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Home My WebLink About20192265.tiff0_5bn%e,n+ owl � ags/al n+ rat C -1 - PRIVILEGED AND CONFIDENTIAL MEMORANDUM _ * c'i Cb9 DATE: April 20, 2021 TO: Board of County Commissioners — Pass -Around FR: Jamie Ulrich, Director, Human Services RE: Agreement Amendment with Specialized Alternatives for Families and Youth of Colorado, INC. Please review and indicate if you would like a work session prior to placing this item on the Board's agenda. Request Board Approval of the Department's Agreement Amendment with Specialized Alternatives for Families and Youth of Colorado, INC. The Department entered into a Child Protection Agreement for services with Specialized Alternatives for Families and Youth of Colorado, INC., identified as Tyler ID 2019-2265 on June 17, 2019. The Agreement was amended on December 9, 2019 to amend the Rate Schedule, on May 18, 2020 to extend the term date through May 31, 2021 and to amend the Rate Schedule, on June 29, 2020 to amend the Rate Schedule, and on August 19, 2020 to amend the Scope of Services and Rate Schedule. The Agreement is now being amended to renew for a third and final year, for the period of June 1, 2021 through May 31, 2022, and to make changes to the Scope of Services and Rate Schedule as noted below. The Human Services Advisory Commission (HSAC) has reviewed and approved this information. Scope of Services: • Remove Therapeutic Visitation from Scope of Services as the provider no longer offers this service. Rate Schedule: Foster Parent Consultation Services: S'12.50$140.00f1 Flout• (Foster Parent Consultation) $140.00/Hour (Family Team Meeting (vim). Team Decision Making (TDM.) Meeting, Professionals Staffing) $140,00/Hour (Telehesalth) $140/Occurrence (No-show, on to two occurrences) $.56/Mile (Mileage) — For distance exceeding thirty (30) miles from practitioner's office located at 1600 Specht Point Road, Suite 105, Fort Collins, Colorado 80525 Pass -Around Memorandum; April 20, 2021-1D gki 4vi 2� C: et,64e,ae O410 02-i• O2--/ Page 1 a)Iq-aa�5 H B0O9 O PRIVILEGED AND CONFIDENTIAL Home Based Services: $140.00/Hour (Multigenerational Treatment Services — Face —to --Face and Telehealth) $140.00/Occurrence (No-show, up to two occurrences) $.56/Mile (Mileage) — For distance exceeding thirty (30) miles from practitioner's office located at I600 Specht Point Road, Suite 105, Fort Collins, Colorado 80525 Home Based Services: $84.00/Day (High Intensity No Medieaid) $52.50/Day (Low Intensity No Medicaid) $40.72/Day (Step Down Level 1 Inside Catchment Medicaid and Core Funding) $54.97/Day (Step Down Level 1 Outside Catchment Medicaid and Core Funding) $15.00/Dayigtep Downy Level Primarily Medicaid Funding with Core Support) $.56/Mile (Mileage) For distance exceeding thirty (30) miles from practitioner's office located at c 105, Dort Collins, CO 80525 Therapoutie Visitation $104.00/Hour (In Office) 4;146.00/f lour (Out of Offiee) $78.00/Hour (PIM, TDM, Prof. Staffing) $54.00/f lour (Na-aliew) 1 do not recommend a Work Session. I recommend approval of this Agreement Amendment. Approve Recommendation Perry L. Buck Mike Freeman Scott K. James, Pro-Tem Steve Moreno, Chair Lori Saine Schedule Work Session Other/Comments: Pass -Around Memorandum; April 20, 2021 - ID 4691e cl(09 a Page 2 AGREEMENT AMENDMENT BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND SPECIALIZED ALTERNATIVES FOR FAMILIES AND YOUTH OF COLORADO, INC. This Agreement Amendment, made and entered into O+day of APB ; I 2021 by and between the Board of Weld County Commissioners, on behalf of the Weld County Department of Human Services, hereinafter referred to as the "Department", and Specialized Altematives for Families and Youth of Colorado, Inc., hereinafter referred to as the "Contractor". WHEREAS the parties entered into an Agreement for Foster Care/Adoption Services, Home Based Services, and Mental Health Services, (the "Original Agreement") identified by the Weld County Clerk to the Board of County Commissioners as document No. 2019-2265, approved on June 17, 2019. WHEREAS the parties hereby agree to amend the term of the Original Agreement in accordance with the terms of the Original Agreement and any previously adopted amendment, which is incorporated by reference herein, as well as the terms provided herein. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: • The Original Agreement was set to end on May 31, 2020. • The Original Agreement was amended on: December 9, 2019 to amend the Rate Schedule. May 18, 2020 to extend the term date through May 31, 2021 and to amend the Rate Schedule. June 29, 2020 to amend the Rate Schedule. August 19, 2020 to amend the Scope of Services and Rate Schedule. The Amendments are identified by the Weld County Clerk to the Board of County Commissioners as document number 2019-2265. • These Amendments, together with the Original Agreement, constitutes the entire understanding between the parties. The following additional changes are hereby made to the current Agreement: 1. Term This agreement is being renewed for a third and final year, for the period of June 1, 2021 through May 31, 2022. 2. Exhibit C, Scope of Services, is hereby amended as attached. 3. Exhibit D, Rate Schedule, is hereby amended as attached. • All other terms and conditions of the Original Agreement remain unchanged. oZo l9- IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written_ ,�.L -' C� �/� COUNTY: ATTEST: �.��t4/1! �I• gC��;e1 BOARD OF COUNTY COMMISSIONERS Weld C n Clerk to be Bo. d „�� WELD COUNTY, COLORADO By: CONTRACTOR: Specialized Alternatives for Families and Youth of Colorado, Inc. 1600 Specht Point Road, Suite 105 Fort Collins, Colorado 80525 By: Date: ,7PxiaCo/e er&�C�{N lean, Coleman, Law 202111,..0T1 Jenna Coleman, Executive Director Apr 16, 2021 020/9_ ��' EXHIBIT C SCOPE OF SERVICES 1. Contractor will provide Foster Care Consultation, Home Based Services, as referred by the Department. 2. Foster Parent Consultation: Contractor will provide Foster Parent Consultation services utilizing cognitive behavioral therapy, motivational interviewing, attachment, regulation, and competency model. a. Capacity for Services: i. One hour per week with a maximum of 3 clients b. Goals of Service: ii. Provide therapeutic interventions to help support foster parents. i. Identify ways to increase healthy communication patterns between parent and youth. c. Outcomes of Service: i. Strengthen confidence in parents in the role of fostering ii. Reduce foster youth disruptions iii. Increase healthy interactions between parent and child d. Target Population: Foster parents with foster youth in their home. e. Languages: Language: English. Contractor will utilize translation services to facilitate communication with families when those services are provided by the Department. f. Service Access: iv. Services will be provided in the client's home 3. Home Based Services Contractor's utilizes a multigenerational approach that is largely informed by the Attachment, Self -Regulation, and Competency model, which focuses on holistic healing of the youth through targeted intervention with the caregiving system. Contractor utilizes a structured team approach, including family and kinship, as partners in developing their own intervention goals and plans. Contractor will collaborate with the referring agency, other community providers (i.e. counselors, school personnel, medical practitioners, therapist, etc.) and, as applicable, faith -based providers/partners, to provide a coordinated program of interventions designed to meet the needs of each family served and either prevent removal from the caretaker or facilitate the reunification. Each treatment plan is oriented to the unique needs of the individual family as directed by the referral and the assessment process. a. Capacity for Services: iii. Services vary from 90 minutes to 5 hours per week depending on the needs of the family. Staffing will be proportional to service need in the area. iv. Contractor's staff can hold 8-12 cases, depending on the service needs of their case load. v. Duration of a typical case will be 6- 9 months, depending on the family's needs and progress. Contractor's state leadership routinely monitors the progress made by families and reviews the status of the anticipated termination date for services for the family during weekly individual consultation meetings with the Specialists. Contractor internally staffs, as needed, ensuring the Contractor's team is providing a cohesive service. Families at great risk of disruption are assessed at a High Intensity of services and can expect to receive 8-10 hours of total service per week along with the 24/7 on -call service. As families begin to regulate and heal or if they are not experiencing severe crisis impacting the family functioning, they can be decreased to a low level of services, averaging 4-6 hours of total service per week per family. From here, families can receive services under the Step -Down category (with Department permission) where they'll receive a minimum of 7.5 hours of contact per month. vi. Contractor has the capacity to serve up to 12 families at any given time. b. Goals of Service: i. Contractor's mission of "Preserving Families and Securing Futures" is achieved through evidence -based programming designed and delivered with fidelity to best facilitate safe and stable family environments and achieve desired treatment outcomes. ii. Empower the child and the family in treatment planning, service design and evaluation. Services are designed with the goal of permanency with biological and kinship relationships for families, whenever possible. iv. Keep youth in the least restrictive level of care. v. Facilitate whole family healing and provide services aimed at mitigating the symptoms of the individual's mental health challenges, so they can effectively reside in home or community setting. vi. Family centered approach is focusing attention on the family, on sub -systems within the family and on the family's interaction within the community. This includes recognizing and placing value on the family's cultural background and individual needs. c. Outcomes of Service: i. Child will be able to safely stay in their permanent home or reunify from a higher level of care. ii. Decreased hospitalizations and decreased police contact. iii. Increased family function as evidenced by decreased crisis. iv. Increased ability to independently problem -solve and a reduction of trauma symptoms and associated behaviors. v. Caregiver attunement, execution of trauma -focused caregiving, and self -regulation to promote overall stability. d. Target Population: i. Children stepping down from congregate care or prevent children from entering higher levels of care. ii. Youth between the ages of 4 and 18 years old. The interventions are designed to for youth at risk of disruption to a higher level of care and youth preparing to reunify with family. e. Service Access: i. Contractor is centered on family engagement through a multi -generational approach to home -based family preservation and reunification services. Delivered in a 24/7 flexible service and crisis support service paradigm. ii. Contractor has an established an effective on -call process for responding to family and peer needs 24/7 to ensure 24/7 crisis on call support and flexible scheduling. Rather than families calling into an answering service or being "triaged", their call goes directly to a staff person apprised of their family and who has access to pertinent information such as active Releases of Information, effective interventions and the family's crisis plan. Contractor utilizes a rotating on call schedule and back up supervisor schedule to be available to families 24 hours per day, seven days per week to allow for hours of service per the needs of the family. iii. Contractor can provide some services by phone, especially in crisis situations. Contractor cannot provide videoconferencing. f. Language: English. Contractor will utilize translation services to facilitate communication with families when those services are provided by the Department. EXHIBIT D RATE SCHEDULE 1. Funding and Method of Payment The Department agrees to reimburse the Contractor in consideration of the work and services performed under this Agreement at the rate specific in Paragraph 2, below. The total amount to be paid to the Contractor during the term of this Agreement shall be reported by the Department after May 31, 2022. Expenses incurred by the Contractor prior to the term of this Agreement are not eligible Department expenditures and shall not be reimbursed by the Department. Payment pursuant to this Agreement, whether in whole or in part, is subject to and contingent upon the continuing availability of said funds for the purposes hereof. In the event that said funds, or any part thereof, become unavailable as determined by the Department, the Department may immediately terminate the Agreement or amend it accordingly. 2. Fees for Services Foster Parent Consultation Services Rate Unit Type Service Name $140.00 Hour Foster Parent Consultation $140.00 Hour Family Team Meeting, Team Decision Making, Professional Staffing $140.00 Hour Telehealth $140.00 Occurrence No-show, up to two occurrences $0.56 Mile Mileage — For distance exceeding thirty (30) miles from practitioner's office located at 1600 Specht Point Rd. Suite 105, Fort Collins, CO 80525 Home Based Services Rate Unit Type Service Name $140.00 Hour Multigenerational Treatment Services — Face to Face and Telehealth $140.00 Occurrence No-show, up to two (2) occurrences $0.56 Mile Mileage — For distance exceeding thirty (30) miles from practitioner's office located at 1600 Specht Point Rd. Suite 105, Fort Collins, CO 80525 3. Submittal of Vouchers Contractor shall prepare and submit monthly a Request for Reimbursement, Client Verification Form, other supporting documentation, and monthly report if applicable, certifying that services authorized were provided on the date(s) indicated and the charges were made pursuant to the terms and conditions of Paragraph 3 and Exhibit A. Contractor shall submit all Requests for Reimbursement and supporting documentation to the Department by the 7`" day of the month following the month of service, but no later than 60 days from the date of service. Requests for Reimbursement and/or supporting documentation received after 60 days from the date of service may result in delay or forfeiture of payment. Consistent failure to meet the 60 -day deadline may result in termination of the Agreement. For ongoing services, proof of services rendered shall be a Client Verification Form signed by the client and a monthly report submitted in accordance with Paragraph 3(d) of this Agreement. For one-time services, proof of services rendered shall be receipt of a Client Verification Form and the completed product. For Monitored Sobriety services, proof of services rendered shall be the test result. New Contract Request Entity Information Entity Name* Entity ID* SPECIALIZED ALTERNATIVES FOR '100036903 FAMILIES AND YOUTHS OF CO, INC Contract Name* SPECIALIZED ALTERNATIVES FOR FAMILIES AND YOUTHS OF COLORADO, INC. (AGREEMENT AMENDMENT) Contract Status CTB REVIEW Contract Description' * BID X61900025 TERM: 6,x'1 E'21-5;31;22 U New Entity? Contract ID 4692 Contract Lead* APEGG Contract Lead Email apeggO weldgov.com;cobbx xlk zweldgov.com Contract Description 2 CONSENT. PA IS BEING ROUTED THROUGH THE NORMAL PROCESS. ETA TO CTB: 4:22.'21 Contract Type* AMENDMENT Amount* $0,00 Renewable* O Automatic Renewal Grant Department HUMAN SERVICES Department Email CM- HurnanServicescPweldgov.co IT! Department Head Email CM -Hu manServices - aeptHeadZtweldgov.com County Attorney GENERAL COUNTY ATTORNEY EMAIL County Attorney Email CM- COUNTYA t 1 ORNEY g.WELDG OV.COM Requested BOCC Agenda Date* 05}26x`2021 Parent Contract ID 20192265 Requires Board ,Approval YES Department Project it Due Date 05x22,12021 Will a work session with BDCC be required?* NO Does Contract require Purchasing Dept, to be included? If this is a renewal enter previous Contract ID If this is part of a &ISSA enter ;NSA . Contract ID Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in OnBase Contract dates Effective Date Review Date* 04:01:2022 Renewal Date Termination Notice Period Contact Information Contact Info Contact Name Purchasing Purchasing Approver CONSENT Approval Process Department Head JAMIE ULRICH DH Approved Date 04',` 19;' 2021 Final Approval SOCC Approved BOCCC Signed Date BOCC Agenda Date 04:28 2021 Originator APE.GG Committed Delivery Date Contact Type Contact Email Finance Approver CONSENT Expiration Date* 05 31, 2022 Contact Phone 1 Purchasing Approved Date X34: 19 2021 Finance Approved Date 04 19;2021 Tyler Ref # AG 042821 Legal Counsel CONSENT Contact Phone 2 Legal Counsel Approved Date 04:19=2021 ►�ra�� 4-fr 36f c P1d1V11,EGE1.) AND CONFIDENTIAL, MEMORANDUM DATE: August 4, 2020 TO: Board of County Commissioners — Pass -Around FR: Jamie Ulrich, Director, Human Services RE: Agreement Amendment with Specialized Alternatives for Families and Youth of Colorado, Inc. Please review and indicate if you would like a work session prior to placing this item on the Board's agenda. Request Board Approval of the Department's Agreement Amendment with Specialized Alternatives for Families and Youth of Colorado, Inc. The Department entered into a Child Protection Agreement for Services, identified as Tyler 1D 2019-2265, on July 17, 2019 for the term June 1, 2019 through May 31, 2020. On May 18, 2020, the agreement was amended to extend the term from June 1, 2020 through May 31, 2021. Following extension of the term, the agreement was further amended to update the scope of work and restructure the rate schedule. The vendor is requesting additional changes at this time to the scope of work and rate schedule. Those changes are as follows: Foster Parent Consultation $22.50/Day (Consultation) $0.56 — For distance exceeding thirty (30) miles from practitioner's office located at 1600 Specht Point Road, Suite 105, Fort Collins, CO 80525. Home Based Services: $84.00/Day (High Intensity — No Medicaid) $52.50/Day (Low Intensity — No Medicaid) $40.72/Day (Step Down Level l — Inside Catchment - Medicaid and Core Funding) $54.97/Day (Step Down Level 1 — Outside Catchment — Medicaid and Core Funding) $15.00/Day (Step Down Level 2 — Primarily Medicaid Funding with Core Support) $0.56/Mile (Mileage) — For distance exceeding thirty (30) miles from practitioner's office located at 1600 Specht Point Road, Suite 105, Fort Collins, CO 80525. Therapeutic Visitation: $104.00/Hour (In -Office) $146.00/Hour (Out -of -Office) Pass -Around Memorandum; August 4, 2020 — CMS 3986 Bid No. B1900025 6- gx6ae,gaCd O3/11/AO Page 1 p4Ro©Ro 1 1 1 E11 i3 , ('(.) �•ED1-11V1111 $78.00/Hour (FTM. TDM, Prof. Staffing) $54.00/Hour (No show) The following services are being deleted at this time: Foster Parent Consultation $88,80/Hour (2"d Clinician) $74,00/Hour (Consultation Case Collaboration) $74.00/Hour (Family Support Management Assistance) $2,400.00/Month (High Intensity — No Medicaid) $1,500.00/Month (Low Intensity — No Medicaid) $74.00/Hour (TDMs, FTM) $.056/Mile (Mileage) - For distance exceeding thirty (30) miles from practitioner's office located at 1600 Specht Point Road, Suite 105, Fort Collins, CO 80525. Mental Health Services $92.00/Hour (Psychotherapy) $92.00/1lour (TDMs, FTM) I do not recommend a Work Session. I recommend approval of this Amendment and authorize the Chair to sign. Approve Recommendation Mike Freeman, Chair Scott James Barbara Kirkmeyer Steve Moreno, Pro -Tem Kevin Ross Schedule Work Session Other/Comments: Pass -Around Memorandum; August 4, 2020 — CMS 3986 Bid No. B1900025 Page 2 AGREEMENT AMENDMENT BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND SPECIALIZED ALTERNATIVES FOR FAMILIES AND YOUTH OF COLORADO, INC. This Agreement Amendment, made and entered into / 9jday of 2020 by and between the Board of Weld County Commissioners, on behalf of the Weld County Department of Human Services, reinafter referred to as the "Department", and Specialized Altematives for Families and Youth of Colorado, Inc., hereinafter referred to as the "Contractor". WHEREAS the parties entered into an Agreement for foster parent consultation services, in -home services, and mental health services identified by the Weld County Clerk to the Board of County Commissioners as document No. 2019-2265, approved on June 17, 2019. WHEREAS the parties hereby agree to amend the term of the Original Agreement in accordance with the terms of the Original Agreement and any previously adopted amendment, which is incorporated by reference herein, as well as the terms provided herein. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: . The Original Agreement will end on May 31, 2021. . The Original Agreement was amended on December 9, 2019, May 18, 2020 and June 29, 2020. The Amendments are identified by the Weld County Clerk to the Board of County Commissioners as document number 2019-2265. . These Amendments, together with the Original Agreement, constitutes the entire understanding between the parties. The following additional changes are hereby made to the current Agreement: 1. Exhibit C, Scope of Services, is hereby amended as attached. 2. Exhibit D, Rate Schedule, is hereby amended as attached. • All other terns and conditions of the Original Agreement remain unchanged. IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above ATTES We written. • � s COIJ�TY: BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO Deputy Cler % o the : oard �i�1S61 (*�., p�'u ike Freeman, Chair ONTRACTOgi pecialized Altematives for Families and Youth of Colorado Inc. 1600 Specht Point Road, Suite 105 Fort Collins, CO 80525 AUG 19 2020 By: Date: �_ J na Coleman(Jul 30, MO 14:17 MOT) Jenna Coleman, Executive Director Jul 30, 2020 0,2„O/g- o?o2(a5". EXHIBIT C SCOPE OF SERVICES 1. Contractor will provide Foster Care Consultation, Home Based Services, and Therapeutic Visitation as referred by the Department. 2. Foster Parent Consultation: Contractor will provide Foster Parent Consultation services utilizing cognitive behavioral therapy, motivational interviewing, attachment, regulation, and competency model. a. Capacity for Services: i. One hour per week with a maximum of 3 clients b. Goals of Service: ii. Provide therapeutic interventions to help support foster parents. i. Identify ways to increase healthy communication patterns between parent and youth. c. Outcomes of Service: i. Strengthen confidence in parents in the role of fostering ii. Reduce foster youth disruptions iii. Increase healthy interactions between parent and child d. Target Population: Foster parents with foster youth in their home. e. Languages: Language: English. Contractor will utilize translation services to facilitate communication with families when those services are provided by the Department. f. Service Access: iv. Services will be provided in the client's home 3. Home Based Services: Contractor's utilizes a multigenerational approach that is largely informed by the Attachment, Self -Regulation, and Competency model, which focuses on holistic heating of the youth through targeted intervention with the caregiving system. Contractor utilizes a structured team approach, including family and kinship, as partners in developing their own intervention goals and plans. Contractor will collaborate with the referring agency, other community providers (i.e. counselors, school personnel, medical practitioners, therapist, etc.) and, as applicable, faith -based providers/partners, to provide a coordinated program of interventions designed to meet the needs of each family served and either prevent removal from the caretaker or facilitate the reunification. Each treatment plan is oriented to the unique needs of the individual family as directed by the referral and the assessment process. a. Capacity for Services: iii. Services vary from 90 minutes to 5 hours per week depending on the needs of the family. Staffing will be proportional to service need in the area. iv. Contractor's staff can hold 8-12 cases, depending on the service needs of their case load. v. Duration of a typical case will be 6- 9 months, depending on the family's needs and progress. Contractor's state leadership routinely monitors the progress made by families and reviews the status of the anticipated termination date for services for the family during weekly individual consultation meetings with the Specialists. Contractor internally staffs, as needed, ensuring the Contractor's team is providing a cohesive service. Families at great risk of disruption are assessed at a High Intensity of services and can expect to receive 8-10 hours of total service per week along with the 24/7 on - call service. As families begin to regulate and heal or if they are not experiencing severe crisis impacting the family functioning, they can be decreased to a low level of services, averaging 4-6 hours of total service per week per family. From here, families can receive 1 services under the Step -Down category (with Department permission) where they'll receive a minimum of 7.5 hours of contact per month. vi. Contractor has the capacity to serve up to 12 families at any given time. b. Goals of Service: i. Contractor's mission of "Preserving Families and Securing Futures" is achieved through evidence -based programming designed and delivered with fidelity to best facilitate safe and stable family environments and achieve desired treatment outcomes. ii. Empower the child and the family in treatment planning, service design and evaluation. iii. Services are designed with the goal of permanency with biological and kinship relationships for families, whenever possible. iv. Keep youth in the least restrictive level of care. v. Facilitate whole family healing and provide services aimed at mitigating the symptoms of the individual's mental health challenges, so they can effectively reside in home or community setting. vi. Family centered approach is focusing attention on the family, on sub -systems within the family and on the family's interaction within the community. This includes recognizing and placing value on the family's cultural background and individual needs. c. Outcomes of Service: i. Child will be able to safely stay in their permanent home or reunify from a higher level of care. ii. Decreased hospitalizations and decreased police contact. iii. Increased family function as evidenced by decreased crisis. iv. Increased ability to independently problem -solve and a reduction of trauma symptoms and associated behaviors. v. Caregiver attunement, execution of trauma -focused caregiving, and self -regulation to promote overall stability. d. Target Population: i. Children stepping down from congregate care or prevent children from entering higher levels of care. ii. Youth between the ages of 4 and 18 years old. The interventions are designed to for youth at risk of disruption to a higher level of care and youth preparing to reunify with family. e. Service Access: i. Contractor is centered on family engagement through a multi -generational approach to home -based family preservation and reunification services. Delivered in a 24/7 flexible service and crisis support service paradigm. ii. Contractor has an established an effective on -call process for responding to family and peer needs 24/7 to ensure 24/7 crisis on call support and flexible scheduling. Rather than families calling into an answering service or being "triaged", their call goes directly to a staff person apprised of their family and who has access to pertinent information such as active Releases of Information, effective interventions and the family's crisis plan. Contractor utilizes a rotating on call schedule and back up supervisor schedule to be available to families 24 hours per day, seven days per week to allow for hours of service per the needs of the family. iii. Contractor can provide some services by phone, especially in crisis situations. Contractor cannot provide videoconferencing. f. Language: English. Contractor will utilize translation services to facilitate communication with families when those services are provided by the Department. 2 4. Therapeutic Visitation: Contractor will provide Therapeutic Visitation services utilizing cognitive behavioral therapy, motivational interviewing, attachment, regulation, and competency model. a. Capacity for Services: i. One (1) hour per week. Duration of Service: Six (6) to Twelve (12) months. b. Goals of Service: ii. Provide a safe and therapeutic space for parent/child interaction. iii. Provide coaching to parent during interactions. ii. Provide clinical support to both parent and child in high stress situations occurring within the visit. c. Outcomes of Service: v. Achieve court ordered treatment goals vi. Increase healthy parent/child communication vii. Ensure safe and healthy interactions between parent/child d. Target Population: Children, adolescence, and adults of all ages and genders. g. Languages: Language: English. Contractor will utilize translation services to facilitate communication with families when those services are provided by the Department. e. Service Access: viii. In practitioner's office located at 825 Delaware Avenue, Suite 205, Boulder, CO 80501 5. Contractor will respond to the Quality Assurance Team Supervisor (hainleidPweldgov.com, 970-400- 6210) within three (3) business days regarding the ability to accept the received referral. 6. Upon acceptance of a referral, Contractor will offer an initial appointment within seven (7) days of receiving the referral. The first attempt to contact the client will occur within 24 hours of receiving the referral (excluding weekends and holidays). Contractor will document efforts to engage client in referred services. If the client does not respond after three (3) attempts in the first seven (7) days of the referral period, the Contractor will notify the caseworker and the Quality Assurance Team Supervisor (hainleid@weldgov.com, 970-400-6210). 7. Contractor understands that "no shows" are defined as unexcused and unplanned/uncommunicated absences for visitation services. If a rate for "no shows" is not specifically stated in Exhibit D, Rate Schedule, then Contractor understand that the Department will no reimburse for "no shows". Contractor understands that the Department will only reimburse Contractor for up to two (2) "no-shows" on the part of the client per month. After three (3) "no-shows, "Contractor will place client on a behavioral plan requiring attendance or discharged client from services. Contractor must inform the caseworker and the Quality Assurance Team Supervisor (hainleid@weld&ov.com, 970-400-6210). 8. Contractor understands that the Department will not reimburse Contractor for cancelled appointments either on the part of the client or the Contractor. If the cancellation is generated from the Contractor, a "makeup" session/episode, to occur within 30 days of the cancellation, will be offered to the client (excluding session/episodes that fall on holidays). If the cancellation is generated from the client, the Contractor must request a makeup session from the Department prior to the makeup session occurring (excluding session/episodes that fall on holidays). After three (3) cancellations, Contractor will inform the caseworker and the Quality Assurance Team Supervisor (hainleid@weldeov.com) immediately via email, to discuss service continuation. 9. Contractor will identify in detail areas of continued concern and make recommendations to the Department regarding continuation of services and/or the need for additional services. 3 10. Contractor will document in detail all observed or verbalized concerns regarding any child whom the Contractor is working with under an active referral. Areas of concern may include, but are not limited to, any physical, emotional, educational or behavioral issues. Areas of concern should be reported immediately AND on the required monthly report. 11. Contractor will submit reports on a monthly basis for each active referral for ongoing services. Reports will be submitted per the online format required by the Department, unless otherwise directed by the Department. 12. Contractor agrees any change to an existing referral must be pre -approved through the Child Welfare Contract and Services Coordinator, a Department -facilitated Team Decision Making (TDM) or Family Team Meeting (FTM), or by court order. A change is defined as anything outside of the approved documented service on the initial authorized referral form. This may include an increase or decrease in services hours, change in frequency, change in location of services, transportation needs, or any change to the initial referral or subsequent authorizations. 13. Contractor agrees to attend meetings when available and as requested by the Department. Such meetings include Court Facilitations, Court Staffing, Family Team Meetings and/or Team Decision Making meetings. The Department will reimburse for actual participation in the meeting only so long as the meeting is at least one hour in length, the Contractor obtains the Facilitator's signature on the Client Verification Form (if in person) at the time of the meeting and participation in the meeting is deemed appropriate and necessary by the Department. Staffing and/or meetings other than those listed above are not considered reimbursable unless otherwise approved by the Child Welfare Contract and Services Coordinator. Contractor may participate by phone, if approved by the Department. 14. Contractor will notify the Quality Assurance Team Supervisor (hainleid@weldeov.com, 970-400-6210) of new staff who will manage and/or administer the services with the following information: h. Staff member name and contact information i. Education level/degree (if applicable) j. licensure/credentials (if applicable) k. Department of Regulatory Authority (DORA) number (if applicable) I. Supervisor name and contact information 15. The Department reserves the right to decline the new staff members managing and/or administering services to Department clients. 4 EXHIBIT D RATE SCHEDULE 1. Funding and Method of Payment The Department agrees to reimburse the Contractor in consideration of the work and services performed under this Agreement at the rate specific in Paragraph 2, below, The total amount to be paid to the Contractor during the term of this Agreement shall be reported by the Department after May 31, 2021. Expenses incurred by the Contractor prior to the term of this Agreement are not eligible Department expenditures and shall not be reimbursed by the Department. Payment pursuant to this Agreement, whether in whole or in part, is subject to and contingent upon the continuing availability of said funds for the purposes hereof. In the event that said funds, or any part thereof, become unavailable as determined by the Department, the Department may immediately terminate the Agreement or amend it accordingly. 2. Fees for Services Foster Parent Consultation Services: $22.50/Day (Consultation) $.56/Mile (Mileage) — For distance exceeding thirty (30) miles from practitioner's office located at 1600 Specht Point Rd. Suite 105, Fort Collins, CO 80525 Home Based Services: $84.00/Day (High Intensity — No Medicaid) $52.50/Day (Low Intensity — No Medicaid) $40.72/Day (Step Down Level 1— Inside Catchment — Medicaid and Core Funding) $54.97/Day (Step Down Level 1— Outside Catchment — Medicaid and Core Funding) $15.00/Day (Step Down Level 2 — Primarily Medicaid Funding with Core Support) $.56/Mile (Mileage) — For distance exceeding thirty (30) miles from practitioner's office located at 1600 Specht Point Rd. Suite 105, Fort Collins, CO 80525 Therapeutic Visitation $104.00/Hour (In -Office) $146.00/Hour (Out -of -Office) $78.00/Hour (FTM, TDM, Prof. Staffing) $54.00/Hour (No show) 3. Submittal of Vouchers Contractor shall prepare and submit monthly a Request for Reimbursement, Client Verification Form, other supporting documentation, and monthly report if applicable, certifying that services authorized were provided on the date(s) indicated and the charges were made pursuant to the terms and conditions of Paragraph 3 and Exhibit A. Contractor shall submit all Requests for Reimbursement and supporting documentation to the Department by the 7`^ day of the month following the month of service, but no later than 60 days from the date of service. Requests for Reimbursement and/or supporting documentation received after 60 days from the date of service may result in delay or forfeiture of payment. Consistent failure to meet the 60 -day deadline may result in termination of the Agreement. For ongoing services, proof of services rendered shall be a Client Verification Form signed by the client and a monthly report submitted in accordance with Paragraph 3(d) of this Agreement. For one-time services, proof of services rendered shall be receipt of a Client Verification Form and the completed product. For Monitored Sobriety services, proof of services rendered shall be the test result. Contract Form New Contract Request Entity Information Entity Name* Entity ID* SPECIALIZED ALTERNATIVES FOR @00036903 FAMILIES AND YOUTHS OF CO, INC Contract Name* SPECIALIZED ALTERNATIVES FOR FAMILIES AND YOUTH OF COLORADO, INC. Contract Status CTB REVIEW New Entity? Contract ID 3986 Contract Lead* CULLINTA Contract Lead Email cullinta@coweld cous; cobb)od k@co_weld.cous Parent Contract ID 20192265 Requires Board Approval YES Department Project # Contract Description* CW RFP BID NO. 1900025 AGREEMENT AMENDMENT #4 - REVISE THE SOW AND RATE SCHEDULE. DELETE SERVICES FOR MENTAL HEALTH SERVICES, FOSTER PARENT CONSULTATION. ADD THERAPEUTIC VISITATION. Contract Description 2 Contract Type* AGREEMENT Amount* $0.00 Renewable* NO Automatic Renewal Grant IGA Department HUMAN SERVICES Department Email C M- HumanServices@weldgov com Department Head Email CM-HumanServices- DeptHead@weldgov.com County Attorney GENERAL COUNTY ATTORNEY EMAIL County Attorney Email CM- COLINTYATTORN EY@WELD GOV.COM Requested BOCC Agenda Date* 08/12/2020 Due Date 0&/08/2020 Will a work session with BOCC be required?* NO Does Contract require Purchasing Dept to be included? If this is a renewal enter previous Contract ID If this is part of a MSA enter NASA Contract ID Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in OnBase Contract Dates Effective Date Review Date* 04/01/2021 Renewal Date Termination Notice Period Contact Information Contact Info Contact Name Purchasing Purchasing Approver Approval Process Department Head JAMIE ULRICH DH Approved Date 08/14/2020 Final Approval BOCC Approved BOCC Signed Date BOCC Agenda Date 08/19/2020 Originator SNYDERKL Contact Type Committed Delivery Date Contact Email Finance Approver CHRIS D'©VIDIO Expiration Date* 05/31/2021 Contact Phone 1 Contact Phone 2 Purchasing Approved Date Finance Approved Date 08/14/2020 Tyler Ref # AG 081920 Legal Counsel GABE KALUUSEK Legal Counsel Approved Date 08/14/2020 Submit PRIVILEGED AND CONFIDENTIAL MEMORANDUM DATE: June 16, 2020 TO: Board of County Commissioners - Pass -Around FR: Jamie Ulrich, Director, Human Services RE: Agreement Amendment with Specialized Altematives for Families and Youth of Colorado, Inc. Please review and indicate if you would like a work session prior to placing this item on the Board's agenda. Request Board Approval of the Department's Agreement Amendment with Specialized Alternatives for Families and Youth of Colorado, Inc. The Department entered into a Child Protection Agreement for Services, identified as Tyler ID 2019-2265, on July 17, 2019 for the term June 1, 2019 through May 31, 2020. The agreement was amended on December 9, 2019 to update the service descriptions "Caregiver Case Management" and "TDM" to "Family Support Management" and "TDM/FTM/Staffing" respectively, without rate changes. In addition, the agreement was amended on May 18, 2020 to extend the term from June 1, 2020 through May 31, 2021. The Department is requesting to restructure the rate schedule as follows: Foster Care/Adoption Services: edicaid) $52.50/Day (.Low Intensity No Medicaid) $88.80/Hour (2"d Clinician) $74.00/Hour (Consultation Case Collaboration) $74.00/Hour (Family Support Management Assistance) $22.50/Day (Consultation) $2,400.00/Month (High Intensity - No Medicaid) $1,500.00/Month (Low Intensity — No Medicaid) $74.00/Hour (TDMs, FTM) $.056/Mile (Mileage) - For distance exceeding thirty (30) miles from practitioner's office located at 1600 Specht Point Road, Suite 105, Fort Collins, CO 80525. Home Based Services: $2,520.00/Month (Multi generational Treatment Services High Intensity No Medicaid) $1,575.00/Month (Mal -Intensity No Medicaid) Pass -Around Memorandum; June 16, 2020 -CMS 3708 Bid No. B1900025 6kD) Page 1 e n.se,4- ,r G -� PRIVILEGED AND CONFIDENTIAL $84.00/Day (High Intensity — No Medicaid) $52.50/Day (Low Intensity — No Medicaid) $40.72/Day (Step Down Level 1 — Inside Catchment — Medicaid and Core Funding) $54.97/Day (Step Down Level 1 — Outside Catchment — Medicaid and Core Funding) $15.00/Day (Step Down Level 2 — Primarily Medicaid Funding with Core Support) Mental Health Services $92.00/Hour (Psychotherapy) $92.00/Hour (TDMs, FTM) I do not recommend a Work Session. I recommend approval of this Amendment and authorize the Chair to sign. Approve Recommendation Mike Freeman, Chair Scott James Barbara Kirkmeyer Steve Moreno, Pro -Tem Kevin Ross Schedule Work Session Other/Comments: Pass -Around Memorandum; June 16, 2020 — CMS 3708 Bid No. B1900025 Page 2 AGREEMENT AMENDMENT BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND SPECIALIZED ALTERNATIVES FOR FAMILIES AND YOUTH OF COLORADO, INC. This Agreement Amendment, made and entered into �� day of 2020 by and between the Board of Weld County Commissioners, on behalf of the Weld County Department of Hu Services, hereinafter referred to as the "Department", and Specialized Alternatives for Families and Youth of Colorado, Inc., hereinafter referred to as the "Contractor". WHEREAS the parties entered into an Agreement for foster parent consultation services, in -home services, and mental health services identified by the Weld County Clerk to the Board of County Commissioners as document No. 2019-2265, approved on June 17, 2019. WHEREAS the parties hereby agree to amend the term of the Original Agreement in accordance with the terms of the Original Agreement and any previously adopted amendment, which is incorporated by reference herein, as well as the terms provided herein. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: • The Original Agreement will end on May 31, 2020. • The Original Agreement was amended on December 9, 2019 and May 18, 2020. The Amendments are identified by the Weld County Clerk to the Board of County Commissioners as document number 2019-2265. • These Amendments, together with the Original Agreement, constitutes the entire understanding between the parties. The following additional changes are hereby made to the current Agreement: 1. Exhibit D, Rate Schedule, is hereby amended as attached. • All other terms and conditions of the Original Agreement remain unchanged. IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. ATTEST Weld By: W,,,,crAvv rk to the Bo COUNTY: BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO Deputy Clerk o the oard {?; r��, ;�. „ �� Mike Freeman, Chair CONTRACTOR: JUN 2 9 2020 Specialized Alternatives for Families and Youth of Colorado Inc. 1600 Specht Point Road, Suite 105 Fort Collins, CO 80525 By: Date: Jenta Coleman (Jun 9, MDT) Jenna Coleman, Executive Director Jun 9, 2020 ,2-oi 1- �24- EXHIBIT D RATE SCHEDULE 1. Funding and Method of Payment The Department agrees to reimburse the Contractor in consideration of the work and services performed under this Agreement at the rate specific in Paragraph 2, below. The total amount to be paid to the Contractor during the term of this Agreement shall be reported by the Department after May 31, 2021. Expenses incurred by the Contractor prior to the term of this Agreement are not eligible Department expenditures and shall not be reimbursed by the Department. Payment pursuant to this Agreement, whether in whole or in part, is subject to and contingent upon the continuing availability of said funds for the purposes hereof. In the event that said funds, or any part thereof, become unavailable as determined by the Department, the Department may immediately terminate the Agreement or amend it accordingly. 2. Fees for Services Foster Care/Adoption Services: $88.80/Hour (2"a Clinician) $74.00/Hour (Consultation Case Collaboration) $74.00/Hour (Family Support Management Assistance) $22.50/Day (Consultation) $2,400.00/Month (High Intensity — No Medicaid) $1,500.00/Month (Low Intensity — No Medicaid) $74.00/Hour (TDMs, FTM) $.056/Mile (Mileage) — For distance exceeding thirty (30) miles from practitioner's office located at 1600 Specht Point Road, Suite 105, Fort Collins, CO 80525. Home Based Services: $84.00/Day (High Intensity — No Medicaid) $52.50/Day (Low Intensity — No Medicaid) $40.72/Day (Step Down Level 1— Inside Catchment — Medicaid and Core Funding) $54.97/Day (Step Down Level 1— Outside Catchment — Medicaid and Core Funding) $15.00/Day (Step Down Level 2 — Primarily Medicaid Funding with Core Support) Mental Health Services $92.00/Hour(Psychotherapy) $92.00/Hour (TDMs, FTM) 3. Submittal of Vouchers Contractor shall prepare and submit monthly a Request for Reimbursement, Client Verification Form, other supporting documentation, and monthly report if applicable, certifying that services authorized were provided on the date(s) indicated and the charges were made pursuant to the terms and conditions of Paragraph 3 and Exhibit A. Contractor shall submit all Requests for Reimbursement and supporting documentation to the Department by the 7th day of the month following the month of service, but no later than 60 days from the date of service. Requests for Reimbursement and/or supporting documentation received after 60 days from the date of service may result in delay or forfeiture of payment. Consistent failure to meet the 60 -day deadline may result in termination of the Agreement. For ongoing services, proof of services rendered shall be a Client Verification Form signed by the client and a monthly report submitted in accordance with Paragraph 3(d) of this Agreement. For one-time services, proof of services rendered shall be receipt of a Client Verification Form and the completed product. For Monitored Sobriety services, proof of services rendered shall be the test result. Contract Farm Entity Information New Contract Request Entity Name* SPECIALIZED ALTERNATIVES FOR FAMILIES AND YOUTHS OF CO_ INC Entity ID* @00036903 Contract Name* SPECIALIZED ALTERNATIVES FOR FAMILIES AND YOUTH OF COLORADO, INC. Contract Status CTB REVIEW ❑ New Entity? Contract ID 3703 Contract Lead* CULLINTA Contract Lead Email cullinta@co,weldco us;cobbal k@co_weld.co.us Parent Contract ID 20192265 Requires Board Approval YES Department Project # Contract Description* BID NO. B1900025 CONSENT 2020-21 AGREEMENT AMENDMENT TO RESTRUCTURE RATE SCHEDULE. FUNDING: CORE/OTHER. TERM: 06/01/20 THROUGH 05/31/21 YOU WILL RECEIVE A SEPERATE PA Contract Description 2 Contract Type* AGREEMENT Amount* $0.00 Renewable* NO Automatic Renewal Grant IGA Department HUMAN SERVICES Department Email CM- HumanServices@weldgov com Department Head Email CM-HumanServices- DeptHead@weldgov.com County Attorney GENERAL COUNTY ATTORNEY EMAIL County Attorney Email C M- COUNTYA I I ORNEY@WELD GOV.COM If this is a renewal enter previous Contract ID If this is part of a MSA enter MSA Contract ID Requested BOCC Agenda Date* 06/17/2020 Due Date 06;1312020 Will a work session with BOCC be required?* NO Does Contract require Purchasing Dept. to be included? Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in OnBase Contract Dates Eff Review Date* 04/01/2021 Renewal Date Termination Notice Period Committed Delivery Date Expiration Date 05f 31!2021 Contact Information Contact Info Contact Name Purchasing Purchasing Approver Approval Process Department Head JAMIE ULRICH DH Approved Date 06/23'2020 Final Approval BOCC Approved BOCC Signed Date BOCC Agenda Date Originator SNYDERKL Contact Type Contact Email Finance Approver BARB CONNOLLY Contact Phone 1 Contact Phone 2 Purchasing Approved Date Finance Approved Date 06/25/2020 Tyler Ref # CONSENT Legal Counsel GABE KALOUSEK Legal Counsel Approved Date 06/25/2020 Submit 3577 PRIVILEGED AND CONFIDENTIAL MEMORANDUM DATE: April 2, 2020 TO: Board of County Commissioners — Pass -Around FR: Jamie Ulrich, Director, Human Services RE: Child Welfare 2020-21 Service Provider Agreement Amendments Please review and indicate if you would like a work session prior to placing this item on the Board's agenda. Request Board Approval of the Department's Child Welfare 2020-21 Service Provider Agreement Amendments. The Department entered into agreements with various Child Welfare service providers through the 2019-20 Request for Proposal (RFP), identified as Tyler ID 2019-0707). These agreements were issued for a period of three years with the option to renew annually. The attached list reflects the providers, services and rates, including minor rate changes, the Department wishes to enter into for the period of June 1, 2020 through May 31, 2021. The Human Services Advisory Commission (HSAC) has reviewed and approved this information. Upon Board approval of this pass -around, signed agreement amendments will be obtained from providers and submitted to the Board for approval and Chair signature. I do not recommend a Work Session. I recommend approval of these Agreement Amendments. Mike Freeman, Chair Scott James Barbara Kirkmeyer Steve Moreno, Pro-Tem Kevin Ross Approve Schedule Recommendation Work Session Other/Comments: Pass -Around Memorandum; April 2, 2020 — Not in CMS OS h s /© 1-I5Peng6r. os /l q/o Page 1 .9-‘11.q— 2.2263 iMoOgo VENDOR RENEWALS Vendor Program Area Home Based Services Service Name Aftercare In Home Coaching Funding Core Rate $ 75.00 Unit Type Hour Aftercare In Home Therapy Core $ 115.00 Hour Beyond the Walls Program (Aftercare) Core $ 1,050.00 Month Life Skills Life Skills Coaching, In Home Core $; 75.00 Hour Supervised Visitation, In Home Core $ 75.00 Hour Mental Health Services Mental Health Therapy, In Home Core $ 115.00 Hour' Mental Health Therapy, Office Core $ 90.00 Hour Psychological (Episode) Core $ 3,350.00 Episode Psychological Testing (HR) Core $ 165.00 Hour Sexual Abuse Treatment Problematic Sexual Conduct (PSC).Coaching, In Home! Core $ 75.00 Hour Sexual Abuse Treatment/Therapy Core $ 125.00 Hour Specialized Alternatives for Families and Youth Home Based Services Multigenerational Treatment Services -High Intensity - No Medicaid Core $ 2,520.00 Month Multigenerational Treatment Services -Low Intensity - No Medicaid Core $ 1,575.00 Month Multiggenerationat Treatment Services -Medicaid - Inside Catchment Core $ 40.72 Day Multigenerational Treatment Services -Medicaid - Outside Catchment Core $ 54.97 Day Mental Health Services Psychotherapy Core $ 92.00 Hour Staffing, FTM, TDM, etc. Core $ 92.00 Hour Trauma informed Care/Services Foster Parent Consultation 2nd Clinician Core $ 88.80 Hour - Foster Parent Consultation Case Collaboration Core $ 74.00 Hour Foster Parent Consultation Daily Rate Core $ 22.50 Day Foster Parent Consultation Family Support Management Assistance Core $ 74.00 Hour Foster Parent Consultation High Intensity - No Medicaid Core $ 2,400.00 Month Foster Parent Consultation Low Intensity - No Medicaid Core $ 1,500.00 Month Foster Parent Consultation Mileage Core $ 0.56 Month Staffing, FTM, TDM, etc. Core $ 74.00 Hour Strong Foundations Home Studies Additional Fee per Adult, Beyond Two Adults CW Block/Child Welfare Services $ 250.00 Each Cancellation Fee CW Block/Child Welfare Services $ 225.00 Episode Full Home Study CV/ Block/Child Welfare Services $ 950.00 Episode Interpretive Services for Family Home Study CW Block/Child Welfare Services $ 300.00 Episode Interpretive Services for Individual Home Study CV/ Block/Child Welfare Services $ 150.00 Episode Updated Home Study CW Block/Child Welfare Services $ 425.00 Episode The Daisy Center Child,Mentoring and Family Support Coaching Core r `` $ 65.00 Hour Coaching, Step-down Core $ 35.00 Hour The Jacob Center Life Skills Intake Cancellation Core $ 25.00 Hour Intake-Larimer County Core $ 25.00 Hour Intake-OutsideLarimer County Core $ 115.00 Hour Staffing, FTM, TDM, etc. - Outside Larimer County Core $ 175.00 Hour Staffing, FTM, TDM, etc.- Phone or Larimer County Core $ 85.00 Hour WELD COUNTY DEPT. OF HUMAN SERVICES - CHILD WELFARE DIVISION 2020-21 SERVICE VENDORS (CORE/NON-CORE) BID NO.: 82000037 12 557/ AGREEMENT AMENDMENT BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES SPECIALIZED ALTERNATIVES FOR FAMILIES AND YOUTH OF COLORADO, INC. This Agreement Amendment, made and entered into Vg day of Pae4-6--- , 2020 by and between the Board of Weld County Commissioners, on behalf of the Weld County Department of Human Services, hereinafter referred to as the "Department", and Specialized Altematives for Families and Youth of Colorado, Inc., hereinafter referred to as the "Contractor". WHEREAS the parties entered into an Agreement for foster parent consultation services, in -home services, and mental health services identified by the Weld County Clerk to the Board of County Commissioners as document No. 2019-2265, approved on June 17, 2019. WHEREAS the parties hereby agree to amend the term of the Original Agreement in accordance with the terms of the Original Agreement and any previously adopted amendment, which is incorporated by reference herein, as well as the terms provided herein. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: • The Original Agreement will end on May 31, 2020. • The Original Agreement was amended on December 9, 2019. The Amendments are identified by the Weld County Clerk to the Board of County Commissioners as document number 2019-2265. • These Amendments, together with the Original Agreement, constitutes the entire understanding between the parties. The following additional changes are hereby made to the current Agreement: 1. Term This agreement is being renewed for a second full year term, for the period of June 1, 2020 through May 31, 2021. 2. Exhibit D, Rate Schedule, is hereby amended as attached. • All other terms and conditions of the Original Agreement remain unchanged. 69-ri-SPA,,, o5/g/o cc c-(50 One)aagc, osc i9l a.m Mgcc90 IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. COUNTY: ATTEST: di:di& �I• Weld County Clerk to the Board By: -puty Clerk to the Board 4�'L�i BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO Mike Freeman, Chair CONTRACTOR: MAY 18 2020 Specialized Alternatives for Families and Youth of Colorado Inc. 1600 Specht Point Road, Suite 105 Fort Collins, CO 80525 By: Date: Je a Coleman (May 4, 2020) Jenna Coleman, Executive Director May 4, 2020 0019 - a acos EXHIBIT D RATE SCHEDULE 1. Funding and Method of Payment The Department agrees to reimburse the Contractor in consideration of the work and services performed under this Agreement at the rate specific in Paragraph 2, below. The total amount to be paid to the Contractor during the term of this Agreement shall be reported by the Department after May 31, 2021. Expenses incurred by the Contractor prior to the term of this Agreement are not eligible Department expenditures and shall not be reimbursed by the Department. Payment pursuant to this Agreement, whether in whole or in part, is subject to and contingent upon the continuing availability of said funds for the purposes hereof. In the event that said funds, or any part thereof, become unavailable as determined by the Department, the Department may immediately terminate the Agreement or amend it accordingly. 2. Fees for Services Foster Care/Adoption Services: $88.80/Hour (2' Clinician) $74.00/Hour (Consultation Case Collaboration) $74.00/Hour (Family Support Management Assistance) $22.50/Day (Consultation) $2,400.00/Month (High Intensity— No Medicaid) $1,500.00/Month (Low Intensity— No Medicaid) $74.00/Hour (TDMs, FTM) $.056/Mile (Mileage) — For distance exceeding thirty (30) miles from practitioner's office located at 1600 Specht Point Road, Suite 105, Fort Collins, CO 80525. Home Based Services: $2,520.00/Month (Multi -generational Treatment Services - High — No Medicaid) $1,575.00/Month (Multi -generational Treatment Services - Low — No Medicaid) $40.72/Day (Multi -generational Treatment Services — Inside Catchment — Medicaid) $54.97/Day (Multi -generational Treatment Services — Outside Catchment — Medicaid) Mental Health Services $92.00/Hour(Psychotherapy) $92.00/Hour (TDMs, FTM) 3. Submittal of Vouchers Contractor shall prepare and submit monthly a Request for Reimbursement, Client Verification Form, other supporting documentation, and monthly report if applicable, certifying that services authorized were provided on the date(s) indicated and the charges were made pursuant to the terms and conditions of Paragraph 3 and Exhibit A. Contractor shall submit all Requests for Reimbursement and supporting documentation to the Department by the 7th day of the month following the month of service, but no later than 60 days from the date of service. Requests for Reimbursement and/or supporting documentation received after 60 days from the date of service may result in delay or forfeiture of payment. Consistent failure to meet the 60 -day deadline may result in termination of the Agreement. For ongoing services, proof of services rendered shall be a Client Verification Form signed by the client and a monthly report submitted in accordance with Paragraph 3(d) of this Agreement. For one-time services, proof of services rendered shall be receipt of a Client Verification Form and the completed product. For Monitored Sobriety services, proof of services rendered shall be the test result. Contract Form New Contract Request Entity Information Entity Name* Entity ID* SPECIALIZED ALTERNATIVES FOR @00036803 FAMILIES AND YOUTHS OF CO. INC Contract Name* SPECIALIZED ALTERNATIVES FOR FAMILIES AND YOUTH OF COLORADO, INC. {AGREEMENT AMENDMENT) Contract Status CTB REVIEW ❑ New Entity? Contract ID 3571 Contract Lead* CULLINTA Contract Lead Email cullinta@coeld.co.us Parent Contract ID Requires Board Approval YES Department Project # Contract Description* CONSENT. BID NO, 82000037. BOCC APPROVAL 04115120 CHILD PROTECTION AGREEMENT AMENDMENT TERM 0601/20 THROUGH 05/31121 FUNDING CORE/OTHER Contract Description 2 Contract Type* AGREEMENT Amount* $0.00 Renewable* NO Automatic Renewal Grant IGA Department HUMAN SERVICES Department Email CM- HumanServices@weldgov.com Department Head Email CM-HumanServices- DeptHead(c weldgov.com County Attorney GENERAL COUNTY ATTORNEY EMAIL County Attorney Email CM- COUNTYATTORNEY@WELD GOV. COM Requested BOCC Agenda Date* 04115/2020 Due Date U111/2020 Will a work session with BOCC be required?* NO Does Contract require Purchasing Dept. to be included? If this is a renewal enter previous Contract ID If this is part of a MSA enter MSA Contract ID Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in On6ase Contract Dates Effective Date Termination Notice Period Review Date* 04/01/2021 Committed Delivery Date Renewal Date Expiration Date* 05/31/2021 Contact Information Contact Info Contact Name Purchasing Purchasing Approver Approval Process Department Head JAMIE ULRICH DH Approved Date 05/12/2020 Final Approval BOCC Approved BOCC Signed Date BOCC Agenda Date 05/18/2020 Originator SNYDERKL Contact Type Contact Email Finance Approver BARB CONNOLLY Contact Phone 1 Contact Phone 2 Purchasing Approved Date Finance Approved Date 05/13;2020 Tyler Ref # AG 051820 Legal Counsel GABE KALOUSEK Legal Counsel Approved Date 05/112020 Submit Contract xo # 3 l 3 a PRIVILEGED AND CONFIDENTIAL /O2- / MEMORANDUM DATE: November 20, 2019 TO: Board of County Commissioners — Pass -Around FR: Judy A. Griego, Director, Human Services RE: Agreement Amendment with Specialized Alternatives for Families and Youth of Colorado, Inc. Please review and indicate if you would like a work session prior to placing this item on the Board's agenda. Request Board Approval of the Department's Agreement Amendment with Specialized Alternatives for Families and Youth of Colorado, Inc. The Department entered into an agreement with Specialized Alternatives for Families and Youth of Colorado, Inc., with a term of June 1, 2019 through May 31, 2020, for Foster Care/Adoption Services, Home Based Services and Mental Health Services. This agreement is identified as 2019-2265, approved on July 17, 2019. The provider, at the request of the Department, has updated the service descriptions "Caregiver Case Management" and "TDM" to "Family Support Management" and "TDM/FTM/Staffing" respectively. There are no changes in rates. I do not recommend a Work Session. I recommend approval of this Amendment and authorize the Chair to sign. Sean P. Conway Mike Freeman, Pro-Tem Scott James Barbara Kirkmeyer, Chair Steve Moreno Approve Recommendation Work Session Schedule ,e<v\ Other/Comments: Pass -Around Memorandum; November 20, 2019 - CMS 3132 O45D) a -9- /9 Page 1 �0 9° AGREEMENT AMENDMENT BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND SPECIALIZED ALTERNATIVES FOR FAMILIES AND YOUTH OF COLORADO, INC. This Agreement Amendment made and entered into day of. 2019 by and between the Board of Weld County Commissioners, on behalf of the Weld County Department of Human Services, hereinafter referred to as the "Department", and Specialized Altematives for Families and Youth of Colorado, Inc. hereinafter referred to as the "Contractor". WHEREAS the parties entered into an Agreement for Foster Care/Adoption Services, Home Based Services, and Mental Health Services ("Original Agreement") identified by the Weld County Clerk to the Board of County Commissioners as document No. 2019-2265, approved on June 17, 2019. WHEREAS the parties hereby agree to amend the term of the Original Agreement in accordance with the terms of the Original Agreement and any previously adopted amendment, which is incorporated by reference herein, as well as the terms provided herein. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: • The Original Agreement will end on May 31, 2020. • These Amendments, together with the Original Agreement, constitutes the entire understanding between the parties. The following additional changes are hereby made to the current Agreement: 1. Exhibit D, Rate Schedule, is hereby amended as attached. • All other terms and conditions of the Original Agreement remain unchanged. IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. COUNTY: ATTEST: �• J4d1o;K BOARD OF COUNTY COMMISSIONERS Weld C n rk to the Board _ WELD COUNTY, CO RADO By: Deputy Clerk t Bo : rd /J/ =^r,J �� arbara Kirkmeyer, DEC 0 9 2010 NTRACTOR: Specialized Alternatives for Families and Youth of Colorado, Inc. 1600 Specht Point Road, Suite 105 Fort Collins, Colorado 80525 (970)568-2023 By: Date: /r USW Jena Coleman, LCS (Sep 12, 2019) Jenna Coleman, Executive Director Sep 12, 2019 EXHIBIT D RATE SCHEDULE 1. Funding and Method of Payment The Department agrees to reimburse the Contractor in consideration of the work and services performed under this Agreement at the rate specific in Paragraph 2, below. The total amount to be paid to the Contractor during the term of this Agreement shall be reported by the Department after May 31, 2020. Expenses incurred by the Contractor prior to the term of this Agreement are not eligible Department expenditures and shall not be reimbursed by the Department. Payment pursuant to this Agreement, whether in whole or in part, is subject to and contingent upon the continuing availability of said funds for the purposes hereof. In the event that said funds, or any part thereof, become unavailable as determined by the Department, the Department may immediately terminate the Agreement or amend it accordingly. 2. Fees for Services Foster Care/Adoption Services: $88.80/Hour (2nd Clinician) $74.00/Hour (Family Support Management Assistance) $74.00/Hour (Case Collaboration) $22.50/Day (Daily Rate) $2,400.00/Month (High Intensity — No Medicaid) $1,500.00/Month (Low Intensity —No Medicaid) $74.00/Hour (TDM, FTM, Staffing) Home Based Services: $88.80/Hour (2nd Clinician) $74.00/Hour (Family Support Management Assistance) $74.00/Hour (Case Collaboration) $22.50/Day (Daily Rate) $2,400.00/Month (Multi -generational Treatment Services - High — No Medicaid) $1,500.00/Month (Multi -generational Treatment Services - Low —No Medicaid) $74.00/Hour (TDM, FTM, Staffing) Mental Health Services $92.00/Hour (Psychotherapy) $92.00/Hour (TDM, FTM, Staffing) 3. Submittal of Vouchers Contractor shall prepare and submit monthly a Request for Reimbursement, Client Verification Form, other supporting documentation, and monthly report if applicable, certifying that services authorized were provided on the date(s) indicated and the charges were made pursuant to the terms and conditions of Paragraph 3 and Exhibit A. Contractor shall submit all Requests for Reimbursement and supporting documentation to the Department by the 7d' day of the month following the month of service, but no later than 60 days from the date of service. Requests for Reimbursement and/or supporting documentation received after 60 days from the date of service may result in delay or forfeiture of payment. Consistent failure to meet the 60 -day deadline may result in termination of the Agreement. For ongoing services, proof of services rendered shall be a Client Verification Form signed by the client and a monthly report submitted in accordance with Paragraph 3(d) of this Agreement. For one-time services, proof of services rendered shall be receipt of a Client Verification Form and the completed product. For Monitored Sobriety services, proof of services rendered shall be the test result. New Contract Request Entity Information Entity a SPECIALIZED ALTERNATIVES FOR FAMILIES AND YOUTHS OF CO, INC Entity ID @fl003F903 New Entity? Contract Name* SPECIALIZED ALTERNATIVES FOR FAMILIES AND YOUTH OF COLORADO, INC. (AGREEMENT AMENDMENT) Contract Status CTB REVIEW Contract ID 3132 Contract Lead* CULLINTA Contract Lead Email cullinta@co.weld.co us Parent Contract ID 2©192265 Requires d x + c YES Department Project # tract Description* AMENDMENT OF 2019-20 CHILD PROTECTION AGREEMENT FOR SERVICES TO UPDATE SERVICE LANGUAGE Contract Description 2 Contract Type' AGREEMENT Amount* $0.00 Re le* NO Automatic R If this isar If this is Department HU SERVICES Department Email CM- HurnanServices@weldgov.com >r ent Head Email CM-HUmanServices- DeptHeadtilweidgov.cam County Attorney GENERAL COUNTY ATTORNEY EMAIL County Attorney Email CM- COUNTYA I I ORNEY@WELD GOV.COM enter previous Contract ID of a MSA enter VISA Contract ID Requested C Date 09/25/2019 Due Date 09121/2019 Will a work session with BOCC be required?* NO Does Contract require Purchasing Dept. to be included? Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in OnQase E a e Termination Notice Review Date* 04/01/2020 Committed Delve Renewal Date Date Expiration Date 05/3112020 Contact Information Contact Info Contact Narne Pure Approval Process UDY GRIEGO 9 C C Signed Date BaCC n 11/27;2019 Originator CULLINTA Contact Type Contact Email Contact Phone 1 Contact Phone 2 Purchasing _;•=•roved Date Finance Approver L Counsel BARB CONNOLLY KARIN MCDOUGAL Finance > u a oved Date Legal Counsel Approved Date 11.1112019 Tyler Ref # AG 112719 11121,2019 CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND SPECIALIZED ALTERNATIVES FOR FAMILIES AND YOUTH OF COLORADO, INC. This Agreement, made and entered into th�� ayKo 019, by and between the Board of Weld County Commissioners, on behalf of the Weld County Departm of Human Services, hereinafter referred to as the "Department' and Specialized Alternatives for Families and outh of Colorado, Inc., hereinafter referred to as the Contractor". The parties to this Agreement understand and agree that the provisions of this Agreement specifically include the following documents: Exhibit A, Weld County's Request for Proposal, Exhibit B, Contractor's Response to Request for Proposal, Exhibit C, Scope of Services, and Exhibit D, Rate Schedule. Exhibit B, C, and D are attached hereto and incorporated herein by this reference. Exhibit A is Weld County's Request for Proposal Number B1900025, which is incorporated into this agreement by reference and will be provided upon request to the Department. WITNESSETH WHEREAS, required approval, clearance, and coordination have been accomplished from and with appropriate agencies; and WHEREAS, the Colorado Department of Human Services has provided Core Services or other funding to the Department for Foster Care/Adoption Services, Home Based Services, and Mental Health Services. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: 1. Term This agreement shall become effective on June 1, 2019, upon proper execution of this Agreement and shall expire May 31, 2020, unless sooner terminated as provided herein. The agreement is for a period of three years. However, the agreement must be renewed by both parties, in writing, on an annual basis. 2. Scope of Services Services shall be provided by the Contractor to any person(s) eligible for services in compliance with Exhibit B, Contractor's Response to Request for Proposal and Exhibit C, Scope of Services. 3. Referrals, Billing and Tracking a. Contractor understands and will comply with all aspects of the referral authorization, billing and tracking requirements as set forth by the Department. Failure to comply with all aspects may result in a forfeiture of payment. b. Contractor agrees to receive referrals for services through e-mail and will provide an identified e- mail address prior to the start of this Agreement. Contractor acknowledges that services are not authorized until the Contractor has received an authorized referral form from the Department. Contractor further acknowledges that services provided prior to the authorized start date or outside the scope of services on the referral form will not be eligible for reimbursement. Contractor acknowledges that any and all modifications to an existing referral must be approved through the Quality Assurance Team Supervisor (hainleid@weldgov.com, 970-400-6210). No other Department staff or other party to the case may authorize services or modifications to services. C4 -5O 9 2019-2265 426690 c. Contractor agrees to submit a complete Request for Reimbursement and supporting documentation by the 7th of the month, following the month of service, utilizing billing forms required by the Department. Contractor agrees to utilize the Client Verification Form for all scheduled and unscheduled face-to-face services with the exception of home studies and monitored sobriety testing. Contractor agrees that original complete Client Verification Forms are to be submitted with the Request for Reimbursement. Requests for Reimbursement and Client Verification Forms received after 60 days from the date of service may result in delay or forfeiture of payment. Consistent failure to meet 60 -day deadline may result in termination of the Agreement. d. Contractor agrees to submit a monthly report by the 7th of the month, following the month of service, for each client receiving ongoing services. Monthly reports will be submitted through the Department's online reporting system, unless otherwise directed or agreed to by the Department. Monthly reports for ongoing services must include the following information, entered in the "Narrative" box for each date of service: a. Date and time of service b. Where the service took place c. Clinician/therapist name d. Clients participating e. What interventions were used, recommendations and/or goals discussed f. Any and all safety concerns One-time services will be verified through receipt of the completed product (ex. psychological evaluation, substance abuse evaluation, home study). Verification of Monitored Sobriety Services will be the test result. A completed home study may be a full, partial or denied study, as determined by the Department. Contractor will document in detail any and all observed or verbalized concerns regarding any child whom the Contractor is working with under the Agreement. Areas of concern may include, but are not limited to, any physical, emotional, educational or behavioral issues. Areas of concern should be reported immediately to the caseworker AND on the required monthly report. 4. Payment a. The Department and the Contractor agree that all benefits from private insurance and/or other funding sources such as Medicaid (if Contractor is a Medicaid eligible provider) or Victim's Compensation must be exhausted before Core Services or other Department funds can be accessed for services. Exceptions to this Paragraph may include, if approved by the Department, the following: i. The service being provided by the contractor is not a Medicaid eligible service; ii. The service is not deemed medically necessary; iii. The Court with jurisdiction over the case has ordered that a non -Medicaid provider or service be used; iv. A Medicaid provider is not available to provide the needed service; v. Medicaid is exhausted for the needed service; or vi. Medicaid denied service. vii. The client is not eligible for Medicaid. b. Payment shall be made in accordance with Exhibit A, Weld County's Request for Proposal, Exhibit B, Contractor's Response to Request for Proposal, Exhibit C, Scope of Services, and Exhibit D, Rate Schedule, attached hereto and incorporated herein by reference, so long as services are rendered satisfactorily and in accordance with the Agreement. c. Payment pursuant to this Agreement, whether in whole or in part, is subject to, and contingent upon, the continuing availability of said funds for the purposes hereof. 2 d. The Department may withhold reimbursement if Contractor has failed to comply with any part of the Agreement, including the Financial Management requirements, program objectives, contractual terms, or reporting requirements. In the event of forfeiture of reimbursement, Contractor may appeal such circumstance in writing to the Director of Human Services. The decision of the Director of Human Services shall be final. 5. Financial Management At all times from the effective date of the Agreement until completion of the Agreement, Contractor shall comply with the administrative requirements, cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under this Agreement must conform to the Single Audit Act of 1984 and OMG Circular A-133. 6. Payment Method Unless otherwise provided in Exhibit B, Contractor's Proposal, Exhibit C, Scope of Services, and Exhibit D, Rate Schedule: a. If services are funded through Core Services, Contractor agrees to accept reimbursement through ACH direct deposit one time per month. b. If Contractor is not currently set up with the State of Colorado to accept direct deposit, Contractor agrees to complete and submit an, which will be provided by the Department, with a voided check. Failure to complete and submit this form and voided check in a timely and accurate manner may result in a delay of payment. c. Contractor agrees to accept payment through county warrant when funding source does not allow for direct deposit. 7. Compliance with Applicable Laws a. At all times during the performance of this Agreement, Contractor will strictly adhere to all applicable Federal and State laws, order, and applicable standards, regulations, interpretations and/or guidelines issued pursuant thereto. This includes protection of the confidentiality of all applicant/recipient records, papers, documents, tapes and any other materials that have been or may hereafter be established which relate to the Agreement. Contractor shall abide by all applicable laws and regulations, including, but not limited to the following: - Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d-1 Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d-1 et. seq. and its implementing regulation, 45 C.F.R. Part 80 et. seq.; and - all provisions of the Civil Rights Act of 1986 so that no person shall, on the grounds of race, creed, color, sex, or national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under the approved Agreement. - Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 794, and its implementing regulations, 45 C.F.R. Part 84; and - the Age Discrimination Act of 1975, 42 U.S.C. Section 6101 et. seq. and its implementation regulations, 45 C.F.R. Part 91; and 3 - Title VII of the Civil Rights Act of 1964; and - the Age Discrimination in Employment Act of 1967; and - the Equal Pay Act of 1963; and - the Education Amendments of 1972; and - Immigration Reform and Control Act of 1986, P.L. 99-603, 42 C.F.R. Part 2; and - all regulations applicable to these laws prohibiting discrimination because of race, color, national origin, sex, religion, and handicap, including Acquired Immune Deficiency Syndrome (AIDS) or AIDS related conditions covered under Section 504 of the Rehabilitation Act of 1973, as amended, cited above. If necessary, Contractor and the Department will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 C.F.R. Part 2. 45 C.F.R. Part 74, Appendix G 9, which requires that affirmative steps be taken to assure that small and minority businesses are utilized, when possible, as sources of supplies, equipment, construction and services. This assurance is given in consideration of and for the purpose of obtaining any all Federal and/or State financial assistance. - Colorado Revised Statute (C.R.S.) 26-6-104, requiring criminal background record checks for all employees, contractors and sub -contractors. b. Contractor is further charged with the knowledge that any person who feels that s/he has been discriminated against has the right to file a complaint either with the Colorado Department of Human Services or with the United States Department of Health and Human Services, Office for Civil Rights. c. Contractor assures that it will fully comply with all other applicable Federal and State laws which may govern the ability of the Department to comply with the relevant funding requirements. Contractor understands the source of funds to be accessed under the Agreement is determined by the Department. d. Contractor assures and certifies that it and its principals: - Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transaction by a Federal or State department or agency; and - have not, within a three-year period preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or Local) transaction or contract under public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; and - are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state or local) with commission of any of the offenses enumerated in this certification; and - have not, within a three-year period preceding this Agreement, had one or more public transactions (federal, state, or local) terminated for cause or default. 4 e. Public Contracts for Services C.R.S. §8-17.5-101. Contractor certifies, warrants, and agrees that it does not knowingly employ or contract with an illegal alien who will perform work under this contract. Contractor will confirm the employment eligibility of all employees who are newly hired for employment in the United States to perform work under this Agreement, through participation in the E -Verify program or the State of Colorado program established pursuant to C.R.S. §8-17.5- 102(5)(c). Contractor shall not knowingly employ or contract with an illegal alien to perform work under this Agreement or enter into a contract with a subcontractor that fails to certify with Contractor that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this Agreement. Contractor shall not use E -Verify Program or State of Colorado program procedures to undertake pre -employment screening or job applicants while this Agreement is being performed. If Contractor obtains actual knowledge that a subcontractor performing work under the public contract for services knowingly employs or contracts with an illegal alien Contractor shall notify the subcontractor and the Department within three (3) days that Contractor has actual knowledge that a subcontractor is employing or contracting with an illegal alien and shall terminate the subcontract if a subcontractor does not stop employing or contracting with the illegal alien within three (3) days of receiving notice. Contractor shall not terminate the contract if within three days the subcontractor provides information to establish that the subcontractor has not knowingly employed or contracted with an illegal alien. shall comply with reasonable requests made in the course of an investigation, undertaken pursuant to C.R.S. §8-17.5-102(5), by the Colorado Department of Labor and Employment. If Contractor participates in the State of Colorado program, Contractor shall, within twenty days after hiring a new employee to perform work under the contract, affirm that Contractor has examined the legal work status of such employee, retained file copies of the documents, and not altered or falsified the identification documents for such employees. Contractor shall deliver to the Department, a written notarized affirmation that it has examined the legal work status of such employee and shall comply with all of the other requirements of the State of Colorado program. If Contractor fails to comply with any requirement of this provision or of C.R.S. §8-17.5-101 et seq., the Department, may terminate this Agreement for breach, and if so terminated, Contractor shall be liable for actual and consequential damages. f. Except where exempted by federal law and except as provided in C.R.S. § 24-76.5-103(3), if Contractor receives federal or state funds under the contract, Contractor must confirm that any individual natural person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. § 24-76.5-103(4), if such individual applies for public benefits provided under the contract. If Contractor operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it: (a) is a citizen of the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall produce one of the forms of identification required by C.R.S. § 24- 76.5-101, et seq., and (c) shall produce one of the forms of identification required by C.R.S. § 24-76.5- 103 prior to the effective date of the contract. 8. Compliance with Child and Family Services Review The Child and Family Services Review (CFSR) examines child welfare service outcomes in three areas; Safety, Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's performance according to national standards and monitor progress over time. Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance services to families. Contractor agrees to continually strive for positive outcomes in the areas of Safety, Permanency and Well Being. Contractor will ensure that any employee or subcontractor of Contractor providing services under this Agreement will work towards positive outcomes in the aforementioned three areas as outlined under the Child and Family Services Review (CFSR) and will address the aforementioned three areas when completing monthly reports as required by Paragraph 3(d) of this Agreement. 5 9. Insurance Requirements Contractor and the Department agree that Weld County, the Board of County Commissioners of Weld County, its officers and employees, shall not be held liable for injuries or damages caused by any negligent acts or omissions of the Contractor, it subcontractor, or their employees, volunteers, or agents while performing duties described in this Agreement. Contractor shall indemnify, defend and hold harmless Weld County, the Board of County Commissioners of Weld County, its employees, volunteers and agents. Contractor shall provide the liability insurances (including professional liability insurances where necessary) and worker's compensation insurances for all its employees, volunteers, and agents engaged in the performance of this Agreement which are required under Weld County's Request for Proposal, and required by the Colorado Worker's Compensation Act. Contractor shall provide the Department with the acceptable evidence that such coverage is in effect within seven (7) days of the date of this Agreement. At a minimum, Contractor shall procure, either personally or through its employer as applicable to the Contractor's business, at its own expense, and maintain for the duration of the work, the following insurance coverage. Weld County, State of Colorado, by and through the Board of County Commissioners of Weld County, its employees and agents, shall be named as additional named insured on the insurance, where permissible the insurance provider. a. General Requirements: Contractors must secure, at or before the time of execution of any agreement or commencement of any work, the following insurance covering all operations, goods or services provided pursuant to this request. Contractors shall keep the required insurance coverage in force at all times during the term of the Agreement, or any extension thereof, and during any warranty period. The required insurance shall be underwritten by an insurer licensed to do business in Colorado and rated by A.M. Best Company as "A"VIII or better. Each policy shall contain a valid provision or endorsement stating "Should any of the above -described policies by canceled or should any coverage be reduced before the expiration date thereof, the issuing company shall send written notice to the Weld County Director of General Services by certified mail, return receipt requested. Such written notice shall be sent thirty (30) days prior to such cancellation or reduction unless due to non-payment of premiums for which notice shall be sent ten (10) days prior. If any policy is in excess of a deductible or self -insured retention, the Department must be notified by the Contractor. Contractor shall be responsible for the payment of any deductible or self -insured retention. The Department reserves the right to require Contractor to provide a bond, at no cost to the Department, in the amount of the deductible or self -insured retention to guarantee payment of claims. The insurance coverages specified in this Agreement are the minimum requirements, and these requirements do not decrease or limit the liability of Contractor. Contractor shall maintain, at its own expense, any additional kinds or amounts of insurance that it may deem necessary to cover its obligations and liabilities under this Agreement. b. Types of Insurance: Contractor shall obtain, and maintain at all times during the term of any Agreement, insurance in the following kinds and amounts: i.Workers' Compensation Insurance as required by state statute, and Employer's Liability Insurance covering all of Contractor's employees acting within the course and scope of their employment. If Contractor is an Independent Contractor, as defined by the Colorado Worker's Compensation Act, this requirement shall not apply. Contractor must submit to the Department a Declaration of Independent Contractor Status Form prior to the start of this agreement. ii.Commercial General Liability Insurance written on ISO occurrence form CG 00 0110/93 6 or equivalent, covering premises operations, fire damage, independent Contractors, products and completed operations, blanket contractual liability, personal injury, and advertising liability with minimum limits as follows: $1,000,000 each occurrence; $2,000,000 general aggregate; $50,000 any one fire; and $500,000 errors and omissions. iii.Automobile Liability: Contractor shall maintain limits of $1,000,000 for bodily injury per person, $1,000,000 for bodily injury for each accident, and $1,000,000 for property damage applicable to all vehicles operating both on County property and elsewhere. iv.Additional Provisions: Policies for all general liability, excess/umbrella liability, liquor liability and pollution liability must provide the following: - If any aggregate limit is reduced by twenty-five percent (25%) or more by paid or reserved claims, Contractor shall notify the Department within ten (10) days and reinstate the aggregates required; - Unlimited defense costs in excess of policy limits; - Contractual liability covering the indemnification provisions of this Agreement; - A severability of interests provision; Waiver of exclusion for lawsuits by one insured against another; - A provision that coverage is primary; and - A provision that coverage is non-contributory with other coverage or self-insurance provided by the Department. v.For all general liability, excess/umbrella liability, liquor liability, pollution liability and professional liability policies, if the policy is a claims -made policy, the retroactive date must be on or before the contract date or the first date when any goods or services were provided to the Department, whichever is earlier. c. Contractors shall secure and deliver to County's Risk Administrator ("Administrator") at or before the time of execution of this Agreement, and shall keep in force at all times during the term of the Agreement as the same may be extended as herein provided, a commercial general liability insurance policy, including public liability and property damage, in form and company acceptable to and approved by said Administrator, covering all operations hereunder set forth in the related Bid or Request for Proposal. d. Proof of Insurance: Contractor shall provide a copy of this information to its insurance agent or broker and shall have its agent or broker provide proof of Contractor's required insurance. The Department reserves the right to require Contractor to provide a certificate of insurance, a policy, or other proof of insurance as required by the County's Risk Administrator in his sole discretion. e. Additional Insureds: For general liability, excess/umbrella liability, pollution legal liability, liquor liability, and inland marine, Contractor's insurer shall name County as an additional insured as follows f. Waiver of Subrogation: For all coverages, Contractor's insurer shall waive subrogation rights against County. g. Subcontractors: All subcontractors, independent contractors, sub -vendors, suppliers or other entities providing goods or services required by this Agreement shall be subject to all of the requirements herein and shall procure and maintain the same coverages required of Contractor. Contractor shall include all such subcontractors, independent contractors, sub -vendors, suppliers or other entities as insureds under its policies or shall ensure that all subcontractors maintain the required coverages. Contractor agrees to provide proof of insurance for all such subcontractors, independent contractors, sub -vendors, suppliers or other entities upon request by the Department. A provider of Professional Services (as defined in the Bid or RFP) shall provide the following coverage: Professional Liability: Contractor shall maintain limits of $1,000,000 for each claim, and $2,000,000 aggregate limit for all claims. 10. Certification Contractor certifies that, at the time of entering into this Agreement, it has currently in effect all necessary licenses, approvals, insurance, etc., required to properly provide the services and/or supplies covered by this Agreement. Copies of all necessary licenses shall be provided to the Department by the Contractor prior to the start of any Agreement. 11. Training Contractor may be required to attend training at the request of the Department specific to services provided under this Agreement. The Department will not compensate the Contractor for said training in the form of registration fees, time spent traveling to and from training, attending the training or any other associated costs unless otherwise agreed to by the Department. 12. Subpoenas Contractor will, on behalf of its employees and/or officers, accept any subpoena for testimony from the Weld County Attorney's Office by e-mail and will return a waiver of services within 72 business hours. For this purpose, Contractor will designate an e-mail address prior to the start of this Agreement. If the Contractor receives a subpoena via e-mail but will only accept personal service, the Contractor will contact the Weld County Attorney's Office immediately at 970-400-6503 and advise that the subpoena must be personally served. 13. Monitoring and Evaluation Contractor and the Department agree that monitoring and evaluation of the performance of this Agreement shall be conducted by the Contractor and the Department. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners, the Department and the Contractor. Contractor will collaborate in a timely manner with the Department to resolve issues pertaining to service delivery, service quality, documentation, and invoicing during referral period and after services have concluded. The Contractor will require clients sign releases of information. Contractor understands that the Department will not reimburse for services rendered to Department clients until releases of information are obtained. Contractor shall permit the Department, and any other duly authorized agent or governmental agency, to monitor all activities conducted by the Contractor pursuant to the terms of this Agreement. The monitoring agency may, if in its sole discretion deems necessary or appropriate, have access to any 8 program data, special analyses, on -site checking, formal audit examinations, or any other reasonable procedures for purposes of monitoring. All such monitoring shall be performed in a manner that will not unduly interfere with the work conducted under this Agreement. 14. Modification of Agreement All modifications to this Agreement shall be in writing and signed by both parties. 15. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: - Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed. - Deny payment or recover reimbursement for those services or deliverables, which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Department. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to the Department. - Incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation shall be recovered from Contractor by deduction from subsequent payments under this Agreement or other agreements between the Department and Contractor, or by the Department as a debt due to the Department or otherwise as provided by law. 16. Representatives For the purpose of this Agreement, the individuals identified below are hereby designated representatives of the respective parties. Either party may from time to time designate in writing a new or substitute representative(s). For Department: For Contractor: Heather Walker, Child Welfare Division Head Jenna Coleman, Executive Director 17. Notice All notices required to be given by the parties hereunder shall be given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing a substitute person(s) or address to whom such notices shall be sent. For Department: Judy A. Griego, Director P.O. Box A Greeley, CO 80632 (970) 400-6510 9 For Contractor: Jenna Coleman, Executive Director 1600 Specht Point Road, Suite 105 Fort Collins, CO 80525 (970) 568-2023 18. Litigation Contractor shall promptly notify the Department in the event that Contractor learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement. Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any Federal or State court or administrative agency, shall deliver copies of such document(s) to the Director of Human Services. The term "litigation" includes an assignment for the benefit of creditors, and filings of bankruptcy, reorganization and/or foreclosure. 19. Termination This Agreement may be terminated at any time by either party giving thirty (30) days written notice to the individuals identified in paragraph 17. No portion of this Agreement shall be deemed to create an obligation on the part of the County of Weld, State of Colorado, to expend funds not otherwise appropriated in each succeeding year, as this Agreement is subject to the availability of funding. Therefore, the Department may terminate this Agreement at any time if the source of funding for the services made available to the Contractor is no longer available to the Department, or for any other reason. Contractor reserves the right to suspend services to clients if funding is no longer available. 20. No Third -Party Beneficiary Enforcement It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 21. Governmental Immunity No term or condition of this contract shall be construed or interpreted as a waiver, express or implied, of any of the immunities, rights, benefits, protections or other provisions, of the Colorado Governmental Immunity Act of §§24-10-101 et. seq., as applicable now or hereafter amended. 22. Partial Invalidity of Agreement If any section, subsection, paragraph, sentence, clause, or phrase of this Agreement is for any reason held or decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The parties hereto declare that they would have entered into this Agreement and each and every section, subsection, paragraph, sentence, clause, and phrase thereof irrespective of the fact that any one or more sections, subsections, paragraphs, sentences, clauses, or phrases might be declared to be unconstitutional or invalid. 23. Improprieties/Conflict of Interest No officer, member or employee of Weld County and no member of their governing bodies shall have any pecuniary interest, direct or indirect, in the approved Agreement or the proceeds thereof. The Appearance of Conflict of Interest applies to the relationship of a Contractor with the Department when the Contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest, it is not necessary for the Contractor to gain from knowledge of these opposing interests. It is only necessary that the Contractor know that the two relationships are in opposition. During the term of the Agreement, Contractor shall 10 not enter into any third -party relationship that eves the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation, Contractor shall submit to the Department, a full disclosure statement setting forth the details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for the Department's termination, for cause, of its Agreement with the Contractor. A conflict of interest or appearance of a conflict of interest may also apply to personal relationships between providers and clients. If a provider has a personal relationship with a client to whom the Contractor may provide services for, the Contractor must disclose that relationship to the Department. Contractor certifies that Federal appropriated funds have not been paid or will be paid, by or on behalf of Contractor, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of an Federal contract, loan, grant, or cooperative agreement. 24. Storage, Availability and Retention of Records Contractor agrees that authorized local, Federal, and State auditors and representatives shall, during business hours, have access to inspect and copy records, and shall be allowed to monitor and review through on -site visits, all activities related to this Agreement, supported with funds under this Agreement, to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. All such records, documents, communications, and other materials created pursuant or related to this Agreement shall be maintained by the Contractor in a central location and shall be made available to the Department upon its request, for a period of seven (7) years from the date of final payment under this Agreement, or for such further period as may be necessary to resolve any matters which may be pending, or until an audit has been completed with the following qualifications: If an audit by or on behalf of the Federal and/or State government has begun but is not completed at the end of the seven (7) year period, or if audit findings have not been resolved after a seven (7) period, the materials shall be retained until the resolution of the audit finding. 25. Confidentiality of Records Contractor shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Agreement except for purposes directly connected with the administration of Child Protection. No information about or obtained from any applicant/recipient in possession of Contractor shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with the Contractor's written policy governing access to, duplication and dissemination of, all such information, in any form, including social networks. Contractor shall advise its employees, agents, and subcontractor, if any, that they are subject to these confidentiality requirements. Contractor shall provide its employees, agents, and subcontractors, if any, with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. Contractor shall have its employees, agents, and subcontractors, if any, sign a written confidentiality agreement and shall provide a copy of such agreement to the Department, if requested. 11 26. Proprietary Information Proprietary information for the purposes of this Agreement is information relating to a party's research, development, trade secrets, business affairs, internal operations and management procedures and those of its customers, clients or affiliates, but does not include information (1) lawfully obtained from third parties, (2) that which is in the public domain, or (3) that which is developed independently. Neither party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of this Agreement. Any proprietary information removed from the Department's site by the Contractor in the course of providing services under this Agreement will be accorded at least the same precautions as are employed by the Contractor for similar information in the course of its own business. 27. Independence of Contractor: Not an Employee of Weld County Contractor agrees that it is an independent Contractor and that Contractor's officers, agents or employees will not become employees of County, nor entitled to any employee benefits from County as a result of the execution of this Agreement. Contractor shat perform its duties hereunder as an independent Contractor. Contractor shall be solely responsible for its acts and those of its agents and employees for all acts performed pursuant to this Agreement. Contractor, its employees and agents are not entitled to unemployment insurance or workers' compensation benefits through County and County shall not pay for or otherwise provide such coverage for Contractor or any of its agents or employees. Unemployment insurance benefits will be available to Contractor and its employees and agents only if such coverage is made available by Contractor or a third party. Contractor shall pay when due all applicable employment taxes and income taxes and local head taxes (if applicable) incurred pursuant to this Agreement. Contractor shall not have authorization, express or implied, to bind County to any agreement, liability or understanding, except as expressly set forth in this Agreement. Contractor shall have the following responsibilities with regard to workers' compensation and unemployment compensation insurance matters: (a) provide and keep in force workers' compensation and unemployment compensation insurance in the amounts required by law, and as set forth in Exhibit A provide proof thereof when requested to do so by County. 28. Entire Agreement This Agreement, together with all attachments hereto, constitutes the entire understanding between the parties with respect to the subject matter hereof, and may not be changed or modified except as state in Paragraph 14 herein. This Agreement shall be binding upon the parties hereto, their successors, heirs, legal representatives, and assigns. The Contractor and the Department may not assign any of its rights or obligations hereunder without the prior consent of both parties. 29. Agreement Nonexclusive This Agreement does not guarantee any work, nor does it create an exclusive agreement for services. 30. Warranty The Contractor warrants that services performed under this Agreement will be performed in a manner consistent with the professional standards goveming such services and the provisions of this Agreement. The Contractor shall faithfully perform the work in accordance with the standards of care, skill, training, diligence and judgment provided by highly competent individuals and entities that perform services of a similar nature to those described in this Agreement including Exhibits A, B, C, and D. 12 31. Acceptance of Services Not a Waiver Upon completion of the work, the Contractor shall submit to the Department originals of all tests and results, reports, etc., generated during completion of this work. Acceptance by the Department of reports and incidental material(s) furnished under this Agreement shall not in any way relieve the Contractor of responsibility for the quality and accuracy of the services. In no event shall any action by the Department hereunder constitute or be construed to be a waiver by the Department of any breach of covenant or default which may then exist on the part of the Contractor, and the Department's action or inaction when any such breach or default shall exist shall not impair or prejudice any right or remedy available to the Department with respect to such breach or default; and no assent, expressed or implied, to any breach of any one or more covenants, provisions or conditions of the Agreement shall be deemed or taken to be a waiver of any other breach. Acceptance by the Department of, or payment for, any services performed under this Agreement shall not be construed as a waiver of any of the Department's rights under this Agreement or under the law generally. 32. Employee Financial Interest/Conflict of Interest. C.R.S. §§24-18-201 et seq. and §24-50-507 The signatories to this Agreement aver that to their knowledge, no employee of Weld County has any personal or beneficial interest whatsoever in the service or property which is the subject matter of this Agreement. The Contractor has no interest and shall not acquire any interest direct or indirect, which would in any manner or degree with the performance of the Contractor's services and the Contractor, shall not employ any person having such known interests. During the term of this Agreement, the Contractor shall not engage in any in any business or personal activities or practices or maintain any relationships which actually conflicts with or in any way appear to conflict with the full performance of its obligations under this Agreement. Failure by the Contractor to ensure compliance with this provision may result, in the Department's sole discretion, in immediate termination of this Agreement. No employee of the Contractor nor any member of the Contractor's family shall serve on a County Board, committee or hold any such position which either by rule, practice or action nominates, recommends, supervises Contractor's operations, or authorizes funding to the Contractor. 33. Board of County Commissioners of Weld County Approval This Agreement shall not be valid until it has been approved by the Board of County Commissioners of Weld County, Colorado. 34. Choice of Law/Jurisdiction Colorado law, and rules and regulations established pursuant thereto, shall be applied in the interpretation, execution, and enforcement of this Agreement. Any provision included or incorporated herein by reference which conflicts with said laws, rules and/or regulations shall be null and void. In the event of a legal dispute between the parties, Contractor agrees that the Weld County District Court shall have exclusive jurisdiction to resolve said dispute. 35. Subcontractors Contractor acknowledges that the Department has entered into this Agreement in reliance upon the particular reputation and expertise of Contractor. Contractor shall not enter into any subcontractor agreements for the completion of this project without the Department's prior written consent, which may be withheld in the Department's sole discretion. 13 36. Attorneys Fees/Legal Costs In the event of a dispute between the Department and Contractor, concerning this Agreement, the parties agree that each party shall be responsible for the payment of attorney fees and/or legal costs incurred by or on its own behalf. 37. Ownership All work and information obtained by Contractor under this Agreement or individual work order shall become or remain (as applicable), the property of the Department. In addition, all reports, documents, data, plans, drawings, records and computer files generated by Contractor in relation to this Agreement and all reports, test results and all other tangible materials obtained and/or produced in connection with the performance of this Agreement, whether or not such materials are in completed form, shall at all times be considered the property of the Department. Contractor shall not make use of such material for purposes other than in connection with this Agreement without prior written approval of the Department. 38. Interruptions Neither party to this Agreement shall be liable to the other for delays in delivery or failure to deliver or otherwise to perform any obligation under this Agreement, where such failure is due to any cause beyond its reasonable control, including but not limited to Acts of God, fires, strikes, war, flood, earthquakes or Governmental actions. 39. Severabilitv If any term or condition of this Agreement shall be held to be invalid, illegal, or unenforceable by a court of competent jurisdiction, this Agreement shall be construed and enforced without such provision, to the extent that this Agreement is then capable of execution within the original intent of the parties. 14 IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. COUNTY: ATTEST: diriff/0 G►• �dO;gek Weld Cou Clerk to the Board WELD COUNTY, COLORADO BOARD OF COUNTY COMMISSIONERS By: o ►, _Ace //I'Alir1/104 Deputy Clerk to the oard r\ �I 15 arbara Kirkmeyer, Chair CONTRACTOR: Specialized Alternatives for Families and Youth of Colorado, Inc. 1600 Specht Point Road, Suite 105 Fort Collins, CO 80525 (970) 568-2023 L7exia CoGewa4 ZCSGv Jenna Coleman, LCSW (May 10, 2019) By: Date: Jenna Coleman, Executive Director May 10, 2019 aoj9_�� EXHIBIT A WELD COUNTY'S REQUEST FOR PROPOSAL (Weld County's Request for Proposal is incorporated into this agreement by reference and will be provided upon request to the Department.) This page intentionally left blank. EXHIBIT B CONTRACTOR'S RESPONSE TO REQUEST FOR. PROPOSAL Preserving Families .securing Futures January 25, 2019 Tobi A. Cullins Contract Management and. Compliance Coordinator Weld County Department of Human Services HS_Contract_Management@co.weld.co.us SAFY of Colorado 710 11th Avenue, Suite 103 Greeley, CO 80631 R1 -4,o Weld County 2019-2020 Child Welfare Various Services RFP Dear Ms. Cullins, Office: (970) 515-6219 Toll Free: (800) 532-7239 Fax: (970) 494-5895 VIA EMAIL ONLY On behalf of Specialized Alternatives for Families and Youth of Colorado (SAFY of CO), I am pleased to submit the attached proposal to continue SAFY of CO services in Weld County in relation to the RFP for Child Welfare Services (Bid Number B1900025.) SAFY of CO's proposal includes foster parent consultation services, in -home services, and mental health services. At Specialized Alternatives for Families and Youth of Colorado, Inc. (SAFY of CO), we work with children and families to reach their full potential increasing the wellbeing of our communities. Driven by our mission of Preserving Families and Securing Futures, SAFY of CO has constructed a comprehensive blueprint of services allowing youth and families to receive varying levels of care without the delays, confusion and stress associated with switching service providers. Our Model of Care includes treatment foster care, family preservation and reunification services, and mental health services. SAFY is committed to research -based and trauma effective interventions and strategies to address the roots of problematic behavior and trauma while effecting lasting change. This structure offers the tools needed to develop and maintain stable mental, physical and emotional foundations helping youth and families overcome the storm where they are — in home, in detention, at school or work, or in the community. SAFY of CO has successfully provided services to youth and families in Weld County in a prompt, reliable and responsive manner and we are fully committed to continuing to help meet the needs of our community. If awarded a contract in Weld County, SAFY will continue to comply with the specific requirements set out by the County, as stated in the Request for Proposals and in Exhibit A, Sample Agreement. Thank you for your consideration of this proposal. Sincerely, Lec Ryann Vernetson, MA, LPC Fiexecutive Director SAFY of Colorado, Inc. EXHIBIT B PROVIDER INFORMATION FORM Weld County Department of Human Services Specialized Alternatives for Families and Youth of Colorado, Inc. (SAFY of CO) 1657085 (CORE Services) AGENCY OR PRIVATE PRACTICE TRAILS PROVIDER ID (If Known) Ryann Vernetson Executive Director PRIMARY CONTACT— FULL NAME PRIMARY CONTACT- TITLE ( 970 1222-7581 PHONE NUMBER safygrants@safy.org PRIMARY CONTACT— E-MAIL ADDRESS 1600 Specht Point Road, Ste. 105 AGENCY MAILING ADDRESS I 970 )494-5895 EXT. FAX NUMBER www.safy.org/colorado AGENCY/PRACTICE WEB ADDRESS (IF APPLICABLE) Fort Collins CITY 80525 ZIP Benjamin Stephens REFFERAL CONTACT— FULL NAME (970 )692-7450 REFERRAL CONTACT— PHONE NUMBER REFERRALCONTACT EXT. Treatment Director REFERRAL CONTACT - TITLE stephensb@safy.org REFERRAL CONTACT— E-MAIL ADDRESS BILLING CONTACT Brenda Hoersten BILLING CONTACT— FULL NAME (419 ) 695-8010 BILLING CONTACT— PHONE NUMBER 1045 EXT. Revenue Cycle Specialist BILLING CONTACT -TITLE hoerstenb@safy.org BILLING CONTACT —E-MAIL ADDRESS I certify that the services proposed for intended use by the Weld County Department of Human Services will meet all the specifications it has so indicated in this bid form. I further affirm intention to enter into an agreement with Weld County, on behalf of the Weld County Department of Human Services, and comply with all requirements of the contract, if awarded. The Board of Weld County Commissioners reserve the right to reject any or all bids, to waive any informality in the bids, and to accept the bid, or part of a bid, that, in the opinion of the Board, is in the best interests of the Board and of the County of Weld, State of Colorado. The Board of Weld County Commissioners shall give preference to resident Weld County bidders in all cases where the bids are competitive in price and quality. 126- 041.41 Ah, I.PG Signature of Authorized Representative: Date of Signature: 1/25/2019 Bid No.: B1900025 EXHIBIT C PROPOSAL TEMPLATE 1. Bidder's legal entity name: 2. Program name or service type being proposed: Specialized Alternatives for Families and Youth of Colorado, Inc. (SAFY of CO) Home -Based Intervention 3. Modalities, curriculum or tools that will be utilized in the delivery of the service. SAFY of CO will provide home based intervention services to children ages 4 -18 years who are at imminent risk of removal and in immediate need of crisis stabilization/intervention and conflict resolution or seeking reunification. SAFY of CO provides a cafeteria plan of innovative, trauma effective services allowing the family to engage and choose services to meet their unique needs and focus on the family's strengths. These services compliment the coordination of trauma recommendations to be carried out in the home, school, and community. SAFY of CO strives for all interactions with children and families to be therapeutic. The therapeutic alliance between staff and families is critical to engagement and success. Building a relationship based on trust, accountability and ethical boundaries is essential to promoting change. Trained SAFY of CO staff counsel families using Motivational Interviewing (MI), which is identified by SAMSHA as an evidence -based practice. MI is used as an engagement tool for individuals and families, including those with mental health and substance abuse issues. Families who have histories of abuse, neglect, familial violence and out of home placements feel the weight of these events and can be triggered by environmental stimuli which can lead to violent outbursts, substance abuse relapse, loss of employment and loss of housing resulting in re - engagement with the child welfare system. Additionally, SAFY of CO has invested years of research and study on attachment and the ramifications of how it plays out in creating a "healing home" and permanency for children and youth. Research shows us nothing is more effective or important than creating relationships with families in crisis. Staff have been trained in emotional regulatory principles creating a paradigm of trauma healing in conjunction with any treatment/program model. SAFY of CO's multigenerational approach is largely informed by the Attachment, Self -Regulation, and Competency model, which focuses on holistic healing of the youth through targeted intervention with the caregiving system. Additionally, SAFY of CO employs the National Child Traumatic Stress Network Resource Parent training for families, staff, and resource parents; Trauma Systems Theory (Dr. Glenn Saxe) principles; Cognitive Processing Therapy; Use of the Columbia Suicide Severity Rating Scale; Crisis Prevention Institute (CPI) Nonviolent de-escalation training; Secondary Traumatic Stress assessment and care for staff; Practice coaching in the environment by a supervisor to ensure fidelity to SAFY of CO's trauma informed care model; and an on -going commitment to feedback and continuous quality improvement. SAFY of CO utilizes a structured team approach, including family and kinship, as partners in developing their own intervention goals and plans. In addition, SAFY of CO will collaborate with the referring agency, other community providers (i.e. counselors, school personnel, medical practitioners, therapist, etc.) and, as applicable, faith -based providers/partners, to provide a coordinated program of interventions designed to meet the needs of each family served and either prevent removal from the caretaker or facilitate the reunification. Each treatment plan is oriented to the unique needs of the individual family as directed by the referral and the assessment process. Bid No.: 1900025 EXHIBIT C PROPOSAL TEMPLATE 4. Capacity to Provide Services (ex. 4 hours/week). SAFY of CO Home -Based Interventions vary from 90 minutes to 5 hours per week depending on the needs of the family. Staffing will be proportional to service need in the area. As a general practice, SAFY of CO staff hold 8-12 cases, depending on the service needs of their case load. SAFY of CO seeks to grow sustainability through clinical excellence and financial responsibility. The duration of a typical case will be 6- 9 months, depending on the family's needs and progress. SAFY of CO's state leadership routinely monitors the progress made by families and reviews the status of the anticipated termination date for services for the family during weekly individual consultation meetings with the Specialists. SAFY internally staffs, as needed, ensuring the SAFY team is providing a cohesive service. Families at great risk of disruption are assessed at a High Intensity of services and can expect to receive 8-10 hours of total service per week along with the 24/7 on -call service. As families begin to regulate and heal or if they are not experiencing severe crisis impacting the family functioning, they can be decreased to a low level of services, averaging 4-6 hours of total service per week per family. From here, families can receive services under the Step -Down category (with DHS permission) where they'll receive a minimum of 7.5 hours of contact per month. SAFY of CO has the capacity to serve up to 12 families at any given time. 5. Goals of the service. SAFY of CO's mission of "Preserving Families and Securing Futures" is achieved through evidence -based programming designed and delivered with fidelity to best facilitate safe and stable family environments and achieve desired treatment outcomes. Central to the philosophy of treatment evidenced in all SAFY of CO program is to empower the child and the family in treatment planning, service design and evaluation. Services are designed with the goal of permanency with biological and kinship relationships for families, whenever possible. SAFY of CO Home -Based Interventions work to keep youth in the least restrictive level of care. Home -Based Interventions help facilitate whole family healing and provide services aimed at mitigating the symptoms of the individual's mental health challenges, so they can effectively reside in home or community setting. Understanding the goal is to safely maintain children in their natural environment, SAFY of CO's multi - generational approach is rooted in Family System Theory. The basis for a family centered approach is focusing attention on the family, on sub -systems within the family and on the family's interaction within the community. This includes recognizing and placing value on the family's cultural background and individual needs. 6. Outcomes of service. Trauma healing is an ongoing process, which is often not linear. As such, SAFY of CO does not define success as a child no longer having trauma symptoms entirely. Rather, SAFY of CO focuses on the child being able to safely stay in their permanent home or reunify from a higher level of care; additionally, decreased hospitalizations and decreased police contact are important achievements for permanency. We also define success as increased family function as evidenced by decreased crises, increased ability to independently problem solve and a reduction of trauma symptoms and associated behaviors. We strive to improve caregiver attunement, execution of trauma -focused caregiving, and self -regulation to promote overall stability. Bid No.: 1900025 EXHIBIT C PROPOSAL TEMPLATE 7. Target population for service. Colorado is widely cited as having one of the highest percentages of out of home youth in congregate care (Annie E. Casey Foundation). As such, SAFY of CO seeks to offer family -based solutions to promote permanency, safety, and well-being. SAFY of CO is seeking to offer services in Weld County to serve children stepping down from congregate care or prevent children from entering higher levels of care. SAFY of CO Home -Based Interventions target youth between the ages of 4 and 18 years -old. The interventions are designed to for youth at risk of disruption to a higher level of care and youth preparing to reunify with family. 8. Service access. SAFY of CO's proposed service for families is centered on family engagement through a multi -generational approach to home -based family preservation and reunification services. Delivered in a 24/7 flexible service and crisis support service paradigm, SAFY of CO's services will benefit children and families throughout Weld County by promoting permanency, safety, and wellbeing. SAFY of CO has an established an effective on -call process for responding to family and peer needs 24/7 to ensure 24/7 crisis on call support and flexible scheduling. Rather than families calling into an answering service or being "triaged", their call goes directly to a staff person apprised of their family and who has access to pertinent information such as active Releases of Information, effective interventions and the family's crisis plan. All staff utilize a rotating on call schedule and back up supervisor schedule to be available to families 24 hours per day, seven days per week to allow for hours of service per the needs of the family. SAFY of CO has proposed an incremental fee for travel to/from areas outside (but not including) a 20 -mile radius from the SAFY of CO home office in Greeley. SAFY of CO can provide some services by phone, especially in crisis situations. We are not, however, set up for videoconferencing. 9. Languages service is available in. English. SAFY of CO is committed to providing services in a culturally and linguistically responsive manner. SAFY of CO will utilize translation services to facilitate communication with families when those services are provided by Weld County DHS. 10. Rates of service. Service Item Notes I Base Rate I +30 Mile Round Trip Radius Daily Rate Billed per day; covers cost of 24/7/365 availability of on -call clinician and on -call supervisor. $22.50/day n/a TDMs Per Person/hour, billed at 0.25 increments. $74 n/a Court Per Person/hour, billed at 0.25 increments. $74 n/a 2nd Clinician* 1 Hourly Rate for 2nd clinician to attend home visit $88.80 $0.56/mile Bid No.: 1900025 EXHIBIT C PROPOSAL TEMPLATE Completing reporting in FIDOS Hourly rate, billed at .25 increments $74.00 n/a I Case collaboration that does not align with T1017 requirements Hourly rate, billed at .25 increments $74.00 n/a Caregiver case management assistance Hourly rate, billed at .25 increments $74.00 $0.56/mi Low Intensity Case - no Medicaid $1,500.00 High Intensity Case- No Medicaid $2,400.00 Bid No.: 1900025 EXHIBIT C PROPOSAL TEMPLATE 1. Bidder's legal entity name: 2. Program name or service type being proposed: Specialized Alternatives for Families and Youth of Colorado, Inc. Mental Health Services 3. Modalities, curriculum or tools that will be utilized in the delivery of the service. Many of the families we serve have experienced multi -generational poverty and trauma in addition to children presenting with complex behavioral and medical needs. It is critical that our communities invest in a trauma -informed response to treatment and recovery offering families healing and hope. Through collaborative partnership with referral agencies, SAFY of CO has successfully and safely served children and caregivers in the community and reduced stays in placements such as foster care, residential treatment, and juvenile detention. SAFY of CO is committed to research -based and trauma effective interventions along with intervention strategies to address the roots of criminal behavior and trauma while effecting lasting change that is seen in reduced negative behaviors and reported on identified assessment scales. SAFY of CO Mental Health Services provide dynamic, effective mental health treatment for youth and families who have endured trauma. Modalities include individual, couple and family therapy, Trauma Focused — Cognitive Behavioral Therapy (TF-CBT), Canine Assisted Mental Health Treatment, and cognitive therapy. Notably, our Canine -Assisted approach treatment has afforded participating youth and families a unique avenue for accessing services, increasing motivation to engage in treatment, and producing positive, sustainable treatment outcomes. 4. Capacity to Provide Services (ex. 4 hours/week). SAFY of CO's outpatient mental health services are typically 1 hour per week. SAFY of CO has the capacity to provide Mental Health services to 6 to 8 individuals at any point in time. 5. Goals of the service. The goals of our Mental Health Services include keeping youth in least restrictive level of care, facilitating whole family healing and mitigating the systems of the client's trauma experience. As individuals build relational skills it impacts other relationships and their ability to engage in the community. For youth, often a lack of relatedness whether with biological, kinship or foster family is a source of difficulty and can lead to disruption of placement. Moreover, relatedness is an essential element of child resiliency, which is known to mitigate the impact of trauma. The potential for long term impact, for both the youth and their family, but also the community is substantial through a potential reduction in child hospitalizations, police contact, school disruptions, and substance abuse. Additionally, adults with unmet mental health needs often have difficulty achieving self -resiliency, personal safety, or even meeting their basic needs. 6. Outcomes of service. Bid No.: 1900025 EXHIBIT C PROPOSAL TEMPLATE Good mental health is like having a level, stable foundation for our thoughts, emotions, and behaviors. It supports our ability to live up to our potential and fully participate in our communities. SAFY of CO's Mental Health services help children and parents build lifelong skills for maintaining mental and emotional well-being. Successful treatment of traumatized youth and parents can reduce child hospitalizations for mental health issues, reduced police contact, promote healthier decision making, support more appropriate physical and emotional boundaries, and increase ability to form and maintain healthy relationships. Since August 2014, SAFY of CO has helped over 300 children and youth in Colorado who have suffered from complex trauma, including parental abuse and neglect. Outcomes suggest that those who have participated in SAFY of CO services increase their resiliency, have reduced trauma symptoms and improved family functioning. 7. Target population for service. Note: Please include age range, applicable genders, and any specific characteristics/traits/needs. Any individual whose mental health symptoms disrupt day to day functioning; individuals, couples or families who have experienced trauma ranging in age 4 through adult. 8. Service access. Note: Bidder must indicate capacity for video conferencing, phone conferencing and in person. If office -based, bidder should provide full physical addresses for all locations. If provided outside the office, bidder should note home -based and/or community -based, and geographical area(s) bidder is willing to travel to. SAFY of CO Mental Health Services are an office -based service available at out Greeley location, 71011th Ave., Greeley, CO 80631. SAFY of CO offers evening hours for sessions to accommodate working families. SAFY of CO will offer the treatment sessions at an ADA compliant facility to accommodate mobility issues. SAFY of CO can provide some services by phone, especially in crisis situations. We are not, however, set up for videoconferencing. 9. Languages service is available in. Note: Bidder should note the language and level of proficiency. English. SAFY of CO is committed to providing services in a culturally and linguistically responsive manner. For individuals with a hearing impairment or English as a second language, SAFY of CO works with interpretation services to meet their needs. SAFY of CO staff treats each person in a caring and respectful fashion, mindful of individual differences and cultural and ethnic diversity. Staff receive specific training focusing on cultural and linguistic competency. As such, all services are provided in a culturally and linguistically responsive manner. This includes recognizing and placing value on the family's cultural background and individual needs including: race/ethnicity, gender, sexual orientation, physical abilities, age, nationality, geographic region and religion. 10. Rates of service. Note: Bidder should include fee for service, staffing, mileage, and any other applicable costs bidder Bid No.: 1900025 EXHIBIT C PROPOSAL TEMPLATE would like considered. Rates must be an exact amount and must include the unit of cost (i.e., hour, day, month, episode). Approximate rates or a range of rates for a service will not be accepted. Service Item Notes Base Rate +30 Mile Round Trip Radius TDMs Per Person/hour, billed at 0.25 increments. $92.00 n/a _ Court Per Person/hour, billed at 0.25 increments. $92.00 n/a Psychotherapy Per hour $92.00 n/a Bid No.: 1900025 EXHIBIT C PROPOSAL TEMPLATE 1. Bidder's legal entity name: 2. Program name or service type being proposed: Specialized Alternatives for Families and Youth of Colorado, Inc. (SAFY of CO) Foster Parent Consultation 3. Modalities, curriculum or tools that will be utilized in the delivery of the service. SAFY of CO will provide Foster Parent Consultation based on our model for home -based intervention services to children ages 4 - 18 years who are at risk of placement disruption and in immediate need of crisis stabilization/intervention and conflict resolution or seeking reunification. SAFY of CO provides a cafeteria plan of innovative, trauma effective services allowing the caregiver to engage and choose services to meet their unique needs and focus on the child's strengths. These services compliment the coordination of trauma recommendations to be carried out in the home, school, and community. SAFY of CO strives for all interactions with children and caregivers to be therapeutic. The therapeutic alliance between staff and caregivers is critical to engagement and success. Building a relationship based on trust, accountability, and ethical boundaries is essential to promoting change. Trained SAFY of CO staff counsel caregivers using Motivational Interviewing (MI), which is identified by SAMSHA as an evidence -based practice. MI is used as an engagement tool for individuals and families, including those with mental health and substance abuse issues. Additionally, SAFY of CO has invested years of research and study on attachment and the ramifications of how it plays out in creating a "healing home" and permanency for children and youth. Research shows us nothing is more effective or important than creating relationships. Staff have been trained in emotional regulatory principles creating a paradigm of trauma healing in conjunction with any treatment/program model. SAFY of CO's approach is largely informed by the Attachment, Self - Regulation, and Competency model, which focuses on holistic healing of the youth through targeted intervention with the caregiving system. Additionally, SAFY of CO employs the following: • National Child Traumatic Stress Network Resource Parent training for caregivers, staff, and resource parents • Utilization of Trauma Systems Theory (Dr. Glenn Saxe) principles • Motivational Interviewing for all clinical staff and supervisors • Cognitive Processing Therapy • Use of the Columbia Suicide Severity Rating Scale • Crisis Prevention Institute (CPI) Nonviolent de-escalation training • Secondary Traumatic Stress assessment and care for staff • Practice coaching in the environment by a supervisor to ensure fidelity to SAFY of CO's trauma informed care model • Commitment to feedback and continuous quality improvement Bid No.: 1900025 EXHIBIT C PROPOSAL TEMPLATE 4. Capacity to Provide Services (ex. 4 hours/week). SAFY of CO Foster Parent Consultation vary from 90 minutes to 5 hours per week depending on the needs of the caregiver. Staffing will be proportional to service need in the area. As a general practice, SAFY of CO staff hold 8-12 cases, depending on the service needs of their case load. SAFY of CO seeks to grow sustainability through clinical excellence and financial responsibility. The duration of a typical case will be 6 months, depending on the presenting needs and progress. SAFY internally staffs, as needed, ensuring the SAFY team is providing a cohesive service. Placements at great risk of disruption are assessed at a High Intensity of services and can expect to receive 8-10 hours of service per week along with the 24/7 on -call service. As families begin to use new tools and children regulate and heal, they can be decreased to a low level of services, averaging 4-6 hours of service per week per family. From here, families can receive services under the Step -Down category (with DHS permission) where they'll receive a minimum of 7.5 hours of contact per month. SAFY of CO has the capacity to provide Foster Parent Consultation services to up to 12 families at any given time. 5. Goals of the service. As child placement agency, SAFY of CO is familiar with the issues foster parents face, as well as the myriad of rules and regulations that govern fostering. SAFY of CO Foster Parent Consultation services are customized based on our unique knowledge of their presenting challenges. Overall, our work is focused on keeping youth in the least restrictive level of care and mitigating the symptoms of the youth's mental health challenges, so they can effectively reside in a community setting. 6. Outcomes of service. Trauma healing is an ongoing process, which is often not linear. As such, SAFY of CO does not define success as a child no longer having trauma symptoms entirely. Rather, SAFY of CO focuses on the child being able to safely remain in a community setting. Foster Parent Consultation services are focused on: • Fostering an increased understanding of child trauma, increased trauma focused parenting skills, improved availability to self -regulate; • Increase ability to navigate relationships between caregiver and foster youth or bio youth in home; and • Placement stability in their permanent home or reunify from a higher level of care. As well, decreased hospitalizations and decreased police contact are important achievements for permanency. We strive to improve caregiver attunement, execution of trauma -focused caregiving, and self -regulation to promote overall stability. 7. Target population for service. Note: Please include age range, applicable genders, and any specific characteristics/traits/needs. SAFY of CO is seeking to offer Foster Parent Consultation services to individuals identified by Weld County DHS needing additional support to manage youth in their care. The interventions are designed for youth at risk of disruption to a higher level of care and youth preparing to reunify with family. Within this service line, SAFY of CO will provide one time help with crisis stabilization for WCDHS foster/kin parents for up to one hour. SAFY of CO will contact the Utilization Management Team as soon as possible to notify them of the crisis intervention. It is our understanding the Utilization Management Team and Bid No.: 1900025 EXHIBIT C PROPOSAL TEMPLATE Kinship Care Coordinator/Foster Care Coordinator will follow up with the care provider to set up foster parent consultation as an ongoing service/support for the foster parent. In the event of future crisis, the SAFY of CO clinician will encourage the foster parent to contact their Kinship Care Coordinator/Foster Care Coordinator and foster parent consultant for assistance in moments of crises. 8. Service access. Note: Bidder must indicate capacity for video conferencing, phone conferencing and in person. If office -based, bidder should provide full physical addresses for all locations. If provided outside the office, bidder should note home -based and/or community -based, and geographical area(s) bidder is willing to travel to. SAFY of CO Foster Parent Consultation is a home -based service. SAFY of CO has an established an effective on -call process for responding to caregivers and peer needs 24/7 to ensure 24/7 crisis on call support and flexible scheduling. Rather than caregivers calling into an answering service or being "triaged", their call goes directly to a staff person apprised of their family and who has access to pertinent information such as active Releases of Information, effective interventions and the child's crisis plan. All staff utilize a rotating on call schedule and back up supervisor schedule to be available to families 24 hours per day, seven days per week to allow for hours of service per the needs of the family. SAFY of CO has proposed an incremental fee for travel to/from areas outside (but not including) a 20 -mile radius from the SAFY of CO home office in Greeley. SAFY of CO does not currently have videoconferencing capacity. SAFY of CO can provide some services by phone, especially in crisis situations. We are not, however, set up for videoconferencing. 9. Languages service is available in. Note: Bidder should note the language and level of proficiency. English. SAFY of CO is committed to providing services in a culturally and linguistically responsive manner. SAFY of CO will utilize translation services to facilitate communication with families when those services are provided by Weld County DHS. 10. Rates of service. Note: Bidder should include fee for service, staffing, mileage, and any other applicable costs bidder would like considered. Rates must be an exact amount and must include the unit of cost (i.e., hour, day, month, episode). Approximate rates or a range of rates for a service will not be accepted. Service Item Notes I Base Rate D +30 Mile Round Trip Radius Daily Rate Billed per day; covers cost of 24/7/365 availability of on -call clinician and on -call supervisor. $22.50/day n/a TDMs 1 Per Person/hour, billed at 0.25 increments. $74 n/a Bid No.: 1900025 EXHIBIT C PROPOSAL TEMPLATE Court Per Person/hour, billed at 0.25 increments. $74 n/a 2nd Clinician* Hourly Rate for 2nd clinician to attend home visit $88.80 $0.56/mile Completing reporting in FIDOS Hourly rate, billed at .25 increments $74.00 n/a Case collaboration that does not align with T1017 requirements Hourly rate, billed at .25 increments $74.00 n/a Caregiver case management assistance Hourly rate, billed at .25 increments Q $74.00 $0.56/mi Low Intensity Case - no Medicaid $1,500.00 High Intensity Case- No Medicaid $2,400.00 Bid No.: 1900025 SAFY Preserving Families Securing Futures 0 MEMORANDUM To: Rachel Wisdom, WCDHS From: Ryann Vernetson, Executive Director SAFY of CO Date: February 27, 2019 RE: 2019/2020 Child Welfare Services Contact Bid Follow-up With the addition of line items and openness to cost sharing with NEHP for rural cases, SAFY of CO revisited our braiding funding matrix. We have determined that a small daily rate, in addition to an hourly rate for non -Medicaid billable services would better meet the community's needs. This approach is more streamlined and fiscally manageable. Daily Rate The addition of a daily fee rate (opposed to a monthly fee) will fund SAFY of CO 24/7/365 on -call availability for the direct service clinician and their backup on call supervisor. All other non -Medicaid services are billed as rendered under a fee for service model. Utilization Management SAFY of CO is open to working with WCDHS to adopt a utilization management model for any non -Medicaid billable services, based on case needs. Under this model, SAFY will bill Medicaid for all Medicaid eligible activities, and WCDHS only for the services rendered on a case, which are not Medicaid billable. Second Clinician The "Second Clinician" is only for situations where it is deemed necessary due to safety or case crisis to have an additional clinician attend a home visit. SAFY of CO will seek approval from Weld County prior to utilizing a Second Clinician. The primary clinician's time will be billed to Medicaid at SAFY of CO's rate. The second clinician's rate is set at $88.80 per hour based on the skill and engagement required to deliver this service, as compared to those required for participating in a meeting our court. TDM & Court Time TDMs and court time are billed per person at the proposed rate of $74/hour per person. Depending on the needs of the youth and family, SAFY of CO typically has 1 to 2 clinicians attend TDMs and court. SAFY is proposing the rates as indicated in the chart below. SAFY Preserving Families Securing Futures Service Item Notes I Base Rate +30 Mile Round Trip Radius Daily Rate Billed per day; covers cost of 24/7/365 availability of on -call clinician and on -call supervisor. $22.50/day n/a TDMs Per Person/hour, billed at 0.25 increments. $74 n/a Court Per Person/hour, billed at 0.25 increments. $74 n/a 2nd Clinician* Hourly Rate for 2nd clinician to attend home visit $88.80 0 $0.56/mile Completing reporting in FIDOS Hourly rate, billed at .25 increments $74.00 n/a Case collaboration that does not align with T1017 requirements Hourly rate, billed at .25 increments $74.00 n/a Caregiver case management assistance Hourly rate, billed at .25 increments $74.00 , $0.56/mi Low Intensity Case - no Medicaid $1,500.00 _ High Intensity Case- No Medicaid $2,400.00 STAFF DATA SHEET EXHIBIT D Bidder must list all applicable staff who will manage and/or administer the proposed service. One Staff Data Sheet per proposed service. Bidder should not combine services.) PROPOSED SERVICE OR SERVICE TYPE: In -Home Services BIDDER LEGAL ENTITY NAME: Specialzied Alternatives for Families and Youth of Colorado, Inc. APPLICABLE STAFF MEMBER'OR CONTRACTOR INFORMATION " SUPERVISOR INFORMATION - No. Last Name first Name Workq - Work Email Educ,•ation Level Degree Focus g Licensure/ •" Credentials ' DORA tt (If applicable)._ Last Name First Name Work If Work Email No. Last Name, First Name Worktt Work Einail Education Level • Degree Focus Licensure/ Credentials ` DORA If . (If applicable) Last Name - • First Name Work tt . ' . Work Email ; 1 Aliffi Megan 970-494-5891 aliffimPsafv.org MSW Social Reg. Psychothera pist N/A Sowrn Kimberly 970-494-5891 swornk@safy.org 2 Blohm Jennifer 720-610-0645 blohmi@safv.org MSW Social Work LSW N/A Sworn Kimberly 970-494-5891 swornk@safy.org 3 Campbell Jane 970-494-5891 campbelij@safy.o rg MSW Social Worker Clinical LCSW N/A Sworn Kimberly 970-494-5891 swornk@safy.org 4 Cochran Nichole 970-515-6219 cochrann@safy.o rg MSW Social Work LSW N/A Ullrich Emily 970-494-5891 ullriche@safy.org 5 Collison Carley 970-494-5891 collisonc@safy.or g BSW Social Work N/A N/A Stephens Benjamin 970-494-5891 stephensb@safy. org 7 Fihn Gabrielle 970-494-5891 fihng@safy.org MS Reg. Psychotherapis t Reg. Psychothera pint N/A Ullrich Emily 970-494-5891 ullriche@safy.org 8 Howshar Mackenzie 970-494-5891 howsharm@safy. org MS Marriage & Family Therapist MFTC, Reg. Psychothera pist N/A Campbell Jane 970-494-5891 campbellj@safy.o rg 10 McKinney Megan 970-494-5891 mckinneym@safy .org BS Human Development Family Studies, Prevention and Intervention Studies N/A N/A Collison Carley 970-494-5891 collis'onc@safy.or g Bid No.: B1900025 STAFF DATA SHEET EXHIBIT D (Bidder must list all applicable staff who will manage and/or administer the proposed service. One Staff Data Sheet per proposed service. Bidder should not combine services. 11 Ortiz Al 970-494-5891 ortiza@safy.org BSW Social Work N/A N/A Bailey Tiffany 513-771-7239 bailevt@safy.org 12 Patrick Treven D 970-494-5891 patrickt@safy.org MS Social Services LPCC N/A Ullrich Emily 970-494-5891 ullriche@safy.org 13 Perez Gina 970-494-5891 perezg@safy.org BSW Social Work N/A N/A Collison Carley 970-494-5891 collisonc@safy.or g 14 Ruich Meghan 970-413-1859 ruichm@safy.org MSW Social Work Reg. Psychothera pist N/A Sworn Kimberly 970-494-5891 swornk@safy.org 15 Schlachter Megan 970-494-5891 schlachterm@saf y.org MSW Social Work Reg. Psychothera pist N/A Sworn Kimberly 970-494-5891 swornk@safy.org 16 Shults Cassidy 970-494-5891 shultsc@safy.org MSW Counseling, Mental Health LSW N/A Sworn Kimberly 970-494-5891 swornk@safy.org 17 Stephens Benjamin 970-494-5891 stephensb@safy. org MSW Counseling, Mental Health Reg. Psychothera pist N/A Vernetson Ryann 970-494-5891 vernetsonr@safy. org 18 Swan Steve 970-568-6970 swans@safy.org BSN, BA Clinical Mental Health Counseling Former RN N/A Campbell Jane 970-494-5891 campbellj@safy.o rg 19 Sworn Kimberly 970-494-5891 swornk@safy.org MSW Social Worker Clinical LCSW, Reg. Psychothera pist N/A Vernetson Ryann 970-494-5891 vernetsonr@safy. org 20 Ullrich Emily 970-494-5891 ullriche@safy.org MSW Counseling Reg. Psychothera gist N/A Stephens Benjamin 970-494-5891 stephensb@safy. org 21 Van Nest Danielle 970-494-5891 vannestd@safy.o rg MSW Social Work Reg. Psychothera gist N/A Ullrich Emily 970-494-5891 ullriche@safy.org 22 Van Patten Victoria 970-494-5891 vanpattenv@safy .org BA English, Education N/A N/A Vernetson Ryann 970-494-5891 vernetsonr@safy. org Bid No.: B1900025 . STAFF DATA SHEET EXHIBIT D (Bidder must list all applicable staff who will manage and/or administer the proposed service. One Staff Data Sheet per proposed service. Bidder should not combine services. 23 Vernetson Ryann 970-494-5891 vernetsonr@safy. org MA Counseling, Mental Health LPC N/A Matt William 419-695-8010 mattwPsafv.org 24 Waller Rebecca 970-286-3704 wangk@safy.org BSW Social Work N/A N/A Stephens Benjamin 970-494-5891 stephensb@safy. org 25 Wang Kolin 970-494-5891 wangk@safy.org BA Human Services, N/A N/A Collison Carley 970-494-5891 collisonc@safy.or g 27 28 Bid No.: B1900025 Foster Parent Consultation BIDDER LEGAL ENTITY NAME: Specialized Alternatives for Families and Youth of Colorado, Inc. ' APPLICABLE STAFF MEMBER -OR CONTRACTOWINFORMATION No. Last Name' First Name Work# - Work Email . Education Level , , -. - Degree -Focus ' 1 Aliffi Megan 970-494-5891 aliffim@safv.org MSW Social 2 Blohm Jennifer 720-610-0645 blohmj@safv.org MSW Social Work 3 Campbell Jane 970-494-5891 campbellj@safy.org MSW Social Worker Clinical 4 Cochran Nichole 970-515-6219 cochrann@safy.org MSW Social Work 5 Collison Carley 970-494-5891 collisonc@safy.org BSW Social Work 7 Fihn Gabrielle 970-494-5891 fihng@safy.org MS Reg. Psychotherapist 8 Howshar Mackenzie 970-494-5891 howsharm@safy.org MS Marriage & Family Therapist 10 McKinney Megan 970-494-5891 mckinneym@safy.org BS Human Development Family Studies, Prevention and Intervention Studies it Ortiz AJ 970-494-5891 ortiza@safy.org BSW Social Work 12 Patrick Treven D 970-494-5891 patrickt@safy.org MS Social Services 13 Perez Gina 970-494-5891 perezg@safy.org BSW Social Work 14 Ruich Meghan 970-413-1859 ruichm@safy.org MSW Social Work 15 Schlachter Megan 970-494-5891 schlachterm@safy.org MSW Social Work 16 Shults Cassidy 970-494-5891 shultsc@safy.org MSW Counseling, Mental Health 17 Stephens Benjamin 970-494-5891 stephensb@safy.org MSW Counseling, Mental Health 18 Swan Steve 970-568-6970 swans@safy.org BSN, BA Clinical Mental Health Counseling 19 Sworn Kimberly 970-494-5891 swornk@safy.org MSW Social Worker Clinical 20 Ullrich Emily 970-494-5891 ullriche@safy.org MSW Counseling 21 Van Nest Danielle 970-494-5891 vannestd@safy.org MSW Social Work 22 Van Patten Victoria 970-494-5891 vanpattenv@safy.org BA English, Education 23 Vernetson Ryann 970-494-5891 vernetsonr@safy.org MA Counseling, Mental Health 24 Waller Rebecca 970-286-3704 wangk@safy.org BSW Social Work 25 Wang Kolin 970-494-5891 wangk@safy.org BA Human Services SUPERVISOR INFORMATION Licensure/ Credentials . DORA,# (If applicable)- Last Name ..First Name Work # Work Email Reg. Psychotherapist N/A Sowrn Kimberly 970-494-5891 swornk@safy.org LSW N/A Sworn Kimberly 970-494-5891 swornk@safy.org LCSW N/A Sworn Kimberly 970-494-5891 swornk@safy.org LSW N/A Ullrich Emily 970-494-5891 ullriche@safy.org N/A N/A Stephens Benjamin 970-494-5891 stephensb@safy.org Reg. Psychotherapist N/A Ullrich Emily 970-494-5891 ullriche@safy.org MFTC, Reg. Psychotherapist N/A Campbell Jane 970-494-5891 campbellj@safy.org N/A N/A Collison Carley 970-494-5891 collisonc@safy.org N/A N/A Bailey Tiffany 513-771-7239 bailevt@safy.org LPCC N/A Ullrich Emily 970-494-5891 ullriche@safy.org N/A N/A Collison Carley 970-494-5891 collisonc@safy.org Reg. Psychotherapist N/A Sworn Kimberly 970-494-5891 swornk@safy.org Reg. Psychotherapist N/A Sworn Kimberly 970-494-5891 swornk@safy.org LSW N/A Sworn Kimberly 970-494-5891 swornk@safy.org Reg. Psychotherapist N/A Vernetson Ryann 970-494-5891 vernetsonr@safy.org Former RN N/A Campbell Jane 970-494-5891 campbellj@safy.org LCSW, Reg. Psychotherapist N/A Vernetson Ryann 970-494-5891 vernetsonr@safy.org Reg. Psychotherapist N/A Stephens Benjamin 970-494-5891 stephensb@safy.org Reg. Psychotherapist N/A Ullrich Emily 970-494-5891 ullriche@safy.org N/A N/A Vernetson Ryann 970-494-5891 vernetsonr@safy.org LPC N/A Matt William 419-695-8010 mattw@safy.org N/A N/A Stephens Benjamin 970-494-5891 stephensb@safy.org N/A N/A Collison Carley 970-494-5891 collisonc@safy.org PROPOSED SERVICE OR SERVICE Mental Health Services BIDDER LEGAL ENTITY NAME: Specialized Alternatives for Families and Youth of Colorado, Inc. APPLICABLE STAFF MEMBER OR'CONTRACTOR INFORMATION I No. Last Name First Name ` Work# `' Work Email Education Levef: -, . . Degree Focus 1 Campbell Jane 970-494-5891 campbellj@safy.org MSW Social Worker Clinical 2 Howshar Mackenzie 970-494-5891 howsharm@safy.org MS Marriage & Family Therapist 3 Shults Cassidy 970-494-5891 shultsc@safy.org MSW Counselor Mental Health 4 Sworn Kimberly 970-494-5891 swornk@safy.org MSW Social Worker Clinical 5 6 7 8 9 10 it 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 j SUPERVISOR INFORMATION Licensure/ Credentials DORA #, (If applicable) • LastNameFirst Name Work # Work Email LCSW Sworn Kimberly 970-494-5891 swornk@safy.org M FTC Reg. Psychother. Campbell Jane 970-494-5891 campbellj@safy.org LSW Sworn Kimberly 970-494-5891 swornk@safy.org LCSW Vernetson Ryann 970-494-5891, 4101 vernetsonr@safy.org A� o® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYI) 1/25/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Peoples Insurance Agcy -Ashland PO Box 210 Marietta OH 45750 NAME: David Lucas PHONE FAX lac. No. Est): 606-920-4489 l (ac, No): 740-376-6401 ADDRESS: David.Lucas@pebo.com INSURER(S) AFFORDING COVERAGE NAIC R INSURER A: Philadelphia Insurance Company 18058 INSURED SAFY-1 Specialized Alternatives for Families and Youth of Colorado, Inc. DBA SAFY of Colorado, Inc 10100 Elida Rd Delphos OH 45833 INSURER B: Argonaut Insurance Company 19828 INSURER C: INSURER D: INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 1313988328 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y PHPK1772514 2/1/2018 2/1/2019 EACH OCCURRENCE $1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 X Professional MED EXP (Any y one person) $ 5,000 PERSONAL SADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PRO - JET PER: GENERAL AGGREGATE $ 3,000,000 PRODUCTS- COMP/OP AGG $ 3,000,000 $ A AUTOMOBILE X _ LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED SCHEDULED AUTOS NON -OWNED AUTOS ONLY Y Y PHPK1772514 - 2/1/2018 2/1/2019 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE Y Y PHUB616629 2/1/2018 2/1/2019 EACH OCCURRENCE $4,000,000 AGGREGATE $ 4,000,000 DED I X I RETENTIONS iumnfl $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N/A W - 6/1/2018 6/1/2019 (C928398372694 X I STATUTE I I ERH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 A A Crime Abuse/Molestation Cyber Liability PHPK1772514 PHSD1318253 2/1/2018 2/1/2018 2/1/2019 2/1/2019 Employee dishonesty Abuse/Molestation (yber Liability 1,000,000 1,000,000 3,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) "The certificate holder is additional insured as required by written contract, coverage is primary and non contributory, waiver of subrogation applies, 30 day notice of cancellation" CERTIFICATE HOLDER CANCELLATION Weld County Department of Human Resources 1150 O Street Greeley CO 80634 I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. MOWED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD EXHIBIT C SCOPE OF SERVICES 1. Contractor will provide Foster Care/Adoption Services, Home Based Services, and Mental Health Services, as referred by the Department. 2. Foster Care/Adoption Services: Services for children ages 4 -18 years who are at risk of placement disruption and in immediate need of crisis stabilization/intervention and conflict resolution or seeking reunification. Contractor will provide a cafeteria plan of innovative, trauma effective services allowing the caregiver to engage and choose services to meet their unique needs and focus on the child's strengths. These services compliment the coordination of trauma recommendations to be carried out in the home, school, and community. a. Capacity for Services: i. Services vary from 90 minutes to 5 hours per week depending on the needs of the caregiver. ii. Contractor can hold 8-12 cases, depending on the service needs of their case load. iii. Duration of a typical case will be 6 months, depending on the presenting needs and progress. iv. Placements at great risk of disruption are assessed at a High Intensity of services and can expect to receive 8-10 hours of service per week along with the 24/7 on -call service. As families begin to use new tools and children regulate and heal, they can be decreased to a low level of services, averaging 4-6 hours of service per week per family. From here, families can receive services under the Step -Down category (with DHS permission) where they'll receive a minimum of 7.5 hours of contact per month. v. Contractor has the capacity to provide Foster Parent Consultation services to up to 12 families at any given time. b. Goals of Service: i. Services are customized based on our unique knowledge of their presenting challenges. ii. Contractor will focus on keeping youth in the least restrictive level of care and mitigating the symptoms of the youth's mental health challenges, so they can effectively reside in a community setting. c. Outcomes of Service: i. Fostering an increased understanding of child trauma, increased trauma focused parenting skills, improved availability to self -regulate. ii. Increase ability to navigate relationships between caregiver and foster youth or bio youth in home. iii. Placement stability in their permanent home or reunify from a higher level of care. iv. Decreased hospitalizations and decreased police contact are important achievements for permanency. v. Caregiver attunement, execution of trauma -focused caregiving, and self -regulation to promote overall stability. d. Target Population: i. Individuals identified needing additional support to manage youth in their care. ii. Youth at risk of disruption to a higher level of care and youth preparing to reunify with family. iii. Contractor help with crisis stabilization for foster/kin parents for up to one (1) hour. Contractor contact the Utilization Management Team as soon as possible to notify them of the crisis intervention. It is our understanding the Utilization Management Team and 1 Kinship Care Coordinator/Foster Care Coordinator will follow up with the care provider to set up foster parent consultation as an ongoing service/support for the foster parent. In the event of future crisis, Contractor will encourage the foster parent to contact their Kinship Care Coordinator/Foster Care Coordinator and foster parent consultant for assistance in moments of crises. e. Service Access: i. Home based. ii. Contractor has an established an effective on -call process for responding to family and peer needs 24/7 to ensure 24/7 crisis on call support and flexible scheduling. Rather than families calling into an answering service or being "triaged", their call goes directly to a staff person apprised of their family and who has access to pertinent information such as active Releases of Information, effective interventions and the family's crisis plan. Contractor utilizes a rotating on call schedule and back up supervisor schedule to be available to families 24 hours per day, seven days per week to allow for hours of service per the needs of the family. iii. Contractor can provide some services by phone, especially in crisis situations. Contractor cannot provide videoconferencing. \ f. Language: English. Contractor will utilize translation services to facilitate communication with families when those services are provided by the Department. 3. Home Based Services: Contractor's utilizes a multigenerational approach that is largely informed by the Attachment, Self -Regulation, and Competency model, which focuses on holistic healing of the youth through targeted intervention with the caregiving system. Contractor utilizes a structured team approach, including family and kinship, as partners in developing their own intervention goals and plans. Contractor will collaborate with the referring agency, other community providers (i.e. counselors, school personnel, medical practitioners, therapist, etc.) and, as applicable, faith -based providers/partners, to provide a coordinated program of interventions designed to meet the needs of each family served and either prevent removal from the caretaker or facilitate the reunification. Each treatment plan is oriented to the unique needs of the individual family as directed by the referral and the assessment process. a. Capacity for Services: i. Services vary from 90 minutes to 5 hours per week depending on the needs of the family. Staffing will be proportional to service need in the area. ii. Contractor's staff can hold 8-12 cases, depending on the service needs of their case load. iii. Duration of a typical case will be 6- 9 months, depending on the family's needs and progress. Contractor's state leadership routinely monitors the progress made by families and reviews the status of the anticipated termination date for services for the family during weekly individual consultation meetings with the Specialists. Contractor internally staffs, as needed, ensuring the Contractor's team is providing a cohesive service. Families at great risk of disruption are assessed at a High Intensity of services and can expect to receive 8-10 hours of total service per week along with the 24/7 on - call service. As families begin to regulate and heal or if they are not experiencing severe crisis impacting the family functioning, they can be decreased to a low level of services, averaging 4-6 hours of total service per week per family. From here, families can receive services under the Step -Down category (with Department permission) where they'll receive a minimum of 7.5 hours of contact per month. iv. Contractor has the capacity to serve up to 12 families at any given time. 2 b. Goals of Service: i. Contractor's mission of "Preserving Families and Securing Futures" is achieved through evidence -based programming designed and delivered with fidelity to best facilitate safe and stable family environments and achieve desired treatment outcomes. ii. Empower the child and the family in treatment planning, service design and evaluation. iii. Services are designed with the goal of permanency with biological and kinship relationships for families, whenever possible. iv. Keep youth in the least restrictive level of care. v. Facilitate whole family healing and provide services aimed at mitigating the symptoms of the individual's mental health challenges, so they can effectively reside in home or community setting. vi. Family centered approach is focusing attention on the family, on sub -systems within the family and on the family's interaction within the community. This includes recognizing and placing value on the family's cultural background and individual needs. c. Outcomes of Service: i. Child will be able to safely stay in their permanent home or reunify from a higher level of care. ii. Decreased hospitalizations and decreased police contact. iii. Increased family function as evidenced by decreased crisis.. iv. Increased ability to independently problem -solve and a reduction of trauma symptoms and associated behaviors. v. Caregiver attunement, execution of trauma -focused caregiving, and self -regulation to promote overall stability. d. Target Population: i. Children stepping down from congregate care or prevent children from entering higher levels of care. ii. Youth between the ages of 4 and 18 years -old. The interventions are designed to for youth at risk of disruption to a higher level of care and youth preparing to reunify with family. e. Service Access: i. Contractor is centered on family engagement through a multi -generational approach to home -based family preservation and reunification services. Delivered in a 24/7 flexible service and crisis support service paradigm. ii. Contractor has an established an effective on -call process for responding to family and peer needs 24/7 to ensure 24/7 crisis on call support and flexible scheduling. Rather than families calling into an answering service or being "triaged", their call goes directly to a staff person apprised of their family and who has access to pertinent information such as active Releases of Information, effective interventions and the family's crisis plan. Contractor utilizes a rotating on call schedule and back up supervisor schedule to be available to families 24 hours per day, seven days per week to allow for hours of service per the needs of the family. iii. Contractor can provide some services by phone, especially in crisis situations. Contractor cannot provide videoconferencing. f. Language: English. Contractor will utilize translation services to facilitate communication with families when those services are provided by the Department. 4. Mental Health Services: Contractor will provide dynamic, effective mental health treatment for youth and families who have endured trauma. Modalities include individual, couple and family therapy, Trauma Focused — Cognitive Behavioral Therapy (TF-CBT), Canine Assisted Mental Health Treatment, and cognitive 3 therapy. Notably, our Canine -Assisted approach treatment has afforded participating youth and families a unique avenue for accessing services, increasing motivation to engage in treatment, and producing positive, sustainable treatment outcomes. a. Capacity for Services: i. One (1) hour per week. ii. Contractor has the capacity to provide services to 6 to 8 individuals at any point in time. b. Goals of Service: i. Keep youth in least restrictive level of care. ii. Facilitate whole family healing iii. Mitigate the systems of the client's trauma experience. c. Outcomes of Service: i. Help children and parents build lifelong skills for maintaining mental and emotional well-being. ii. Reduced child hospitalizations for mental health issues. iii. Reduced police contact. iv. Healthier decision making. v. More appropriate physical and emotional boundaries. vi. Increased ability to form and maintain healthy relationships. vii. Increased resiliency. viii. Reduced trauma symptoms. ix. Improved family functioning. d. Target Population: Any individual whose mental health symptoms disrupt day to day functioning; individuals, couples or families who have experienced trauma ranging in age 4 through adult. e. Service Access: i. Office -based. 71011th Ave., Greeley, CO 80631. ii. Contractor can provide some services by phone, especially in crisis situations. Contractor cannot provide videoconferencing f. Language: English. Contractor is committed to providing services in a culturally and linguistically responsive manner. For individuals with a hearing impairment or English as a second language, Contractor works with interpretation services to meet their needs. All services are provided in a culturally and linguistically responsive manner. This includes recognizing and placing value on the family's cultural background and individual needs including: race/ethnicity, gender, sexual orientation, physicalabilities, age, nationality, geographic region and religion. 5. Contractor will respond to the Quality Assurance Team Supervisor (hainleid@weldgov.com, 970-400- 6210) within three (3) business days regarding the ability to accept the received referral. 6. Upon acceptance of a referral, Contractor will offer an initial appointment within seven (7) days of receiving the referral. The first attempt to contact the client will occur within 24 hours of receiving the referral (excluding weekends and holidays). Contractor will document efforts to engage client in referred services. If the client does not respond after three (3) attempts in the first seven (7) days of the referral period, the Contractor will notify the caseworker and the Quality Assurance Team Supervisor (hainleid@weldgov.com, 970-400-6210). 7. Contractor understands that "no shows" are defined as unexcused and unplanned/uncommunicated absences for visitation services. If a rate for "no shows" is not specifically stated in Exhibit D, Rate Schedule, then Contractor understand that the Department will no reimburse for "no shows". Contractor understands that the Department will only reimburse Contractor for up to two (2) "no-shows" on the part 4 of the client per month. After three (3) "no-shows, "Contractor will place client on a behavioral plan requiring attendance or discharged client from services. Contractor must inform the caseworker and the Quality Assurance Team Supervisor (hainleid@weldgov.com, 970-400-6210). 8. Contractor understands that the Department will not reimburse Contractor for cancelled appointments either on the part of the client or the Contractor. If the cancellation is generated from the Contractor, a "makeup" session/episode, to occur within 30 days of the cancellation, will be offered to the client (excluding session/episodes that fall on holidays). If the cancellation is generated from the client, the Contractor must request a makeup session from the Department prior to the makeup session occurring (excluding session/episodes that fall on holidays). After three (3) cancellations, Contractor will inform the caseworker and the Quality Assurance Team Supervisor(hainleid@weldgov.com) immediately via email, to discuss service continuation. 9. Contractor will identify in detail areas of continued concern and make recommendations to the Department regarding continuation of services and/or the need for additional services. 10. Contractor will document in detail any and all observed or verbalized concerns regarding any child whom the Contractor is working with under an active referral. Areas of concern may include, but are not limited to, any physical, emotional, educational or behavioral issues. Areas of concern should be reported immediately AND on the required monthly report. 11. Contractor will submit reports on a monthly basis for each active referral for ongoing services. Reports will be submitted per the online format required by the Department, unless otherwise directed by the Department. 12. Contractor agrees any change to an existing referral must be pre -approved through the Child Welfare Contract and Services Coordinator, a Department -facilitated Team Decision Making (TDM) or Family Team Meeting (FTM), or by court order. A change is defined as anything outside of the approved documented service on the initial authorized referral form. This may include an increase or decrease in services hours, change in frequency, change in location of services, transportation needs, or any change to the initial referral or subsequent authorizations. 13. Contractoragreesto attend meetings when available and as requested by the Department. Such meetings include Court Facilitations, Court Staffings, Family Team Meetings and/or Team Decision Making meetings. The Department will reimburse for actual participation in the meeting only so long as the meeting is at least one hour in length, the Contractor obtains the Facilitator's signature on the Client Verification Form (if in person) at the time of the meeting and participation in the meeting is deemed appropriate and necessary by the Department. Staffings and/or meetings other than those listed above are not considered reimbursable unless otherwise approved by the Child Welfare Contract and Services Coordinator. Contractor may participate by phone, if approved by the Department. 14. Contractor will notify the Quality Assurance Team Supervisor (hainleid@weldgov.com, 970-400-6210) of new staff who will manage and/or administer the services with the following information: g. Staff member name and contact information h. Education level/degree (if applicable) i. Licensure/credentials (if applicable) j. Department of Regulatory Authority (DORA) number (if applicable) k. Supervisor name and contact information 5 The Department reserves the right to decline the new staff members managing and/or administering services to Department clients. 6 EXHIBIT D RATE SCHEDULE 1. Funding and Method of Payment The Department agrees to reimburse the Contractor in consideration of the work and services performed under this Agreement at the rate specific in Paragraph 2, below. The total amount to be paid to the Contractor during the term of this Agreement shall be reported by the Department after May 31, 2020. Expenses incurred by the Contractor prior to the term of this Agreement are not eligible Department expenditures and shall not be reimbursed by the Department. Payment pursuant to this Agreement, whether in whole or in part, is subject to and contingent upon the continuing availability of said funds for the purposes hereof. In the event that said funds, or any part thereof, become unavailable as determined by the Department, the Department may immediately terminate the Agreement or amend it accordingly. 2. Fees for Services Foster Care/Adoption Services: $88.80/Hour (2' Clinician) $74.00/Hour (Caregiver Case Management) $74.00/Hour (Case Collaboration) $22.50/Day (Daily Rate) $2,400.00/Month (High Intensity— No Medicaid) $1,500.00/Month (Low Intensity — No Medicaid) $74.00/Hour (TDMs, FTM) Home Based Services: $88.80/Hour (2"d Clinician) $74.00/Hour (Caregiver Case Management) $74.00/Hour (Case Collaboration) $22.50/Day (Daily Rate) $2,400.00/Month (Multi -generational Treatment Services - High — No Medicaid) $1,500.00/Month (Multi -generational Treatment Services - Low— No Medicaid) $74.00/Hour (TDMs, FTM) Mental Health Services $92.00/Hour (Psychotherapy) $92.00/Hour (TDMs, FTM) 3. Submittal of Vouchers Contractor shall prepare and submit monthly a Request for Reimbursement, Client Verification Form, other supporting documentation, and monthly report if applicable, certifying that services authorized were provided on the date(s) indicated and the charges were made pursuant to the terms and conditions of Paragraph 3 and Exhibit A. Contractor shall submit all Requests for Reimbursement and supporting documentation to the Department by the 7th day of the month following the month of service, but no later than 60 days from the date of service. Requests for Reimbursement and/or supporting documentation received after 60 days from the date of service may result in delay or forfeiture of payment. Consistent failure to meet the 60 -day deadline may result in termination of the Agreement. For ongoing services, proof of services rendered shall be a Client Verification Form signed by the client and a monthly report submitted in accordance with Paragraph 3(d) of this Agreement. For one-time services, proof of services rendered shall be receipt of a Client Verification Form and the completed product. For Monitored Sobriety services, proof of services rendered shall be the test result. s Hello