abuse of Process, Discrimination If COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY COVERAGE is not otherwise excluded from this Coverage Part, the definition of "personal and advertising injury" is amended as follows: 1. SECTION V - DEFINITIONS, Paragraph 14.b. is deleted in its entirety and replaced by the following: b. Malicious prosecution or abuse of process; 2. SECTION V - DEFINITIONS, Paragraph 14. is amended by adding the following: Discrimination based on race, color, religion, sex, age or national origin, except when: a. Done intentionally by or at the direction of, or with the knowledge or consent of: (1) Any insured; or (2) Any executive officer, director, stockholder, partner or member of the insured; b. Directly or indirectly related to the employment, former or prospective employment, termination of employment, or application for employment of any person or persons by an insured; Page 11 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company PI-GLD-HS (10/11) c. Directly or indirectly related to the sale, rental, lease or sublease or prospective sales, rental, lease or sub -lease of any room, dwelling or premises by or at the direction of any insured; or d. Insurance for such discrimination is prohibited by or held in violation of law, public policy, legislation, court decision or administrative ruling. The above does not apply to fines or penalties imposed because of discrimination. Page 12 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. O 2011 Philadelphia Indemnity Insurance Company PINK flCOL ASSURANCE 7501 E. Lowry Blvd. Denver, CO 80230-7006 303.361.4000 / 800.873.7242 Pinnacol.com Britin LLC dba First Light Home Care 1021 E South Boulder Road, Unit J Louisville, CO 80027 ENDORSEMENT: Blanket Waiver of Subrogation NCCI #: WC000313B Policy #: 4206758 Hub International Insurance Service 2000 S. Colorado Blvd. Tower 2, Suite 150 Denver, CO 80222 (888) 795-0300 We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE To any person or organization when agreed to under a written contract or agreement, as defined above and with the insured, which is in effect and executed prior to any loss. Effective Date:June 11, 2024 Expires on: June 1, 2025 Pinnacol Assurance has issued this endorsement June 11, 2024 7501 E. Lowry Blvd Denver, CO 80230-7006 Page 1 of 1 P DEANGELM - Underwriter 06/11/2024 08:09:44 4206758 83460857 359-B Contract Form Entity Information Entity Name * BRITIN LLC Entity ID* @00036424 Q New Entity? Contract Name* Contract ID BRITIN LLC DBA FIRSTLIGHT HOMECARE BOULDER 8650 Contract Status CTB REVIEW Contract Lead * SADAMS Contract Lead Email sadams@weld.gov;cobbx xlk@weld.gov Parent Contract ID 20242077 Requires Board Approval YES Department Project # Contract Description * (CONSENT) BRITIN LLC DBA FIRSTLIGHT HOMECARE BOULDER PROFESSIONAL SERVICE AGREEMENT FOR THE OAA IN -HOME VOUCHER PROGRAM. TERM 7/1 /2024 THROUGH 6/30/2025. Contract Description 2 Contract Type * AGREEMENT Amount* $0.00 Renewable* NO Automatic Renewal Grant IGA Department Requested BOCC Agenda Due Date HUMAN SERVICES Date* 08/24/2024 08/28/2024 Department Email CM- HumanServices@weldgov. com Department Head Email CM-HumanServices- DeptHead@weldgov.com County Attorney GENERAL COUNTY ATTORNEY EMAIL County Attorney Email CM- COUNTYATTORNEY@WEL D.GOV 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 * Renewal Date 04/30/2025 Termination Notice Period Contact Information Committed Delivery Date Expiration Date* 06/30/2025 Contact Info Contact Name Contact Type Contact Email Contact Phone 1 Contact Phone 2 Purchasing Purchasing Approver Purchasing Approved Date CONSENT 08/23/2024 Approval Process Department Head Finance Approver Legal Counsel JAMIE ULRICH CONSENT CONSENT DH Approved Date Finance Approved Date Legal Counsel Approved Date 08/23/2024 08/23/2024 08/23/2024 Final Approval BOCC Approved Tyler Ref # AG 082824 BOCC Signed Date Originator SADAMS BOCC Agenda Date 08/28/2024 Hello