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Home My WebLink About20201257.tiff(t:: / %� X5770 PRIVILEGED AND CONFIDENTIAL MEMORANDUM DATE: March 29, 2022 TO: Board of County Commissioners — Pass -Around FR: Jamie Ulrich, Director, Human Services RE: Child Protection Agreement Amendments for 2020-21 Core/Non-Core Contracted Services B2000037 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 Protection Agreement Amendments for 2020- 21 Core/Non-Core Contracted Services B2000037. The Department entered into Agreements with various Child Welfare service providers through the 2020-2021 Request for Proposal (RFP), Bid Number: B2000037, identified as Tyler ID 2020-0373. These Agreements were issued for a period of three (3) years with the option to renew annually. The Department is requesting to renew the current Agreements with no changes for eight (8) providers reflected in the attached list. Agreements will be renewed for the third year for the period of June 1, 2022 through May 31, 2023. The Human Services Advisory Commission (HSAC) has reviewed and approved this information. Upon Board approval of this pass -around, signed Agreement Amendments will be obtained from providers and submitted to the Board for approval and Chair signature. I do not recommend a Work Session. I recommend approval of these Agreement Amendments and authorize the Chair to sign. A rove Schedule Recommendation Work Session Perry L. Buck Mike Freeman, Pro -Tern W1 Scott K. James, Chair Steve Moreno TI — Lori Saine Other/Comments: Pass -Around Memorandum; March 29, 2022 - CMS ID — Van u Page 1 o - h67 /a 5 7 PRIVILEGED AND CONFIDENTIAL [Y) IT1TF1iuz- Baseline Associates, Inc. :1T11 B2000037 202E1-21 2020-1213 Jeremy T. Sharp, PhD,LLC B2000037 2020-21 2020-1378 KPJ First Services, EEC ________82000037__2020-21___2020-1375 Kraft, Darla B2000037 2020-21 2020-1255 Kula, Julie K. B2000037 2020-21 2020-1256 'f0 New Hope Parenting Solutions B2000037 2020-21 2020-1257 Polaris Partners Counseling and Consulting, LLC 82000037 2020-21 2020-1214 Specialized Sitters 82000037 2020-21 2020-1785 Pass -Around Memorandum; March 29, 2022 — CMS ID — Various Page 2 Karla Ford From: Sent: To: Subject: yes Lori Saine Weld County Commissioner, District 3 1150 O Street PO Box 758 Greeley CO 80632 Phone: 970-400-4205 Fax: 970-336-7233 Email: Isaine@'weldaov.com Website: www.co.weld.co.us In God We Trust Lori Saine Tuesday, March 29, 2022 11:33 AM Karla Ford RE: Please Reply - PA FOR ROUTING: CW Core Non -Core 2020-21 Renewals B2000037 (CMS Various) Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. From: Karla Ford <kford@weldgov.com> Sent: Tuesday, March 29, 2022 10:44 AM To: Lori Saine <Isaine@weldgov.com> Subject: Please Reply - PA FOR ROUTING: CW Core Non -Core 2020-21 Renewals 62000037 (CMS Various) Importance: High Please advise if you approve recommendation. Thank you. Karla Ford R Executive Assistant & Office Manager, 1150 0 Street, P.O. Box 758, Greeley, :: 970.336-7204 :: kford@wetdgov. con **Please note my working hours are Board of Weld County Commissioners Colorado 80632 1:: www.weldgov.com :: Monday -Thursday 7:00a.m.-5:00p.m.** 1 AGREEMENT AMENDMENT BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND NEW HOPE PARENTING SOLUTIONS This Agreement Amendment, made and entered into __ day of , 2022 by and between the Board of Weld County Commissioners, on behalf of the Weld County epartment of Human Services, hereinafter referred to as the "Department", and New Hope Parenting Solutions, hereinafter referred to as the "Contractor". WHEREAS the parties entered into an Agreement for Foster Parent Coaching Kinship Coaching, Parent Coaching, Parenting Classes/Step 1, Parenting Classes/Trauma Focused Step 1, (the "Original Agreement") identified by the Weld County Clerk to the Board of County Commissioners as document No. 2020-1257, approved on April 29, 2020. WHEREAS the parties hereby agree to amend the term of the Original Agreement in accordance with the terms of the Original Agreement and any previously adopted amendment, which is incorporated by reference herein, as well as the terms provided herein. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: • The Original Agreement was set to end on May 31, 2021. • The Original Agreement was amended on: • April 21, 2021 to extend the term date through May 31, 2022. • The Amendments are identified by the Weld County Clerk to the Board of County Commissioners as document number 2020-1257. • These Amendments, together with the Original Agreement, constitutes the entire understanding between the parties. The following additional changes are hereby made to the current Agreement: 1. Term This agreement is being renewed for a third and final year, for the period of June 1, 2022 through May 31, 2023. 2. Section 17 of the Agreement, Notice Heather Ackley, Executive Director 3739 Faith Drive Conway, South Carolina 29527 • All other terms and conditions of the Original Agreement remain unchanged. IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. A B BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO Scott K. James, Chair APR 2 7 2022 New Hope Parenting Solutions 3739 Faith Drive Conway, South Carolina 29527 By: Heather Ackley (Apt 20, 2022 17:34 EDT} Heather Ackley, Executive Director Apr20,2022 Date: New Contract Request Entity Information Entity Name* Entity ID NEW HOPE PARENTING SOLUTIONS C00041600 Contract Name * NEW HOPE PARENTING SOLUTIONS (AGREEMENT AMENDMENT PY 2022-23) Contract Status CTB REVIEW Contract Description * BID# 82000037. TERM 6/1 /22-5/31 123. Contract Description 2 CONSENT: PA WAS SENT TO CTB ON: 3/30:2022. Contract Type * Department AMENDMENT HUMAN SERVICES Amount* Department Email $0.00 CM - H u manService s veldgov. co Renewable rn NO Department Head Email Automatic Renewal CM-HumanServices- DeptHeadreIdgov.com Grant County Attorney GENERAL COUNTY !GA ATTORNEY EMAIL County Attorney Email CM- COU NTYATTORN EYWELDG OV.COM if this is a renewal enter previous Contract ID If this is part of a MSA enter MSA Contract ID ❑ New Entity? Contract ID 5770 Contract Lead* APEGG Contract Lead Email apegg{?zwe Idgov. com ; co bbx xlkrweldgov.com Parent Contract ID 20201257 Requires Board Approval YES Department Project # Requested BOCC Agenda Due Date Date* 05,21/2022 0525 2022 Will a work session with BOCC be required?* NO Does Contract require Purchasing Dept. to be included? Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in On Base Contract Dates Effective Date Termination Notice Period Contact Information Contact Info Contact Name Purchasing Purchasing Approver CONSENT Approval Process Department Head JAMIE ULRICH DH Approved Date 04,2212022 Final Approval BOCC Approved BOCC Signed Date BOCC Agenda Date 04,;2712022 Originator APEGG Contact Type Review Date * 04,"03:2023 Committed Delivery Date Contact Email Renewal Date Expiration Date 05: 312023 Contact Phone 1< Contact Phone 2 Purchasing Approved Date 04. 22,2022 Finance Approver CONSENT Finance Approved Date 04;22,"2022 Tyler Ref # AG 042722 Legal Counsel CONSENT Legal Counsel Approved Date 04'22;2022 PRIVILEGED AND CONFIDENTIAL MEMORANDUM DATE: March 30, 2021 TO: Board of County Commissioners — Pass -Around FR: Jamie Ulrich, Director, Human Services RE: Child Protection Agreement Amendments for 2020- 21 Core/Non-Core Contracted Services 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 Protection Agreement Amendments for 2020- 21 Core/Non-Core Contracted Services. The Department entered into Agreements with various Child Welfare service providers through the 2020-2021 Request for Proposal (RIP), Bid Number: B2000037, identified as Tyler ID 2020-0373. These Agreements were issued for a period of three (3) years with the option to renew annually. The Department is requesting to renew the current Agreements with no changes for ten (10) providers reflected in the attached list. Agreements will be renewed for the second year for the period of June 1, 2021 through May 31, 2022. The Human Services Advisory Commission (HSAC) has reviewed and approved this information. Upon Board approval of this pass -around, signed Agreement Amendments will be obtained from providers and submitted to the Board for approval and Chair signature. I do not recommend a Work Session. I recommend approval of these Agreement Amendments. Approve Recommendation Perry L. Buck Mike Freeman Scott K. James, Pro -Tern Steve Moreno, Chair Lori Saine Schedule Work Session Other/Comments: Pass -Around Memorandum; March 30, 2021— CMS TD — Various Page 1 �— O2/ — /2 5 7 Roo 992- AGREEMENT AMENDMENT BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND NEW HOPE PARENTING SOLUTIONS This Agreement Amendment, made and entered into day of 2021 by and between the Board of Weld County Commissioners, on behalf of the Weld County Department of Hu an Services, hereinafter referred to as the "Department", and New Hope Parenting Solutions, hereinafter referred to as the "Contractor". WHEREAS the parties entered into an Agreement for Foster Parent Coaching, Kinship Coaching, Parent Coaching, Parenting Classes/Step 1, Parenting Classes/Trauma Focused Step 1, (the "Original Agreement") identified by the Weld County Clerk to the Board of County Commissioners as document No. 2020-1257, approved on April29, 2020. WHEREAS the parties hereby agree to amend the term of the Original Agreement in accordance with the terms of the Original Agreement and any previously adopted amendment, which is incorporated by reference herein, as well as the terms provided herein. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: • The Original Agreement will end on May 31, 2021. • These Amendments, together with the Original Agreement, constitutes the entire understanding between the parties. The following additional changes are hereby made to the current Agreement: Term This Agreement is being renewed for a second full year term, for the period of June 1, 2021 through May 31, 2022. • All other terms and conditions of the Original Agreement remain unchanged. IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. Cam( �/�•� j COUNTY: ATTEST • BOARD OF COUNTY COMMISSIONERS Weld ou ty lerk to the B ar ff WELD COUNTY, COLORADO Deputy Cler o die and Steve Moreno, Chair 1 _.. ;APR 2 2021 New Hope Parenting Solutions 2505 Sapphire Street Loveland, Colorado 80537 By: Heather Ackley (Apr 12, 202114:54 MDT) Heather Ackley, Executive Director Date: Apr 12, 2021 New Contract Request Entity Information Entity Name* Entity ID* NEW HOPE PARENTING SOLUTIONS O004 1600 Contract Narne * NEW HOPE PARENTING SOLUTIONS (AGREEMENT AMENDMENT) Contract Status CTB REVIEW Contract Descriptions BID #B2000037 TERM: 6/1 /21-5131 /22 Contract Description 2 CONSENT. PA WAS SENT TO CTB ON 3 31 21. ❑ New Entity? Contract ID 4672 Contract Lead APEGG Contract Lead Email apegg''weIdgov.com;cobbx xlkCalweldgov.com Parent Contract ID 20201257 Requires Board Approval YES Department Project # Contract Type * Department Requested BOCC Agenda Due Date AMENDMENT HUMAN SERVICES Date* 0522,2021 0526/2021 Amount* Department Email 50.00 CM- Will a work session with BOCC be required?* HurnanServicescreidgov.co NO Renewable m NO Does Contract require Purchasing Dept. to be included? Department Head Email Automatic Renewal CM-HumanServices- DeptHead;1zeldgov.com Grant County Attorney GENERAL COUNTY IGA ATTORNEY EMAIL County Attorney Email CM- COU NTYATTORN EY•'WELDG OV.COM if this is a renewal enter previous Contract ID If this is part of a MSA enter MSA Contract ID Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in OnBase Contract Dates Effective Date Review Date" Renewal Date 04 01.2022 Termination Notice Period Committed Delivery Date Expiration Date 05,'311,2022 Contact Information Contact Info Contact Name Purchasing Purchasing Approver CONSENT Approval Process Department Head JAMIE ULRICH DH Approved Date 04:14,)2021 Final Approval BOCC Approved BOCC Signed Date BOCC Agenda Date 04212021 Originator APEGG Contact Type Contact Email Contact Phone I Contact Phone 2 Purchasing Approved Date 041412021 Finance Approver CONSENT Finance Approved Date 04;1412021 Tyler Ref # AG 042121 Legal Counsel CONSENT Legal Counsel Approved Date 04 14:2021 CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND NEW HOPE PARENTING SOLUTIONS This Agreement, made and entered into thaay o 2020, by and between the Board of Weld County Commissioners, on behalf of the Weld County Departure of Human Services, hereinafter referred to as the "Department' and New Hope Parenting Solutions, hereinafter referred to as the "Contractor". The parties to this Agreement understand and agree that the provisions of this Agreement specifically include the following documents: Exhibit A, Weld County's Request for Proposal, Exhibit B, Contractor's Response to Request for Proposal, Exhibit C, Scope of Services, and Exhibit D, Rate Schedule. Exhibit B, C, and D are attached hereto and incorporated herein by this reference. Exhibit A is Weld County's Request for Proposal Number 82000037, which is incorporated into this agreement by reference and will be provided upon request to the Department. WITNESSETH WHEREAS, required approval, clearance, and coordination have been accomplished from and with appropriate agencies; and WHEREAS, the Colorado Department of Human Services has provided Child Welfare Administration or other funding to the Department for Foster Parent Coaching, Kinship Coaching, Parent Coaching, Parenting Classes/Step 1, Parenting Classes/Trauma Focused Step 1. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: Term This agreement shall become effective on June 1, 2020, upon proper execution of this Agreement and shall expire May 31, 2021, unless sooner terminated as provided herein. The agreement is for a period of three years. However, the agreement must be renewed by both parties, in writing, on an annual basis. 2. Scope of Services Services shall be provided by the Contractor to any person(s) eligible for services in compliance with Exhibit B, Contractor's Response to Request for Proposal and Exhibit C, Scope of Services. 3. Referrals, Billing and Tracking a. Contractor understands and will comply with all aspects of the referral authorization, billing and tracking requirements as set forth by the Department. Failure to comply with all aspects may result in a forfeiture of payment. b. Contractor agrees to receive referrals for services through e-mail and will provide an identified e- mail address prior to the start of this Agreement. Contractor acknowledges that services are not authorized until the Contractor has received an authorized referral form from the Department. Contractor further acknowledges that services provided prior to the authorized start date or outside the scope of services on the referral form will not be eligible for reimbursement. Contractor acknowledges that any and all modifications to an existing referral must be approved through the Quality Assurance Team Supervisor (hainleid@weldgov.com, 970-400-6210). No other Department staff or other party to the case may authorize services or modifications to services. () 4 9, ao 2020-1257 c. Contractor agrees to submit a complete Request for Reimbursement and supporting documentation by the 7`h of the month, following the month of service, utilizing billing forms required by the Department. Contractor agrees to utilize the Client Verification Form for all scheduled and unscheduled face-to-face services with the exception of one-time services (ex. home studies, evaluations and monitored sobriety testing). Contractor agrees that original complete Client Verification Forms with original signatures are to be submitted with the Request for Reimbursement. Requests for Reimbursement and Client Verification Forms received after 60 days from the date of service may result in delay or forfeiture of payment. Consistent failure to meet 60 -day deadline may result in termination of the Agreement. d. Contractor agrees to submit a monthly report by the 7th of the month, following the month of service, for each client receiving ongoing services. Monthly reports will be submitted through the Department's online reporting system, unless otherwise directed or agreed to by the Department. Monthly reports for ongoing services must include the following information, entered in the "Narrative" box for each date of service: a. Date and time of service b. Where the service took place c. Clinician/therapist name d. Clients participating e. What interventions were used, recommendations and/or goals discussed f. Any and all safety concerns One-time services will be verified through receipt of the completed product (ex. evaluations, substance abuse evaluation, home study). Verification of Monitored Sobriety Services will be the test result. A completed home study may be a full, partial or denied study, as determined by the Department. Contractor will document in detail any and all observed or verbalized concerns regarding any child whom the Contractor is working with under the Agreement. Areas of concern may include, but are not limited to, any physical, emotional, educational or behavioral issues. Areas of concern should be reported immediately to the caseworker AND on the required monthly report. Payment a. The Department and the Contractor agree that all benefits from private insurance and/or other funding sources such as Medicaid (if Contractor is a Medicaid eligible provider) or Victim's Compensation must be exhausted before Core Services or other Department funds can be accessed for services. Exceptions to this Paragraph may include, if approved by the Department, the following: i. The service being provided by the contractor is not a Medicaid eligible service; ii. The service is not deemed medically necessary; iii. The Court with jurisdiction over the case has ordered that a non -Medicaid provider or service be used; iv. A Medicaid provider is not available to provide the needed service; v. Medicaid is exhausted for the needed service; or vi. Medicaid denied service. vii. The client is not eligible for Medicaid. b. Payment shall be made in accordance with Exhibit A, Weld County's Request for Proposal, Exhibit B, Contractor's Response to Request for Proposal, Exhibit C, Scope of Services, and Exhibit D, Rate Schedule, attached hereto and incorporated herein by reference, so long as services are rendered satisfactorily and in accordance with the Agreement. c. Payment pursuant to this Agreement, whether in whole or in part, is subject to, and contingent upon, the continuing availability of said funds for the purposes hereof. d. The Department may withhold reimbursement if Contractor has failed to comply with any part of the Agreement, including the Financial Management requirements, program objectives, contractual terms, or reporting requirements. In the event of forfeiture of reimbursement, Contractor may appeal such circumstance in writing to the Director of Human Services. The decision of the Director of Human Services shall be final. 5. Financial Management At all times from the effective date of the Agreement until completion of the Agreement, Contractor shall comply with the administrative requirements, cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under this Agreement must conform to the Single Audit Act of 1984 and OMG Circular A-133. 6. Payment Method Unless otherwise provided in Exhibit B, Contractor's Proposal, Exhibit C, Scope of Services, and Exhibit D, Rate Schedule: a. If services are funded through Core Services, Contractor agrees to accept reimbursement through ACH direct deposit one time per month. b. If Contractor is not currently set up with the State of Colorado to accept direct deposit, Contractor agrees to complete and submit a State of Colorado direct deposit enrollment form, which will be provided by the Department, with a voided check. Failure to complete and submit this form and voided check in a timely and accurate manner may result in a delay of payment. c. Contractor agrees to accept payment through county warrant when funding source does not allow for direct deposit. 7. Compliance with Applicable Laws a. At all times during_the performance of this Agreement, Contractor will strictly adhere to all applicable Federal and State laws, order, and applicable standards, regulations, interpretations and/or guidelines issued pursuant thereto. This includes protection of the confidentiality of all applicant/recipient records, papers, documents, tapes and any other materials that have been or may hereafter be established which relate to the Agreement. Contractor shall abide by all applicable laws and regulations, including, but not limited to the following: - Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d-1 Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d-1 et. seq. and its implementing regulation, 45 C.F.R. Part 80 et. seq.; and - all provisions of the Civil Rights Act of 1986 so that no person shall, on the grounds of race, creed, color, sex, or national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under the approved Agreement. - Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 794, and its implementing regulations, 45 C.F.R. Part 84; and - the Age Discrimination Act of 1975, 42 U.S.C. Section 6101 et. sea• and its implementation regulations, 45 C.F.R. Part 91; and - Title VII of the Civil Rights Act of 1964; and - the Age Discrimination in Employment Act of 1967; and - the Equal Pay Act of 1963; and - the Education Amendments of 1972; and - Immigration Reform and Control Act of 1986, P.L. 99-603, 42 C.F.R. Part 2; and - all regulations applicable to these laws prohibiting discrimination because of race, color, national origin, sex, religion, and handicap, including Acquired Immune Deficiency Syndrome (AIDS) or AIDS related conditions covered under Section 504 of the Rehabilitation Act of 1973, as amended, cited above. If necessary, Contractor and the Department will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 C.F.R. Part 2. 45 C.F.R. Part 74, Appendix G 9, which requires that affirmative steps be taken to assure that small and minority businesses are utilized, when possible, as sources of supplies, equipment, construction and services. This assurance is given in consideration of and for the purpose of obtaining any all Federal and/or State financial assistance. - Colorado Revised Statute (C.R.S.) 26-6-104, requiring criminal background record checks for all employees, contractors and sub -contractors. b. Contractor is further charged with the knowledge that any person who feels that s/he has been discriminated against has the right to file a complaint either with the Colorado Department of Human Services or with the United States Department of Health and Human Services, Office for Civil Rights. c. Contractor assures that it will fully comply with all other applicable Federal and State laws which may govern the ability of the Department to comply with the relevant funding requirements. Contractor understands the source of funds to be accessed under the Agreement is determined by the Department. d. Contractor assures and certifies that it and its principals: - Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transaction by a Federal or State department or agency; and - have not, within a three-year period preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or Local) transaction or contract under public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; and - are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state or local) with commission of any of the offenses enumerated in this certification; and - have not, within a three-year period preceding this Agreement, had one or more public transactions (federal, state, or local) terminated for cause or default. 4 e. Public Contracts for Services C.R.S. §8-17.5-101. Contractor certifies, warrants, and agrees that it does not knowingly employ or contract with an illegal alien who will perform work under this contract. Contractor will confirm the employment eligibility of all employees who are newly hired for employment in the United States to perform work under this Agreement, through participation in the E -Verify program or the State of Colorado program established pursuant to C.R.S. §8-17.5- 102(5)(c). Contractor shall not knowingly employ or contract with an illegal alien to perform work under this Agreement or enter into a contract with a subcontractor that fails to certify with Contractor that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this Agreement. Contractor shall not use E -Verify Program or State of Colorado program procedures to undertake pre -employment screening or job applicants while this Agreement is being performed. If Contractor obtains actual knowledge that a subcontractor performing work under the public contract for services knowingly employs or contracts with an illegal alien Contractor shall notify the subcontractor and the Department within three (3) days that Contractor has actual knowledge that a subcontractor is employing or contracting with an illegal alien and shall terminate the subcontract if a subcontractor does not stop employing or contracting with the illegal alien within three (3) days of receiving notice. Contractor shall not terminate the contract if within three days the subcontractor provides information to establish that the subcontractor has not knowingly employed or contracted with an illegal alien, shall comply with reasonable requests made in the course of an investigation, undertaken pursuant to C.R.S. §8-17.5-102(5), by the Colorado Department of Labor and Employment. If Contractor participates in the State of Colorado program, Contractor shall, within twenty days after hiring a new employee to perform work under the contract, affirm that Contractor has examined the legal work status of such employee, retained file copies of the documents, and not altered or falsified the identification documents for such employees. Contractor shall deliver to the Department, a written notarized affirmation that it has examined the legal work status of such employee and shall comply with all of the other requirements of the State of Colorado program. If Contractor fails to comply with any requirement of this provision or of C.R.S. §8-17.5-101 et seq., the Department, may terminate this Agreement for breach, and if so terminated, Contractor shall be liable for actual and consequential damages. f. Except where exempted by federal law and except as provided in C.R.S. § 24-76.5-103(3), if Contractor receives federal or state funds under the contract, Contractor must confirm that any individual natural person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. § 24-76.5-103(4), if such individual applies for public benefits provided under the contract. If Contractor operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it: (a) is a citizen of the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall produce one of the forms of identification required by C.R.S. § 24- 76.5-101, et seq., and (c) shall produce one of the forms of identification required by C.R.S. § 24-76.5- 103 prior to the effective date of the contract. 8. Compliance with Child and Family Services Review The Child and Family Services Review (CFSR) examines child welfare service outcomes in three areas; Safety, Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's performance according to national standards and monitor progress over time. Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance services to families. Contractor agrees to continually strive for positive outcomes in the areas of Safety, Permanency and Well Being. Contractor will ensure that any employee or subcontractor of Contractor providing services under this Agreement will work towards positive outcomes in the aforementioned three areas as outlined under the Child and Family Services Review (CFSR) and will address the aforementioned three areas when completing monthly reports as required by Paragraph 3(d) of this Agreement. 9. Insurance Requirements Contractor and the Department agree that Weld County, the Board of County Commissioners of Weld County, its officers and employees, shall not be held liable for injuries or damages caused by any negligent acts or omissions of the Contractor, it subcontractor, or their employees, volunteers, or agents while performing duties described in this Agreement. Contractor shall indemnify, defend and hold harmless Weld County, the Board of County Commissioners of Weld County, its employees, volunteers and agents. Contractor shall provide the liability insurances (including professional liability insurances where necessary) and worker's compensation insurances for all its employees, volunteers, and agents engaged in the performance of this Agreement which are required under Weld County's Request for Proposal, and required by the Colorado Worker's Compensation Act. Contractor shall provide the Department with the acceptable evidence that such coverage is in effect within seven (7) days of the date of this Agreement. At a minimum, Contractor shall procure, either personally or through its employer as applicable to the Contractor's business, at its own expense, and maintain for the duration of the work, insurance coverage listed in this agreement. The Board of County Commissioners of Weld County and its Officers/Employees shall be named as additional insured. a. General Requirements: Contractors must secure, at or before the time of execution of any agreement or commencement of any work, the following insurance covering all operations, goods or services provided pursuant to this request. Contractors shall keep the required insurance coverage in force at all times during the term of the Agreement, or any extension thereof, and during any warranty period. The required insurance shall be underwritten by an insurer licensed to do business in Colorado and rated by A.M. Best Company as "A"VIII or better. Each policy shall contain a valid provision or endorsement stating "Should any of the above -described policies by canceled or should any coverage be reduced before the expiration date thereof, the issuing company shall send written notice to the Weld County Director of General Services by certified mail, return receipt requested. Such written notice shall be sent thirty (30) days prior to such cancellation or reduction unless due to non-payment of premiums for which notice shall be sent ten (10) days prior. If any policy is in excess of a deductible or self -insured retention, the Department must be notified by the Contractor. Contractor shall be responsible for the payment of any deductible or self -insured retention. The Department reserves the right to require Contractor to provide a bond, at no cost to the Department, in the amount of the deductible or self -insured retention to guarantee payment of claims. The insurance coverages specified in this Agreement are the minimum requirements, and these requirements do not decrease or limit the liability of Contractor. Contractor shall maintain, at its own expense, any additional kinds or amounts of insurance that it may deem necessary to cover its obligations and liabilities under this Agreement. b. Types of Insurance: Contractor shall obtain, and maintain at all times during the term of any Agreement, insurance in the following kinds and amounts: i.Workers' Compensation Insurance as required by state statute, and Employer's Liability Insurance covering all of Contractor's employees acting within the course and scope of their employment. If Contractor is an Independent Contractor, as defined by the Colorado Worker's Compensation Act, this requirement shall not apply. Contractor must submit to the Department a Declaration of Independent Contractor Status Form prior to the start of this agreement. 6 ii.Commercial General Liability Insurance written on ISO occurrence form CG 00 01 10/93 or equivalent, covering premises operations, fire damage, independent Contractors, products and completed operations, blanket contractual liability, personal injury, and advertising liability with minimum limits as follows: - $1,000,000 each occurrence; - $2,000,000 general aggregate; - $50,000 any one fire; and - $500,000 errors and omissions. iii.Automobile Liability: Contractor shall maintain limits of $1,000,000 for bodily injury per person, $1,000,000 for bodily injury for each accident, and $1,000,000 for property damage applicable to all vehicles operating both on County property and elsewhere. iv.Additional Provisions: Policies for all general liability, excess/umbrella liability, liquor liability and pollution liability must provide the following: If any aggregate limit is reduced by twenty-five percent (25%) or more by paid or reserved claims, Contractor shall notify the Department within ten (10) days and reinstate the aggregates required; - Unlimited defense costs in excess of policy limits; Contractual liability covering the indemnification provisions of this Agreement; - A severability of interests provision; - Waiver of exclusion for lawsuits by one insured against another; - A provision that coverage is primary; and - A provision that coverage is non-contributory with other coverage or self-insurance provided by the Department. v.For all general liability, excess/umbrella liability, liquor liability, pollution liability and professional liability policies, if the policy is a claims -made policy, the retroactive date must be on or before the contract date or the first date when any goods or services were provided to the Department, whichever is earlier. c. Contractors shall secure and deliver to County's Risk Administrator ("Administrator") at or before the time of execution of this Agreement, and shall keep in force at all times during the term of the Agreement as the same may be extended as herein provided, a commercial general liability insurance policy, including public liability and property damage, in form and company acceptable to and approved by said Administrator, covering all operations hereunder set forth in the related Bid or Request for Proposal. d. Proof of Insurance: Contractor shall provide a copy of this information to its insurance agent or broker and shall have its agent or broker provide proof of Contractor's required insurance. The Department reserves the right to require Contractor to provide a certificate of insurance, a policy, or other proof of insurance as required by the County's Risk Administrator in his sole discretion. e. Additional Insureds: For general liability, excess/umbrella liability, pollution legal liability, liquor liability, and inland marine, Contractor's insurer shall name County as an additional insured. f. Waiver of Subrogation: For all coverages, Contractor's insurer shall waive subrogation rights against County. g. Subcontractors: All subcontractors, independent contractors, sub -vendors, suppliers or other entities providing goods or services required by this Agreement shall be subject to all of the requirements herein and shall procure and maintain the same coverages required of Contractor. Contractor shall include all such subcontractors, independent contractors, sub -vendors, suppliers or other entities as insureds under its policies or shall ensure that all subcontractors maintain the required coverages. Contractor agrees to provide proof of insurance for all such subcontractors, independent contractors, sub -vendors, suppliers or other entities upon request by the Department. A provider of Professional Services (as defined in the Bid or RFP) shall provide the following coverage: Professional Liability: Contractor shall maintain limits of $1,000,000 for each claim, and $2,000,000 aggregate limit for all claims. 10. Certification Contractor certifies that, at the time of entering into this Agreement, it has currently in effect all necessary licenses, approvals, insurance, etc., required to properly provide the services and/or supplies covered by this Agreement. Copies of all necessary licenses shall be provided to the Department by the Contractor prior to the start of any Agreement. 11. Training Contractor may be required to attend training at the request of the Department specific to services provided under this Agreement. The Department will not compensate the Contractor for said training in the form of registration fees, time spent traveling to and from training, attending the training or any other associated costs unless otherwise agreed to by the Department. 12. Subpoenas Contractor will, on behalf of its employees and/or officers, accept any subpoena for testimony from the Weld County Attorney's Office by e-mail and will return a waiver of services within 72 business hours. For this purpose, Contractor will designate an e-mail address prior to the start of this Agreement. If the Contractor receives a subpoena via e-mail but will only accept personal service, the Contractor will contact the Weld County Attorney's Office immediately at 970-336-7235, and advise that the subpoena must be personally served. 13. Monitorine and Evaluation Contractor and the Department agree that monitoring and evaluation of the performance of this Agreement shall be conducted by the Contractor and the Department. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners, the Department and the Contractor. Contractor will collaborate in a timely manner with the Department to resolve issues pertaining to service delivery, service quality, documentation, and invoicing during referral period and after services have concluded. The Contractor will require clients sign releases of information. Contractor understands that the Department will not reimburse for services rendered to Department clients until releases of information are obtained. Contractor shall permit the Department, and any other duly authorized agent or governmental agency, to monitor all activities conducted by the Contractor pursuant to the terms of this Agreement. The monitoring agency may, if in its sole discretion deems necessary or appropriate, have access to any program data, special analyses, on -site checking, formal audit examinations, or any other reasonable procedures for purposes of monitoring. All such monitoring shall be performed in a manner that will not unduly interfere with the work conducted under this Agreement. 14. Modification of Agreement All modifications to this Agreement shall be in writing and signed by both parties. 15. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: - Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed. - Deny payment or recover reimbursement for those services or deliverables, which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Department. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to the Department. - Incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation shall be recovered from Contractor by deduction from subsequent payments under this Agreement or other agreements between the Department and Contractor, or by the Department as a debt due to the Department or otherwise as provided by law. 16. Representatives For the purpose of this Agreement, the individuals identified below are hereby designated representatives of the respective parties. Either party may from time to time designate in writing a new or substitute representative(s). For Department: For Contractor: Heather Walker, Child Welfare Division Head Heather Ackley, Executive Director 17. Notice All notices required to be given by the parties hereunder shall be given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing a substitute person(s) or address to whom such notices shall be sent. For Department: Jamie Ulrich, Director P.O. Box A Greeley, CO 80632 (970) 400-6581 18. Litigation For Contractor: Heather Acklev. Executive Director 2505 Sapphire Street Loveland, CO 80537 (970) 682-4048 Contractor shall promptly notify the Department in the event that Contractor learns of any actual 2 litigation in which it is a party defendant in a case that involves services provided under this Agreement. Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any Federal or State court or administrative agency, shall deliver copies of such document(s) to the Director of Human Services. The term "litigation" includes an assignment for the benefit of creditors, and filings of bankruptcy, reorganization and/or foreclosure. 19. Termination This Agreement may be terminated at any time by either party giving thirty (30) days written notice to the individuals identified in paragraph 17. No portion of this Agreement shall be deemed to create an obligation on the part of the County of Weld, State of Colorado, to expend funds not otherwise appropriated in each succeeding year, as this Agreement is subject to the availability of funding. Therefore, the Department may terminate this Agreement at any time if the source of funding for the services made available to the Contractor is no longer available to the Department, or for any other reason. Contractor reserves the right to suspend services to clients if funding is no longer available. 20. No Third -Party Beneficiary Enforcement It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 21. Governmental Immunity No term or condition of this contract shall be construed or interpreted as a waiver, express or implied, of any of the immunities, rights, benefits, protections or other provisions, of the Colorado Governmental Immunity Act of §§24-10-101 et. sea.. as applicable now or hereafter amended. 22. Partial Invalidity of Agreement If any section, subsection, paragraph, sentence, clause, or phrase of this Agreement is for any reason held or decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The parties hereto declare that they would have entered into this Agreement and each and every section, subsection, paragraph, sentence, clause, and phrase thereof irrespective of the fact that any one or more sections, subsections, paragraphs, sentences, clauses, or phrases might be declared to be unconstitutional or invalid. 23. Improprieties/Conflict of Interest No officer, member or employee of Weld County and no member of their governing bodies shall have any pecuniary interest, direct or indirect, in the approved Agreement or the proceeds thereof. The Appearance of Conflict of Interest applies to the relationship of a Contractor with the Department when the Contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest, it is not necessary for the Contractor to gain from knowledge of these opposing interests. It is only necessary that the Contractor know that the two relationships are in opposition. During the term of the Agreement, Contractor shall not enter into any third -party relationship that gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation, Contractor shall submit to the Department, a full disclosure statement setting forth the details that create the appearance of a conflict 10 of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for the Department's termination, for cause, of its Agreement with the Contractor. A conflict of interest or appearance of a conflict of interest may also apply to personal relationships between providers and clients. If a provider has a personal relationship with a client to whom the Contractor may provide services for, the Contractor must disclose that relationship to the Department. Contractor certifies that Federal appropriated funds have not been paid or will be paid, by or on behalf of Contractor, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of an Federal contract, loan, grant, or cooperative agreement. 24. Storage. Availability and Retention of Records Contractor agrees that authorized local, Federal, and State auditors and representatives shall, during business hours, have access to inspect and copy records, and shall be allowed to monitor and review through on -site visits, all activities related to this Agreement, supported with funds under this Agreement, to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. All such records, documents, communications, and other materials created pursuant or related to this Agreement shall be maintained by the Contractor in a central location and shall be made available to the Department upon its request, for a period of seven (7) years from the date of final payment under this Agreement, or for such further period as may be necessary to resolve any matters which may be pending, or until an audit has been completed with the following qualifications: If an audit by or on behalf of the Federal and/or State government has begun but is not completed at the end of the seven (7) year period, or if audit findings have not been resolved after a seven (7) period, the materials shall be retained until the resolution of the audit finding. 25. Confidentiality of Records Contractor shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Agreement except for purposes directly connected with the administration of Child Protection. No information about or obtained from any applicant/recipient in possession of Contractor shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with the Contractor's written policy governing access to, duplication and dissemination of, all such information, in any form, including social networks. Contractor shall advise its employees, agents, and subcontractor, if any, that they are subject to these confidentiality requirements. Contractor shall provide its employees, agents, and subcontractors, if any, with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. Contractor shall have its employees, agents, and subcontractors, if any, sign a written confidentiality agreement and shall provide a copy of such agreement to the Department, if requested. 26. Proprietary Information Proprietary information for the purposes of this Agreement is information relating to a party's research, development, trade secrets, business affairs, internal operations and management procedures and those 11 of its customers, clients or affiliates, but does not include information (1) lawfully obtained from third parties, (2) that which is in the public domain, or (3) that which is developed independently. Neither party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of this Agreement. Any proprietary information removed from the Department's site by the Contractor in the course of providing services under this Agreement will be accorded at least the same precautions as are employed by the Contractor for similar information in the course of its own business. 27. Independence of Contractor: Not an Employee of Weld County Contractor agrees that it is an independent Contractor and that Contractor's officers, agents or employees will not become employees of County, nor entitled to any employee benefits from County as a result of the execution of this Agreement. Contractor shall perform its duties hereunder as an independent Contractor. Contractor shall be solely responsible for its acts and those of its agents and employees for all acts performed pursuant to this Agreement. Contractor, its employees and agents are not entitled to unemployment insurance or workers' compensation benefits through County and County shall not pay for or otherwise provide such coverage for Contractor or any of its agents or employees. Unemployment insurance benefits will be available to Contractor and its employees and agents only if such coverage is made available by Contractor or a third party. Contractor shall pay when due all applicable employment taxes and income taxes and local head taxes (if applicable) incurred pursuant to this Agreement. Contractor shall not have authorization, express or implied, to bind County to any agreement, liability or understanding, except as expressly set forth in this Agreement. Contractor shall have the following responsibilities with regard to workers' compensation and unemployment compensation insurance matters: (a) provide and keep in force workers' compensation and unemployment compensation insurance in the amounts required by law, and as set forth in Exhibit A, provide proof thereof when requested to do so by County. 28. Entire Agreement This Agreement, together with all attachments hereto, constitutes the entire understanding between the parties with respect to the subject matter hereof, and may not be changed or modified except as state in Paragraph 14 herein. This Agreement shall be binding upon the parties hereto, their successors, heirs, legal representatives, and assigns. The Contractor and the Department may not assign any of its rights or obligations hereunder without the prior consent of both parties. 29. Agreement Nonexclusive This Agreement does not guarantee any work nor does it create an exclusive agreement for services. 30. Warranty The Contractor warrants that services performed under this Agreement will be performed in a manner consistent with the professional standards governing such services and the provisions of this Agreement. The Contractor shall faithfully perform the work in accordance with the standards of care, skill, training, diligence and judgment provided by highly competent individuals and entities that perform services of a similar nature to those described in this Agreement including Exhibits A, B, C, and D. 31. Acceptance of Services Not a Waiver Upon completion of the work, the Contractor shall submit to the Department originals of all tests and results, reports, etc., generated during completion of this work. Acceptance by the Department of reports and incidental material(s) furnished under this Agreement shall not in any way relieve the Contractor of responsibility for the quality and accuracy of the services. In no event shall any action by the Department 12 hereunder constitute or be construed to be a waiver by the Department of any breach of covenant or default which may then exist on the part of the Contractor, and the Department's action or inaction when any such breach or default shall exist shall not impair or prejudice any right or remedy available to the Department with respect to such breach or default; and no assent, expressed or implied, to any breach of any one or more covenants, provisions or conditions of the Agreement shall be deemed or taken to be a waiver of any other breach. Acceptance by the Department of, or payment for, any services performed under this Agreement shall not be construed as a waiver of any of the Department's rights under this Agreement or under the law generally. 32. Emolovee Financial Interest/Conflict of Interest. C.R.S. §§24-18-201 et sea. and §24-50-507 The signatories to this Agreement aver that to their knowledge, no employee of Weld County has any personal or beneficial interest whatsoever in the service or property which is the subject matter of this Agreement. The Contractor has no interest and shall not acquire any interest direct or indirect, which would in any manner or degree with the performance of the Contractor's services and the Contractor, shall not employ any person having such known interests. During the term of this Agreement, the Contractor shall not engage in any in any business or personal activities or practices or maintain any relationships which actually conflicts with or in any way appear to conflict with the full performance of its obligations under this Agreement. Failure by the Contractor to ensure compliance with this provision may result, in the Department's sole discretion, in immediate termination of this Agreement. No employee of the Contractor nor any member of the Contractor's family shall serve on a County Board, committee or hold any such position which either by rule, practice or action nominates, recommends, supervises Contractor's operations, or authorizes funding to the Contractor. 33. Board of County Commissioners of Weld County Approval This Agreement shall not be valid until it has been approved by the Board of County Commissioners of Weld County, Colorado. 34. Choice of Law/Jurisdiction Colorado law, and rules and regulations established pursuant thereto, shall be applied in the interpretation, execution, and enforcement of this Agreement. Any provision included or incorporated herein by reference which conflicts with said laws, rules and/or regulations shall be null and void. In the event of a legal dispute between the parties, Contractor agrees that the Weld County District Court shall have exclusive jurisdiction to resolve said dispute. 35. Subcontractors Contractor acknowledges that the Department has entered into this Agreement in reliance upon the particular reputation and expertise of Contractor. Contractor shall not enter into any subcontractor agreements for the completion of this project without the Department's prior written consent, which may be withheld in the Department's sole discretion. 36. Attorney's Fees/Legal Costs In the event of a dispute between the Department and Contractor, concerning this Agreement, the parties agree that each party shall be responsible for the payment of attorney fees and/or legal costs incurred by or on its own behalf. 37. Ownership All work and information obtained by Contractor under this Agreement or individual work order shall become or remain (as applicable), the property of the Department. In addition, all reports, documents, 13 data, plans, drawings, records and computer files generated by Contractor in relation to this Agreement and all reports, test results and all other tangible materials obtained and/or produced in connection with the performance of this Agreement, whether or not such materials are in completed form, shall at all times be considered the property of the Department. Contractor shall not make use of such material for purposes other than in connection with this Agreement without prior written approval of the Department. 38. Interruptions Neither party to this Agreement shall be liable to the other for delays in delivery or failure to deliver or otherwise to perform any obligation under this Agreement, where such failure is due to any cause beyond its reasonable control, including but not limited to Acts of God, fires, strikes, war, flood, earthquakes or Governmental actions. 39. Severability If any term or condition of this Agreement shall be held to be invalid, illegal, or unenforceable by a court of competent jurisdiction, this Agreement shall be construed and enforced without such provision, to the extent that this Agreement is then capable of execution within the original intent of the parties. IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. ATTEST: We By: Dep 14 BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO Mike Freeman, Chair APR 2 9 2020 CONTRACTOR: New Hope Parenting Solutions 2505 Sapphire Street Loveland, CO 80537 (970) 682-4048 By: HeatherAckley (Apr Heather Ackley, Executive Director Date: Apr 13, 2020 aoao - ,'a� 7 EXHIBIT A WELD COUNTY'S REQUEST FOR PROPOSAL (Weld County's Request for Proposal is incorporated into this agreement by reference and will be provided upon request to the Department.) This page intentionally left blank. EXHIBIT B CONTRACTOR'S RESPONSE TO REQUEST FOR PROPOSAL New Hope Parenting Solutions Introduction Letter 2020-2021 Bid Proposal New Hope Parenting Solutions (NHPS) is based out of Loveland, Colorado. We offer parenting support to anyone raising a child ages birth to 18 years old. We work with biological, foster, kinship, and adoptive families. We offer services as a coach and through classes. We specialize in typical families as well as those who have been impacted by trauma. We are a 501 (c)(3) organization and offer services in person at the clients home and online. Our classes and support groups take place in various locations including but not limited to family homes, churches, and libraries. We are open to offer services in the community but abide by HIPPA and need to maintain that level of confidentiality regardless of where the meetings occur. NHPS has a policy to contact clients within 24 business hours of receiving a new referral. If the client does not respond, our policy is to try the second call within 72 business hours of the initial call. If there is no response within a week, we contact the referring worker to let them know. All intakes are scheduled as soon as possible but not further out than two weeks of the initial phone call in which we speak with the client. If the client is unavailable during that time frame, the intake will take place as soon as the client is available and the referring worker will be notified. If there is a time in which NHPS has a full case load, Weld County will be notified and new clients will be put on a wait list with the attempt to open them within a 2 week window. If that 2 week window is not an option because of an existing waitlist or caseload, Weld County will be notified immediately. As for the parenting classes, a parenting class will be scheduled once NHPS receives referrals for at least four individuals to participate. One class can hold up to 12 individuals. Classes will be scheduled throughout the year and more than one class can be held during the same 6-8 week time frame. NHPS has all mandated insurance and ensures that their practice abides by the law, ethics and values of the social work profession, any appropriate contracts obtained, and rules set forth by NHPS. NHPS mandates that all paperwork, emails, and phone calls be completed within 2 business days of the appointments or receiving of correspondence. P11 1 r%%A I I V I L 1 tl 1 U WELD COUNTY DEPARTMENT OF HUMAN SERVICES - PROVIDER INFORMATION FORM (PIF Please type your information using the form fields (boxes) below. You can press the Tab key to move from field to field. Agency Information Agency Name: New Hope Parenting Solutions Primary Contact Full Name: Heather Ackley Primary Phone Number (10 -digit): Primary Contact Email: 970-682-4048 Ext.: Trails Provider ID (if known): Title: Executive Director Fax Number (10 -digit): Heather@NewHopeParentingSolutions.org www,NewHopeParentingsolutions.org Web Address: Agency Location Address (street, city, state, zip): 2505 Sapphire Street Loveland CO 80537 Agency Mailing Address (street, city, state, zip): 2505 Sapphire Street Loveland CO 80537 Agency Type (pick one): fl Private F Private Non -Profit 11 Private for Profit DHS service referrals should be sent to whom in your organization: Referral Contact Name: Heather Ackley Referral Phone Number (10 -digit): 970-682-4048 Ext.: Title: Executive Director Email: Heather@NewHopeParentingSolutions.org Billing Contact Billing Contact Name: Heather Ackley Title: Executive Director 970-682-4048 Heather@NewHopeParentingSolutions.org Billing Phone Number (io-digit): Ext.: Email: ------av a s a s__ a a a-ama -- -- -a -a -a a a a aOW a a -an a --r a s --- as ---a--a-ME -- --I CERTIFICATION I certify that the services proposed for intended use by the Weld County Department of Human Services will meet all the specifications it has so indicated in this bid form. I further affirm intention to enter into an agreement with Weld County, on behalf of the Weld County Department of Human Services, and comply with all requirements of the contract, if awarded. The Board of Weld County Commissioners reserve the right to reject any or all bids, to waive any informality in the bids, and to accept the bid, or part of a bid, that, in the opinion of the Board, is in the best interests of the Board and of the County of Weld, State of Colorado. The Board of Weld County Commissioners shall give preference to resident Weld County bidders in all cases where the bids are competitive in price and quality. Authorized Rep. Full Name: Heather Ackley Title: Executive Director Authorized Rep. Email: Heather@NewHopeParentingSolutions.org Phone: 970-682-4048 Authorized Rep. Address: 2505 Sapphire Street Loveland CO 80537 Signature of Authorized a. a-- a r a Date: Ext.: 1/21/2020 a- OWN as aOW -- cal ATTACHMENT C - PROPOSAL TEMPLATE Please type your answers in the boxes below. SECTION 1 Provider and Program Area Information Bidder's Legal Name: New Hope Parenting Solutions Program Area: J Foster Parent Consultation Program Areas are listed in column 1 of the table located in Item Xl of the Request for Proposal starting on page 13. Service #1 Name: Number of services offered on this Exhibit C (max 5): You may complete another Exhibit Cif you have more than S. SECTION 2 — Service Name(s) and Information Foster Parent Coaching 2.1a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): We pull from a variety of parenting curriculum including Trauma Informed Care, Bruce Perry, Bryan Post, Love and Logic, 123 Magic, and the Protective Factors Survey. 2.1b Anticipated frequency of service per week (i.e. 4 hours/week): We meet twice a week in the beginning for an hour to an hour and a half each session and then taper t once every other week. 2.1c Anticipated duration of service (i.e. 3-4 months): Typically 3-6 months 2.1d Three (3), or more, specific goals of the service (DO use bullet points): • Increase trauma specific parenting knowledge, including the specifics of struggles faced by children placed in foster care. • Decrease unwanted and/or unsafe behaviors in order to support the child in being safe in their placement. • Increase the attachment between the child and foster parent(s). 2.1e Three (3), or more, specific outcomes of service: • Maintain placement to decrease number of foster homes experienced by the child. • increase relationship health and understanding of trauma for children in faster homes. • Increase child's success in their foster home and other areas including school. 2.1f Target population of the service, including age and gender: I Anyone raising or working with children ages;birth to 18 years. old 2.1g Languages service is available in (please list proficiency and if interpreter services are available): English 2.1h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: I. it is not eligible for Medicaid. Service #2 Name: 2.2a 2.2b 2.2c 2.2d 2.2e 2.Zf Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Anticipated frequency of service per week (i.e. 4 hours/week): Anticipated duration of service (i.e. 3-4 months): Three (3), or more, specific goals of the service (DO use bullet points): Three (3), or more, specific outcomes of service: Target population of the service: i g 4 REV. NOV 2019 1. ATTACHMENT C - PROPOSAL TEMPLATE 2.2g Languages service is available in (please list proficiency and if interpreter services are available): 2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Service #3 Name: 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.3b Anticipated frequency of service per week (i.e. 4 hours/week): 2.3c Anticipated duration of service (i.e. 3-4 months): 2.3d Three (3), or more, specific goals of the service (DO use bullet points): 2.3e Three (3), or more, specific outcomes of service: 2.3f Target population of the service: 2.3g Languages service is available in (please list proficiency and if interpreter services are available): 2.3h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Service #4 Name: 2.4a Modalities, curriculum, tools used in deliveryof service (DO NOT list company history; DO use bullet 2.4b Anticipated frequency of service per week (i.e. 4 hours/week): 2.4c Anticipated duration of service (i.e. 3-4 months): 2.4d Three (3), or more, specific goals of the service (DO use bullet points): 2.4e Three (3), or more, specific outcomes of service: 2.4f Target population of the service: 2.4g Languages service is available in (please list proficiency and if interpreter services are available): 2.4h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Service #5 Name: 2.5a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.5b Anticipated frequency of service per week (i.e. 4 hours/week): 2.5c Anticipated duration of service (i.e. 3-4 months): REV. NOV 2019 2 ATTACHMENT C - PROPOSAL TEMPLATE 2.5d Three (3), or more, specific goals of the service (DO use bullet points): 2.5e Three (3), or more, specific outcomes of service: 2.5f Target population of the service: 2.5g Languages service is available in (please list proficiency and if interpreter services are available): 2.5h Medicaid eligibility list whether the service is eligible for Medicaid in whole or in part Section 3 — Service Access and Transportation 3.1 Will you conduct services in your office? Yes • 3.1a If yes, office location(s): Online— We offer services nation wide. Our address for online services is SOS:. a. Sapphire Street Loveland CO 90537. 3.2 Will you conduct services out of the office? j• Yes 3.2a If yes, how many miles will you travel from your office? We will meet in person with families that Iivewithin 40 miles of our office. 3.3 Will you transport clients to and from No services? 3.3a If yes, what is your starting point -, address? • 3.3b If yes, how many miles will you travel from your starting point address? SECTION 4 - SERVICE RATES All rates need to include administrative work (i.e. report writing). Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly, daily, or monthly rates will be accepted for services, with the exception those listed above. Home study providers need to list their rates in 4.6. Monitored sobriety testing providers needs to list their rates in 4.7. 4.1 Service #1 Name: Foster Parent Coaching $ Amount Unit Type 4.1a 4.lb 4.1c 4.ld 4.1e In -Office rate: Out -of -office rate: FTM, TDM, Prof. Staffing: No show: Mileage rate after catchment: $130.00 per $140.00 per $90.00 per $40.00 per $0.56 1 per Hour Hour Meeting Missed Appointment Mile Catchment area in miles: 30 1 miles 4.1f If the rate(s) listed above are a monthly package, complete the boxes below. No. of Face-to-face hours: 1 per month No. of admin/case management hours: per month No, of travel hours per month REV. NOV 2019 ATTACHMENT C - PROPOSAL TEMPLATE TOTAL HOURS: ] per month 4.2 Service #2 Name: I.. $ Amount Unit Type 4.2a In -Office Rate: 4.2b Out -of -Office Rate: 4.2c FTM, TDM, Prof. Staffing: 4.2d No show: 4.2e Mileage rate after catchment: per per per per per Mile q. Catchment area in miles: miles 4.2f If the rate(s) listed above are a monthly package, complete the boxes below. No. of Face-to-face hours: No. of admin/case management hours: No. of travel hours TOTAL HOURS: per month per month per month per month 4.3 Service #3 Name: , $ Amount Unit Type 4.3a In -Office Rate: 4.3b Out -of -Office Rate: 4.3c FTM, TDM, Prof, Staffing: 4.3d No show: 4.3e Mileage rate after catchment: per per per per per Mite Catchment area in miles: 0 miles 4.3f If the rate(s) listed above are a monthly package, complete the boxes below. No. of Face-to-face hours: No. of admin/case management hours: No. of travel hours TOTAL HOURS: per month per month per month per month 4.4 Service #4 Name: $ Amount Unit Type 4Aa In -Office Rate: 4.4b Out -of -Office Rate: 4.4c FTM, TDM, Prof. Staffing: 4.4d No show: 4.4e Mileage rate after catchment: per per per per per Mile Catchment area in miles: 0 mites 4.4f If the rate(s) listed above are a monthly package, complete the boxes below. No. of Face-to-face hours: No. of admin/case management hours: Noof travel hours TOTAL HOURS: per month per month per month per month 4.5 Service #5 Name: ,p,._..g. �<<.Y ..q. m. �nF\ REV. NOV 2019 4 ATTACHMENT C - PROPOSAL TEMPLATE $ Amount 4.5a In -Office Rate: 4.5b Out -of -Office Rate: 4.5c FTM, TDM, Prof. Staffing: 4.5d No show: 4.5e Mileage rate after catchment: Unit Type per per per per per Mile Catchment area in miles: miles 4.5f if the rate(s) listed above area monthly package, complete the boxes below. No. of Face-to-face hours: No. of admin/case management hours: No. of travel hours TOTAL HOURS: 4.6 Home Study Providers — List your rates in the box below. 4.7 Monitored Sobriety Providers — List your rates in the box below. Provider special notes: Our- online°rate js $130.00 an hour. per month per month per month per month REV. NOV 21U9 5 ATTACHMENT C - PROPOSAL TEMPLATE Please type your answers in the boxes below. SECTION 1 Provider and Program Area information Bidder's Legal Name: New Hope Parenting-So'lutions Program Area: Kinship Services Program Areas are listed in column 1 of the table located in item XI of the Request for Proposal starting on page 13. Number of services offered on this Exhibit C (max 5): 1 You may complete another Exhibit C If you hove more than 5. SECTION 2 — Service Name(s) and Information Service #1 Name: Kinship Coaching 2.1a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): We pull from a variety of parenting curriculum including Trauma Informed Care, Bruce Perry, Bryan Post, Love and Logic, :123 Magic, and the Protective Factors Survey. 2.1b Anticipated frequency of service per week (i.e. 4 hours/week): We meet twice a week in the beginning for an hour to an hour and a half each session and then taper to once everyo1her week. 2.1c Anticipated duration of service (i.e. 3-4 months): Typically 3-6 months 2.1d Three (3), or more, specific goals of the service (DO use bullet points): • Increase trauma specific and dualrelationship parenting knowledge in order to support kinship parents in maintaining their original relationships with the child as well as how to parent in their new role. • Decrease unwanted and/or unsafe behaviors in order to maintain their kinship placement. • Increase the attachment between the child and kinship provider. 2.1e Three (3), or more, specific outcomes of service: • Maintain kinship placement in order to limit the number of placements experienced by the child. • Increase relationship health and understanding of trauma by kinship parents. increase child's success at their kinship home and other areas including school. i 2.1f Target population of the service, including age and gender: 1' -Anyone raising or working with children ages birth to 18 years=old 2.1g Languages service Is available in (please list proficiency and if interpreter services are available): English.., 2.1h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: rlt is not eligible for Medicaid. Service #Z Name: 2.2a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.2b Anticipated frequency of service per week (i.e. 4 hours/week): 2.2c Anticipated duration of service (i.e. 3-4 months): 2.2d Three (3), or more, specific goals of the service (DO use bullet points): 2.2e Three (3), or more, specific outcomes of service: 2.2f Target population of the service: -yx S ! f^- T fK^o'i- `E�° f Y' L" F 5,r M.c-� H i -Y_n 5�' -+V K YF e IIy T' q.. -hA ♦ i t 3 5 $T :Ft' ♦'5 _ Flw Riff5il i sv hs v m ? A.ft�A� .�. . v✓uELn /+='.4 �.4 Lot � u J �. REV. NOV 2019 1 ATTACHMENT C - PROPOSAL TEMPLATE 2.2g Languages service is available in (please list proficiency and if interpreter services are available): 2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: • Service #3 Name: 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.3b Anticipated frequency of service per week (i.e. 4 hours/week): • RnY¢�+v a 'iF£ VI tl Y 1. yt } �.. .. . I icy. q r f i P'i Sy} .i'. t Y 'i. a '�•: A W 1 O ,� � ...yYu4A s.v .Wy-+.nsL.'4.*�.l+�art.+�'.�r et -a++.+' 6h C ) 9Y t .• 2.3c Anticipated duration of service (i.e. 3-4 months): 2.3d Three (3), or more, specific goals of the service (DO use bullet 2.3e Three (3), or more, specific outcomes of service: 2.3f Target population of the service: 2.3g Languages service is available in (please list proficiency and if interpreter services are available): -_ r —. .. - A ..rk . -. .- R - - 2.3h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Service #4 Name: 2.4a Modalities, curriculum, tools used in delivery of service (DO NOT list company history, DO use bullet points): 2.4b Anticipated frequency of service per week (i.e. 4 hours/week): 2.4c Anticipated duration of service (i.e. 3-4 months): 2.4d Three (3), or more, specific goals of the service (DO use bullet points): 2.4e Three (3), or more, specific outcomes of service: 2.4f Target population of the service: 2.4g Languages service is available in (please list proficiency and if interpreter services are available): 2.4h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in Service #5 Name: 2.5a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.5b Anticipated frequency of service per week (i.e. 4 hours/week): 2.5c Anticipated duration of service (i.e. 3-4 months): REV. NOV 2019 2 ATTACHMENT C - PROPOSAL TEMPLATE 2.5d Three (3), or more, specific goals of the service (DO use bullet points): ID' +.Yrt^Yy Y:.. n 7 4 C i +yil l ET C x%55 y fr I` w't PR ''m_ � XM1` t 'i 2.5e Three (3), or more, specific outcomes of service: 2.5f Target population of the service: 2.Sg Languages service is available in (please list proficiency and if interpreter services are available): 1 . 2.Sh Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part Section 3 — Service Access and Transportation 3.1 Will you conduct services in your office? Yes - 3.1a if yes, office location(s): Online - We offer services nationwide. Our.address_ for amine services`Ks 2505 . ; ., Sapphire Street Loveland CO 80537. 3.2 Will you conduct services out of the office? L yes 3.Za if yes, how many miles will you travel from your office? We will meet in person with families that rive within 40 miles of our offices -- 3.3 Will you transport clients to and from No' services? 3.3a if yes, what is your starting point - address? - 3.3b If yes, how many miles will you travel from your starting point address? SECTION 4 —SERVICE RATES All rates need to include administrative work (i.e. report writing). Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly, daily, or monthly rates will be accepted for services, with the exception those listed above. Home study providers need to list their rates in 4.6. Monitored sobriety testing providers needs to list their rates In 4.7. 4.1 Service #1 Name: Knship Coaching $ Amount Unit Type 4.la 4.lb 4.1c 4.ld 4.le In -Office rate: Out -of -office rate: FrM, TOM, Prof. Staffing: No show: Mileage rate after catchment: $130.00 per $140.00 per $90.00 per $40.00 per $056 j per Hour Hour Meeting Missed Appointment Mile Catchment area in miles: Ii' 30 miles 4.lf If the rate(s) listed above are a monthly package, complete the boxes below. No. of Face-to-face hours: per month No. of admin/case management hours: per month No. of travel hours per month REV. NOV 2019 3 ATTACHMENT C - PROPOSAL TEMPLATE TOTAL HOURS: per month 4.2a In -Office Rate: 4.2b Out -of -Office Rate: 4.2c FTM, TDM, Prof. Staffing: 4.2d No show: 4.2e Mileage rate after catchment: 4.2f per per per per per Mile Catchment area in miles: miles If the rate(s) listed above are a monthly package, complete the boxes below. No. of Face-to-face hours: j per month No. of admin/case management hours: per month No. of travel hours - per month TOTAL HOURS: I per month 4.3 Service #3 Name: i $ Amount Unit Type 4.3a In -Office Rate: 4.3b Out -of -Office Rate: 4.3c FTM, TDM, Prof. Staffing: 4.3d No show: 4.3e Mileage rate after catchment; per per per per per Mile Catchment area in miles: miles 43f If the rate(s) listed above are a monthly package, complete the boxes below. No. of Face-to-face hours: No. of admin/case management hours: No. of travel hours TOTAL HOURS: per month per month per month per month 4.4 Service #4 Name: $ Amount Unit Type 4.4a In -Office Rate: 4.4b Out -of -Office Rate: 4.4c FTM, TDM, Prof. Staffing: 4.4d No show: 4.4e Mileage rate after catchment: per per per per per Catchment area in miles: 1: miles 4.4f If the rate(s) listed above are a monthly package, complete the boxes below. No. of Face-to-face hours: No. of admin/case management hours: No. of travel hours TOTAL HOURS: per month per month per month per month 4.5 Service #5 Name: REV. NOV 2019 4 ATTACHMENT C - PROPOSAL TEMPLATE 4.5a In -Office Rate: 4.5b Out -of -Office Rate: 4.5c FTM, TDM, Prof. Staffing: 4.5d No show: 4.5e Mileage rate after catchment: per per _______ � per —{ per per Unit Type Mile Catchment area in miles: L miles 4.Sf If the rate(s) listed above are a monthly package, complete the boxes below. No. of Face-to-face hours: No. of admin/case management hours: No. of travel hours TOTAL HOURS: 4.6 Home Study Providers — List your rates in the box below. 4.7 Monitored Sobriety Providers — List your rates in the box below. Provider special notes: i uronline rate Is$130M0 an hour: per month per month per month per month REV. N0V 2019 5 ATTACHMENT C - PROPOSAL TEMPLATE Please type your answers in the boxes below. SECTION 1 Provider and Program Area Information Bidder's Legal Name: New Hope Parenting Solutions Program Area: I.L1fesi1ts Program Areas are listed in column I of the table located in Item XI of the Request for Proposal starting on page 13. Number of services offered on this Exhibit C (max 5): 13 i You may complete another Exhibit C if you have more than 5. SECTION 2 — Service Name(s) and Information Service #1 Name: [Parent Coaching 2.1a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): We pull from a variety of parenting curriculum including Trauma Informed Care, Bruce Perry, Bryan Post, Love and Logic, 123 Magic, and the Protective Factors Survey. 2.1b Anticipated frequency of service per week (i.e. 4 hours/week): We meet twice a week in the beginning for an hour to an hour and a half each session and then_taper to once every other week. _ _ 2.1c Anticipated duration of service (i.e. 3-4 months): Typically 3-6 months 2.1d Three (3), or more, specific goals of the service (DO use bullet points); • Increase parenting knowledge to create a safe and healthy environment • decrease unwanted and/or unsafe behaviors • increase the attachment between the child and parent or caregiver. 2.1e Three (3), or more, specific outcomes of service: • Maintain placement • increase relationship health and understanding of trauma • increase child's success at home and other areas including school 2.1f Target population of the service, including age and gender: Anyone raising or working with children ages birth to 18 years old. Any of the primary caregiver or parents social supports, family supports, and other caregivers are welcome to attend all meetings. 2.ig Languages service is available in (please list proficiency and If interpreter services are available): English 2.1h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: It is not eligible; for Medicaid:, Service #2 Name: Parenting Classes/Step 1 2.2a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): We pull from a variety of parenting curriculum including Trauma Informed Care, Bruce Perry, Bryan Post, Love and Logic, 123 Magic, and the Protective Factors Survey. 2.2b Anticipated frequency of service per week (i.e. 4 hours/week): Classes run for an hour to an hour and a half a week. 2.2c Anticipated duration of service (i.e. 3-4 months): 6 Weeks 2.2d Three (3), or more, specific goals of the service (DO use bullet points): • increase general parenting knowledge to create a safe and healthy environment • decrease unwanted and/or unsafe behaviors • Increase the attachment between the child and parent or caregiver. 2.2e Three (3), or more, specific outcomes of service: REV. Nov 2019 ATTACHMENT C - PROPOSAL TEMPLATE • Maintain placement • Increase relationship health and understanding of trauma • Increase child's success at home and other areas including school 2.2f Target population of the service: Anyone raising or working with children ages birth to 18 years old 2.2g Languages service is available in (please list proficiency and If interpreter services are available): 2.2h Medicaid eligibility - list whether the service is eligible for Medicaid in whole or in part: it is not eligible for Medicaid, Service #3 Parentingdasses/Trauma Focused Step 1 Name: 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): We pull from a variety of patenting curriculum including Trauma informed Care, Bruce Perry, Bryan Post, Love and Logic, 123 Magic, and the Protective Factors Survey. 2.3b 2.3c 23d Anticipated frequency of service per week (i.e. 4 hours/week): gasses run for.an hourto an hourand a half a week. Anticipated duration of service (i.e. 3-4 months): B Weeks Three (3), or more, specific goals of the service (DO use bullet points): • •increase trauma specific and general parenting knowledge to create a safe • decrease unwanted and/or unsafe behaviors • increase the attachment between the child and parent or caregiver. 2.3e Three (3), or more, specific outcomes of service: • Maintain placement • increase relationship health and understanding of trauma • increase child's success at home and other areas including school 2.3f Target population of the service: I Anyone raising or workingwith children ages birth to 18 years old 2.3g Languages service is available in (please list proficiency and if interpreter services are available): English 2.3h Medicaid eligibility — list whether the service Is eligible for Medicaid in whole or in part: It is -not eligible for Medicaid. Service #4 Name; 2.4a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.4b Anticipated frequency of service per week (i.e. 4 hours/week): 2.4c Anticipated duration of service (i.e. ) 3-4 months : environment 2.4d Three (3), or more, specific goals of the service (DO use bullet points): 2.4e Three (3), or more, specific outcomes of service: 2.4f Target population of the service: 2.4g Languages service is available in (please list proficiency and if interpreter services are available): 2.4h Medicaid eligibility— list whether the service is eligible for Medicaid in whole or in part: REV. NOV 2019 2 ATTACHMENT C - PROPOSAL TEMPLATE Service #5 Name: 2.5a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.5b 2.5c 2.5d 2.5e Anticipated frequency of service per week (i.e. 4 hours/week): .�, x �''�`x«a+,�"� ":. m.. } yar 4 991'iriltiJ��".to-� Y.a�,aSryrytl"Yavri t{ ti via. .t�o-{�NNa�iYd. 'VaRAY `#dh.w ..... �.> ec_ t`5ue�M1 Yr.!'4. Anticipated duration of service (i.e. 3-4 months): Three (3), or more, specific goals of the service (DO use bullet points): 2.5f Target population of the service: 2.5g Languages service is available in (please list proficiency and if interpreter services are available): . 2.sh Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part Section 3 — Service Access and Transportation 3.1 Will you conduct services in your office? 3.1a if yes, office location(s): Online — We offer services nation wide. Our address for .online services is 2505 Sapphire Street Loveland_CO 80537, 3.2 Will you conduct services out of the office? Yes ' 3.2a If yes, how many miles will you travel from your office? 3.3 Will you transport clients to and from services? 3.3a if yes, what is your starting point address? We will meet in person with families that live within 40 miles of our office. 33b if yes, how many miles will you travel from your starting point address? SECTION 4 -SERVICE RATES All rates need to include administrative work (i.e. report writing). Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly, daily, or monthly rates will be accepted for services, with the exception those listed above. Home study providers need to list their rates in 4.6. Monitored sobriety testing providers needs to list their rates in 4.7. 4.1 Service #1 Name: Parent Coaching $ Amount Unit Type 4.1a In -Office rate: $130.00 per Hour REV. NOV 2019 3 ATTACHMENT C - PROPOSAL TEMPLATE 4.1b Out -of -office rate: 4.1c FTM, TOM, Prof. Staffing: 4.1d No show: 4.1e Mileage rate after catchment: $140.00 $90.00 $40.00 $0.56 per Hour per Meeting per Missed. per Mile Catchment area in miles: 4.lf if the rate(s) listed above are a monthly package, complete the boxes below. No. of Face-to-face hours: No. of admin/case management hours: No. of travel hours TOTAL HOURS: per month per month per month per month 30 1miles 4.2 Service #2 Name: Parenti•ngtlasses/Step 1: •r - $ Amount Unit Type 4.2a In -Office Rate: 4.2b Out -of -Office Rate: 4.2c FTM, TOM, Prof. Staffing: 4.2d No show: 4.2e Mileage rate after catchment: $40.00 $15.00 $0.56 4.2f If the rate(s) listed above are a monthly No. of Face-to-face hours: No. of admin/case management hours: No. of travel hours TOTAL HOURS: per per per per per Class Meeting Missed Class Mile complete -- per per per per 4.3 Service #3 Name: Parenting Classes/Trauma Focused Step 1 $ Amount Unit Type 4.3a In -Office Rate: 4.3b Out -of -Office Rate: 4.3c FTM, TDM, Prof. Staffing: 4.3d No show: 4.3e Mileage rate after catchment: per $40.00 per $90.00 $15.00 per per per Meeting Missed Class Mile Catchment area in miles: the boxes below. month month month month Catchment area in miles: 4.3f if the rate(s) listed above are a monthly package, complete the boxes below. No. of Face-to-face hours: No. of admin/case management hours: No. of travel hours TOTAL HOURS: per month per month per month per month 4.4 Service #4 Name: $ Amount Unit Type 4.4a in -Office Rate: per jg =` miles • k. 0 miles REV. NOV 2019 4 ATTACHMENT C - PROPOSAL TEMPLATE 4,4b Out -of -Office Rate: per Catchment area in miles miles: 4.4c FTM, TDM, Prof. Staffing: per L:J 4.4d No show: per 4.4e Mileage rate after per Mile catchment: 4.4f If the rate(s) listed above area monthly package, complete the boxes below. No. of Face-to-face hours: per month No. of admin/case management hours: _ - per month No. of travel hours per month TOTAL HOURS: per month 4.5 Service #5 Name: ;T21'F , , $ Amount Unit Type 4.5a In -Office Rate: per 4.5b Out -of -Office Rate: per Catchment area in •,' ,,,' miles ( miles: # 4.5c FTM, TDM, Prof. Staffing: per 4.5d No show: I per 4.5e Mileage rate after catchment: per Mile 4,5f If the rate(s) listed above are a monthly package, complete the boxes below. No. of Face-to-face hours: per month No. of admin/case management hours: per month No. of travel hours per month TOTAL HOURS: per month 4.6 Home Study Providers — List your rates in the box below. 4.7 Monitored Sobriety Providers — List your rates in the box below. Provider special notes: Qur online rate.is $131).OO arrt hour. REV. NOV 2019 5 �R R • ! I • FR i . J n / • 1:' (. ! 1 i - 1Y Y..: • i T.' •i.. 1• . • _R �. a _ i,11 Tf f '• . •.. • 1 1. • '.1 a'_ e. ' • •If - n • -i" • T • i a' I f' i a1 -•1 ♦ S(� SC'�9i •'1'--� T __ n iw, ' i _. . r . a _ • • • � • 1 ft. F 1 I n a •.. 1 • • a � . a : a • � ' ® i I a a - • - -- ____ -- - - - I - H- a- ____ --- - -- - 81800058 DATE (MMIDDNYYY) ACORo® CERTIFICATE OF LIABILITY INSURANCE 2/7/2020 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 Secure American Insurance Lance Leivestad 2105 Maple Drive Loveland INSURED New Hope Parenting Solutions 2505 SAPPH RE ST LOVELAND COVERAGES CO 80538 CO 80537 CERTIFICATE NUMBER: NAME: Rachel Rogers fIPHONIFAX aifl bi F„o- 970-663-9197 IAtC. Not: 970-237-3412 rachel@yoursai.com AFFORDING COVERAGE INSURER A: HISCOX INS CO INC INSURER B: INSURER C: INSURER 0: INSURER E: INSURER F: REVISION NUMBER: NAIC # 10200 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. *43W LTR TYPE OF INSURANCE AUJUt INSD SUBR WVD POLICY NUMBER POLICY EFF (MMIDD(YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A K COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I x OCCUR Y UDC-4394624-CGL-20 01/31/2020 01/31/2021 EACH OCCURRENCE $ 1,000,000 PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 'L AGGREGATE LIMIT APPLIES PER: POLICYJE�LOC GENERAL AGGREGATE $ 2,000,000 MOTHER: PRODUCTS-COMP/OPAGG $ 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY (Ea accident) BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE$ (Per accident) UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION ND EMPLOYERS' LIABILITY V/ N ANY PROPRIETORIPARTNERJEXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A STATUTE - ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Additional Insured: Board of County Commissioners of Weld County and its Officers/Employees CFRTIFIrATF HAI DFR 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. 1150 O ST AUTHORIZED REPRESENTATIVE Ra4aL Rogers Greeley CO 80631 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD EXHIBIT C SCOPE OF SERVICES 1. Contractor will provide Parent Coaching, Parenting Classes, Foster Parent Coaching and Kinship Coaching, as referred by the Department. 2. Parenting Coaching: a. Contractor utilizes a curriculum developed by Contractor's staff that is based upon evidence - based approaches, as well as trauma informed approach. b. Capacity for Services: i. Initially up to two (2) hours per week. A minimum of two (2) times per week for one (1) hour to two (2) hours. Contractor will taper hours per referred family as needed. c. Goals of Service: Increase parenting knowledge in order to prevent child abuse. d. Outcomes of Service: i. Maintain children with their families. ii. Decreased violent behaviors in children. e. Target Population: i. Children, ages birth to 18 years old. ii. Biological, foster, kinship and adoptive families. f. Location of Services: i. Contractor provides services online. ii. Will travel up to 40 miles from practitioner's office, 2505 Sapphire Street, Loveland, CO 80537. g. Language: English only. 3. Parenting Classes: a. Contractor utilizes a curriculum developed by Contractor's staff that is based upon evidence - based approaches, as well as trauma informed approach. b. Capacity for Services: Contractor offers two (2) classes; Step 1 and Trauma Focused Step 1. i. Step 1: 1. Six -week class, one (1) and one-half (1/2) hours per week. 2. Class focuses on specific parenting supports including, but not limited to, the following: a. Consistency. b. Follow through. c. Appropriate consequences. d. Child's need for positive attention. e. Rewards. ii. Trauma Focused Step 1: 1. Eight -week class, one (1) and one-half (1/2) hours per week 2. Class focuses on specific parenting supports including, but not limited to, the following: a. Consistency. b. Follow through. c. Appropriate consequences. d. Child's need for positive attention. e. Rewards. 3. Includes two (2) additional classes that focus on trauma -specific knowledge, including, but not limited to, the following: a. Why the child is struggling more than a typically developing child. b. Why the child may exhibit violence. c. Psycho -education around trauma and how it impacts the brain. d. Importance of timing. c. Goals of Service: Increase parenting knowledge in order to prevent child abuse. d. Outcomes of Service: i. Increased parental knowledge. ii. Maintain children with their families. iii. Decreased violent behaviors in children. e. Target Population: i. Children, ages birth to 18 years old. ii. Biological, foster, kinship and adoptive families. iii. Individuals and families affected by trauma. f. Location of Services: i. Online ii. Will travel up to 40 miles from practitioner's office, 2505 Sapphire Street, Loveland, CO 80537. g. Language: English only. 4. Kinship Coaching: a. Contractor utilizes a curriculum developed by Contractor's staff that is based upon evidence - based approaches, as well as trauma informed approach. b. Capacity for Services: i. A minimum of two (2) times per week for one (1) hour to two (2) hours. Contractor will taper hours per referred family as needed. Anticipated duration is (3) three to (4) four months. c. Goals of Service: i. Increase parenting knowledge in order to prevent child abuse. ii. Decrease unwanted and/or unsafe behaviors in order to maintain the kinship placement. iii. Increase the attachment between the child and kinship provider. d. Outcomes of Service: i. Maintain children with their families. ii. Decreased violent behaviors in children. iii. Increase the relationship health and understanding of trauma by kinship parents. e. Target Population: i. Children, ages birth to 18 years old. ii. Biological, foster, kinship and adoptive families. f. Location of Services: i. Online ii. Will travel up to 40 miles from practitioner's office, 2505 Sapphire Street, Loveland, CO 80537. g. Language: English only. 5. Foster Parent Coaching: a. Contractor utilizes a curriculum developed by Contractor's staff that is based upon evidence - based approaches, as well as trauma informed approach. b. Capacity for Services: I. A minimum of two (2) times per week for one (1) hour to two (2) hours. Contractor will taper hours per referred family as needed. Anticipated duration is (3) three to (4) four months. c. Goals of Service: i. Increase parenting knowledge in order to prevent child abuse. ii. Decrease unwanted and/or unsafe behaviors in order to maintain the kinship placement. iii. Increase the attachment between the child and kinship provider. d. Outcomes of Service: i. Maintain children with their families. ii. Increase relationship health and understanding of trauma for children in foster homes. iii. Increase measurable success is the foster home and school. e. Target Population: i. Children, ages birth to 18 years old. ii. Biological, foster, kinship and adoptive families. f. Location of Services: i. Online ii. Will travel up to 40 miles from practitioner's office, 2505 Sapphire Street, Loveland, CO 80537. g. Language: English only. 6. Contractor will respond to the Quality Assurance Team Supervisor (hainleid@weldgov.com. 970-400- 6210) within three (3) business days regarding the ability to accept the received referral. 7. Upon acceptance of a referral, Contractor will offer an initial appointment within seven (7) days of receiving the referral. The first attempt to contact the client will occur within 24 hours of receiving the referral (excluding weekends and holidays). Contractor will document efforts to engage client in referred services. If the client does not respond after three (3) attempts in the first seven (7) days of the referral period, the Contractor will notify the caseworker and the Quality Assurance Team Supervisor (hainleid@weideov.com, 970-400-6210). 8. Contractor understands that "no shows" are defined as unexcused and unplanned/uncommunicated absences for visitation services. If a rate for "no shows" is not specifically stated in Exhibit D, Rate Schedule, then Contractor understands that the Department will not reimburse for "no shows". Contractor understands that the Department will only reimburse Contractor for up to two (2) "no-shows" on the part of the client per month. After three (3) "no-shows", Contractor will place client on a behavioral plan requiring attendance or discharged client from services. Contractor must inform the caseworker and the Quality Assurance Team Supervisor (hainleid@weldgov.com, 970-400-6210). 9. Contractor understands that the Department will not reimburse Contractor for cancelled appointments either on the part of the client or the Contractor. If the cancellation is generated from the Contractor, a "makeup" session/episode, to occur within 30 days of the cancellation, will be offered to the client (excluding session/episodes that fall on holidays). If the cancellation is generated from the client, the Contractor must request a makeup session from the Department prior to the makeup session occurring (excluding session/episodes that fall on holidays). After three (3) cancellations, Contractor will inform the caseworker and the Quality Assurance Team Supervisor (hainleid@weldeov.com) immediately via email, to discuss service continuation. 10. Contractor will identify in detail areas of continued concern and make recommendations to the Department regarding continuation of services and/or the need for additional services. 11. 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 immediately AND on the required monthly report. 12. Contractor will submit reports on a monthly basis for each active referral for ongoing services. Reports will be submitted per the online format required by the Department, unless otherwise directed by the Department. 13. Contractor agrees any change to an existing referral must be pre -approved through the Child Welfare Contract and Services Coordinator, a Department -facilitated Team Decision Making (TDM) or Family Team Meeting (FTM), or by court order. 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. 14. Contractor will notify the Quality Assurance Team Supervisor (hainleid@weldgov.com, 970-400-6210) of new staff who will manage and/or administer the services with the following information: a. Staff member name and contact information b. Education level/degree (if applicable) c. Licensure/credentials (if applicable) d. Department of Regulatory Authority (DORA) number (if applicable) e. Supervisor name and contact information The Department reserves the right to decline the new staff members managing and/or administering services to Department clients. EXHIBIT D RATE SCHEDULE 1. Funding and Method of Payment The Department agrees to reimburse the Contractor in consideration of the work and services performed under this Agreement at the rate specific in Paragraph 2, below. The total amount to be paid to the Contractor during the term of this Agreement shall be reported by the Department after May 31, 2021. Expenses incurred by the Contractor prior to the term of this Agreement are not eligible Department expenditures and shall not be reimbursed by the Department. Payment pursuant to this Agreement, whether in whole or in part, is subject to and contingent upon the continuing availability of said funds for the purposes hereof. In the event that said funds, or any part thereof, become unavailable as determined by the Department, the Department may immediately terminate the Agreement or amend it accordingly. Fees for Services Parent Coaching $130.00/Hour (In -Office) $140.00/Hour (Out -of -Office) $90.00/Meeting (FTM, TDM, Prof. Staffing) $40.00/Missed Appointment (No show) $ .56/Mile (Mileage) — For distance exceeding thirty (30) miles from practitioner's office located at 2505 Sapphire Street, Loveland, CO 80537 Parenting Classes/Step 1 $40.00/Class (Out -of -Office) $90.00/Meeting (FTM, TDM, Prof. Staffing) $15.00/Missed Class (No show) $ .56/Mile (Mileage) — For distance exceeding thirty (30) miles from practitioner's office located at 2505 Sapphire Street, Loveland, CO 80537 Parenting Classes/Trauma Focused Step 1 $40.00/Class (Out -of -Office) $90.00/Meeting (FTM, TDM, Prof. Staffing) $15.00/Missed Class (No show) $ .56/Mile (Mileage) — For distance exceeding thirty (30) miles from practitioner's office located at 2505 Sapphire Street, Loveland, CO 80537 Foster Parent Coaching $130.00/Hour (In -Office) $140.00/Hour (Out -of -Office) $90.00/Meeting (FTM, TDM, Prof. Staffing) $40.00/Missed Appointment (No show) $ .56/Mile (Mileage) — For distance exceeding thirty (30) miles from practitioner's office located at 2505 Sapphire Street, Loveland, CO 80537 Kinship Coaching $130.00/Hour (In -Office) $140.00/Hour (Out -of -Office) $90.00/Meeting (FTM, TDM, Prof. Staffing) $40.00/Missed Appointment (No show) $ .56/Mile (Mileage) — For distance exceeding thirty (30) miles from practitioner's office located at 2505 Sapphire Street, Loveland, CO 80537 Contractor will be above rates for the identified service, associated team meetings and court appearances. Submittal of Vouchers Contractor shall prepare and submit monthly a Request for Reimbursement, Client Verification Form, other supporting documentation, and monthly report 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 and Exhibit A. Contractor shall submit all Requests for Reimbursement and supporting documentation to the Department by the 7th day of the month following the month of service, but no later than 60 days from the date of service. Requests for Reimbursement and/or supporting documentation received after 60 days from the date of service may result in delay or forfeiture of payment. Consistent failure to meet the 60 -day deadline may result in termination of the Agreement. For ongoing services, proof of services rendered shall be a Client Verification Form signed by the client and a monthly report submitted in accordance with Paragraph 3(d) of this Agreement. For one-time services, proof of services rendered shall be receipt of a Client Verification Form and the completed product. For Monitored Sobriety services, proof of services rendered shall be the test result. New Contract Request Entity Information Entity Name* Entity tD * ❑ New Entity? NEW HOPE PARENTING SOLUTIONS @00041600 Contract Narne* Contract ID Parent Contract ID NEW HOPE PARENTING SOLUTIONS (CHILD PROTECTION 3543 AGREEMENT FOR SERVICES) Contract Lead * Requires Board Approval Contract Status CULLINTA YES CTB REVIEW Contract Lead Email Department Project # cullintatco-weld. co. us Contract Description * CONSENT. BID NO. 2000037. NEW AGREEMENT FOR SERVICES, TERM: 06101/20 THROUGH 05/31/21 _ FUNDING: CORE/OTHER Contract Description 2 Contract Type Depamnent Requested BOCC Agenda Due Date AGREEMENT HUMAN SERVICES Date* 04/18/2020 0412212020 aunt * Department Email $0.00 CSI- Will a work session with BOCC be rewired?* HumanServices@we11dgov. corn NO Renewable YES Department Head l Does Contract require Purchasing Dept. to be included? CM-HunianServtces- Automatic Renewal DeptHead eldg€ay.corn County Attorney Grant GENERAL COUNTY ATTORNEY EMAIL County Attorney Email CM- COUNTYATTOR.NEY WEC D GOV.COM 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 On8ase Contract Dates Effective Date Termination Notice Period Review Date* 04/0112021 Committed Delivery Date Renewal Date* 0510112021 Expiration Date Contact Information Contact Info Contact Name Purchasing Purchasing Approver Approval Process Departnint Head JAMIE ULRIGH DH Approved Date 04/2112020 ROCC Agenda Date 0412912020 Originator SNYDERKL Submit Contact Type Contact Email Contact Phone 1 Contact Phone 2 :iu,ii 21 Purchasing Approved Date Tyler Ref # AG 042920 Legal Counsel GABE KALOUSEK Legal Counsel Approved Date 04/22(2020 Hello