HomeMy WebLinkAbout20202393.tiffRESOLUTION
RE: APPROVE AGREEMENT FOR SUBSTANCE ABUSE TREATMENT SERVICES AND
AUTHORIZE CHAIR TO SIGN - SIGNAL BEHAVIORAL HEALTH NETWORK
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board has been presented with an Agreement for Substance Abuse
Treatment Services between the County of Weld, State of Colorado, by and through the Board of
County Commissioners of Weld County, on behalf of the Department of Human Services, and
Signal Behavioral Health Network, commencing June 1, 2020, and ending June 30, 2021, with
further terms and conditions being as stated in said agreement, and
WHEREAS, after review, the Board deems it advisable to approve said agreement, a copy
of which is attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County, Colorado, that the Agreement for Substance Abuse Treatment Services between the
County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld
County, on behalf of the Department of Human Services, and Signal Behavioral Health Network,
be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said agreement.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 5th day of August, A.D., 2020, nunc pro tunc June 1, 2020.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST: detAtio� Jd,o•e1
Weld County Clerk to the Board
BY:
Mike Freeman, Chair
Stev-/ oreno, Pro-Tem
Scat K. James
APP'�,ED :FOR' �..•'!!._, �� GLA—
arbara Kirkmey
County ttorney
Date of signature: •z /P-/
Kevin D. Ross
CC: H SD
08119/20
2020-2393
HR0092
PRIVILEGED AND CONFIDENTIAL
MEMORANDUM
DATE: July 24, 2020
TO: Board of County Commissioners — Pass -Around
FR: Jamie Ulrich, Director, Human Services
RE: Substance Abuse Evaluation and Treatment
Agreement - FY 2020/21 with Signal Behavioral Health
Network
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 Substance Abuse Evaluation and Treatment
Agreement — FY 2020/21 with Signal Behavioral Health Network. Signal agrees and desires
to participate as a service provider coordinator for the Department's qualified child welfare
clients. Signal will ensure the provision of high -quality substance abuse evaluation and
treatment services to clients in a delivery system of limited resources and public funding. Due to
varying State funding cycles, the periods of performance within this agreement will overlap. For
Core Services funding, the period of performance shall be June 1, 2020, through May 31, 2021,
unless sooner terminated. The Additional Family Services (AFS) funding shall have a period of
performance of July 1, 2020, through June 30, 2021, unless sooner terminated. The Department
agrees to contract with Signal for a maximum of $300,000.00 in Core Services funding. Signal
agrees to contribute a maximum of $150,000.00 in AFS funds, as designated by the Office of
Behavioral Health (OBH), for the purpose of serving eligible clients in accordance with the
terms of this agreement.
I do not recommend a Work Session. I recommend approval of this agreement and authorize
Director and Chair to sign.
Mike Freeman, Chair
Scott James
Barbara Kirkmeyer
Steve Moreno, Pro-Tem
Kevin Ross
Approve
Recommendation Work Session
Schedule
4
ti
Other/Comments:
Cat
Pass -Around Memorandum; July 24, 2020 - CMS 3940
Y/c
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2020-2393
SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2020/2021
CHILD WELFARE CLIENTS
This Agreement is between the Weld County Department of Human Services,
hereinafter referred to as "WCDHS" and Signal Behavioral Health Network, and
hereinafter referred to as "Signal."
WHEREAS, the Colorado Department of Human Services has provided Colorado
Core Services substance abuse treatment funding to WCDHS for outpatient and
residential core services for families, children, and adolescents; and
WHEREAS, WCDHS requires the services of substance abuse treatment
providers to assist the County in delivering substance abuse treatment services to child
welfare clients, and Signal is willing and able to coordinate and manage such services;
and
WHEREAS, Signal is a Colorado not -for-profit corporation organized for the
purpose of managing and coordinating high quality, cost efficient, integrated chemical
dependency and related behavioral health care services in the State of Colorado.
NOW, THEREFORE, it is mutually agreed as follows:
I. INTRODUCTION.
The terms of this Agreement are contained in the terms recited in this document
and in Exhibits A, B, C, D, and E, each of which forms an integral part of this Agreement.
Exhibits A, B, C, D, and E are specifically incorporated herein by this reference. WCDHS
and Signal acknowledge and agree that this Agreement, including specifically Exhibits A,
B, C, D, and E define the performance obligations of WCDHS and Signal and the parties'
willingness and ability to meet those requirements.
II. SERVICES:
A. Responsibilities of Signal
1. Signal agrees and desires to participate as the service provider coordinator
for WCDHS qualified child welfare clients. This service is described in State
CDHS Rules and Regulations Volume 7, Section 7, and the State approved
Weld County Family Preservation Program/Core Service Plan. Section
7.303.1 of Volume 7 describes Core Substance Abuse Treatment Services
as: diagnostic and/or therapeutic services to assist in the development of
the family service plan, to assess and/or improve family communication,
functioning and relationships, and to prevent further abuse of drugs or
alcohol.
2. Signal will ensure the delivery of a high quality of clinical care to clients in a
delivery system of limited resources and public funding. The full continuum
of care (Outpatient, Intensive Outpatient, Transitional Residential, Intensive
Residential, Therapeutic Community, or comparable alternatives as
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CHILD WELFARE CLIENTS
mutually agreed upon) will be available to clients. The client's clinical needs
will determine the level of care Signal is to provide and Signal will meet
those needs regardless of "modality."
3. Signal will assure that all eligible child welfare clients referred by WCDHS
in need of treatment will receive such in accordance with American Society
of Addiction Medicine Patient Placement Criteria (ASAM PPC) II R level of
care, as reimbursed by the State of Colorado, Office of Behavioral Health.
4. It is the intention of WCDHS to utilize the substance abuse
counselors/therapists furnished through Signal providers to provide
substance abuse evaluation and treatment services for all of WCDHS
qualified clients at agreed upon rates for specified services. Signal will
ensure that provider therapists will provide all of the following services for
Weld County clients: assessments, evaluations, standard out -patient
services, enhanced out -patient services and intensive out -patient services.
5. Signal will evaluate priority service as follows:
a. Signal will give priority service to child welfare clients (parents and
children) who comply with the following criteria as WCDHS refers:
i. Case is active on TRAILS, and
ii. Case meets the State DHS program category criteria 4, 5, or 6,
and,
iii. Case meets the definition of "imminent risk for out -of -home
placement/reunification" set forth by the State of Colorado.
b. Signal will secondarily evaluate and treat ColoradoWorks, Temporary
Assistance for Needy Families (TANF), and Employment First clients as
referred by WCDHS.
6. Signal will include the following provisions in all subcontracts with providers:
a. The Provider shall submit a treatment plan to WCDHS within 30 days.
b. The Provider shall enter monthly progress reports into the Signal system
no later than the 7th calendar day of the month following the month
during in which the service was rendered. Services submitted without
monthly progress reports will be pended for official billing and utilization
against AFS funds until such reports are submitted.
c. Providers will give timely notice of cancelled appointments to theclients
and will reschedule such appointments as soon as practical.
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CHILD WELFARE CLIENTS
7. Signal, or their designee, agrees to provide WCDHS monitoring results (UA,
BA, patch, tox trap) by faxing said results to WCDHS at (970) 346-7667 or
via access to online system no later than 72 hours after the day of service.
8. Signal agrees to make available Core and AFS Utilization Reports to
WCDHS each month by the 7th of each month.
9. Signal agrees to cooperate with WCDHS to resolve any duplicated fees
and/or errors identified by the WCDHS billing review process.
10. Signal will also make monthly progress reports available on its website for
each WCDHS client in treatment by the 7th of the month following the date
of service.
11. Signal will provide training and technical support, as necessary, for WCDHS
staff in accessing data and billing reports and on the use of the child welfare
referral system.
12. Signal shall reconcile all treatment providers' claims to AFS funds within 90
days from the date of service delivery. Claims not properly submitted to
Signal within this timeline will be denied.
13 Signal will assure that the providers in its network give timely notice to
cancelled appointments to the clients and will reschedule such
appointments as soon as possible.
14. Signal will collaborate with WCDHS and the providers in its network to
provide quarterly reports to WCDHS which contain timelines from referral
date to service start date, service length of stay, service no show rates,
service completion rates and average number of outreach contacts to
clients to engage them in treatment. WCDHS will provide a template to the
providers as requested.
15. At all times from the effective date of this Contract until completion of this
Contract, Signal 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 the Child Welfare Services and Family and
Children's Program funding must conform to the Single Audit Act of 1984
and OMB Circular A-133.
16. Signal agrees to comply with the Standard Procedures for Core Services as
set forth in the attached Exhibit E, which is attached hereto and incorporated
herein by reference.
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WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2020/2021
CHILD WELFARE CLIENTS
B. Responsibilities of WCDHS:
1. WCDHS will work cooperatively with Signal and its Providers to deliver
quality, efficient and cost-effective substance abuse treatment services to
WCDHS qualified clients.
2. WCDHS will make every effort to inform Signal and its Providers in a timely
manner of system issues, developments, and complications so that Signal
and the Provider can make informed choices in its role as the managed
service organization and treatment agency respectively.
3. WCDHS will assure that all referrals under this contract meet the eligibility
criteria expressed in Section l(A)(5) above.
4. WCDHS agrees to provide Signal with the name of a primary contact person
who will be responsible for interacting with Signal's accounting and
information systems departments.
5. WCDHS, or its authorized designee(s), will be responsible for electronically
authorizing services to various providers.
6. WCDHS will review monthly AFS actual reports and determine any
duplicate charges pursuant to Core or other previously paid services.
WCDHS will report monthly any discrepancies in duplication and/or errors
to Signal, and in cooperation with Signal, work with Signal to resolve any
conflicts of billed services or fees.
7. WCDHS will send a remittance advice within 10 business days of
completion of each month's TRAILS payroll date. WCDHS shall work with
Signal and other counties to develop standard claims denial criteria.
WCDHS shall reimburse Signal for all complete services invoiced within 45
calendar days from the date of receipt of Signal's invoice.
8. WCDHS shall inform Signal of the county primary contacts along with
contact information. WCDHS shall provide such contact information for all
contract, data and billing related matters.
III. PERIOD OF PERFORMANCE
Due to different State funding cycles, the period of performance under this
Agreement will overlap. For the County Core Services the period of performance
shall be for the 12 -month period beginning, June 1, 2020 through May 31, 2021,
unless sooner terminated. The Signal Additional Family Service (AFS) period of
performance under this Agreement shall be for the 12 -month period beginning July
1, 2020 through June 30, 2021, unless sooner terminated. Either party hereto
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WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2020/2021
CHILD WELFARE CLIENTS
may terminate this Agreement at any time by giving not less than 45 days advance
written notice to the other party.
As a condition of continuing to render services under this Agreement, it is
understood that Signal will report any limitation or restriction of their license or
insurance or the ability to perform the services covered by this Agreement under
any condition of impairment.
In the absence of any formal agreement beyond the term of this agreement, Signal
agrees to continue providing treatment, under the terms of this agreement, for
clients that are in treatment or referred by WCDHS for treatment. This is with the
further understanding that service delivery and payment are subject to the
termination terms mentioned above.
Signal reserves the right to suspend services to clients if funding is no longer
available. WCDHS acknowledges financial responsibility for all services
authorized and performed before the effective date of termination.
IV. COMPENSATION
See Exhibit A for specific compensation which is attached hereto and
incorporated by reference.
V. CLIENT FEES OR CO -PAYS
Neither Signal nor their network Providers shall assess a client fee or co -pay to
child welfare clients served under this contract, unless the client is required to
pay for any positive urine screen as a condition of their Family Service Plan or
through court order for monitored sobriety and/or treatment as a condition of their
treatment plan. Any such client fees or co -pays shall be outside the scope of this
contract, and Signal shall have no responsibility for accounting for such fees and
co -pays.
VI. INDEPENDENT CONTRACTOR
Signal and its providers shall be providing services hereunder as an independent
contractor and the relationship of employer and employee does not exist between
WCDHS and Signal. None of the provisions of this Agreement are intended to
create, nor shall they be deemed or construed to create, any relationship among
Signal, Providers, or WCDHS other than that of independent entities contracting
solely for the purpose of effecting the provisions of this Agreement. Signal and
Providers shall pay when due all required employment taxes and income
withholding taxes, shall provide and keep in force worker's compensation (and
show proof of such insurance as requested) and unemployment compensation
insurance in the amounts required by law, and shall be solely responsible for the
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CHILD WELFARE CLIENTS
acts for Signal, its employees and agents.
VII. ASSURANCES
Signal shall abide by all assurances as set forth in the attached Exhibit D, which is
attached hereto and incorporated herein by reference.
VIII. COMPLIANCE WITH APPLICABLE LAWS AND NON-DISCRIMINATION
A. At all times during the performance of this contract, Signal shall strictly adhere
to all applicable federal and state laws, orders, and all applicable standards,
regulations, interpretations or guidelines issued pursuant thereto. This
includes the 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 Contract. Signal acknowledges
that the following laws are included:
Title VI and VII of the Civil Rights Act of 1964 and 1986 amendments, 42 U.S.C.
Sections 2000d —1 et. seq. and its implementing regulation, 45 C.F.R. Part 80 et.
seq.; and Sections 503 and 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. Sections 6101 et. seq. and its
implementation regulations, 45 C.F.R. Part 91; and the Age Discrimination in
Employment Act of 1967; and the Equal Pay Act of 1963 as amended; and the
Education Amendments of 1972; and Immigration Reform and Control Act of
1986, P.L. 99-603; 42 C.F.R. Part 2 Executive Order 11246, as amended Title VII
and VIII of the Public Health Services Act Vietnam Era Veteran's Readjustment
Assistance Act of 1974 Non-discrimination laws of the State of Colorado.
B. All regulations applicable to above referenced laws prohibiting discrimination
because of race, color, national origin, and sex, religion, veteran status 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, Signal and WCDHS will resist in
judicial proceedings any efforts to obtain access to client records except as
permitted by 42 CFR Part 2.
C. WCDHS and Signal shall sign a Qualified Service Organization Agreement in
compliance with 42 CFR Part 2, and attached hereto and incorporated by
reference as Exhibit B.
D. Additionally, 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
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CHILD WELFARE CLIENTS
possible, as sources of supplies, equipment, construction and services. This
assurance is given in consideration of and for the purpose of obtaining any and
all federal and/or state financial assistance.
E. Any person who feels that s/he has been discriminated against has the rightto
file a complaint either with the Colorado Department of Human Services or with
the U.S. Department of Health and Human Services, Office for Civil Rights.
IX. EMPLOYMENT OR CONTRACTING WITH ILLEGAL ALIENS UNDER
COLORADO LAW
Signal certifies that it shall comply with the provisions of Section 8-17.5-101, et
seq., C.R.S., Signal 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 to Signal that the subcontractor shall not knowingly employ or
contract with an illegal alien to perform work under this Contract. Signal represents,
warrants, and agrees that it (a) has verified that it does not employ any illegal
aliens, through participation in the Basic Pilot Employment Verification Program
administered by the Social Security Administration and Department of
Homeland Security, and (b) otherwise comply with the requirements of Section 81-
.5-102(2)(b), C.R.S. Signal shall comply with all reasonable requests made in the
course of an investigation under Section 8-17,5-102, C.R.S., by the Colorado
Department of Labor and Employment. If Signal fails to comply with any
requirements of this provision or Section 8-17.5-101. et seq. C.R.S., Weld County
may terminate this Agreement for breach and Signal shall be liable for actual and
consequential damages to Contractor.
Except where exempted by federal law and except as provided in Section 24-76/5-
103(3), C.R.S, if Signal receives federal or state funds under this Agreement,
Signal must confirm that any individual natural person eighteen (18) years of age
or older is lawfully present in the United States pursuant to Section 24-76.5-103(4),
C.R.S., if such individual applies for public benefits provided under this Agreement.
If Signal 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 product one of the forms of
identification required by Section 24-76/5-101. et seq., C.R.S., and (c) shall
produce one of the forms of identification required by Section 24-76.5-103, C.R.S.,
prior to the effective date of this Agreement.
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SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2020/2021
CHILD WELFARE CLIENTS
X. CERTIFICATIONS
Signal 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 contract.
Xl. MONITORING AND EVALUATION
Signal and WCDHS agree that monitoring and evaluation of the performance of
this Agreement shall be conducted by Signal and WCDHS. The results of the
monitoring and evaluation shall be provided to the Board of Weld County
Commissioners and Signal.
Signal shall permit WCDHS, and any other duly authorized agent or governmental
agency, to monitor all activities conducted by Signal pursuant to the terms of this
Agreement. As the monitoring agency may in its sole discretion deem necessary
or appropriate, such program data, special analyses, on -site checking, formal audit
examinations, or any other reasonable procedures. All such monitoring shall be
performed in a manner that will not unduly interfere with agreement work.
XII. ACCESS TO RECORDS
Signal, its Providers and WCDHS agree to make available in a timely manner, all
books, documents, and records pertinent to this contract for the purpose of billing
for services, audit, and compliance with requirements and regulations of federal
and state agencies and commercial insurance carriers.
Signal acknowledges that in reviewing, storing, processing, or otherwise dealing
with any client records dealing with any client seen by a Signal provider or the on -
site substance abuse counselor is bound by the confidentiality provisions of 42
CFR Part 2. If necessary, Signal shall resist in judicial proceedings any efforts to
obtain access to client records except as permitted by 42 CFR Part 2.
XIII. MODIFICATION OF AGREEMENT
All modifications to this agreement shall be in writing and signed by both parties.
XIV. REMEDIES
A. Signal and WCDHS shall exhaust all remedies as provided in Exhibit E,
"Standards of Procedures for Core Services", if applicable, prior to pursuing any
further remedies provided in this section of theAgreement.
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B. The Director of WCDHS or designee may exercise the following remedial
actions should s/he find Signal 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 Signal that is
not corrected through procedures set forth in Exhibit E. These remedial actions
are as follows:
Provide reasonable advance written notice of perceived failure to
satisfy the scope of work. After Signal receives such notice and a
reasonable opportunity to cure WCDHS may withhold payment of
Signal until the necessary services or corrections in performance are
satisfactorily completed; and
ii. Deny payment or recover reimbursement for those services or
deliverables, which have not been performed and which due to
circumstances caused by Signal cannot be performed or if performed
would be of no value to the WCDHS. Denial of the amount of payment
shall be reasonably related to the amount of work or deliverables lost
to WCDHS; and
iii. Incorrect payment to Signal due to omission, error, fraud, and/or
defalcation shall be recovered from Signal by deduction from
subsequent payments under this Agreement or other agreements
between WCDHS and Signal, or by WCDHS as a debt due to WCDHS
or otherwise as provided by law.
C. Signal may appeal the decision of the Director of WCDHS or designee, as
provided in this Section, by submitting, within thirty (30) calendar days of the
Director's action, and basis of such appeal to the Board of County
Commissioners.
D. Should disputes remain, Signal and WCDHS hereby agree to submit all
unresolved controversies, claims, and disputes arising out of this Agreement to
mediation in Denver, Colorado, according to the commercial rules and
practices of the American Arbitration Association then in force, or pursuant to
other rules or procedures as to which the parties may agree. Mediation is not
binding and regardless of the outcome, each party agrees to fund their own
litigation expenses.
XV. OBLIGATIONS
Obligations of WCDHS and Signal are contingent upon funds for that purpose
being appropriated, budgeted and otherwise made available.
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XVI. PROVISIONS
This Agreement may be amended only by written agreement signed by each of the
parties hereto. This Agreement shall be binding upon and shall inure to the benefit
of the respective parties hereto and shall not be assigned without the consent of
all parties hereto.
XVII. NOTICES:
Any notice required to be given pursuant to the terms and provisions hereof shall
be in writing and shall be sent by certified mail, return receipt requested;
To Signal at:
Daniel Darting
CEO
Signal Behavioral Health Network
6130 Greenwood Plaza Blvd., Suite 150
Greenwood Village, CO 80111
To WCDHS at:
Jamie Ulrich
Director
Weld County Department of Human Services
P.O. Box A
Greeley, CO 80632
XVIII. LITIGATION
Signal shall promptly notify WCDHS in the event that Signal learns of any actual
litigation in which it is a party defendant in a case that involves services provided
under this Agreement. Signal, 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 WCDHS Director. The term "litigation" includes an assignment for the benefit
of creditors, and filings in bankruptcy, reorganization and/or foreclosure.
XIX. MISCELLANEOUS PROVISIONS
A. Headings. The headings of the sections and subsections of this
Agreement are inserted solely for ease of reference and shall not in any
way affect the meaning or interpretation of this Agreement.
B. Non -Assignment. None of the parties shall have the right to assign the
benefits or delegate the obligations in this Agreement without prior written
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consent of the other parties. Subject to the foregoing, this Agreement shall
be binding upon and inure to the benefit of the parties and their respective
heirs, successors, legal or personal representatives and permitted assigns.
C. Waiver of Breach. The waiver of any party of a breach or violation of any
provision of this Agreement shall not operate as, or be construed to be, a
waiver of any subsequent breach of the same or any other provision thereof.
D. Gender and Number. Whenever the context of this Agreement requires,
the gender of all words shall include the masculine, feminine and neuter,
and the number of all words shall include singular and plural.
E. Severability. If any provision of this Agreement is held to be unenforceable
for any reason, the unenforceability thereof shall not affect the remainder of
this Agreement, which shall remain in full force and effect and be
enforceable in accordance with its terms.
F. Counterparts. This Agreement may be executed in duplicate originals,
each of which shall be an original instrument but both of which taken
together shall constitute one and the same instrument.
G. Entire Agreement. This Agreement constitutes the entire understanding
and agreement between the parties with respect to its subject matter and
supersedes all prior agreements or understandings, whether written or
unwritten, with respect to the same subject matter.
H. Non -Exclusivity. Participation in this Agreement shall be non-exclusive
in nature and either party may enter into other Agreements other than
through Signal or WCDHS. The only restriction is on the amount of funding
included in this Agreement. Neither party may enter into other Agreements
that may dilute the funding base in this Agreement.
Hold Harmless. To the extent authorized by law each party agrees to
defend, hold harmless, and indemnify the other party and its affiliates,
directors, trustees, officers, and employees from and against all claims,
demands, suits, judgments, expenses, and costs of any and all kinds arising
as a result of damages or injuries arising out of, or incident to, the
performance or failure of performance of this Agreement by such
indemnifying party or its agents of its duties, obligations, or rights
hereunder.
J. Negligence/Malpractice. In the event that negligence or malpractice of
Signal or an employee of Signal shall subject County to potential or actual
liability, Signal shall hold the WCDHS harmless from all monetary loss
resulting from such liability. This obligation to hold harmless shall, in
addition to any other obligations commonly associated with it, would
obligate Signal to pay all reasonable attorney fees, costs, expenses, and
damages incurred as a result of such liability. Signal acknowledges that the
WCDHS is a department of Weld County and, thus, to the extent authorized
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by law, Signal agrees to indemnify, save, and hold harmless the Board of
County Commissioners of Weld County, or Weld County, or both, against
any and all claims, damages, liability, and the like as above set forth.
The indemnities and assumptions of liabilities and obligations herein
provided for shall continue in full force and effect notwithstanding the
expiration or termination of this Agreement.
K. 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 actions 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.
L. 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, Signal agrees that the Weld County District Court shall have
exclusive jurisdiction to resolve said dispute.
M. 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 §§24-10-101 et seq., as applicable now or
hereafter amended.
APPROVED BY:
7/23/2020
Daniel Darting, Chief Executive Officer Date
SIGNAL BEHAVIORAL HEALTH NETWORK
Mike Freeman, Chair
' EL COUNTY BO RD OF COUNTY COMMISSIONERS
.( n
Jam
WEI
AUG 0 5 2020
Date
Ulrich, Director Date
COUNTY DEPARTMENT OF HUMAN SERVICES
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SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2020/2021
CHILD WELFARE CLIENTS
EXHIBIT A - COMPENSATION
Compensation
WCDHS agrees to contract with Signal for a maximum of $300,000 from their Core
Service Funding.
Signal agrees to contribute a maximum of $150,000 annually from designated OBH
Additional Family Service (AFS) funds to serve eligible clients in accordance with the
terms herein.
Signal's administration fee shall be calculated as five percent of the service fees, salaries,
and other authorized costs that are actually incurred in the delivery of treatment services.
Signal's administration fee shall obligate Signal to perform, or deliver, the responsibilities,
services, and reports specifically mentioned in this agreement. Other requested services
or reports may be considered outside the scope of this agreement and, therefore, subject
to an additional fee.
Some Core Service funds may be used to pay for some counselor services and some
Core funds will be dedicated to pay for drug tests and other authorized services. Some
AFS funds may be used to pay for some counselor services and some AFS funds will be
dedicated to paying for withdrawal management, outpatient, residential treatment (TRT
or IRT) at AFS funded providers in the Signal network and/or for other authorized
treatment services. Medicaid will be billed first when available to pay for the services.
Signal will utilize Core and/or AFS monies to pay for services in cooperation with the Core
Services Coordinator. The WCDHS Core Services Coordinator will initially place all
clients under either Core or AFS funding source for off -site services. Any changes that
switch clients to another funding source will be mutually decided by the Core Services
Coordinator and Signal prior to switching the funding source. If the parties fail to agree,
the procedures contained in Exhibit E, shall be followed. All services for clients that have
been designated as approved for services as of 6/1/2020 for Core or 7/1/2020 for AFS
will be billed to either funding source according to the designation in effect on 6/1/2020.
WCDHS will share a list of these clients and compare with a list that Signal produces to
make sure that the lists from both entities are in agreement.
Payment
A. Responsibilities
1. Signal shall submit an itemized monthly bill to WCDHS for all costs
incurred and services provided in accordance with criteria established
by WCDHS and Signal. Requests to modify criteria must be provided
with 30 days advance notice. Signal shall submit all itemized monthly
billings to WCDHS no later than the 7th of the month following the
current month the cost was incurred in accordance with the Trails
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WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2020/2021
CHILD WELFARE CLIENTS
payroll calendar. Monthly billings received after 60 days from the date
of services my result in delay or forfeiture of payment.
2 Signal shall make available, on its web site, monthly billing reports in
accordance with the billing criteria established by WCDHS no later than
the 7th of the month following the month of service. Monthly client
progress reports must be made available to the Core Services
Caseworker, in the format provided by the Department, for download
from the Signal database by the 7th of the month following the date of
service. Signal's contracted providers will be required by Signal to input
the monthly progress information into the Signal database prior to their
ability to bill service charges for that client. Any incomplete progress
report will be deemed incomplete and all such associated services will
be pended.
3. Failure to submit monthly billings and/or monthly client reports in
accordance with the terms of this agreement or to comply with the
Financial Management Requirements, program objective or other
contractual terms or program objectives may result in Signal's forfeiture
of all rights to be reimbursed for such expenses. In the event of a
forfeiture of reimbursement, Signal may appeal such circumstance in
accordance with the Remedies Section of this Agreement.
4 WCDHS shall not be billed for, and reimbursement shall not be made
for, time involved in activities outside of those defined in Exhibit C,
"Scope of Services" and this Exhibit's Fee for Reimbursement
Schedule. Work performed prior to the execution of this Contract shall
not be reimbursed or considered part of this Agreement.
5. Signal shall provide proper monthly invoices, make available monthly
progress reports for each client incurring charges, and verification of
services performed for costs incurred in the performance of the
agreement.
AFS and Core Services Reimbursement
Funding Sources
AFS
Core
Total
On -Site Salaries and Benefits
-
-
-
Supplies, Supervision and Travel
-
-
-
Subtotal-Onsite Costs
-
-
-
Admin Fee
-
-
-
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SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2020/2021
CHILD WELFARE CLIENTS
Total Onsite Costs
-
-
-
Fee -for -service funding
$142,857
$ 285,714
$ 428,571
Signal Fee
$ 7,143
$ 14,286
$ 21,429
Total fee -for -service
$ 150,000
$ 300,000
$ 450,000
Total Contract Costs
$ 150,000
$ 300,000
$ 450,000
Fee -For -Service Reimbursement
County Core Services and Signal AFS funding will be responsible for purchasing services
in accordance with the schedule below (to a maximum funding specified in the contract
language).
The County and Signal acknowledge that all UA services MUST be physically
monitored/observed by an individual in order for payment to be considered.
The County and Signal further acknowledge that any and all monitoring beyond standard
urinalysis or breathalyzer tests must be approved by the County prior to administration.
Service Code
Value
Service Code Description
Unit of Measure
Description
Payor
Rate
80100:HF
UA - Ethyl Glucuronide (EtG)
Each
$ 31.50
80101:AC
UA - 5 Panel w/Auto-Confirmation
Each
$ 15.75
80101:AO
UA - Optional Add -On Panel
Each
$ 2.10
81002
UA - Multi -panel instant
Each
$ 15.75
82055
Oral Swab - Lab or instant
Each
$ 15.75
82055:OF
Oral Fluid Panel
Each
$ 17.85
82055:OS
Oral Swab - Synthetic Cannabinoids
(Spice)
Each
$ 36.75
82055:SC
UA - Synthetic Cannabinoids (Spice)
Each
$ 36.75
82075
Breathalyzer
Each
$ 5.25
82541
GC/MS - Qualitative
Each
$ 36.75
82542
GC/MS - Quantitative
Each
$ 36.75
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SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2020/2021
CHILD WELFARE CLIENTS
83000:80
Expanded Designer Stimulants - 14 panel
Each
$ 52.50
83000:81
MDPV & Mephedrone (Bath Salts)
Each
$ 36.75
84999
Hair Testing
Each
$105.00
94664
SUD Inhalant Drug Screen (Vapor
inhalations evaluation)
Each
$ 63.00
99075
DEPRECATED: Medical testimony (travel,
wait, prep time)
15 Minute
Session(s)
$ 21.00
99199
DEPRECATED: Court Case Consultation
15 Minute
Session(s)
$ 10.50
B0020
Beacon - Opioid Replacement
(Methadone), per month
Month(s)
$435.75
H0001:HH
Evaluation: III
Each
$262.50
H0001:11
Evaluation: I1
Each
$183.75
H0004
Individual Counseling
15 Minute
Session(s)
$ 31.50
H0004:HE:GT
Individual Counseling w/HE:GT modifier
15 Minute
Session(s)
$ 31.50
H0004:HE:HF
:GT
Individual Counseling w/HE:HF:GT
modifier
15 Minute
Session(s)
$ 31.50
H0005
Group Counseling
Hour(s)
$ 26.29
H0005:HE:GT
Group Counseling
Hour(s)
$ 26.29
H0005:HR
Group counseling: Family/Couple with
client present
15 Minute
Session(s)
$ 26.29
H0005:HS
Group counseling: Family/couple without
client present
15 Minute
Session(s)
$ 26.25
H0006
Case Management
15 Minute
Session(s)
$ -
H0006:HE:GT
Case Management w/HE:GT modifier
15 Minute
Session(s)
$ -
H0006:HE:HF
:GT
Case Management w/HE:HF:GT modifier
15 Minute
Session(s)
$ -
H0011
Detox
Day(s)
$315.00
H0018:HA
Intensive Short -Term Residential:
Adolescent
Day(s)
$239.40
H0018:HB
Intensive Short -Term Residential: Adult
Day(s)
$204.75
H0019
Transitional Long -Term Residential
Day(s)
$183.75
H0019:HA
Therapeutic Behavioral Srvcs: Adolescent,
per diem
Day(s)
$131.25
H0019:HB
Therapeutic Behavioral Srvcs: Adult w/o
Infant, per diem
Day(s)
$ 61.95
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SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2020/2021
CHILD WELFARE CLIENTS
H0019:HD
Therapeutic Behavioral Srvcs:
Preg/Parent, per diem
Day(s)
$104.48
H0019:HD
Transitional Long -Term Residential:
Preg/Parent (NDF)
Day(s)
$204.75
H0020
Opioid Replacement (Methadone), per
encounter
Each
$ 14.52
H0038
Self-Help/Peer Services, per 15 minutes
15 Minute
Session(s)
$ 7.49
H0038:CG
Peer Services Recovery Groups
15 Minute
Session(s)
$ 15.75
H0038:HE:GT
Self-Help/Peer Services, per 15 minutes
w/HE:GT modifier
15 Minute
Session(s)
$ 7.49
H0038:HE:HF
:GT
Self-Help/Peer Services, per 15 minutes
w/HE:HF:GT modifier
15 Minute
Session(s)
$ 7.49
H0048:HF
Drug Screen Collection w/HF Modifier
(Drug Patch Monitoring)
Each
$ 52.50
H2012:HA
Day Treatment: Adolescent
Hour(s)
$ 10.36
H2012:HB
Day Treatment: Adult
Hour(s)
$ 7.25
H2033:F
FFT Daily
Day(s)
$ 36.75
H2033:M
MST Daily
Day(s)
$ 68.25
H3000:HL
In -home Addictions Treatment: High Level
Day(s)
$ 56.00
H3000:LL
In -home Addictions Treatment: Low Level
Day(s)
$ 28.00
T1006
Family Counseling
Hour(s)
$ 88.20
80100:HF
UA - Ethyl Glucuronide (EtG)
Each
$ 31.50
80101:AC
UA - 5 Panel w/Auto-Confirmation
Each
$ 15.75
80101:AO
UA - Optional Add -On Panel
Each
$ 2.10
81002
UA - Multi -panel instant
Each
$ 15.75
82055
Oral Swab - Lab or instant
Each
$ 15.75
82055:OF
Oral Fluid Panel
Each
$ 17.85
82055:OS
Oral Swab - Synthetic Cannabinoids
(Spice)
Each
$ 36.75
82055:SC
UA - Synthetic Cannabinoids (Spice)
Each
$ 36.75
82075
Breathalyzer
Each
$ 5.25
82541
GC/MS - Qualitative
Each
$ 36.75
82542
GC/MS - Quantitative
Each
$ 36.75
83000:80
Expanded Designer Stimulants - 14 panel
Each
$ 52.50
83000:81
MDPV & Mephedrone (Bath Salts)
Each
$ 36.75
84999
Hair Testing
Each
$105.00
94664
SUD Inhalant Drug Screen (Vapor
inhalations evaluation)
Each
$ 63.00
99075
DEPRECATED: Medical testimony (travel,
wait, prep time)
15 Minute
Session(s)
$ 21.00
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SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2020/2021
CHILD WELFARE CLIENTS
99199
DEPRECATED: Court Case Consultation
15 Minute
Session(s)
$ 10.50
B0020
Beacon - Opioid Replacement
(Methadone), per month
Month(s)
$435.75
H0001:HH
Evaluation: III
Each
$262.50
H0001:ll
Evaluation: II
Each
$183.75
H0004
Individual Counseling
15 Minute
Session(s)
$ 31.50
H0004:HE:GT
Individual Counseling w/HE:GT modifier
15 Minute
Session(s)
$ 31.50
H0004:HE:HF
:GT
Individual Counseling w/HE:HF:GT
modifier
15 Minute
Session(s)
$ 31.50
H0005
Group Counseling
Hour(s)
$ 26.29
H0005:HE:GT
Group Counseling
Hour(s)
$ 26.29
H0005:HR
Group counseling: Family/Couple with
client present
15 Minute
Session(s)
$ 26.29
H0005:HS
Group counseling: Family/couple without
client present
15 Minute
Session(s)
$ 26.25
H0006
Case Management
15 Minute
Session(s)
$ -
H0006:HE:GT
Case Management w/HE:GT modifier
15 Minute
Session(s)
$ -
H0006:HE:HF
:GT
Case Management w/HE:HF:GT modifier
15 Minute
Session(s)
$ -
H0011
Detox
Day(s)
$315.00
H0018:HA
Intensive Short -Term Residential:
Adolescent
Day(s)
$239.40
H0018:HB
Intensive Short -Term Residential: Adult
Day(s)
$204.75
H0019
Transitional Long -Term Residential
Day(s)
$183.75
H0019:HA
Therapeutic Behavioral Srvcs: Adolescent,
per diem
Day(s)
$131.25
H0019:HB
Therapeutic Behavioral Srvcs: Adult w/o
Infant, per diem
Day(s)
$ 61.95
H0019:HD
Therapeutic Behavioral Srvcs:
Preg/Parent, per diem
Day(s)
$104.48
H0019:HD
Transitional Long -Term Residential:
Preg/Parent (NDF)
Day(s)
$204.75
H0020
Opioid Replacement (Methadone), per
encounter
Each
$ 14.52
H0038
Self-Help/Peer Services, per 15 minutes
15 Minute
Session(s)
$ 7.49
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SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2020/2021
CHILD WELFARE CLIENTS
H0038:CG
Peer Services Recovery Groups
15 Minute
Session(s)
$ 15.75
H0038:HE:GT
Self-Help/Peer Services, per 15 minutes
w/HE:GT modifier
15 Minute
Session(s)
$ 7.49
H0038:HE:HF
:GT
Self-Help/Peer Services, per 15 minutes
w/HE:HF:GT modifier
15 Minute
Session(s)
$ 7.49
H0048:HF
Drug Screen Collection w/HF Modifier
(Drug Patch Monitoring)
Each
$ 52.50
H2012:HA
Day Treatment: Adolescent
Hour(s)
$ 10.36
H2012:HB
Day Treatment: Adult
Hour(s)
$ 7.25
H2033:F
FFT Daily
Day(s)
$ 36.75
H2033:M
MST Daily
Day(s)
$ 68.25
H3000:HL
In -home Addictions Treatment: High Level
Day(s)
$ 56.00
H3000:LL
In -home Addictions Treatment: Low Level
Day(s)
$ 28.00
T1006
Family Counseling
Hour(s)
$ 88.20
Signal, in accordance with Federal HIPAA regulations, adopted a standard transaction
code set for all treatment services on October 16, 2003, which are subject to change
throughout each contract year. Even though this compliance changed the service
labels and groupings (shown above), the net amount of the fees associated with those
services has not changed.
The following services are available exclusively through AFS funds and must be
purchased in conjunction with the residential treatment services described in the fee -for -
service schedule above:
Service
Code
Service Code Description
Units Measured
Payer
Rate
S9976:HB
Room & Board: Adult: ARTS
Daily
$17.72
S9976:HB
Room & Board: Adult: Community Reach
Daily
$63.00
S9976:HB
Room & Board: Adult: Crossroads
Daily
$42.00
S9976:HB
Room & Board: Adult: North Range Beh. Health
Daily
$68.25
S9976:HB
Room & Board: Adult: RESADA
Daily
$18.90
S9976:HB
Room & Board: Adult: Sobriety House
Daily
$23.10
S9976:HB
Room & Board: Adult: Stout Street
Daily
$30.00
S9976:HD
Room & Board: Preg/Parent: ARTS
Daily
$17.72
S9976:HD
Room & Board: Preg/Parent: MHBH/TBD
Daily
$68.25
S9976:HD
Room & Board:/ Preg/Parent: North Range
Daily
$89.25
S9976:HD
Room & Board: Preg/Parent: Crossroads
Daily
$52.50
S9976:HD
Room & Board: Preg/Parent: RESADA
Daily
$18.90
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SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2020/2021
CHILD WELFARE CLIENTS
EXHIBIT B
SIGNAL BEHAVIORAL HEALTH NETWORK
QUALIFIED SERVICE ORGANIZATION AGREEMENT
Signal Behavioral Health Network (MSO) and Weld County Department of Human
Services (WCDHS) hereby enter into a Qualified Service Organization Agreement
(QSOA) whereby the MSO agrees to accept and serve WCDHS clients' substance abuse
treatment needs. In light of the relationship between WCDHS and the MSO, WCDHS
requires client identifying information and data and information related to the services
furnished to the clients. WCDHS and MSO will have this relationship from June 1, 2020
- June 30, 2021, thus the QSOA will be in effect during this period.
Furthermore, WCDHS:
1. acknowledges that in receiving, storing, processing, or otherwise dealing with
any information from the MSO about the clients in the MSO's program, it is fully bound by
the provisions of the federal regulations governing Confidentiality of Alcohol and Drug
Abuse Patient Records, 42 CFR Part 2; and
2. undertakes to resist in judicial proceedings any effort to obtain access to
information pertaining to clients otherwise than as expressly provided for in the federal
confidentiality regulations, 42 CFR Part 2.
Executed this 1 day of -dttly JUNE, 2020.
Daniel Darting
Chief Executive Officer
Signal Behavioral Health Network
20 of 34
e Ulrich :erector
W:l a County Department of Human
Se r ices
02O -O 37_3
SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2020/2021
CHILD WELFARE CLIENTS
EXHIBIT C - SCOPE OF SERVICES
(Associated with H3000:HL and H3000:LL in attached rate sheet)
A. IN -HOME ADDICTION TREATMENT PROGRAM
Turning Point
Substance Abuse Treatment
Scope of Services for State Fiscal Year 2020- 2021
The In -Home Addictions Treatment Program (IHAT) is an intensive in -home therapy
program designed to serve at -risk families that have come to the attention of the
Department due to drug/alcohol concerns. Clients referred to the IHAT program typically
have a mental health and/or substance abuse disorder, and are continuing to struggle
despite having been treated at lower levels of care such as outpatient therapy. Families
served in the program often have a history that may include inpatient substance abuse
treatment, trauma, criminal and/or delinquent behaviors, verbal or physical aggression,
or attachment difficulties.
Features of the program include:
• Intensive short-term treatment, averaging 4 to 5 months in duration.
• Two sessions per week in -home (or 1 session and phone consultation,
dependent on client need).
• Availability of on —call services 24 hours a day 7 days a week.
• Case consultation with collaterals such as treatment providers (SA and MH),
school personnel, probation, DHS, etc.
• Therapist flexibility in terms of drawing from a variety of evidence -informed
treatment models including: Seeking Safety, Dialectical Behavioral Therapy,
Trauma Informed Cognitive Behavioral Therapy, Cognitive Behavioral Therapy,
Solution Focused Therapy, and behavior management techniques.
• Drug testing of clients as therapeutically necessary.
• Therapist flexibility in terms of modality of treatment used (parents -only sessions,
family therapy, occasional individual therapy, or some of each).
• Focus of treatment that is highly parent/family oriented and interventions
designed to be sustainable for the family.
• Support in linking to other therapeutic services as appropriate including coaching,
medication evaluation and management, substance abuse treatment, DBT
programming, trauma focused services, etc.
• Integrating social supports into family treatment planning. Establishing positive
daily life routines. Develop family stable patterns: Rules, Roes, Rituals, Routines,
Relationships (Barnes, 1995).
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SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2020/2021
CHILD WELFARE CLIENTS
• Additional interventions for parents of delinquent adolescents around
monitoring/supervision, holding youth accountable for behavior and choices, and
therapists will collaborate closely with the juvenile justice system.
Rate of Payment (to Turning Point) and Service Description:
High -end Service
4-6 hours a week of Therapist intervention $1600/month per family OR
2-3 hours a week of Case Manager $53.33/day per family
Low -end Service
2-3 hours a week of Therapist Intervention $800/month per family OR
1-2 hours a week of Case Manager $26.67/day per family
B. ASSESSMENTS
1. Alcohol and Drug Differential Assessment (3 -Hours)
Assessment will evaluate alcohol/drug involvement as well as mental health
status, history of mental health issues, sexual history, legal history, and certain
standard tests (ASAP, ASAM PPC-2, ASI, SOCRATE, AODUI, Drinking
History Questionnaire, Family Environment Scale) may be given. Signal will
provide two collateral contacts as part of the Assessment.
2. Co -Occurring Alcohol and Drug with Domestic Violence Assessment (3 -
Hours)
Summary of assessment with recommendations sent to referring agency.
The following areas will be assessed:
Criminal History
Profile of Client's Violent
Behaviors
Potential for Violence
Mental Health Status
Client's Medical History
Substance Abuse History
Suicidal/Psychological/Cultural
History
Milton Test, if needed
3. Substance Abuse Forensic Evaluation (3 hours, as staff expertise permits)
A forensic evaluation is specifically geared toward the substance -abusing
offender. It involves additional testing to determine the crimogenic aspect of
the person to be taken into consideration when developing treatment
recommendations. Testing will be comprised of CVI, ASUS, SASSI, Milton
Clinical Multiaxial Inventory (MCMI-III), a clinical interview, and a behavioral
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SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2020/2021
CHILD WELFARE CLIENTS
profile. The testing is cross-referenced with the clinical interview, and in
relation to collateral data.
4. Evaluation: II - Level II Assessment
A Level II Assessment is the initial diagnostic interview enrolling a client in
services. It is conducted by a Master's Level Therapist (OR AT THE
MINIMUM A CAC II OR III). A Level II is typically completed in 1-1.5 hours.
Areas addressed:
Referral information and Chief Complaint / Precipitating Event(s)
Presenting Problem
Psychosocial History
Legal History
Abuse and/or Victimization History
Strengths, Resources and Needs
Prior Treatment History
Drug and Alcohol History and Assessment
Medical History
Mental Status
DSM Diagnosis and Rationale
Risk Assessment
Level of Care Assessment
Disposition and Recommendations for treatment
5. Evaluation: Ill - Level III Assessment
In addition to all areas identified in the Level II assessment, a Level III may
include the use of assessment tools and/or include extensive history review
and collateral input as appropriate. A Level III Assessment is always
completed by a dually trained and credentialed (license and certification)
Behavioral Health Therapist so that, if necessary, he or she can act as an
expert witness. A Level III is typically completed over the course of 2-3
hours. All Co -Occurring Alcohol or Drug with Domestic Violence or Anger
Management assessments will be billed at the Evaluation: III rate.
The primary difference between a level II and level III assessment is the amount of time
involved (2-3 hours for a level III versus 1-2 hours for a level II). A level III assessment
requires more time and is more in-depth than a level II assessment. A level III
assessment also includes more lengthy documentation, typically will involve more
collateral contacts, and is suitable for court purposes. Both assessments assess
substance abuse and mental health issues/concerns. However, we do not dictate which
tools are used for each level of assessment. As indicated in the contract, a level III
assessment is always conducted by a duly trained and certified/licensed individual who
can act as an expert witness if necessary.
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SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2020/2021
CHILD WELFARE CLIENTS
Level III assessments are typically requested by outside agencies for the purposes of
obtaining clear information on treatment recommendations and prognoses (e.g.,
likelihood of continued risky behaviors). Collateral information/contacts are required (not
just typical) in order to better understand the reason for the referring parties request for
an evaluation, and a more formal written report is provided (e.g., no abbreviations or
jargon, more comprehensive psychosocial history) so the referral source better
understands the issues, and treatment recommendations and prognoses (e.g., likelihood
of continued risky behaviors) are more formally addressed, as they pertain to the reason
for the referral. Formal psychological testing is not administered for a Level III
assessment.
C. TREATMENT OPTIONS
1. Co -Occurring Alcohol and Drug with Domestic Violence Group Therapy
(average length of treatment, 24 to 36 weeks): Groups for both men and
women are offered. The group addresses anger management, healthy
relationships, male and female roles, and boundaries. As needed, a Milton
Test may be given, a standardized psychological test which measures
functioning level in 22 personality disorders and clinical syndromes for
adults (8th grade reading level: > 18; available in Spanish).
2 Family Therapy (average length of treatment, 8 to 16 sessions):
Involves two or more family members and provides therapeutic intervention
to improve family communications, functioning, and relationships. Length
of participation is dependent on client goals and progress toward meeting
goals.
3 Individual Counseling (average length of treatment, 6 to 12 sessions):
Primary client is seen on an individual basis. Length of participation is
dependent on client goals and progress toward goals.
4. Substance Abuse Therapy (average length of treatment, 12 to 20
sessions): A group to enhance positive coping skills by focusing on their
lifestyle dealing with use and abuse of chemicals.
5. Adult Intensive Outpatient (average length of treatment, 4 to 12
weeks): An intensive outpatient group therapy track that offers groups
every evening, Monday through Friday, with a family program component.
This program will include medical aspects of addiction and adult relapse
education components focusing on understanding the relapse process as
well as group process (focuses on individual issues relating to their abuse
of alcohol). The program length and participation level will be individualized
based on the presenting issues and other factors.
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6. Women's Group (average length of treatment, 12-20 sessions): A
gender -specific group addressing issues affecting women and their
relationships, such as family violence, co-dependency, self-esteem and
stress management.
7. Motivational Enhancement Therapy and Cognitive Behavioral Therapy
for Adolescent Cannabis Users (MET/CBT5 average length of
treatment 5-8 weeks): The MET/CBT5 is a brief treatment approach for
cannabis abusing adolescents. Treatment consists of two individual
motivational enhancement therapy sessions (MET) Sessions, followed by
participation in three group cognitive behavioral therapy (CBT) sessions.
The assessment includes a psychosocial history and data from the Global
Assessment of Individual Needs (GAIN), and a personalized feedback
report.
8. Adolescent Intensive Outpatient (length of treatment - 3 to 12 weeks):
This intensive outpatient track offers therapy and education groups
utilizing the Matrix Model for Youth and Young adults curriculum. Groups
are offered Monday through Friday. This program also provides individual
and family therapy as well as family group therapy. Topics addressed
include the medical aspects of addiction and relapse -prevention education
focusing on understanding the relapse process. The program length and
participation level will be individualized based on the presenting issues
and other factors.
D. SPECIAL PROGRAM OPTION
1. Special Connections (through pregnancy and up to one year
postpartum): A gender -specific program that focuses on healthy babies,
appropriate child care, prenatal care, birth control, developmental stages of
the baby, parenting skills, relationship issues, and other issues as identified
by the counselor. Services include group and individual therapy, case
management and family health education.
E. MISCELLANEOUS SERVICE OPTIONS
1. Extended Detoxify Stay: This is an option when case management goals
require that the person be in a stable environment until they can be referred
to the next level of care.
2. Enhanced Services: Enhanced services as approved services that are
requested by WCDHS for specific cases, which fall outside of the
definitions, listed above in the description of the DBH menu of services.
Enhanced services may be services not described on the menu, services
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not included in the definition or due to lack of economy of scale, or rural
location, or result in additional costs to Signal. In order for Signal to provide
enhanced service, the cost would be outside of the approved rates. Any
additional fees would be negotiated on a case -by -case basis.
Signal can arrange for services outside of the approved definitions, but
WCDHS will be charged an additional fee that would be negotiated on a
case -by -case basis by the designated representative listed in the contract.
F. MEASURABLE OUTCOMES AND OBJECTIVES
Signal shall abide by WCDHS outcome indicators of Safety, Permanency and
Child and Family Well -Being, which are provided under Adoption and Safe
Families Act (ASFA), 1997; Colorado Child and Family Services Plan 2000 -2004;
and ACF Reviews (Reference: Federal Register, Volume 65, Number 16: 45 CRF
Parts 1355, 1356, and 1357), March 25, 2000.
1. Outcome Reports as Prescribed by Human Services
2. Outcome reports will be developed and provided as mutually agreed
upon by the parties.
3. Client Objectives
The WCDHS caseworker will identify a maximum of three child welfare
objectives to be addressed within each client's treatment plan. Signal shall
develop action steps to reach the identified child welfare objectives. Signal
shall report monthly on each client's progress in meeting the three identified
objectives while the client is receiving treatment services.
4. Overall Program Objectives
Signal and WCDHS agree to monitor the ability of the substance abuse
program offered by Signal to achieve objectives as follows:
a. Demonstrate Abstinence with the use of UA/Patch Monitoring Only.
b. Improve parental capabilities currently impaired by substance abuse.
c. Develop the capacity to ask for help and assistance without resorting
back to substance abuse.
d. Develop or increase the ability to recognize, prioritize and meet
child(ren)'s needs.
e. Parent will identify how their substance use has affected their
parenting.
f. Parent will identify how their substance use got them involved with
Human Services.
g. Parent will identify how their substance use helped them parent.
h. Parent will identify relapse triggers and develop a safety plan for their
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children.
Parent will identify whom they consider to be a support in their
recovery.
j. Parent will identify who will care for their children should they relapse.
k. Parent will identify what they enjoy about parenting sober.
Improve parent -child functioning to lower the risk of out of home
placement.
m. Parent will support their children in speaking about how living in a
substance -effected family has impacted them.
n. Parents will demonstrate increased verbal skills, empathy and
accountability with child(ren).
o. Parent will identify their parenting strengths.
p. Family members including significant other, children and extended
family will increase ability to communicate more effectively.
q. Family members will identify how they can support the identified
client in their recovery.
r. Family members will identify the positive parenting changes the
substance -effected person is making.
s. Family members will identify who will care for the children in the
event of a relapse.
t. Family members will identify relapse systems of the identified client.
u. Family members will identify how they can reach out for help if a
relapse occurs.
v. Increase level of functioning currently impaired by living in a
substance affected family.
w. Identify how living in substance affected family has impacted their life
x. Improve level of functioning currently impaired by substance abuse
issues.
y. Decrease aggressive behaviors at home and/or school and in the
community.
z. Learn how to socialize without the use of substances.
aa. Identify relapse triggers.
bb. Create a sober support network.
G. STAFF QUALIFICATIONS
Signal staff members who will provide services to WCDHS clients will have
credentials and/or certifications as required by the Colorado Department of Human
Services, Colorado Board of Education, Division of Behavioral Health, and the
Colorado Board of Medical Examiners.
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EXHIBIT D - ASSURANCES
1. No portion of this Contract shall be deemed to constitute a waiver of any immunities
the parties or their officers or employees may possess, not shall any portion of this
Agreement be deemed to have created a duty of care with respect to any persons
not a party of this Agreement.
2. No portion of this Contract 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.
3. 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.
4. Signal assures that sufficient, auditable, and otherwise adequate records that will
provide accurate, current, separate, and complete disclosure of the status of the
funds received under the Contract are maintained for four (4) years or the until the
completion and resolution of an audit, whichever is later. Such records shall be
sufficient to allow authorized local, Federal, and State auditors, and
representatives to audit and monitor Signal.
5. All such records, documents, communications, and other materials shall be the
property of WCDHS and shall be maintained by Signal, in a central location and
as custodian, on behalf of WCDHS, for a period of four (4) years from the date of
final payment under this Contract, 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 four (4) year
period, or if audit findings have not been resolved after a four (4) year period, the
materials shall be retained until the resolution of the audit finding.
6. Signal assures that authorized local, federal, and state auditors and
representatives shall, during business hours, have access to inspect any copy
records, and shall be allowed to monitor and review through on -site visits, all
contract activities, supported with funds under this Contract 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.
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7. Signal certifies that federal appropriated funds have not been paid or will be paid,
by or on behalf of Signal, 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 any Federal
contract, loan, grant, or cooperative agreement.
8. Signal assures that it will fully comply with all other applicable federal and state
laws. Signal understands that the source of funds to be used under this Contract
is: Colorado Core Services substance abuse treatment funds.
9. Signal assures and certifies that it and its principals:
A. Are not presently debarred, suspended, proposed for debarment, declared
ineligible, or voluntarily excluded from covered transaction by a federal
department of agency.
B. Have not, within a three-year period of preceding this Agreement, been
convicted of, or had a civil judgment rendered against them for commission
of fraud or a criminal offense in connection with obtaining, attempting to
obtain, or performing a public (federal, state, or local) transaction or contract
under a public transaction; violation of federal or state antitrust statutes or
commission of embezzlement, theft, forgery, bribery, falsification or
destruction of records, making false statements, or receiving stolen
property;
C. Are not presently indicted for or otherwise criminally or civilly charged by a
government entity (federal, state, or local) with commission of any of the
offenses enumerated in paragraph 9(B) of this certification; and
D. Have not within a three-year period preceding this Contract, had one or
more public transactions (federal, state, and local) terminated for cause or
default.
10. The Appearance of Conflict of Interest applies to the relationship of Signal with
WCDHS when Signal 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 Signal to gain from knowledge of these opposing
interests. It is only necessary that Signal know that the two relationships are in
opposition. During the term of the Contract, Signal shall not enter any third -party
relationship that gives the appearance of creating a conflict of interest. Upon
learning of an existing appearance of a conflict of interest situation, Signal shall
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submit to WCDHS, 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 WCDHS'
termination, for cause, of its contract with Signal.
11. Signal shall protect the confidentiality of all applicant records and other materials
that are maintained in accordance with this Contract. Except for purposes directly
connected to the administration of Child Protection, no information about or
obtained from any applicant/recipient in possession of Signal shall be disclosed in
a form identifiable with the applicant/recipient or a minor's parent or guardian
unless in accordance with Signal written policies governing access to, duplication
and dissemination of, all such information. Signal shall advise its employees,
agents, and sub -providers of Signal, if any, that they are subject to these
confidentiality requirements. Signal shall provide its employees, agents, and sub -
providers of Signal, if any, with a copy or written explanation of these confidentiality
requirements before access to confidential data is permitted.
12. Proprietary information for the purposes of this contract is information relating toa
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
Contract. Any proprietary information removed from the State's site by Signal in
the course of providing services under this Contract will be accorded at least the
same precautions as are employed by Signal for similar information in the course
of its own business.
13. Signal certifies it will abide by Colorado Revised Statue (C.R.S.) 26-6-104,
requiring criminal background record checks for all employees, contractors, and
sub -contractors.
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EXHIBIT E- STANDARDS OF PROCEDURES FOR CORE SERVICES
1. Signal and WCDHS agree to develop a case management plan (aka substance
abuse treatment plan) on each referred family within 30 days of the date the Signal
received the referral. The case management plan will be monitored and modified
monthly to measure progress toward goals. Copies of the case management plan
must be sent to the caseworker, program area supervisor, and Core and Service
Contract Coordinator at Weld County Department of Human Services, P. O. Box
A, 822 7th Street, Suite 150, Greeley, Colorado 80632. The case management
plan will include, at a minimum, goals, timelines, and measurement of success.
2. Signal agrees that payments for levels of care are not authorized for
reimbursement by WCDHS until a referral from WCDHS is provided to Signal. A
referral must be received prior to services rendered by Signal. Furthermore, Signal
and its providers agree that any monitoring in conjunction with treatment beyond
standard urinalysis and breathalyzer tests, as well as changes in level of care are
not authorized for reimbursement by WCDHS until staffed with designated
WCDHS staff. WCDHS agrees to identify designated staff that may provide this
authorization.
3. Signal agrees not to accept any referral from WCDHS unless the referral contains
all information required on the form and necessary for reimbursement by WCDHS
and authorized for reimbursement. If Signal accepts the referral without all data
fields required on the referral form or authorization, Signal may assume fiscal
responsibility for the services provided under the incomplete referral. Inaccurate
information listed on the referral form by WCDHS will be excluded as a fiscal
responsibility for Signal.
4. Signal agrees to provide access to all monthly client progress reports for clients
with treatment charges by the 7th day after the month of service, via the Signal
website. The monthly progress report for each client must be entered into the
Signal Service Management website by the provider previous to the monthly billing
claims in order for payment to be honored. Failure to submit such monthly reports
will result in delays or forfeiture of payment. It is expected, at a minimum, that
these reports will reflect all information requested on the Monthly Progress Report.
5. Signal agrees to submit a final discharge summary of client outcomes to Human
Services within thirty (30) calendar days after the completion date.
6. Signal agrees to report expenditures and case disbursement at agreed upon times.
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7. Signal agrees to assume fiscal responsibility for expenses incurred by Signal that
do not meet the requirements of this Exhibit and Agreement. Those expenses
incurred by Signal outside of the requirements of this Agreement are not eligible
WCDHS expenditures and shall not be reimbursed by WCDHS.
8. Signal agrees to the definition of a complete and timely billing form for purposes of
submitting an original bill under as described in this Exhibit. A complete and timely
billing form must include the following elements.
A. The billing must include all forms designed for Core Services reimbursement
and approved by WCDHS; Core Services Authorization of Funds, Project
Report, Update Report, and original signed client verification forms for
therapy and group services. Additionally, Signal agrees to provide WCDHS
monitoring results (UA, BA, patch, tox trap swab) by faxing said results to
WCDHS at 970.346-7667 or via access to online system no later than 72
hours after the day of service.
B. The Department will determine billed services not eligible for payment by
identifying conflicts in the following:
1. Details provided in client referrals and renewals, including approved
hours of service, begin and end dates of service, client name, and
Case ID.
2 Details in supporting documentation provided by the Provider and
submitted with the original bill, including, but not limited to, original
signed client verifications, receipt of monitoring results, time of service
and units or hours of service provided, and names of clients receiving
the services, and monthly progress reports with all the information
specified on the Monthly Progress Report.
3 Details provided in the current approved contract and Notification of
Financial Assistance, including, but not limited to unit of service, cost
per unit of service, and special conditions and/or revisions to said
contract.
C. The above items, 8 B,1, 2, and 3, will supersede all requests from Signal
for review of billing errors. Items submitted for billing will be processed
according to the criteria established by the above documentation. The
Department will make obvious corrections to minor errors in the bill in order
to expedite processing the claims for payment. Minor errors include missing
or transposed digits in Household Numbers, TRAILS Case ID, or other
Department -generated information.
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D. An Administrative fee will be assessed to all fees reimbursed through County
only funding. Such fees include, but are not limited to, those service fees
previously billed and determined by the Department to be not eligible for
payment.
9. Signal will develop and utilize evaluation tools (pre- and post -assessment test
instruments) to collect necessary data in cooperation with WCDHS staff to monitor
effectiveness of program.
10. Signal will meet with the WCDHS designated supervisor quarterly and/or the Core
Services Coordinator (more if needed) to review program usage and effectiveness
to discuss necessary improvements to better serve families or increase referrals.
11. Signal will be available to meet with WCDHS staff to explain program, timelinesof
response to referrals and answer questions to enhance program.
12. Signal, or their authorized designee, will be available for the Families, Youth and
Children (FYC) Commission review and attendance at the FYC meetings.
13. Regarding all forms referenced herein in the Agreement, Signal shall replicate
these forms in format, content and according to the specifications of WCDHS or
as mutually agreed upon by Signal and WCDHS. Signal agrees to modify these
treatment authorization forms according to WCDHS specifications and
requirements.
14. WCDHS will be responsible for electronically authorizing services to various Signal
providers and initially designating if Core funds shall be used for payment.
WCDHS shall assure that the authorization will have all information required for
reimbursement from the county.
15. WCDHS agrees to provide Signal with the name of a primary contact who will be
responsible for interacting with Signal's data system.
16. WCDHS agrees to provide the TRAILS Remittance Advice to Signal within ten (10)
business days of the monthly TRAILS Core Main Payroll date.
17. WCDHS agrees to render payment for one full billing invoice at a time, as billed
monthly by Signal, and not to submit payment for a mixture of separate invoices
within one payment.
18. Signal and WCDHS agree to resolve level of care conflicts at the Signal/County
level through cooperation. WCDHS and Signal shall attempt to resolve all levels
of care conflicts and disputes at the lowest level possible within each organization.
Should WCDHS and/or Signal fail to agree upon the level of care offered by Signal,
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they may appeal the case directly to the WCDHS Director, or designee, and the
Signal Chief Operating Officer. Both Signal and WCDHS will have an opportunity
to provide consultation and documentation regarding the appeal. Appeals are to
be resolved within 72 working hours, unless good cause justifies an extension.
19. If the WCDHS and Signal are unable to resolve the dispute, either party may
request that the State intervene. Any further unresolved issues may be submitted
to the Colorado Department of Human Services, Office of Behavioral Health or
their designee(s) for case presentation and review.
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Contract Form
Entity Information
New Contract Request
Entity Name* Entity ID*
SIGNAL BEHAVIORAL HEALTH @00033360
Contract Name*
SIGNAL BEHAVIORAL HEALTH
Contract Status
CTB REVIEW
❑ New Entity?
Contract ID
3940
Contract Lead ir
CULLINTA
Contract Lead Email
r_ullinta@co.weld co.us;cobbxxl
k@co_weld.co.us
Parent Contract ID
Requires Board Approval
YES
Department Project #
Contract Description*
NEW SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY2020/2021
TERM: CORE SERVICES 06/01/20 THROUGH 05/31/21. AFS SERVICES 07/01/20 THROUGH 06/30i21.
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
CM-
COUNTYATTORNEY@WELD
GOV.COM
Requested 80CC Agenda
Date*
08/05/2020
Due Date
08/01/2020
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
OnBase
Contract Dates
Effective Date Review Date* Renewal Date
04/0112021
Termination Notice Period Committed Delivery Date Expiration Date*
05/3112021
Contact Information
Contact Info
Contact Name
Purchasing
Purchasing Approver
Approval Process
Department Head
JAMIE ULRICH
DH Approved Date
07/2712020
Final Approval
BOCC Approved
BOCC Signed Date
BOCC Agenda Date
08/05/2020
Originator
SNYDERKL
Contact Type
Contact Email
Finance Approver
BARB CONNOLLY
Contact Phone 1 Contact Phone 2
Purchasing Approved Date
Finance Approved Date
07/28/2020
Tyler Ref*
AG 080520
Legal Counsel
GABE KALOUSEK
Legal Counsel Approved Date
07/28/2020
Submit
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