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Home My WebLink About20192252.tiffRESOLUTION RE: APPROVE FIVE (5) STANDARD FORMS OF AGREEMENTS AND RATES FOR VARIOUS OUT -OF -HOME PLACEMENT SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND VARIOUS PROVIDERS ON ATTACHED LISTS AND AUTHORIZE CHAIR TO SIGN AGREEMENTS CONSISTENT WITH SAID FORMS WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board, has been presented with five (5) Standard Forms of Agreements for Various Out -of -Home Placement Services and Rates between the Weld County Department of Human Services and various providers as shown on the attached provider lists, and 1. Exhibit to SS23A - Additional Provisions for Purchase of Child Placement Agency Services 2. Exhibit to SS23A - Additional Provisions for Purchase of Group Home/Group Center Care Services 3. Exhibit to SS23A - Additional Provisions for Purchase of Residential Child Care Facility Services 4. Exhibit to SS23A for the Purchase of Treatment Foster Care Services 5. Exhibit A to CWS-7A Individual Provider Contract for Purchase of Foster Care Services and Foster Care Facility Agreement WHEREAS, after review, the Board deems it advisable to approve the five (5) Standard Forms of Agreements and Rates for Various Out -of -Home Placement Services, copies of which are attached hereto and incorporated herein by reference, and to delegate standing authority to the Chair of the Board of County Commissioners to execute individual agreements between the Department of Human Services and the individuals identified on the attached provider lists. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that these standard forms and rates between the Weld County Department of Human Services and various providers be, and hereby are, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign any agreements consistent with said forms. cc : H5p, C aC 1'5 IY1), C -T f3 ©Co/a0(19 2019-2252 HR0090 APPROVE FIVE (5) STANDARD FORMS OF AGREEMENTS AND RATES FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND VARIOUS PROVIDERS PAGE 2 The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 17th day of June, A.D., 2019. BOARD OF COUNTY COMMISSIONERS ATTEST:doj' p;�,� Weld County Clerk to the Board BY: SL. a• ty Clerk to the Board APP o.>a AV- R ounty Attorney Date of signature: ()Co(Ol t°1 WELD COUNTY, CC)LORADO • arbara Kirkmeye , Chair Mike Freeman, Pro -Tern EXCUSED Sean Conway . James XCUSED Steve Moreno 2019-2252 HR0090 MEMORANDUM DATE: June 12, 2019 TO: Board of County Commissioners — Pass -Around FR: Judy A. Griego, Director, Human Services RE: 2019-2020 SFY Out -of -Home Provider Contract Templates and Rates and Provider List 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 Department's Child Welfare 2019-2020 SFY Out -of -Home (OOH) Provider Contract Templates Rates and Provider Lists. Listed below and attached for your reference are the proposed updates to the Standard Form Agreements for Human Services. These updated templates, which increases the bed holds from 7 days to 14 days for hospitalization, have been reviewed and approved for use by Assistant County Attorney, Robin Cochran. The updated forms are as follows 1. Exhibit to the SS23A for the Purchase of Child Placement Agency Services 2. Exhibit to the SS23A for the Purchase of Group Home/Group Center Care Services 3. Exhibit to the SS23A for the Purchase of Residential Child Care Facility Services 4. Exhibit to the SS23A for the Purchase of Treatment Foster Care Services 5. Exhibit A to the CWS-7A Individual Provider Contract The above exhibits are attached, along with the following: 1. List of out -of -home providers for SFY 2019-2020 2. State approved rate sheets for the Child Placement Agencies and the Residential Child Care Facilities On June 7, 2019, the Colorado Department of Human Services issued and Information Memorandum, IM-CW-2019-0030, communicating for the SFY 2019-2020 the base anchor rates will change for Child Placement Agencies (CPAs) and Residential Child Care Facilities (RCCFs)_. effective July 1, 2019. It further stated all other rates will remain the same. Pass -Around Memorandum; June 12, 2019 — Not in CMS 2019-2252 Page 1 l --1 R O 090 I do not recommend a Work Session. I recommend approval of these contract templates, the list of providers, and the rate sheets. Sean P. Conway Mike Freeman, Pro-Tem Scott James Barbara Kirkineyer, Chair Steve Moreno Approve Schedule Recommendation Work Session 7 Ofrove Vi a Other/Comments: Pass -Around Memorandum; June 12, 2019 — Not in CMS Page 2 Karla Ford From: Sent: To: Subj .c Karla - Approve. Sean Sent from my iPhone Sean Conway Wednesday, June 12, 2019 6:05 PM Karla Ford Re: PA for Routing - 2019-20 Out -of -Home Placement Templates, Providers, Rates (TIME SENSITIVE) > On Jun 12, 2019, at 3:14 PM, Karla Ford <kford@weldgov.com>wrote: > THIS IS FOR MONDAY'S AGENDA Thanks! > Please let me know if you approve recommendation. > Karla Ford- > Office Manager, Board of Weld County Commissioners > 1150 O Street, P.O. Box 758, Greeley, Colorado 80632 > :: 970.330-7204 :: kford@weldgov.com<niailto:kford@weldgov.com> www.weldgov.corn<http://www.weldgov.com/> > My working hours are Monday -Thursday 7:00a.m.-4:00 p.m. > Friday 7:00a.m. - Noon > [WC Logo Color] > Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. > > From: Amanda Petzold > Sent: Wednesday, June 12, 2019 3:09 PM > To: Karla Ford <kford@weldgov.com> > Cc: Heather Walker <walkerhd@weldgov.com>; Robin Overmyer > <overmyrs@weldgov.com>; CTB <CTB@co.weld.co.us>; Barb Connolly > <bconnolly@weldgov.com>; Bruce Barker <bbarker@weldgov.com>; Esther > Gesick <egesick@weldgov.conn>; HS Contract Management > <HS-ContractManagement@co.weld.co.us>; Jamie Ulrich > <ulrichjj@weldgov.com>; Judy Griego <griegoja@weldgov.com>; Lennie > Bottorff <bottorll@weldgov.com> > Subject: PA for Routing - 2019-20 Out -of -Home Placement Templates, > Providers, Rates (TIME SENSITIVE) > Karla, i nat0 Sent: To: Cc: Subject: Approve ** Sent from my iPhone ** Scott James Wednesday, June 12, 2019 7:43 PM Mike Freeman Barbara Kirkrneyer; Karla Ford; Commissioners Re: PA for Routing - 2019-20 Out -of -Home Placement Templates, Providers, Rates (TIME SENSITIVE) Scott K. James Weld County Commissioner, District 2 1150 O Street, P.O. Box 758, Greeley, Colorado 80632 970.336.7204 (Office) 970.381.7496 (Cell) Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited On Jun 12, 2019, at 6:57 PM, Mike Freeman <m. reerr an@weldgov.com> wrote: Approve Sent from my iPhone On Jun 12, 2019, at 4:53 PM, Barbara Kirkrneyer <bkirkmeyer@weldgov.com>wrote: Approve Sent from my iPhone on Jun 12, 2019, at 3:14 PM, Karla Ford <kford@weldgov.com>wrote: THIS IS FOR MONDAY'S AGENDA —Thanks! Please let me know if you approve recommendation. 1 aria For Frern: Sent: To: Cc: Subject: Steve Moreno Thursday, June 13, 2019 4:25 A V1 Karla Ford Commissioners Re: PA for Routing ._ 2019-20 Out -of -Home Placement Templates, Providers, Rates (TIME SENSITIVE) Approve Sent from my iPhone On Jun 12, 2019, at 5:14 PM, Karla Ford k ord v,com> wrote: THIS IS FOR MONDAY'S AGENDA ® Thanks! Please let me know if you approve recommendation. Karla Ford IC Office Manager, Board of Weld County Commissioners 1150 0 Street, P.O. Box 758, Greeley, Colorado 80632 970.336-7204 .: F r+ @v el c ou, p ::yvwv.f.vveidaoy.ppcoMo 0 �/yy,.{■w�orkingp,yg� hours q�pare Monday -Thursday 7:00a.m.4:00 :00 p. . Friday 6Qy 7: P/an7 Y Na -Noon Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication, Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. Fr .: Amanda Petzold Sent: Wednesday, June 12, 2019 3:09 PM To: Karla Ford <k<fordye,1dgov.com> Cc: Heather Walker <wai erhd@wei ov,c >; Robin Overmyer <ofern. # ass:! veld, ovecor >; CTB < T@cam w .rco_us>; Barb Connolly < onnol y@ eidpov,c -m>; Bruce Barker <b arker@wel >; Esther Gesick <eges c c@weldgoy.c m>; HS Contract Management <HS - Con tr ccMana emept c)cc.weI tos as>; Jamie Ulrich <u .richl' y e3 , ,�ov.corn>; Judy (3riego <grjegaip@widgovyc i >; Lennie Bottorff <hottorlwr v.co > Subject: PA for Routing - 2019-20 Out -of -Home Placement Templates, Providers, Rates (TIME SENSITIVE) Karla, EXHIBIT A to the SS23A Additional Provisions for the Agreement to Purchase Out -of -Home Placement Services SS23A For the Purchase of Child Placement Agency Services The following additional provisions of this Exhibit apply to the agreement entitled, "Agreement to Purchase Out -of -Home Placement Services SS23A, attached hereto, by and between the Board of County Commissioners of Weld County, on behalf of the Weld County Department of Human Services," hereinafter referred to as, "County," and «Agency», hereinafter referred to as, "Contractor." 1. County agrees to purchase and Contractor agrees to provide the care and services which are listed in this agreement for Facility ID <<Facility_ID» at the Contractor's base anchor rate of $«Agency_Rate» per day, as outlined in the Colorado Department of Human Services Informational Memorandum, IM-CW-2019-0030, unless for the 2019-2020 fiscal year the Contractor and County have agreed to a previously negotiated higher rate based on the significant needs of a specific child. These services will be for children who have been deemed eligible for social services under the statues, rules, and regulations of the State of Colorado. 2. All bed hold authorizations and payments are subject to a 7 -day maximum for a child's temporary absence from a facility; however, if the absence is a result of hospitalization, the maximum bed hold authorization may be up to 14 days. Bed hold requests must have prior written authorization from County's Department Administrator or Designee before payment will be release to provider. 3. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished by the Contractor under this contract for facilities that provide sex offender treatment. 4. Contractor agrees to have appropriate personnel available to attend or participate in Family Engagement, Team Decision Making meetings, or court hearings. Contractor shall be notified by County staff of the dates and times attendance is requested. 5. Contractor agrees to cooperate with any vendors hired by the County to shorten the duration of placement. 6. Contractor agrees to have physical examinations completed within 14 days and dental examinations completed within 8 weeks of the child being placed with Contractor. All documentation of these examinations shall be forward to County. 7. Contractor agrees to arrange a full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student every 3 years and coordinate reviews every year. If the IEP is due while the child is in placement, the Contractor shall complete or obtain a completed IEP. A copy will then be forwarded to the County. Exhibit to the SS23A 1 Revised 6/2019 8. Children in Psychiatric Residential Treatment Facilities, Residential Child Care Facilities and Child Placement Agencies are generally not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. However, a one-time emergency clothing allowance may be approved in limited circumstances, prior written authorization from the County's Department Administrator is required before payment will be released to provider. 9. County shall have access to Contractor's financial records as they relate to this Agreement for purposes of audit. Such records shall be complete and available for audit 90 days after final payment hereunder and shall be retained and available for audit purposes for at least five years after final payment hereunder. 10. Time is of the essence in each and all of the provisions of this Agreement. 11. Neither party to this Agreement shall be liable to the other for delays in delivery or failure to deliver or otherwise to perform any obligation under this Agreement, where such failure is due to any cause beyond its reasonable control, including but not limited to Acts of God, fires, strikes, war, flood, earthquakes or Governmental actions. 12. Any notice required to be given under this Agreement shall be in writing and shall be mailed or delivered to the other party at that party's address as stated above. 13. This Agreement and the provision of services hereunder shall be subject to the laws of Colorado and be in accordance with the policies, procedures, and practices of County. 14. This Agreement is nonexclusive and County may engage or use other contractors or persons to perform services of the same or similar nature. 15. Contract Professional certifies, warrants, and agrees that it does not knowingly employ or contract with an illegal alien who will perform work under this contract. Contract Professional will confirm the employment eligibility of all employees who are newly hired for employment in the United States to perform work under this Agreement, through participation in the E -Verify program or the State of Colorado program established pursuant to C.R.S. §8-17.5-102(5)(c). Contract Professional shall not knowingly employ or contract with an illegal alien to perform work under this Agreement or enter into a contract with a subcontractor that fails to certify with Contract Professional that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this Agreement. Contract Professional shall not use E -Verify Program or State of Colorado program procedures to undertake pre -employment screening or job applicants while this Agreement is being performed. If Contract Professional obtains actual knowledge that a subcontractor performing work under the public contract for services knowingly employs or contracts with an illegal alien Contract Professional shall notify the subcontractor and County within three (3) days that Contract Professional has actual knowledge that a subcontractor is employing or contracting with 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. Exhibit to the SS23A 2 Revised 6/2019 Contract Professional shall not terminate the contract if within three days the subcontractor provides information to establish that the subcontractor has not knowingly employed or contracted with an illegal alien. Contract Professional shall comply with reasonable requests made in the course of an investigation, undertaken pursuant to C.R.S. §8-17.5-102(5), by the Colorado Department of Labor and Employment. If Contract Professional participates in the State of Colorado program, Contract Professional shall, within twenty days after hiring an new employee to perform work under the contract, affirm that Contract Professional has examined the legal work status of such employee, retained file copies of the documents, and not altered or falsified the identification documents for such employees. Contract Professional shall deliver to County, a written notarized affirmation that it has examined the legal work status of such employee, and shall comply with all of the other requirements of the State of Colorado program. If Contract Professional fails to comply with any requirement of this provision or of C.R.S. §8-17.5-101 et seq., County, may terminate this Agreement for breach, and if so terminated, Contract Professional shall be liable for actual and consequential damages. Except where exempted by federal law and except as provided in C.R.S. § 24-76.5- 103(3), if Contract Professional receives federal or state funds under the contract, Contract Professional must confirm that any individual natural person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. § 24-76.5- 103(4), if such individual applies for public benefits provided under the contract. If Contract Professional operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it: is a citizen of the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall produce one of the forms of identification required by C.R.S. § 24-76.5-101, et seq., and (c) shall produce one of the forms of identification required by C.R.S. § 24-76.5-103 prior to the effective date of the contract. 16. Contractor assures and certifies that it and its principals: a. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency; b. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above; Exhibit to the SS23A 3 Revised 6/2019 d. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 17. In addition to terminating this Agreement, in accordance with the provisions of the attached Agreement, the County may exercise the following remedial actions if the County finds and determines that the Contractor has substantially failed to satisfy the scope of work found in the Agreement, any Exhibit, or the child specific addendum SS23B. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions include, but are not limited to, any one or more of the following: a. Withhold payment to Contractor until the necessary services or corrections in performance are satisfactorily completed. b. Deny payment or recover reimbursement for those services or deliverables which have not been performed and which due to circumstances caused by Contractor cannot be performed or if performed would be of no value to County. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to County. c. Recover from Contractor any incorrect payment to Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement, or other agreements between County and Contractor, or as a debt to County, or otherwise as provided by law. 18. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 19. No portion of this Agreement shall be deemed to constitute a waiver of any immunity including those provided by the Colorado Governmental Immunity Act §§24-10-101 et seq., as applicable now or hereafter amended, that the parties or their officers or employees may possess, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 20. Contractor shall promptly notify County in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the County Director. The term Exhibit to the SS23A 4 Revised 6/2019 "litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. 21. Any amendments or modifications to this agreement shall be in writing signed by both parties. 22. Financial obligations of the County payable after the current fiscal year are contingent upon funds for that purpose being appropriated, budgeted and otherwise made available. Execution of this Agreement by County does not create an obligation on the part of County to expend funds not otherwise appropriated in each succeeding year. 23. Contractor agrees that it is an independent Contractor and that Contractor's officers, agents or employees will not become employees of County, nor entitled to any employee benefits from County as a result of the execution of this Agreement. Contractor shall perform its duties hereunder as an independent Contractor. Contractor shall be solely responsible for its acts and those of its agents and employees for all acts performed pursuant to this Agreement. Contractor, 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. 24. County reserves the right to require the Contractor to provide a certificate of insurance, policy, or other proof of insurance at its sole discretion. Exhibit to the SS23A 5 Revised 6/2019 Table 1: Child Placement Agency Name Trails ID# Admin Services Admin Maintenance Child Maintenance Respite FY 19-20 Daily Rates A KID'S HOPE HOMES INC. 1531474 $ 7.39 $ 49.47 $ 35.70 $ 0.66 $ 93.22 A NEW WORLD 1621990 7.39 49.47 35.70 0.66 93.22 ADOPTION OPTIONS 45078 7.39 49.47 35.70 0.66 93.22 ALOHA 1702755 7.39 49.47 35.70 0.66 93.22 ARIEL CLINICAL SERVICES 90205 7.39 49.47 35.70 0.66 93.22 AURORA COMP COMM MENTAL HEALTH 1668882 7.39 49.47 35.70 0.66 93.22 BETHANY CHRISTIAN SERVICES 45514 7.39 49.47 35.70 0.66 93.22 BRIDGES CHILD PLACEMENT AGENCY 1980 7.39 49.47 35.70 0.66 93.22 CATHOLIC CHARITIES - FAMILY SERVICES 45071 7.39 49.47 35.70 0.66 93.22 CATHOLIC CHARITIES OF CENTRAL COLORADO 63384 7.39 49.47 35.70 0.66 93.22 CGL-CPA, LLC 1615382 7.39 49.47 35.70 0.66 93.22 COURAGE COMMUNITY FOSTER CARE 1621587 7.39 49.47 35.70 0.66 93.22 DENVER AREA YOUTH SERVICES 45069 7.39 49.47 35.70 0.66 93.22 DENVER CHILDREN'S HOME 1588160 7.39 49.47 35.70 0.66 93.22 DUNGARVIN, COLORADO INC. 1547661 7.39 49.47 35.70 0.66 93.22 FAMILY RESOURCE NETWORK 1508602 7.39 49.47 35.70 0.66 93.22 GRIFFITH CENTERS FOR CHILDREN - CHINS UP 1510565 7.39 49.47 35.70 0.66 93.22 HAND IN HAND 45077 7.39 49.47 35.70 0.66 93.22 HOPE AND HOME 29867 7.39 49.47 35.70 0.66 93.22 HOPES PROMISE 74241 7.39 49.47 35.70 0.66 93.22 KAIROS FAMILY SERVICES, LLC 1724901 7.39 49.47 35.70 0.66 93.22 KIDSCROSSING 79752 7.39 49.47 35.70 0.66 93.22 LOVE IS TRINITY 1691137 7.39 49.47 35.70 0.66 93.22 LUTHERAN FAMILY SVCS ROCKY MNT. (LFSRM) 45080 7.39 49.47 35.70 0.66 93.22 MAPLE STAR COLORADO 90967 7.39 49.47 35.70 0.66 93.22 MOUNT SAINT VINCENT 1676598 7.39 49.47 35.70 0.66 93.22 NEHEMIAH - GLOBAL FOUNDATION 1653433 7.39 49.47 35.70 0.66 93.22 NEW HORIZONS 1509375 7.39 49.47 35.70 0.66 93.22 NEW START YOUTH SERVICES LLC 1528224 7.39 49.47 35.70 0.66 93.22 NIGHTLIGHT CHRISTIAN ADOPTIONS - CPA 1590226 7.39 49.47 35.70 0.66 93.22 PARKER PERSONAL CARE HOMES INC 1512100 7.39 49.47 35.70 0.66 93.22 QUALITY LIFE SERVICE L.L.C. 32066 7.39 49.47 35.70 0.66 93.22 ROCKY MOUNTAIN KIDS 1593378 7.39 49.47 35.70 0.66 93.22 SAMPLE SUPPORTS 1686456 7.39 49.47 35.70 0.66 93.22 SAVIO HOUSE 37330 7.39 49.47 35.70 0.66 93.22 SMITH AGENCY INCORPORATED 44882 7.39 49.47 35.70 0.66 93.22 SPECIAL KIDS/SPECIAL FAMILIES 43184 7.39 49.47 35.70 0.66 93.22 SPECIALIZED ALTRNTVS FOR FAMILY AND YOUTH 1662183 7.39 49.47 35.70 0.66 93.22 STRONG FOUNDATIONS 1594056 7.39 49.47 35.70 0.66 93.22 THE INSTITUTE FOR ATTACHMENT AND CHILD DEV 45165 7.39 49.47 35.70 0.66 93.22 THIRD WAY CENTER FOSTER HOMES 1559499 7.39 49.47 35.70 0.66 93.22 TOP OF THE TRAIL INC 28112 7.39 49.47 35.70 0.66 93.22 WHIMSPIRE CHILD PLACEMENT AGENCY 19562 $ 7.39 $ 49.47 $ 35.70 $ 0.66 $ 93.22 EXHIBIT to the SS23A Additional Provisions for the Agreement to Purchase Out -of -Home Placement Services SS23A For the Purchase of Group Home/Group Center Care Services The following additional provisions of this Exhibit apply to the agreement entitled, "Agreement to Purchase Out -of -Home Placement Services SS23A, attached hereto, by and between the Board of County Commissioners of Weld County, on behalf of the Weld County Department of Human Services," hereinafter referred to as, "County," and «Agency», hereinafter referred to as, "Contractor." 1. County agrees to purchase and Contractor agrees to provide the care and services which are listed in this agreement for Facility ID «Facility_ID» at the contractor's base anchor rate of $ «Agency_Rate» per day, as outlined in the Colorado Department of Human Services Informational Memorandum IM-CW-2018-0040, unless for the 2019-2020 fiscal year the Contractor and County have agreed to a previously negotiated higher rate based on the significant needs of a specific child. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. All bed hold authorizations and payments are subject to a 7 -day maximum for a child's temporary absence from a facility; however, if the absence is a result of hospitalization, the maximum bed hold authorization may be up to 14 days. Bed hold requests must have prior written authorization from the Weld County Department Administrator or Designee before payment will be release to Contractor. 3. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished under this contract for facilities that provide sex offender treatment. 4. The services purchased under this Agreement for Group Home/Center services may include, but are not limited to: Basic 24 -hour care and child maintenance (food, shelter, clothing, educational supplies and allowance), direct child care, transportation, administrative overhead, support overhead, service delivery staff, which may include but are not limited to: Parent training for teens, independent living training, and mentor/advocate services. 5. Contractor agrees to have appropriate personnel available to attend or participate in Family Engagement, Team Decision Making meetings, or court hearings. Contractor shall be notified by County staff of the dates and times attendance is requested. 6. Contractor agrees to actively participate in achieving the child's Permanency Goal and cooperate with any vendors hired by the Weld County Department of Human Services to shorten the duration of placement. Exhibit to the SS23A 20 Revised 6/2019 7. Contractor agrees to have physical examinations completed within 14 days and dental examinations completed within 8 weeks of the child being placed with Contractor. All documentation of these examinations shall be forward to the County. 8. Contractor agrees to arrange a full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student every 3 years and coordinate reviews every year. If the IEP is due while the child is in placement, the Contractor shall complete or obtain a completed IEP. A copy will then be forwarded to the County. 9. Children in Psychiatric Residential Treatment Facilities, Residential Child Care Facilities and Child Placement Agencies are generally not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. However, a one-time emergency clothing allowance may be approved in limited circumstances, with prior written authorization from County's Department Administrator required before payment will be released to provider. 10. County shall have access to Contractor's financial records as they relate to this Agreement for purposes of audit. Such records shall be complete and available for audit 90 days after final payment hereunder and shall be retained and available for audit purposes for at least five years after final payment hereunder. 11. Time is of the essence in each and all of the provisions of this Agreement. 12. Neither party to this Agreement shall be liable to the other for delays in delivery or failure to deliver or otherwise to perform any obligation under this Agreement, where such failure is due to any cause beyond its reasonable control, including but not limited to Acts of God, fires, strikes, war, flood, earthquakes or Governmental actions. 13. Any notice required to be given under this Agreement shall be in writing and shall be mailed or delivered to the other party at that party's address as stated above. 14. This Agreement and the provision of services hereunder shall be subject to the laws of Colorado and be in accordance with the policies, procedures, and practices of County. 15. This Agreement is nonexclusive and County may engage or use other contractors or persons to perform services of the same or similar nature. 16. Contract Professional certifies, warrants, and agrees that it does not knowingly employ or contract with an illegal alien who will perform work under this contract. Contract Professional will confirm the employment eligibility of all employees who are newly hired for employment in the United States to perform work under this Agreement, through participation in the E -Verify program or the State of Colorado program established pursuant to C.R.S. §8-17.5-102(5)(c). Contract Professional shall not knowingly employ or contract with an illegal alien to perform work under this Agreement or enter into a contract with a subcontractor that fails to certify with Contract Professional that the subcontractor shall not knowingly employ or contract with an Exhibit to the SS23A 21 Revised 6/2019 illegal alien to perform work under this Agreement. Contract Professional shall not use E -Verify Program or State of Colorado program procedures to undertake pre- employment screening or job applicants while this Agreement is being performed. If Contract Professional obtains actual knowledge that a subcontractor performing work under the public contract for services knowingly employs or contracts with an illegal alien Contract Professional shall notify the subcontractor and County within three (3) days that Contract Professional has actual knowledge that a subcontractor is employing or contracting with an illegal alien and shall terminate the subcontract if a subcontractor does not stop employing or contracting with the illegal alien within three (3) days of receiving notice. Contract Professional shall not terminate the contract if within three days the subcontractor provides information to establish that the subcontractor has not knowingly employed or contracted with an illegal alien. Contract Professional shall comply with reasonable requests made in the course of an investigation, undertaken pursuant to C.R.S. §8-17.5-102(5), by the Colorado Department of Labor and Employment. If Contract Professional participates in the State of Colorado program, Contract Professional shall, within twenty days after hiring an new employee to perform work under the contract, affirm that Contract Professional has examined the legal work status of such employee, retained file copies of the documents, and not altered or falsified the identification documents for such employees. Contract Professional shall deliver to County, a written notarized affirmation that it has examined the legal work status of such employee, and shall comply with all of the other requirements of the State of Colorado program. If Contract Professional fails to comply with any requirement of this provision or of C.R.S. §8-17.5-101 et seq., County, may terminate this Agreement for breach, and if so terminated, Contract Professional shall be liable for actual and consequential damages. Except where exempted by federal law and except as provided in C.R.S. § 24-76.5- 103(3), if Contract Professional receives federal or state funds under the contract, Contract Professional must confirm that any individual natural person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. § 24-76.5- 103(4), if such individual applies for public benefits provided under the contract. If Contract Professional operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it: (a) is a citizen of the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall produce one of the forms of identification required by C.R.S. § 24-76.5-101, et seq., and (c) shall produce one of the forms of identification required by C.R.S. § 24-76.5-103 prior to the effective date of the contract. 17. Contractor assures and certifies that it and its principals: a. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency; b. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a Exhibit to the SS23A 22 Revised 6/2019 criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above; d. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 18. In addition to terminating this Agreement, in accordance with the provisions of the attached Agreement, the County may exercise the following remedial actions if County finds and determines that Contractor has substantially failed to satisfy the scope of work found in the Agreement, any Exhibit, or the child specific addendum SS23B. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions include, but are not limited to, any one or more of the following: a. Withhold payment to Contractor until the necessary services or corrections in performance are satisfactorily completed. b. Deny payment or recover reimbursement for those services or deliverables which have not been performed and which due to circumstances caused by Contractor cannot be performed or if performed would be of no value to County. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to County. c. Recover from Contractor any incorrect payment to Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement, or other agreements between County and Contractor, or as a debt to County, or otherwise as provided by law. 19. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 20. No portion of this Agreement shall be deemed to constitute a waiver of any immunity including those provided by the Colorado Governmental Immunity Act §§24-10-101 et seq., as applicable now or hereafter amended, that the parties or their officers or Exhibit to the SS23A 23 Revised 6/2019 employees may possess, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 21. Contractor shall promptly notify County in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the County Director. The term "litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. 22. Any amendments or modifications to this agreement shall be in writing signed by both parties. 23. Financial obligations of the County payable after the current fiscal year are contingent upon funds for that purpose being appropriated, budgeted and otherwise made available. Execution of this Agreement by County does not create an obligation on the part of County to expend funds not otherwise appropriated in each succeeding year. 24. Contractor agrees that it is an independent Contractor and that Contractor's officers, agents or employees will not become employees of County, nor entitled to any employee benefits from County as a result of the execution of this Agreement. Contractor shall perform its duties hereunder as an independent Contractor. Contractor shall be solely responsible for its acts and those of its agents and employees for all acts performed 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 foror otherwise provide such coverage for Contractor or any of its agents or employees. 25. County reserves the right to require the Contractor to provide a certificate of insurance, policy, or other proof of insurance at its sole discretion. Exhibit to the SS23A 24 Revised 6/2019 GROUP HOME PROVIDERS AND RATES It A New World 1621990 Ariel Clinical Services Bethany Christian Services CGL-CPA, LLC 'Griffith Center for Children • Kids Crossing 90205 All Hands In Ascend Brighter Pathways Brighter Pathways II Candi's House Cornerstone Specialized G.C. Diamonds In The Rough Gems and Jewels House of Healing Rocky Mountain Group Home Turning Lights Group Center His Home Reflections Parker Personal Care Homes Inc. Rocky Mountain Kids Savio House 45514 1615382 1510565 Ariel Sprite House Kismet House Daisy Center Rise Home for Boys 1686513 1705635 1649791 1693759 ........... 1652108 1707380 1686516 4291 S. Fundy Way 1.7905 E. Bails Place 4006 S. Mission Parkway 1697 S. Kenton St. 1170 Norfolk St. 3070 S. Quintero Way 322 Lima Street 1639923 5376 S. Truckee Court 1709708 1036 S. Ouray ray St. 1701369 16621 E. 107th Ave. 1621806 1365 S. Lewiston St. 1719420 4606 S. Joplin Way 1723736 1083 S. Mobile St. Cortinez Field of Dreams LGC Is Vine LGC II - Marion St. LGC III - Williams ST. 79752 1512100 1593378 Strong Foundations, LLC Prospect Youth Home 1643047 1630179 1565168 1680477 Aurora, CO 80013 Aurora, CO 80017 Aurora, CO 80013 Aurora, CO 80012 Aurora, CO 80011 Aurora, CO 80013 2938 North Ave., Suite G 861 N. Sable Blvd. 643 27 1/2 Rd. 754 Hanover St. 74864 6137 Kearney St. A Better Way Evergreen Helping Hands Group Home Hudson Group Home LaMar Place 37330 Robinson Saiph Group Center Drew's Place Future Bound Jeremiah 29 Nevada House Brad's House 1620241 2836 Vine Street 1619053 3659 Marion Street 1620076 3025 Williams Street 1543863 28 Farragut Ave. Aurora, CO 80010 Centennial, CO 80015 Aurora, CO 80017 Commerce City, CO 80022 Aurora, CO 80017 Aurora, CO 80015 Aurora, CO 80017 Grand Junction, CO 81504 Aurora, CO 80011 Grand Junction, CO 81.506 Aurora, CO 80010 Commerce City, CO 80022 Denver, CO 80205 Denver, CO 80205 Denver, CO 80205 $114.13 $114.13 $114.13 $114.13 $114.13 $114.13 $114.13 $114.13 $114.13 $116.59 $139.29 $114.13 Colorado Springs, CO 80909 1621890 14202 E 24th Ave 61317 1436 Hilltop Dr. 1551132 21622E Alamo Place 1623469 2060 Bula Dr. 1534441 3590 LaMar Pl. 1538302 5082 Tucson Way Bridgeway Group Home Carr Group Center for Girls Carradine Center Carradine Center Il J CS Journey for Girls Aurora, CO 80011 Longmont, CO 80504 Centennial, CO 80015 Colorado Springs, CO 80915 Colorado Springs, CO 80911 Denver, CO 80239 1666303 1493 S. Wheeling Circle 1613088 1599810 1619041 1599808 1710657 65 Diamond Road E 3101 Palmer Park Blvd. 4841 Sand Ripples Lane 2129 N. Nevada Ave. 2810 Hunters Glen Rd. 1644205 9820 W. 21st Ave. 1548445 3297 Jasmine Street 1559137 4515 Gibraltar 1621801 14101,E. 46th Ave. 1548844 705 S. Harlen St. 1594056 C & M Group Home 9875 Marie Alirez Group Home 70335 _ Michael Alirez Group Home 54150 x x x 1920 81st Ave. 1405 26th Street 1709 37th Ave. Aurora, CO 80012 B C D E F G H J $114.13 $114.13 $117.44 $117.44 $90.32 $129.89 $141.90 $132.48 D K L M N Fountain, CO 80817 Colorado Springs, CO 80909 Colorado Springs, CO 80922 Colorado Springs, CO 809.07 Mounument, CO 80132 Lakewood, CO 80215 Denver, CO 80207 Denver, CO 80249 Denver, CO 80239 Lakewood, CO 80226 Greeley, CO 80634 Greeley, CO 80631 Greeley, CO 80634 $131.18 $114.13 $114.13 $93.94 $114.13 $114.13 $114.13 $114.13 B $114.13 $114.13 $114.13 $159.70 B C D G E F $172.72 D $172.72 E $120.88 F $114.13 $114.13 $114.13 B C D EXHIBIT to the SS23A Additional Provisions for the Agreement to Purchase Out -of -Home Placement Services SS23A For the Purchase of Residential Child Care Facility Services The following additional provisions of this Exhibit apply to the agreement entitled, "Agreement to Purchase Out -of -Home Placement Services SS23A, attached hereto, by and between the Board of County Commissioners of Weld County, on behalf of the Weld County Department of Human Services," hereinafter referred to as, "County," and «Agency», hereinafter referred to as, "Contractor." 1. County agrees to purchase and Contractor agrees to provide the care and services which are listed in this agreement for Facility ID# «Facility_ID» at the contractor's base anchor rate of $«Agency_Rate» per day, as outlined in the Colorado Department of Human Services Informational Memorandum IM-CW-2019-0030, unless for the 2019-2020 fiscal year the Contractor and County have agreed to a previously negotiated higher rate based on the significant needs of a specific child. These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 2. All bed hold authorizations and payments are subject to a 7 -day maximum for a child's temporary absence from a facility; however, if the absence is a result of hospitalization, the maximum bed hold authorization may be up to 14 days. Bed hold requests must have prior written authorization from the Department Administrator or Designee before payment will be release to provider. Reimbursement rates for bed hold days may not exceed the state standard rate for administrative maintenance and administrative services or may be a reduced rate that is mutually agreed upon. 3. The services purchased under this Agreement as Child Maintenance, Administrative Maintenance and Services for Residential Child Care Facilities include, but are not limited to: Food, shelter, clothing, personal needs and allowance, administration, administrative overhead, support staff, support overhead, sleep -over staff, direct child care, transportation, therapeutic recreation, service delivery staff, parent training for teens, independent living training, mentor/advocate, supervised visitation and all other services as outlined in the Child Specific Addendum. The anticipated minimum percentage for each item is as follows and will be subject to County monitoring as outlined in Section VI of this contract: a. Food, including meals and snacks (25%). b. Clothing (3%). c. Shelter, including utilities and use of household furnishing and equipment and daily supervision, including those activities that a parent would normally carry out to assure protection, emotional support and care of the child (30%). Exhibit to the SS23A 12 Revised 6/2019 d. Personal items and grooming care for the child, such as toothpaste, toothbrushes, soap, combs, haircuts, and other essentials (2%). e. Other/miscellaneous items considered usual in the care and supervision of the child, include, but are not limited to, transportation, recreation and overhead (40%). 4. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished by the Contractor under this contract for facilities that provide sex offender treatment. 5. Contractor agrees to have appropriate personnel available to attend or participate in Family Engagement, Team Decision Making meetings or court hearings. Provider shall be notified by County staff of the dates and times attendance is requested. 6. Contractor agrees to cooperate with any vendors hired by the Weld County Department of Human Services to shorten the duration of placement. 7. Contractor agrees to have physical examinations scheduled within 14 days and dental examinations scheduled within 8 weeks of the child being placed with Contractor. All documentation of these examinations shall be forward to the County. 8. Contractor agrees to arrange a full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student every 3 years and coordinate reviews every year. If the IEP is due while the child is in placement, the Contractor will complete or obtain a completed IEP. A copy will then be forwarded to the County. 9. Children in Residential Child Care Facilities and Child Placement Agencies are generally not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. However, a one-time emergency clothing allowance may be approved in limited circumstances, with prior written authorization from County's Department Administrator required before payment will be released to provider. 10. County shall have access to Contractor's financial records as they relate to this Agreement for purposes of audit. Such records shall be complete and available for audit 90 days after final payment hereunder and shall be retained and available for audit purposes for at least five years after final payment hereunder. 11. Time is of the essence in each and all of the provisions of this Agreement. 12. Neither party to this Agreement shall be liable to the other for delays in delivery or failure to deliver or otherwise to perform any obligation under this Agreement, where such failure is due to any cause beyond its reasonable control, including but not limited to Acts of God, fires, strikes, war, flood, earthquakes or Governmental actions. Exhibit to the SS23A 13 Revised 6/2019 13. Any notice required to be given under this Agreement shall be in writing and shall be mailed or delivered to the other party at that party's address as stated above. 14. This Agreement and the provision of services hereunder shall be subject to the laws of Colorado and be in accordance with the policies, procedures, and practices of County. 15. This Agreement is nonexclusive and County may engage or use other contractors or persons to perform services of the same or similar nature. 16. Contract Professional certifies, warrants, and agrees that it does not knowingly employ or contract with an illegal alien who will perform work under this contract. Contract Professional will confirm the employment eligibility of all employees who are newly hired for employment in the United States to perform work under this Agreement, through participation in the E -Verify program or the State of Colorado program established pursuant to C.R.S. §8-17.5-102(5)(c). Contract Professional shall not knowingly employ or contract with an illegal alien to perform work under this Agreement or enter into a contract with a subcontractor that fails to certify with Contract Professional that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this Agreement. Contract Professional shall not use E -Verify Program or State of Colorado program procedures to undertake pre -employment screening or job applicants while this Agreement is being performed. If Contract Professional obtains actual knowledge that a subcontractor performing work under the public contract for services knowingly employs or contracts with an illegal alien Contract Professional shall notify the subcontractor and County within three (3) days that Contract Professional has actual knowledge that a subcontractor is employing or contracting with an illegal alien and shall terminate the subcontract if a subcontractor does not stop employing or contracting with the illegal alien within three (3) days of receiving notice. Contract Professional shall not terminate the contract if within three days the subcontractor provides information to establish that the subcontractor has not knowingly employed or contracted with an illegal alien. Contract Professional shall comply with reasonable requests made in the course of an investigation, undertaken pursuant to C.R.S. §8-17.5-102(5), by the Colorado Department of Labor and Employment. If Contract Professional participates in the State of Colorado program, Contract Professional shall, within twenty days after hiring an new employee to perform work under the contract, affirm that Contract Professional has examined the legal work status of such employee, retained file copies of the documents, and not altered or falsified the identification documents for such employees. Contract Professional shall deliver to County, a written notarized affirmation that it has examined the legal work status of such employee and shall comply with all of the other requirements of the State of Colorado program. If Contract Professional fails to comply with any requirement of this provision or of C.R.S. §8-17.5-101 et seq., County, may terminate this Agreement for breach, and if so terminated, Contract Professional shall be liable for actual and consequential damages. Except where exempted by federal law and except as provided in C.R.S. § 24-76.5- 103(3), if Contract Professional receives federal or state funds under the contract, Exhibit to the SS23A 14 Revised 6/2019 Contract Professional must confirm that any individual natural person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. § 24-76.5- 103(4), if such individual applies for public benefits provided under the contract. If Contract Professional operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it: (a) is a citizen of the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall produce one of the forms of identification required by C.R.S. § 24-76.5-101, et seq., and (c) shall produce one of the forms of identification required by C.R.S. § 24-76.5-103 prior to the effective date of the contract. 17. Contractor assures and certifies that it and its principals: a. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency; b. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above; d. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 18. In addition to terminating this Agreement, in accordance with the provisions of the attached Agreement, the County may exercise the following remedial actions County find and determine that Contractor has substantially failed to satisfy the scope of work found in the Agreement, any Exhibit, or the child specific addendum SS23B. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions include, but are not limited to, any one or more of the following: a. Withhold payment to Contractor until the necessary services or corrections in performance are satisfactorily completed. b. Deny payment or recover reimbursement for those services or deliverables which have not been performed and which due to circumstances caused by Contractor cannot be performed or if performed would be of no value to County. Denial of Exhibit to the SS23A 15 Revised 6/2019 the amount of payment shall be reasonably related to the amount of work or deliverables lost to County. c. Recover from Contractor any incorrect payment to Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement, or other agreements between County and Contractor, or as a debt to County, or otherwise as provided by law. 19. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 20. No portion of this Agreement shall be deemed to constitute a waiver of any immunity including those provided by the Colorado Governmental Immunity Act §§24-10-101 et seq., as applicable now or hereafter amended, that the parties or their officers or employees may possess, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 21 Contractor shall promptly notify County in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the County Director. The term "litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. 22. Any amendments or modifications to this agreement shall be in writing signed by both parties. 23. Financial obligations of the County payable after the current fiscal year are contingent upon funds for that purpose being appropriated, budgeted and otherwise made available. Execution of this Agreement by County does not create an obligation on the part of County to expend funds not otherwise appropriated in each succeeding year. 24. Contractor agrees that it is an independent Contractor and that Contractor's officers, agents or employees will not become employees of County, nor entitled to any employee benefits from County as a result of the execution of this Agreement. Contractor shall perform its duties hereunder as an independent Contractor. Contractor shall be solely responsible for its acts and those of its agents and employees for all acts performed pursuant to this Agreement. Contractor, its employees and agents are not entitled to Exhibit to the SS23A 16 Revised 6/2019 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. 25. County reserves the right to require the Contractor to provide a certificate of insurance, policy, or other proof of insurance at its sole discretion. Exhibit to the SS23A 17 Revised 6/2019 Residential Child Care Facilities -Accredited Name Trails ID# Admin Services Admin Maintenance Child Maintenance FY 19-20 Daily Rates ALTERNATIVE HOMES FOR YOUTH - GREELEY 2016 $ 23.05 $ 18.90 $ 189.43 $ 231.38 CEDAR SPRINGS HOSPITAL 1517006 23.05 18.90 189.43 231.38 DENVER CHILDRENS HOME 49551 23.05 18.90 189.43 231.38 DEVEREUX CLEO WALLACE CENTER AT WESTMINSTER 39794 23.05 18.90 189.43 231.38 GATEWAY RESIDENTIAL PROGRAM -DELTA 1609500 23.05 18.90 189.43 231.38 GATEWAY RESIDENTIAL PROGRAM -GRAND JUNCTION 1608993 23.05 18.90 189.43 231.38 GRIFFITH CENTER COLORADO SPRINGS 39212 23.05 18.90 189.43 231.38 JEFFERSON HILLS 88459 23.05 18.90 189.43 231.38 JEFFERSON HILLS -AURORA 12284 23.05 18.90 189.43 231.38 MOUNT SAINT VINCENTS HOME 45174 23.05 18.90 189.43 231.38 RIDGE VIEW YOUTH SERVICES 1565507 23.05 18.90 189.43 231.38 RITE OF PASSAGE - SAGE 1698203 23.05 18.90 189.43 231.38 SAVIO HOUSE 48170 23.05 18.90 189.43 231.38 SHILOH CENTER FOR YOUTH 1588986 23.05 18.90 189.43 231.38 SHILOH HOUSE 54169 23.05 18.90 189.43 231.38 SHI LOH HOUSE - ADAMS CAMPUS 1528492 23.05 18.90 189.43 231.38 SHILOH HOUSE - ESTES 20335 23.05 18.90 189.43 231.38 SHILOH HOUSE - LONGMONT CAMPUS 1539982 23.05 18.90 189.43 231.38 SHILOH HOUSE - YARROW 70967 23.05 18.90 189.43 231.38 SHILOH HOUSE FAMILY PAVILION 1672508 23.05 18.90 189.43 231.38 SOUTHERN PEAKS REGIONAL TREATMENTCENTER 1526789 23.05 18.90 189.43 231.38 TENNYSON CENTER AT COLORADO CHRISTIAN HOME 1529814 23.05 18.90 189.43 231.38 THIRD WAY CENTER- BANNOCK 1507881 23.05 18.90 189.43 231.38 THIRD WAY CENTER- LINCOLN 77810 23.05 18.90 189.43 231.38 THIRD WAY CENTER - LOWREY 1547437 23.05 18.90 189.43 231.38 THIRD WAY CENTER - PONTIAC 65346 23.05 18.90 189.43 231.38 THIRD WAY CENTER - YORK 49487 23.05 18.90 189.43 231.38 TURNING POINT - MATTHEWS RESIDENTIAL 45179 23.05 18.90 189.43 231.38 TURNING POINT - PROSPECT 1616504 $ 23.05 $ 18.90 $ 189.43 $ 231.38 Table 3. J Residential Child Care Facilities - Non -Accredited Name Trails ID# Admin Services Admin Maintenance Child Maintenance FY 19-20 Daily Rates ATTENTION HOMES - CHASE HOUSE 11679 $ 115.34 $ 62.40 $ 22.26 $ 200.00 ATTENTION HOMES - The Source 1615850 22.93 28.09 148.98 200.00 AVANTI HOUSE 1695623 22.93 28.09 148.98 200.00 CONTINUUM OF COLORADO - KINGSTON 1708778 22.93 28.09 148.98 200.00 FAMILY FIRST CHILDRENS CENTER 57632 149.30 31.95 18.75 200.00 FOREST HEIGHTS LODGE 45558 69.42 130.58 200.00 HILLTOP RESIDENTIAL YOUTH SERVICES (RYS) 96474 22.91 11.12 165.97 200.00 MIDWAY YOUTH SERVICES 44002 18.87 151.64 29.49 200.00 RESILIENCE RISING 1701821 22.93 28.09 148.98 200.00 ROUND UP FELLOWSHIP III 45211 43.68 122.40 33.92 200.00 ROUNDUP FELLOWSHIP V 45212 51.97 115.91 32.12 200.00 SERENITY CHILDRENS HOME 96482 149.30 31.95 18.75 200.00 SERNEITY II CHILDRENS HOME 6566 $ 149.30 $ 31.95 $ 18.75 $ 200.00 EXHIBIT A to the SS23A Additional Provisions for the Agreement to Purchase Out -of -Home Placement Services SS23A For the Purchase of Treatment Foster Care Services The following additional provisions of this Exhibit apply to the agreement entitled, "Agreement to Purchase Out -of -Home Placement Services SS23A, attached hereto, by and between the Board of County Commissioners of Weld County, on behalf of the Weld County Department of Human Services," hereinafter referred to as, "County," and «Agency», hereinafter referred to as, "Contractor." 1. Contractor agrees to provide the care and services which are listed in this agreement and tie to IM-CW-2018-0002, and County agrees to purchase said care and services at the Contractor's base anchor rate of $«Agency_Rate» per day, as outlined in the Colorado Department of Human Services Informational Memorandum, IM-CW-2019-0010, unless for the 2019-2020 fiscal year the Contractor and County have agreed to a previously negotiated higher rate based on the significant needs of a specific child. These services will be for children who have been deemed eligible for social services under the statues, rules, and regulations of the State of Colorado. 2. All bed hold authorizations and payments are subject to a 7 -day maximum for a child's temporary absence from a facility; however, if the absence is a result of hospitalization, the maximum bed hold authorization may be up to 14 days. Bed hold requests must have prior written authorization from County's Department Administrator or Designee before payment will be release to provider. 3. A minimum of one polygraph test per Colorado fiscal year, if needed by the child, will be furnished by the Contractor under this contract for facilities that provide sex offender treatment. 4. Contractor agrees to have appropriate personnel available to attend or participate in Family Engagement, Team Decision Making meetings, or court hearings. Contractor shall be notified by County staff of the dates and times attendance is requested. 5. Contractor agrees to cooperate with any vendors hired by the County to shorten the duration of placement. 6. Contractor agrees to have physical examinations completed within 14 days and dental examinations completed within 8 weeks of the child being placed with Contractor. All documentation of these examinations shall be forward to County. 7. Contractor agrees to arrange a full evaluation of an Individualized Educational Plan (IEP) for youth designated as a Special Education Student every 3 years and coordinate reviews every year. If the IEP is due while the child is in placement, the Exhibit to the SS23A 1 Revised 6/2019 Contractor shall complete or obtain a completed IEP. A copy will then be forwarded to the County. 8. Children in Psychiatric Residential Treatment Facilities, Residential Child Care Facilities and Child Placement Agencies are generally not eligible to receive clothing allowances as outlined in the Weld County Department of Human Services Policy and Procedure Manual. However, a one-time emergency clothing allowance may be approved in limited circumstances, prior written authorization from the County's Department Administrator is required before payment will be released to provider. 9. County shall have access to Contractor's financial records as they relate to this Agreement for purposes of audit. Such records shall be complete and available for audit 90 days after final payment hereunder and shall be retained and available for audit purposes for at least five years after final payment hereunder. 10. Time is of the essence in each and all of the provisions of this Agreement. 11. Neither party to this Agreement shall be liable to the other for delays in delivery or failure to deliver or otherwise to perform any obligation under this Agreement, where such failure is due to any cause beyond its reasonable control, including but not limited to Acts of God, fires, strikes, war, flood, earthquakes or Governmental actions. 12. Any notice required to be given under this Agreement shall be in writing and shall be mailed or delivered to the other party at that party's address as stated above. 13. This Agreement and the provision of services hereunder shall be subject to the laws of Colorado and be in accordance with the policies, procedures, and practices of County. 14. This Agreement is nonexclusive and County may engage or use other contractors or persons to perform services of the same or similar nature. 15. Contract Professional certifies, warrants, and agrees that it does not knowingly employ or contract with an illegal alien who will perform work under this contract. Contract Professional will confirm the employment eligibility of all employees who are newly hired for employment in the United States to perform work under this Agreement, through participation in the E -Verify program or the State of Colorado program established pursuant to C.R.S. §8-17.5-102(5)(c). Contract Professional shall not knowingly employ or contract with an illegal alien to perform work under this Agreement or enter into a contract with a subcontractor that fails to certify with Contract Professional that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this Agreement. Contract Professional shall not use E -Verify Program or State of Colorado program procedures to undertake pre -employment screening or job applicants while this Agreement is being performed. If Contract Professional obtains actual knowledge that a subcontractor performing work under the public contract for services knowingly employs or contracts with an illegal alien Contract Professional shall notify the subcontractor and County within Exhibit to the SS23A 2 Revised 6/2019 three (3) days that Contract Professional has actual knowledge that a subcontractor is employing or contracting with an illegal alien and shall terminate the subcontract if a subcontractor does not stop employing or contracting with the illegal alien within three (3) days of receiving notice. Contract Professional shall not terminate the contract if within three days the subcontractor provides information to establish that the subcontractor has not knowingly employed or contracted with an illegal alien. Contract Professional shall comply with reasonable requests made in the course of an investigation, undertaken pursuant to C.R.S. §8-17.5-102(5), by the Colorado Department of Labor and Employment. If Contract Professional participates in the State of Colorado program, Contract Professional shall, within twenty days after hiring an new employee to perform work under the contract, affirm that Contract Professional has examined the legal work status of such employee, retained file copies of the documents, and not altered or falsified the identification documents for such employees. Contract Professional shall deliver to County, a written notarized affirmation that it has examined the legal work status of such employee, and shall comply with all of the other requirements of the State of Colorado program. If Contract Professional fails to comply with any requirement of this provision or of C.R.S. §8-17.5-101 et seq., County, may terminate this Agreement for breach, and if so terminated, Contract Professional shall be liable for actual and consequential damages. Except where exempted by federal law and except as provided in C.R.S. § 24-76.5- 103(3), if Contract Professional receives federal or state funds under the contract, Contract Professional must confirm that any individual natural person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. § 24- 76.5-103(4), if such individual applies for public benefits provided under the contract. If Contract Professional operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it: is a citizen of the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall produce one of the forms of identification required by C.R.S. § 24-76.5-101, et seq., and (c) shall produce one of the forms of identification required by C.R.S. § 24-76.5-103 prior to the effective date of the contract. 16. Contractor assures and certifies that it and its principals: a. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency; b. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; Exhibit to the SS23A 3 Revised 6/2019 c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above; d. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause or default. 17. In addition to terminating this Agreement, in accordance with the provisions of the attached Agreement, the County may exercise the following remedial actions if the County finds and determines that the Contractor has substantially failed to satisfy the scope of work found in the Agreement, any Exhibit, or the child specific addendum SS23B. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions include, but are not limited to, any one or more of the following: a. Withhold payment to Contractor until the necessary services or corrections in performance are satisfactorily completed. b. Deny payment or recover reimbursement for those services or deliverables which have not been performed and which due to circumstances caused by Contractor cannot be performed or if performed would be of no value to County. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to County. c. Recover from Contractor any incorrect payment to Contractor due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement, or other agreements between County and Contractor, or as a debt to County, or otherwise as provided by law. 18. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 19. No portion of this Agreement shall be deemed to constitute a waiver of any immunity including those provided by the Colorado Governmental Immunity Act §§24-10-101 et seq., as applicable now or hereafter amended, that the parties or their officers or employees may possess, nor shall any portion of this Agreement be deemed to have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of Exhibit to the SS23A 4 Revised 6/2019 this Agreement is intended to circumvent or replace such immunities. 20. Contractor shall promptly notify County in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the County Director. The term "litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. 21. Any amendments or modifications to this agreement shall be in writing signed by both parties. 22. Financial obligations of the County payable after the current fiscal year are contingent upon funds for that purpose being appropriated, budgeted and otherwise made available. Execution of this Agreement by County does not create an obligation on the part of County to expend funds not otherwise appropriated in each succeeding year. 23. Contractor agrees that it is an independent Contractor and that Contractor's officers, agents or employees will not become employees of County, nor entitled to any employee benefits from County as a result of the execution of this Agreement. Contractor shall perform its duties hereunder as an independent Contractor. Contractor shall be solely responsible for its acts and those of its agents and employees for all acts performed pursuant to this Agreement. Contractor, 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. 24. County reserves the right to require the Contractor to provide a certificate of insurance, policy, or other proof of insurance at its sole discretion. Exhibit to the SS23A 5 Revised 6/2019 WELD COUNTY FOSTER HOMES Agone, Talia and Emore, Lansing Foster Bass, Kayci and Jonathan Foster Moore, Jay and Candice Foster Bishop, Leilani and Robert, Mathis Foster Brown, Rachel and Williford, Julie Foster Castaneda, Freddy and Gutierrez-Castaneda, Natalie Foster Davidson, Stacey A. Foster Easley, Allison and William Eric Foster Garcia, Fernando and Aracely- Foster Heimer, Sara _ Foster Korby, Stephanie and Trenton Foster Lind, Patricia and Dalby, Katherine Marin, Gilbert and Lazuick-Marin, Justine Maronek, Patricia Marinez, Stacey and Jeremy Radi, Tera Roderick, Douglas and Kelli Sanchez, Tracy and Isidro Scheer, James L. and Elizabeth Schmelz, Pamela and Romero, Shane Schulz, Lindsey Seader, Erin and Ryan Wright, Jon and Nicole Van Den Elzen, Dawn Walker, Kayla and Renae Walker, Kurt and Jennifer Williams, Allison and Buddy Carruth, Ashlee B. Mann, Kristin and Russell Bingley, Anja and Richard Blank, Matthew and Emily Dunn, James and Gari Erickson, Joshuah and Tessa Foster Foster Foster Foster Foster Foster Foster Foster Gillette, Michael and Alisyn Gomez, Maira and Ibarra, Eric Haines, Ryan and Kara Haynes, Donna Klaus, Dawn Long, Joshua and Jennifer Matzke, Michael and Sara Menzel, Kathrina and Jared Purtell, Nicole and Christopher Ritter, Thomas and Deborah 1694421 1687306 1692443 1694008 1640956 1678403 1694419 1674424 1561879 1547292 1659973 1658999 1661206 1520627 1649838 1683320 10994 1687293 1666078 Foster 1694423 Foster 1665608 Foster 1694425 Foster 1639129 Foster Foster Foster Foster Kinship Foster Foster Foster Foster Foster Kinship Foster Foster Kinship Foster Foster Foster Foster Foster Kinship 44282 1693525 1546248 1687324 833 Columbine Drive 1632 Pioneer Place 171226th Ave Ct 1106 S. Park Ave 7920 West 12th St. 2837 Avocado Ave. 520 Marquiss Ct. 488 Stonebrook Dr. 3919 28th Ave. 3000 W. 19th St. 3105 70th Ave. 1611 15th Ave. 25000 CR 69 2929 56th Aveune 1149 Northview Dr. 1678635 1674765^ 1700655 1669659 1714413 1717024 1716936 1707673 1714134 1688399 1710929 1712147 1716250 1707638 1708813 1554009 501 28th Ave. 3110 57th Ave. 423 28th Ave. 37700 Co. Rd. 23 Windsor, CO 80550 Eaton, CO 80615 Greeley, CO 80634 444 Johnstown, CO 80534 Greeley, CO 80634 Greeley, CO 80631 Dacono, CO 8.0514 Windsor, CO 80550 Evans, CO 80620 411 Pinyon St. 5121 W. 11th St., Apt. 409 319 Hackberry Ct 3919 W. 22nd Street 5819 W. 16th St. Ln. 318 Trailwood Drive 7681 Carlson Court 5540 S. Helena St. 3306 San Marco Ave. 420 Bobcat Dr. 418 30th Ave. Ct. 1251 Vail Ln. 413 Ash St. 2057 26th St. Rd. 5527 Wilderness Loop 200 N. 35th Ave., #219 2737 W. 14th St. 2343 W. 11th St. Rd. 348 Valley Ave. 2548 Palmer Ave. _ 1979 Cataluna Dr. 6025 Lynx Creek Circle 2391 Tate Ave. 1058 Mt. Columbia Drive Greeley, CO 80634 Greeley, CO 80634 Greeley, CO 80631 Kersey, CO 80644 Greeley, CO 80634 Erie, CO 80516 Greeley, CO 80634 Greeley, CO 80634 Greeley, CO 80634 Severance/ CO 80550 Frederick, CO 80530 Greeley, CO 80634 Eaton, CO 80615 Greeley, CO 80634 Greeley, CO 80634 Windsor, CO 80550 Ft. Collins, CO 80524 Centennial, CO 80015 Evans, CO 80620 Milliken, CO 80543 Greeley, CO 80634 Longmont, CO 80503 Kersey, CO 80644 Greeley, CO 80631 Marysville, CA 95901 Greeley, CO 80634 tt Greeley, CO 80634 Greeley, CO 80634 Lochbuie, CO 80603 Mead, CO 80542 Windsor, CO 80550 Frederick, CO 8053O Ft. Lupton, CO 80620 Severance CO 80550 WELD COUNTY FOSTER HOMES !!Shenk, Christopher and Diaz, Xioma Smith, Elizabeth Ann and Sean Michael Taylor, Jeff and Alexander Tucker, Tasha and Thomas Vance, Morgan and Kindvall, Brandon Visser, Ryan and Amanda White, Kristen Winterfeld, Rachel Jeffery, Jamie and Timothy, Walker Olson, Stacey Schultz, Alisha WestHolmes, Liesl and Corey Braunagel, Karen Schmidt, Constance and Donald II Schumaker, Russel and Colleen Wipf, Keith and Bethany Kidd, Roger and Michelle Johnston, Loyd and Trisha Hidalgo, Maribelle and Daniel Anderson, Lauren and Wayne Schmitz, Jill and Henry III DeSwarte, Jeremy and Melissa Thorman, Joel and Kira Shultzaberger, Shawn and Angela Johnson, Trevor and Angela Krisko, Tina Mars, Zachary and Maddisen Voigt, Joshua and Keri Hernandez, Robert and Christina Duarte, Tanya Gross, Nathan and Jennifer Lake, Austin and Carlie Baldwin, Tierney and Danny Osgood, Ed and Ja'Nae Rosales, Emilio and Martinez -Rosales, Esmeralda Meads, Amanda Armstrong, Zachary and Nicole Aikens, Carly and George Prine, Joseph and Tristie Tinnin, Chad and Julie Lopez, Vincent and Rose Lechman, Jay and Pamela Torres, Daniel and Jeannie Grigsby, Michael and Dennis, Esther Foster Foster Foster Foster Foster Foster Foster Foster Foster Kinship Foster Kinship Foster Foster Kinship Foster Foster Foster Foster Foster Kinship Foster Foster Foster Foster Foster Foster Kinship Kinship Kinship 1715961 1679422 1712176 1702726 1703052 1673369 1711814 1712735 1708865 1698259 1698304 1667110 1714402 1511343 1713457 1706601 1715791 1685257 1717718 1717024 1724587 1729279 709 Keensburg Ct. 2912 McIntosh Dr. 4943 W. C Street 2317 44th Ave. 500 Campbell St. 3212 68th Ave. Ct. M 1651 Kelmsley Ct. 340, W. 16th Street, #89 339 Valley Ave. 1297 Midland Street 812 North 6th Street 413 Spinnaker Lane 1775 Laurus Ln. 1725276 1725981 1723996 1720818 1721766 1725001 Foster Foster Foster Foster Kinship Kinship Foster Foster Kinship Kinship Kinship Kinship Foster Foster 1722438 1719596 1718928 1725170 1717778 1645611 1636676 1726778 1723158 1717024 1725512 1726195 1725071 1587465 1556847 1687385 17900 CR 5 10428 Cherry Vale St. 3266 Cramer Ave. 15182 Oak Knoll 2817 E. Aloma Ct. 5025 W. 22nd Street 8137 22nd Street 1915 88th Ave Ct 1302 S. 32nd Street 1315 20th Street, Unit A_ 1571 Red Tail Road Ft. Collins, CO 80525 Longmont, CO 80503 Greeley, CO 80634 Greeley, CO 80634 Kersey, CO 8O644 Greelen., CO 80634 Windsor, CO 80550 Greeley, CO 8063 1914 84th Ave. 201 E. South 1st Street 180 Muscovey Lane 195418th Ave. 14750 E. Pacific Place 420 E. 57th Street, #1.96 1301 14th Ave 2212 34th Avenue 4 Lochbuie, CO 80603 Brighton, CO 80601 11179 Yosemite Court 6760 Rodney Street 4315 W. 20th St. Road 2002 Battlecreek Drive, #10203 108 N. 50th Ave. 2225O WCR 62 1810 Avery Plaza Street 730 S. McKinley Ave. 1280 Lake Circle #G 5151 W. 29th Street, Unit 2004 6756 Sage Ave 5502 W. 3rd Street Manitowoc, WI 54220 Ft. Collins, CO 80525 Johnstown, CO 80534 Berthoud, CO 80513 Firestone, CO 80504 Evans, CO 80620 Monroe, MI 48161 Wichita, KS 67211 Greeley, CO 80634 Greeley, CO 80634 Greeley, CO 80634 Manitowoc, WI 54220 Greeley, CO 80631 Eaton, CO 80615 Greeley, CO 80634 Johnstown, CO 80534 Johnstown, CO 80534 Greeley, CO 80631 Aurora, CO 80014 Loveland, CO 80538 Greeley, CO 80631 Greeley, CO 80634 Longmont, CO 80504 Windsor, CO 80550 Greeley, CO 80634 Fort Collins, CO 80528 Greeley, CO 80634 Greeley, CO 80631 Severance, CO 80550 Fort Lupton, CO 80621 Windsor, CO 80550 Greeley, CO 80634 Firestone, CO 80504 Greeley, CO 80634 WELD COUNTY FOSTER HOMES Smith, Lynn and Clark, Wendy Billingsley, William Ill and Pribble, Kelly Foster Clark, David and Kaci Bauer, Steven and Cristine `McKeta, Steve and Clorisa Powell, Robert and Terrie Borchert, David and Jessica Troyer, Rodney and Kline -Troyer, Cynthia Van Winkle, Jonathon and Michelle Carrigan, Thomas and Robin Scudder, Nathan and Mistie Foster Foster Foster Foster v, .. Kinship C49 ......... .....x,5.••...y...n, 0000_ - - .,, Foster Foster Foster Foster Foster TOTTT .44,“ ,4.1.4%4w:.. -".S- jS -•-� 1603929 1659978 1725980 1726438 1728774 1643044 1729136 1659935 1731807 1728752 1521113 3000 Adobe Drive 2000 80th Ave Ct. 1862 18th Ave 29569 WCR 70 1870 Chesapeake Circle 19031 WCR 72 625 Dukes Way 2625 28th Ave 10163 Sandy Ridge Court 1452 Moraine Valley Drive 747 Rock Rd _ -4 ..._.'_r.n Fort Collins, CO 80525 Greeley, CO 80634 Greeley, CO 80631 Gill, CO 80624 000.0 Johnstown, CO 80534 Eaton, CO 80615 Dacono, CO 80514 Greeley, CO 80634 Firestone, CO 80504 Severance, CO 80550 Eaton, CO 80615 EXHIBIT A to the CWS-7A Additional Provisions for the Agreement to Purchase Foster Care Services and Foster Care Facility Agreement CWS-7A The following additional provisions in this Exhibit A, and Addendum 1 and Addendum 2, apply to the agreement entitled, "Individual Provider Contract for Purpose of Foster Care Services and Foster Care Facility Agreement," by and between the Weld County Department of Human Services, hereinafter referred to as, "County," and «Agency», hereinafter referred to as, "Provider." GENERAL PROVISIONS Each party shall have the right to terminate this Agreement by giving the other party written notice received at least thirty (30) days prior to the intended date of termination. If notice is so given, this Agreement shall terminate upon the expiration of thirty (30) days, or until the eligible child(ren) may be placed elsewhere, whichever occurs first, and the liability of the parties hereunder for further performance of the terms of this Agreement shall thereupon cease; however, the parties shall not be released from the duty to perform their obligations up to the date of termination. This provision does not affect removal of a child in an emergencysituation. 2. Provider agrees that Provider is an independent contractor and that neither Provider nor Provider's agents or employees are, or shall be deemed to be, agents or employees of the County for any purpose. Provider shall have no authorization, express or implied, to bind the County to any agreement, liability, or understanding. The parties agree that Provider will not become an employee of County, nor is Provider entitled to any employee benefits from County as a result of the execution of this Agreement. Provider shall be solely and entirely responsible for its acts or of any agent, employee, servants and sub -Providers during the performance of this Agreement. 3. Payment pursuant to this Agreement, if in State of Colorado, county, or federal funds, whether in whole or in part, is subject to and contingent upon the continuing availability of State of Colorado, county, and federal funds for the purpose thereof. 4. This Amendment is intended to be applied in conjunction with attached Agreement and the Needs Based Care Addendum as the complete integration of all understandings between the parties. No prior or contemporaneous addition, deletion or other amendment hereto shall have any force or affect whatsoever, unless embodied herein in writing. No subsequent notation, renewal, addition, deletion, or other amendment hereto shall have any force or effect unless embodied as a part of this written Agreement. This section shall not be construed as prohibiting the periodic amending of this Agreement or the Needs Based Care Addendum in writing, if agreed to by both parties. The Agreement, this Exhibit A and the Needs Based Care Addendum are intended to be in lieu of and supersede all prior agreements between the parties hereto and relating to the care and services herein described. 5. The State of Colorado Department of Human Services and the County shall be and hereby is permitted to monitor the service program, fiscal and other records sufficiently to assure the purchase of services in this Agreement are carried out for the benefit of the aforementioned child or youth. Monitoring may occur through review of program reports, on -site visits where applicable and other Agreements as deemed necessary. Provider understands that the State Department and the County may provide consultation to Provider to assure satisfactory performance in the provision of purchased services under thisAgreement. 6. County shall have access to Provider's service program, financial and other records, which will sufficiently and properly reflect all direct and indirect costs of any nature incurred in the performance of this Agreement for purposes of audit. Such records shall be complete and available for audit 90 days after final payment hereunder and shall be retained and available for audit purposes for at least five years after final paymenthereunder. 7. Time is of the essence in each and all of the provisions of this Agreement. Exhibit A to the CWS-7A 5 Revised 6/2019 8. 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. 9. Any notice required to be given under this Agreement shall be in writing and shall be mailed or delivered to the other party at that party's address as stated in this Agreement. 10. This Agreement is nonexclusive and County may engage or use other Providers or persons to perform services of the same or similar nature. 11. Provider certifies, warrants, and agrees that it does not knowingly employ or contract with an illegal alien who will perform work under this contract. Provider will confirm the employment eligibility of all employees who are newly hired for employment in the United States to perform work under this Agreement, through participation in the E -Verify program or the State of Colorado program established pursuant to C.R.S. §8-17.5-102(5)(c). Provider shall not knowingly employ or contract with an illegal alien to perform work under this Agreement or enter into a contract with a sub -contractor that fails to certify with Provider that the sub -contractor shall not knowingly employ or contract with an illegal alien to perform work under this Agreement. Provider 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 Provider obtains actual knowledge that a sub -contractor performing work under the public contract for services knowingly employs or contracts with an illegal alien Provider shall notify the sub -contractor and County within three (3) days that Provider has actual knowledge that a sub -contractor is employing or contracting with an illegal alien and shall terminate the subcontract if a sub -contractor does not stop employing or contracting with the illegal alien within three (3) days of receiving notice. Provider shall not terminate the contract if within three days the sub -contractor provides information to establish that the sub -contractor has not knowingly employed or contracted with an illegal alien. Provider 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 Provider participates in the State of Colorado program, Contract Professional shall, within twenty days after hiring a new employee to perform work under the contract, affirm that Provider 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. Provider shall deliver to County, a written notarized affirmation that it has examined the legal work status of such employee, and shall comply with all of the other requirements of the State of Colorado program. If Provider fails to comply with any requirement of this provision or of C.R.S. §8-17.5-101 et seq., County, may terminate this Agreement for breach, and if so terminated, Provider shall be liable for actual and consequential damages. Except where exempted by federal law and except as provided in C.R.S. § 24-76.5 103(3), if Provider receives federal or state funds under the contract, Provider 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 Provider 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. 12. Provider assures and certifies that it and its principals: A. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by a federal department or agency. Exhibit A to the CWS-7A 6 Revised 6/2019 B. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; C. Are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph (B) above. D. Have not within a three-year period preceding this Agreement, had one or more public transactions (federal, state, and local) terminated for cause ordefault. 13. In addition to terminating this Agreement in accordance with the provisions herein, County may exercise the following remedial actions if the County finds and determines that the Provider has substantially failed to satisfy the duties found in this Agreement, Exhibit A or the Needs Based Care Addendum. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Provider. These remedial actions include, but are not limited to, any one or more of the following: A. Withhold payment to Provider until the necessary services or corrections in performance are satisfactorily completed. B. Deny payment or recover reimbursement for those services or deliverables which have not been performed and which due to circumstances caused by Provider cannot be performed or if performed would be of no value to County. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to County. C. Recover from Provider any incorrect payment to Provider due to omission, error, fraud, and/or defalcation by deducting from subsequent payments under this Agreement, or other agreements between County and Provider, or as a debt to County, or otherwise as provided by law. 14. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties or their assignees receiving services or benefits under this Agreement shall be an incidental beneficiary only. 15. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or their officers or employees may possess, nor shall any portion of this Agreement be deemedto have created a duty of care that did not previously exist with respect to any person not a party to this Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to circumvent or replace such immunities. 16. Provider shall promptly notify County in the event in which it is a party defendant or respondent in a case, which involves services provided under the agreement. The Provider, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any federal or state court or administrative agency, shall deliver copies of such document(s) to the County Director. The term "litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy, reorganizations and/or foreclosure. 17. This Agreement and the provision of services hereunder shall be subject to the laws ofColorado and be in accordance with the policies, procedures, and practices of County. Provider shall strictly comply with all applicable federal and State laws, rules and regulations in effect or hereafter established. 18. Financial obligations of the County payable after the current fiscal year are contingent upon funds Exhibit A to the CWS-7A 7 Revised 6/2019 for that purpose being appropriated, budgeted and otherwise made available. Execution of this Agreement by County does not create an obligation on the part of County to expend funds not otherwise appropriated in each succeeding year. 19. County and Provider agree that a child specific Needs Based Care Assessment, designated as Addendum 1 shall be used to determine the Child Maintenance and Medical Needs, if applicable, for each child placed with Provider unless otherwise negotiated and approved by the County. 20. County agrees to purchase and Provider agrees to provide the care and services, which are listed in this Agreement, based on the Needs Based Care Assessment levels determined. The specific rate of payment will be paid for the Child Maintenance level of service, as indicated by the Needs Based Care Rate Table, designated as Addendum 2, for children placed within the Weld County Certified Foster Care Home identified as Provider ID# «Agency_ID». These services will be for children who have been deemed eligible for social services under the statutes, rules and regulations of the State of Colorado. 21. All bed hold authorizations and payments are subject to a 7 -day maximum for a child's temporary absence from a facility; however, if the absence is a result of hospitalization the maximum bed hold authorization may be up to 14 days. Bed hold requests must have prior written authorization from the Department Administrator or Designee before payment will be release to Provider. 22. Any additional costs for specialized services, which may include but are not limited to; Co -pays, deductibles, or services not covered by Medicaid, will need to be authorized, in writing by the Department Administrator, prior to the service being performed. Any payment for specialized services not authorized in writing may be denied. 23. All reimbursement requests shall: A. Be submitted in a format approved by the County. If submitted in an unapproved format or inadequate documentation is provided, the County reserves the right to deny payment. B. Be submitted by the 4th of each month following the month of service. If the reimbursement request is not submitted within twenty-five (25) calendar days ofthe month following service, it may result in forfeiture ofpayment. C. Placement service reimbursement shall be paid from the date of placement up to, but not including the day of discharge. D. Transportation reimbursement shall be for visitation purposes only. If medical transportation is needed, Provider will arrange reimbursement through Medicaid. Any other special requests for transportation reimbursement shall require prior approval by the Resource Manager or the DepartmentAdministrator. E. Clothing allowance reimbursement shall be approved and reimbursed as indicated on the clothing allowance form accessed through the Foster Parents Database On-line System (FIDOS). 24. It is agreed that if, after investigation, it is shown that reasonable care was given to guard and protect personal items brought to Provider by the children, Provider shall be released from responsibility for loss or damage to such personal items. PROVIDER SHALL: 1 Conform with and abide by all rules and regulations of the Colorado Department of Human Services, the Colorado Department of Health Care Policy and Financing (if appropriate), the State of Colorado and any applicable federal laws and regulations, as such, which may be amended from time to time, and shall be binding on Provider and control any disputes in this Agreement. 2. Not charge any fees to children or families of children referred by County for any services provided under this Agreement. Exhibit A to the CWS-7A 8 Revised 6/2019 3. Not assign the obligations under this Agreement nor enter into any sub -Agreement without the express written approval of the Director of the County Department or his/her appointed designee. 4. Maintain at all times during the term of this Agreement a liability insurance policy of atleast $25,000 for property damage liability, $150,000 for injury and/or damage to any one person, and $500,000 for total injuries arising from any one accident. Provider shall provide a certificate of insurance provided by its insurer upon request by County. 5. Indemnify the County against any and loss against all claims and actions based upon or arising out of damage or injury, including death, to persons or property caused or sustained in connection with the performance of this Agreement or by conditions created thereby, or based upon any violations of any statute, ordinance, or regulation and the defense of any such claims or actions. 6. Attend or participate in Ice Breaker, Family Engagement or Team Decision making meetings, if requested by the Department. County staff shall notify the Provider of the dates and times attendance is requested. 7. Request a staffing if considering giving notice to remove a child, except in emergency situations. These requests shall be made through the child's caseworker and/or the Provider's Foster Care Coordinator. 8. Actively participate in achieving the child's permanency goal, cooperate with any contractors hired by the Weld County Department of Human Services to preserve placement in the least restrictive placement appropriate, comply with the treatment plan of the child, and attendcourt hearings as requested. 9. Have physical examinations completed within 14 days and dental examinations completed within 8 weeks of the child being placed with Provider. All documentation of these examinations will be placed in the foster child's placement binder. 10. Attend all necessary school meetings and support any plan that is developed regarding the child in order to promote educational success. 11. Immediately report to the County Department and/or local law enforcement any known or suspected child abuse or neglect as set forth in Section 19-3-304, C.R.S. 12. Maintain, access and review information weekly on FIDOS. 13. Maintain/update information in the foster child's binder. The binder will be reviewed on amonthly basis and signed off by child's caseworker and/or the Provider's Foster Care Coordinator. 14. Maintain/update medication logs on a daily basis, if child is taking medications. 15. Maintain behavior observation notes as required by the level of care assessed for each child. 16. Comply with all County and State certification requirements as set forth in the State Department rules, Staff Manual Volume VII and the Weld County Department of Human Services Policy and Procedure manual. Exhibit A to the CWS-7A 9 Revised 6/2019 ADDENDUM 1 Needs Based Care Assessment NBC (NEEDS BASED CARE ASSESSMENT) Answers to the following questions will determine the NBC closest rating for this child. The following seven (7) questions Care Payment. For each question below please select the are mutually exclusive. P1. How often does the child require transportation by the foster care provider for the following: Therapy; Medical Treatment; Family Visitation; Extraordinary Educational Needs; etc., as outlined in the treatment plan? Select One P2. How often is the foster care provider required to participate in child's therapy or counseling sessions? Select One P3. How much time is the provider required to intervene at home and/or at school with the child in conjunction with a regular or special education plan? Select One P4. How often does the child require special and extensive scheduling and monitoring of time and/or activities and/or involvement by the provider in Select One crisis management? P5. How much time is the provider required to assist the child beyond aqe appropriate needs with feeding, bathing, grooming, because of impairments physical, and/or Select One occupational therapy? Al. How often is CPA/County case management required? (Does not include therapy) **Please Note: The Case Management level may be assessed on a combined basis if a sibling group or more than one County foster child is with the same provider. Select One T1. How assessment? NBC (NEEDS often are therapy services needed to address child's individual needs per NBC Select One BASED CARE ASSESSMENT) — Behavioral Assessment Assessment Areas: Comment: Rating: ❑ Aggression/Cruelty to Animals Select One ❑ Verbal or Physical Threatening Select One ❑ Destructive of Property/Fire Setting Select One ❑ Stealing Select One ❑ Self -injurious Behavior Select One ❑ Substance Abuse Select One ❑ Presence of Psychiatric Symptoms/Conditions Select One • Enuresis/Encopresis Select One ❑ Runaway Select One ❑ Sexual Offenses Select One ❑ Inappropriate Sexual Behavior Select One ❑ Disruptive Behavior Select One ❑ Delinquent Behavior Select One ❑ Depressive -like Behavior Select One ❑ Medical Needs - (If condition is rated "severe", please complete the Medically fragile NBC) Select One I Emancipation Select One ❑ Eating Problems Select One ❑ Boundary Issues Select One ❑ Requires Night Care Select One ❑ Education Select One 1-1 Involvement with Child's Family Select One Addendum 1 10 Revised 5/2018 ADDENDUM 2 Needs Based Care Rate Table Weld County Department of Human Services (Effective 7/01/2018) . LEVEL' OF SERVICE CHILD MAINTENANCE RESPITE 'MEDICAL NEEDS Level Daily Rate Daily Rate Daily Rate County Basic Maintenance Rate $35.70 $.66 1 $35.70 $.66 $3.54 1 'V2 $35.70 $.66 2 $35.70 $.66 $5.09 2 ''/ $38.99 $.66 3 $42.28 $.66 $6.66 3 1/2 $45.57 $.66 4 Congregate Care Drop Down $48.86 $.66 Negotiated Assessment/ Emergency Level Rate $35.70 $.66 Addendum 2 11 Revised 8/2018 Hello