HomeMy WebLinkAbout20221795.tiffRESOLUTION
RE: APPROVE FIVE (5) STANDARD FORMS OF AGREEMENTS FOR VARIOUS OUT -OF -
HOME PLACEMENT SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF
HUMAN SERVICES AND VARIOUS PROVIDERS ON ATTACHED LISTS AND
AUTHORIZE CHAIR TO SIGN AGREEMENTS CONSISTENT WITH SAID FORMS
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board, has been presented with five (5) Standard Forms of Agreements
for Various Out -of -Home Placement Services between the Weld County Department of Human
Services and various providers as shown on the attached provider lists, and
1. Exhibit to SS23A—Additional Provisions for Purchase of Child
Placement Agency Services
2. Exhibit to SS23A — Additional Provisions for Purchase of
Treatment Foster Care Services
3. Exhibit to SS23A — Additional Provisions for Purchase of
Group Home/Group Center Care Services
4. Exhibit to SS23A — Additional Provisions for Purchase of
Residential Child Care Facility Services
5. Exhibit to SS23A — Additional Provisions for Purchase of
Qualified Residential Treatment Program Services
WHEREAS, after review, the Board deems it advisable to approve the five (5) Standard
Forms of Agreements for Various Out -of -Home Placement Services, copies of which are attached
hereto and incorporated herein by reference, and to delegate standing authority to the Chair of
the Board of County Commissioners to execute individual agreements between the Department
of Human Services and the individuals identified on the attached provider lists.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County, Colorado, that these standard forms between the Weld County Department of Human
Services and various providers, be, and hereby are, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign any agreements consistent with said forms.
CC: I -IS D, c A (KN), AcT(cp/cD),
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2022-1795
HR0094
FIVE (5) STANDARD FORMS OF AGREEMENTS FOR VARIOUS OUT -OF -HOME
PLACEMENT SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN
SERVICES AND VARIOUS PROVIDERS ON ATTACHED LISTS
PAGE 2
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 22nd day of June, A.D., 2022.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST: ddttA) W J440;4.
ott K. James, Chair
Weld County Clerk to the Board
BY:
eputy Clerk to
APPRO./ED
Mi'-man, Pro-Te
Perry L. Buc
teve Moreno
ounty `' orney ( ; ' -:�, � , _ ''+ �1ti.1%A.
Date of signature: 7/7/2
Lori Saine
2022-1795
HR0094
PRIVILEGED AND CONFIDENTIAL
MEMORANDUM
DATE: June 14, 2022
TO: Board of County Commissioners — Pass -Around
FR: Jamie Ulrich, Director, Human Services
RE: The Weld County Department of Human Services'
Child Welfare SFY 2022-23 Out -of -Home (OOH)
State Licensed Provider Exhibit Templates, OOH
Provider List, and Associated Rates
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 Weld County Department of Human Services' Child
Welfare SFY 2022-23 Out -of -Home (OOH) State Licensed Provider Exhibit Templates,
Provider List, and Associated Rates. The State requires Counties to enter into agreements with
providers for the purchase of out -of -home (OOH) placement services and has established the
Agreement to Purchase Out -of -Home Placement Services SS23A as the State prescribed
agreement for these services. Counties are unable to alter the State SS23A agreement, therefore
Weld County has chosen to add County specific requirements for these providers within the
specified exhibits. Listed below and attached for your reference are the proposed County
exhibits to the SS23A for the purchase of OOH placement services and the SFY 2022-23
provider lists. The updated templates have been reviewed by Assistant County Attorney, Catlin
Perry, and have been approved for use for the 2022-23 contract year. Upon approval by the
Board, individual agreements will be issued and processed through CMS. The service rate will
be the Contractor's base anchor rate as outlined by the Colorado Office of Children, Youth &
Families Division of Child Welfare, unless the Contractor and County agree to utilize the
Inventory for Client and Agency Planning (ICAP) assessment and corresponding rate structure
for children who have significant intellectual or developmental disabilities or intensive medical
or physical needs.
The term of these agreements will be from July 1, 2022 to June 30, 2023. The following
information is attached for your review:
State Licensed Providers Child Placement Agencies (CPA)
I. Exhibit to the SS23A Agreement to Purchase OOH Placement Services with CPA
providers.
2. List of CPA State Licensed OOH placement providers for SFY 21-22.
Pass -Around Memorandum; June 14, 2022 - CMS (Not in CMS) Page 1
2022-1795
OWN_
PRIVILEGED AND CONFIDENTIAL
State Licensed Providers Treatment Foster Care
1. Exhibit to the SS23A Agreement to Purchase OOH Placement Services with Treatment
Foster Care providers.
2. List of Treatment Foster Care State Licensed 001-1 placement providers for SFY 22-23.
State Licensed Providers Group Home/Group Center
1. Exhibit to the SS23A Agreement to Purchase OOH Placement Services with Group
Home/Group Center providers.
2. List of Group Home/Group Center State Licensed OOH Placement providers for SFY 22-
23.
State Licensed Providers Residential Child Care Facilities (RCCFI
1. Exhibit to the SS23A Agreement to Purchase OOH Placement Services with RCCF
providers.
2. List of RCCF State Licensed OOH Placement providers for SFY 22-23.
State Licensed Oualified Residential Treatment Program (ORTP),
I . Exhibit to the SS23A Agreement to Purchase OOH Placement Services with QRTP
providers.
2. List of QRTP State Licensed OOH Placement providers for SFY 22-23.
I do not recommend a Work Session. I recommend approval of the agreement exhibit templates, provider
rates, and listed OOH State licensed providers, and authorize the Chair to sign approved agreements.
Approve Schedule
Re mendation Work Session Other/Comments:
Perry L. Buck
Mike Freeman, Pro -Tenn
Scott K. James, Chair
Steve Moreno
Lori Saine
Pass -Around Memorandum; June 14, 2022 - CMS (Not in CMS) Page 2
COLORADO
Office of Children,
Youth & Families
Department of Human Set vices
CI
111
CI
CI
SS -23A Agreement to Purchase
Revised 10/15
AGREEMENT TO PURCHASE
OUT -OF -HOME PLACEMENT
SERVICES SS23A
CHILD PLACEMENT AGENCY SERVICES (CPA)
CHILD HABILITATION RESIDENTIAL PROGRAM (CI-IRP)
GROUP HOME/GROUP CENTER CARE
INDEPENDENT LIVING
PSYCHIATRIC RESIDENTIAL TREATMENT FACILITY (PRTF)
RESIDENTIAL CHILD CARE FACILITY (RCCF)
RESIDENTIAL DRUG/ALCOHOL PROGRAM
SHELTER CARE
SUBSIDIZED ADOPTION
TRANSITION/HOME BASED AFTER -CARE (RCCF)
OTHER (DESCRIBE):
THIS IS AN AGREEMENT, made this day of
between Weld County Department of Social/Human Services, PO Box A, Greeley, Colorado,
80632, hereinafter called "County" and «Agency», «Agency_Mailing_Address»,
«Agency_City_StateZip», hereinafter called "contractor"
THIS AGREEMENT:
Shall include all children placed by Weld County Department of Social/Human Services and
placed with «Agency».
A child specific addendum, identifying individual service needs, must be completed and
attached to supplement this agreement for each child being served by the facility. If this
is a CPA placement, the child specific addendum should also address how administrative
services will be provided in the event the child is placed for adoption in a foster home
supervised by the CPA.
WHEREAS, the Colorado State Department of Human Services, hereinafter called "State
Department" is authorized to provide social services to individuals and families of
individuals through its agents, County Departments of Social/Human Services, and
WHEREAS, the County is authorized to purchase certain services for eligible children
under State Department rules, and
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WHEREAS, the County wishes to provide these services by purchasing them from
Contractor, and,
WHEREAS, the Contractor is licensed as a Child Placement Agency, Residential Child
Care Facility, certified Psychiatric Residential Treatment Facility, or meets the
requirements for other licensed service types.
NOW THEREFORE, it is hereby agreed that in consideration of the mutual undertakings
the County and the Contractor agree as follows:
1. This Agreement shall be in force from the date of the agreement,
July 1, 2022, until the end of the Colorado fiscal year, June 30, 2023.
Any child may be removed from the facility prior to the end of the fiscal
year by the county department.
2. This Agreement may be renewed only by entering into a new written
Agreement such as this Agreement signed by the authorized
representatives of the parties. Except as otherwise provided above, either
party shall have the right to terminate this contract by giving the other
party thirty (30) days notice by registered mail, return receipt requested. If
notice is so given, this contract shall terminate on the expiration of the
thirty (30) days or until the eligible child(ren) can be placed elsewhere,
whichever occurs first, and the liability of the parties hereunder for further
performance of the terms of this Agreement shall thereupon cease, but the
parties shall not be released from the duty to perfortn their obligations up
to the date of termination.
3. This Agreement is in lieu of and supersedes all prior agreements between
the parties hereto and relating to the care and services herein described.
SECTION I: DESCRIPTION OF SERVICES TO BE PURCHASED:
I . The total rate of payment for care and services under this Agreement shall not exceed:
the established rate for the PRTF; for CPA placements, the negotiated rate or the
approved vendor rate; for RCCF placements, the established Fee -for -Service rate and the
negotiated rate or the approved vendor rate; and, for CHRP placements, the agreed upon
service proposal rate. The total rate of payment for care and services for other service
types will be as negotiated between the County and the Contractor. Medicaid rules shall
govern activities to be covered in the daily rate paid to PRTFs.
The amount paid for purchased care and services for less than a full month will be based
upon the daily rate.
2. Payment -fora child's temporary -absence from the -facility, including -absence due -to -----
hospitalization, will be made in accordance with State Department rules in Staff Manual
Volume VII, 7.406.1, F (12 CCR 2509-5).
3. Transportation shall be furnished by County between the child's residence and
Contractor's facility for the initial placement and return after the treatment plan is
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completed. If the child runs away from the Contractor's facility, the County shall provide
transportation to either return the child to the facility or to other care as arranged by the
County. The County has responsibility for the decision to return the child to the facility,
with input from the Contractor.
4. All other transportation associated with the Contractor's proposed services will be
provided by Contractor. Any transportation costs not covered or contemplated in the
original treatment plan must be negotiated between County and Contractor and are not
subject to reimbursement under this Agreement. However, provisions for payment of
other transportation may be provided for in the Family Service Plan / Individual Plan of
Care.
5. Any transportation costs to be incurred on behalf of a child in placement, which are to
be borne by persons, or agencies, which are not a party to this contract, shall be specified
in the treatment/service plan, and those persons shall acknowledge their responsibility by
signing the treatment/service plan.
SECTION II: LEGAL STATUS AND AUTHORIZATIONS:
1. Such permission as is held by the County is hereby granted to the Contractor to
authorize routine or emergency medical and dental treatment except that:
a. Medical or dental care shall be provided by personnel duly licensed by law as
required by the State of Colorado. It is mutually understood hereto that hospital
expenses, surgery, ophthalmology services, eyeglasses, orthodontia or other
unusual expenses are not included in the monthly rate. The cost of any items not
covered by Medicaid will be negotiated between County and Contractor. Medicaid
rules shall govern activities to be covered in the daily rate paid to PRTFs.
2. County and Contractor shall insure that the child(ren) is enrolled in the Early and
Periodic Screening, Diagnosis and Treatment Program.
3. It is agreed and permission is granted for the child(ren) to participate in planned
recreational and social activities of Contractor, including supervised off grounds
excursions and extended trips within the State, provided that Contractor has written
permission from County and legal guardian for any trips out of Colorado for any reason
and any planned absence from the facility of over seven (7) days within a consecutive
30- day period. Such written permission may be in the treatment/service plan. Further,
Contractor and County will also secure, where possible, permission from parents or
guardians of the child placed with the Contractor. Any planned absence of more than 24
hours for children placed in a PRTF is not Medicaid reimbursable.
4. County and Contractor shall inform each other and the local school district of any
changes in parental residence affecting educational status which comes to their attention.
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SECTION III: REASONS FOR REFERRAL, TREATMENT PLAN, AND PROGRESS
REPORTS:
I. County and Contractor agree and understand that the reasons for referral, which
necessitate purchasing services for children are specified in the attached child specific
addendum and Family Services Plan. Any other relevant information concerning these
children that does not necessitate purchasing services is also included in the addendum.
2. County and Contractor shall develop an initial plan that addresses the immediate
and/or emergency needs of the child within 72 hours of admission for children in RCCFs
or group homes except PRTF. County and Contractor shall formulate an initial individual
plan of care within 14 calendar days after admission for children in RCCFs or group
homes except PRTF. The placement date is that date noted in the attached child specific
addendum included with this contract. The Child's Family Service Plan may be utilized
as an Individual Plan of Care for this purpose for facilities. Modifications to this plan
shall be agreed to in writing on the plan or as a supplemental document.
3. County and Contractor shall formulate an initial individual plan of care for children in
PRTFs within 72 hours. For children in a PRTF a comprehensive individual plan of care
must be completed by the multidisciplinary team within 14 calendar days from the
placement date. The placement date is that date noted in the attached child specific
addendum included with this contract. Modifications to this plan shall be agreed to in
writing on the plan or as a supplemental document.
4. The individual plan of care shall be goal oriented and time -limited and shall:
a. Address all areas listed in Section 7.714.4, C, 2, (12 CCR 2509-8) together with
clinical and other needs including the child's presenting problems, physical
health, emotional status, behavior, support system in the community, available
resources, and discharge plan.
b. Include specific goals and measurable objectives, expected dates of
achievement, specific discharge and transitional/after-care and follow up services
criteria to be met for termination of treatment.
c. Specify the type, frequency, and duration of clinical therapy services,
rehabilitation services, medication management, emergency services, initial
assessment, documented treatment modifications, and other services determined
to be necessary to meet the child's specific goals.
d. Specify that all therapeutic services are necessary to meet the needs of the child
and to treat the child's current diagnosis.
e. Identify the provision of, or the referral for, services other than RCCF services
and shall document any court ordered treatment including identifying the agency
responsible for providing the court ordered treatment.
f. Anticipated living arrangement for the child at the date of discharge;
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g. Anticipated educational arrangement for the child at the time of discharge;
h. Anticipated date for discharge from treatment purchased for the child.
i. A permanency goal for the child.
5. Monthly, Child Placement Agencies, RCCFs and other contractor types other than
PRTF, shall conduct a monthly review of each plan to evaluate whether the short-term
and long-term goals have been achieved or not achieved. These parties shall provide the
County with written reports which address changes to the child's physical condition,
psychological and social functioning, changes in the child's family situation, educational
progress, significant incidents or disciplinary actions, and progress made to achieve goals
specified in the treatment plan. Further, the Contractor agrees to sequence reports to be
received by the County 15 calendar days prior to judicial or administrative hearings or
reviews when provided with 30 calendar days advance notice of such dates by County.
6. Every 14 days, PRTFs shall provide the County with written reports which address
changes to the child's physical condition, psychological and social functioning, changes
in the child's family situation, educational progress, significant incidents or disciplinary
actions, and progress made to achieve goals specified in the treatment plan.
SECTION IV: CONTRACTOR SHALL:
1. Conform with and abide by all rules and regulations of the Colorado Department of
Human Services, the Colorado Department of Health Care Policy and Financing (if
appropriate), the State of Colorado and any applicable federal laws and regulations, as
such, which may be amended from time to time, and shall be binding on Contractor and
control any disputes in this Agreement.
2. Maintain a current license and maintain license requirements as specified under State
law and rule.
3. Not charge any fees to children or families of children referred by county for any
services provided under this Agreement.
4. Not assign the obligations under this Agreement nor enter into any sub -contract
without the express written approval of the Director of the County Department or his/her
appointed designee.
5. Abide by all applicable provisions of Title VI and VII of the Federal Civil Rights Act
of 1964, Section 504 of the Rehabilitation Act of 1973, Title XX of the Social Security
Act of 1975 as revised, and provide confidentiality of information concerning the child in
compliance with the Health Insurance Portability and Accountability Act (HIPAA).
6. Maintain during the term of this Agreement a liability insurance policy of at least
$25,000 for CPAs and $400,000 for PRTFs, and RCCFs for property damage liability,
$150,000 for injury and/or damage to any one person, and $600,000 for total injuries
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Jared Polls, Governor I Michelle Barnes, Executive Director
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arising from any one accident.
7. Maintain during the terms of this Agreement an insurance policy or a fidelity bond in
an amount deemed sufficient by the county, covering the activities of any of its officers,
agents, or employees responsible for the implementation and/or administration of this
contract in order to make reparations for any wrongful acts, omissions, or any other
defalcations of the Contractor.
8. Indemnify County, Colorado Department of Human Services, Colorado Department of
Health Care Policy & Financing, and the State of Colorado against any and loss against
all claims and actions based upon or arising out of damage or injury, including death, to
persons or property caused or sustained in connection with the performance of this
contract or by conditions created thereby, or based upon any violations of any statute,
ordinance, or regulation and the defense of any such claims or actions.
Paragraphs 6, 7 and 8 do not apply to the University of Colorado contracts with county
departments.
9. In regards to University of Colorado contractors only, the contractor shall be
responsible for its own wrongful or negligent acts or omissions or those of its officers,
agents, or employees while performing their professional duties to the full extent allowed
by law. Notwithstanding the foregoing, nothing in this Agreement is a limitation or
waiver of the application of the Colorado Governmental Immunity Act set forth in §24-
10-101 to §24-10-120, C.R.S., any claims resulting from the performance of the
University ofCoTorad"o, its employees or agents under this Agreement.
10. Maintain service program records, fiscal records, documentation and other records,
which will sufficiently and properly reflect all direct and indirect costs of any nature
incurred in the performance of this Agreement. The above shall be subject at all
reasonable times to inspection, review or audit by federal, Colorado Department of
Human Services, Colorado Department of Health Care Policy & Financing, or county
personnel, and other persons authorized in writing by the Executive Director of the
Colorado Department of Human Services.
11. Contractor shall, in any instance of a potential adoption by a foster parent, provide the
initial home study, the SAFE study update, annual certification updates and related
materials when requested by the County within fourteen working days of the request. At
all other times the Contractor shall make home studies and related materials available to
the County for review, at a location agreed upon by the County and the Contractor,
during regular business hours.
12. Bill the County for services rendered, using the required form. This form is to be
mailed to the County by the last day of the month of care. Billings for PRTFs shall be
made to the MMIS System only. Billings for RCCF fee -for —service and CHRP shall be
made to either the MMIS System or the County. Billings for RCCFs daily rate, CPAs and
other contractor types shall be made to the County only. Contractor will not be paid by
the county when billing is not received by the County within 30 calendar days following
the billing due date.
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13. Attend and participate in Administrative Reviews for children in placement with the
Contractor pursuant to two (2) weeks written notice by the County. The Contractor shall
encourage children over the age of twelve to attend their Administrative Reviews.
Participation may be in person or by teleconference.
14. The Contractor shall pay the foster parent the amount agreed upon with the county as
the child maintenance or room and board. Any payment to the foster parent in excess of
the child maintenance or room and board amount shall be treated as income to the foster
parent.
15. The Contractor shall have the on -site presence of at least one (1) official who has
received State training in how to use and apply the reasonable and prudent parent
standard and who, with respect to any child or youth placed at the Contractor's facility, is
designated to be the caregiver authorized to apply the reasonable and prudent parent
standard to decisions involving the participation of the child or youth in age or
developmentally -appropriate activities. In the case of a Foster Care Home certified by a
Child Placement Agency, Contractor agrees that each foster parent has received State
training in how to use and apply the reasonable and prudent parent standard to decisions
involving the participation of the child or youth in age or developmentally appropriate
activities.
16. Contractor shall ensure that each foster parent or caregiver authorized to apply the
reasonable and prudent parent standard receives sufficient, ongoing training to continue
to use and apply the reasonable and prudent parent standard for each child or youth
placed in the foster home or facility.
SECTION V: COUNTY SHALL:
1. Determine eligibility of the children under this Agreement for placement and medical
coverage. Medicaid rules and regulations shall govern determination of Medicaid
eligibility.
2. Assess and collect fees in accordance with the rules and regulations of the Colorado
Department of Human Services.
3. Reimburse Contractor by the 15th of the following month in accordance with fiscal
system time frames for services purchased under this Agreement in accordance with the
established rate when billing is submitted as described in Section IV, Number 10
(above).
4. Abide by all the rules and regulations of the Colorado Department of Human Services,
federal rules and regulations and the laws of the State of Colorado, any of which may be
amended from time to time.
5. If this agreement covers an initial placement for a child, the Contractor may receive a
clothing allowance in accordance with State Department rules.
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6. Monitor children's progress in accordance with the treatment/family services plan and
the requirements of Colorado Department of Human Services rules and provide
consultation to Contractor in relation to the services purchased under this Agreement.
7. Invite Contractor to Administrative Reviews at least 2 weeks prior to the scheduled
review.
8. Involve Contractor in planning for the child and give the Contractor a copy of the
Family Services Plan at time of piacement or as soon as completed and when updated or
revised.
9. The County shall seek recovery from the RCCF, CPA or other contractor type for any
non -Medicaid payment amounts that have been misused as defined in rules. The County
may withhold subsequent payments to recover any funds misused by the RCCF, CPA or
other contractor type. The County shall seek recovery of any remaining funds as a debt
due the County for the benefit of the state. The RCCF or CPA may appeal the decision to
recover or withhold subsequent payments as defined in rules.
10. The County shall identify the amount agreed upon with the Contractor to be paid to
the foster parent for the child's room and board. Such amount will be the same as shown
in Trails for the child's maintenance.
11. Reimbursement rates that are negotiated between the County and the Contractor shall
be for allowable costs in one or more of four primary components: child maintenance,
administrative services, administrative maintenance, and treatment. Contractor type will
determine which of these four components will be included in the reimbursement rate.
12. The County shall provide the Contractor with a copy of the policy that identifies
activities that providers trained in the reasonable and prudent parent standard may
approve, and identifies activities that require County department approval.
13. The County shall require that the person(s) authorized to apply the reasonable and
prudent parent standard, including each foster parent, will complete State training
specific to the reasonable and prudent parent standard and will receive ongoing training
as necessary in order., to meet the needs of each child or youth, and to use and apply the
reasonable and prudent parent standard.
SECTION VI: GENERAL PROVISIONS:
1. The Parties to this Agreement intend that the relationship between them, contemplated
by this Agreement is that of employer —independent contractor. No agent, employee, or
servant of Contractor shall be deemed to be an employee, agent, or servant of the County.
Contractor will be solely and entirely responsible for its acts or of any agent, employee,
servants and sub -contractors during the performance of this Agreement.
2. Payment pursuant to this Agreement, if in State of Colorado, county, or federal funds,
whether in whole or in part, is subject to and contingent upon the continuing availability
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of State of Colorado, county, and federal funds for the purpose thereof.
3. It is agreed that if, after investigation, it is shown that reasonable care was given to
guard and protect personal items brought to Contractor by the children, Contractor will be
released from responsibility for loss or damage to such personal items.
4. This Agreement is intended to be applied in conjunction with the child specific
addendum and family services plan as the complete integration of all understandings
between the parties. No prior or contemporaneous addition, deletion or other amendment
hereto shall have any force or affect whatsoever, unless embodied herein in writing. No
subsequent notation, renewal, addition, deletion, or other amendment hereto shall have
any force or effect unless embodied as a part of this written Agreement. This section shall
not be construed as either prohibiting the periodic amending of the family services plan
or appending a county designed addendum to this agreement.
5. The contract shall permit the State Department to monitor service program, fiscal and
other records sufficiently to assure the purchase of services in this Agreement are carried
out for the benefit of the aforementioned client. Monitoring may occur through review of
program reports, on -site visits where applicable and other contracts as deemed necessary.
The Contractor understands that the State Department may provide consultation to
Contractor to assure satisfactory performance in the provision of purchased services
under this Agreement.
a. All reimbursement requests shall be submitted to and approved by the
appropriate County staff. Reimbursement for placement services shall be paid
from the date of admission up to, but not including, the day of discharge.
Furthermore, Medicaid payments for PRTF and CHRP placements are permitted
on the day of discharge in compliance with regulations promulgated by the
Colorado Department of Health Care Policy and Finance. Fee for Service will be
reimbursed as per Medicaid regulations. Medicaid funds shall not be limited to
funds encumbered in this contract and shall also include Medicaid funds for
PRTF and RCCF therapeutic services and CHRP services paid by the
Department of Health Care Policy and Financing. Payment for placement
services will not be provided for clients on "runaway" status unless the County
has previously approved it. Reimbursement requests for therapy costs for clients
enrolled in PRTF, RCCF, and CHRP programs shall be submitted to the
Medicaid Fiscal Agent in accordance with instructions provided by such Fiscal
Agent. The Contractor shall forward copies of such billings to the County on a
monthly basis.
In the event that a Contractor receives payment for a per diem discharge day,
regardless of funding source, the Contractor shall refund those dollars forthwith.
b.The purpose of these requirements is to provide minimum assurance that the
Contractor has adequate accounting and budgeting information available to allow
management to maintain a financially viable enterprise and to demonstrate
financial accountability to the county departments of human/social services and
Colorado Department of Human Services for the use of public funds.
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Jared Polls, Governor I Michelle Barnes, Executive Director
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(1) The Contractor must have in place a double entry accounting system and all
financial transactions must be posted to this system. Financial statements,
prepared from information provided by this system, shall be presented in
conformity with U.S. generally accepted accounting principles (GAAP). The
Contractor must also have adequate time keeping and cost allocation systems to
allocate salary cost and indirect cost to appropriate cost centers. Books and
records of the Contractor shall be subject, at any reasonable time, to inspection,
audit or copying by appropriate Federal, State or county personnel, or such
independent auditors or accountants as may be designated by these personnel.
(2) All billing by the contractor must be in a format approved by the fiscal agent
or county. Contractors must bill the fiscal agent and county at least once a
month. Contractors may bill twice a month, on the 15th and last day of the
month, for services rendered. Bills will be returned unpaid if the bills do not
conform to the approved format or the documentation is inadequate.
(3) All Contractors whose total annual expenditures are $100,000 or more shall
submit an annual audit of their financial statements by an independent certified
public accountant. Contractors with total annual expenditures less than $100,000
may submit an audit as described above or may submit compiled or reviewed
financial statements, prepared in accordance with generally accepted accounting
principles. If the Contractor is a government agency that has an independent audit
done by another agency of that government, its audited financial statements,
prepared in accordance with generally accepted accounting principles for state
and local governments meet this requirement. The audited, compiled or reviewed
financial statements of PRTFs, RCCFs, and CPAs must be completed and a copy
provided to the Colorado Department of Human Services (Attn: Administrator
for PRTFs, and RCCFs and Attn: Audit Division Director for CPAs) within 180
days after the contractor's fiscal year end. The audited financial statements and
supplementary information defined in regulation for various agencies shall be
presented as described in Section VI, B (1), above and must contain sufficient
detail to provide evidence of financial accountability under the terms of this
contract and controlling state regulations. Contractors that are a subsidiary of a
parent organization must submit separate financial statements for the subsidiary
that detail each of the Contractor's facilities and/or programs that provide services
for the Colorado Department of Human Services and also must provide a
reconciliation of these financial statements to the consolidated financial
statements of the organization as a whole. When applicable, the Contractor must
comply with the audit requirements found in the Single Audit Act of 1984 and the
Single Audit Act Amendments of 1996 and U. S. Office of Management and
Budget (OMB) Circular A-133, Audits of States, Local Governments, and Non -
Profit Organizations including subsequent revisions, and appropriate audit and
financial reporting requirements as defined in State laws, rules, and regulations.
(4) If Contractors do not submit their annual audit or refuse to disclose financial
information regarding the operation of the program in a timely manner, the Fiscal
Agent may withhold payment until the audit and/or requested information is
1575 Sherman Street, 2nd Floor, Denver, CO 80203 P 303-866-5932 F 303-866-5536 www.colorado.govlcdhs
Jared Polls, Governor I Michelle Barnes, Executive Director
10
submitted. If the contractor is a CPA, then sanctions of the contractor may occur
for failure to submit.
(5) In cases where documentation does not exist to support audit information or
services provided, contractor will be required to repay all funds received for
which documentation does not exist.
(6) In cases where audit deficiencies are noted, a plan of corrective action shall be
submitted to the State Department's Audit Division for approval within 4 months
of the date of the audit.
(7) Failure to comply with any of these requirements, including items on the
addendum is justification for the County to impose fiscal sanctions, penalties, or
cancel the contract.
6. In the event this contract is terminated, final payment to the Contractor may be
withheld at the discretion of the County until final audit. Incorrect payments to the
Contractor due to omission, error, fraud, or misuse of funds shall be recovered from the
Contractor either by deduction from subsequent payments under this contract or other
contracts between the County and the Contractor or by the County, as a debt due to both
the State of Colorado, the Colorado Department of Human Services and the County. The
waiver of any violation shall not be construed as a waiver of any other or subsequent
violation of this contract or appropriate statutes and regulations.
WHEREFORE, the parties have herein set their hands and affixed their seals the day and
date first written above.
COUNTY:
ATTEST: BOARD OF COUNTY COMMISSIONERS
Clerk to the Board WELD COUNTY, COLORADO
BY:
Deputy Clerk to the Board Scott K. James, Chair
CONTRACTOR:
«Agency»
«Agency_Mailing_Address»
«Agency_C ity_State_Z ip»
By:
Contractor's (or designee's) Signature
and Date
1575 Sherman Street, 2nd Floor, Denver, CO 80203 P 303-866-5932 F 303-866-5536 www.colorado.govlcdhs
Jared Polls, Governor I Michelle Barnes, Executive Director
11
EXHIBIT to the SS23A
Additional Provisions for the Agreement to
Purchase Out -of -Home Placement Services SS23A
For the Purchase of
Child Placement Agency Services
The following additional provisions of this Exhibit apply to the agreement entitled,
"Agreement to Purchase Out -of -Home Placement Services SS23A, attached hereto, by and
between the Board of County Commissioners of Weld County, on behalf of the Weld County
Department of Human Services," hereinafter referred to as, "County," and «Agency»,
hereinafter referred to as, "Contractor."
1. County agrees to purchase and Contractor agrees to provide the care and services which
are listed in this agreement for Facility ID# «Agency_ID» at the Contractor's base
anchor rate as outlined by the Colorado Office of Children, Youth & Families Division of
Child Welfare, unless the Contractor and County have agreed to utilize the Inventory for
Client and Agency Planning (ICAP) assessment and corresponding rate structure for
children who have significant intellectual or developmental disabilities or intensive
medical or physical needs. These services will be for children who have been deemed
eligible for social services under the statues, rules, and regulations of the State of
Colorado.
2. All bed hold authorizations and payments are subject to a 7 -day maximum for a child's
temporary absence from a facility; however, if the absence is a result of hospitalization,
the maximum bed hold authorization may be up to 14 days. Bed hold requests must have
prior written authorization from County's Department Administrator or Designee before
payment will be release to provider.
3. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be
furnished by the Contractor under this contract for facilities that provide sex offender
treatment.
4. Contractor agrees to have appropriate personnel available to attend or participate in
Family Engagement, Team Decision Making meetings, or court hearings. Contractor
shall be notified by County staff of the dates and times attendance is requested.
5. Contractor agrees to cooperate with any vendors hired by the County to shorten the
duration of placement.
6. Contractor agrees to have physical examinations completed within 14 days and dental
examinations completed within 8 weeks of the child being placed with Contractor. All
documentation of these examinations shall be forward to County.
7. Contractor agrees to arrange a full evaluation of an Individualized Educational Plan (IEP)
for youth designated as a Special Education Student every 3 years and coordinate reviews
Exhibit to the SS23A
Revised 6/2022
every year. If the IEP is due while the child is in placement, the Contractor shall
complete or obtain a completed [EP. A copy will then be forwarded to the County.
8. Children in Psychiatric Residential Treatment Facilities, Residential Child Care Facilities
and Child Placement Agencies arc generally not eligible to receive clothing allowances as
outlined in the Weld County Department of Human Services Policy Manual. However, a
one-time emergency clothing allowance may be approved in limited circumstances, prior
written authorization from the County's Department Administrator is required before
payment will he released to provider.
9. County shall have access to Contractor's financial records as they relate to this
Agreement for purposes of audit. Such records shall be complete and available for audit
90 days after final payment hereunder and shall be retained and available for audit
purposes for at least five years after final payment hereunder.
10. Time is of the essence in each and all of the provisions of this Agreement.
11. Neither party to this Agreement shall be liable to the other for delays in delivery or
failure to deliver or otherwise to perform any obligation under this Agreement, where
such failure is due to any cause beyond its reasonable control, including but not limited to
Acts of God, fires, strikes, war, flood, earthquakes or Governmental actions.
12. Any notice required to be given under this Agreement shall be in writing and shall be
mailed or delivered to the other party at that party's address as stated above.
13. This Agreement and the provision of services hereunder shall be subject to the laws of
Colorado and be in accordance with the policies, procedures, and practices of County.
14. This Agreement is nonexclusive and County may engage or use other contractors or
persons to perform services of the same or similar nature.
15. Contract Professional certifies, warrants, and agrees that it does not knowingly employ or
contract with an illegal alien who will perform work under this contract. Contract
Professional 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). Contract Professional 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 Contract Professional
that the subcontractor shall not knowingly employ or contract with an illegal alien to
perform work under this Agreement. Contract Professional 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 Contract
Professional obtains actual knowledge that a subcontractor performing work under the
public contract for services knowingly employs or contracts with an illegal alien Contract
Professional shall notify the subcontractor and County within three (3) days that Contract
Professional has actual knowledge that a subcontractor is employing or contracting with
Exhibit to the SS23A
2 Revised 6/2022
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.
Contract Professional 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. Contract Professional 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 Contract
Professional participates in the State of Colorado program, Contract Professional shall,
within twenty days after hiring an new employee to perform work under the contract,
affirm that Contract Professional 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. Contract Professional shall deliver to County, 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
Contract Professional fails to comply with any requirement of this provision or of
C.R.S. §8-17.5-101 et seq., County, may terminate this Agreement for breach, and if so
terminated, Contract Professional shall be liable for actual and consequential damages.
Except where exempted by federal law and except as provided in C.R.S. § 24-76.5-
103(3), if Contract Professional receives federal or state funds under the contract,
Contract Professional 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
Contract Professional operates as a sole proprietor, it hereby swears or affirms under
penalty of perjury that it: 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.
16. Contractor assures and certifies that it and its principals:
a. Are not presently debarred, suspended, proposed for debarment, and
declared ineligible or voluntarily excluded from covered transactions by a
federal department or agency;
b. Have not, within a three-year period of preceding this Agreement, been
convicted of or had a civil judgment rendered against them for commission of
fraud or a criminal offense in connection with obtaining, attempting to obtain,
or performing a public (federal, state, or local) transaction or contract under a
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;
c. 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
Exhibit to the SS23A
3 Revised 6/2022
offenses enumerated in paragraph (B) above;
d. Have not within a three-year period preceding this Agreement, had one or more
public transactions (federal, state, and local) terminated for cause or default.
17. In addition to terminating this Agreement, in accordance with the provisions of the
attached Agreement, the County may exercise the following remedial actions if the
County finds and determines that the Contractor has substantially failed to satisfy the
scope of work found in the Agreement, any Exhibit, or the child specific addendum
SS23B. 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 include, but
are not limited to, any one or more of the following:
a. Withhold payment to Contractor until the necessary services or corrections
in performance are satisfactorily completed.
b. Deny payment or recover reimbursement for those services or deliverables
which have not been performed and which due to circumstances caused by
Contractor cannot be performed or if performed would be of no value to
County. Denial of the amount of payment shall be reasonably related to the
amount of work or deliverables lost to County.
c. Recover from Contractor any incorrect payment to Contractor due to omission,
error, fraud, and/or defalcation by deducting from subsequent payments under
this Agreement, or other agreements between County and Contractor, or as a
debt to County, or otherwise as provided by law.
18. 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 or their assignees, and nothing contained 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 or their assignees receiving
services or benefits under this Agreement shall be an incidental beneficiary only.
19. No portion of this Agreement shall be deemed to constitute a waiver of any immunity
including those provided by the Colorado Governmental Immunity Act §§24-10-101 et
seq., as applicable now or hereafter amended, that the parties or their officers or
employees may possess, nor shall any portion of this Agreement be deemed to have
created a duty of care that did not previously exist with respect to any person not a party
to this Agreement. The parties hereto acknowledge and agree that no part of this
Agreement is intended to circumvent or replace such immunities.
20. Contractor shall promptly notify County in the event in which it is a party defendant or
respondent in a case, which involves services provided under the agreement. The
Contractor, within five (5) calendar days after being served with a summons, complaint,
Exhibit to the SS23A
4 Revised 6/2022
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 County Director. The term
"litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy,
reorganizations and/or foreclosure.
21. Any amendments or modifications to this agreement shall be in writing signed by both
parties.
22. Financial obligations of the County payable after the current fiscal year are contingent
upon funds for that purpose being appropriated, budgeted and otherwise made available.
Execution of this Agreement by County does not create an obligation on the part of
County to expend funds not otherwise appropriated in each succeeding year.
23. 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 is not entitled to unemployment insurance or
workers' compensation benefits through County and County shall not pay for or
otherwise provide such coverage for Contractor. Unemployment insurance benefits
will not be available to Contractor for services provided under this Agreement.
Contractor shall pay when due any/all applicable employment taxes and income
taxes and local head taxes (if applicable) incurred as a result of the services
provided under this Agreement.
24. County reserves the right to require the Contractor to provide a certificate of insurance,
policy, or other proof of insurance at its sole discretion.
25. Contractor shall ensure all homes are recertified within required timelines and will follow
Colorado Volume 7 Social Services Rules 7.710.35 Renewal or Continuation Notice and
7.710.36 Recertification.
26. Contractor will notify the County a minimum of 30 days prior to a license expiring if a
home is not going to be recertified within the required timeline. In the event the County
has children placed in the home and the license expires, the County will not be
responsible for any payment to the Contractor during the unlicensed time.
27. For Children's Habilitation Residential Program (CHRP) waiver funded placements, the
Contractor and the Community Center Board (CCB) will be responsible for ensuring all
Prior Authorizations (PAR) are current and that there is no gap in reimbursement. The
County will not be responsible for any non -reimbursement to the provider if PARS are
not approved.
Exhibit to the SS23A
5 Revised 6/2022
CHILD PLACEMENT AGENCIES
SFY 2022-
ACILI ' 7
op4 , oR AopR s s C81N' CTtf!l1IiY/SikTEJ21P
ANEW -WORLD
162199O
10800 East Bethany Drive, Suite 225
.
1355 S. Colorado Blvd., Suite 501
4660 Wadsworth Blvd,
2821 South Parker Road, Suite 425
Aurora, CO 80014
Denver, CO 80222
Wheat Ridge, CO 80033
Aurora, CO 80014
ADOPTION OPTIONS
45078
ARIEI, CLINICAL SERVICES.
90205 _ ,
BETHANY CHRISTIAN SERVICES OF COLORADO
45514
COURAGE COMMUNITY FOSTER°CARE
1621587
9845 Mesa, PO Box 262 -
Cascade, CO 80809
6
DENVER AREA YOUTH SERVICES
45069
363 South Harlan Street, Suite 100
1501 Albion Street
4704 Harlan St., Suite 150
5360 N, Academy Blvd., Suite 130
10190 Bannock Street, Suite 120
4945 N. 30th Street, Suite 300
Lakewood, CO 80226
Denver, CO 80220
Denver, CO 80212
Colorado Springs, CO 80918'
Northglenn, CO 80260
Colorado Springs, CO 8Q919-3152
7
DENVER<cHILpRENS_MQME
. . 158816O.
8
DUNGARVIN, COLORADO INC.
1547661
9
FAMILY RESOURCE NETWORK
1
15'08602
10
GRIFFITH CENTERS FOR CHILDREN, INC.
1510565
11
HOPE.AND HOME
29867
12
HOPE'S PROMISE
74241
1585 Perry Street, Suite E
Castlerock, CO 80104
KAIROS.FAMILY.SERVICES, LLC
172490/
13170 Crane Canyon Loop
Colorado Springs, CO 80921
KIDS CROSSING
79752
1440 E. Fountain Blvd.
Colorado Springs, CO 80910-3502
LOVE IS TRINITY
1691137
4651 Tulsa Ct
Denver, CO 80239
LUTHERAN FAMILY SERVICES ROCKY MOUNTAIN
45080
363 S. Harlan Street, Suite 200
2250 S. Oneida Street, Suite 200
Denver, CO 80226
Denver, CO 80224-2557
MAPLE STAR COLORADO
90967
=
MOUNT SAINT VINCENT
1676598
4159 Lowell Blvd
Denver, CO 80211
19
NEW HORIZONS MINISTRIES INC.
1509375
1025 Royal Gorge Boulevard, PO Box 1500
Canyon City, CO 80212
20
NIGHTLIGHT CHRISTIAN ADOPTIONS
1590226
1511 E 11th Street, Suite 240
1597 Cole Blvd., Suite 250
2210 E La Salle
620 Kimbark St
325 King St.
6400 West Coal Mine Avenue
14364 E Evans Ave
1915 Aerotech Dr, #100
1600 Specht Point Rd, Suite 105
1702 68th Ave.
156 Colorado Ave
11059 East Bethany Drive, Suite 150
Loveland, CO 80537
Lakewood, CD 80401-3417
Colorado Springs, CO 80909
Longmont, CO 80501
Denver, CO 80219
Littleton, CO 80123
Aurora, CO 80014
Colorado Springs, CO 80916
Fort Collins, CO 80525
Greeley, CO 80634
Montrose, CO 8140.1
Aurora, CO 80014
PARKER PERSONAL CARE HOMES INC
1512100
ROCKY MOUNTAIN KIDS
1593378
SAMPLE SUPPORTS
1684456
SAVIO HOUSE
37330
SHILOH HOUSE INC
67201
•
SMITH AGENCY INC
44882
27
SPECIAL KIDS/SPECIAL FAMILIES
43184
28
SPECIALIZED ALTERNATIVES FOR FAMILY AND YOUTH
1662183
1594056
STRONG FOUNDATIONS
30
TOP OF THE TRAIL INC
28112
31
WHIMSPIRE CHILD PLACEMENT AGENCY
19562
EXHIBIT B to the SS23A
Additional Provisions for the Agreement to
Purchase Out -of -Home Placement Services SS23A
For the Purchase of
Treatment Foster Care Services
The following additional provisions of this Exhibit apply to the agreement entitled,
"Agreement to Purchase Out -of -Home Placement Services SS23A, attached hereto, by and
between the Board of County Commissioners of Weld County, on behalf of the Weld County
Department of Human Services," hereinafter referred to as, "County," and «Agency»,
hereinafter referred to as, "Contractor."
1. County agrees to purchase and Contractor agrees to provide the care and services
which are listed in this agreement for Facility ID# «Agency_ID>> at the Contractor's
base anchor rate as outlined by the Colorado Office of Children, Youth & Families
Division of Child Welfare, unless the Contractor and County have agreed to utilize
the Inventory for Client and Agency Planning ([CAP) assessment and corresponding
rate structure for children who have significant intellectual or developmental
disabilities or intensive medical or physical needs. These services will be for children
who have been deemed eligible for social services under the statues, rules, and
regulations of the State of Colorado.
2. All bed hold authorizations and payments are subject to a 7 -day maximum for a
child's temporary absence from a facility; however, if the absence is a result of
hospitalization, the maximum bed hold authorization may be up to 14 days. Bed hold
requests must have prior written authorization from County's Department
Administrator or Designee before payment will be release to provider.
3. A minimum of one polygraph test per Colorado fiscal year, if needed by the child,
will be furnished by the Contractor under this contract for facilities that provide sex
offender treatment.
4. Contractor agrees to have appropriate personnel available to attend or participate in
Family Engagement, Team Decision Making meetings, or court hearings. Contractor
shall be notified by County staff of the dates and times attendance is requested.
5. Contractor agrees to cooperate with any vendors hired by the County to shorten the
duration of placement.
6. Contractor agrees to have physical examinations completed within 14 days and dental
examinations completed within 8 weeks of the child being placed with Contractor. All
documentation of these examinations shall be forward to County.
7. Contractor agrees to arrange a full evaluation of an Individualized Educational Plan
(IEP) for youth designated as a Special Education Student every 3 years and
coordinate reviews every year. If the IEP is due while the child is in placement, the
Contractor shall complete or obtain a completed IEP. A copy will then be forwarded
to the County.
Exhibit to the SS23A
1 Revised 6/2022
8. Children in Psychiatric Residential Treatment Facilities, Residential Child Care
Facilities and Child Placement Agencies are generally not eligible to receive clothing
allowances as outlined in the Weld County Department of Human Services Policy
Manual. However, a one-time emergency clothing allowance may be approved in
limited circumstances, prior written authorization from the County's Department
Administrator is required before payment will be released to provider.
9. County shall have access to Contractor's financial records as they relate to this
Agreement for purposes of audit. Such records shall be complete and available for
audit 90 days after final payment hereunder and shall be retained and available for
audit purposes for at least five years after final payment hereunder.
10. Time is of the essence in each and all of the provisions of this Agreement.
11. Neither party to this Agreement shall be liable to the other for delays in delivery or
failure to deliver or otherwise to perform any obligation under this Agreement, where
such failure is due to any cause beyond its reasonable control, including but not
limited to Acts of God, fires, strikes, war, flood, earthquakes or Governmental
actions.
12. Any notice required to be given under this Agreement shall be in writing and shall be
mailed or delivered to the other party at that party's address as stated above.
13. This Agreement and the provision of services hereunder shall be subject to the Taws of
Colorado and be in accordance with the policies, procedures, and practices of County.
14. This Agreement is nonexclusive and County may engage or use other contractors or
persons to perform services of the same or similar nature.
15. Contract Professional certifies, warrants, and agrees that it does not knowingly
employ or contract with an illegal alien who will perform work under this contract.
Contract Professional 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). Contract Professional
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
Contract Professional that the subcontractor shall not knowingly employ or contract
with an illegal alien to perform work under this Agreement. Contract Professional
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 Contract Professional obtains actual knowledge that a subcontractor performing
work under the public contract for services knowingly employs or contracts with an
illegal alien Contract Professional shall notify the subcontractor and County within
three (3) days that Contract Professional 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. Contract Professional shall not terminate the
contract if within three days the subcontractor provides information to establish that
Exhibit to the SS23A
2 Revised 6/2022
the subcontractor has not knowingly employed or contracted with an illegal alien.
Contract Professional 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 Contract Professional participates in the State
of Colorado program, Contract Professional shall, within twenty days after hiring an
new employee to perform work under the contract, affirm that Contract Professional 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. Contract
Professional shall deliver to County, 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 Contract Professional fails to comply
with any requirement of this provision or of C.R.S. §8-17.5-101 et seq., County, may
terminate this Agreement for breach, and if so terminated, Contract Professional shall be
liable for actual and consequential damages.
Except where exempted by federal law and except as provided in C.R.S. § 24-76.5-
103(3), if Contract Professional receives federal or state funds under the contract,
Contract Professional 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
Contract Professional operates as a sole proprietor, it hereby swears or affirms under
penalty of perjury that it:
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.
16. Contractor assures and certifies that it and its principals:
a. Are not presently debarred, suspended, proposed for debarment, and
declared ineligible or voluntarily excluded from covered transactions by a
federal department or agency;
b. Have not, within a three-year period of preceding this Agreement, been
convicted of or had a civil judgment rendered against them for commission of
fraud or a criminal offense in connection with obtaining, attempting to obtain,
or performing a public (federal, state, or local) transaction or contract under a
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;
c. 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 paragraph (B) above;
d. Have not within a three-year period preceding this Agreement, had one or
more public transactions (federal, state, and local) terminated for cause or
default.
Exhibit to the SS23A
3 Revised 6/2022
17. In addition to terminating this Agreement, in accordance with the provisions of the
attached Agreement, the County may exercise the following remedial actions if the
County finds and determines that the Contractor has substantially failed to satisfy the
scope of work found in the Agreement, any Exhibit, or the child specific addendum
SS23B. 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
include, but are not limited to, any one or more of the following:
a. Withhold payment to Contractor until the necessary services or corrections
in pertormance are satisfactorily completed.
b. Deny payment or recover reimbursement for those services or deliverables
which have not been performed and which due to circumstances caused by
Contractor cannot be performed or if performed would be of no value to
County. Denial of the amount of payment shall be reasonably related to the
amount of work or deliverables lost to County.
c. Recover from Contractor any incorrect payment to Contractor due to omission,
error, fraud, and/or defalcation by deducting from subsequent payments under
this Agreement, or other agreements between County and Contractor, or as a
debt to County, or otherwise as provided by law.
18. 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 or their assignees, and nothing contained 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 or their
assignees receiving services or benefits under this Agreement shall be an incidental
beneficiary only.
19. No portion of this Agreement shall be deemed to constitute a waiver of any immunity
including those provided by the Colorado Governmental Immunity Act §§24-10-101
et seq., as applicable now or hereafter amended, that the parties or their officers or
employees may possess, nor shall any portion of this Agreement be deemed to have
created a duty of care that did not previously exist with respect to any person not a
party to this Agreement. The parties hereto acknowledge and agree that no part of
this Agreement is intended to circumvent or replace such immunities.
20. Contractor shall promptly notify County in the event in which it is a party defendant
or respondent in a case, which involves services provided under the agreement. The
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 County
Director. The term "litigation" includes an assignment for the benefit of creditors, and
filings in bankruptcy, reorganizations and/or foreclosure.
21. Any amendments or modifications to this agreement shall be in writing signed by both
parties.
Exhibit to the SS23A
4 Revised 6/2022
22. Financial obligations of the County payable after the current fiscal year are contingent
upon funds for that purpose being appropriated, budgeted and otherwise made
available. Execution of this Agreement by County does not create an obligation on the
part of County to expend funds not otherwise appropriated in each succeeding year.
23. 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 is not
entitled to unemployment insurance or workers' compensation benefits through
County and County shall not pay for or otherwise provide such coverage for
Contractor. Unemployment insurance benefits will not be available to
Contractor for services provided under this Agreement. Contractor shall pay
when due any/all applicable employment taxes and income taxes and local head
taxes (if applicable) incurred as a result of the services provided under this
Agreement.
24. County reserves the right to require the Contractor to provide a certificate of
insurance, policy, or other proof of insurance at its sole discretion.
25. Contractor shall ensure all homes are recertified within required timelines and will
follow Colorado Volume 7 Social Services Rules 7.710.35 Renewal or Continuation
Notice and 7.710.36 Recertification.
26. Contractor will notify the County a minimum of 30 days prior to a license expiring if
a home is not going to be recertified within the required timeline. In the event the
County has children placed in the home and the license expires, the County will not
be responsible for any payment to the Contractor during the unlicensed time.
27. For Children's Habilitation Residential Program (CI-IRP) waiver funded placements, the
Contractor and the Community Center Board (CCB) will be responsible for ensuring all
Prior Authorizations (PAR) are current and that there is no gap in reimbursement. The
County will not be responsible for any non -reimbursement to the provider if PARS are
not approved.
Exhibit to the SS23A
5 Revised 6/2022
TREATMENT FOSTER CARE AGENCIES
SFY 2022-2023
1
2
3
4
KAIROS FAMILY SERVICES, LLC
!C'
SPECIALIZED ALTERNATIVES FOR FAMILY AND YOUTH
1724901
67201
1662183
13170 Crane Canyon Loop
6400 West Cf i Mine Avenue
1600 Specht Point Rd, Suite 105
Colorado Springs. CO
Colorado Springs, CO 80921
L€ttletR +> 3 23
Fort Collins, CO 80525
EXHIBIT to the SS23A
Additional Provisions for the Agreement to Purchase
Out -of -Home Placement Services SS23A
For the Purchase of
Group Home/Group Center Care Services
The following additional provisions of this Exhibit apply to the agreement entitled, "Agreement
to Purchase Out -of -Home Placement Services SS23A, attached hereto, by and between the Board
of County Commissioners of Weld County, on behalf of the Weld County Department of Human
Services," hereinafter referred to as, "County," and «Agency», hereinafter referred to as,
"Contractor."
1. County agrees to purchase and Contractor agrees to provide the care and services which
are listed in this agreement for Facility ID# «Facility_ID» at the contractor's base
anchor rate outlined by the Colorado Office of Children, Youth & Families Division of
Child Welfare, unless the Contractor and County have agreed to utilize the Inventory for
Client and Agency Planning (ICAP) assessment and Corresponding rate structure for
children who have significant intellectual or Developmental disabilities or intensive
medical or physical needs. These services will be for children who have been deemed
eligible for social services under the statutes, rules and regulations of the State of
Colorado.
2. All bed hold authorizations and payments are subject to a 7 -day maximum for a child's
temporary absence from a facility; however, if the absence is a result of hospitalization,
the maximum bed hold authorization may be up to 14 days. Bed hold requests must
have prior written authorization from the Weld County Department Administrator or
Designee before payment will be release to Contractor.
3. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will
be furnished under this contract for facilities that provide sex offender treatment.
4. The services purchased under this Agreement for Group Home/Center services may
include, but are not limited to: Basic 24 -hour care and child maintenance (food, shelter,
clothing, educational supplies and allowance), direct child care, transportation,
administrative overhead, support overhead, service delivery staff, which may include but
are not limited to: Parent training for teens, independent living training, and
mentor/advocate services.
5. Contractor agrees to have appropriate personnel available to attend or participate in
Family Engagement, Team Decision Making meetings, or court hearings. Contractor
shall be notified by County staff of the dates and times attendance is requested.
6. Contractor agrees to actively participate in achieving the child's Permanency Goal and
cooperate with any vendors hired by the Weld County Department of Human Services to
shorten the duration of placement.
7. Contractor agrees to have physical examinations completed within 14 days and dental
examinations completed within 8 weeks of the child being placed with Contractor. All
documentation of these examinations shall be forward to the County.
Exhibit to the SS23A
1 Revised 6/2022
8. Contractor agrees to arrange a full evaluation of an Individualized Educational Plan
(IEP) for youth designated as a Special Education Student every 3 years and coordinate
reviews every year. If the [EP is due while the child is in placement, the Contractor shall
complete or obtain a completed [EP. A copy will then be forwarded to the County.
9. Children in Psychiatric Residential Treatment Facilities, Residential Child Care
Facilities and Child Placement Agencies are generally not eligible to receive clothing
allowances as outlined in the Weld County Department of Human Services Policy
Manual. However, a one-time emergency clothing allowance may he approved in
limited circumstances, with prior written authorization from County's Department
Administrator required before payment will be released to provider.
10. County shall have access to Contractor's financial records as they relate to this
Agreement for purposes of audit. Such records shall be complete and available for audit
90 days after final payment hereunder and shall be retained and available for audit
purposes for at least five years after final payment hereunder.
11. Time is of the essence in each and all of the provisions of this Agreement.
12. 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.
13. Any notice required to be given under this Agreement shall be in writing and shall be
mailed or delivered to the other party at that party's address as stated above.
14. This Agreement and the provision of services hereunder shall be subject to the laws of
Colorado and be in accordance with the policies, procedures, and practices of County.
15. This Agreement is nonexclusive and County may engage or use other contractors or
persons to perform services of the same or similar nature.
16. Contract Professional certifies, warrants, and agrees that it does not knowingly employ
or contract with an illegal alien who will perform work under this contract. Contract
Professional 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(5Xc). Contract Professional 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 Contract
Professional that the subcontractor shall not knowingly employ or contract with an
illegal alien to perform work under this Agreement. Contract Professional 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
Contract Professional obtains actual knowledge that a subcontractor performing work
under the public contract for services knowingly employs or contracts with an illegal
alien Contract Professional shall notify the subcontractor and County within three (3)
days that Contract Professional has actual knowledge that a subcontractor is employing
Exhibit to the SS23A
2 Revised 6/2022
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. Contract Professional 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. Contract Professional 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 Contract Professional participates in the State of Colorado program,
Contract Professional shall, within twenty days after hiring an new employee to perform
work under the contract, affirm that Contract Professional 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. Contract Professional shall
deliver to County, 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 Contract Professional fails to comply with any requirement of
this provision or of C.R.S. §8-17.5-101 et seq., County, may terminate this Agreement
for breach, and if so terminated, Contract Professional shall be liable for actual and
consequential damages.
Except where exempted by federal law and except as provided in C.R.S. § 24-76.5-
103(3), if Contract Professional receives federal or state funds under the contract,
Contract Professional 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
Contract Professional 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.
17. Contractor assures and certifies that it and its principals:
a. Are not presently debarred, suspended, proposed for debarment, and declared
ineligible or voluntarily excluded from covered transactions by a federal
department or agency;
b. Have not, within a three-year period of preceding this Agreement, been convicted
of or had a civil judgment rendered against them for commission of fraud or a
criminal offense in connection with obtaining, attempting to obtain, or performing
a public (federal, state, or local) transaction or contract under a 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;
c. 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 paragraph (B) above;
Exhibit to the SS23A
3 Revised 6/2022
d. Have not within a three-year period preceding this Agreement, had one or more
public transactions (federal, state, and local) terminated for cause or default.
18. In addition to terminating this Agreement, in accordance with the provisions of the
attached Agreement, the County may exercise the following remedial actions if County
finds and determines that Contractor has substantially failed to satisfy the scope of work
found in the Agreement, any Exhibit, or the child specific addendum SS23B. 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 include, but are not
limited to, any one or more of the following:
a. Withhold payment to Contractor until the necessary services or corrections in
performance are satisfactorily completed.
b. Deny payment or recover reimbursement for those services or deliverables which
have not been performed and which due to circumstances caused by Contractor
cannot be performed or if performed would be of no value to County. Denial of
the amount of payment shall be reasonably related to the amount of work or
deliverables lost to County.
c. Recover from Contractor any incorrect payment to Contractor due to omission,
error, fraud, and/or defalcation by deducting from subsequent payments under this
Agreement, or other agreements between County and Contractor, or as a debt to
County, or otherwise as provided by law.
19. 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 or their assignees, and nothing contained 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 or their assignees receiving
services or benefits under this Agreement shall be an incidental beneficiary only.
20. No portion of this Agreement shall be deemed to constitute a waiver of any immunity
including those provided by the Colorado Governmental Immunity Act §§24-10-101
et seq., as applicable now or hereafter amended, that the parties or their officers or
employees may possess, nor shall any portion of this Agreement be deemed to have
created a duty of care that did not previously exist with respect to any person not a party
to this Agreement. The parties hereto acknowledge and agree that no part of this
Agreement is intended to circumvent or replace such immunities.
21. Contractor shall promptly notify County in the event in which it is a party defendant or
respondent in a case, which involves services provided under the agreement. The
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 County Director. The term
"litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy,
reorganizations and/or foreclosure.
Exhibit to the SS23A
4 Revised 6/2022
22. Any amendments or modifications to this agreement shall be in writing signed by both
parties.
23. Financial obligations of the County payable after the current fiscal year are contingent
upon funds for that purpose being appropriated, budgeted and otherwise made available.
Execution of this Agreement by County does not create an obligation on the part of
County to expend funds not otherwise appropriated in each succeeding year.
24. 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 is not entitled to unemployment insurance or
workers' compensation benefits through County and County shall not pay for or
otherwise provide such coverage for Contractor. Unemployment insurance benefits
will not be available to Contractor for services provided under this Agreement.
Contractor shall pay when due any/all applicable employment taxes and income
taxes and local head taxes (if applicable) incurred as a result of the services
provided under this Agreement.
25. County reserves the right to require the Contractor to provide a certificate of insurance.
policy, -or other proof of insurance at its sole discretion.
26. Contractor shall ensure all homes are recertified within required timelines and will
follow Colorado Volume 7 Social Services Rules 7.710.35 Renewal or Continuation
Notice and 7.710.36 Recertification.
27. Contractor will notify the County a minimum of 30 days prior to a license expiring if a
home is not going to be recertified within the required timeline. In the event the County
has children placed in the home and the license expires, the County will not be
responsible for any payment to the Contractor during the unlicensed time.
28. For Children's Habilitation Residential Program (CHRP) waiver funded placements, the
Contractor and the Community Center Board (CCB) will be responsible for ensuring all
Prior Authorizations (PAR) are current and that there is no gap in reimbursement. The
County will not be responsible for any non -reimbursement to the provider if PARS are
not approved.
Exhibit to the SS23A
5 Revised 6/2022
GROUP HOME/GROUP CENTER AGENCIES
CONTRACTOR
CONTRACTOR ADDRESS
CONTRACTOR
CITY/STATE/Zip
FACILJTYNAMIE
FACILI ID
FACILITY ADDRESS
FACI6JTYCITYj5TATE/ZiP
ARIEL
Grand Junction, CO 81504
1
4660 Wadsworth Blvd.
Wheat Ridge, CO 80033
ARIEL SPRITE HOUSE
1643047
2938 North Ave., Suite G
2
4660 Wadsworth Blvd.
Wheat Ridge, CO 80033
ASCEND
1705635
17905 E. Bails Place
Aurora, CO 80017
3
4660 Wadsworth Blvd.
Wheat Ridge, CO 80033
KISMET HOUSE
1630179
861 N. Sable Blvd.
Aurora, CO 80011
4
4660 Wadsworth Blvd.
Wheat Ridge, CO 80033
• REFLECTIONS
1723736
1083 S. Mobile St.
-
Aurora, CO 80017
5
4660 Wadsworth Blvd.
Wheat Ridge, CO 80033
RISE HOME FOR BOYS
1680477
754 Hanover St.
Aurora, CO 80010
DENVER
CHILDRENS HOME
6
1501 Albion Street
Denver, CO' 80220
DENVER CHILDREN'S
HOME/DISCOVERY HOME
1588158
4140E 16th Ave
Denver, CO 80220
KIDS CROSSING
7
1440 E. Fountain Blvd.
Colorado Springs, CO
80910-3502
EVERGREEN GROUP
CENTER
61317
1436 Hilltop Or.
Longmont, CO 80504
8
1440 E, Fqunfain Blvd.
Calora¢erSpringsg'p
80910,350Z •
SARAH'S HOME CORP
1669240
185 4th Street
Caihan, CO 80808
.
SAVIO HOUSE:.
9
325 King St.
Denver, CO 80219
CARR GROUP CENTER
FOR GIRLS
1548445
3297 Jasmine Street
Denver, CO 80207
10
....
325:IcIng Stt
Denver, CO 80219
GLORY GROUP HOME.
• AURORA
1585302
2424 S Scranton Way
Aurora, CO 80014
• -
11
S
Sm#th ASen •-,a_
.
14364 E Evans Ave
Aurora, CO 80014
ROCKY MOUNTAIN
GROUP HOME
1701369
16621 E. 107th Ave.
Commerce City, CO 80022
12
15200 E Girard Ave, Suite
X450
Aurora, CO 80014 .
TURNING LIgiT5
1621806
1365 S,. Lewiston St.
Aurora, CO 80017
13
15200 E. Girard Ave, Suite
3450
Aurora, CO 80014
GEMS AND JEWELS
1639923
5376 S. Truckee Court
Centennial, CO 80015
EXHIBIT A to the SS23A
Additional Provisions for the Agreement to Purchase
Out -of -Home Placement Services SS23A
For the Purchase of
Residential Child Care Facility Services
The following additional provisions of this Exhibit apply to the agreement entitled, "Agreement
to Purchase Out -of -Home Placement Services SS23A. attached hereto, by and between the Board
of County Commissioners of Weld County, on behalf of the Weld County Department of Human
Services," hereinafter referred to as, "County," and «Agency», hereinafter referred to as,
"Contractor."
I. County agrees to purchase and Contractor agrees to provide the care and services which
are listed in this agreement for Facility ID# «Facility_ID» at the contractor's base
anchor rate as outlined by the Colorado Office of Children, Youth & Families Division of
Child Welfare, unless the Contractor and County have agreed to utilize the Inventory for
Client and Agency Planning (ICAP) assessment and corresponding rate structure for
children who have significant intellectual or developmental disabilities or intensive
medical or physical needs. These services will be for children who have been deemed
eligible for social services under the statutes, rules and regulations of the State of
Colorado.
2. All bed hold authorizations and payments are subject to a 7 -day maximum for a child's
temporary absence from a facility; however, if the absence is a result of hospitalization,
the maximum bed hold authorization may be up to 14 days. Bed hold requests must have
prior written authorization from the Department Administrator or Designee before
payment will be release to provider. Reimbursement rates for bed hold days may not
exceed the state standard rate for administrative maintenance and administrative services
or may be a reduced rate that is mutually agreed upon.
3. The services purchased under this Agreement as Child Maintenance, Administrative
Maintenance and Services for Residential Child Care Facilities include, but are not
limited to: Food, shelter, clothing, personal needs and allowance, administration,
administrative overhead, support staff, support overhead, sleep -over staff, direct child
care, transportation, therapeutic recreation, service delivery staff, parent training for
teens, independent living training, mentor/advocate, supervised visitation and all other
services as outlined in the Child Specific Addendum. The anticipated minimum
percentage for each item is as follows and will be subject to County monitoring as
outlined in Section VI of this contract:
a. Food, including meals and snacks (25%).
b. Clothing (3%).
c. Shelter, including utilities and use of household furnishing and equipment and
daily supervision, including those activities that a parent would normally carry out
Exhibit to the SS23A
I Revised 6/2022
to assure protection, emotional support and care of the child (30%).
d. Personal items and grooming care for the child, such as toothpaste, toothbrushes,
soap, combs, haircuts, and other essentials (2%).
e. Other/miscellaneous items considered usual in the care and supervision of the
child, include, but are not limited to, transportation, recreation and overhead
(40%).
4. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be
furnished by the Contractor under this contract for facilities that provide sex offender
treatment.
5. Contractor agrees to have appropriate personnel available to attend or participate in
Family Engagement, Team Decision Making meetings or court hearings. Provider shall
be notified by County staff of the dates and times attendance is requested.
6. Contractor agrees to cooperate with any vendors hired by the Weld County Department
of Human Services to shorten the duration of placement.
7. Contractor agrees to have physical examinations scheduled within 14 days and dental
examinations scheduled within 8 weeks of the child being placed with Contractor. All
documentation of these examinations shall be forward to the County.
8. Contractor agrees to arrange a full evaluation of an Individualized Educational Plan (IEP)
for youth designated as a Special Education Student every 3 years and coordinate reviews
every year. If the IEP is due while the child is in placement, the Contractor will complete
or obtain a completed [EP. A copy will then be forwarded to the County.
9. Children in Residential Child Care Facilities and Child Placement Agencies are generally
not eligible to receive clothing allowances as outlined in the Weld County Department of
Human Services Policy Manual. However, a one-time emergency clothing allowance
may be approved in limited circumstances, with prior written authorization from
County's Department Administrator required before payment will be released to
provider.
10. County shall have access to Contractor's financial records as they relate to this
Agreement for purposes of audit. Such records shall be complete and available for audit
90 days after final payment hereunder and shall be retained and available for audit
purposes for at least five years after final payment hereunder.
11. Time is of the essence in each and all of the provisions of this Agreement.
12. 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
Exhibit to the SS23A
2 Revised 6/2022
Acts of God, fires, strikes, war, flood, earthquakes or Governmental actions.
13. Any notice required to be given under this Agreement shall be in writing and shall be
mailed or delivered to the other party at that party's address as stated above.
14. This Agreement and the provision of services hereunder shall be subject to the laws of
Colorado and be in accordance with the policies, procedures, and practices of County.
15. This Agreement is nonexclusive and County may engage or use other contractors or
persons to perform services of the same or similar nature.
16. Contract Professional certifies, warrants, and agrees that it does not knowingly employ or
contract with an illegal alien who will perform work under this contract. Contract
Professional 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). Contract Professional 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 Contract Professional
that the subcontractor shall not knowingly employ or contract with an illegal alien to
perform work under this Agreement. Contract Professional 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 Contract
Professional obtains actual knowledge that a subcontractor performing work under the
public contract for services knowingly employs or contracts with an illegal alien Contract
Professional shall notify the subcontractor and County within three (3) days that Contract
Professional 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. Contract Professional 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. Contract Professional 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 Contract
Professional participates in the State of Colorado program, Contract Professional shall,
within twenty days after hiring an new employee to perform work under the contract,
affirm that Contract Professional 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. Contract Professional shall deliver to County, 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
Contract Professional fails to comply with any requirement of this provision or of C.R.S.
§8-17.5-101 et seq., County, may terminate this Agreement for breach, and if so
terminated, Contract Professional shall be liable for actual and consequential damages.
Exhibit to the SS23A
3 Revised 6/2022
Except where exempted by federal law and except as provided in C.R.S. § 24-76.5-
103(3), if Contract Professional receives federal or state funds under the contract,
Contract Professional 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
Contract Professional 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.
17. Contractor assures and certifies that it and its principals:
a. Are not presently debarred, suspended, proposed for debarment, and declared
ineligible or voluntarily excluded from covered transactions by a federal
department or agency;
b. Have not, within a three-year period of preceding this Agreement, been convicted
of or had a civil judgment rendered against them for commission of fraud or a
criminal offense in connection with obtaining, attempting to obtain, or performing
a public (federal, state, or local) transaction or contract under a 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;
c. 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 paragraph (B) above;
d. Have not within a three-year period preceding this Agreement, had one or more
public transactions (federal, state, and local) terminated for cause or default.
18. In addition to terminating this Agreement, in accordance with the provisions of the
attached Agreement, the County may exercise the following remedial actions County find
and determine that Contractor has substantially failed to satisfy the scope of work found
in the Agreement, any Exhibit, or the child specific addendum SS23B. 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 include, but are not limited to, any
one or more of the following:
a. Withhold payment to Contractor until the necessary services or corrections in
performance are satisfactorily completed.
b. Deny payment or recover reimbursement for those services or deliverables which
have not been performed and which due to circumstances caused by Contractor
Exhibit to the SS23A
4 Revised 6/2022
cannot be performed or if performed would be of no value to County. Denial of
the amount of payment shall be reasonably related to the amount of work or
deliverables lost to County.
c. Recover from Contractor any incorrect payment to Contractor due to omission,
error, fraud, and/or defalcation by deducting from subsequent payments under this
Agreement, or other agreements between County and Contractor, or as a debt to
County, or otherwise as provided by law.
19. 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 or their assignees, and nothing contained 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 or their assignees receiving
services or benefits under this Agreement shall be an incidental beneficiary only.
20. No portion of this Agreement shall be deemed to constitute a waiver of any immunity
including those provided by the Colorado Governmental Immunity Act §§24-10-101 et
seq., as applicable now or hereafter amended, that the parties or their officers or
employees may possess, nor shall any portion of this Agreement be deemed to have
created a duty of care that did not previously exist with respect to any person not a party
to this Agreement. The parties hereto acknowledge and agree that no part of this
Agreement is intended to circumvent or replace such immunities.
21. Contractor shall promptly notify County in the event in which it is a party defendant or
respondent in a case, which involves services provided under the agreement. The
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 County Director. The term
"litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy,
reorganizations and/or foreclosure.
22. Any amendments or modifications to this agreement shall be in writing signed by both
parties.
23. Financial obligations of the County payable after the current fiscal year are contingent
upon funds for that purpose being appropriated, budgeted and otherwise made available.
Execution of this Agreement by County does not create an obligation on the part of
County to expend funds not otherwise appropriated in each succeeding year.
24. 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
Exhibit to the SS23A
5 Revised 6/2022
pursuant to this Agreement. Contractor is not entitled to unemployment insurance or
workers' compensation benefits through County and County shall not pay for or
otherwise provide such coverage for Contractor. Unemployment insurance benefits
will not be available to Contractor for services provided under this Agreement.
Contractor shall pay when due any/all applicable employment taxes and income
taxes and local head taxes (if applicable) incurred as a result of the services
provided under this Agreement.
25. County reserves the right to require the Contractor to provide a certificate of insurance,
policy, or other proof of insurance at its sole discretion.
26. Contractor shall ensure all homes are recertified within required timelines and will follow
Colorado Volume 7 Social Services Rules 7.710.35 Renewal or Continuation Notice and
7.71036 Recertification.
27. Contractor will notify the County a minimum of 30 days prior to a license expiring if a
home is not going to be recertified within the required timeline. In the event the County
has children placed in the home and the license expires, the County will not be
responsible for any payment to the Contractor during the unlicensed time.
28. For Children's Habilitation Residential Program (CHRP) waiver funded placements, the
Contractor and the Community Center Board (CCB) will be responsible for ensuring all
Prior Authorizations (PAR) are current and that there is no gap in reimbursement. The
County will not be responsible for any non -reimbursement to the provider if PARS are
not approved.
Exhibit to the SS23A
6 Revised 6/2022
RESIDENTIAL CHILD CARE FACILITIES
SFY 2022-2023
CONTRACTOR NAME
CONTRACTOR ADDRESS
CONTRACTOR CITY/STATE/ZIP
FACILITY NAME
FACILITY ID
FACILITY ADDRESS
FACILITY CITY/STATE/ZIP
1
ARIEL
4660 Wadsworth Blvd.
Wheat Ridge, CO 80033
THE DAISY CENTER
15653.68
643 27 112 Rd.
Grand Junction, CO 81506
2
ALTERNATIVE HOMES
FOR YOUTH
1110 M St.
1440 Pine Street,
Greeley, CO 80631
ALTERNATIVE HOMES FOR
YOUTH - GREELEY
2016
1110 '
freeley, CO 80631
Suite B,Boulder,
�, ..v_.._
CO 80302
3
ATTENTION INC dba
TGTHR, Chase House on
Trails
TGTHR, Chase House on Trails
11679
3682 Chase Ct
Boulder, CO 80305
4
BRAD'S HOUSE
28101-lunters Glen Rd.
Mounument, CO 80132
BRAD'S HOUSE
1710657
2810 Hunters Glen Rd.
Monument, CO 80132
CORNELL CORRECTIONS
OF CALIFORNIA, LLC.,
OPERATING SOUTHERN
PEAKS REGIONAL
•TREATMENT CENTER
700 Four Mile
Parkway
¢: ,
Canon City, CO 81212
SOUTHERN PEAKS REGIONAL
TREATMENT CENTER
1526789
700 Four Mile=Parkway ,.„;
Canon City, CO 81212
DALE Ht70SE PROJECT
n
..
6
7 W. Dale Street
Colorado Springs, CO 80903
_
DALE HOUSE PROJ=CT 24
1502911
24 E. Dale St. rColorado
Springs, CO 80903
7
7 W. Dale St Bet
Colorado Springs, CO 80903
DALE HOUSE PROJECT 802
1502990
802 N. Tejon St.
Colorado Springs, CO 80903
DENVER CHILDRENS
HOME
1501 Albion Street
Denver, CO 80220
DENVER CHILDRENS HOME
49551
1501 Albion Street
Denver, CO 80220
DEVEREUX CLEO
WALLACE CENTER
8405 Church Ranch Blvd
1
Westminster, CO 80021
DEVEREUX CLEO YIWALLAiCE
CENTER AT WESTMINSTER
39794
_
.
8405 church Ranch Blvd
Westminster, CO 80021
GATEWAY RESIDENTIAL
PROGRAM
10
11
3338 Ash Mesa Rd
Delta, CO 81416
GATEWAY RESIDENTIAL
PROGRAM -DELTA
1609500
3338 Ash Mesa Rd
Delta, CO 81416
3338 Ash M sa Rd
Delta, CO 81416
GATEWAY RESIDENTIAL
PROGRAM -GRAND JUNeTION
1608993
835 Colorado Ave
Grand Junction, CO 81501
12
GRIFFITH CENTERS FOR
CHILDREN INC
1724 Gilpin _
treet
Denver, CO 80218
GRIFFITH CENTER COLORADO
SPRINGS..
39212
17 N Farragut
Colorado Springs CO 80909
13,
HABILITATION CENTER,
LLC DBA LITTLE CREEK
BEHAVIORAL
161 Skunk Hollow Road
Conway, AR 72032
HABILITATION CENTER, LLC DBA
LITTLE CREEK BEHAVIORAL
.
1760913
1828 lodustrial! Dr.
Fordyce, AR 71742
1
14
,4EF!ERSON HILLS
421 Zang St I
•Lakewood, CO 80228 ".,.
JEFFERSON HILLS
88459
421Zang-Street
Lakewood, CO 80228
15
LARADOhi
5100 Lincolr Street
Denver, CO 80216
LARADON
1734100
tl:' :
5100 Lincoln Street
Denver, CO 80216
RESIDENTIAL CHILD CARE FACILITIES
17
2129 N. Nevada Ave.
2210 E LaSalle, #219
2210 E LaSalle, #219
18
Colorado Springs, CO 80909
Colorado Springs, CO 80909
Colorado Sprints, CO 80909
SFY 2022-2023
NEVADA HOUSE
0REWS PLACE
FUTURE BOUND
1599808
ROUNDUP FELLOWSHIP
19
20
3443 South Galena St.,
Suite 310
3443 South Galena St.,
Suite 310
1613088
1599810
1060 Valkenburg Drive
3101 Palmer Park Blvd
Colorado Springs, CO 80907
Colorado Springs, CO 80907
Colorado Springs, CO 80909
Denver, CO 80231
Denver, CO 80231
ROUND UP FELLOWSHIP III
ROUNDUP FELLOWSHIP V
45211
45212
4441 Fortune Cir
1234 N Meade St
21
22
23
24
SHILOH HOUSE INC
SMITH AGENCY INC
26
27
28
29
30
31
Colorado Springs, CO 80917
Colorado Springs, CO 80909
6400 West Coal Mine
Avenue
6400 West Coal Mine
Avenue
6400 West Coal Mine
Avenue
6400 West Coal Mine
Avenue
6400 West Coal Mine
Avenue
Littleton, CO 80123
Littleton, CO 80123
Littleton, CO 80123
Littleton, CO 80123
Littleton, CO 80123
SHILOH CENTER FOR YOUTH
(Thornton)
SHILOH HOUSE - ADAMS
CAMPUS
1588986
8461 Delaware St
Thornton CO 80221
1528492
7400 Kearney Street
Commerce City CO 80022
SHILOH HOUSE - ESTES
SHILOH HOUSE- LONGMONT
CAMPUS
20335
1539982
7623 S Estes Ct
2700 E Ken Pratt BLVD
Littleton, CO 80128
Longmont CO 80501
SHILOH HOUSE - YARROW
70967
7227 5 Yarrow Ct
Littleton CO 80123
14364 E Evans Ave
14364 E Evans Ave
Aurora, CO 80014
Aurora, CO 8D014
SERENITY CHILDRENS HOME
SERENITY II CHILDRENS HOME
THIRD WAY CENTER
PO Box 61385
PO Box 61385
96482
6566
15001 E Tufts PI
14.759 E Pacific PI
Aurora, CO 80015
Aurora, CO 80014
Denver, CO 80206
Denver, CO 80206
THIRD WAY CENTER - LINCOLN
77810
PO Box 61385
Denver, CO 80206
PO Box 61385
Denver, CO 80206
THIRD WAY CENTER - LOWRY
THIRD WAY CENTER - PONTIAC
1547437
1133 Lincoln
Denver CO 80203
9100 E Lowry Blvd
Denver CO 80230
65346
THIRD WAY CENTER - YORK 49487
1735 Pontiac St
Denver CO 80220
1295 York St
Denver CO 80206
EXHIBIT to the SS23A
Additional Provisions for the Agreement to Purchase
Out -of -Home Placement Services SS23A
For the Purchase of
Qualified Residential Treatment Program Services
The following additional provisions of this Exhibit apply to the agreement entitled, "Agreement
to Purchase Out -of -Home Placement Services SS23A, attached hereto, by and between the Board
of County Commissioners of Weld County, on behalf of the Weld County Department of Human
Services," hereinafter referred to as, "County," and <<Agency», hereinafter referred to as,
"Contractor."
I. County agrees to purchase and Contractor agrees to provide the care and services which
are listed in this agreement for Facility ID# <<Facility_ID» at the contractor's base
anchor rate as outlined by the Colorado Office of Children, Youth & Families Division of
Child Welfare, unless the Contractor and County have agreed to utilize the Inventory for
Client and Agency Planning (ICAP) assessment and corresponding rate structure for
children who have significant intellectual or developmental disabilities or intensive
medical or physical needs. These services will be for children who have been deemed
eligible for social services under the statutes, rules and regulations of the State of
Colorado.
2. All bed hold authorizations and payments are subject to a 7 -day maximum for a child's
temporary absence from a facility; however, if the absence is a result of hospitalization,
the maximum bed hold authorization may be up to 14 days. Bed hold requests must have
prior written authorization from the Department Administrator or Designee before
payment will be release to provider. Reimbursement rates for bed hold days may not
exceed the state standard rate for administrative maintenance and administrative services
or may be a reduced rate that is mutually agreed upon.
3. The services purchased under this Agreement as Child Maintenance, Administrative
Maintenance and Services for the Qualified Residential Treatment Program include, but
are not limited to: Food, shelter, clothing, personal needs and allowance, administration,
administrative overhead, support staff, support overhead, sleep -over staff, direct child
care, transportation, therapeutic recreation, service delivery staff, parent training for
teens, independent living training, mentor/advocate, supervised visitation and all other
services as outlined in the Child Specific Addendum. The anticipated minimum
percentage for each item is as follows and will be subject to County monitoring as
outlined in Section VI of this contract:
a. Food, including meals and snacks (25%).
b. Clothing (3%).
c. Shelter, including utilities and use of household furnishing and equipment and
daily supervision, including those activities that a parent would normally carry out
Exhibit to the SS23A
6/2022
to assure protection, emotional support and care of the child (30%).
d. Personal items and grooming care for the child, such as toothpaste, toothbrushes,
soap, combs, haircuts, and other essentials (2%).
e. Other/miscellaneous items considered usual in the care and supervision of the
child, include, but are not limited to, transportation, recreation and overhead
(40%).
4. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be
furnished by the Contractor under this contract for facilities that provide sex offender
treatment.
5. Contractor agrees to have appropriate personnel available to attend or participate in
Family Engagement, Team Decision Making meetings or court hearings. Provider shall
be notified by County staff of the dates and times attendance is requested.
6. Contractor agrees to cooperate with any vendors hired by the Weld County Department
of Human Services to shorten the duration of placement.
7. Contractor agrees to have physical examinations scheduled within 14 days and dental
examinations scheduled within 8 weeks of the child being placed with Contractor. All
documentation of these examinations shall be forward to the County.
8. Contractor agrees to arrange a full evaluation of an Individualized Educational Plan (IEP)
for youth designated as a Special Education Student every 3 years and coordinate reviews
every year. If the IEP is due while the child is in placement, the Contractor will complete
or obtain a completed IEP. A copy will then be forwarded to the County.
9. Children in Residential Child Care Facilities, Qualified Residential Treatment Programs
and Child Placement Agencies are generally not eligible to receive clothing allowances as
outlined in the Weld County Department of Human Services Policy Manual. However, a
one-time emergency clothing allowance may be approved in limited circumstances, with
prior written authorization from County's Department Administrator required before
payment will be released to provider.
10. County shall have access to Contractor's financial records as they relate to this
Agreement for purposes of audit. Such records shall be complete and available for audit
90 days after final payment hereunder and shall be retained and available for audit
purposes for at least five years after final payment hereunder.
11. Time is of the essence in each and all of the provisions of this Agreement.
12. 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
Exhibit to the SS23A
2 6/2022
Acts of God, fires, strikes, war, flood, earthquakes or Governmental actions.
13. Any notice required to be given under this Agreement shall be in writing and shall be
mailed or delivered to the other party at that party's address as stated above.
14. This Agreement and the provision of services hereunder shall be subject to the laws of
Colorado and be in accordance with the policies, procedures, and practices of County.
15. This Agreement is nonexclusive and County may engage or use other contractors or
persons to perform services of the same or similar nature.
16. Contract Professional certifies, warrants, and agrees that it does not knowingly employ or
contract with an illegal alien who will perform work under this contract. Contract
Professional 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). Contract Professional 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 Contract Professional
that the subcontractor shall not knowingly employ or contract with an illegal alien to
perform work under this Agreement. Contract Professional 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 Contract
Professional obtains actual knowledge that a subcontractor performing work under the
public contract for services knowingly employs or contracts with an illegal alien Contract
Professional shall notify the subcontractor and County within three (3) days that Contract
Professional 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. Contract Professional 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. Contract Professional 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 Contract
Professional participates in the State of Colorado program, Contract Professional shall,
within twenty days after hiring an new employee to perform work under the contract,
affirm that Contract Professional 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. Contract Professional shall deliver to County, 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
Contract Professional fails to comply with any requirement of this provision or of C.R.S.
§8-17.5-101 et seq., County, may terminate this Agreement for breach, and if so
terminated, Contract Professional shall be liable for actual and consequential damages.
Exhibit to the SS23A
3 6/2022
Except where exempted by federal law and except as provided in C.R.S. § 24-76.5-
103(3), if Contract Professional receives federal or state funds under the contract,
Contract Professional 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
Contract Professional 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.
17. Contractor assures and certifies that it and its principals:
a. Are not presently debarred, suspended, proposed for debarment, and declared
ineligible or voluntarily excluded from covered transactions by a federal
department or agency;
b. Have not, within a three-year period of preceding this Agreement, been convicted
of or had a civil judgment rendered against them for commission of fraud or a
criminal offense in connection with obtaining, attempting to obtain, or performing
a public (federal, state, or local) transaction or contract under a 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;
c. 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 paragraph (B) above;
d. Have not within a three-year period preceding this Agreement, had one or more
public transactions (federal, state, and local) terminated for cause or default.
18. In addition to terminating this Agreement, in accordance with the provisions of the
attached Agreement, the County may exercise the following remedial actions County find
and determine that Contractor has substantially failed to satisfy the scope of work found
in the Agreement, any Exhibit, or the child specific addendum SS23B. 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 include, but are not limited to, any
one or more of the following:
a. Withhold payment to Contractor until the necessary services or corrections in
performance are satisfactorily completed.
b. Deny payment or recover reimbursement for those services or deliverables which
have not been performed and which due to circumstances caused by Contractor
Exhibit to the SS23A
4 6/2022
cannot be performed or if performed would be of no value to County. Denial of
the amount of payment shall be reasonably related to the amount of work or
deliverables lost to County.
c. Recover from Contractor any incorrect payment to Contractor due to omission,
error, fraud, and/or defalcation by deducting from subsequent payments under this
Agreement, or other agreements between County and Contractor, or as a debt to
County, or otherwise as provided by law.
19. 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 or their assignees, and nothing contained 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 or their assignees receiving
services or benefits under this Agreement shall be an incidental beneficiary only.
20. No portion of this Agreement shall be deemed to constitute a waiver of any immunity
including those provided by the Colorado Governmental Immunity Act §§24-10-101 et
seq., as applicable now or hereafter amended, that the parties or their officers or
employees may possess, nor shall any portion of this Agreement be deemed to have
created a duty of care that did not previously exist with respect to any person not a party
to this Agreement. The parties hereto acknowledge and agree that no part of this
Agreement is intended to circumvent or replace such immunities.
21. Contractor shall promptly notify County in the event in which it is a party defendant or
respondent in a case, which involves services provided under the agreement. The
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 County Director. The term
"litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy,
reorganizations and/or foreclosure.
22. Any amendments or modifications to this agreement shall be in writing signed by both
parties.
23. Financial obligations of the County payable after the current fiscal year are contingent
upon funds for that purpose being appropriated, budgeted and otherwise made available.
Execution of this Agreement by County does not create an obligation on the part of
County to expend funds not otherwise appropriated in each succeeding year.
24. 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
Exhibit to the SS23A
5 6/2022
pursuant to this Agreement. Contractor is not entitled to unemployment insurance or
workers' compensation benefits through County and County shall not pay for or
otherwise provide such coverage for Contractor. Unemployment insurance benefits
will not be available to Contractor for services provided under this Agreement.
Contractor shall pay when due any/all applicable employment taxes and income
taxes and local head taxes (if applicable) incurred as a result of the services
provided under this Agreement.
25. County reserves the right to require the Contractor to provide a certificate of insurance,
policy, or other proof of insurance at its sole discretion.
26. Contractor shall ensure all homes are recertified within required timelines and will follow
Colorado Volume 7 Social Services Rules 7.710.35 Renewal or Continuation Notice and
7.710.36 Recertification.
27. Contractor will notify the County a minimum of 30 days prior to a license expiring if a
home is not going to be recertified within the required timeline. In the event the County
has children placed in the home and the license expires, the County will not be
responsible for any payment to the Contractor during the unlicensed time.
28. For Children's Habilitation Residential Program (CHRP) waiver funded placements, the
Contractor and the Community Center Board (CCB) will be responsible for ensuringail
Prior Authorizations (PAR) are current and that there is no gap in reimbursement. The
County' will not be responsible for any non -reimbursement to the provider if PARS are
not approved.
Exhibit to the SS23A
6 6/2022
Qualified Residential Treatment Program
SFY 2022-2023
, DNT1RAfCTOR A RESS
cowTRA R;CITr/STA ' �.' :
' CIRttY SAME
I I ITY ID
FACYU7'Y ADDRESS
`;FACILITY CITY/STATE/ZIP
1
ARIEL
4660 Wadsworth Blvd.
Wheat Ridge, CO 80033
THE DAISY CENTER
1565168
643 27 1/2 Rd.
Grand Junction, CO 81506
2
ALTERNATIVE HOMES
FOR YOUTH
1110 M St.
Greeley, CO 80631
ALTERNATIVE HOMES FOR
YOUTH GREELEY
2016
1110 M St.
Greeley, CO 80631
3
ATTENTION INC dba
TGTHR, Chase House on
Trails
1440 Pine Street, Suite B
Boulder, CO 80302
TGTHR, chase House on
Trails
11679
3682 Chase Ct
Boulder, CO 80305
GATEWAY RESIDENTIAL
PROGRAM
4
3338 Ash Mesa Rd
Delta, CO 81416 .
GATEWAY RESIDENTIAL
PROGRAM -DELTA
1609500
3338 Ash Mesa Rd
Delta, CO 81416
5
3338 Ash Mesa Rd
Delta, CO 81416
GATEWAY RESIDENTIAL
PROGRAM -GRAND JUNCTION
1608993
835 Colorado Ave
Grand Junction, CO 81501
6
GRIFFITH CENTERS FOR
CHILDREN INC
1724 Gilpin Street
Denver, CO 80218
GRIFFITH CENTER COLORADO
SPRINGS
39212
17 N Farragut
Colorado Springs CO 80309
SHILOH HOUSE INC
6407
ADO West Coal Mine
Littletonenue, CO 80123
SHILOH ',17623 OUSE - ESTES
i
20335
5 Estes Ct
Littleton, CO 80128
8
6400 West Coal Mine
Avenue
Littleton, CO 80123
SHILOH HOUSE LONGMONT
CAMPUS
1539982
2700 E Ken Pratt BLVD
Longmont CO 80501
9
6400 West Coal Mine
Avenue
Littleton, CO 80123
SHILOHOUSE -YARROW
70967
7227 5 Yarrow Ct
Littleton CO 80123
ROCKY MOUNTAIN KIDS
10
2210 E LaSalle, #219
Colorado Springs, CO 80909
NEVADA HOUSE
1599808
2129 N. Nevada Ave.
Colorado Springs, CO 80907
11
21O E LaSalle, #219
Colorado Springs, CO 80909 °
DREWS PLACE
1613088
1060 Valkenburg Drive
Colorado Springs, CO 80907
12
2210 E LaSalle, #219
Colorado Springs, CO 80909
FUTURE BOUND
1599810
3101 Palmer Park Blvd
Colorado Springs, CO 80909
THIRD WAY CENTER
13
PO. Box 61385
Denver, CC 80206
THIRD
PONTI
Y NTEFt -
GE
65346
1735 Pontiac St
Denver CO 80220
14
PO Box 61385
Denver, CO 80206
THIRD WAY
CENTER - YORK
49487
1295 York St
Denver CO 80206
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