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Home My WebLink About20251866.tiffCor*vack lea (o�5 PROFESSIONAL SERVICE AGREEMENT BETWEEN WELD COUNTY AND PARKER PERSONAL CARE HOMES, INC. THIS AGREEMENT is made and entered into this 3dhday of citA t1 , , 2025 by and between the Board of Weld County Commissioners, on behalf of the Weld County Department of Human Services, hereinafter referred to as "County," and Parker Personal Care Homes, Inc., hereinafter referred to as "Contractor". WHEREAS, County desires to retain Contractor to perform services as required by County and set forth in the attached Exhibits; and WHEREAS, Contractor is willing and has the specific ability, qualifications, and time to perform the required services according to the terms of this Agreement; and WHEREAS, Contractor is authorized to do business in the State of Colorado and has the time, skill, expertise, and experience necessary to provide the services as set forth below; and WHEREAS, the Colorado Department of Human Services has provided Core and Non -Core Services funding to the Department. NOW, THEREFORE, in consideration of the mutual promises and covenants contained herein, the parties hereto agree as follows: 1. Introduction. The terms of this Agreement are contained in the terms recited in this document and in the attached Exhibits, each of which forms an integral part of this Agreement and are incorporated herein. The parties each acknowledge and agree that this Agreement, including the attached Exhibits, define the performance obligations of Contractor and Contractor's willingness and ability to meet those requirements (the "Work"). If a conflict occurs between this Agreement and any Exhibit or other attached document, the terms of this Agreement shall control, and the remaining order of precedence shall be based upon order of attachment. Exhibit A consists of the HIPAA Business Associates Agreement. Exhibit B consists of the Scope of Services. Exhibit C consists of the Rate Schedule. Exhibit D consists of County's Invitation for Bid (IFB) as set forth in Bid Package No. B2500043 which is incorporated into this agreement by reference and will be provided upon request to the Department. Exhibit E consists of Contractor's Bid Response to County's Invitation. 2. Service or Work. Contractor agrees to diligently provide all services, labor, personnel and materials necessary to perform and complete the Work described in the attached c onse.rii- Pv.r1G+s,- (o/3CYZ5 C C : OnbckSe (pIS (n/ 30/25 2025-1866 Exhibits. Services shall be provided by the Contractor to any person(s) eligible for services in compliance with Exhibits B, Scope of Services, and Exhibit E, Contractor's Bid Response to County's Invitation. Contractor shall further be responsible for the timely completion and acknowledges that a failure to comply with the standards and requirements of Work within the time limits prescribed by County may result in County's decision to withhold payment or to terminate this Agreement. 3. Term. The term of this Agreement shall be from June 1, 2025 through October 31, 2028, unless sooner terminated as provided herein, and is subject to continued budget appropriations. 4. Termination; Breach; Cure. County may terminate this Agreement for its own convenience upon thirty (30) days written notice to Contractor. Either Party may immediately terminate this Agreement upon material breach of the other party, however the breaching party shall have fifteen (15) days after receiving such notice to cure such breach. If this Agreement is terminated by County, Contractor shall be compensated for, and such compensation shall be limited to, (1) the sum of the amounts contained in invoices which it has submitted and which have been approved by the County; (2) the reasonable value to County of the services which Contractor provided prior to the date of the termination notice, but which had not yet been approved for payment; and (3) the cost of any work which the County approves in writing which it determines is needed to accomplish an orderly termination of the work. County shall be entitled to the use of all material generated pursuant to this Agreement upon termination. Upon termination of this Agreement by County, Contractor shall have no claim of any kind whatsoever against the County by reason of such termination or by reason of any act incidental thereto, except for compensation for work satisfactorily performed and/or materials described herein properly delivered. 5. Extension or Amendment. Any amendments or modifications to this agreement shall be in writing signed by both parties. No additional services or work performed by Contractor shall be the basis for additional compensation unless and until Contractor has obtained written authorization and acknowledgement by County for such additional services. Accordingly, no claim that the County has been unjustly enriched by any additional services, whether or not there is in fact any such unjust enrichment, shall be the basis of any increase in the compensation payable hereunder. In the event that written authorization and acknowledgment by the County for such additional services is not timely executed and issued in strict accordance with this Agreement, Contractor's rights with respect to such additional services shall be deemed waived and such failure shall result in non-payment for such additional services or work performed. Any claims by the Contractor for adjustment hereunder must be made in writing prior to performance of any work covered in the anticipated Amendment, unless approved and documented otherwise by the County Representative. Any change in work made without such prior Amendment shall be deemed not covered in the compensation and time provisions of this Agreement, unless approved and documented otherwise by the County Representative. 6. Compensation. County agrees to pay Contractor through an invoice process during the course of this Agreement in accordance with the Rate Schedule as described as Exhibit C. Contractor agrees to submit invoices which detail the work completed by Contractor. 2 The County will review each invoice and if it agrees Contractor has completed the invoiced items to the County's satisfaction, it will remit payment to the Contractor. No payment in excess of that set forth in the Exhibits will be made by County unless an Amendment authorizing such additional payment has been specifically approved by Weld County as required pursuant to the Weld County Code. If, at any time during the term or after termination or expiration of this Agreement, County reasonably determines that any payment made by County to Contractor was improper because the service for which payment was made did not perform as set forth in this Agreement, then upon written notice of such determination and request for reimbursement from County, Contractor shall forthwith return such payment(s) to County. Upon termination or expiration of this Agreement, unexpended funds advanced by County, if any, shall forthwith be returned to County. County will not withhold any taxes from monies paid to the Contractor hereunder and Contractor agrees to be solely responsible for the accurate reporting and payment of any taxes related to payments made pursuant to the terms of this Agreement. Unless expressly enumerated in the attached Exhibits, Contractor shall not be entitled to be paid for any other expenses (e.g. mileage). Notwithstanding anything to the contrary contained in this Agreement, County shall have no obligations under this Agreement after, nor shall any payments be made to Contractor in respect of any period after December 31 of any year, without an appropriation therefore by County in accordance with a budget adopted by the Board of County Commissioners in compliance with Article 25, Title 30 of the Colorado Revised Statutes, the Local Government Budget Law (C.R.S. 29-1-101 et. seq.) and the TABOR Amendment (Colorado Constitution, Article X, Sec. 20). 7. Independent Contractor. Contractor agrees that it is an independent contractor and that Contractor's officers, agents or employees will not become employees of County, nor entitled to any employee benefits (including unemployment insurance or workers' compensation benefits) from County as a result of the execution of this Agreement. Contractor shall be solely responsible for its acts and those of its agents and employees for all acts performed pursuant to this Agreement. Any provisions in this Contract that may appear to give the County the right to direct contractor as to details of doing work or to exercise a measure of control over the work mean that Contractor shall follow the direction of the County as to end results of the work only. The Contractor is obligated to pay all federal and state income tax on any moneys earned or paid pursuant to this contract. 8. Subcontractors. Contractor acknowledges that County has entered into this Agreement in reliance upon the particular reputation and expertise of Contractor. Contractor shall not enter into any subcontractor agreements for the completion of the Work without County's prior written consent, which may be withheld in County's sole discretion. County shall have the right in its reasonable discretion to approve all personnel assigned to the Work during the performance of this Agreement and no personnel to whom County has an objection, in its reasonable discretion, shall be assigned to the Work. Contractor shall require each subcontractor, as approved by County and to the extent of the Work to be performed by the subcontractor, to be bound to Contractor by the terms of this Agreement, and to assume toward Contractor all the obligations and responsibilities which Contractor, by this Agreement, assumes toward County. County shall have the right (but not the obligation) to enforce the provisions of this Agreement against any subcontractor 3 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 infomiation obtained by Contractor under this Agreement or individual work order shall become or remain (as applicable), the property of County. In addition, all reports, documents, data, plans, drawings, records and computer files generated by Contractor in relation to this Agreement and all reports, test results and all other tangible materials obtained and/or produced in connection with the performance of this Agreement, whether or not such materials are in completed form, shall at all times be considered the property of the County. Contractor shall not make use of such material for purposes other than in connection with this Agreement without prior written approval of County. 10. Confidentiality. Confidential information of the Contractor should be transmitted separately from non -confidential information, clearly denoting in red on the relevant document at the top the word, "CONFIDENTIAL." However, Contractor is advised that as a public entity, Weld County must comply with the provisions of the Colorado Open Records Act (CORA), C.R.S. 24-72-201, et seq., with regard to public records, and cannot guarantee the confidentiality of all documents. Contractor agrees to keep confidential all of County's confidential information. Contractor agrees not to sell, assign, distribute, or disclose any such confidential information to any other person or entity without seeking written permission from the County. Contractor agrees to advise its employees, agents, and consultants, of the confidential and proprietary nature of this confidential information and of the restrictions imposed by this Agreement. 11. Warranty. Contractor warrants that the Work performed under this Agreement will be performed in a manner consistent with the standards governing such services and the provisions of this Agreement. Contractor further represents and warrants that all Work shall be performed by qualified personnel in a professional manner, consistent with industry standards, and that all services will conform to applicable specifications. 12. Acceptance of Services Not a Waiver. Upon completion of the Work, Contractor shall submit to County originals of all test results, reports, etc., generated during completion of this work. Acceptance by County of reports and incidental material(s) furnished under this Agreement shall not in any way relieve Contractor of responsibility for the quality and accuracy of the project. In no event shall any action by County hereunder constitute or be construed to be a waiver by County of any breach of this Agreement or default which may then exist on the part of Contractor, and County's action or inaction when any such breach or default exists shall not impair or prejudice any right or remedy available to County with respect to such breach or default. No assent expressed or implied, to any breach of any one or more covenants, provisions or conditions of the Agreement shall be deemed or taken to be a waiver of any other breach. Acceptance by the County of, or payment for, the Work completed under this Agreement shall not be construed as a waiver of any of the County's rights under this Agreement or under the law generally. 13. Insurance. Contractor must secure, before the commencement of the Work, the following insurance covering all operations, goods, and services provided pursuant to this Agreement, and shall keep the required insurance coverage in force at all times during the 4 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. Contractor shall provide coverage with limits of liability no less than those stated below. An excess liability policy or umbrella liability policy may be used to meet the minimum liability requirements provided that the coverage is written on a "following form" basis. Acceptability of Insurers: Insurance is to be placed with insurers duly licensed or authorized to do business in the state of Colorado and with an "A.M. Best" rating of not less than A -VII. The County in no way warrants that the above -required minimum insurer rating is sufficient to protect the Contractor from potential insurer insolvency. Required Types of Insurance Workers' Compensation and 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. Minimum Limits: Coverage A (Workers' Compensation) Coverage B (Employers Liability) Commercial General Liability Insurance - Occurrence Form. Statutory $ 100,000 $ 100,000 $ 500,000 Policy shall include bodily injury, property damage, liability assumed under an Insured Contract. The policy shall be endorsed to include the following additional insured language: "Weld County, its elected officials, employees, associated and/or affiliated entities, successors, or assigns, agents, and volunteers shall be named as additional insureds with respect to liability arising out of the activities performed by, or on behalf of the Contractor." Such policy shall include Minimum Limits as follows: General Aggregate Products/Completed Operations Aggregate Each Occurrence Limit Personal/Advertising Injury Automobile Liability Insurance $ 1,000,000 $ 1,000,000 $ 1,000,000 $ 1,000,000 Bodily Injury and Property Damage for any owned, hired, and non -owned vehicles used in the performance of this Contract. Such policy shall maintain Minimum Limits as follows: Bodily Injury/Property Damage (Each Accident) $ 1,000,000 5 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: Per Loss Aggregate $ 1,000,000 $ 2,000,000 14. Proof of Insurance. Upon County's request, Contractor shall provide to County, for examination, a policy, endorsement, or other proof of insurance as determined in County's sole discretion. Provided information for examination shall be considered confidential, and as such, shall be deemed not subject to Colorado Open Records Act (CORA) disclosure. All insurers must be licensed or approved to do business within the State of Colorado, and unless otherwise specified, all policies must be written on a per occurrence basis. The Contractor shall provide the County with a Certificate of Insurance evidencing required coverages, before commencing work or entering the County premises. The Contractor shall furnish the County with certificates of insurance (ACCORD) form or equivalent approved by the County as required by this Contract. The certificates for each insurance policy are to be signed by a person authorized by that insurer to bind coverage on its behalf. The Contractor shall name on the Certificate of Insurance "Weld County, its successors or assigns; its elected officials, employees, agents, affiliated entities, and volunteers as Additional Insureds" for work that is being performed by the Contractor. On insurance policies where Weld County is named as an additional insured, the County shall be an additional insured to the full limits of liability purchased by the Contractor even if those limits of liability are in excess of those required by this Contract. Each insurance policy required by this Agreement must be in effect at or prior to commencement of work under this Agreement and remain in effect for the duration of the project, and for a longer period of time if required by other provisions in this Agreement. Failure to maintain the insurance policies as required by this Agreement or to provide evidence of renewal is a material breach of contract. All certificates and any required endorsement(s) shall be sent directly to the County Department Representative's Name and Address. The project/contract number and 6 project description shall be noted on the Certificate of Insurance. The County reserves the right to require complete, certified copies of all insurance policies required by this Agreement at any time, and such shall also be deemed confidential. Any modification or variation from the insurance requirements in this Agreement shall be made by the County Attorney's Office, whose decision shall be final. Such action will not require a formal contract amendment but may be made by administrative action. 15. Additional Insurance Related Requirements. The County requires that all policies of insurance be written on a primary basis, non-contributory with any other insurance coverages and/or self-insurance carried by the County. The Contractor shall advise the County in the event any general aggregate or other aggregate limits are reduced below the required per occurrence limit. At their own expense, the Contractor will reinstate the aggregate limits to comply with the minimum requirements and shall furnish the County with a new certificate of insurance showing such coverage is in force. Commercial General Liability Completed Operations coverage must be kept in effect for up to three (3) years after completion of the project. Contractors Professional Liability (Errors and Omissions) policy must be kept in effect for up to three (3) years after completion of the project. Certificates of insurance shall state that on the policies that the County is required to be named as an Additional Insured, the insurance carrier shall provide a minimum of 30 days advance written notice to the County for cancellation, non -renewal, suspension, voided, or material changes to policies required under this Agreement. On all other policies, it is the Contractor's responsibility to give the County 30 days' notice if policies are reduced in coverage or limits, cancelled or non -renewed. However, in those situations where the insurance carrier refuses to provide notice to County, the Contractor shall notify County of any cancellation, or reduction in coverage or limits of any insurance within seven (7) days of receipt of insurer's notification to that effect. The Contractor agrees that the insurance requirements specified in this Agreement do not reduce the liability Contractor has assumed in the indemnification/hold harmless section of this Agreement. Failure of the Contractor to fully comply with these requirements during the term of this Agreement may be considered a material breach of contract and may be cause for immediate termination of the Agreement at the option of the County. The County reserves the right to negotiate additional specific insurance requirements at the time of the contract award. 16. 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 7 policies to the minimum limits as required herein. Contractor agrees to provide proof of insurance for all such subcontractors upon request by the County. 17. 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. 18. Certification of Compliance with Insurance Requirements. The Contractor stipulates that it has met the insurance requirements identified herein. The Contractor shall be responsible for the professional quality, technical accuracy, and quantity of all services provided, the timely delivery of said services, and the coordination of all services rendered by the Contractor and shall, without additional compensation, promptly remedy and correct any errors, omissions, or other deficiencies. 19. Mutual Cooperation. The County and Contractor shall cooperate with each other in the collection of any insurance proceeds which may be payable in the event of any loss, including the execution and delivery of any proof of loss or other actions required to effect recovery. 20. Indemnity. The Contractor shall indemnify, hold harmless and, not excluding the County's right to participate, defend the County, its officers, officials, agents, and employees, from and against any and all liabilities, claims, actions, damages, losses, and expenses including without limitation reasonable attorneys' fees and costs, (hereinafter referred to collectively as "claims") for bodily injury or personal injury including death, or loss or damage to tangible or intangible property caused, or alleged to be caused, in whole or in part, by the negligent or willful acts or omissions of Contractor or any of its owners, officers, directors, agents, employees or subcontractors. This indemnity includes any claim or amount arising out of 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. It is the specific intention of the parties that the County shall, in all instances, except for claims arising solely from the negligent or willful acts or omissions of the County, be indemnified by Contractor from and against any and all claims. It is agreed that the Contractor will be responsible for primary loss investigation, defense, and judgment costs where this indemnification is applicable. In consideration of the award of this contract, the Contractor agrees to waive all rights of subrogation against the County, its officers, officials, agents, and employees for losses arising from the work performed by the Contractor for the County. 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 8 of its performance under this Agreement or its failure to comply with the provisions of the Agreement. A failure of Contractor to comply with these indemnification provisions shall result in County's right but not the obligation to terminate this Agreement or to pursue any other lawful remedy. 21. 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. 22. 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. 23. Interruptions. Neither party to this Agreement shall be liable to the other for delays in delivery or failure to deliver or otherwise to perform any obligation under this Agreement, where such failure is due to any cause beyond its reasonable control, including but not limited to Acts of God, fires, strikes, war, flood, earthquakes or Governmental actions. 24. Notices. County may designate, prior to commencement of Work, its project representative ("County Representative") who shall make, within the scope of his or her authority, all necessary and proper decisions with reference to the project. All requests for contract interpretations, change orders, and other clarification or instruction shall be directed to County Representative. All notices or other communications made by one party to the other concerning the terms and conditions of this contract shall be deemed delivered under the fallowing circumstances: a) personal service by a reputable courier service requiring signature for receipt; or b) five (5) days following delivery to the United States Postal Service, postage prepaid addressed to a party at the address set forth in this contract; or c) electronic transmission via email at the address set forth below, where a receipt or acknowledgment is required and received by the sending party; or 9 Either party may change its notice address(es) by written notice to the other. Notice may be sent to: TO CONTRACTOR: Name: Natasha Bossio Position: Director of Behavioral Health Address: 1597 Cole Boulevard, Suite 250 Address: Lakewood, Colorado 80401 E-mail: nbossioaparkergch.com Phone: j303) 424-6078 TO COUNTY: Name: Jamie Ulrich Position: Director Address: P.O. Box A Address: Greeley, Colorado 80632 E-mail: ulrichjjaweld.gov Phone: (970) 400-6510 25. 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. 26. Health Insurance Portability & Accountability Act of 1996 ("HIPAA"). Federal law governing the privacy of certain health information requires a "Business Associate" agreement between Contractor and the County. 45 CFR Section 164.504(e). Attached and incorporated herein by reference as Exhibit A is a HIPAA Business Associate Agreement for HIPAA compliance. 27. 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. 28. 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. 29. 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. 30. 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 10 which is the subject matter of this Agreement. Contractor agrees that if Contractor was a former employee of the Department of Human Services, or employs a former employee of the Department of Human Services, that Contractor will also abide by applicable requirements under C.R.S. 24-18-201 et seq. 31. 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. 32. 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. 33. Non -Waiver. The parties hereto understand and agree that the County is relying on, and does not waive or intend to waive by any provision of this Contract, the monetary limitations or any other rights, immunities, and protections provided by the Colorado Governmental Immunity Act, §§24-10-101 et seq. as from time to time amended, or otherwise available to the County, its subsidiary, associated and/or affiliated entities, successors, assigns; or its elected officials, employees, agents, and volunteers. 34. 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 or results from acts beyond the impacted Party's reasonable control, including without limitation, the following "force majeure" events that frustrate the purpose of this Agreement: 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, government order or law, action by any governmental authority, and other similar events beyond the reasonable control of the impacted party, 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. However, if force majeure occurs after the party delays performance, the party shall not be exempted from liability. The Party affected by the force majeure shall make reasonable efforts to reduce the consequences caused by the force majeure. If the force majeure affects the performance of the contract, the party that is subject to force majeure shall promptly notify the other party and submit to the other party a sufficient and valid proof of force majeure within a reasonable period of time. Otherwise, the corresponding liability shall not be waived. 35. 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 11 any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 36. 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. 37. 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. 38. No Employment of Unauthorized Aliens. Contractor certifies, warrants, and agrees that it does not knowingly employ or contract with an unauthorized alien who will perform work under this Agreement (see 8 U.S.C.A. §1324a and (h)(3)), nor enter into a contract with a subcontractor that employs or contracts with an unauthorized alien to perform work under this Agreement. Upon request, contractor shall deliver to the County a written notarized affirmation that it has examined the legal work status of an employee and shall comply with all other requirements of federal or state law, including employment verification requirements contained within state or federal grants or awards funding public contracts. Contractor agrees to comply with any reasonable request from the Colorado Department of Labor and Employment in the course of any investigation. If Contractor fails to comply with any requirement of this provision, County may terminate this Agreement for breach, and if so terminated, Contractor shall be liable for actual and consequential damages. 39. 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. 40. 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. 41. 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. 12 IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. COUNTY: ATTEST: BY: Clerk to the Board Deputy Clerk to the Boa 1861 BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO 1 T c f er Personal Care Homes, Inc. 97 Cole Boulevard, Suite 250 Lakewood, Colorado 80401 erry L.uck, Chair JUN 3 0 2025 it/a.�eifa. Seaa�v By: Natasha Bossio, Director of Behavioral Health Date: 06/24/2025 13 202:5— 18LcAD Exhibit A HIPAA BUSINESS ASSOCIATE AGREEMENT This Business Associate Agreement ("BAA") is entered into by and between the County and the Contractor, referred to as "Business Associate", to set forth the terms and conditions under which protected health information ("PHI"), as defined by the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, Regulations enacted hereunder (HIPAA) , created or received by Business Associate on behalf of County may be used or disclosed. This BAA shall commence on the effective date outlined in Paragraph 3 of the Professional Services Agreement and the obligations herein shall continue in effect so long as Business Associate uses, discloses, creates or otherwise possesses or maintains any PHI created, or received, maintained or transmitted on behalf of County and until all PHI created, received, maintained or transmitted by Business Associate on behalf of County is destroyed or returned to County pursuant to Paragraph 16 herein. 1. The following terms, if and when used in this BAA, shall have the same meaning as those terms in the HIPAA Rules: Breach, Data Aggregation, Disclosure, Health Care Operations, Individual, Minimum Necessary, Notice of Privacy Practices, Protected Health Information, Required by Law, Secretary, Security Incident, Subcontractor, Unsecured Protected Health Information, and Use. a. Business Associate. "Business Associate" shall generally have the same meaning as the term "business associate" at 45 CFR 160.103. b. Covered Entity. "Covered Entity" shall generally have the same meaning as the term "covered entity" at 45 CFR 160.103. c. HIPAA Rules. "HIPAA Rules" shall mean the Privacy, Security, Breach Notification, and Enforcement rules at 45 CFR Part 160 and Part 164. 2. County and Business Associate hereby agree that Business Associate shall be permitted to use and/or disclose PHI created, received, maintained or transmitted on behalf of County in accordance with this BAA. The permitted uses and disclosures, as may be outlined in a contract or Memorandum of Understanding, must be within the scope of, and necessary to achieve, the obligations and responsibilities of the Business Associate in performing on behalf of, or providing services to, County, or as Required by Law. Business Associate may not use or disclose PHI in a manner that would violate Subpart E of 45 CFR Part 164 if done by County except for the specific uses and disclosures set forth herein. 3. Business Associate acknowledges Business Associate is required by law to comply with the HIPAA Security Rule (45 CFR 164.302 through 164.318), the use and disclosure provisions of the HIPAA Privacy Rule and the Health Information Technology for Economic and Clinical Health Act (HITECH). To the extent Business Associate is to carry out one or more of County's obligations under Subpart E of 45 CFR Part 164, Business Associate hereby agrees to comply with the requirements of Subpart E that apply to County in the performance of such obligations. 14 4. Business Associate may use and disclose PHI created or received by Business Associate on behalf of County if necessary for the proper management and administration of Business Associate or to carry out Business Associate's legal responsibilities, provided that: a. Any disclosure is required by law; or b. Business Associate obtains reasonable assurances from the person to whom the PHI is disclosed that (i) the PHI will be held confidentially and used or further disclosed only as required by law or for the purpose for which it was disclosed to the person; and (ii) the Business Associate will be notified of any instances of which the person is aware in which the confidentiality of the information is breached. 5. Business Associate hereby agrees to maintain the security and privacy of all PHI in a manner consistent with state and federal laws and regulations, including HIPAA, HITECH, 42 CFR Pt. 2 if applicable, and all other applicable laws. 6. Business Associate shall ensure that any subcontractors that create, receive, maintain, or transmit PHI on behalf of the Business Associate agree to the same restrictions, conditions, and requirements that apply to the Business Associate with respect to such information. Business Associate shall not disclose PHI created or received by Business Associate on behalf of County to a person, including any agent or subcontractor of Business Associate but not including a member of Business Associate's own workforce, until such person agrees in writing to be bound by provisions not less restrictive than this BAA and applicable state or federal law. 7. Business Associate shall not disclose PHI to any member of its workforce unless Business Associate has advised such person of Business Associate's privacy and security obligations under this Agreement, including the consequences for violation of such obligations. Business Associate shall take appropriate disciplinary action against any member of its workforce who uses or discloses PHI in violations of this Agreement and applicable law, in addition to meeting its reporting obligations owed to County hereunder. 8. Business Associate represents and warrants that it will use and disclose PHI in accordance with the Privacy Rule's "minimum necessary" standards by taking reasonable steps to limit uses and disclosures to the minimum amount of PHI required in accomplishing the intended purpose and consistent with the County's minimum necessary policies and procedures. Business Associate agrees to use appropriate safeguards to prevent use or disclosure of PHI not permitted by this Agreement or applicable law. 9. Business Associate agrees to maintain a record of its disclosures of PHI, including disclosures not made for the purposes of this Agreement. Such record shall include the date of the disclosure, the name and, if known, the address of the recipient of the PHI, the name of the individual who is the subject of the PHI, a brief description of the PHI disclosed, and the purpose of the disclosure consistent with enabling County to meet its 15 accounting of disclosure obligations under the HIPAA Rules. Business Associate shall make such record available to County within thirty (30) days of a request and shall include disclosures made on or after the date which is six (6) years prior to the request. Business Associate shall not be required to maintain a record of disclosures of PHI made for the following purposes, unless such disclosures become mandatory for accounting of disclosure purposes under HIPAA: a. For the purpose of treatment, payment or health care operations (as those terms are defined under HIPAA); b. To an individual who is the subject of the PHI; and c. Pursuant to an Authorization which is valid under HIPAA. 10. Business Associate agrees to report to County any unauthorized use or disclosure of PHI by Business Associate or its workforce or subcontractors within ten (10) days and the remedial/mitigating action taken or proposed to be taken with respect to such use or disclosure and account for such disclosure. 11. In the event of a or Security Incident involving the County's PHI, Business Associate shall provide County a report including patient name, contact information, nature/cause of the breach, PHI breached and the date or period of time during which the breach occurred. Business Associate understands that such a report must be provided to County within ten (10) days from the date of the breach or the date the breach should have been known to have occurred, or as soon as possible upon discovery (not to exceed 10 days from the date of the breach/breach discovery). Business Associate is responsible for any actual and direct costs related to notification of individuals or next of kin (if the individual is deceased) of any successful Security Incident or Breach reported or caused by Business Associate to County. 12. Business Associates agrees to make its internal practices, books, and records relating to the use and disclosure of PHI received from County or created or received by Business Associate on behalf of County, available to the Secretary of the United States Department of Health and Human Services, for purposes of determining the County's and/or Business Associate's compliance with HIPAA. 13. Within ten (10) days of a written request by County, Business Associate shall allow a person who is the subject of PHI, such person's legal representative, or County to have access to and to copy such person's PHI maintained by Business Associate. Business Associate shall provide PHI in the format requested by such person, legal representative, or County unless it is not readily producible in such format, in which case it shall be produced in standard hard copy format. Business Associate shall forward any request for access to PHI by an individual to County promptly upon receipt thereof. 14. Business Associate agrees to amend, pursuant to a request by County, PHI maintained and created or received by Business Associate on behalf of County. Business Associate further agrees to complete such amendment within ten (10) days 16 of a written request by County, and to make such amendment as directed by County. Business Associate shall forward any request for amendment by an individual to County promptly upon receipt thereof. 15. County shall notify Business Associate of any changes in, or revocation of, the permission by an individual to use or disclose his or her PHI, to the extent that such changes may affect Business Associate's use or disclosure of PHI. 16. In the event Business Associate fails to perform its obligations under this Agreement, County may, at its option: a. Require Business Associate to submit to a plan of compliance, including monitoring by County and reporting by Business Associate, as County, in its sole discretion, determines necessary to maintain compliance with this Agreement and applicable law. Such plan shall be incorporated into this Agreement by amendment hereto; b. Require Business Associate to mitigate any loss occasioned by the unauthorized disclosure or use of PHI; and c. Immediately discontinuing providing PHI to Business Associate with or without written notice to Business Associate. 17. County may immediately terminate this and related agreements if County determines that Business Associate has breached a material term of this Agreement. Alternatively, County may choose to: (i) provide Business Associate with ten (10) days written notice of the existence of an alleged material breach and (ii) afford Business Associate an opportunity to cure said alleged material breach to the satisfaction of County within ten (10) days of receipt of notice. Business Associate's failure to cure shall be grounds for immediate termination of this BAA. County's remedies under this BAA are cumulative and the exercise of any remedy shall not preclude the exercise of any other. 18. After termination or expiration of the Underlying Agreement for any reason, Business Associate with respect to PHI received created or maintained from or on behalf County, shall: (i) retain only that PHI which is necessary for Business Associate to continue its proper management and administration or to carry out its legal responsibilities; (ii) destroy (subject to the Underlying Agreement) the remaining PHI that the Business Associate still maintains in any form; and (iii) not use or disclose the PHI retained by Business Associate other than for the purposes for which such PHI was retained and subject to the same conditions set out in this BAA which applied before termination. If the destruction of the PHI is not feasible, in Business Associate's discretion, Business Associate shall notify County of the reasons destruction is not feasible and Business Associate shall continue to for as long as Business Associate retains the PHI. This section shall survive termination of this BAA. 19. Upon termination of this BAA for any reason, Business Associate, with respect to PHI received from County, or created, maintained, transmitted, or received by Business Associate on behalf of County, shall: a. Retain only that PHI which is necessary for Business Associate to continue its 17 proper management and administration or to carry out its legal responsibilities. b. Return to County the remaining PHI that the Business Associate still maintains in any form or destroy said PHI. c. Continue to use appropriate safeguards and comply with Subpart C of 45 CFR part 164 with respect to electronic protected health information to prevent use or disclosure of the PHI, other than as provided for in this Section, for as long as Business Associate retains the PHI. d. Not use or disclose the PHI retained by Business Associate other than for the purposes for which such PHI was retained and subject to the same conditions which applied prior to termination. e. Return to County or destroy the PHI retained by Business Associate when it is no longer needed by Business Associate for its proper management and administration or to carry out its legal responsibilities. The provisions of this section shall survive the BAA's termination. 20. The parties agree to amend this Agreement in order to maintain compliance with State or Federal law. County shall provide ten (10) days prior written notice to Business Associate of a need to amend the BAA and propose such amendments for Business Associate's consideration. Upon written agreement between the parties, such amendment shall be binding upon the parties. Either party may elect to terminate the BAA and any underlying service agreement(s) if an amendment is not able to be agreed upon within a reasonable timeframe from an amendment's commencement. All duties hereunder to maintain the security and privacy of PHI shall survive such termination. County and Business Associate may otherwise amend this Agreement by mutual written consent. 21. To the fullest extent permitted by law, each party (the "Indemnifying Party") shall indemnify the other party, and its officers, directors, employees and agents (collectively the "Indemnified Parties"), against any and all claims brought by or directly resulting from third parties, including reasonable attorneys' fees (the "Third Party Losses"), to the extent Third Party Losses are proximately caused by a breach of this BAA by the Indemnifying Party, each by the Indemnifying Party or its employees, directors, officers, subcontractors, and agents. The Indemnifying Party shall have the right to control the defense or settlement of such third -party claim, subject to the reasonable participation of, and approval by, the Indemnified Parties of any such settlement or defense strategy. The foregoing indemnification shall not apply to the extent such claims arise out of (i) the Indemnified Party's negligence or willful misconduct, or (ii) the negligence or willful misconduct of any subcontractor or agent other than Business Associate under the Indemnified Party's control. 18 EXHIBIT B SCOPE OF SERVICES Contractor will provide Services, as referred by the County. 1. Anger Management/Domestic Violence Prevention a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Diagnostic and therapeutic services to help: 1. Prevent future violence. 2. Improve family communication. 3. Increase relationship functioning. 4. Aid in the development of the Family Services Plans (FSP's) when necessary. ii. Clinicians are trained to work with victims, offenders, as well as family members, and are able to provide these services in alignment with Domestic Violence Offender Management Board (DVOMB) criteria. b. Anticipated Frequency of Services: i. One (1) or two (2) sessions per week, depending on the needs of the client. c. Anticipated Duration of Services: i. Three (3) months to two (2) years. ii. Typically, the service is short-term. d. Goals of Services: i. Improve client(s) anger management skills and prevent further incidents of violence. ii. Improve family communication and functioning and strengthen family relationships. iii. Provide support to the whole family system to ensure safety and stability. iv. Support multidisciplinary professionals by providing input and guidance on safety planning, recommendations, and progress. v. Align treatment goals with goals identified in the Family Service Plan (FSP). vi. Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. vii. Engage families with outcome -based treatment modalities with proven efficacy. viii. Maintain frequent and thorough communication with Child Welfare Social Case Workers and provide written reporting on at least a monthly basis. ix. In keeping with the Family First Prevention Services Act, the ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. e. Outcomes of Services: i. Client(s) have improved ability to regulate emotions. ii. Family members are safer, and the family unit is more stable. iii. Client(s) are better able to meet treatment goals. iv. Increased safety and welfare of children by working with parents to understand what is best for and act in the long-term interest of their child(ren). v. Improved individual and/or family functioning to maintain the welfare of clients. f. Target Population: i. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Any age, gender, or other characteristics/traits. g. Language: i. English. ii. Interpreters may also be utilized. h. Medicaid Eligibility: i. This service may be Medicaid eligible. i. Service Access and Transportation: i. In-OfficeNideo. ii. In -Home or Community with Transportation. within Weld County. 2. Foster Care/Adoption Support a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Observation of family functioning to identify individual and family strengths and weaknesses. ii. Development of strategies to decrease conflict, build resiliency, and strengthen relationships. iii. Provision of psycho -educational information concerning trauma, abuse, and/or neglect. iv. Ability to work with child welfare clients and/or caseworkers and Department personnel to evaluate and address specific cognitive, mental health, and/or developmental issues. v. Provision of trauma -informed care that also includes behavioral interventions to support the child/family. b. Anticipated Frequency of Services: i. Dependent on the needs of the client. c. Anticipated Duration of Services: i. Dependent on the needs of the client. d. Goals of Services: i. Support caseworkers and clients to meet the treatment goals outlined in the Family Service Plan (FSP). ii. Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. iii. Engage families with outcome -based treatment modalities with proven efficacy. iv. Maintain frequent and thorough communication with Child Welfare Social Case Workers and provide written reporting on at least a monthly basis. v. In keeping with the Family First Prevention Services Act, the ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. e. Outcomes of Services: i. Caseworkers are supported in addressing treatment recommendations. ii. Client(s) have improved ability to regulate emotions. Client(s) are better able to meet treatment goals. iv. Increased safety and welfare of children by working with foster parents to understand what is best for and act in the long-term interest of the child(ren). v. Improved individual and/or family functioning to maintain the welfare of clients. f. Target Population: i. Caseworkers or clients. ii. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. iii. Any age, gender, or other characteristics/traits. g. Language: i. English. ii. Interpreters may also be utilized. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. I n-OfficeNideo. ii. In -Home or Community with Transportation. within Weld County. 3. Foster Parent Training a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Training for foster parents provided in group or individual sessions concerning the effects of trauma, abuse, neglect, transitions, system of care navigation, and reunification. ii. Contractor's expertise in developmental issues will ensure thorough training for providers on appropriate expectations for and behaviors of children being served by the foster care system. iii. Contractor has extensive experience working with foster and adoptive families on issues related to attachment and in helping preserve family structures. iv. Working with child welfare clients and/or caseworkers and department personnel to identify cognitive, mental health, and/or developmental issues to be addressed during training sessions. b. Anticipated Frequency of Services: i. Dependent on the needs of the client. c. Anticipated Duration of Services: i. Dependent on the needs of the client. d. Goals of Services: i. Based on observation of family functioning, develop and communicate strategies to decrease conflict, build resiliency, and strengthen relationships. ii. Educate foster parents regarding treatment goals outlined in the Family Service Plan (FSP), especially in regard to specific cognitive, mental health, and/or developmental issues of the foster child(ren). iii. Provide training regarding specific diagnoses/behaviors to support children in the foster placement without disruption. iv. Work with the foster parents to understand the child's current functioning, trauma, and diagnoses to build a behavioral support plan. v. Provide psycho -educational information concerning trauma, abuse, and/or neglect. vi. Work with the family to understand the dynamics between the foster child, foster parents, and others in the home to help them establish a positive routine and daily interventions that reduce negative behaviors. vii. Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. viii. Maintain frequent and thorough communication with Child Welfare Social Case Workers and provide written reporting on at least a monthly basis. ix. In keeping with the Family First Prevention Services Act, the ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. e. Outcomes of Services: i. Caseworkers are supported in addressing treatment recommendations. ii. Foster parents have an improved ability to help child(ren) regulate emotions and meet treatment goals. iii. Increased safety and welfare of children by working with foster parents to understand child -welfare -specific concerns such as abuse, neglect, loss, and grief. iv. Improved individual and/or family functioning to maintain the welfare of clients. f. Target Population: i. Caseworkers or clients. ii. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. iii. Any age, gender, or other characteristics/traits. g. Language: i. English. ii. Interpreters may also be utilized. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In-OfficeNideo. ii. In -Home or Community with Transportation. 4. Home -Based Intervention a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Preservation & Removal Prevention Services to assess individual and family needs and provide short-term intensive services in the home. This service includes: 1. Conflict resolution/ 2. Case management consultation. 3. Behavioral and parenting skills modeling/coaching. 4. Parenting skill development. 5. Bonding/attachment and adoption preservation services, transition support, systems of care navigation, individual and family therapy, and help in developing structure and life skills. ii. Adoption preservation services that include: 1. Behavioral management consultation. 2. Assistance with the navigation of care systems. 3. Provision of psycho -educational information. 4. Family/individual therapy to foster bonding and attachment with the goal of supporting permanency and preventing out - of -home placement when possible. iii. Supportive In -Home Family Services which includes services to ensure: 1. Child safety. 2. Improve parent/child(ren) interactions. 3. Teach parenting techniques. 4. Enable clients to access appropriate community resources. 5. Minimize family conflict. 6. Enable household management. iv. Evidence -based services that include: 1. Multi -systemic therapy. 2. Cognitive behavioral therapy (CBT) and Trauma -Focused Cognitive Behavioral Therapy (TF-CBT). 3. Applied Behavior Analysis (ABA) therapy. 4. Therapeutic family time services. 5. Dialectical behavioral therapy. 6. Eye Movement Desensitization and Reprocessing (EMDR). 7. Psychological and cognitive evaluations. 8. Family therapy. b. Anticipated Frequency of Services: i. One (1) to two (2) sessions per week. ii. Dependent on the needs of client. c. Anticipated Duration of Services: i. Three (3) months to two (2) years. ii. Typically, this service is short-term. d. Goals of Services: i. Align treatment goals with goals identified in the Family Service Plan (FSP). ii. Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. iii. Engage families with outcome -based treatment modalities with proven efficacy. iv. Maintain frequent and thorough communication with Child Welfare Social Case Workers and provide written reporting on at least a monthly basis. v. In keeping with the Family First Prevention Services Act, the ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. e. Outcomes of Services: i. Client(s) have improved ability to regulate emotions. ii. Client(s) are better able to meet treatment goals. iii. Increased safety and welfare of children by working with parents to understand what is best for and act in the long-term interest of their child(ren). iv. Improved individual and/or family functioning to maintain the welfare of clients. f. Target Population: i. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Any age, gender, or other characteristics/traits g. Language: i. English. ii. Interpreters may also be utilized. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. In-OfficeNideo. ii. In -Home or Community with Transportation. within Weld County. 5. Family Preservation Services a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Consultation and individual and family therapy to 1. Foster bonding and attachment. 2. Support reunification or other permanent placement. 3. Support permanency. 4. Prevent out -of -home placement when possible. ii. Behavioral management intervention, provision of psycho - educational information on bonding and attachment, and assistance with navigation of care systems. iii. Cognitive behavioral strategies, educational strategies, and applied behavioral analysis are utilized, as well as assistance to help families understand such disorders as 1. Attention-Deficit/Hyperactivity Disorder (ADHD). 2. Trauma. 3. Autism specific disorders. b. Anticipated Frequency of Services: i. One (1) to two (2) sessions per week. ii. Dependent on the needs of the client. c. Anticipated Duration of Services: i. Three (3) months to two (2) years. ii. Typically, this service is short-term. d. Goals of Services: i. Align treatment goals with goals identified in the Family Service Plan (FSP). ii. Utilize behavioral management strategies to improve behavioral regulation and the stability of the individual/family. Provide psycho -educational information on bonding and attachment, including supporting the client(s) as needed with their comprehension of the educational material and with specific ways to implement strategies provided. iv. Assist and support clients in navigating the network of applicable community- based services and supports. v. Through individual and/or family therapy, foster bonding and attachment to prevent out -of -home placement, when possible, support reunification, or facilitate the transition to other permanent placement when necessary. vi. Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. vii. Engage families with outcome -based treatment modalities with proven efficacy. viii. Maintain frequent and thorough communication with Child Welfare Social Case Workers and provide written reporting on at least a monthly basis. ix. In keeping with the Family First Prevention Services Act, the ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. e. Outcomes of Services: i. Families are strengthened and, when possible, kept intact or reunited. ii. Individual and family functioning is improved. iii. Client(s) have improved ability to regulate emotions. iv. Client(s) are better able to meet treatment goals. v. Increased safety and welfare of children by working with parents to understand what is best for and act in the long-term interest of their child(ren). f. Target Population: i. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Any age, gender, or other characteristics/traits. g. Language: i. English. ii. Interpreters may be utilized. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. In-OfficeNideo. ii. In -Home or Community with Transportation. 6. Kinship Services (Therapeutic) a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Observation of kinship family dynamics and individual functioning as well as provision of psycho -educational information and therapeutic services to ensure positive relationships and decreased conflict. ii. Child -welfare -specific concerns such as coping with past abuse/neglect and loss/grief are addressed. iii. Evidence -based services provided by contractor's service team include. 1. Multi- systemic therapy. 2. Cognitive Behavioral Therapy (CBT) and Trauma -Focused Cognitive Behavioral Therapy (TF-CBT). 3. Applied Behavior Analysis (ABA) therapy. 4. Therapeutic family time services. 5. Dialectical Behavioral Therapy (DBT). 6. Eye Movement Desensitization and Reprocessing (EMDR). 7. Psychological and cognitive evaluations. 8. Family therapy. iv. When applicable, services are tailored for individuals with limited cognitive abiities. v. Behavioral Services/Coaching are also available, which can include. 1. Assessment. 2. Evaluation. 3. Counseling. 4. Coaching 5. Consultation. 6. Coaching and consultation for family members and other professionals supporting them. vi. Trauma -Based Relational Intervention (TBRI) coaching is also available to family members. b. Anticipated Frequency of Services: i. One (1) to two (2) sessions per week. ii. Dependent upon the needs of the client. c. Anticipated Duration of Services: i. Three (3) months to two (2) years. ii. Typically, this service is short-term. d. Goals of Services: i. Align treatment goals with goals identified in the Family Service Plan (FSP). ii. Enrich and improve the quality of kinship services. iii. Improve family dynamics and functioning, including decreasing conflict in the home and strengthening resiliency. iv. Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. v. Engage families with outcome -based treatment modalities with proven efficacy. vi. Maintain frequent and thorough communication with Child Welfare Social Case Workers and provide written reporting on at least a monthly basis. vii. In keeping with the Family First Prevention Services Act, the ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. e. Outcomes of Services: i. Client(s) have improved ability to regulate emotions. ii. Client(s) are better able to meet treatment goals. iii. Increased safety and welfare of children by working with kinship providers to understand what is best for and act in the long-term interest of the child(ren). iv. Improved individual and/or family functioning to maintain the welfare of clients. f. Target Population: i. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Any age, gender, or other characteristics/traits. g. Language: i. English. ii. Interpreters may be utilized. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. In-OfficeNideo. ii. In -Home or Community with Transportation. 7. Life Skills a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Supportive (In -Home) Family Services to include active therapeutic coaching strategies employed to ensure 1. Child safety. 2. Improve parent/child(ren) interactions. 3. Teach parenting techniques. 4. Enable clients to access appropriate community resources, 5. Minimize family conflict. 6. Enable household management. ii. Child -welfare -specific concerns such as coping with past abuse/neglect and loss/grief are addressed. iii. When applicable, services are tailored for individuals with limited cognitive abilities. iv. Curriculum is developed to meet the individual needs of the parent(s) and utilizes modeling, repetition, and specific teaching techniques/methods to help clients develop skills to mastery to alleviate current and future child protection concerns. v. Services are tailored to clients' current levels of functioning and enable clients to build upon their current skill set. vi. Various therapeutic techniques such as 1. Cognitive behavioral therapy (CBT). 2. Behavioral, and Trauma -Focused Cognitive Behavioral Therapy (TF-CBT). 3. Applied Behavior Analysis (ABA) therapy. 4. Dialectical Behavioral Therapy (DBT) to further skill development. vii. Address the practical skill development as well as the emotional skills in order to remove barriers to learning and to help provide supports for success in the home. viii. Therapist level is determined by need of client. b. Anticipated Frequency of Services: i. One (1) to two (2) sessions per week. ii. Dependent upon the needs of the client. c. Anticipated Duration of Services: i. Three (3) months to two (2) years. ii. Typically, this service is short-term. d. Goals of Services: i. Align treatment goals with goals identified in the Family Service Plan (FSP). ii. Address specific child -welfare concerns through 1. Intervention. 2. Parent education. 3. Modeling. 4. Feedback to deal with past abuse/neglect and loss/grief. 5. Reestablish parent/child connection after lengthy separations. 6. Repair bonding. 7. Address dysfunctional dynamics including parentification of child(ren). 8. Address inappropriate and/or unsafe behaviors. 9. Specific physical and/or sexual abuse and/or substance abuse concerns will also be addressed. iii. Foster safe and age -appropriate parent/child interactions. iv. Strengthen family bonding and promote nurturing interactions. v. Engage families with outcome -based treatment modalities with proven efficacy. vi. Maintain frequent and thorough communication with Child Welfare Social Case Workers and provide written reporting on at least a monthly basis. vii. In keeping with the Family First Prevention Services Act, the ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. e. Outcomes of Services: i. Client(s) have improved ability to regulate emotions. ii. Client(s) are better able to meet treatment goals. iii. Increased safety and welfare of children by working with parents to understand what is best for and act in the long-term interest of their child(ren). iv. Improved individual and/or family functioning to maintain the welfare of clients. v. Specific learning needs of the client(s) are met, as well as their emotional needs. f. Target Population: i. Individuals with intellectual/developmental disabilities, including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Any age, gender, or other characteristics/traits. g. Language: i. English. ii. Interpreters may be utilized. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. In-Office/Video. ii. In -Home or Community with Transportation. 8. Parent Coaching a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Therapeutic and frequent intervention. ii. Education. iii. Modeling. iv. Feedback. v. A structured parent education curriculum to 1. Foster bonding/attachment. 2. Teach appropriate discipline 3. Develop empathy. 4. Provide education on developmental stages. 5. Communicate safe and healthy parenting techniques. 6. Specific criteria utilized to measure parenting education progress. vi. Child -welfare -specific concerns such as coping with past abuse/neglect and loss/grief are addressed. vii. When applicable, services are tailored for individuals with limited cognitive abilities. viii. Curriculum is developed to meet the individual needs of the parent(s) and utilizes 1. Modeling. 2. Repetition. 3. Specific teaching techniques/methods to help clients develop skills to mastery to alleviate current and future child protection concerns. ix. Parent coaches may be Bachelors and Masters level who can utilize various therapeutic techniques such as 1. Cognitive Behavioral Therapy (CBT). 2. Behavioral, and Trauma -Focused Cognitive Behavioral Therapy (TF-CBT). 3. Applied Behavior Analysis (ABA) therapy. 4. Dialectical Behavioral Therapy (DBT) to further skill development. x. Address the practical skill development as well as emotional skills in order to remove barriers to learning and help provide supports for success in the home. xi. Therapist level is determined by need of client. b. Anticipated Frequency of Services: i. One (1) to two (2) sessions per week. ii. Dependent upon the needs of the client. c. Anticipated Duration of Services: i. Three (3) months to two (2) years. ii. Typically, this service is short-term. d. Goals of Services: i. Align treatment goals with goals identified in the Family Service Plan (FSP). ii. Address specific child -welfare concerns through 1. Intervention. 2. Parent education. 3. Modeling. 4. Feedback to deal with past abuse/neglect and loss/grief. 5. Reestablish parent/child connection after lengthy separations. 6. Repair bonding. 7. Address dysfunctional dynamics including parentification of child(ren). 8. Address inappropriate and/or unsafe behaviors. 9. Specific physical and/or sexual abuse and/or substance abuse concerns will also be addressed. iii. Foster safe and age -appropriate parent/child interactions. iv. Strengthen family bonding and promote nurturing interactions. v. Engage families with outcome -based treatment modalities with proven efficacy. vi. Maintain frequent and thorough communication with Child Welfare Social Case Workers and provide written reporting on at least a monthly basis. vii. In keeping with the Family First Prevention Services Act, the ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. e. Outcomes of Services: i. Client(s) have improved ability to regulate emotions. ii. Client(s) are better able to meet treatment goals. iii. Increased safety and welfare of children by working with parents to understand what is best for and act in the long-term interest of their child(ren). iv. Improved individual and/or family functioning to maintain the welfare of clients. v. Specific learning needs of the client(s) are met, as well as their emotional needs. f. Target Population: i. Individuals with intellectual/developmental disabilities, including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Any age, gender, or other characteristics/traits. g. Language: i. English. ii. Interpreters may be utilized. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. In-Office/Video. ii. In -Home or Community with Transportation. 9. Supervised Family Time a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Active interventions. ii. Education. iii. Coaching to promote positive behavioral change in parent/child relationships. iv. Appropriate parent -child interactions are modeled, and feedback is provided to parents after each visit. v. Practical skill development. vi. Emotional skill development. vii. Address child -welfare -specific concerns such as coping with past abuse/neglect and loss/grief. viii. When applicable, services are tailored for individuals with limited cognitive abilities. ix. Curriculum is developed to meet the individual needs of the parent(s) and utilizes 1. Modeling. 2. Repetition. 3. Specific teaching techniques/methods to help clients develop skills to mastery to alleviate current and future child protection concerns. x. Therapeutic Supervised Family Time active interventions include 1. Education. 2. Coaching to promote positive behavioral change in parent/child relationships. 3. Appropriate parent -child interactions are modeled, and feedback is provided to parents after each visit. xi. Therapists will focus on utilizing various therapeutic techniques such as. 1. Cognitive Behavioral Therapy (CBT). 2. Behavioral, and Trauma -Focused Cognitive Behavioral Therapy (TF-CBT). 3. Applied Behavior Analysis (ABA) therapy. 4. Dialectical Behavioral Therapy (DBT) to further skill development. xii. Address practical skill development. xiii. Address emotional skills in order to remove barriers to learning and help provide supports for success in the home. xiv. Therapist level is determined by need of client. b. Anticipated Frequency of Services: i. One (1) to two (2) sessions per week. ii. Dependent upon the needs of the client. c. Anticipated Duration of Services: i. Three (3) months to two (2) years. ii. Typically, this service is short-term. d. Goals of Services: i. Align treatment goals with goals identified in the Family Service Plan (FSP). ii. Address specific child -welfare concerns through 1. Intervention. 2. Parent education. 3. Modeling. 4. Feedback to deal with past abuse/neglect and loss/grief. 5. Reestablish parent/child connection after lengthy separations. 6. Repair bonding. 7. Address dysfunctional dynamics including parentification of child(ren). 8. Address inappropriate and/or unsafe behaviors. iii. Address specific physical and/or sexual abuse and/or substance abuse concerns. iv. Foster safe and age -appropriate parent/child interactions. v. Strengthen family bonding and promote nurturing interactions. vi. Engage families with outcome -based treatment modalities with proven efficacy. vii. Maintain frequent and thorough communication with Child Welfare Social Case Workers and provide written reporting on at least a monthly basis. viii. In keeping with the Family First Prevention Services Act, the ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. e. Outcomes of Services: i. Client(s) have improved ability to regulate emotions. ii. Client(s) are better able to meet treatment goals. iii. Increased safety and welfare of children by working with parents to understand what is best for and act in the long-term interest of their child(ren). iv. Improved individual and/or family functioning to maintain the welfare of clients. v. Specific learning needs of the client(s) are met, as well as their emotional needs. f. Target Population: i. Individuals with intellectual/developmental disabilities, including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. All age, gender, or other characteristics/traits. 9. Language: i. English. ii. Interpreters may be utilized. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. In-OfficeNideo. ii. In -Home or Community with Transportation. 10. Counseling/Psychotherapy a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Address child -welfare -specific concerns such as coping with past abuse/neglect and loss/grief. ii. Evidence -based services provided by contractor's service team include. 1. Multi -Systemic Therapy (MST). 2. Cognitive Behavioral Therapy (CBT). 3. Trauma- Focused Cognitive Behavioral Therapy (TF-CBT). 4. Applied Behavior Analysis (ABA). 5. Therapeutic family time services. 6. Dialectical Behavioral Therapy (DBT). 7. Eye Movement Desensitization and Reprocessing (EMDR). 8. Sensory Integration. 9. Psychological and cognitive evaluations, and family therapy. iii. When applicable, services are tailored for individuals with limited cognitive abilities. iv. Behavioral Services/Coaching are also available, which can include 1. Assessment. 2. Evaluation. 3. Counseling. 4. Coaching. 5. Consultation. 6. Line services to individuals. 7. Coaching and consultation for family members and other professionals supporting them. v. Trauma -Based Relational Intervention (TBRI) coaching is also available to family members. b. Anticipated Frequency of Services: i. One (1) to two (2) sessions per week. ii. Dependent upon the needs of the client. c. Anticipated Duration of Services: i. Three (3) months to two (2) years. ii. Typically, this service is short-term. d. Goals of Services: i. Align treatment goals with goals identified in the Family Service Plan (FSP). ii. Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. iii. Engage families with outcome -based treatment modalities with proven efficacy. iv. Maintain frequent and thorough communication with Child Welfare Social Case. v. Workers and provide written reporting on at least a monthly basis. vi. In keeping with the Family First Prevention Services Act, the ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. e. Outcomes of Services: i. Client(s) have improved ability to regulate emotions. ii. Client(s) are better able to meet treatment goals. iii. Increased safety and welfare of children by working with parents to understand what is best for and act in the long-term interest of their child(ren). iv. Improved individual and/or family functioning to maintain the welfare of clients. f. Target Population: i. Individuals with intellectual/developmental disabilities, including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Any age, gender, or other characteristics/traits. g• Language: i. English. ii. Interpreters may be utilized. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. In-Office/Video. ii. In -Home or Community with Transportation. 11. Consultation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Working with child welfare clients and/or caseworkers and department personnel to address cognitive, mental health, and/or developmental issues. ii. Consultation will be performed by a Ph.D level clinician. iii. Providing support to clients and/or caseworkers to address issues identified by psychological evaluations and to ensure progress on recommendations made in the evaluations. iv. This service will be v. Expert -level court testimony can also be provided. b. Anticipated Frequency of Services: i. Dependent upon the needs of the client. c. Anticipated Duration of Services: i. Dependent upon the needs of the client. d. Goals of Services: i. Support caseworkers and clients to meet the treatment goals outlined in the FSP. ii. Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. iii. Engage families with outcome -based treatment modalities with proven efficacy. iv. Maintain frequent and thorough communication with Child Welfare Social Case Workers and provide written reporting on at least a monthly basis. v. In keeping with the Family First Prevention Services Act, the ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. e. Outcomes of Services: i. Caseworkers are supported in addressing treatment recommendations. ii. Client(s) have improved ability to regulate emotions. iii. Client(s) are better able to meet treatment goals. iv. Increased safety and welfare of children by working with parents to understand what is best for and act in the long-term interest of their child(ren). v. Improved individual and/or family functioning to maintain the welfare of clients. f. Target Population: i. Individuals with intellectual/developmental disabilities, including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Any age, gender, or other characteristics/traits. g• Language: i. English. ii. Interpreters may be utilized. h. Medicaid Eligibility: i. This service may be Medicaid eligible. i. Service Access and Transportation: i. In-OfficeNideo. ii. In -Home or Community with Transportation. 12. Psychological Evaluation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Evaluations will be performed by a Ph.D. or PsyD level clinician. ii. Evaluations include a thorough assessment of mental health concerns, cognitive abilities, and academic skills. iii. Evaluations are tailored specifically to the referral question at hand, including evaluating for developmental issues such as 1. Autism spectrum disorder. 2. Learning disabilities. 3. Attention-deficit/hyperactivity disorder. iv. Behavioral concerns, including. 1. Observations. 2. Review of records. 3. Identification of target behaviors, 4. Recommendations for behavioral modification. 5. Adaptive behavior to investigate skills/abilities versus current daily performance. v. If desired, a feedback session to go over the report. b. Anticipated Frequency of Services: i. One (1) to four (4) sessions. c. Anticipated Duration of Services: i. One (1) to two (2) months. d. Goals of Services: i. To schedule with the client as quickly as possible once the referral is received. ii. To conduct a thorough evaluation with the client, including addressing all of the referral questions. iii. To complete the evaluation in a timely manner while making client- specific and thorough recommendations on evidenced treatments with proven efficacy. iv. Address specific child -welfare concerns such as increasing coping skills to process past abuse/neglect and/or deal with loss/grief. v. To maintain frequent and thorough communication with Child Welfare Social Case Workers throughout the evaluation process through written and verbal communication. vi. In keeping with the Family First Prevention Services Act, the ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. e. Outcomes of Services: i. Client's specific needs for support in meeting treatment goals have been identified, improving the likelihood that treatment goals can be met. ii. Client -specific outcome -based treatment modalities with evidenced efficacy have been recommended. iii. Increased safety and welfare of children by providing recommendations to ensure parents understand what is best for and act in the long-term interest of their child(ren). iv. Improved individual and/or family functioning to maintain the welfare of clients. f. Target Population: i. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Any age, gender, or other characteristics/traits. g. Language: i. English. ii. Interpreters may be utilized. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. In-Office/Video. ii. In -Home or Community with Transportation. 13. Trauma Assessment a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Psychological and cognitive testing. ii. Full trauma assessment. iii. Recommendations will be geared toward helping the individual understand 1. How trauma affects emotions and behaviors. 2. How the individual can be supported in the appropriate environment. 3. What interventions will lead to increased resilience. 4. Skill development. 5. Emotional regulation. 6. Success for the individual. iv. If desired, a feedback session to go over the report. b. Anticipated Frequency of Services: i. One (1) to four (4) sessions. c. Anticipated Duration of Services: i. One (1) to two (2) months. d. Goals of Services: i. Schedule with the client as quickly as possible once the referral is received. ii. Conduct a thorough trauma assessment with the client, including addressing all of the referral questions. iii. Complete the evaluation in a timely manner while making client - specific and thorough recommendations on validated treatments with evidenced efficacy. iv. Address specific child -welfare concerns such as increasing coping skills to process past abuse/neglect and/or deal with loss/grief. v. Help the client understand how trauma affects emotions and behaviors. vi. Identify how the individual can best be supported in the appropriate environment. vii. Identify what interventions will lead to increased resilience, skill development, emotional regulation, and ultimately individual and family success. viii. Maintain frequent and thorough communication with Child Welfare Social Case Workers throughout the evaluation process through written and verbal communication. ix. In keeping with the Family First Prevention Services Act, the ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. e. Outcomes of Services: i. Specific trauma -focused evidenced -based interventions with evidenced efficacy have been identified in recommendations to meet the client's specific needs. iii. Increased safety and welfare of children by providing recommendations to ensure parents understand what is best for and act in the long-term interest of their child(ren). iv. Improved individual and/or family functioning to maintain the welfare of clients. f. Target Population: i. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. i. Any age, gender, or other characteristics/traits. g. Language: i. English. ii. Interpreter may also be utilized. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In-OfficeNideo. ii. In -Home or Community with Transportation. 14. Parent -Child Interactional (PCI) Evaluation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Interviews with parents and other collateral sources. b. Anticipated Frequency of Services: i. One (1) or two (2) observational appointments. c. Anticipated Duration of Services: i. One (1) to two (2) months. d. Goals of Services: i. To schedule with the client as quickly as possible once the referral is received. ii. Conduct a thorough observation(s) of the family members, with special focus on referral questions. iii. Complete the observation(s) and recommendations in a timely manner. iv. Identify strengths and weaknesses in parenting. v. Identify next steps in treatment to inform treatment plans. vi. Identify how the family can best be supported in the appropriate environment. vii. Identify what interventions will lead to increased resilience, skill development, emotional regulation, and ultimately individual and family success. viii. Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. ix. Maintain frequent and thorough communication with Child Welfare Social Case Workers throughout the evaluation process and to provide written reporting on at least a monthly basis. x. In keeping with the Family First Prevention Services Act, the ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. e. Outcomes of Services: i. Parenting strengths and weaknesses have been identified and articulated. ii. Next steps in treatment plan goals have been identified. iii. Interventions have been identified to improve individual and family functioning. iv. Family preservation/reunification has been facilitated whenever possible. f. Target Population: i. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Any age, gender, or other characteristics/traits. g. Language: i. English. ii. Interpreters may also be utilized. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In-OfficeNideo. ii. In -Home or Community with Transportation. 15. Substance Abuse Therapeutic Services a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Substance abuse treatment services to improve family functioning and support future sobriety and, ultimately, work towards preserving or reuniting the family whenever possible. ii. Individual and family therapeutic services. iii. Consultation to aid in Family Service Plan (FSP) development. iv. Provision of psycho -educational information for those impacted by substance abuse. b. Anticipated Frequency of Services: i. One (1) or two (2) times per week, depending on the needs of the client. c. Anticipated Duration of Services: i. Duration can span three (3) months to two (2) years. ii. Contractor is committed to accomplishing treatment goals within court- mandated timeframes. d. Goals of Services: i. To provide therapeutic interventions specific to reducing substance abuse and treating underlying issues. ii. Assist in crafting a Family Service Plan that addresses the substance abuse issues at hand. iii. Improve family functioning and relationships by addressing substance abuse issues. iv. Prevent further substance abuse. v. Support team members at meetings by offering expert -level guidance into treatment planning, safety planning, and next steps. vi. Provide education to team members and clients regarding substance abuse specific concerns e. Outcomes of Services: i. Assistance is provided in outlining substance -abuse -specific treatment goals. ii. Therapy and education are provided to prevent further substance abuse and its negative impacts on the family. Client(s) are better able to meet treatment goals. iv. Family functioning is improved. v. Safety of family members is improved. f. Target Population: i. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Any age, gender, or other characteristics/traits. g. Language: i. English. ii. Interpreters may also be utilized. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. In-OfficeNideo. ii. In -Home or Community with Transportation. 16. Sexual Abuse Therapeutic Services a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Contractor's clinical team includes a Master's level Sex Offender Management Board (SOMB) therapist who has extensive experience working with SOMB standards, treating sexual abuse victims, and working with sexually abusive individuals. ii. Sex -offense -specific therapy and consultation services such as 1. Therapeutic Sexual Abuse services. 2. Offense -Specific Treatment for Sexual Offenders. 3. Informed Supervision Training for Caregivers. iii. Attend Multi -Disciplinary Team meetings to provide consultation, guidance, and support. iv. Assist in safety planning and development of next steps. v. Provide psycho -educational information for those impacted by sexual abuse, including for education for parents on clarification/reunification, informed supervision, family therapy, and safety planning. b. Anticipated Frequency of Services: i. One (1) or two (2) times per week, depending on the needs of the client. c. Anticipated Duration of Services: i. Duration can span three (3) months to two (2) years. ii. Contractor is committed to accomplishing treatment goals within court- mandated timeframes. d. Goals of Services: i. To provide therapeutic interventions specific to behaviors related to sexual abuse victimization, sexual dysfunction, and sexual abuse perpetration. ii. Prevent further sexual abuse and victimization. iii. Support multidisciplinary team members at meetings by offering expert -level guidance into treatment planning, safety planning, and next steps. iv. Provide education to team members and clients regarding sexual abuse specific concerns, including 1. Clarification. 2. Reunification. 3. Family therapy. 4. Informed supervision. 5. Boundary establishment. 6. Safety planning. e. Outcomes of Services: i. Assistance is provided in outlining sex -offense -specific treatment goals. ii. Therapy and education are provided to decrease problem behaviors and avoid abuse and victimization. iii. Client(s) are better able to meet treatment goals. f. Target Population: i. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Age, gender, or other characteristics/traits. g. Language: i. English. ii. Interpreters may also be utilized. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. In-OfficeNideo. ii. In -Home or Community with Transportation. 17. Psychosexual Evaluations/Sex-Offender-Specific Evaluation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Thorough psychosexual evaluations/sex-offender-specific evaluation completed by a Master's level SOMB therapist. ii. A PhD level clinician may provide support with additional measures or testing, if needed (dependent on client). b. Anticipated Frequency of Services: i. One (1) to four (4) appointments. c. Anticipated Duration of Services: i. One (1) to two (2) months. d. Goals of Services: i. Schedule with the client as quickly as possible once the referral is received. ii. Conduct a thorough evaluation with the client, including addressing all of the referral questions. iii. Complete the evaluation in a timely manner while making client - specific and thorough recommendations on validated treatments with proven efficacy. iv. Determine issues and behaviors related to sexual abuse, dysfunction, and perpetration. v. Determine whether co-occurring conditions exist. vi. Develop thorough evidence -based treatment plan recommendations to assist with treatment, including addressing safety needs and needs for family therapy. vii. Prevent further sexual abuse victimization. viii. Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. ix. Maintain frequent and thorough communication with Child Welfare Social Case Workers throughout the evaluation process and to provide written reporting on at least a monthly basis. e. Outcomes of Services: i. Client's specific needs for support in meeting treatment goals have been identified, improving the likelihood that treatment goals can be met. ii. Client -specific outcome -based treatment modalities with proven efficacy have been recommended. iii. Increased safety and welfare of children by providing recommendations to ensure parents understand what is best for and act in the long-term interest of their child(ren). iv. Improved individual and/or family functioning to maintain the welfare of clients. v. Team members are supported in the development of safety planning and Family Service Plan (FSP) goals. f. Target Population: i. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Age, gender, or other characteristics/traits. g. Language: i. English. ii. Interpreters may also be utilized. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In-OfficeNideo. ii. In -Home or Community with Transportation. Terms 1. Contractor understands and will comply with all aspects of the referral authorization, billing and tracking requirements as set forth by the County. Failure to comply with all aspects may result in a forfeiture of payment. 2. Contractor agrees to receive referrals for services through e-mail and will provide an identified e-mail address prior to the start of this Agreement. Contractor acknowledges that services are not authorized until the Contractor has received an authorized referral form from the County. Contractor further acknowledges that services provided prior to the authorized start date or outside the scope of services on the referral form will not be eligible for reimbursement. 3. Contractor will respond to the Mental Health and Support Services Team (HS- CWServiceReferralOyveld.gov) within three (3) business days regarding the ability to accept the received referral. 4. Upon acceptance of a referral, Contractor will offer an initial appointment within seven (7) days of receiving the referral. The first attempt to contact the client will occur within 24 hours of receiving the referral (excluding weekends and holidays). Contractor will document efforts to engage client in referred services. If the client does not respond after three (3) attempts in the first seven (7) days of the referral period, the Contractor will notify the caseworker and the Mental Health and Support Services Team HS-CWServiceReferralAweld.gov. 5. Contractor acknowledges that any and all modifications to an existing referral must be approved through the Mental Health and Support Services Team HS- CWServiceReferralAweld.gov. No other County staff or other party to the case may authorize services or modifications to services. 6. Contractor understands that "no shows" are defined as unexcused and unplanned/uncommunicated absences for services. If a rate for "no shows" is not specifically stated in Exhibit B, Rate Schedule, then Contractor understands that the County will not reimburse for "no-shows". Contractor understands that the County will only reimburse Contractor for up to two (2) "no-shows" on the part of case participants who cancel without 24 -hour notice. After three (3) "no- shows", Contractor will place client on a behavioral plan requiring attendance or discharge the client from services. Contractor must inform the caseworker and the Mental Health and Support Services Team HS- CWServiceReferralAweld.gov within three (3) days of when the client is placed on a behavioral plan or discharged. 7. Contractor understands that the County will not reimburse Contractor for cancelled appointments either on the part of the client or the Contractor. If the cancellation is generated from the Contractor, a "makeup" session/episode, to occur within 30 days of the cancellation, will be offered to the client (excluding session/episodes that fall on holidays). If the cancellation is generated from the client, the Contractor must request a makeup session from the County prior to the makeup session occurring (excluding session/episodes that fall on holidays). After three (3) cancellations, Contractor will inform the caseworker and the Mental Health and Support Services Team HS-CWServiceReferral(a weld.gov immediately via email, to discuss service continuation. 8. Contractor will identify, in detail, areas of continued concern and make recommendations to the caseworker in a monthly report regarding continuation of services and/or the need for additional services. 9. Contractor will submit reports on a monthly basis for each active referral for ongoing services. Reports will be submitted per the online format required by the County, unless otherwise directed by the County. 10. Contractor will document in detail any and all observed or verbalized concerns regarding any child whom the Contractor is working with under an active referral. Areas of concern may include, but are not limited to, any physical, emotional, educational, or behavioral issues. Areas of concern should be reported to the caseworker and the Mental Health and Support Services Team HS- CWServiceReferralAweld.gov immediately AND on the required monthly report. 11. Contractor agrees any change to an existing referral must be pre -approved through the Child Welfare Core Service Coordinator or any member of the Mental Health and Support Services Team. Any changes to Family Time referrals will be approved by a new referral signed by the Child Welfare Supervisor. A change is defined as anything outside of the approved documented service on the initial authorized referral form. This may include an increase or decrease in services hours, change in frequency, change in location of services, transportation needs, or any change to the initial referral or subsequent authorizations. 12. Contractor agrees to attend meetings when available and as requested by the County. Such meetings include Court Facilitations, Bid Meetings, Professional Staffings, Family Team Meetings and/or Team Decision Making meetings. The County will reimburse for actual participation in the meeting only so long as there is written authorization from the Mental Health and Support Services Team, and the facilitator documents in the meeting notes the timeframe that the provider attended and when participation in the meeting is deemed appropriate and necessary by the County. The Facilitator will be responsible for filling out the time attended on the meeting notes. Staffings and/or meetings other than those listed above are not considered reimbursable unless otherwise approved by the Mental Health and Support Services Team. Contractor may participate by phone or virtually, if approved by the County. 13.On a monthly basis, the Contractor will notify the Mental Health and Support Services Team HS-CWServiceReferral(a�weld.gov of new staff who will manage and/or administer the services with the following information: a. Staff member name and contact information b. Education level/degree (if applicable) c. Licensure/credentials (if applicable) d. Department of Regulatory Authority (DORA) number (if applicable) e. Supervisor name and contact information The County reserves the right to decline the new staff members managing and/or administering services to County clients. 14. Compliance with Child and Family Services Review The Child and Family Services Review (CFSR) examines child welfare service outcomes in three areas: Safety, Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's performance according to national standards and monitor progress over time. Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance services to families. Contractor agrees to continually strive for positive outcomes in the areas of Safety, Permanency and Well Being. Contractor will ensure that any employee or subcontractor of Contractor providing services under this Agreement will work towards positive outcomes in the aforementioned three areas as outlined under the Child and Family Services Review (CFSR) and will address the aforementioned three areas when completing monthly reports as required by Paragraph 9 of this Exhibit. 15. Certification Contractor certifies that, at the time of entering into this Agreement, it has currently in effect all necessary licenses, approvals, insurance, etc., required to properly provide the services and/or supplies covered by this Agreement. Copies of all necessary licenses shall be provided to the County by the Contractor prior to the start of any Agreement. 16. Training Contractor may be required to attend training at the request of the County specific to services provided under this Agreement. The County will not compensate the Contractor for said training in the form of registration fees, time spent traveling to and from training, attending the training or any other associated costs unless otherwise agreed to by the County. 17.Subpoenas Contractor will, on behalf of its employees and/or officers, accept any subpoena for testimony from the Weld County Attorney's Office by e-mail and will return a waiver of services within 72 business hours. For this purpose, Contractor will designate an e-mail address prior to the start of this Agreement. If the Contractor receives a subpoena via e-mail but will only accept personal service, the Contractor will contact the Weld County Attorney's Office immediately at (970) 336-7235 and advise that the subpoena must be personally served. 18. Monitoring and Evaluation Contractor and the County agree that monitoring and evaluation of the performance of this Agreement shall be conducted by the Contractor and the County. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners, the County, and the Contractor. Contractor will collaborate in a timely manner with the County to resolve issues pertaining to service delivery, service quality, documentation, and invoicing during referral period and after services have concluded. The Contractor will require clients to sign releases of information. Contractor understands that the County will not reimburse for services rendered to County clients until releases of information are obtained. Contractor shall permit the County, and any other duly authorized agent or governmental agency, to monitor all activities conducted by the Contractor pursuant to the terms of this Agreement. The monitoring agency may, if in its sole discretion deems necessary or appropriate, have access to any program data, special analyses, on -site checking, formal audit examinations, or any other reasonable procedures for purposes of monitoring. All such monitoring shall be performed in a manner that will not unduly interfere with the work conducted under this Agreement. 19. Credentialing Criteria Contractor and its employee(s) and sub-contractor(s) shall remain in good standing with the Colorado Department of Regulatory Affairs (DORA) and may not, at any time during the term of this contract, be listed as excluded or debarred in the System for Award Management (SAM). Contractor shall ensure that all employees/subcontractors who provide services to clients under this contract meet the credentials/qualifications specific to the County's identified credentialing standards and C.R.S Title 12, Article 43 and in the Social Services Manual Volume 7.000.6(M) (12 CCR 2509-4). The County has the right to approve Contractor's employees/subcontractors who will be performing services under this contract prior to the commencement of the work and shall have the right to review the employee(s)'/subcontractor(s)' employment files prior to granting approval. Contractor must retain copies of employee credentialing qualifications and background checks in personnel files and make such records available to the County Representative upon request. Contractor shall obtain reference and background checks, including fingerprint - based police (CBI and/or FBI) checks (if required by statute or regulation or if there will be unsupervised contact with children), checks of County records, and Sexual Offender Registry checks and receive, at minimum, preliminary results before assigning/hiring employees/subcontractors to perform under this contract. If the County becomes dissatisfied with Contractor's employee(s)/subcontractor(s), the County will notify Contractor of its concerns about the employee(s)/subcontractor(s). Disciplinary measures, if any, will be the sole responsibility of Contractor. However, if the concerns/issues cannot resolve to the County's satisfaction, Contractor's employee(s)/subcontractor(s) may not be allowed to provide services under this contract. The County reserves the right to review all Contractor's or Sub -Contractors background checks. It is the responsibility of the Contractor to notify the County of results of background checks. EXHIBIT C RATE SCHEDULE 1. Funding and Method of Payment The County agrees to reimburse the Contractor in consideration of the work and services performed under this Agreement at the rate(s) specified below in Paragraph 2, Fees for Services. Expenses incurred by the Contractor prior to the term of this Agreement are not eligible County expenditures and shall not be reimbursed by the County. For services funded through Core Services, Contractor agrees to accept reimbursement through ACH direct deposit one time per month. If Contractor is not currently set up with the State of Colorado to accept direct deposit, Contractor agrees to complete and submit a State of Colorado direct deposit enrollment form, which will be provided by the County, with a voided check, deposit slip or bank letter. Failure to complete and submit this form and voided check in a timely and accurate manner may result in a delay of payment. For services not funded through Core Services; Contractor agrees to accept payment through County Warrant when funding source does not allow for direct deposit. Payment pursuant to this Agreement, whether in whole or in part, is subject to and contingent upon the continuing availability of said funds for the purposes hereof. In the event that said funds, or any part thereof, become unavailable as determined by the County, the County may immediately terminate the Agreement or amend it accordingly. 2. Fees for Services Pate $ 200.00 Unit e Type Hour Service Name Anger Management/Domestic Violence Prevention: In OfficeMdeo AND In Horne or Community AND with Transportation $ 150.00 Hour Anger Management/Domestic Violence Prevention: FTM, TDM, Professional Staffing $ 150.00 Each Anger Management/Domestic Violence Prevention: No Show $ 200.00 Hour Foster Care/Adoption Support: In Office/Video AND In Home or Community AND with Transportation $ 200.00 Hour Foster Care/Adoption Suppoart: FTM, TOM, Professional Staffing $ 150.00 Each Foster Care/Adoption Support: No Show $ 200.00 Hour Foster Parent Training: FTM, TDM, Prof. Staffing oo Training: No Show $ 200.00 Hour Home Based Intervention: In OfficeNideo AND In Home or Community AND with Transportation $ 200.13! Hour 4sed Services: M,"TI M, Professsionat S $ 150.00 Each Home Based Services: No Show 200.01} Hour Family, Preservation Services: In Community ARID with Transportation idea AND. In Horne $ 200.00 Hour Family Preservation Services: FTM, TDM, Professional Staffing $ 150.00 each Family Preservation Services: No Show $ 200.00 Hour Kinship Services (Therapeutic): In OfficeNideo AND In Home or Community AND with Transportation 150.00 Hour Kinship Services (Therapeutic): FTM, TDM; Professional Staffing $ 150.00 Each Kinship Services (Therapeutic): No Show $ 120.00 Hour Life Skills - Bachelors: In Office/Video AND In Home or Community AND with Transportation Life `Skills Masters: in OfficeNideo AND In Home or Cornmuni ARID vilth Transportation $ 200.00 $ 120.00 Hour Life Skills - Bachelors: FTM, TDM, Professional Staffing $ 200.00 - Hour ife Skills - Masters: FTM, TDM, Professional Staff $ 70.00 Each Life Skills - Bachelors: No Show 50:00 Each Life Skills - Masters: No Show $ 120.00 Hour Parent Coaching - Bachelors: In OfficeNideo AND In Home or Community AND with Transportation 4 "Coaching Masters: in unity AND with Transportation ieo $ 70.00 Each Parent Coaching - Bachelors: No Show 50- ent Coaching - Masters: No $ 120.0 $ 150.00 Hour rent Coaching - Master's: FTM, TIC, Pwiti rerrt Coaching - Bachelors; FTM, TIM, P essionat Supervised Family Time - Bachelors: In OfficeNideo AND In Home or Community AND with Transportation $ 200.00 Supervised Family Time - Masters: In or'�Community ARID with Transportaitb ea $ 150.00 Hour Supervised Family Time - Bachelors: FTM, TDM, Professional Staffing Rate $ 200.04 Type Hour Service Name Supervised Family Time - Masters: FTM, TDM, Professional Staffing $ 70.00 Each Supervised Family Time - Bachelors: No Show $ 150.00. Each Supervised Family Time - Masters: No Show $ 200.00 Hour Counseling/Psychotherapy: In Office/Video AND with Transportation $ 250.00 Hour Counseling/Psychotherapy: In Home or Community $ 200.00 Each Counseling/Psychotherapy: No Show $ 250.00 Hour Counseling/Psychotherapy: FTM, TDM, Professional Staffing $ 250.00 Hour Consultation — Ph.D.: In OfficeNide° AND In Home or Community AND with Transportation $ 250.00 Hour Consultation: FTM, TDM, Prof.. Staffing $ 200.00 Each Consultation: No Show $ 500.00 Hour Psychological Evaluation: In Office/ Video AND In Home or Community AND with Transportation . $ 250.00 Hour Psychological Evaluation: FTM, TDM, Prof. Staffing $ 500.00 Each Psychological Evaluation: No Show $ 500.00 Hour Trauma Assessment: In OfficeNideo AND In Home or Community AND with Transportation $ 250.00 Hour Trauma Assessment: FTM, TDM, Professional Staffing $ 500.00 Each Trauma Assessment: No Show $ 500.00 Hour Parent -Child Interactional (PCI) Evaluation: In OfficeNideo AND In Home or Community AND with Transportation $ 500.00 Each Parent -Child Interactional (PCI) Evaluation: No Show $ 250.04 Hour Parent -Child Interactional (PCI) Evaluation: FTM, TDM, Professional Staffing $ 200.00 Hour Substance Abuse Therapeutic Services: In OfficeNideo AND In Home or Community AND with Transportation S 200.04 Hour Substance Abuse Therapeutic Services: FTM, TDM, Professional Staffing S 150.00 Each Substance Abuse Therapeutic Services: No Show $ 200.00 Hour Sexual Abuse Therapeutic Services: In Office/Video AND In Home or Community AND with Transportation $ 200.00 Hour Sexual Abuse Therapeutic Services: FTM, TDM, Professional Staffing $ 150.00 Each Sexual Abuse Therapeutic Services:. No Show Rate $ 200.00 Unit Type Hour Service Name Psychosexual/Sex Offender Specific Evaluation - Masters: In OfficeNide° AND IN Home or Community AND with Transportation Hour 'T :twin D N Hoare Come $ 200.00 Hour Psychosexual/Sex Offender Specific Evaluation: Masters - FTM, TDM, Professional Staffing $ 250,0V` ur Psyose�cual/�e�c +� TD M Rrofe tal S1 $ 200.00 Each Psychosexual/Sex Offender Specific Evaluation: Masters - No Show $ 500.00 ch Psychosexual/Sex Offender Spec i6 Evalget rn: PhD - No Show $ 0.50 Mile Mileage * Mileage rate is paid after 25 roundtrip miles from therapist's office/home. Offices located at: 1597 Cole Boulevard, Suite 250 in Lakewood. 357 South McCaslin Boulevard, Suite 200 in Louisville. 14001 East Iliff Avenue, Suite 204 in Aurora. 3. Request for Reimbursement and Supporting Documentation Contractor shall submit all Requests for Reimbursement and supporting documentation to the County by the 7th day of the month following the month of service, but no later than 45 days from the date of service for each client receiving ongoing services. Contractor shall prepare and submit monthly a Request for Reimbursement and monthly report including other supporting documentation, if applicable, certifying that services authorized were provided on the date(s) indicated and the charges were made pursuant to the terms and conditions of Paragraph 3 of this Agreement. Monthly reports will be submitted through the County's online reporting system, unless otherwise directed or agreed to by the County. Monthly reports for ongoing services must include the following information, entered in the "Narrative" box for each date of service: a. Time(s) of service (i.e. 2-4pm) b. Location of where the service took place (i.e. clinician's office, client's home, in the community.) c. Clinician/therapist name d. What interventions were used, recommendations and/or goals discussed, progressions towards goals, and client engagement. e. For mileage reimbursement, if applicable, the mileage accumulated minus roundtrip mileage that is included in the rate, starting location, and ending location. f. Any and all safety concerns. When submitting a Request for Reimbursement for a one-time service, the contractor shall submit the first and last page of the evaluation/report to confirm proof of services rendered. The full evaluation/report should be submitted by the contractor to the caseworker. For Monitored Sobriety services, proof of services rendered shall be the test result. Requests for Reimbursement and/or supporting documentation received after the 7th day of the month may delay payment. Requests for Reimbursement and/or supporting documentation received after 45 days from the date of service may result in delay or forfeiture of payment. Consistent failure to meet the 45 -day deadline may result in termination of the Agreement. 4. Payment The County and the Contractor agree that all benefits from private insurance and/or other funding sources such as Medicaid (if Contractor is a Medicaid eligible provider) or Victim's Compensation must be exhausted before Core Services or other County funds can be accessed for services. Exceptions to this Paragraph may include, if approved by the County, the following: The service being provided by the contractor is not a Medicaid eligible service; a. The service is not deemed medically necessary; b. The Court with jurisdiction over the case has ordered that a non - Medicaid provider or service be used; c. A Medicaid provider is not available to provide the needed service; d. Medicaid is exhausted for the needed service; or e. Medicaid denied service. f. The client is not eligible for Medicaid. The County may withhold reimbursement if Contractor has failed to comply with any part of the Agreement, including the Financial Management requirements, program objectives, contractual terms, or reporting requirements. In the event of forfeiture of reimbursement, Contractor may appeal such circumstance in writing to the Director of Human Services. The decision of the Director of Human Services shall be final. 5. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: a. Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed. b. Deny payment or recover reimbursement for those services or deliverables, which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the County. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to the County. Incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation shall be recovered from Contractor by deduction from subsequent payments under this Agreement or other agreements between the County and Contractor, or by the County as a debt due to the County or otherwise as provided by law. 6. Financial Management At all times from the effective date of the Agreement until completion of the Agreement, Contractor shall comply with the administrative requirements, cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under this Agreement must conform to the Single Audit Act of 1984 and OMB Circular A-133. Exhibit D WELD COUNTY'S INVITATION FOR BID (Weld County's Invitation for Bid is incorporated into this agreement by reference and will be provided upon request to the Department.) This page is intentionally left blank Exhibit E Contractor's response to the Invitation for Bid Exhibit E contains the following documents: • Attachment 1 — Bid Attestation • Attachment 2 — Bid Form • Attachment 3 — Provider Information Form (PIF) • Attachment 4 — Staff Data Sheet • Certificate of Insurance (COI) ATTACHMENT 1 BID ATTESTATION Failure to include a signed Attestation upon submittal of your bid may result in your bid being incomplete, non -responsive, and your bid being rejected. If there are any exclusions or contingencies submitted with your bid of may be disqualified. Bidder's Legal Name as reflected on W-9 Parker Personal Care Homes, Inc. Address 1597 Cole Blvd Ste 250, Lakewood, CO 80401 Phone Number (303) 424-6078 Email sswitzerna,parkerpch com/amckeonaparkerpch com FEIN/Federal Tax ID # or SS# 84-1582091 The undersigned, by his or her signature, hereby acknowledges and represents that 1 The bid proposed herein meets all the conditions, specifications and special provisions set ' forth in the Invitation for Bid for Request No #B2500043 2 The quotations set forth herein are exclusive of any federal excise taxes and all other state and local taxes _ 3 He or she is authonzed to bind the below -named bidder for the amount shown on the 'accompanying bid sheets 4` Acknowledgement of Schedule E — Insurance and Bond 5 Acknowledgment of Schedule F — Weld County Contract 6 By submitting a responsive bid or proposal, the supplier agrees to be bound by all terms and conditions of the solicitation as established by Weld County 7 Weld County reserves the nght to reject any and all bids, to waive any informality in the bids, and to accept the bid that, in the opinion of the Board of County Commissioners, is to the best interests of Weld County The bid(s) may be awarded to more than one vendor CONTRACTOR: Name Amelia McKeon Title Chief Executive Officer By X 4nuzZa. 7Y1c."cee. (Double Click in' box to sign electronically) 12/3/2024 ADA ATTACHMENT 2 BID FORM Please complete the following: Number of services offered on this Attachment 2 (max 5): 5 You may complete another Attachment 2 if you have more than 5 services. Service #1 Service Name: Anger Management/Domestic Violence Prevention Scope of Work Please Note: If the service is a monthly package, different levels should be indicated. All monthly packages must state a specific minimum number of direct service hours. (Please address each line item below using bulleted points) 1.01 Modalities, curriculum, tools used in delivery of service (DO NOT list company history): Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Diagnostic and therapeutic services to help prevent future violence, improve family communication, increase relationship functioning, and aid in the development of the Family Services Plans when necessary. ii. Contractor's clinicians are trained to work with victims, offenders, as well as family members, and are able to provide these services in alignment with Domestic Violence Offender Management Board (DVOMB) criteria. 1.02 Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: One (1) or two (2) times per week, depending on the needs of the client. 1.03 Anticipated duration of service (i.e. 3-4 months): Service may range three (3) months to two (2) years, typically it is more short-term. 1.04 Three (3), or more, specific goals of the service (DO use bullet points): - Improve client(s) anger management skills and prevent further incidents of violence. - Improve family communication and functioning and strengthen family relationships. - Provide support to the whole family system to ensure safety and stability. - Support multidisciplinary professionals by providing input and guidance on safety planning, recommendations, and progress. - Align treatment goals with goals identified in the Family Service Plan (FSP). - Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM - Engage families with outcome -based treatment modalities with proven efficacy - Maintain frequent and thorough communication with Child Welfare Social Case Workers and provide wntten reporting on at least a monthly basis - In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible 1.05 Three (3), or more, specific outcomes of service: 1 Client(s) have improved ability to regulate emotions 2 Family members are safer, and the family unit is more stable 3 Client(s) are better able to meet treatment goals 4 Increased safety and welfare of children by working with parents to understand what is best for and act in the long-term interest of their chdd(ren) 5 Improved individual and/or family functioning to maintain the welfare of clients 1.06 Target population of the service, including age and gender' 1 Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders 2 Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits 1.07 Languages service is available in (please list proficiency and if interpreter services are available). , English Interpreters may also be utilized 1.08 Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part This service is Medicaid eligible (AM is covered, DV is partially covered) 1.09 Service location — list where the service will take place (i.e. client's home, in -office, other): _ i In -Home ii In Community within Weld County in Video iv In any of Contractor's offices, which include 1 1597 Cole Boulevard, Suite 250 in Lakewood 2 357 South McCaslin Boulevard, Suite 200 in Louisville Revised 12/3/2024 ADA ATTACHMENT 2 BI D FORM 3. 14001 East Iliff Avenue, Suite 204 in Aurora. Rates Please Note: All rates need to include overhead and administrative work (i.e., scheduling or report writing). All rates should be per hour unless service is for evaluations/assessments, Home Studies, or Monitored Sobriety. • For hourly Service rates please complete section 1.10 • For monthly Service rates please complete section 1.11 • For Home Study Providers please complete section 1.12 • For monitored Sobriety Providers please complete section 1.13 1.10 Hourlv Service Rates: Service #1 Service Type $ Amount Unit Type 1.10a In-Office/Video $200 Per Hour 1.10b In Community $200 Per Hour -Home or 1.10c Service with Transportation Provided $200 Per Hour 1.10d $150 Per Hour FTM, TDM, Prof. Staffing 1.10e No show $150 Per No Show 1.10f , Mileage rate* $0.50 Per Mile * If applicable — Mileage rate is paid after 25 roundtrip miles. 1.11 Monthly Service Rates each level must be listed): If applicable Service Name with Level Rate Month per Minimum of Service: Hours 1.11a $ 1.11b $ 1.11c $ 1.11d $ 1.11e $ 1.11f $ 1.11g $ $ 1.11h 1.111 $ 1.11j $ 1.12 Home Study Providers - List your rates in the box below. 1.13 Monitored Sobriety Providers - List your rates in the box below. Revised 12/3/2024 ADA ATTACHMENT -2 ,BeD FORM 1.14 Additional Comments: Y Revised 12/3/2024 ADA ATTACHMENT 2 Bo® FORM Weld County Use Only Service #1: Initial Proposal Determination: If Applicable, Select One Date: Reason for follow up or negotiation' List specific item(s) needing follow up or discussion Changes approved to proposal' List specific item(s) that were changed Changes approved by: Name of Authonzed Representative for Bidder Date Method changes were approved: If Applicable, Select One Final Proposal Determination Select One Date Comments Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM Service #2 Service Name: Foster Care/Adoption Support Scope of Work Please Note: If the service is a monthly package, different levels should be indicated. All monthly packages must state a specific minimum number of direct service hours. (Please address each line item below using bulleted points) 2.01 Modalities, curriculum, tools used in delivery of service (DO NOT list company history): Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Observation of family functioning to identify individual and family strengths and weaknesses. ii. Development of strategies to decrease conflict, build resiliency, and strengthen relationships. iii. Provision of psycho -educational information concerning trauma, abuse, and/or neglect. iv. Ability to work with child welfare clients and/or caseworkers and department personnel to evaluate and address specific cognitive, mental health, and/or developmental issues. v. Can be provided remotely, in -person, and/or at Family Service Plan (FSP) meetings. vi. Provision of trauma -informed care that also includes behavioral interventions to support the child/family. 2.02 Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Frequency will be case dependent. 2.03 Anticipated duration of service (i.e. 3-4 months): Duration will be case dependent. 2.04 Three (3), or more, specific goals of the service (DO use bullet points): - Support caseworkers and clients to meet the treatment goals outlined in the FSP. - Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. - Engage families with outcome -based treatment modalities with proven efficacy. - Maintain frequent and thorough communication with Child Welfare Social Case Workers and provide written reporting on at least a monthly basis. - In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM 2.05 Three (3), or more, specific outcomes of service: 1 Caseworkers are supported in addressing treatment recommendations 2 Client(s) have improved ability to regulate emotions 3 Client(s) are better able to meet treatment goals 4 Increased safety and welfare of children by working with foster parents to understand what is best for and act in the long-term interest of the child(ren) 5 Improved individual and/or family functioning to maintain the welfare of clients 2.06 Target population of the service, including age and gender: 1 Caseworkers or clients 2 Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders 3 Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits 2.07 Languages service is available in (please list proficiency and if interpreter services are available): English Interpreters may also be utilized 2.08 Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: This service is not Medicaid eligible 2.09 Service location — list where the service will take place (i.e. client's home, in -office, other): i Video ii In -Home in In Community within Weld County iv In any of Contractor's offices, which include 1 1597 Cole Boulevard, Suite 250 in Lakewood 2 357 South McCaslin Boulevard, Suite 200 in Louisville 3 14001 East Iliff Avenue, Suite 204 in Aurora Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM Rates Please Note: All rates need to include overhead and administrative work (i.e., scheduling or report writing). All rates should be per hour unless service is for evaluations/assessments, Home Studies, or Monitored Sobriety. • For hourly Service rates please complete section 2.10 • For monthly Service rates please complete section 2.11 • For Home Study Providers please complete section 2.12 • For monitored Sobriety Providers please complete section 2.13 2.10 Hourlv Service Rates: Service #2 Service Type $ Amount Unit Type 2.10a In-Office/Video $200 Per Hour 2.10b In -Home or Community $200 Per Hour 2.10c Service with Transportation Provided $200 Per Hour 2.10d FTM, TDM, Prof. Staffing $200 Per Hour 2.10e No show $150 Per No Show 2.10f Mileage rate* $0.50 Per Mile * If applicable — Mileage rate is paid after -25 roundtrip miles. 2.11 Monthly Service Rates each level must be listed): If applicable Service Name with Level Rate Month per Minimum of Service: Hours 2.11a $ 2.11b $ 2.11c $ 2.11d -- - $ 2.11e $ 2.11f $ 2.11g $ 2.11h $ 2.11i $ 2.11j $ 2.12 Home Study Providers - List your rates in the box below. 2.13 Monitored Sobriety Providers - List your rates in the box below. 2.14 Additional Comments: Revised 12/3/2024 ADA ATTACHMENT 2 -�I FORM Weld Countv Use Only Service #2: Initial Proposal Determination If Applicable, Select One Date Reason for follow up or negotiation: List specific item(s) needing follow up or discussion Changes approved to proposal. List specific item(s) that were changed Changes approved by. Name of Authorized Representative for Bidder Date. Method changes were approved: If Applicable, Select One Final Proposal Determination' Select One Date Comments Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM Service #3 Service Name: Foster Parent Training Scope of Work Please Note: If the service is a monthly package, different levels should be indicated. All monthly packages must state a specific minimum number of direct service hours. (Please address each line item below using bulleted points) 3.01 Modalities, curriculum, tools used in delivery of service (DO NOT list company history): Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Training for foster parents provided in group or individual sessions concerning the effects of trauma, abuse, neglect, transitions, system of care navigation, and reunification. ii. Contractor's expertise in developmental issues will ensure thorough training for providers on appropriate expectations for and behaviors of children being served by the foster care system. iii. Contractor has extensive experience working with foster and adoptive families on issues related to attachment and in helping preserve family structures. Contractor offers foster/adoptive parent consultation services including observation of family functioning, strategies to decrease conflict, build resiliency, and strengthen relationships, and, when appropriate, provision of psycho -educational information concerning trauma, abuse, and/or neglect. Contractor also offers therapeutic kinship services, including observation of kinship family dynamics and individual functioning as well as provision of psycho -educational information and therapeutic services to ensure positive relationships and decreased conflict. Oar adoption preservation services include behavioral management consultation, assistance with the navigation of care systems, provision of psycho -educational information, and family/individual therapy to foster bonding and attachment with the goal of supporting permanency and preventing out -of -home placement when possible. iv. Working with child welfare clients and/or caseworkers and department personnel to identify cognitive, mental health, and/or developmental issues to be addressed during training sessions. 3.02 Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Frequency will be case dependent. 3.03 Anticipated duration of service (i.e. 3-4 months): Duration will be case dependent. 3.04 Three (3), or more, specific goals of the service (DO use bullet points): - Based on observation of family functioning, develop and communicate strategies to decrease conflict, build resiliency, and strengthen relationships. - Educate foster parents regarding treatment goals outlined in the FSP, especially in regard to specific cognitive, mental health, and/or developmental issues of the foster child(ren). Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM - Provide training regarding specific diagnoses/behaviors to support children in the foster placement without disruption. - Work with the foster parents to understand the child's current functioning, trauma, and diagnoses to build a behavioral support plan. - Provide psycho -educational information concerning trauma, abuse, and/or neglect. - Work with the family to understand the dynamics between the foster child, foster parents, and others in the home to help them establish a positive routine and daily interventions that reduce negative behaviors. - Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. - Maintain frequent and thorough communication with Child Welfare Social Case Workers and provide written reporting on at least a monthly basis. - In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. 3.05 Three (3), or more, specific outcomes of service: 1. Caseworkers are supported in addressing treatment recommendations. 2. Foster parents have an improved ability to help children) regulate emotions and meet treatment goals. 3. Increased safety and welfare of children by working with foster parents to understand child - welfare -specific concerns such as abuse, neglect, loss, and grief. 4. Improved individual and/or family functioning to maintain the welfare of clients. 3.06 Target population of the service, including age and gender: i. Caseworkers or clients. ii. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. iii. Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits. 3.07 Languages service is available in (please list proficiency and if interpreter services are available): English. Interpreters may also be utilized. 3.08 Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM This service is not Medicaid eligible. 3.09 Service location — list where the service will take place (i.e. client's home, in -office, other): i. Video. ii. In -Home. iii. In Community within Weld County. iv. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South McCaslin Boulevard, Suite 200 in Louisville. 3. 14001 East Iliff Avenue, Suite 204 in Aurora. Rates Please Note: All rates need to include overhead and administrative work (i.e., scheduling or report writing). All rates should be per hour unless service is for evaluations/assessments, Home Studies, or Monitored Sobriety. • For hourly Service rates please complete section 3.10 • For monthly Service rates please complete section 3.11 • For Home Study Providers please complete section 3.12 • For monitored Sobriety Providers please complete section 3.13 3.10 Hourly Service Rates: Service #3 Service Type $ Amount Unit Type 3.10a In-Office/Video $200 Per Hour 3.10b In Community $200 Per Hour -Home or 3.10c $200 Service with Transportation Provided Per Hour 3.10d $200 FTM, TDM, Prof. Staffing Per Hour 3.10e No show $150 Per No Show 3.10f Mileage rate* $0.50 Per Mile * If applicable Mileage rate is paid after (25) roundtrip miles. 3.11 Monthly Service Rates each level must be listedl: If apalicable Service Name with Level � Rate Month per Minimum of Service: Hours 3.11a $ 3.11b $ 3.11c $ 3.11d $ 3.11e $ Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM 311f $ 311g $ 311h $ 311i $ 311j $ 3.12 Home Study Providers — List your rates in the box below. 3.13 Monitored Sobriety Providers — List your rates in the box below. 3.14 Additional Comments: Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM Weld County Use Only Service #3: Initial Proposal Determination. If Applicable, Select One Date: Reason for follow up or negotiation: List specific item(s) needing follow up or discussion Changes approved to proposal. ,List specific item(s) that were changed Changes approved by: Name of Authorized Representative for Bidder Date. Method changes were approved: If Applicable, Select One Final Proposal Determination' Select One Date: Comments: Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM Service #4 Service Name: Home Based Intervention Scope of Work Please Note: If the service is a monthly package, different levels should be indicated. All monthly packages must state a specific minimum number of direct service hours. (Please address each line item below using bulleted points) 4.01 Modalities, curriculum, tools used in delivery of service (DO NOT list company history): Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Preservation & Removal Prevention Services — Contractor is able assess individual and family needs and provide short-term intensive services in the home. Contractor offers conflict resolution, case management consultation, behavioral and parenting skills modeling/coaching, parenting skill development, bonding/attachment and adoption preservation services, transition support, systems of care navigation, individual and family therapy, and help in developing structure and life skills. ii. Adoption preservation services — including behavioral management consultation, assistance with the navigation of care systems, provision of psycho -educational information, and family/individual therapy to foster bonding and attachment with the goal of supporting permanency and preventing out -of -home placement when possible. iii. Supportive In -Home Family Services — including services to ensure child safety, improve parent/child(ren) interactions, teach parenting techniques, enable clients to access appropriate community resources, minimize family conflict, and enable household management. Contractor is able to provide therapeutic family time in the home, office, and/or community settings. iv. Evidence -based services provided by contractor's service team include: multi -systemic therapy, cognitive behavioral therapy and trauma -focused Cognitive Behavioral Therapy (CBT), Applied Behavior Analysis (ABA) therapy, therapeutic family time services, dialectical behavioral therapy, Eye Movement Desensitization and Reprocessing (EMDR), psychological and cognitive evaluations, and family therapy. 4.02 Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: One (1) or two (2) times per week, depending on the needs of the client. 4.03 Anticipated duration of service (i.e. 3-4 months): Service may range from three (3) months to two (2) years, typically it is more short-term. 4.04 Three (3), or more, specific goals of the service (DO use bullet points): Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM - Align treatment goals with goals identified in the FSP - Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/gnef - Engage families with outcome -based treatment modalities with proven efficacy - Maintain frequent and thorough communication with Child Welfare Social Case Workers and provide written reporting on at least a monthly basis - In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate ' reuniting families or keeping them intact whenever possible 4.05 Three (3), or more, specific outcomes of service: 1 Client(s) have improved ability to regulate emotions 2 Client(s) are better able to meet treatment goals 3 Increased safety and welfare of children by working with parents to understand what is best for and act in the long-term interest of their chdd(ren) 4 Improved individual and/or family functioning to maintain the welfare of clients 4.06 Target population of the service, including age and gender. i Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and_comorbid mental health and/or substance abuse disorders ii Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits 4.07 Languages service is available in (please list proficiency and if interpreter services are available). English Interpreters may also be utilized 4.06 Medicaid eligibility — list whether the service is eligible for Medicaid_ in whole or in part. This service is Medicaid eligible 4.09 Service location — list where the service will take place (i.e. client's home, in -office, other): i Video ii In -Home iii In Community within Weld County Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM iv. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South McCaslin Boulevard, Suite 200 in Louisville. 3. 14001 East Iliff Avenue, Suite 204 in Aurora. Rates Please Note: All rates need to include overhead and administrative work (i.e., scheduling or report writing). All rates should be per hour unless service is for evaluations/assessments, Home Studies, or Monitored Sobriety. • For hourly Service rates please complete section 4.10 • For monthly Service rates please complete section 4.11 • For Home Study Providers please complete section 4.12 • For monitored Sobriety Providers please complete section 4.13 4.10 Hourly Service Rates: Service #4 Service Type $ Amount Unit Type 4.10a In-Office/Video $200 Per Hour 4.10b Community $200 Per Hour In -Home or 4.10c $200 Service with Transportation Provided Per Hour 4.10d $200 Per Hour FTM, TDM, Prof. Staffing 4.10e No show $150 Per No Show 4.10f Mileage rate* $0.50 Per Mile * If applicable — Mileage rate is paid after 25 roundtrip miles. 4.11 Monthly Service Rates each level must be listed): If applicable Service Name with Level Rate Month per Minimum of Service: Hours 4.11a $ 4.11b $ 4.11c $ 4.11d $ 4.11e $ 4.11f $ 4.11g $ 4.11h $ 4.111 $ 4.11j $ 4.12 Home Study Providers - List your rates in the box below. Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM ,,fi 4.13 Monitored Sobriety_ Providers — List your rates in the box below. 4.14 . Additional Comments: - ' ,�_, , '10-$0,per mile will be the reimbursement rate, however the finable form would not allow'1= ' lrb,less than $1 c t� 3 s� Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM Meld County Use Only Service #4• Initial Proposal Determination. If Applicable, Select One Date. Reason for follow up or negotiation: List specific item(s) needing follow up or discussion Changes approved to proposal: List specific item(s) that were changed Changes approved by. Name of Authonzed Representative for Bidder Date. Method changes were approved: If Applicable, Select One Final Proposal Determination Select One Date' Comments: Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM Service #5 Service Name: Family Preservation Services Scope of Work Please Note: If the service is a monthly package, different levels should be indicated. All monthly packages must state a specific minimum number of direct service hours. (Please address each line item below using buktea pQnts) 5.01 Modalities, curriculum, tools used in delivery of service (DO NOT list company history): Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Consultation and individual and family therapy to foster bonding and attachment, support reunification or other permanent placement, support permanency, and prevent out -of -home placement when possible. ii. Behavioral management intervention, provision of psycho -educational information on bonding and attachment, and assistance with navigation of care systems. iii. Cognitive behavioral strategies, educational strategies, and applied behavioral analysis are utilized, as well as assistance to help families understand such disorders as ADHD, trauma, and autism specific disorders. 5.02 Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: One (1) or two (2) times per week, depending on the needs of the client. 5.03 Anticipated duration of service (i.e. 3-4 months): Service may range from three (3) months to two (2) years, typically it is more short-term. 5.04 Three (3), or more, specific goals of the service (DO use bullet points): - Align treatment goals with goals identified in the Family Service Plan (FSP). - Utilize behavioral management strategies to improve behavioral regulation and the stability of the individual/family. - Provide psycho -educational information on bonding and attachment, including supporting the client(s) as needed with their comprehension of the educational material and with specific ways to implement strategies provided. - Assist and support clients in navigating the network of applicable community- based services and supports. - Through individual and/or family therapy, foster bonding and attachment to prevent out -of - Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM home placement, when possible, support reunification, or facilitate the transition to other permanent placement when necessary - Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/gnef - Engage families with outcome -based treatment modalities with proven efficacy - Maintain frequent and thorough communication with Child Welfare Social Case Workers and provide wntten reporting on at least a monthly basis - In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible 5.05 Three (3), or more, specific outcomes of service: 1 Families are strengthened and, when possible, kept intact or reunited 2 Individual and family functioning is improved 3 Client(s) have improved ability to regulate emotions 4 Client(s) are better able to meet treatment goals 5 Increased safety and welfare of children by working with parents to understand what is best for and act in the long-term interest of their child(ren) 5.06 Target population of the service, including age and gender 1 Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders 2 Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits 5.07 Languages service is available in (please list proficiency and if interpreter services are available). English Interpreters may also be utilized 5.08 Medicaid eligibility — list whether the service is eligible for Medicaid in whole or on part. This service is Medicaid eligible 5.08 Service location — list where the service will take place (i.e. client's home, in -office, other) i Video ii In Community within Weld County Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM iii. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South McCaslin Boulevard, Suite 200 in Louisville. 3. 14001 East Riff Avenue, Suite 204 in Aurora. Rates Please Note: All rates need to include overhead and administrative work (i.e., scheduling or report writing). All rates should be per hour unless service is for evaluations/assessments, Home Studies, or Monitored Sobriety. • For hourly Service rates please complete section 5.10 • For monthly Service rates please complete section 5.11 • For Home Study Providers please complete section 5.12 • For monitored Sobriety Providers please complete section 5.13 5.10 Hourlv Service Rates: Service #5 Service Type . $ Amount Unit Type 5.10a In-Office/Video $200 Per Hour 5.10b In -Home or Community $200 Per Hour 5.10c Service with Transportation Provided $200 Per Hour 5.10d FTM, TDM, Prof. Staffing $200 Hour Per 5.10e No show $150 Per No Show 5.10f Mileage rate'` $0.50 Per Mile * If applicable — Mileage rate is paid after X25) roundtrip miles. 5.11 Monthly Service Rates each level must be listed): If applicable Service Name with Level Rate Month per Minimum of Service: Hours 5.11a $ 5.11b $ 5.11c $ 5.11d $ 5.11e $ 5.11f $ 5.11g $ 5.11h $ 5.111 $ 5.11j $ 5.12 Home Study Providers — List your rates in the box below. Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM 5.13 Monitored Sobriety Providers — List your rates m the box below. 5.14 Additional Comments' $0 50 per mile will be the reimbursement rate, however the fellable form would not allow for any less than $1 Revised 12/3/2024 ADA ATTACH ENT 2 Bi FZ Weld County Use Only Service #5' Initial Proposal Determination: If Applicable, Select One Date. Reason for follow up or negotiation' List specific item(s) needing follow up or discussion Changes approved to proposal: List specific item(s) that were changed Changes approved by* Name of Authorized Representative for Bidder Date. Method changes were approved If Applicable, Select One Final Proposal Determination Select One Date Comments' Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM P lease complete the following: N umber of services offered on this Attachment 2 (max 5): 5 You may complete another Attachment 2 if you have more than 5 services. Service #1 Service Name: Kindship Services (Therapeutic) Scope of Work Please Note: If the service is a monthly package, different levels should be indicated. All monthly packages must state a specific minimum number of direct service hours. (Please address each line item below using bulleted points) 1.01 Modalities, curriculum, tools used in delivery of service (DO NOT list company history): Contractor will utilize the following modalities, curriculum, and tools in the delivery of services u nder this agreement: i. Observation of kinship family dynamics and individual functioning as well as provision of psycho -educational information and therapeutic services to ensure positive relationships and decreased conflict. ii. Child -welfare -specific concerns such as coping with past abuse/neglect and loss/grief are addressed. iii. Evidence -based services provided by contractor's service team include: multi- systemic therapy, cognitive behavioral therapy and trauma -focused Cognitive Behavioral Therapy (CBT), Applied Behavior Analysis (ABA) therapy, therapeutic family time services, dialectical behavioral therapy, Eye Movement Desensitization and Reprocessing (EMDR), psychological and cognitive evaluations, and family therapy. iv. When applicable, services are tailored for individuals with limited cognitive abilities. ✓ . Behavioral Services/Coaching are also available, which can include assessment, evaluation, counseling, coaching, consultation, and line services to individuals, as well as coaching and consultation for family members and other professionals supporting them. ✓ i. Trauma -Based Relational Intervention (TBRI) coaching is also available to family members. 1.02 Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: One (1) or two (2) times per week, depending on the needs of the client. 1.03 Anticipated duration of service (i.e. 3-4 months): Service may range three (3) months to two (2) years, typically it is more short-term. Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM 1.04 Three (3), or more, specific goals of the service (DO use bullet points). - Align treatment goals with goals identified in the FSP - Ennch and improve the quality of kinship services - Improve family dynamics and functioning, including decreasing conflict in the home and strengthening resiliency - Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/gnef - Engage families with outcome -based treatment modalities with proven efficacy - Maintain frequent and thorough communication with Child Welfare Social Case Workers and provide wntten reporting on at least a monthly basis - In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible 1.05 Three (3), or more, specific outcomes of service: 1 Client(s) have improved ability to regulate emotions ,i 2 Client(s) are better able to meet treatment goals 3 Increased safety and welfare of children by working with kinship providers to understand what is best for and act in the long-term interest of the children) 4 Improved individual and/or family functioning to maintain the welfare of clients 1.06 Target population of the service, including age and gender: 1 Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders 2 Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits - 1.07 Languages service is available in (please list proficiency and if interpreter services are available): English Interpreters may also be utilized 1.08 Medicaid eligibility — list whether the service is eligible for Medicaid on whole or in part: This service is Medicaid eligible 1.09 Service location — list where the service will take place (i.e. client's home, in -office, other): Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM i. In -Home. ii. In Community within Weld County. iii. Video. iv. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South McCaslin Boulevard, Suite 200 in Louisville. 3. 14001 East Iliff Avenue, Suite 204 in Aurora. Rates Please Note: All rates need to include overhead and administrative work (i.e., scheduling or report writing). All rates should be per hour unless service is for evaluations/assessments, Home Studies, or Monitored Sobriety. • For hourly Service rates please complete section 1.10 • For monthly Service rates please complete section 1.11 • For Home Study Providers please complete section 1.12 • For monitored Sobriety Providers please complete section 1.13 1.10 Hourlv Service Rates: $ Amount Unit Type Service #1 Service Type 1.10a In-Office/Video $200 Per Hour Community $200 Per Hour 1.10b In -Home or $200 Per Hour 1.10c Service with Transportation Provided $150 Hour 1.10d FTM, TDM, Prof. Staffing Per 1.10e No show $150 Per No Show 1.10f Mileage rate* $0.50 Per Mile * If applicable — Mileage rate is paid after 25 roundtrip miles. Service Name with Level Rate Month per Minimum of Service: Hours 1.11a $ 1.11b $ 1.11c $ 1.11d $ 1.11e $ 1.11f $ $ 1.11g Revised 12/3/2024 ADA ATTACHMENT 2 BAD E®R`='� 1 11h $ $ $ 1 11i 1 11j 1.12 Home Study Providers — List your rates in the box below. 1.13 Monitored Sobriety Providers — List your rates in the box below. 1.14 Additional Comments Revised 12/3/2024 ADA ATTACHMENT 2 MD FORM Weld County Use Only Service #1 Initial Proposal Determination If Applicable, Select One Date. Reason for follow up or negotiation: List specific item(s) needing follow up or discussion Changes approved to proposal. List specific item(s) that were changed Changes approved by Name of Authonzed Representative for Bidder Date: Method changes were approved: If Applicable, Select One Final !Proposal Determination. Select One Date. Comments Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM Service #2 Service Name: Life Skills Scope of Work Please Note: If the service is a monthly package, different levels should be indicated. All monthly packages must state a specific minimum number of direct service hours. (Please address each line item below using bulleted points) 2.01 Modalities, curriculum, tools used in delivery of service (DO NOT list company history): Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Supportive (In -Home) Family Services — to include active therapeutic coaching strategies employed to ensure child safety, improve parent/child(ren) interactions, teach parenting techniques, enable clients to access appropriate community resources, minimize family conflict, and enable household management. Contractor is able to provide therapeutic family tine in the home, office, and/or community settings. ii. Child -welfare -specific concerns such as coping with past abuse/neglect and loss/grief are addressed. iii. When applicable. services are tailored for individuals with limited cognitive abilities. Curriculum is developed to meet the individual needs of the parent(s) and utilizes modeling, repetition, and specific teaching techniques/methods to help clients develop skills to mastery to al eviate current and future child protection concerns. iv Services are tailored to clients' current levels of functioning and enable clients to build upon their current skill set. v. Life skills therapists may be Bachelors- and Masters -level therapists who can utilize various therapeutic techniques such as: cognitive behavioral therapy, behavioral, and trauma -focused Cognitive Behavioral Therapy (CBT), Applied Behavior Analysis (ABA) therapy, and dialectical behavioral therapy to further skill development. Many individuals who experience cognitive and/or developmental issues have difficulty with learning, which impedes the skill development process from both a cognitive standpoint but also an emotional one, as learning has always been difficult for that individual. Our approach is to not only address the practical skill development but also emotional skills in order to remove barriers to learning and help provide sLpports for success in the home. Therapist level is determined by need of client. 2.02 Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Ole (1) or two (2) times per week, depending on the needs of the client. 2.03 Anticipated duration of service (i.e. 3-4 months): Service may range from three (3) months to two (2) years, typically it is more short-term. Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM 2.04 Three (3), or more, specific goals of the service (DO use bullet points): - Align treatment goals with goals identified in the FSP. Address specific child -welfare concerns through intervention, parent education, modeling, and feedback to deal with past abuse/neglect and loss/grief, reestablish parent/child connection after lengthy separations, repair bonding, address dysfunctional dynamics including parentification of child(ren), and address inappropriate and/or unsafe behaviors. Specific physical and/or sexual abuse and/or substance abuse concerns will also be addressed. - Foster safe and age -appropriate parent/child interactions. - Strengthen family bonding and promote nurturing interactions. - Engage families with outcome -based treatment modalities with proven efficacy. - Maintain frequent and thorough communication with Child Welfare Social Case Workers and provide written reporting on at least a monthly basis. - In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. 2.05 Three (3), or more, specific outcomes of service: 1. Client(s) have improved ability to regulate emotions. 2. Client(s) are better able to meet treatment goals. 3. Increased safety and welfare of children by working with parents to understand what is best for and act in the long-term interest of their child(ren). 4. Improved individual and/or family functioning to maintain the welfare of clients. 5. Specific learning needs of the client(s) are met, as well as their emotional needs. 2.06 Target population of the service, including age and gender: 1. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. 2. Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits. 2.07 Languages service is available in (please list proficiency and if interpreter services are available): English. Interpreters may also be utilized. 2.08 Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: This service is Medicaid eligible. Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM 2.09 Service location — list where the service will take place (i.e. client's home, in -office, other): i. Video. ii. In -Home. iii. In Community within Weld County. iv. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South McCaslin Boulevard, Suite 200 in Louisville. 3. 14001 East Riff Avenue, Suite 204 in Aurora. Rates Please Note: All rates need to include overhead and administrative work (i.e., scheduling or report writing). All rates should be per hour unless service is for evaluations/assessments, Home Studies, or Monitored Sobriety. • For hourly Service rates please complete section 2.10 • For monthly Service rates please complete section 2.11 • For Home Study Providers please complete section 2.12 • For monitored Sobriety Providers please complete section 2.13 2.10 Hourlv Service Rates: Service #2 Service Type $ Amount Unit Type 2.10a In-Office/Video $120200 Per Hour 2.10b In $120200 Per Hour -Home or Community 2.10c Service with Transportation Provided $120200 Per Hour 2.10d FTM, TDM, Prof. Staffing $120200 Per Hour 2.10e No show $70150 Per No Show 2.10f Mileage rate* $0.50 Per Mile * If applicable — Mileage rate is paid after -25 roundtrip miles. 2.11 Monthly Service Rates each level must be listed): If applicable Service Name with Level Rate Month per Minimum of Service: Hours 2.11a $ 2.11b $ 2.11c $ 2.11d $ 2.11e $ 2.11f $ 2.11g $ Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM 2 11h $ $ $ 2 11i 2 111 2.12 Home Study Providers — List your rates in the box below. 2.13 Monitored Sobriety Providers — List your rates in the box below. 2.14 Additional Comments Bachelors level rate is $120/hr , No Shows $70, Masters level rate isl $200/hr , No Shows $150 Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM Weld County Use Only Service #2: Initial Proposal Determination: If Applicable, Select One Date: Reason for follow up or negotiation: List specific item(s) needing follow up or discussion Changes approved to proposal. List specific item(s) that were changed Changes approved by: Name of Authonzed Representative for Bidder Date. Method changes were approved: If Applicable, Select One Final Proposal Determination: Select One Date' Comments: Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM Service #3 Service Name: Parent Coaching Scope of Work Please Note: If the service is a monthly package, different levels should be indicated. All monthly packages must state a specific minimum number of direct service hours. (Please address each line item below using bulleted points) 3.01 Modalities, curriculum, tools used in delivery of service (DO NOT list company history): Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Parent Coaching — include therapeutic and frequent intervention, education, modeling, and feedback. Utilizes a structured parent education curriculum to foster bonding/attachment, teach appropriate discipline, develop empathy, provide education on developmental stages, and communicate safe and healthy parenting techniques. Specific criteria utilized to measure parenting education progress. ii. Child -welfare -specific concerns such as coping with past abuse/neglect and loss/grief are addressed. iii. When applicable, services are tailored for individuals with limited cognitive abilities. Curriculum is developed to meet the individual needs of the parent(s) and utilizes modeling, repetition, and specific teaching techniques/methods to help clients develop skills to mastery to alleviate current and future child protection concerns. iv. Services are tailored to clients' current levels of functioning and enable clients to build upon their current skill set. v. Parent coaches may be Bachelors- and Masters -level who can utilize various therapeutic techniques such as: cognitive behavioral therapy, behavioral, and trauma -focused Cognitive Behavioral Therapy (CBT), Applied Behavior Analysis (ABA) therapy, and dialectical behavioral therapy to further skill development. Many individuals who experience cognitive and/or developmental issues have difficulty with learning, which impedes the skill development process from both a cognitive standpoint but also an emotional one, as learning has always been difficult for that individual. Our approach is to not only address the practical skill development but also emotional skills in order to remove barriers to learning and help provide supports for success in the home. Therapist level is determined by need of client. 3.02 Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: One (1) or two (2) times per week, depending on the needs of the client. Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM 3.03 Anticipated duration of service (i.e. 3-4 months): Service may range from three (3) months to two (2) years, typically it is more short-term. 3.04 Three (3), or more, specific goals of the service (DO use bullet points): - Align treatment goals with goals identified in the FSP. - Address specific child -welfare concerns through intervention, parent education, modeling, and feedback to deal with past abuse/neglect and loss/grief, reestablish parent/child connection after lengthy separations, repair bonding, address dysfunctional dynamics including parentification of child(ren), and address inappropriate and/or unsafe behaviors. Specific physical and/or sexual abuse and/or substance abuse concerns will also be addressed. - Foster safe and age -appropriate parent/child interactions. - Strengthen family bonding and promote nurturing interactions. - Engage families with outcome -based treatment modalities with proven efficacy. - Maintain frequent and thorough communication with Child Welfare Social Case Workers and provide written reporting on at least a monthly basis. - In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. 3.05 Three (3), or more, specific outcomes of service: 1. Client(s) have improved ability to regulate emotions. 2. Client(s) are better able to meet treatment goals. 3. Increased safety and welfare of children by working with parents to understand what is best for and act in the long-term interest of their child(ren). 4. Improved individual and/or family functioning to maintain the welfare of clients. 5. Specific learning needs of the client(s) are met, as well as their emotional needs. 3.06 Target population of the service, including age and gender: i. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits. 3.07 Languages service is available in (please list proficiency and if interpreter services are available): Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM English. Interpreters may also be utilized. 3.08 Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: This service is Medicaid eligible. 3.09 Service location — list where the service will take place (i.e. client's home, in -office, other): i. Video. ii. In -Home. iii. In Community within Weld County. iv. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South MCCaslin Boulevard, Suite 200 in Louisville. 3. 14001 East Riff Avenue, Suite 204 in Aurora. Rates Please Note: All rates need to include overhead and administrative work (i.e., scheduling or report writing). All rates should be per hour unless service is for evaluations/assessments, Home Studies, or Monitored Sobriety. • For hourly Service rates please complete section 3.10 • For monthly Service rates please complete section 3.11 • For Home Study Providers please complete section 3.12 • For monitored Sobriety Providers please complete section 3.13 3.10 Hourly Service Rates: Service #3 Service Type $ Amount Unit Type 3.10a In-Office/Video $120200 Per Hour 3.10b Community $120200 Per Hour In -Home or 3.10c Service with Transportation Provided $120200 Per Hour 3.10d FTM, TDM, Prof. Staffing $120200 Per Hour 3.10e No show $70150 Per No Show 3.10f Mileage rate'` $0.50 Per Mile * If applicable — Mileage rate is paid after (25) roundtrip miles. 3.11 Monthlv Service Rates each level must be listed): If applicable Service Name with Level Rate Month per Minimum of Service: Hours 3.11a $ 3.11b $ Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM 3 11c $ 3 11d $ 311e $ 311f $ 311g $ 311h $ 311i $ 311j $ 3.12 Home Study Providers — List your rates in the box below. 3.13 Monitored Sobriety Providers — List your rates in the box below. 3.14 Additional Comments: ' Bachelors level rate is $120/hr , No Shows $70, Masters level rate isl $200/hr , No Shows $150 Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM Weld County Use Only Service #3: Initial Proposal Determination: If Applicable, Select One Date: Reason for follow up or negotiation: List specific item(s) needing follow up or discussion Changes approved'to proposal: List specific item(s) that were changed Changes approved by. Name of Authonzed Representative for Bidder Date' Method changes were approved: If Applicable, Select One Final Proposal Determination: Select One Date Comments: Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM Service #4 Service Name: Supervised Family Time Scope of Work Please Note: If the service is a monthly package, different levels should be indicated. All monthly packages must state a specific minimum number of direct service hours. (Please address each line item below using bulleted points) 4.01 Modalities, curriculum, tools used in delivery of service (DO NOT list company history): Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: a. Supervised Family Time - active interventions, education, and coaching to promote positive behavioral change in parent/child relationships. Appropriate parent -child interactions are modeled, and feedback is provided to parents after each visit. Our approach is to not only address the practical skill development but also emotional skills in order to remove barriers to learning and help provide supports for success in the home. This is a Bachelors -level service. ii. Child -welfare -specific concerns such as coping with past abuse/neglect and loss/grief are addressed. iii. When applicable, services are tailored for individuals with limited cognitive abilities. Curriculum is developed to meet the individual needs of the parent(s) and utilizes modeling, repetition, and specific teaching techniques/methods to help clients develop skills to mastery to alleviate current and future child protection concerns. iv. Services are tailored to clients' current levels of functioning and enable clients to build upon their current skill set. b. Therapeutic Supervised Family Time - active interventions, education, and coaching to promote positive behavioral change in parent/child relationships. Appropriate parent -child interactions are modeled, and feedback is provided to parents after each visit. i. Therapists will focus on utilizing various therapeutic techniques such as: cognitive behavioral therapy, behavioral, and trauma -focused Cognitive Behavioral Therapy (CBT), Applied Behavior Analysis (ABA) therapy, and dialectical behavioral therapy to further skill development. Many individuals who experience cognitive and/or developmental issues have difficulty with learning, which impedes the skill development process from both a cognitive standpoint but also an emotional one, as learning has always been difficult for that individual. Our approach is to not only address the practical skill development but also emotional skills in order to remove barriers to learning and help provide supports for success in the home. This is a Master -level service. Level of of therapist is determined based on need of client. 4.02 Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: One (1) or two (2) times per week, depending on the needs of the client. Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM 4.03 Anticipated duration of service (i.e. 3-4 months). Service may range from three (3) months to two (2) years, typically it is more short-term 4.04 Three (3), or more, specific goals of the service (DO use bullet points): - Align treatment goals with goals identified in the FSP - Address specific child -welfare concerns through intervention, parent education, modeling, and feedback to deal with past abuse/neglect and loss/grief, reestablish parent/child connection after lengthy separations, repair bonding, address dysfunctional dynamics including parentification of child(ren), and address inappropriate and/or unsafe behaviors Specific physical and/or sexual abuse and/or substance abuse concern's will also be addressed - Foster safe and age -appropriate parent/child interactions - Strengthen family bonding and promote nurturing interactions - Engage families with outcome -based treatment modalities with proven efficacy - Maintain frequent and thorough communication with Child Welfare Social Case Workers and provide written reporting on at least a monthly basis - In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible 4.05 Three (3), or more, specific outcomes of service: 1 Client(s) have improved ability to regulate emotions 2 Client(s) are better able to meet treatment goals 3 Increased safety and welfare of children by working with parents to understand what is best for and act in the long-term interest of their children) 4 Improved individual and/or family functioning to maintain the welfare of clients 5 Specific learning needs of the client(s) are met, as well as their emotional needs 4.06 Target population of the service, including age and gender i Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders ii Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM 4.07 Languages service is available in (please list proficiency and if interpreter services are available): English. Interpreters may also be utilized. 4.08 Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Tr is service is Medicaid eligible. 4.09 Service location — list where the service will take place (i.e. client's home, in -office, other): i. Video. ii. In -Home. iii. 11 Community within Weld County. iv. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South McCaslin Boulevard, Suite 200 in Louisville. 3. 14001 East Iliff Avenue, Suite 204 in Aurora. Rates Please Note: All rates need to include overhead and administrative work (i.e., scheduling or report writing). All rates should be per hour unless service is for evaluations/assessments, Home Studies, or Monitored Sobriety. • For hourly Service rates please complete section 4.10 • For monthly Service rates please complete section 4.11 • For Home Study Providers please complete section 4.12 • For monitored Sobriety Providers please complete section 4.13 4.10 Hourlv Service Rates: Service #4 Service Type $ Amount Unit Type 4.10a In-Office/Video $150200 Per Hour 4.10b In -Home or Community $150200 Per Hour 4.10c $150200 Per Hour Service with Transportation Provided 4.10d FTM, TDM, Prof. Staffing $150200 Per Hour 4.10e No show $70150 Per No Show 4.10f Mileage rate* $0.50 Per Mile * I- applicable — Mileage rate is paid after 25 roundtrip miles. 4.11 Monthly Service Rates (each level must be listed): If applicable Service Name with Level Rate Month per Minimum of Service: Hours 4.11a $ Revised 12/3/2024 ADA ATTACHMENT 2 BAD FORM 4 11b $ 4 11c $ 411d $ 411e $ 411f $ 411g $ 4 11h $ 4 11i $ 411i $ 4.12 Horne Study Providers — List your rates in the box below. 4 13 Monitored Sobriety Providers — List your rates m the box below. 4.14 Additional Comments Bachelors level rate is $120/hr , No Shows $70, Masters level rate isl $200/hr , No Shows $150 Revised 12/3/2024 ADA ATTACHMENT 2 BI® FORM Weld County Use Only Service #4. Initial Proposal Determination: If Applicable, Select One Date: Reason for follow up or negotiation: List specific item(s) needing follow up or discussion Changes approved to proposal: List specific item(s) that were changed Changes approved by. Name of Authorized Representative for Bidder Date. Method changes were approved: If Applicable, Select One Final Proposal Determination: Select One Date Comments: Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM Please complete the following: Number of services offered on this Attachment 2 (max 5): 5 You may complete another Attachment 2 if you have more than 5 services. Service #3 Service Name: Counseling/Psychotherapy Scope of Work Please Note: If the service is a monthly package, different levels should be indicated. All monthly packages must state a specific minimum number of direct service hours. (Please address each line item below using bulleted points) 3.01 Modalities, curriculum, tools used in delivery of service (DO NOT list company history): Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Child -welfare -specific concerns such as coping with past abuse/neglect and loss/grief are addressed. ii. Evidence -based services provided by contractor's service team include: multi -systemic therapy, cognitive behavioral therapy and trauma- focused Cognitive Behavioral Therapy (CBT), Applied Behavior Analysis (ABA), therapeutic family time services, Dialectical Behavioral Therapy, Eye Movement Desensitization and Reprocessing (EMDR), Sensory Integration, psychological and cognitive evaluations, and family therapy. iii. When applicable, services are tailored for individuals with limited cognitive abilities. iv. Behavioral Services/Coaching are also available, which can include assessment, evaluation, counseling, coaching, consultation, and line services to individuals, as well as coaching and consultation for family members and other professionals supporting them. Trauma -Based Relational Intervention (TBRI) coaching is also available to family members. 3.02 Anticipated frequency of direct service time with the clientlfamily per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: One (1) or two (2) times per week, depending on the needs of the client. 3.03 Anticipated duration of service (i.e. 3-4 months): Service may range from three (3) months to two (2) years, typically it is more short-term. 3.04 Three (3), or more, specific goals of the service (DO use bullet points): - Align treatment goals with goals identified in the FSP. - Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM - Engage families with outcome -based treatment modalities with proven efficacy - Maintain frequent and thorough communication with Child Welfare Social Case Workers and provide wntten reporting on at least a monthly basis - In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible 3.05 Three (3), or more, specific outcomes of service: 1 Client(s) have improved ability to regulate emotions 2 Client(s) are better able to meet treatment goals 3 Increased safety and welfare of children by working with parents to understand what is best for and act in the long-term interest of their children) 4 Improved individual and/or family functioning to maintain the welfare of clients 3.06 Target population of the service, including age and gender: i , Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism; and comorbid mental health and/or substance abuse disorders ii Contractor is committed to inclusivity and has a history of working with individuals regardless of age,, gender, or other characteristics/traits 3.07 Languages service is available in (please list proficiency and if interpreter services are available). English Interpreters may also be utilized 3.08 Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: This service is Medicaid eligible 3.09 Service location — list where the service will take place (i.e. client's home, in -office, other): i Video ii In -Home ui In Community within Weld County iv In any of Contractor's offices, which include 1 1597 Cole Boulevard, Suite 250 in Lakewood 2 357 South McCaslin Boulevard, Suite 200 in Louisville 3 14001 East lliff Avenue, Suite 204 in Aurora Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM Rates Please Note: All rates need to include overhead and administrative work (i.e., scheduling or report writing). All rates should be per hour unless service is for evaluations/assessments, Home Studies, or Monitored Sobriety. • For hourly Service rates please complete section 3.10 • For monthly Service rates please complete section 3.11 • For Home Study Providers please complete section 3.12 • For monitored Sobriety Providers please complete section 3.13 3.10 3.11 Service #3 Service Type $ Amount Unit Type 3.10a In-Office/Video $200 Per Hour 3.10b In -Home or Community $250 Per Hour 3.10c Service with Transportation Provided $200 Per Hour 3.10d $250 Per Hour FTM, TDM, Prof. Staffing 3.10e No show $200 Per No Show 3.10f Mileage rate* $0.50 Per Mile " If applicable — Mileage rate is paid after (25) roundtrip miles. Service Name with Level Rate Month per Minimum of Service: Hours $ 3.11a $ 3.11b $ 3.11c $ 3.11d $ 3.11e $ 3.11f $ 3.11g $ 3.11h $ 3.111 $ 3.11j 3.12 Home Study Providers - List your rates in the box below. 3.13 Monitored Sobriety Providers - List your rates in the box below. 3.14 Additional Comments: Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM Weld County Use Only Service #3. Initial Proposal Determination: ,If Applicable, Select One Date: Reason for follow up or negotiation: List specific item(s) needing follow up or discussion Changes approved to proposal: List specific item(s) that were changed Changes approved by: Name of Authonzed Representative for Bidder Date' Method changes were approved: If Applicable, Select One Final Proposal Determination: Select One Date. Comments: Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM Service #4 Service Name: Consultation Scope of Work Please Note: If the service is a monthly package, different levels should be indicated. All monthly packages must state a specific minimum number of direct service hours. (Please address each line item below using bulleted points) 4.01 Modalities, curriculum, tools used in delivery of service (DO NOT list company history): Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Working with child welfare clients and/or caseworkers and department personnel to address cognitive, mental health, and/or developmental issues. ii. Providing support to clients and/or caseworkers to address issues identified by psychological evaluations and to ensure progress on recommendations made in the evaluations. iii. Can be provided remotely, in -person, and/or at FSP meetings. iv. Expert -level court testimony can also be provided. 4.02 Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Frequency is case dependent. 4.03 Anticipated duration of service (i.e. 3-4 months): Duration is case dependent. 4.04 Three (3), or more, specific goals of the service (DO use bullet points): 1. Support caseworkers and clients to meet the treatment goals outlined in the FSP. 2. Address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. 3. Engage families with outcome -based treatment modalities with proven efficacy. 4. Maintain frequent and thorough communication with Child Welfare Social Case Workers and provide written reporting on at least a monthly basis. 5. In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM 4.05 Three (3), or more, specific outcomes of service: 1. Caseworkers are supported in addressing treatment recommendations. 2. Client(s) have improved ability to regulate emotions. 3. Client(s) are better able to meet treatment goals. 4. Increased safety and welfare of children by working with parents to understand what is best for and act in the long-term interest of their child(ren). 5. Improved individual and/or family functioning to maintain the welfare of clients. 4.06 Target population of the service, including age and gender: i. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. ii. Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits. 4.07 Languages service is available in (please list proficiency and if interpreter services are available): English. Interpreters may also be utilized. 4.08 Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: This service may be Medicaid eligible, dependent on type of consultation (not usual). 4.09 Service location — list where the service will take place (i.e. client's home, in -office, other): i. Video. ii. In -Home. iii. In Community within Weld County. iv. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South McCaslin Boulevard, Suite 200 in Louisville. 3. 14001 East Iliff Avenue, Suite 204 in Aurora. Rates Please Note: All rates need to include overhead and administrative work (i.e., scheduling or report writing). Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM All rates should be per hour unless service is for evaluations/assessments, Home Studies, or Monitored Sobriety. • For hourly Service rates please complete section 4.10 • For monthly Service rates please complete section 4.11 • For Home Study Providers please complete section 4.12 • For monitored Sobriety Providers please complete section 4.13 4.10 Hourly Service Rates: $ Amount Unit Type Service #4 Service Type 4.10a In-Office/Video $250 Per Hour 4.10b In -Home or Community $250 Per Hour $250 Per Hour 4.10c Service with Transportation Provided 4.10d FTM, TDM, Prof. Staffing $250 Per Hour 4.10e No show $200 Per No Show 4.10f Mileage rate* $0.50 Per Mile * If applicable — Mileage rate is paid after 25 roundtrip miles. 4.11 Monthly Service Rates each level must be listed): If applicable Service Name with Level Rate Month per Minimum of Service: Hours 4.11a $ 4.11b $ 4.11c $ 4.11d $ 4.11e $ 4.11f $ 4.118 $ 4.11h $ 4.111 $ 4.11j $ 4.12 Home Study Providers - List your rates in the box below. 4.13 Monitored Sobriety Providers — List your rates in the box below. 4.14 Additional Comments: his is a PhD -level service. Revised 12/3/2024 ADA ATTACH ENT 2 MD FORM Weld County Use Only Service #4• Initial Proposal Determination. If Applicable, Select One Date Reason for follow up or negotiation• List specific item(s) needing follow up or discussion Changes approved to proposal. List specific item(s) that were changed Changes approved by: Name of Authonzed Representative for Bidder Date: Method changes were approved• If Applicable, Select One Final Proposal Determination Select One Date• Comments Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM Service #5 Service Name: Psychological Evaluation Scope of Work Please Note: If the service is a monthly package, different levels should be indicated. All monthly packages must state a specific minimum number of direct service hours. (Please address each line item below using bulleted points) 5.01 Modalities, curriculum, tools used in delivery of service (DO NOT list company history): Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Evaluations include a thorough assessment of mental health concerns, cognitive abilities, and academic skills. ii. Evaluations are tailored specifically to the referral question at hand, including evaluating for developmental issues such as autism spectrum disorder, learning disabilities, attention- deficit/hyperactivity disorder, behavioral concerns (including observations, review of records, identification of target behaviors, and recommendations for behavioral modification), and/or adaptive behavior (to investigate skills/abilities versus current daily performance). iii. If desired, a feedback session to go over the report. This can be useful to minimize any confusion, provide clarification, and/or have an opportunity to ask questions. Meetings can be conducted virtually, by phone, or in -person (based on availability). 5.02 Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: One (1) to four (4) appointments. 5.03 Anticipated duration of service (i.e. 3-4 months): One (1) to two (2) months. 5.04 Three (3), or more, specific goals of the service (DO use bullet points): - To schedule with the client as quickly as possible once the referral is received. - To conduct a thorough evaluation with the client, including addressing all of the referral questions. - To complete the evaluation in a timely manner while making client- specific and thorough recommendations on evidenced treatments with proven efficacy. This might include addressing specific child -welfare concerns such as increasing coping skills to process past abuse/neglect and/or deal with loss/grief. Revised 12/3/2024 ADA ATTACHMENT 2 -BID FQRMM - To maintain frequent and thorough communication with Child Welfare Social Case Workers throughout the evaluation process through written and verbal, communication -' In keeping with the Family First Prevention Seances Act, our, ultimate goal IS to facilitate reuniting families or keeping them intact whenever possible 5.05 Three (3), or more, specific outcomes of service: 1 Client's specific needs for support in meeting treatment goals have been identified, improving the likelihood that treatment goals can be met r 2 Client -specific outcome -based treatment modalities with evidenced efficacy have been recommended , 3 Increased safety and welfare of children by providing recommendations to ensure,parents understand what is best for and act in the long-term interest of their chdd(ren) _4 Improved individual and/or family functioning to maintain the welfare of clients' 5.06 Target population of the service,including age and gender 1 Individuals with intellectual/developmental disabilities including genetic disorders, J -developmental'disorders including'autism, and comorbid mental health and/or substance _ abuse disorders 2 Contractor is committed to inclusivity and has a history of working with individuals `regardless of age, gender, or other charactenstics/traits 5.07 Languages service is available in (please list proficiency and if interpreter services are available). English Interpreters may also be utilized 5.08 Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: This service is typically Medicaid eligible, however, specifics about the reason for referral may deem the evaluation Medicaid ineligible and follow-uo will occur as needed 5.09 Service location = hst where the service will take place (i.e: client's home, in -office, other) - i Video µ - 'n In Community within Weld County ui In any of Contractor's offices; which` include 1 1597 Cole Boulevard, Suite 250 in Lakewood 2 357 South McCaslin Boulevard, Suite'200 in Louisville 3 14001 East Iliff Avenue, Suite 204 in Aurora , _Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM Rates Please Note: All rates need to include overhead and administrative work (i.e., scheduling or report writing). All rates should be per hour unless service is for evaluations/assessments, Home Studies, or Monitored Sobriety. • For hourly Service rates please complete section 5.10 • For monthly Service rates please complete section 5.11 • For Home Study Providers please complete section 5.12 • For monitored Sobriety Providers please complete section 5.13 5.10 Hourly Service Rates: Service #5 Service Type $ Amount Unit Type 5.10a In-Office/Video $500 Per Hour 5.10b In -Home or Community $500 Per Hour 5.10c Service with Transportation Provided $500 Per Hour 5.10d FTM, TDM, Prof. Staffing $250 Per Hour 5.10e No show $500 Per No Show 5.10f Mileage rate* $0.50 Per Mile * If applicable — Mileage rate is paid after (25) roundtrip miles. 5.11 Monthly Service Rates each level must be listed): If applicable Service Name with Level Rate Month per Minimum of Service: Hours 5.11a $ 5.11b $ 5.11c $ 5.11d $ 5.11e $ 5.11f $ 5.118 $ 5.11h $ 5.111 $ 5.11j $ 5.12 Home Study Providers - List your rates in the box below. 5.13 Monitored Sobriety Providers - List your rates in the box below. 5.14 Additional Comments: Revised 12/3/2024 ADA ATTACHME!' T2 Bii FORM Weld County Use Only Service #5. Initial Proposal Determination. If Applicable, Select One Date: Reason for follow up or negotiation' List specific item(s) needing follow up or discussion Changes approved to proposal. List specific item(s) that were changed Changes approved by' Name of Authorized Representative for Bidder Date. Method changes were approved: If Applicable, Select One Final Proposal Determination: Select One Date Comments Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM Please complete the following: Number of services offered on this Attachment 2 (max 5): 5 You may complete another Attachment 2 if you have more than 5 services. Service #1 Service Name: Trauma Assessment Scope of Work Please Note: If the service is a monthly package, different levels should be indicated. All monthly packages must state a specific minimum number of direct service hours. (Please address each line item below using bulleted points) 1.01 Modalities, curriculum, tools used in delivery of service (DO NOT list company history): Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Includes psychological and cognitive testing as needed in addition to a full trauma assessment. ii.Recommendations will be geared toward helping the individual understand how trauma affects emotions and behaviors, how the individual can be supported in the appropriate environment, and what interventions will lead to increased resilience, skill development, emotional regulation, and ultimately success for the individual. iii.lf desired, a feedback session to go over the report. This can be useful to minimize any confusion, provide clarification, and/or have an opportunity to ask questions. Meetings can be conducted virtually, by phone, or in -person (based on availability). 1.02 Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: One (1) to four (4) appointments. 1.03 Anticipated duration of service (i.e. 3-4 months): One (1) to two (2) months. 1.04 Three (3), or more, specific goals of the service (DO use bullet points): i. To schedule with the client as quickly as possible once the referral is received. ii. To conduct a thorough trauma assessment with the client, including addressing all of the referral questions. iii. To complete the evaluation in a timely manner while making client- specific and thorough recommendations on validated treatments with evidenced efficacy. This might include addressing specific child -welfare concerns such as increasing coping skills to process past abuse/neglect and/or deal with loss/grief. Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM iv. To help the client understand how trauma affects emotions and behaviors. v. To identify how the individual can best be supported in the appropriate environment. vi. To identify what interventions will lead to increased resilience, skill development, emotional regulation, and ultimately individual and family success. vii. To maintain frequent and thorough communication with Child Welfare Social Case Workers throughout the evaluation process through written and verbal communication. viii. In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. 1.05 Three (3), or more, specific outcomes of service: i. Specific trauma -focused evidenced -based interventions with evidenced efficacy have been identified in recommendations to meet the client's specific needs. ii. Increased safety and welfare of children by providing recommendations to ensure parents understand what is best for and act in the long-term interest of their child(ren). Improved individual and/or family functioning to maintain the welfare of clients. 1.06 Target population of the service, including age and gender: 1. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. 2. Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits. 1.07 Languages service is available in (please list proficiency and if interpreter services are available): English. Interpreters may also be utilized. 1.08 Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: This service is not Medicaid eligible. 1.09 Service location — list where the service will take place (i.e. client's home, in -office, other): i. In -Home. ii. In Community within Weld County. iii. Video. Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM iv. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South McCaslin Boulevard, Suite 200 in Louisville. 3. 14001 East Iliff Avenue, Suite 204 in Aurora. Rates Please Note: All rates need to include overhead and administrative work (i.e., scheduling or report writing). All rates should be per hour unless service is for evaluations/assessments, Home Studies, or Monitored Sobriety. • For hourly Service rates please complete section 1.10 • For monthly Service rates please complete section 1.11 • For Home Study Providers please complete section 1.12 • For monitored Sobriety Providers please complete section 1.13 1.10 Hourlv Service Rates: Service #1 Service Type $ Amount Unit Type 1.10a In-Office/Video $500 Per Hour 1.10b Community $500 Hour Per In -Home or 1.10c Service with Transportation Provided $500 Hour Per 1.10d $250 FTM, TDM, Prof. Staffing Per Hour 1.10e No show $500 Per No Show 1.10f Mileage rate* $0.50 Per Mile * If applicable — Mileage rate is paid after 25 roundtrip miles. 1.11 Monthly Service Rates each level must be listed): If applicable Service Name with Level Rate Month per Minimum of Service: Hours 1.11a $ 1.11b $ 1.11c $ 1.11d $ 1.11e $ 1.11f $ 1.11g $ 1.11h $ 1.111 $ 1.11j $ 1.12 Home Study Providers - List your rates in the box below. Revised 12/3/2024 ADA BID FORM 1.13 Monitored Sobriety Providers — List your rates in the box below.` 1.14: Additional Comments: 4 t ,..-- Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM Weld County Use Only Service #1: Initial Proposal Determination: If Applicable, Select One Date: Reason for follow up or negotiation: List specific item(s) needing follow up or discussion Changes approved to proposal: List specific item(s) that were changed Changes approved by: Name of Authorized Representative for Bidder Date: Method changes were approved: If Applicable, Select One Final Proposal Determination: Select One Date: Comments: Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM Service #2 Service Name: Parent -Child Interactional (PCI) Evaluation Scope of Work Please Note: If the service is a monthly package, different levels should be indicated. All monthly packages must state a specific minimum number of direct service hours. (Please address each line item below using bulleted points) 2.01 Modalities, curriculum, tools used in delivery of service (DO NOT fist company history): Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Interviews with parents and other collateral sources. 2.02 Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: One (1) or two (2) observational appointments. 2.03 Anticipated duration of service (i.e. 3-4 months): One (1) to two (2) months. 2.04 Three (3), or more, specific goals of the service (DO use bullet points): i. To schedule with the client as quickly as possible once the referral is received. ii. To conduct a thorough observation(s) of the family members, with special focus on referral questions. iii. To complete the observation(s) and recommendations in a timely manner. iv. To identify strengths and weaknesses in parenting. v. To identify next steps in treatment to inform treatment plans. vi. To identify how the family can best be supported in the appropriate environment. vii. To identify what interventions will lead to increased resilience, skill development, emotional regulation, and ultimately individual and family success. viii. To address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. x. To maintain frequent and thorough communication with Child Welfare Social Case Workers throughout the evaluation process and to provide written reporting on at least a monthly basis xi. In keeping with the Family First Prevention Services Act, our ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. 2.05 Three (3), or more, specific outcomes of service: i. Parenting strengths and weaknesses have been identified and articulated. ii. Next steps in treatment plan goals have been identified. Revised ' 2/3/2024 ADA ATTACHMENT 2 BID FORM iii. Interventions have been identified to improve individual and family functioning. iv. Family preservation/reunification has been facilitated whenever possible. 2.06 Target population of the service, including age and gender: 1. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. 2. Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits. 2.07 Languages service is available in (please list proficiency and if interpreter services are available): English. Interpreters may also be utilized. 2.08 Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: This service is not Medicaid eligible. 2.09 Service location — list where the service will take place (i.e. client's home, in -office, other): i. Video. ii. In -Home. iii. In Community within Weld County. iv. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South McCaslin Boulevard, Suite 200 in Louisville. 3. 14001 East Iliff Avenue, Suite 204 in Aurora. Rates Please Note: All rates need to include overhead and administrative work (i.e., scheduling or report writing). All rates should be per hour unless service is for evaluations/assessments, Home Studies, or Monitored Sobriety. • For hourly Service rates please complete section 2.10 • For monthly Service rates please complete section 2.11 • For Home Study Providers please complete section 2.12 • For monitored Sobriety Providers please complete section 2.13 2.10 Hourly Service Rates: Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM Service #2 Service Type $ Amount Unit Type 2.10a In -Off ce/Video $500 Per Hour 2.10b In -Home or Community $500 Hour Per 2.10c Service with Transportation Provided $500 Hour Per 2.10d FTM, TDM, Prof. Staffing $250 Per Hour 2.10e No show $500 Per No Show 2.10f Mileage rate"` $0.50 Per Mile * If applicable — Mileage rate is paid after -25 roundtrip miles. 2.11 Monthly Service Rates each level must be listed If applicable Service Name with Level Rate Month per Minimum of Service: Hours 2.11a $ 2.11b $ 2.11c $ 2.11d $ 2.11e $ 2.11f $ 2.11g $ 2.11h $ 2.111 $ 2.11j $ 2.12 Home Study Providers - List your rates in the box below. 2.13 Monitored Sobriety Providers - List your rates in the box below. 2.14 Additional Comments: Revised 12/3/2024 ADA DID FOR Weld County Use Only Service #2• Initial Proposal Determination. If Applicable, Select One Date: Reason for follow up or negotiation• List specific item(s) needing follow up or discussion Changes approved to proposal List specific item(s) that were changed Changes approved by Name of Authonzed Representative for Bidder Date. Method changes were approved: If Applicable, Select One Final Proposal Determination• Select One Date. Comments: Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM Service #5 Service Name: Substance Abuse Therapeutic Services Scope of Work Please Note: If the service is a monthly package, different levels should be indicated. All monthly packages must state a specific minimum number of direct service hours. (Please address each line item below using bulleted„points) 5.01 Modalities, curriculum, tools used in delivery of service (DO NOT list company history): Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Contractor's clinical team includes a Licensed Addiction Counselor (LAC). Contractor is able to provide the following substance abuse treatment services to improve family functioning and support future sobriety and, ultimately, work towards preserving or reuniting the family whenever possible: 1. Individual and family therapeutic services. 2. Consultation to aid in Family Service Plan (FSP) development. 3. Provision of psycho -educational information for those impacted by substance abuse. 5.02 Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: One (1) or two (2) times per week, depending on the needs of the client. 5.03 Anticipated duration of service (i.e. 3-4 months): i. Duration can span three (3) months to two (2) years. ii. Contractor is committed to accomplishing treatment goals within court- mandated timeframes. 5.04 Three (3), or more, specific goals of the service (DO use bullet points): i. To provide therapeutic interventions specific to reducing substance abuse and treating underlying issues. ii. To assist in crafting a Family Service Plan that addresses the substance abuse issues at hand. To improve family functioning and relationships by addressing substance abuse issues. iv. To prevent further substance abuse. v. To support team members at meetings by offering expert -level guidance into treatment planning, safety planning, and next steps. vi. To provide education to team members and clients regarding substance abuse specific concerns 5.05 Three (3), or more, specific outcomes of service: Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM i. Assistance is provided in outlining substance -abuse -specific treatment goals. ii. Therapy and education are provided to prevent further substance abuse and its negative impacts on the family. iii. Client(s) are better able to meet treatment goals. iv. Family functioning is improved. v. Safety of family members is improved. 5.06 Target population of the service, including age and gender: 1. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. 2. Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits. 5.07 Languages service is available in (please list proficiency and if interpreter services are available): English. Interpreters may also be utilized. 5.08 Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: This service is Medicaid eligible. 5.09 Service location — list where the service will take place (i.e. client's home, in -office, other): i. Video. ii. In Community within Weld County. iii. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South McCaslin Boulevard, Suite 200 in Louisville. 3. 14001 East lliff Avenue, Suite 204 in Aurora. Rates Please Note: All rates need to include overhead and administrative work (i.e., scheduling or report writing). All rates should be per hour unless service is for evaluations/assessments, Home Studies, or Monitored Sobriety. • For hourly Service rates please complete section 5.10 • For monthly Service rates please complete section 5.11 Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM • For Home Study Providers please complete section 5.12 • For monitored Sobriety Providers please complete section 5.13 5.10 Hourlv Service Rates: Service #5 Service Type $ Amount Unit Type 5.10a In-Office/Video $200 Per Hour 5.10b Community $200 Per Hour In -Home or 5.10c Service with Transportation Provided $200 Per Hour 5.10d FTM, TDM, Prof. Staffing $200 Per Hour 5.10e No show $150 Per No Show 5.10f Mileage rate* $0.50 Per Mile * If applicable — Mileage rate is paid after (25) roundtrip miles. 5.11 Monthly Service Rates each level must be listed): If applicable Service Name with Level Rate Month per Minimum of Service: Hours 5.11a _ , $ 5.11b $ 5.11c $ 5.11d $ 5.11e $ 5.11f $ 5.119 $ 5.11h $ 5.111 $ 5.11j $ 5.12 Home Study Providers - List your rates in the box below. 5.13 Monitored Sobriety Providers - List your rates in the box below. 5.14 Additional Comments: Revised 12/3/2024 ADA ATTACHMENT 2 =sID FORM Weld County Use Only Service #5 Initial Proposal Determination. If Applicable, Select One Date. Reason for follow up or negotiation: List specific item(s) needing follow up or discussion Changes approved to proposal. List specific item(s) that were changed Changes approved by• Name of Authorized Representative for Bidder Date' Method changes were approved: If Applicable, Select One Final Proposal Determination. Select One Date Comments. Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM Please complete the following: Number of services offered on this Attachment 2 (max 5): 2 You may complete another Attachment 2 if you have more than 5 services. Service #1 Service Name: Sexual Abuse Therapeutic Services Scope of Work Please Note: If the service is a monthly package, different levels should be indicated. All monthly packages must state a specific minimum number of direct service hours. (Please address each line item below using bulleted points) 1.01 Modalities, curriculum, tools used in delivery of service (DO NOT list company history): Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Contractor's clinical team includes a Master's level Sex Offender Management Board (SOMB) therapist who has extensive experience working with SOMB standards, treating sexual abuse victims, and working with sexually abusive individuals. Therefore, Contractor is able to provide the following sex -offense -specific therapy and consultation services: 1. Therapeutic Sexual Abuse services. 2. Offense -Specific Treatment for Sexual Offenders. 3. Informed Supervision Training for Caregivers. 4. Attending Multi -Disciplinary Team meetings to provide consultation, guidance, and support, and to assist in safety planning and development of next steps. 6. Providing psycho -educational information for those impacted by sexual abuse, including for education for parents on clarification/reunification, informed supervision, family therapy, and safety planning. 1.02 Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: One or two times per week, depending on the needs of the client. 1.03 Anticipated duration of service (i.e. 3-4 months): i. Duration can span three (3) months to two (2) years. ii. Contractor is committed to accomplishing treatment goals within court- mandated timeframes. 1.04 Three (3), or more, specific goals of the service (DO use bullet points): Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM i. To provide therapeutic interventions specific to behaviors related to sexual abuse victimization, sexual dysfunction, and sexual abuse perpetration. ii. To prevent further sexual abuse and victimization. iii. To support multidisciplinary team members at meetings by offering expert -level guidance into treatment planning, safety planning, and next steps. iv. To provide education to team members and clients regarding sexual abuse specific concerns, including clarification, reunification, family therapy, informed supervision, boundary establishment, safety planning. 1.05 Three (3), or more, specific outcomes of service: I. Assistance is provided in outlining sex -offense -specific treatment goals. ii. Therapy and education are provided to decrease problem behaviors and avoid abuse and victimization. iii. Clients) are better able to meet treatment goals. 1.06 Target population of the service, including age and gender: 1. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. 2. Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits. 1.07 Languages service is available in (please list proficiency and if interpreter services are available): English. Interpreters may also be utilized. 1.08 Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: This service is Medicaid eligible. 1.09 Service location — list where the service will take place (i.e. client's home, in -office, other): i.In-Home. ii. In Community within Weld County. iii. Video. iv. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South McCaslin Boulevard, Suite 200 in Louisville. Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM 3. 14001 East Iliff Avenue, Suite 204 in Aurora. Rates Please Note: All rates need to include overhead and administrative work (i.e., scheduling or report writing). All rates should be per hour unless service is for evaluations/assessments, Home Studies, or Monitored Sobriety. • For hourly Service rates please complete section 1.10 • For monthly Service rates please complete section 1.11 • For Home Study Providers please complete section 1.12 • For monitored Sobriety Providers please complete section 1.13 1.10 Hourlv Service Rates: Service #1 Service Type $ Amount Unit Type 1.10a In-Office/Video $200 Per Hour 1.10b In Community $200 Per Hour -Home or 1.10c Service with Transportation Provided $200 Per Hour 1.10d FTM, TDM, Prof. Staffing $200 Per Hour 1.10e No show $150 Per No Show 1.10f Mileage rate* $0.50 Per Mile * If applicable — Mileage rate is paid after 25 roundtrip miles. 1.11 Monthly Service Rates each level must be listed): If applicable Service Name with Level Rate Month per Minimum of Service: Hours 1.11a $ 1.11b $ 1.11c $ 1.11d $ 1.11e $ 1.11f $ 1.11g $ 1.11h $ 1.111 $ 1.11j $ 1.12 Home Study Providers - List your rates in the box below. 1.13 Monitored Sobriety Providers - List your rates in the box below. 1.14 Additional Comments: Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM Weld County Use Only Service #1 Initial Proposal Determination. If Applicable, Select One Date. Reason for follow up or negotiation' List specific item(s) needing follow up or discussion Changes approved to proposal. List specific item(s) that were changed Changes approved by• Name of Authorized Representative for Bidder Date Method changes were approved: If Applicable, Select One Final Proposal Determination• Select One Date Comments Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM Service #2. Service Name: Psychosexual Evaluations/Sex-Offender-Specific Evaluation Scope of Work Please Note: If the service is a monthly package, different levels should be indicated. All monthly packages must state a specific minimum number of direct service hours. (Please address each line item _below using bulleted points) 2.01 Modalities, curriculum, tools used in delivery of service (DO NOT list company history): Contractor will utilize the following modalities, curriculum, and tools in the delivery of services ur der this agreement: i. Thorough psychosexual evaluations/sex-offender-specific evaluation completed by a Master's level SOMB therapist. A PhD level clinician may provided support with additional measures or testing, if needed (dependent on client). 2.02 Anticipated frequency of direct service time with the client/family per week, not in :luding professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: One (1) to four (4) appointments.. 2.03 Anticipated duration of service (i.e. 3-4 months): One (1) to two (2) months. 2.04 Three (3), or more, specific goals of the service (DO use bullet points): i. To schedule with the client as quickly as possible once the referral is received. ii. To conduct a thorough evaluation with the client, including addressing all of the referral questions. To complete the evaluation in a timely manner while making client- specific and thorough recommendations on validated treatments with proven efficacy. iv. To determine issues and behaviors related to sexual abuse, dysfunction, and perpetration. v. To determine whether co-occurring conditions exist. vi. To develop thorough evidence -based treatment plan recommendations to assist with treatment, including addressing safety needs and needs for family therapy. vii. To prevent further sexual abuse victimization. viii. To address specific child -welfare concerns such as increasing coping skills to deal with past abuse/neglect and loss/grief. ix. To maintain frequent and thorough communication with Child Welfare Social Case Workers throughout the evaluation process and to provide written reporting on at least a monthly basis. x. In keeping with the Family First Prevention Services Act, Contractor's ultimate goal is to facilitate reuniting families or keeping them intact whenever possible. Revised ' 2/3/2024 ADA ATTACHMENT 2 BID FORM 2.05 Three (3), or more, specific outcomes of service: i. Client's specific needs for support in meeting treatment goals have been identified, improving the likelihood that treatment goals can be met. ii. Client -specific outcome -based treatment modalities with proven efficacy have been recommended. iii. Increased safety and welfare of children by providing recommendations to ensure parents understand what is best for and act in the long-term interest of their child(ren). iv. Improved individual and/or family functioning to maintain the welfare of clients. v. Team members are supported in the development of safety planning and FSP g owls 2.06 Target population of the service, including age and gender: 1. Individuals with intellectual/developmental disabilities including genetic disorders, developmental disorders including autism, and comorbid mental health and/or substance abuse disorders. 2. Contractor is committed to inclusivity and has a history of working with individuals regardless of age, gender, or other characteristics/traits. 2.07 Languages service is available in (please list proficiency and if interpreter services are available): English. Interpreters may also be utilized. 2.08 Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: This service is not Medicaid eligible. 2.09 Service location — list where the service will take place (i.e. client's home, in -office, other): i. Video. ii. In -Home. iii. In Community within Weld County. iv. In any of Contractor's offices, which include: 1. 1597 Cole Boulevard, Suite 250 in Lakewood. 2. 357 South MCCaslin Boulevard, Suite 200 in Louisville. 3. 14001 East Iliff Avenue, Suite 204 in Aurora. Rates Please Note: All rates need to include overhead and administrative work (i.e., scheduling or report writing). Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM All rates should be per hour unless service is for evaluations/assessments, Home Studies, or Monitored Sobriety. • For hourly Service rates please complete section 2.10 • For monthly Service rates please complete section 2.11 • For Home Study Providers please complete section 2.12 • For monitored Sobriety Providers please complete section 2.13 2.10 Hourlv Service Rates: Service #2 Service Type $ Amount Unit Type 2.10a In-OfficeNideo $200500 Per Hour 2.10b In -Home or Community $200500 Per Hour 2.10c $200500 Service with Transportation Provided Per Hour 2.10d $20O250 FTM, TDM, Prof. Staffing Per Hour 2.10e No show $200500 Per No Show 2.10f Mileage rate* $0.50 Per Mile * I' applicable — Mileage rate is paid after -25 roundtrip miles. 2.11 Monthly Service Rates each level must be listed): If applicable Service Name with Level Rate Month per Minimum of Service: Hours 2.11a $ 2.11b $ 2.11c $ 2.11d $ 2.11e $ 2.11f $ 2.11g $ 2.11h $ 2.111 $ 2.11j $ 2.12 Home Study Providers - List your rates in the box below. 2.13 Monitored Sobriety Providers — List your rates in the box below. 2.14 Additional Comments: The majority of work would be done by a Master -level clinician at the Masters -level rate; however, certain cases may require collaboration with a PhD clinician for parts of the evaluation, which would be billed at the PhD rate for ONLY that time. $200/hr for Masters level clinician and $500/hr for PHD clinician Revised 12/3/2024 ADA ATTACHMENT 2 BID FORM Weld County Use Only Service #2: Initial Proposal Determination: If Applicable, Select One Date: Reason for follow up or negotiation: List specific item(s) needing follow up or discussion Changes approved to proposal: List specific item(s) that were changed Changes approved by: Name of Authorized Representative for Bidder Date: Method changes were approved: If Applicable, Select One Final Proposal Determination: Select One Date: Comments: Revised 12/3/2024 ADA ATTACHMENT 3 WELD COUNTY DEPARTMENT OF HUMAN SERVICES PROVIDER INFORMATION FORM (PIF) Agency Information: As listed on W-9 Agency Name: Parker Personal Care Homes, Inc. Trails Provider ID (if known): 1606668 Provider Contact Full Name:Natasha a t a s h a B o s s i o Title: Director of Behavioral Health Primary Phone Number (10 -digit): 303-424-6078 Ext.: 179 Primary Contact Email: nbossio(a�parkerpch.com Agency Location Address (Street, city, state, zip): 1 5 9 7 Cole Blvd Ste 2 5 0 , Lakewood, CO 80401 Agency Mailing Address (Street, city, state, zip): same as above Agency Type: Private for Profit Send Referrals for Service to: Referral Contact Name: Natasha B o s s i o Title: Director of Behavioral Services Referral Phone Number (10 -digit): 303-424-6078 Ext.: 179 Email: nbossio(a�parkerpch.com Billing Contact: Billing Contact Name: An q e la Paola s s o Title: Billing Coordinator Billing Phone Number (10 -digit): 303-424-6078 Ext.: 149 Email: apaolasso(c�parkerpch.com Revised ADA 12/3/2024 ATTACHMENT 4 - STAFF DATA SHEET Bidder Must List All Staff Who Will Administer the Proposed Service(s) BIDDER'S LEGAL NAME (As it appears on the W-9): AGENCY CONTACT: Amelia McKeon Parker Personal Care Homes (PPCH) PHONE NUMBER: 303.424-6078 EMAIL: amckeon@parkerpch.com PROPOSED SERVICE(S): Bossio Previous Legal Last Name (If applicable)` Legal First Name Service Type Licensure/ Credentials Natasha Behavioral/ therapeutic services CSW.09926929, LCSW Switzer Suzanne Evaluations/ psychological services PSY.0006381, PhD CHILD WELFARE INVITATION FOR BID 2025-26 - VARIOUS SERVICES ACOR©® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 6/18/2025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER IMA, Inc. - Colorado 1705 17th Street, Suite 100 Denver CO 80202 NAMEACT IMA Denver Team PHONE FAX a No. E.: 303-534-4567 (A/c, No): %ass: DenAccountTechs@imacorp.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Plnnacol Assurance 41190 INSURED PARKPER-02 Parker Personal Care Homes, Inc. 1597 Cole Blvd #250 Lakewood„ CO 80401 INSURER B : Berkshire Hathaway Specialty Insurance Company 22276 INSURER C: INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 1481561148 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR T`PE OF INSURANCE ADDL SUBR INSD WVD POLICY NUMBER POLICY EFF (lial)YYYY) POLICY EXP (MM/ITDYP YY) LIMITS B X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE EI OCCUR 47SPK25819808 7/31/2024 7/31/2025 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 1,000,000 MED EXP (Any one person) $ 20,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY EPROT LOC JEC OTHER: PRODUCTS - COMP/OP AGG $ 3,000,000 $ B AUTOMOBILE UABILITY _ X ANY AUTO OWNED AUTOS ONLY X HIRED AUTOS ONLY SCHEDULED AUTOS X NON -OWNED AUTOS ONLY 47RWS25819908 7/31/2024 7/31/2025 CONIBINEDSINGLELIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ B X UMBRELLALIAB EXCESS UAB X OCCUR CLAIMS -MADE 47SUM25820008 7/31/2024 7/31/2025 EACH OCCURRENCE $3,000,000 AGGREGATE $ 3,000,000 $ DED I X I RETENTION $ 1, -inn A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PAMEDREEXECUTIVE Y� OFFICER/MEMBEREXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 4007978 12/1/2024 12/1/2025 X I STATUTE I I ERH E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY .IT $ 500,000 B Professional Liabilitylnduding Abuse & Molestation 47SPK25819808 7/31/2024 7/31/2025 Per Occurrence Aggregate $1,000,000 $3,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Cyber/Network Security and Privacy Liability Coverage: Policy #C4LVO185272CYBER2024 Effective Dates: 07/31/24 - 07/31/25 Insurer: Arch Specialty Insurance Company $1,000,000 Per Occurrence; $1,000,000 Aggregate; $10,000 Deductible Crime/Employee Dishonesty Coverage: Policy #47SPK25819807 Effective Dates: 07/31/24 - 07/31/25 Insurer B: See Above $250,000 Limit; $1,000 Deductible See Attached... CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Weld County ACCORDANCE WITH THE POLICY PROVISIONS. 315 N. 11th Avenue, Bldg A GREELEY CO 80631 AUTHORIZED REPRESENTATIVE USA s ACORD 25 (2016/03) @ 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: PARKPER-02 LOC #: ACORO® ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY IMA, Inc. - Colorado POLICY NUMBER CARRIER NAIC CODE NAMED INSURED Parker Personal Care Homes, Inc. 1597 Cole Blvd #250 Lakewood„ CO 80401 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Board of County Commissioners of Weld County and its Officers/Employees is included as Additional Insured on the General and Umbrella Liability Policies if required by written contract or agreement subject to the policy terms and conditions. A Waiver of Subrogation is provided in favor of Additional Insured on the General Liability and Workers Compensation Policies if required by written contract or agreement subject to the policy terms and conditions. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SIGNATURE REQUESTED: Weld/PPC PSA Final Audit Report 2025-06-24 Created: 2025-06-19 By: Windy Luna (wluna@weld.gov) Status: Signed Transaction ID: CBJCHBCAABAA3TRMbb19amRF_K9wwT8tFjY-pmQDDj5V "SIGNATURE REQUESTED: Weld/PPC PSA" History t Document created by Windy Luna (wluna@weld.gov) 2025-06-19 - 3:05:31 PM GMT- IP address: 204.133.39.9 E2. Document emailed to Natasha Bossio (nbossio@parkerpch.com) for signature 2025-06-19 - 3:09:36 PM GMT 5 Email viewed by Natasha Bossio (nbossio@parkerpch.com) 2025-06-19 - 3:42:00 PM GMT- IP address: 76.130.156.9 Oe Document e -signed by Natasha Bossio (nbossio@parkerpch.com) Signature Date: 2025-06-24 - 6:28:45 PM GMT - Time Source: server- IP address: 76.130.156.9 O Agreement completed. 2025-06-24 - 6:28:45 PM GMT Powered by Adobe Acrobat Sign Contract Fo Entity Information Entity Name* Entity ID* PARKER PERSONAL CARE HOMES @00042447 INC (I) New Entity? Contract Name* Contract ID PARKER PERSONAL CARE HOMES INC (NEW PSA 9685 RELATED TO BID #B2500043) Contract Status CTB REVIEW Contract Lead* WLUNA Contract Lead Email wluna@weld.gov;cobbxxl k@weld.gov Parent Contract ID Requires Board Approval YES Department Project # Contract Description* (CONSENT) PARKER PERSONAL CARE HOMES INC (NEW PSA RELATED TO BID #B2500043). TERM: JUNE 1, 2025 THROUGH OCTOBER 31, 2028. Contract Description 2 (CONSENT) TEMPLATE APPROVED ON APRIL 23, 2025. THIS WILL BE A CONSENT ITEM. Contract Type* AGREEMENT Amount* $0.00 Renewable* YES Automatic Renewal Grant IGA Department Requested BOCC Agenda Due Date HUMAN SERVICES Date* 06/28/2025 07/02/2025 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 Will a work session with BOCC be required?* NO Does Contract require Purchasing Dept. to be included? If this is a renewal enter previous Contract ID If this is part of a MSA enter MSA Contract ID Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in OnBase Contract Dates Effective Date Termination Notice Period Contact Information Review Date* 08/31/2028 Renewal Date* 06/01/2026 Committed Delivery Date Expiration Date Contact Info Contact Name Contact Type Contact Email Contact Phone 1 Contact Phone 2 Purchasing Purchasing Approver Purchasing Approved Date Approval Process Department Head Finance Approver Legal Counsel JAMIE ULRICH CHERYL PATTELLI BYR0N HOWELL DH Approved Date Finance Approved Date Legal Counsel Approved Date 06/25/2025 06/25/2025 06/25/2025 Final Approval BOCC Approved Tyler Ref # AG 063025 BOCC Signed Date Originator WLUNA BOCC Agenda Date 06/30/2025 Hello