HomeMy WebLinkAbout20231453.tiffRESOLUTION
RE: APPROVE STANDARD FORM OF AGREEMENT, AND PROVIDER LIST FOR
THERAPEUTIC FOSTER CARE RESPITE SERVICES BETWEEN DEPARTMENT OF
HUMAN SERVICES AND VARIOUS PROVIDERS, AND AUTHORIZE CHAIR TO SIGN
AGREEMENTS CONSISTENT WITH SAID FORM
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board, sitting as the Weld County Board of Human Services, has been
presented with the Standard Form of Agreement and Provider List for Therapeutic Foster Care
Respite Services between the Department of Human Services and various providers, and
WHEREAS, after review, the Board deems it advisable to approve the Standard Form of
said Agreement and Provider List, a copy of which is attached hereto and incorporated herein by
reference, and to delegate standing authority to the Chair of the Board of County Commissioners
to execute individual agreements between the Department of Human Services and various
providers.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County, Colorado, sitting as the Weld County Board of Human Services, that the Standard Form
of Agreement and Provider List for Therapeutic Foster Care Respite Services between the
Department of Human Services and various providers, be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign agreements consistent with said form.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 24th day of May, A.D., 2023.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST: ddrAvio •aC.lsO•6k,
Weld County Clerk to the Board
BY:
APP
Coun y Attorney
Date of signature: O6/O7/23
Mik man, Chair
Per L. Buck ro-Tem
ott K. James
evin D. Ross
Lori Saine
cc'•HSD
06/0q (23
2023-1453
HR0095
PRIVILEGED AND CONFIDENTIAL
MEMORANDUM
DATE: May 16, 2023
TO: Board of County Commissioners — Pass -Around
FR: Jamie Ulrich, Director, Human Services
RE: Child Welfare 2023-24 SFY Therapeutic Respite
Care Provider List and Therapeutic Respite
Agreement Template
Please review and indicate if you would like a work session prior to placing this item on the Board's
agenda.
Request Board Approval of the Department's Child Welfare 2023-24 SFY Therapeutic Respite
Care Provider List and Therapeutic Respite Agreement Template. Below is a list of Providers who
have elected to provide Therapeutic Respite Care services for the term of July 1, 2023 through June 30,
2024. These individuals and couples, who are Weld County Certified Therapeutic foster parents, have
met certification requirements. Therapeutic respite care hours are dependent upon the needs of the foster
parent and the youth placed in the home. Payment for Therapeutic Respite Care will be the state daily
rate or prorated into an hourly rate if respite is less than a full day.
Upon approval by the Board, Therapeutic Respite Agreements will be issued on attached Therapeutic
Respite Agreement templates and processed through CMS.
Provider
Last Name
Fretwell
Berrelez
Provider
First Name
Crystal
Yvette
Co -Provider
Last Name
Fretwell
Berrelez
Co -provider
First Name
Steven
Matthew
City
Greeley
Greeley
I do not recommend a Work Session. I recommend approval of the SFY 2023-24 Therapeutic Respite
Care provider list and Therapeutic Respite Agreement template and authorize the Chair to sign.
Peery Not
fVldv�e tietin0*i
Scott K. James
Kevin Ross
Lori Saine
Approve
Recommendation
ONC--
Schedule
Work Session
Pass -Around Memorandum; May 16, 2023 — Not in CMS
Other/Comments:
Page 1
2023-1453
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5/1L1
AGREEMENT FOR THERAPUTIC FOSTER CARE RESPITE SERVICES
BETWEEN WELD COUNTY
AND (PROVIDER)
THIS AGREEMENT is made and entered into this day of , 2023
by and between the Board of County Commissioners of the County of Weld, State of Colorado,
on behalf of the Weld County Department of Human Services, whose address is 1150 "O" Street,
Greeley, Colorado 80631, hereinafter referred to as "County", and (PROVIDER), whose address
is (ADDRESS) hereinafter referred to as "Contractor."
WITNESSETH:
WHEREAS, required approval, clearance, and coordination have been accomplished
from and with appropriate agencies; and
WHEREAS, County has determined that due to the significant challenges often
experienced by certified therapeutic foster care providers, it is necessary to offer them therapeutic
foster care respite services, as described in Exhibit A, "Scope of Services", a copy of which is
attached hereto and made a part hereof by this reference, to allow them to continue to provide high
quality care for the children in their charge, and
WHEREAS, Contractor is willing and able to abide by the terms and conditions required
by County, as more fully set forth in this Agreement,
WHEREAS, Contractor is able and available to provide therapeutic foster care respite
services as defined in this Agreement at the rates set forth in Exhibit B, "Rate Schedule" a copy of
which is attached hereto and made a part hereof by this reference,
NOW, THEREFORE, in consideration of the mutual promises and covenants contained
herein, the parties hereto agree as follows:
RESPITE CARE PROVIDER'S RIGHTS AND RESPONSIBILITIES:
1. As used in this Agreement "Respite Care" is defined as those childcare services
required by one or more children who are in the care of a certified therapeutic foster
home. Respite Care is provided in order to support the therapeutic foster parents
and allow them to step away from caregiving responsibilities and to take a break.
Respite care is also provided to support the youth in the therapeutic foster homes
to build relationships with other adults and have a support network they can rely
on. These services are described in Exhibit A. These services may also include
transporting the child to school and other appointments previously arranged by the
foster parent. Transportation services are provided at the sole risk,
responsibility and liability of Contractor.
1 Revised 5/2023
Q. Contractor shall provide respite days as approved by the Foster Care Coordinator
and Foster Care Supervisor in order to support the therapeutic foster home and
ensure stability of placement for youth in those homes.
3. 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.
4. Contractor agrees to accept payment by either County warrant or ACH direct
deposit.
5. Contractor agrees to obtain a criminal background check and warrants that if any
previous criminal charge filed against Contractor does not appear in the background
check, he/she shall disclose such charges.
6. Contractor assures that it will fully comply with all applicable Federal and State
laws which govern the ability of the County to comply with the relevant funding
requirements.
7. Contractor assures and certifies as follows:
a. He/She is not presently debarred, suspended, proposed for debarment,
declared ineligible, or voluntarily excluded from participation with any
program with a Federal or State department or agency; and
b. He/She has not, within a three-year period preceding this Agreement, been
convicted of or had a civil judgment rendered against him/her for
commission of fraud or criminal offense in connection with obtaining,
attempting to obtain, or performing a public (Federal, State or Local)
transaction or contract under public transaction; or commission of
embezzlement, theft, forgery, bribery, falsification or destruction of
records, making false statements, or receiving stolen property; and
c. He/She is not presently indicted for or otherwise criminally or civilly
charged by a government entity (federal, state or local) with commission of
any of the offenses enumerated in this certification; and
d. He/She has not, within a three-year period preceding this Agreement, had
one or more public transactions (federal, state, or local) terminated for cause
or default.
8. Contractor certifies that, at the time of entering into this Agreement, he/she has
currently in effect all necessary licenses, approvals, insurance, etc., required to
properly provide the services covered by this Agreement. These requirements
2 Revised 5/2023
I include the following:
a. Current Colorado driver's license indicating Contractor is at least eighteen
(18) years of age; and
b. Completed background check through the Colorado Bureau of Investigation
(CBI) and the Federal Bureau of Investigation (FBI).
c. Current CPR and First Aid certifications. If either certification expires
during the term of this Agreement, Contractor shall renew the certification
ensuring that there is no lapse in certification. County will pay for
certification through select CPR and First Aid trainers identified by the
County.
d. Contractor shall procure at least the minimum amount of automobile
liability insurance required by the State of Colorado. County provides no
automobile liability coverage for Contractor. Proof of said automobile
liability insurance shall be provided to County prior to the performance of
any services under this Agreement.
e. Copies of all documentation relating to the foregoing requirements shall be
provided to the County by Contractor prior to the performance of any
services covered under this Agreement. County shall determine eligibility
for certification based upon the successful completion of all required
training and receipt of current documentation.
9. Contractor shall have attended twenty-seven (27) hours of the National Training
and Development Curriculum ("NTDC") through the Weld County Department of
Human Services and the additional twelve (12) hours of training required for
Therapeutic Foster Homes prior to the performance of services under this
Agreement. County shall not compensate Contractor for said training; including
time spent traveling to and from training, time spent in attendance of the training,
or any associated costs paid by Contractor for such training, unless specifically
agreed to in writing in advance by County.
10. Contractor shall indemnify, defend and hold harmless Weld County, the Board of
County Commissioners of Weld County, its employees, volunteers and agents for
any damages caused by his/her actions while performing services pursuant to this
Agreement, and shall hold County harmless from any loss occasioned as a result
of the performance of this Agreement.
11. Contractor shall be totally responsible to provide whatever personal liability
and/or other insurances he/she deems necessary to cover his/her personal liability
for any injuries caused by Contractor in the course of providing services under
this Agreement.
12. Contractor shall perform his/her duties hereunder as an independent contractor
3 Revised 5/2023
and not as an employee of County. Contractor shall be solely responsible for
his/her acts performed pursuant to this Agreement. Under no circumstances shall
Contractor be deemed to be an agent or employee of Weld County. Contractor is
nut entitled to unemployment insurance or workers' compensation benefits
through Weld County and Weld County shall not pay for or otherwise
provide such coverage for Contractor. Unemployment insurance benefits will
not be available to Contractor for services provided under this Agreement.
Contractor shall pay when due any/all applicable employment taxes and
income taxes and local head taxes (if applicable) incurred as a result of the
services provided under this Agreement.
13. Contractor shall not have authorization, express or implied, to bind County to any
agreement, liability or understanding.
14. Contractor agrees that he/she shall not use alcohol, illegal drugs, marijuana,
whether for recreational or medical purposes, or any other drugs which have the
potential of impacting Contractor's ability to supervise the children in his/her care
while providing services under this Agreement or within five (5) hours prior to
the provision of said services.
Contractor shall protect the confidentiality of all records and other materials to
which he/she has access relating to the foster family and children) to whom the
services are provided, which are maintained in accordance with this Agreement
except for purposes directly connected with the administration of Child
Protection.
COUNTY'S RIGHTS AND RESPONSIBILITIES:
1. Weld County, the Board of County Commissioners of Weld County, its officers
and employees, shall not be held liable for injuries or damages caused by any
negligent acts or omissions of Contractor while performing duties described in this
Agreement.
2. County shall not indemnify Contractor for any loss incurred by Contractor as a
result of services performed under this Agreement.
3. County shall pay Contractor in accordance with the terms set forth in Exhibit B, as
long as services arc rendered satisfactorily and in accordance with the Agreement.
4. Payment pursuant to this Agreement is subject to, and contingent upon, the
continuing availability of funds made available for the purposes hereof. No portion
of this Agreement shall be deemed to create an obligation on the part of County to
expend funds not otherwise appropriated. The County may terminate this
4 Revised 5/2023
Agreement at any time if said source of funding is no longer available to County.
County may withhold payment under this Agreement if Contractor fails to comply
with any part of the Agreement. In the event County withholds payment, Contractor
may appeal such circumstance in writing to the Weld County Director of Human
Services. The decision of the Weld County Director of Human Services shall be
final.
GENERAL PROVISIONS:
1. This Agreement shall become effective on July 1, 2023, upon proper execution of
this Agreement, and shall expire on Jgne 304 2024 unless sooner terminated as
provided herein. This Agreement is for a period of three years subject to annual
renewal by written mutual agreement of the parties.
2. Either party may terminate this Agreement at any time for any reason by providing
the other party with a 30 -day written notice thereof. Furthermore, this Agreement
may be terminated by County at any time without notice upon a material breach by
Contractor of the terms of the Agreement.
3. Contractor may not assign or transfer this Agreement, any interest therein or claim
hereunder, without the prior written approval of County. It is expressly
understood and agreed that the enforcement of the terms and conditions of this
Agreement, and all rights of action relating to such enforcement, shall be strictly
reserved to the undersigned parties and nothing in this Agreement shall give or
allow any claim or right of action whatsoever by any other person not included in
this Agreement. It is the express intention of the undersigned parties that any
entity other than the undersigned parties receiving services or benefits under this
Agreement shall be an incidental beneficiary only.
4. No term or condition of this contract shall be construed or interpreted as a waiver,
express or implied, of any of the immunities, rights, benefits, protections or other
provisions, of the Colorado Governmental Immunity Act of §§24-10-101 et. seq.,
as applicable now or hereafter amended.
5. If any section, subsection, paragraph, sentence, clause, or phrase of this Agreement
is for any reason held or decided to be unconstitutional, such decision shall not
affect the validity of the remaining portions. The parties hereto declare that they
would have entered into this Agreement and each and every section, subsection,
paragraph, sentence, clause, and phrase thereof irrespective of the fact that any one
or more sections, subsections, paragraphs, sentences, clauses, or phrases might be
declared to be unconstitutional or invalid.
5 Revised 5/2023
6. No officer, member or employee of County and no member of their governing
bodies shall have any pecuniary interest, direct or indirect, in the approved
Agreement or the proceeds thereof. The appearance of conflict of interest applies
to the relationship of a Contractor with County when the Contractor also maintains
a relationship with a third party and the two relationships are in opposition. In
order to create the appearance of a conflict -of -interest, it is not necessary that the
Contractor gain from knowledge of these opposing interests. It is only necessary
that the Contractor knows that the two relationships are in opposition. During the
term of the Agreement, Contractor shall not enter into any third -party relationship
that gives the appearance of creating a conflict of interest. Upon learning of an
existing appearance of a conflict of interest situation, Contractor shall submit to the
Department, a full disclosure statement setting forth the details that create the
appearance of a conflict of interest. Failure to promptly submit a disclosure
statement required by this paragraph shall constitute grounds for the Department's
termination, for cause, of its Agreement with the Contractor. Contractor certifies
that no Federally appropriated funds have been paid or will be paid, by or on behalf
of Contractor, to any person for influencing or attempting to influence an officer or
employee of an agency, a Member of Congress, an officer or employee of Congress,
or an employee of a Member of Congress in connection with the awarding of any
Federal contract, the making of any Federal grant, the making of any Federal loan,
the entering into of any cooperative agreement, and the extension, continuation,
renewal, amendment, or modification of an Federal contract, loan, grant, or
cooperative agreement.
7. This Agreement, together with Exhibits A and B, constitutes the entire
understanding between the parties with respect to the subject matter hereof, and
may not be changed or modified, unless by a written amendment executed by both
parties. This Agreement shall be binding upon the parties hereto, their successors,
heirs, legal representatives, and assigns. Neither County nor Contractor may
assign any of its rights or obligations hereunder without the prior consent of the
other party.
8. This Agreement shall not be valid until it has been approved by the Board of County
Commissioners of Weld County, Colorado.
9. 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.
10. In the event of a dispute between County and Contractor, concerning this
6 Revised 5/2023
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.
11. 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.
12. All work and information obtained by Contractor under this Agreement 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.
13. 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 services and/or terms
outlined in this Agreement without County's prior written consent, which may be
withheld in County's sole discretion.
14. Upon completion of the work, the Contractor shall submit to Department originals
of all tests and results, reports, etc., generated during completion of this work.
Acceptance by Department of reports and incidental material(s) furnished under
this Agreement shall not in any way relieve the Contractor of responsibility for the
quality and accuracy of the services. In no event shall any action by the Department
hereunder constitute or be construed to be a waiver by the Department of any breach
of covenant or default which may then exist on the part of the Contractor, and the
Department's action or inaction when any such breach or default shall exist shall
not impair or prejudice any right or remedy available to the Department with respect
to such breach or default; and no assent, expressed or implied, to any breach of any
one or more covenants, provisions or conditions of the Agreement shall be deemed
or taken to be a waiver of any other breach. Acceptance by the Department of, or
payment for, any services performed under this Agreement shall not be construed
as a waiver of any of the Department's rights under this Agreement or under the
law generally.
15. The Contractor warrants that services performed under this Agreement will be
performed in a manner consistent with the professional standards governing such
services and the provisions of this Agreement. The Contractor shall faithfully
perform the work in accordance with the standards of care, skill, training, diligence
and judgment provided by highly competent individuals and entities that perform
services of a similar nature.
7 Revised 5/2023
16, This Agreement does not guarantee any work nor does it create an exclusive
agreement for services.
17. Contractor agrees that authorized local, Federal, and State auditors and
representatives shall, during business hours, have access to inspect and copy
records, and shall be allowed to monitor and review through on -site visits, all
activities related to this Agreement, supported with funds under this Agreement, to
ensure compliance with the terms of this Agreement. Contracting parties agree
that monitoring and evaluation of the performance of the Agreement shall be
conducted by appropriate funding sources. The results of the monitoring and
evaluation activities shall be provided to the appropriate and interested parties.
8 Revised 5/2023
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 Board
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
Mike Freeman, Chair
CONTRACTOR;
(PROVIDER)
(ADDRESS)
(CITY, STATE ZlP )
By:
(PROVE 1)ERj
Date:
By:
(PROVIDER)
Date:
9 Revised 5/2023
EXHIBIT A
SCOPE OF SERVICES
1. Contractor shall provide respite care as approved by the Foster Care Coordinator and the
Foster Care Supervisor for foster children residing in Weld County certified therapeutic
foster homes.
2. Contractor will, at the time of entering into this Agreement, ensure he/she has completed
all the necessary paperwork and has in effect all necessary licenses, approvals, insurance,
etc., required to provide the Respite care services covered by this Agreement.
Contractor will have:
a. Completed and submitted the Colorado Department of Human Services
Application and signed as "Foster Parent/Home" PRIOR to completing
NTDC training.
b. Successfully completed 27 hours of NTDC training and the additional
twelve (12) hours of training required to be a therapeutic foster home
through the County prior to the performance of services under this
Agreement.
c. Provided a copy of their current Colorado driver's license indicating
Contractor is at least eighteen (18) years of age; and
d. Completed a background check through the Colorado Bureau of
Investigation (CBI) and the Federal Bureau of Investigation (FBI).
e. Provided three (3) reference forms completed by non -relatives.
f. Provided proof of current CPR and First Aid certifications.
g. Completed and signed Confidentiality, Discipline and Mandated Reporter
Policies.
h. Provided proof that Contractor has procured at least the minimum amount
of automobile liability insurance required by the State of Colorado. County
provides no automobile liability coverage for Contractor.
Copies of all documentation relating to the foregoing requirements shall be provided to the
County by Contractor prior to the performance of any services covered under this
Agreement. County shall determine eligibility for certification based upon the successful
completion of all required training and receipt of current documentation.
Contractor further acknowledges that he/she will remain current with all documentation or
certifications for the term of this Agreement. Should an item expire or otherwise become
invalid, Contractor will submit current documentation to the County to avoid a lapse in
documentation and/or certification.
10 Revised 5/2023
3. Contractor acknowledges that the County shall not compensate Contractor for said
training; including time spent traveling to and from training, time spent in attendance at
the training, or any associated costs paid by Contractor for such training, unless
specifically agreed to in writing in advance by County.
4. Contractor acknowledges that arrangements to provide Respite care services must be
communicated to the child's Caseworker and the Foster Care Coordinator prior to Respite
taking place in order to discuss arrangements and ensure all the child's needs are met.
5. Contractor will become familiar with and follow all the State and Federal rules and
regulations as applicable to the services provided under this Agreement.
6. Contractor will complete and submit the Respite Care Payment Form each month by the
2°d of the month following the month of service. The Respite Care Payment Form will be
provided by the Foster Care Coordinator.
11 Revised 5/2023
EXHIBIT B
RATE SCHEDULE
F
The County agrees to reimburse the Contractor in consideration of the work and services
performed under this Agreement at the rate specified in Paragraph 2, below. The total
amount to be paid to the Contractor during the term of this Agreement shall be reported by
the County after June 30, 2023.
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.
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
The number of hours of respite care to be provided each month is dependent upon the needs
of the therapeutic foster parents and the youth placed in their homes. Ideally one (1)
weekend of respite per month is provided, however, there is no guarantee of a set number of
respite hours and respite must be approved by the Foster Care Coordinator and Foster Care
Supervisor. Payment will be the state daily rate or prorated into an hourly rate if respite is
less than a full day. The County will pay this cost in full to the Therapeutic Respite Care
provider.
Human Services referrals will not be sent to collections by Contractor for default of co-
pay/fees. Services will be performed regardless of client's refusal or inability to pay co -pay.
Contractor will collect any applicable sliding scale co -pays and credit Human Services for
any payments received on the monthly billing statements.
3. Submittal of Vouchers
Contractor shall prepare and submit a Respite Care Payment Form each month to certify that
the services authorized were provided on the date(s) indicated and the charges made were
pursuant to the terms and conditions of Exhibit A. The Therapeutic Respite Care Payment
Form will be provided by the Foster Care Coordinator.
12 Revised 5/2023
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