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CHILD PROTECTION AGREEMENT FOR SERVICES
BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES
AND FIELD OF OPPORTUNITY COUNSELING
This Agreement, made and entered into theL day o , 2019, by and between the Board of
Weld County Commissioners, on behalf of the Weld County Depa me f Human Services, hereinafter referred to
as the "Department' and Field of Opportunity Counseling, hereinafter r erred 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 Sexual Abuse Treatment (Offense Specific).
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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 (hainlejd@weldgov.com, 970-400-6210). No other
Department staff or other party to the case may authorize services or modifications to services.
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 reauired by the
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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.
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
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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
- 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
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- 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.
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-
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102(5)(c). Contractor shall not knowingly employ or contract with an illegal alien to perform work
under this Agreement or enter into a contract with a subcontractor that fails to certify with Contractor
that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work
under this Agreement. Contractor shall not use E -Verify Program or State of Colorado program
procedures to undertake pre -employment screening or job applicants while this Agreement is being
performed. If Contractor obtains actual knowledge that a subcontractor performing work under the
public contract for services knowingly employs or contracts with an illegal alien Contractor shall notify
the subcontractor and the Department within three (3) days that Contractor has actual knowledge
that a subcontractor is employing or contracting with an illegal alien and shall terminate the
subcontract if a subcontractor does not stop employing or contracting with the illegal alien within three
(3) days of receiving notice. Contractor shall not terminate the contract if within three days the
subcontractor provides information to establish that the subcontractor has not knowingly employed
or contracted with an illegal alien. shall comply with reasonable requests made in the course of an
investigation, undertaken pursuant to C.R.S. §8-17.5-102(5), by the Colorado Department of Labor and
Employment. If Contractor participates in the State of Colorado program, Contractor shall, within
twenty days after hiring a new employee to perform work under the contract, affirm that Contractor
has examined the legal work status of such employee, retained file copies of the documents, and not
altered or falsified the identification documents for such employees. Contractor shall deliver to the
Department, a written notarized affirmation that it has examined the legal work status of such
employee and shall comply with all of the other requirements of the State of Colorado program. If
Contractor fails to comply with any requirement of this provision or of C.R.S. §8-17.5-101 et seq., the
Department, may terminate this Agreement for breach, and if so terminated, Contractor shall be liable
for actual and consequential damages.
f. Except where exempted by federal law and except as provided in C.R.S. § 24-76.5-103(3), if
Contractor receives federal or state funds under the contract, Contractor must confirm that any
individual natural person eighteen (18) years of age or older is lawfully present in the United States
pursuant to C.R.S. § 24-76.5-103(4), if such individual applies for public benefits provided under the
contract. If Contractor operates as a sole proprietor, it hereby swears or affirms under penalty of
perjury that it: (a) is a citizen of the United States or is otherwise lawfully present in the United States
pursuant to federal law, (b) shall produce one of the forms of identification required by C.R.S. § 24-
76.5-101, et seq., and (c) shall produce one of the forms of identification required by C.R.S. § 24-76.5-
103 prior to the effective date of the contract.
8. Compliance with Child and Family Services Review
The Child and Family Services Review (CFSR) examines child welfare service outcomes in three areas;
Safety, Permanency and Well Being of families. For each outcome, data and performance indicators
measure each state's performance according to national standards and monitor progress over time.
Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance
services to families.
Contractor agrees to continually strive for positive outcomes in the areas of Safety, Permanency and Well
Being. Contractor will ensure that any employee or subcontractor of Contractor providing services under
this Agreement will work towards positive outcomes in the aforementioned three areas as outlined under
the Child and Family Services Review (CFSR) and will address the aforementioned three areas when
completing monthly reports as required by Paragraph 3(d) of this Agreement.
9. Insurance Requirements
Contractor and the Department agree that Weld County, the Board of County Commissioners of Weld
County, its officers and employees, shall not be held liable for injuries or damages caused by any negligent
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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 01 10/93
or equivalent, covering premises operations, fire damage, independent Contractors,
products and completed operations, blanket contractual liability, personal injury, and
advertising liability with minimum limits as follows:
- $1,000,000 each occurrence;
- $2,000,000 general aggregate;
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- $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.
B. 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. Trainin
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
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.
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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 Deborah Paulsen, Owner
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
18. Litigation
For Contractor:
Deborah Paulsen, Owner
109 East Railroad Avenue, Suite 1
Fort Morgan, CO 80701
(970) 353-0422
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
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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
not enter into any third -party relationship that gives the appearance of creating a conflict of interest.
Upon learning of an existing appearance of a conflict of interest situation, Contractor shall submit to the
Department, a full disclosure statement setting forth the details that create the appearance of a conflict
of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute
grounds for the Department's termination, for cause, of its Agreement with the Contractor.
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
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Contractor may provide services for, the Contractor must disclose that relationship to the Department.
Contractor certifies that Federal appropriated funds have not been paid or will be paid, by or on behalf of
Contractor, to any person for influencing or attempting to influence an officer or employee of an agency,
a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in
connection with the awarding of any Federal contract, the making of any Federal grant, the making of any
Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal,
amendment, or modification of an Federal contract, loan, grant, or cooperative agreement.
24. Storage, Availability and Retention of Records
Contractor agrees that authorized local, Federal, and State auditors and representatives shall, during
business hours, have access to inspect and copy records, and shall be allowed to monitor and review
through on -site visits, all activities related to this Agreement, supported with funds under this Agreement,
to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and
evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The
results of the monitoring and evaluation activities shall be provided to the appropriate and interested
parties.
All such records, documents, communications, and other materials created pursuant or related to this
Agreement shall be maintained by the Contractor in a central location and shall be made available to the
Department upon its request, for a period of seven (7) years from the date of final payment under this
Agreement, or for such further period as may be necessary to resolve any matters which may be pending,
or until an audit has been completed with the following qualifications: If an audit by or on behalf of the
Federal and/or State government has begun but is not completed at the end of the seven (7) year period,
or if audit findings have not been resolved after a seven (7) period, the materials shall be retained until
the resolution of the audit finding.
25. Confidentiality of Records
Contractor shall protect the confidentiality of all applicant records and other materials that are
maintained in accordance with this Agreement except for purposes directly connected with the
administration of Child Protection. No information about or obtained from any applicant/recipient in
possession of Contractor shall be disclosed in a form identifiable with the applicant/recipient or a minor's
parent or guardian unless in accordance with the Contractor's written policy governing access to,
duplication and dissemination of, all such information, in any form, including social networks. Contractor
shall advise its employees, agents, and subcontractor, if any, that they are subject to these confidentiality
requirements.
Contractor shall provide its employees, agents, and subcontractors, if any, with a copy or written
explanation of these confidentiality requirements before access to confidential data is permitted.
Contractor shall have its employees, agents, and subcontractors, if any, sign a written confidentiality
agreement and shall provide a copy of such agreement to the Department, if requested.
26. Proprietary Information
Proprietary information for the purposes of this Agreement is information relating to a party's research,
development, trade secrets, business affairs, internal operations and management procedures and those
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
11
under this Agreement will be accorded at least the same precautions as are employed by the Contractor
for similar information in the course of its own business.
27. Independence of Contractor: Not an Employee of Weld County
Contractor agrees that it is an independent Contractor and that Contractor's officers, agents or employees
will not become employees of County, nor entitled to any employee benefits from County as a result of
the execution of this Agreement. Contractor shall perform its duties hereunder as an independent
Contractor. Contractor shall be solely responsible for its acts and those of its agents and employees for all
acts performed pursuant to this Agreement. Contractor, its employees and agents are not entitled to
unemployment insurance or workers' compensation benefits through County and County shall not pay for
or otherwise provide such coverage for Contractor or any of its agents or employees. Unemployment
insurance benefits will be available to Contractor and its employees and agents only if such coverage is
made available by Contractor or a third party. Contractor shall pay when due all applicable employment
taxes and income taxes and local head taxes (if applicable) incurred pursuant to this Agreement.
Contractor shall not have authorization, express or implied, to bind County to any agreement, liability or
understanding, except as expressly set forth in this Agreement. Contractor shall have the following
responsibilities with regard to workers' compensation and unemployment compensation insurance
matters: (a) provide and keep in force workers' compensation and unemployment compensation
insurance in the amounts required by law, and as set forth in Exhibit A provide proof thereof when
requested to do so by County.
28. Entire Agreement
This Agreement, together with all attachments hereto, constitutes the entire understanding between the
parties with respect to the subject matter hereof, and may not be changed or modified except as state in
Paragraph 14 herein. This Agreement shall be binding upon the parties hereto, their successors, heirs,
legal representatives, and assigns. The Contractor and the Department may not assign any of its rights or
obligations hereunder without the prior consent of both parties.
29. Agreement Nonexclusive
This Agreement does not guarantee any work, nor does it create an exclusive agreement for services.
30. Warranty
The Contractor warrants that services performed under this Agreement will be performed in a manner
consistent with the professional standards governing such services and the provisions of this Agreement.
The Contractor shall faithfully perform the work in accordance with the standards of care, skill, training,
diligence and judgment provided by highly competent individuals and entities that perform services of a
similar nature to those described in this Agreement including Exhibits A, B, C, and D.
31. Acceptance of Services Not a Waiver
Upon completion of the work, the Contractor shall submit to the Department originals of all tests and
results, reports, etc., generated during completion of this work. Acceptance by the Department of reports
and incidental material(s) furnished under this Agreement shall not in any way relieve the Contractor of
responsibility for the quality and accuracy of the services. In no event shall any action by the Department
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
12
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.
36. Attorney's Fees/Legal Costs
In the event of a dispute between the Department and Contractor, concerning this Agreement, the parties
agree that each party shall be responsible for the payment of attorney fees and/or legal costs incurred by
or on its own behalf.
37. Ownership
All work and information obtained by Contractor under this Agreement or individual work order shall
become or remain (as applicable), the property of the Department. In addition, all reports, documents,
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.
13
38. Interruptions
Neither party to this Agreement shall be liable to the other for delays in delivery or failure to deliver or
otherwise to perform any obligation under this Agreement, where such failure is due to any cause beyond
its reasonable control, including but not limited to Acts of God, fires, strikes, war, flood, earthquakes or
Governmental actions.
39. Severability
If any term or condition of this Agreement shall be held to be invalid, illegal, or unenforceable by a court of
competent jurisdiction, this Agreement shall be construed and enforced without such provision, to the
extent that this Agreement is then capable of execution within the original intent of the parties.
14
IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and
year first above written.
COUNTY:
ATTEST: ddtif•A) Ce • J(.- t.4 4
Weld County Clerk to the Board
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORAD
Deputy Clerk to the Board Barbara Kirkmeyer, Chai
CONTRACTOR:
Field of Opportunity Counseling
109 East Railroad Avenue, Suite 1
Fort Morgan, CO 80701
(970) 353-0422
Debona/i aaGfeir
By: Deborah L Paulsen (May 2, 2019,
Date:
15
Deborah Paulsen, Owner
May 2, 2019
1
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A J
oZdi�-o2�8"2.�
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
Service Proposal for Weld County Department of Human Services
Goal:
Provide Offense Specific Services to families, offenders and victims involved with the Weld
County Department of Human Services. Provide step down services to juveniles in out of home
placement returning to the community. Provide services to ages 12 years old and up. Will
consider 12 and under clients on a case by case basis.
Office location:
3400 W. 16th Street, Building 1N, Unit C, Greeley, CO 80634, no south county location.
Outpatient Treatment Services Provided:
Parent Services
Educational Program
Informed Supervision
Triggers
Grooming
Safety Planning
Non -Offending Parent Support Group
*Materials to be used: Healthy Families; Pathways Guide for Parents; Connections
(Psychoeducational program for non -offending parents of sexually abused children and partners
of sexual offenders), The Chaperon Workbook
Offender Services
Offense Specific Treatment Individual and Group
Safety Plan
Abuse Cycle
Healthy Boundaries/Healthy Sexuality
Clarification/Reunification
Transition Services from Out of Home Placement
MRT (Moral Reconation Therapy)
Relapse Prevention
1
,xg•` rce
tc1 Avenue, *Suite 1
O 80701 ,.
(9 .``370-4235
� •e
3400 W. 16'h St
Greeley, C
*Materials to be used: Footprints: Steps to a Healthy Life; Moving Beyond Sexually Abusive
Behavior; The SAFE Workbook for Youth: new Choices for a Healthy Lifestyle; When Children
Abuse, Pathways: A Guided Workbook for Youth Beginning Treatment; Stages of
Accomplishment Workbook: Stages 1-4; Healthy Thinking/Feeling/Doing/From the Inside Out;
FLASH (Family Life and Sexual Health)
Fees:
Offense Specific Individual Treatment
Offense Specific Group Treatment
MRT Group
MRT Book
Family Services
Client Staffing
Victim Therapy
Clarification/Reunification
LOOK Sexual Attraction Assessment
$95 per one hour session
$65 per 1-1 %2 hours
$30 per 1-1 '/2 hours
$25
$95 per one hour session
$95 per staffing
$95 per one hour session
$95 per one hour session
$120 per test
OFFENSE SPECIFIC EVALUATIONS:
TYPE OF SERVICE (Conducted in our office) COST
Adult & Juvenile Mental Health Sex Offense Specific Evaluation (SOEV) $1,100.00
Adult & Juvenile Pre -Plea SOEV (Attorney Work -Product) $1,400.00
STAFFING RATE — (hourly rates for travel, court testimony, etc.) $95.00
2
EXHIBIT B
PROVIDER INFORMATION FORM
Weld County Department of Human Services
Field of Opportunity Counseling 1634741
AGENCY OR PRIVATE PRACTICE TRAILS PROVIDER ID (If Known)
Deborah Paulsen, BA, CACI Owner
PRIMARY CONTACT— FULL NAME
( 970 ) 353-0422
PHONE NUMBER
fieldoropportunitycounseling@hotmail.com
PRIMARY CONTACT- E-MAIL ADDRESS
109 E. Railroad Ave, Suite 1
AGENCY MAILING ADDRESS
PRIMARY CONTACT - TITLE
( 970 ) 353-0796
EXT. FAX NUMBER
N/A
AGENCY/PRACTICE WEB ADDRESS (IF APPLICABLE)
Fort Morgan
CITY
80701
ZIP
Deborah Paulsen, BA, CACI
REFFERAL CONTACT— FULL NAME
( 970 ) 353-0422
REFERRAL CONTACT— PHONE NUMBER
REFERRAL CONTACT
EXT.
Owner
REFERRAL CONTACT - TITLE
fieldofopportuntycounseling@hotmail.com
REFERRAL CONTACT — E-MAIL ADDRESS
Tarita Propp
BILLING CONTACT —FULL NAME
(970 ) 353-0422
BILLING CONTACT— PHONE NUMBER
EXT.
BILLING CONTACT
Office Manager
BILLING CONTACT - TITLE
fieldofopportunitycounseling@hotmail.com
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.
Signature of Authorized Representative:
Date of Signature:
Bid No.: B1900025
EXHIBIT C
PROPOSAL TEMPLATE
1. Bidder's legal entity name:
2. Program name or service type
being proposed:
Field of Opportunity Counseling
Offense Specific Treatment Services & Sex Offense Specific
Evaluation for Sexually Abusive Youth
3. Modalities, curriculum or tools that will be utilized in the delivery of the service. *Materials to be
used for Parent Services: Healthy Families; Pathways Guide for Parents; Connections
(Psychoeducational program for non -offending parents of sexually abused children and partners of
sexual offenders), The Chaperon Workbook.
*Materials to be used for Offender Services: Footprints: Steps to a Healthy Life; Moving Beyond
Sexually Abusive Behavior; The SAFE Workbook for Youth: new Choices for a Healthy Lifestyle; When
Children Abuse, Pathways: A Guided Workbook for Youth Beginning Treatment; Stages of
Accomplishment Workbook: Stages 1-4; Healthy Thinking/Feeling/Doing/From the Inside Out; FLASH
(Family Life and Sexual Health).
Offense specific evaluations may include the following components (the following is subject to change
based on client's risk, needs and responsivity):
• Millon Adolescent Clinical Inventory (MACI)
• Shipley Institute of Living Scale
• State -Trait Anger Inventory (STAXI)
• Substance Abuse Subtle Screening Inventory IV -Adolescent
• LOOK Assessment
• Offender typology
• Juvenile Sex Offender Assessment Protocol -II (J -SOAP -II)
• Juvenile Sexual Offense Recidivism Risk Assessment Tool -II (JSORRAT-II)
• Polygraph (if requested and felt as therapeutically important) (added expense)
4. Capacity to Provide Services (ex. 4 hours/week). Offense specific treatment services up to 3 hours a
week, based on treatment plan.
Evaluations will be completed within two weeks of meeting with a referred client and their legal
guardian. Evaluations are scheduled in one full day (6-8 hours) or two half -days (3-4 hours each day).
Evaluations include an interview with the juvenile, approximately two hours including a meeting with
the juvenile's guardian.
5. Goals of the service. Each evaluation and treatment services will include recommendations to include
level of treatment (outpatient, residential, ...), level of supervision, a substance abuse screening, initial
treatment targets, ongoing treatment targets, and current estimated risk level.
Bid No.: 1900025 1
EXHIBIT C
PROPOSAL TEMPLATE
6. Outcomes of service.
Field of Opportunity Counseling will document any observed or verbalized concerns regarding the client
or family that arise during the evaluation and treatment process. These concerns will be shared with
the referral source in a timely fashion.
7. Target population for service.
Note: Please include age range, applicable genders, and any specific characteristics/traits/needs.
Provide Offense Specific Services to families, offenders and victims involved with the Weld County
Department of Human Services. Provide step down services to juveniles in out of home placement
returning to the community. Provide services to ages 12 years old and up. Will consider 12 and under
clients on a case by case basis.
The request is for Field of Opportunity Counseling to provide offense specific evaluations for male or
female juveniles (ages 12-17) who have engaged in sexually abusive behaviors.
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.
Field of Opportunity Counseling (2 offices)
Fort Morgan location:
109 E. Railroad Ave., Suite 1, Fort Morgan, CO 80701
Greeley location:
3400 W. 16th Street, Building 1N, Unit C, Greeley, CO 80634
*Staff are able to travel for evaluations scheduled outside of office. Cost of travel is $95.00 per hour
additional for evaluation to and from the office.
9. Languages service is available in. English
Note: Bidder should note the language and level of proficiency.
Bid No.: 1900025 2
EXHIBIT C
PROPOSAL TEMPLATE
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.
2019 Fee Schedule
Sex Offense Specific Individual Treatment
Family Services
Client Staffing/MDT
Reports
Clarification/Reunification
Informed Supervision Training
MRT (Moral Reconation Therapy)
LOOK Sexual Attraction Assessment
$95 per one hour session
$95 per one hour session
$95 per one hour session
$65 per month
$95 per one hour session
$95 (per family at same session)
$30 per one hour session
$120 per test
Offense Specific Evaluations:
TYPE OF SERVICE (Conducted in our office)
Adult & Juvenile Mental Health Sex Offense Specific Evaluation (SOEV)
Adult & Juvenile Pre -Plea SOEV (Attorney Work -Product)
STAFFING RATE — (hourly rates for travel, court testimony, etc.)
COST
$1,100.00
$1,400.00
$95.00
Bid No.: 1900025 3
Fort Morgan Office
109°x. Railroad Avenue, Suite 1
Fort'Illlorg , _CO 80701
Cell phone: (970) 370-4235
2019 Fee Schedule
Sex Offense Specific Individual Treatment
Family Services
Client Staffing
Reports
Clarification/Reunification
Informed Supervision Training
MRT (Moral Reconation Therapy)
MRT Workbook
LOOK Sexual Attraction Assessment
Gree
3400 W. 16th St
reeley, C
6 ne: (9
$95 per one hour session
$95 per one hour session
$95
$65
$95 per one hour session
$95 (per family at same session)
$30
$25
$120 per test
OFFENSE SPECIFIC EVALUATIONS:
TYPE OF SERVICE (Conducted in our office) COST
Adult & Juvenile Mental Health Sex Offense Specific Evaluation (SOEV) $1,100.00
Adult & Juvenile Pre -Plea SOEV (Attorney Work -Product) $1,400.00
STAFFING RATE — (hourly rates for travel, court testimony, etc.) $95.00
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 TY
Offense Specific Treatment Services & Sex Offense Specific Evaluations for Sexually Abusive Youth
Field of Opportun'ty Counseling
APPLICABLE
BIDDER LEGAL ENTITY NAME:
N
AT7ON
Degree:Focu
Ucensnre/
Oedentiate
Paulsen
2
3
4
Deborah L.
970-353-0422
fieldofooportunitvcounselinx@hotmail.com
Bachelors
Criminal
Justice
Administration
BA, CACI
6479
Davies
A. Mervyn
970-353-0422 dayseveinc@ciwestoffice.net
6
7
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
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Bid No.: B1900025
ort I orgy '3ffice
109 Railroad Avenue, Suite l
Fort Morga n O 80701 ..
Cell phine (9 370-4235
Tree
3400 W. 16th St
Greeley, C
Office phone: (97
PROFESSIONAL PROFILE
Conscientious, result oriented professional with over twenty-six years of combined experience in a variety of public
and private criminal justice/treatment settings. Proven qualifications in organizational, leadership, staff, and milieu
management, problem solving, and motivational interviewing skills. Passion for working with clients and families to
promote character development and healthy living.
PROFESSIONAL HIGHLIGHTS:
• Supervision and teaching of curriculum such as: Offense Specific Treatment, Family
Reunification/Clarification, Informed Supervision, Moral Reconation Therapy (MRT), Job Readiness,
Enhancing Empathy, Cognitive Behavioral Therapy, Anger Management, Life Skills, Positive Peer
Culture.
• Trained in MRT, Motivational Interviewing, extended suicide assessments, and QMAP-medication
administration.
• Develop effective Case Service Plans surrounding the vocational, educational, treatment (safety plans, re-
lapse prevention plans, permanency plans), and employment needs of individuals.
• Conduct placement interviews, assessments, coordinator intakes, and educate families on services.
• Strong capability to work in a team environment and/or independently.
• Lead weekly team meetings, monthly multi -disciplinary team meetings, developed community contacts,
and coordinated weekly community service projects.
PROFESSIONAL HISTORY
Field of Opportunity Counseling - Owner
SOMB Provider (August 2012 -Present)
South Platte Community Counseling
Addictions Counselor (June 2008 — August 2012)
SOMB Provider (August 2009 — August 2012)
City of Sterling
Dispatcher (June 2008 — June 2011)
Ridge View Academy, Rite of Passage
Case Manager/Career Coordinator (June 2002 -January 2007)
City of Aurora
Police Officer (April 2001 -June 2002)
EDUCATION
National University, San Diego, CA: Bachelor of Arts in Criminal Justice Administration, June 1993
SOMB Listed Adult and Juvenile Evaluator and Treatment Provider with a DD Specialty
Certified Addictions Counselor I, #6479
EXHIBIT C
SCOPE OF SERVICES
1. Contractor will provide Sexual Abuse Treatment (Offense Specific), as referred by the Department
2. Service available under this agreement, include:
a. Offense Specific Treatment Services
b. Sex Offense Specific Evaluation for Sexually Abusive Youth
3. Capacity for Services:
a. Offense Specific Treatment Services: Up to three (3) hour a week, based on treatment plan.
b. Sex Offense Specific Evaluation for Sexually Abusive Youth: Evaluations will be completed within
two (2) week of meeting with referred client and legal guardian. Evaluations will be scheduled in
one full day, six (6) to eight (8) hours, or two half -days, three (3) to four (4) hours each day.
Evaluations will include an interview the juvenile, approximately two hours include a meeting
with the juvenile's guardian.
4. Goals of Service: Evaluation and treatment services will include recommendations to include level of
treatment, level of supervision, a substance abuse screening, initial treatment targets, ongoing treatment
targets, and current estimated risk level.
5. Outcomes of Service: Contractor will document any observed or verbalized concerns regarding the client
or family that arise during the evaluation and treatment process. Concerns will be shared with the
Department in a timely fashion.
6. Target Population:
a. Families, offenders and victims involved with the Department.
b. Juveniles requiring step down services to return to the community.
c. Male and female youth, ages 12 to 17 years of age.
d. Youth under 12 will be considered on a case -by -case basis.
7. Service Access:
a. 109 East Railroad Avenue, Suite 1, Fort Morgan, CO 80701.
b. 3400 West 16' Street, Building 1N, Unit C, Greeley, CO 80634
c. Contractor will travel for evaluations scheduled outside of the office.
8. Language: English only.
9. 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.
10. 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).
1
11. 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@weldgov.com, 970-400-6210).
12. 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.
13. 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.
14. 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.
15. 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.
16. 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.
17. Contractor agrees to 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.
18. Contractor will notify the Quality Assurance Team Supervisor (hainleid@weldgov.com, 970-400-6210) of
new staff who will manage and/or administer the services with the following information:
a. Staff member name and contact information
2
b. Education level/degree (if applicable)
c. Licensure/credentials (if applicable)
d. Department of Regulatory Authority (DORA) number (if applicable)
e. Supervisor name and contact information
The Department reserves the right to decline the new staff members managing and/or administering
services to Department clients.
3
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
$1,100.00/Episode (Adult/Juvenile Mental Health Sex Offense Specific Evaluation (SOEV))
$65.00/Month (Case Reporting)
$95.00/Hour (Clarification/Reunification)
$95.00/Hour (Family Services)
$95.00/Hour (Informed Supervision Training)
$120.00/Episode (LOOK Sexual Attraction Assessment)
$95.00/Hour (Staffing, Multi -disciplinary Team Meeting, Family Team Meeting, Team Decision Making
Meeting)
$30.00/Hour (Moral Recognition Therapy (MRT))
$95.00/Hour (Sexual Offense Specific Individual Treatment)
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.
1
Contract Form
Entity Information
Entity Name*
FIELD OF OPPORTUNITY
COUNSELING
New Contract Request
Entity ID*
@00039334
9334
Contract Name*
FIELD OF OPPORTUNITY COUNSELING (CHILD
PROTECTION AGREEMENT FOR SERVICES;
Contract Status
CTB REVIEW
❑ New Entity?
Contract ID
2641
Contract Lead*
CULLINTA
Contract Lead Email
cullinta@co weld co us
Parent Contract ID
20190707
Requires Board Approval
YES
Department Project #
Contract Description*
CONSENT. NEW AGREEMENT FOR SERVICES. FUNDING: COREOTHER. TERM. O6i01119-05131(20
Contract Description 2
BID NO. B1900025
Contract Type*
AGREEMENT
Amount*
$0.0C
Renewable*
YES
Automatic Renewal
Grant
IGA
Department
HUMAN SERVICES
Department Email
01,1-
HumanServices@weldgov corn
Department Head Email
C M-HumanSer iices-
DeptHead@ .eldgov corn
County Attorney
GENERAL COUNTY
ATTORNEY EMAIL
County Attorney Email
CM-
COUNTYA 1 I RNEY@WELLS.
GOV. COM
Requested BOCC Agenda
Date*
05/D6(2019
Will a work session with BOCC
NO
Due Date
05.02/2019
be
required?*
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
Termination Notice Period
Review Date*
04t01?2020
Committed Derive
Renewal Date*
D6101/2020
Expiration Date
Contact Information
Contact Info
Contact Name
Purchasing
Purchasing Approver
CONSENT
Approval Process
Department Head
JUDY GRIEGO
DH Approved Date
06/24/2019
Final Approval
BOCC Approved
BOCC Signed Date
BOCC Agenda Date
07/01/2019
Originator
CULLINTA
Contact Type Contact Email
Finance Approver
CONSENT
Contact Phone 1 Contact Phone 2
Purchasing Approved Date
06/24/2019
Finance Approved Date
06124/2019
Tyler Ref *
AG 070119
Legal Counsel
CONSENT
Legal Counsel Approved Date
06124/2019
Submit
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