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Home My WebLink About20182736.tiff(gn+ra c+ _) 4P 0 31 Co CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND COLORADO BOYS RANCH FOUNDATION D.B.A. CBR YOUTHCONNECT This Agreement, made and entered into thep2/day of itu°A , 2018, by and between the Board of Weld County Commissioners, on behalf of the Weld County Department ofTiuman Services, hereinafter referred to as the "Department' and Colorado Boys Ranch d.b.a. CBRYouthConnect, hereinafter referred to as the "Contractor". The parties to this Agreement understand and agree that the provisions of this Agreement specifically include the following documents: Exhibit A, Weld County's Request for Bid, Exhibit B, Contractor's Bid, Exhibit C, Scope of Services, and Exhibit D, Payment Schedule. Each of these documents is attached hereto and incorporated herein by this reference. WITNESSETH WHEREAS, required approval, clearance, and coordination have been accomplished from and with appropriate agencies; and WHEREAS, the Colorado Department of Human Services has provided Core Services or other funding to the Department for Preventative Aftercare (PAC), Specialized Mentoring, Supervised Visitation, Small Group Options, and Community Connections, . NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: 1. Term This agreement shall become effective on June 1, 2018, upon proper execution of this Agreement and shall expire May 31, 2019, unless sooner terminated as provided herein. The agreement is for a period of three years. However, the agreement must be renewed by both parties, in writing, on an annual basis. 2. Scope of Services Services shall be provided by the Contractor to any person(s) eligible for services in compliance with Exhibit B, Contractor's Bid and Exhibit C, Scope of Services. 3. Referrals, Billing and Tracking a. Contractor understands and will comply with all aspects of the referral authorization, billing and tracking requirements as set forth by the Department. Failure to comply with all aspects may result in a forfeiture of payment. b. Contractor agrees to receive referrals for services through e-mail and will provide an identified e- mail address prior to the start of this Agreement. Contractor acknowledges that services are not authorized until the Contractor has received an authorized referral form from the Department. Contractor further acknowledges that services provided prior to the authorized start date or outside the scope of services on the referral form will not be eligible for reimbursement. Contractor acknowledges that any and all modifications to an existing referral must be approved through the Department's Resource Manager, Child Welfare Contract and Services Coordinator, or through a Team Decision Making (TDM) meeting or Family Team Meeting (FTM). No other Department staff or other party to the case may authorize services or modifications to services. 1 46,4zi( 8 -a7 -/g 1-(R©og-q 2018-2736 c. Contractor agrees to submit an itemized complete billing statement by the 7th of the month, following the month of service, utilizing billing forms required by the Department. d. Contractor agrees to submit a monthly report with the billing statement by the 7th of the month following the month of service for each client receiving ongoing services. One-time services will be verified through receipt of the completed product (ex. psychological evaluation, substance abuse evaluation). Verification of Monitored Sobriety Services will be the test result. Contractor will document in detail any and all observed or verbalized concerns regarding any child whom the Contractor is working with under the Agreement. Areas of concern may include, but are not limited to, any physical, emotional, educational or behavioral issues. Areas of concern should be reported immediately to the caseworker AND on the required monthly report. Monthly reports will be submitted through the Department's online reporting system, unless otherwise directed or agreed to by the Department. 4. Payment a. The Department and the Contractor agree that all benefits from private insurance and/or other funding sources such as Medicaid (if Contractor is a Medicaid eligible provider) or Victim's Compensation must be exhausted before Core Services or other Department funds can be accessed for services. Exceptions to this Paragraph may include, if approved by the Department, the following: i. The service being provided by the contractor is not a Medicaid eligible service; ii. The service is not deemed medically necessary; iii. The Court with jurisdiction over the case has ordered that a non -Medicaid provider or service be used; iv. A Medicaid provider is not available to provide the needed service; v. Medicaid is exhausted for the needed service; or vi. Medicaid denied service. vii. The client is not eligible for Medicaid. b. Payment shall be made in accordance with Exhibit A, Weld County's Request for Bid, Exhibit B, Contractor's Bid, Exhibit C, Scope of Services, and Exhibit D, Payment Schedule, attached hereto and incorporated herein by reference, so long as services are rendered satisfactorily and in accordance with the Agreement. c. Payment pursuant to this Agreement, whether in whole or in part, is subject to, and contingent upon, the continuing availability of said funds for the purposes hereof. d. The Department may withhold reimbursement if Contractor has failed to comply with any part of the Agreement, including the Financial Management requirements, program objectives, contractual terms, or reporting requirements. In the event of forfeiture of reimbursement, Contractor may appeal such circumstance in writing to the Director of Human Services. The decision of the Director of Human Services shall be final. 5. Financial Management At all times from the effective date of the Agreement until completion of the Agreement, Contractor shall comply with the administrative requirements, cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under this Agreement must conform to the Single Audit Act of 1984 and OMG Circular A-133. 2 6. Payment Method Unless otherwise provided in Exhibit B, Contractor's Bid, Exhibit C, Scope of Services, and Exhibit D, Payment Schedule: a. If services are funded through Core Services, Contractor agrees to accept reimbursement through ACH direct deposit one time per month. b. If Contractor is not currently set up with the State of Colorado to accept direct deposit, Contractor agrees to complete and submit an ACH Form for Colorado Providers, which will be provided by the Department. Contractor is solely responsible to submit the ACH Form to the State of Colorado per the directions on the form. Failure to complete and submit this form in a timely and accurate manner may result in a delay of payment. c. Contractor agrees to accept payment through county warrant when funding source does not allow for direct deposit. 7. Compliance with Applicable Laws a. At all times during the performance of this Agreement, Contractor will strictly adhere to all applicable Federal and State laws, order, and applicable standards, regulations, interpretations and/or guidelines issued pursuant thereto. This includes protection of the confidentiality of all applicant/recipient records, papers, documents, tapes and any other materials that have been or may hereafter be established which relate to the Agreement. Contractor shall abide by all applicable laws and regulations, including, but not limited to the following: - Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d-1 Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d-1 et. seq. and its implementing regulation, 45 C.F.R. Part 80 et. seq.; and - all provisions of the Civil Rights Act of 1986 so that no person shall, on the grounds of race, creed, color, sex, or national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under the approved Agreement. - Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 794, and its implementing regulations, 45 C.F.R. Part 84; and - the Age Discrimination Act of 1975, 42 U.S.C. Section 6101 et. seq. and its implementation regulations, 45 C.F.R. Part 91; and Title VII of the Civil Rights Act of 1964; and the Age Discrimination in Employment Act of 1967; and the Equal Pay Act of 1963; and the Education Amendments of 1972; and Immigration Reform and Control Act of 1986, P.L. 99-603, 42 C.F.R. Part 2; and - all regulations applicable to these laws prohibiting discrimination because of race, color, national origin, sex, religion, and handicap, including Acquired Immune Deficiency Syndrome (AIDS) or AIDS related conditions covered under Section 504 of the Rehabilitation Act of 3 1973, as amended, cited above. If necessary, Contractor and the Department will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 C.F.R. Part 2. 45 C.F.R. Part 74, Appendix G 9, which requires that affirmative steps be taken to assure that small and minority businesses are utilized, when possible, as sources of supplies, equipment, construction and services. This assurance is given in consideration of and for the purpose of obtaining any all Federal and/or State financial assistance. - Colorado Revised Statute (C.R.S.) 26-6-104, requiring criminal background record checks for all employees, contractors and sub -contractors. b. Contractor is further charged with the knowledge that any person who feels that s/he has been discriminated against has the right to file a complaint either with the Colorado Department of Human Services or with the United States Department of Health and Human Services, Office for Civil Rights. c. Contractor assures that it will fully comply with all other applicable Federal and State laws which may govern the ability of the Department to comply with the relevant funding requirements. Contractor understands the source of funds to be accessed under the Agreement is Core Services. d. Contractor assures and certifies that it and its principals: - Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transaction by a Federal or State department or agency; and - have not, within a three-year period preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or Local) transaction or contract under public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; and - are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state or local) with commission of any of the offenses enumerated in this certification; and - have not, within a three-year period preceding this Agreement, had one or more public transactions (federal, state, or local) terminated for cause or default. e. Public Contracts for Services C.R.S. §8-17.5-101. 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 4 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 a 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. f. 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. 8. Compliance with Child and Family Services Review The Child and Family Services Review (CFSR) examines child welfare service outcomes in three areas; Safety, Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's performance according to national standards and monitor progress over time. Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance services to families. Contractor agrees to continually strive for positive outcomes in the areas of Safety, Permanency and Well Being. Contractor will ensure that any employee or subcontractor of Contractor providing services under this Agreement will work towards positive outcomes in the aforementioned three areas as outlined under the Child and Family Services Review (CFSR), and will address the aforementioned three areas when completing monthly reports as required by Paragraph 3(d) of this Agreement. 9. Insurance Requirements Contractor and Department agree that Weld County, the Board of County Commissioners of Weld County, its officers and employees, shall not be held liable for injuries or damages caused by any negligent acts or omissions of the Contractor, it subcontractor, or their employees, volunteers, or agents while performing duties described in this Agreement. Contractor shall indemnify, defend and hold harmless Weld County, the Board of County Commissioners of Weld County, its employees, volunteers and agents. Contractor shall provide the liability insurances (including professional liability insurances where necessary) and worker's compensation insurances for all its employees, volunteers, and agents engaged in the performance of this Agreement which are required under Weld County's Request for Bid, and required by the Colorado Worker's Compensation Act. Contractor shall provide the Department with the acceptable evidence that such coverage is in effect within seven (7) days of the date of this Agreement. 5 At a minimum, Contractor shall procure, either personally or through its employer as applicable to the Contractor's business, at its own expense, and maintain for the duration of the work, the following insurance coverage. Weld County, State of Colorado, by and through the Board of County Commissioners of Weld County, its employees and agents, shall be named as additional named insured on the insurance, where permissible the insurance provider. a. General Requirements: Contractors/Contract Professionals must secure, at or before the time of execution of any agreement or commencement of any work, the following insurance covering all operations, goods or services provided pursuant to this request. Contractors/Contract Professionals shall keep the required insurance coverage in force at all times during the term of the Agreement, or any extension thereof, and during any warranty period. The required insurance shall be underwritten by an insurer licensed to do business in Colorado and rated by A.M. Best Company as "A"VIII or better. Each policy shall contain a valid provision or endorsement stating "Should any of the above -described policies by canceled or should any coverage be reduced before the expiration date thereof, the issuing company shall send written notice to the Weld County Director of General Services by certified mail, return receipt requested. Such written notice shall be sent thirty (30) days prior to such cancellation or reduction unless due to non- payment of premiums for which notice shall be sent ten (10) days prior. If any policy is in excess of a deductible or self -insured retention, County must be notified by the Contractor/Contract Professional. Contractor/Contract Professional shall be responsible for the payment of any deductible or self -insured retention. County reserves the right to require Contractor/Contract Professional to provide a bond, at no cost to County, in the amount of the deductible or self - insured retention to guarantee payment of claims. The insurance coverages specified in this Agreement are the minimum requirements, and these requirements do not decrease or limit the liability of Contractor/Contract Professional. Contractor/Contract Professional shall maintain, at its own expense, any additional kinds or amounts of insurance that it may deem necessary to cover its obligations and liabilities under this Agreement. b. Types of Insurance: Contractor/Contract Professional shall obtain, and maintain at all times during the term of any Agreement, insurance in the following kinds and amounts: i.Workers' Compensation Insurance as required by state statute, and Employer's Liability Insurance covering all of Contractor's Contract Professional's employees acting within the course and scope of their employment. If Contractor is an Independent Contractor, as defined by the Colorado Worker's Compensation Act, this requirement shall not apply. Contractor must submit to the Department a Declaration of Independent Contractor Status Form prior to the start of this agreement. ii.Commercial General Liability Insurance written on ISO occurrence form CG 00 01 10/93 or equivalent, covering premises operations, fire damage, independent Contractors, products and completed operations, blanket contractual liability, personal injury, and advertising liability with minimum limits as follows: $1,000,000 each occurrence; $2,000,000 general aggregate; $50,000 any one fire; and $500,000 errors and omissions. iii.Automobile Liability: Contractor/Contract Professional shall maintain limits of $1,000,000 for bodily injury per person, $1,000,000 for bodily injury for each accident, and $1,000,000 for property damage applicable to all vehicles operating both on County property and elsewhere. 6 iv.Additional Provisions: Policies for all general liability, excess/umbrella liability, liquor liability and pollution liability must provide the following: If any aggregate limit is reduce by twenty-five percent (25%) or more by paid or reserved claims, Contractor shall notify County within ten (10) days and reinstate the aggregates required; Unlimited defense costs in excess of policy limits; Contractual liability covering the indemnification provisions of this Agreement; A severability of interests provision; Waiver of exclusion for lawsuits by one insured against another; A provision that coverage is primary; and A provision that coverage is non-contributory with other coverage or self-insurance provided by County. v.For all general liability, excess/umbrella liability, liquor liability, pollution liability and professional liability policies, if the policy is a claims -made policy, the retroactive date must be on or before the contract date or the first date when any goods or services were provided to County, whichever is earlier. c. Contractors/Contract Professionals shall secure and deliver to County's Risk Administrator ("Administrator") at or before the time of execution of this Agreement, and shall keep in force at all times during the term of the Agreement as the same may be extended as herein provided, a commercial general liability insurance policy, including public liability and property damage, in form and company acceptable to and approved by said Administrator, covering all operations hereunder set forth in the related Bid or Request for Bid. d. Proof of Insurance: Contractor/Contract Professional shall provide a copy of this information to its insurance agent or broker, and shall have its agent or broker provide proof of Contractor/Contract Professional's required insurance. County reserves the right to require Contractor/Contract Professional to provide a certificate of insurance, a policy, or other proof of insurance as required by the County's Risk Administrator in his sole discretion. e. Additional Insureds: For general liability, excess/umbrella liability, pollution legal liability, liquor liability, and inland marine, Contractor/Contract Professional's insurer shall name County as an additional insured as follows: County of Weld 1150 'O' Street Greeley, Colorado 80631 f. Waiver of Subrogation: For all coverages, Contractor/Contract Professional's insurer shall waive subrogation rights against County. g. Subcontractors: All subcontractors, subcontractors, independent contractors, sub - vendors, suppliers or other entities providing goods or services required by this Agreement shall be subject to all of the requirements herein and shall procure and maintain the same coverages required of Contractor/Contract Professional. Contractor/Contract Professional shall include all such subcontractors, independent contractors, sub -vendors suppliers or other entities as insureds under its policies or shall ensure that all subcontractors maintain the required coverages. Contractor/Contract Professional agrees to provide proof of insurance for all such subcontractors, independent contractors, sub -vendors suppliers or other entities upon request by the County. A provider of Professional Services (as defined in the Bid or RFP) shall provide the following coverage: Professional Liability: Contract Professional shall maintain limits of $1,000,000 for each claim, and $2,000,000 aggregate limit for all claims. 10. Certification Contractor certifies that, at the time of entering into this Agreement, it has currently in effect all necessary licenses, approvals, insurance, etc., required to properly provide the services and/or supplies covered by this Agreement. Copies of all necessary licenses shall be provided to the Department by the Contractor prior to the start of any Agreement. 11. Training Contractor may be required to attend training that the request of the Department specific to services provided under this Agreement. The Department will not compensate the Contractor for said training in the form of registration fees, time spent traveling to and from training, attending the training or any other associated costs unless otherwise agreed to by the Department. 12. Subpoenas Contractor will, on behalf of its employees and/or officers, accept any subpoena for testimony from the Weld County Attorney's Office by e-mail and will return a waiver of services within 72 business hours. For this purpose, Contractor will designate an e-mail address prior to the start of this Agreement. If the Contractor receives a subpoena via e-mail but will only accept personal service, the Contractor will contact the Weld County Attorney's Office immediately at 970-352-1551, x6503, and advise that the subpoena must be personally served. 13. Monitoring and Evaluation Contractor and the Department agree that monitoring and evaluation of the performance of this Agreement shall be conducted by the Contractor and the Department. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners, the Department and the Contractor. Contractor shall permit the Department, and any other duly authorized agent or governmental agency, to monitor all activities conducted by the Contractor pursuant to the terms of this Agreement. As the monitoring agency may in its sole discretion deem necessary or appropriate, such program data, special analyses, on -site checking, formal audit examinations, or any other reasonable procedures. All such monitoring shall be performed in a manner that will not unduly interfere with the work conducted under this Agreement. 14. Modification of Agreement All modifications to this Agreement shall be in writing and signed by both parties. 15. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find 8 the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: - Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed. - Deny payment or recover reimbursement for those services or deliverables, which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Department. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to the Department. - Incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation shall be recovered from Contractor by deduction from subsequent payments under this Agreement or other agreements between the Department and Contractor, or by the Department as a debt due to the Department or otherwise as provided by law. 16. Representatives For the purpose of this Agreement, the individuals identified below are hereby designated representatives of the respective parties. Either party may from time to time designate in writing a new or substitute representative(s). For Department: For Contractor: Heather Walker, Administrator Charles "Chuck" M. Thompson, President/CEO 17. Notice All notices required to be given by the parties hereunder shall be given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing a substitute person(s) or address to whom such notices shall be sent. For Department: Judy A. Griego, Director P.O. Box A Greeley, CO 80632 (970) 352-1551 18. Litigation For Contractor: Charles "Chuck" M. Thompson, President/CEO 12567 West Cedar Drive, Suite 210 Lakewood, CO 80228 (303) 691-6095 Contractor shall promptly notify the Department in the event that Contractor learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement. Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any Federal or State court or administrative agency, shall deliver copies of such document(s) to the Director of Human Services. The term "litigation" includes an assignment for the benefit of creditors, and filings of bankruptcy, reorganization and/or foreclosure. 19. Termination This Agreement may be terminated at any time by either party giving thirty (30) days written notice to the individuals identified in paragraph 17. No portion of this Agreement shall be deemed to create an obligation on the part of the County of Weld, State of Colorado, to expend funds not otherwise 9 appropriated in each succeeding year, as this Agreement is subject to the availability of funding. Therefore, the Department may terminate this Agreement at any time if the source of funding for the services made available to the Contractor is no longer available to the Department, or for any other reason. Contractor reserves the right to suspend services to clients if funding is no longer available. 20. No Third -Party Beneficiary Enforcement It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 21. Governmental Immunity No term or condition of this contract shall be construed or interpreted as a waiver, express or implied, of any of the immunities, rights, benefits, protections or other provisions, of the Colorado Governmental Immunity Act of §§24-10-101 et. seq., as applicable now or hereafter amended. 22. Partial Invalidity of Agreement If any section, subsection, paragraph, sentence, clause, or phrase of this Agreement is for any reason held or decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The parties hereto declare that they would have entered into this Agreement and each and every section, subsection, paragraph, sentence, clause, and phrase thereof irrespective of the fact that any one or more sections, subsections, paragraphs, sentences, clauses, or phrases might be declared to be unconstitutional or invalid. 23. Improprieties/Conflict of Interest No officer, member or employee of Weld County and no member of their governing bodies shall have any pecuniary interest, direct or indirect, in the approved Agreement or the proceeds thereof. The Appearance of Conflict of Interest applies to the relationship of a Contractor with the Department when the Contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest, it is not necessary for the Contractor to gain from knowledge of these opposing interests. It is only necessary that the Contractor know that the two relationships are in opposition. During the term of the Agreement, Contractor shall not enter into any third -party relationship that gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation, Contractor shall submit to the Department, a full disclosure statement setting forth the details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for the Department's termination, for cause, of its Agreement with the Contractor. Contractor certifies that Federal appropriated funds have not been paid or will be paid, by or on behalf of Contractor, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of an Federal contract, loan, grant, or cooperative agreement. 10 24. Storage, Availability and Retention of Records Contractor agrees that authorized local, Federal, and State auditors and representatives shall, during business hours, have access to inspect and copy records, and shall be allowed to monitor and review through on -site visits, all activities related to this Agreement, supported with funds under this Agreement, to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. All such records, documents, communications, and other materials created pursuant or related to this Agreement shall be maintained by the Contractor in a central location and shall be made available to the Department upon its request, for a period of seven (7) years from the date of final payment under this Agreement, or for such further period as may be necessary to resolve any matters which may be pending, or until an audit has been completed with the following qualifications: If an audit by or on behalf of the Federal and/or State government has begun but is not completed at the end of the seven (7) year period, or if audit findings have not been resolved after a seven (7) period, the materials shall be retained until the resolution of the audit finding. 25. Confidentiality of Records Contractor shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Agreement except for purposes directly connected with the administration of Child Protection. No information about or obtained from any applicant/recipient in possession of Contractor shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with the Contractor's written policy governing access to, duplication and dissemination of, all such information, in any form, including social networks. Contractor shall advise its employees, agents, and subcontractor, if any, that they are subject to these confidentiality requirements. Contractor shall provide its employees, agents, and subcontractors, if any, with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. Contractor shall have its employees, agents, and subcontractors, if any, sign a written confidentiality agreement and shall provide a copy of such agreement to the Department, if requested. 26. Proprietary Information Proprietary information for the purposes of this Agreement is information relating to a party's research, development, trade secrets, business affairs, internal operations and management procedures and those of its customers, clients or affiliates, but does not include information (1) lawfully obtained from third parties, (2) that which is in the public domain, or (3) that which is developed independently. Neither party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of this Agreement. Any proprietary information removed from the Department's site by the Contractor in the course of providing services under this Agreement will be accorded at least the same precautions as are employed by the Contractor for similar information in the course of its own business. 27. Independence of Contractor: Not an Employee of Weld County Contract Professional agrees that it is an independent Contract Professional and that Contract Professional'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. Contract Professional shall perform its duties hereunder as an independent Contract Professional. Contract Professional shall be 11 solely responsible for its acts and those of its agents and employees for all acts performed pursuant to this Agreement. Contract Professional, 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 Contract Professional or any of its agents or employees. Unemployment insurance benefits will be available to Contract Professional and its employees and agents only if such coverage is made available by Contract Professional or a third party. Contract Professional shall pay when due all applicable employment taxes and income taxes and local head taxes (if applicable) incurred pursuant to this Agreement. Contract Professional shall not have authorization, express or implied, to bind County to any agreement, liability or understanding, except as expressly set forth in this Agreement. Contract Professional shall have the following responsibilities with regard to workers' compensation and unemployment compensation insurance matters: (a) provide and keep in force workers' compensation and unemployment compensation insurance in the amounts required by law, and as set forth in Exhibit A, and provide proof thereof when requested to do so by County. 28. Entire Agreement This Agreement, together with all attachments hereto, constitutes the entire understanding between the parties with respect to the subject matter hereof, and may not be changed or modified except as state in Paragraph 14 herein. This Agreement shall be binding upon the parties hereto, their successors, heirs, legal representatives, and assigns. The Contractor and the Department may not assign any of its rights or obligations hereunder without the prior consent of both parties. 29. Agreement Nonexclusive This Agreement does not guarantee any work nor does it create an exclusive agreement for services. 30. Warranty The Contractor warrants that services performed under this Agreement will be performed in a manner consistent with the professional standards governing such services and the provisions of this Agreement. The Contractor shall faithfully perform the work in accordance with the standards of care, skill, training, diligence and judgment provided by highly competent individuals and entities that perform services of a similar nature to those described in this Agreement including Exhibits A, B, C, and D. 31. Acceptance of Services Not a Waiver Upon completion of the work, the Contractor shall submit to Department originals of all tests and results, reports, etc., generated during completion of this work. Acceptance by Department of reports and incidental material(s) furnished under this Agreement shall not in any way relieve the Contractor of responsibility for the quality and accuracy of the services. In no event shall any action by the Department hereunder constitute or be construed to be a waiver by the Department of any breach of covenant or default which may then exist on the part of the Contractor, and the Department's action or inaction when any such breach or default shall exist shall not impair or prejudice any right or remedy available to the Department with respect to such breach or default; and no assent, expressed or implied, to any breach of any one or more covenants, provisions or conditions of the Agreement shall be deemed or taken to be a waiver of any other breach. Acceptance by the Department of, or payment for, any services performed under this Agreement shall not be construed as a waiver of any of the Department's rights under this Agreement or under the law generally. 32. Employee Financial Interest/Conflict of Interest. C.R.S. §§24-18-201 et seq. and §24-50-507 The signatories to this Agreement aver that to their knowledge, no employee of Weld County has any personal or beneficial interest whatsoever in the service or property which is the subject matter of this 12 Agreement. The Contractor has no interest and shall not acquire any interest direct or indirect, which would in any manner or degree with the performance of the Contractor's services and the Contractor, shall not employ any person having such known interests. During the term of this Agreement, the Contractor shall not engage in any in any business or personal activities or practices or maintain any relationships which actually conflict with or in any way appear to conflict with the full performance of its obligations under this Agreement. Failure by the Contractor to ensure compliance with this provision may result, in the Department's sole discretion, in immediate termination of this Agreement. No employee of the Contractor nor any member of the Contractor's family shall serve on a County Board, committee or hold any such position which either by rule, practice or action nominates, recommends, supervises Contract Professional's operations, or authorizes funding to the Contractor. 33. Board of County Commissioners of Weld County Approval This Agreement shall not be valid until it has been approved by the Board of County Commissioners of Weld County, Colorado. 34. Choice of Law/Jurisdiction Colorado law, and rules and regulations established pursuant thereto, shall be applied in the interpretation, execution, and enforcement of this Agreement. Any provision included or incorporated herein by reference which conflicts with said laws, rules and/or regulations shall be null and void. In the event of a legal dispute between the parties, Contract Professional agrees that the Weld County District Court shall have exclusive jurisdiction to resolve said dispute. 35. Subcontractors Contract Professional acknowledges that County has entered into this Agreement in reliance upon the particular reputation and expertise of Contract Professional. Contract Professional shall not enter into any subcontractor agreements for the completion of this project without County's prior written consent, which may be withheld in County's sole discretion. 36. Attorneys Fees/Legal Costs In the event of a dispute between County and Contract Professional, concerning this Agreement, the parties agree that each party shall be responsible for the payment of attorney fees and/or legal costs incurred by or on its own behalf. 37. Ownership All work and information obtained by Contract Professional under this Agreement or individual work order shall become or remain (as applicable), the property of County. In addition, all reports, documents, data, plans, drawings, records and computer files generated by Contract Professional in relation to this Agreement and all reports, test results and all other tangible materials obtained and/or produced in connection with the performance of this Agreement, whether or not such materials are in completed form, shall at all times be considered the property of the County. Contract Professional shall not make use of such material for purposes other than in connection with this Agreement without prior written approval of County. 38. Interruptions Neither party to this Agreement shall be liable to the other for delays in delivery or failure to deliver or otherwise to perform any obligation under this Agreement, where such failure is due to any cause beyond its reasonable control, including but not limited to Acts of God, fires, strikes, war, flood, earthquakes or Governmental actions. 13 39. Severability If any term or condition of this Agreement shall be held to be invalid, illegal, or unenforceable by a court of competent jurisdiction, this Agreement shall be construed and enforced without such provision, to the extent that this Agreement is then capable of execution within the original intent of the parties. IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. COUNTY: ATTEST: Weld C By: Deputy Clerk to darrAeo BOARD OF COUNTY COMMISSIONERS ty Clerk to the Board WELD COUNTY, COLORADO 14 arbara Kirkme Chair Pro-Tem CONTRACTOR: Colorado Boys Ranch Foundation d.b.a. CBRYouthConnect 12567 West Cedar Drive, Suite 210 Lakewood, CO 80228 (303) 691- B Date: , President/CEO Charles M. T om pson ao►g- a�3CO EXHIBIT A WELD COUNTY'S REQUEST FOR BID Weld County Department of Human Services Bid No. B1800058 REQUEST FOR BID WELD COUNTY, COLORADO 1150 O STREET GREELEY, CO 80634 DATE: March 1, 2018 BID NUMBER: B1800058 DESCRIPTION: Child Welfare — Various Services DEPARTMENT: Human Services BID OPENING DATE: March 16, 2018 NOTICE TO BIDDERS The Human Services Advisory Commission (HSAC), on behalf of the Weld County Department of Human Services (WCDHS), by and through the Board of Weld County Commissioners, wishes to purchase the following: VARIOUS SERVICES PAGES 1-9 OF THIS REQUEST CONTAINS GENERAL INFORMATION. NOT ALL OF THE INFORMATION CONTAINED IN PAGES 1-8 MAY BE APPLICABLE. SPECIFICATIONS UNIQUE TO THIS REQUEST FOR PROPOSAL FOLLOW PAGE 10. Bids for the stated services will be received electronically by the Weld County Department of Human Services, Resource Unit, Attn: Tobi Vegter at HS Contract Management@co.weld.co.us through: FRIDAY, MARCH 16, 2018 AT 5:00 P.M. II. INVITATION TO BID A. The Human Services Advisory Commission, on behalf of the Weld County Department of Human Services, by and through the board of Weld County Commissioners requests bids for the purchase of Various Services. B. Bids shall include any and all charges for service(s) applied for by the bidder, and shall, in every way, be the total net price which the bidder will expect the Board of County Commissioners of Weld County to pay if awarded the bid. 1 Weld County Department of Human Services Bid No. B1800058 C. Emailed Bids Are Required. Emailed (fully typed) bids are required. See Bid Specifications for specific instructions. After certification of the bid, the other copy will be routed for applicable review. An e-mail confirmation will be sent when we receive your bid/proposal. III. INSTRUCTIONS TO BIDDERS A. Bids shall be typewritten. Each bid must give the full business address of the bidder and be signed by him/her with his/her usual signature. Bids by partnerships must furnish the full names of all partners and must be signed with the partnership name by one of the partners of the partnership or by an authorized representative, followed by the signature and title of the person signing. Bids by corporations must be signed with the legal name of the corporation, followed by the name of the state of the incorporation and by the signature and title of the president, secretary, or other person authorized to bind it in this matter. Bids submitted by limited liability companies must furnish the full names of all members and managers and must be signed by a manager or by an authorized representative, followed by the signature and title of the person signing. The name of each person signing shall also be typed or printed below the signature. A bid by a person who affixes to his signature the word "president," "secretary," "agent," or other title without disclosing his principal, may be held to be the bid of the individual signing. When requested, satisfactory evidence of the authority of the officer signing in behalf of a corporation shall be furnished. All corrections or erasures shall be initialed by the person signing the bid. All bidders shall agree to comply with all of the conditions, requirements, specifications, and/or instructions of this bid as stated or implied herein. All designations and prices shall be fully and clearly set forth. B. Bids may be withdrawn upon written request to the Weld County Department of Human Services received from bidders prior to the submission deadline. Negligence on the part of bidder in preparing the bid confers no right for the withdrawal of the bid after it has been opened. C. Bidders are expected to examine the conditions, specifications, and all instructions contained herein. Failure to do so will be at the bidder's risk. D. Bidders shall not stipulate in their proposals any conditions not contained in the instructions and specifications herein unless specifically requested by the special instructions attached hereto. Any proposal which fails to comply with the letter of the instructions and specifications herein may be rejected. E. Late or unsigned bids shall not be accepted or considered. It is the responsibility of the bidder to ensure that the bid arrives in the Weld County Department of Human Services, Service Utilization Unit, on or prior to the time indicated in Section I., entitled "Notice to Bidders." F. When approximate quantities are stated, Weld County reserves the right to increase or decrease quantity as best fits its needs. 2 Weld County Department of Human Services Bid No. B1800058 G. Whenever requested, samples or descriptive matter shall be filed prior to the opening of bids. H. In accordance with Section 14-9(3) of the Weld County Home Rule Charter, the Board of County Commissioners of Weld County will give preference to resident Weld County bidders in all cases where said bids are competitive in price and quality. It is also understood that the Board of County Commissioners of Weld County will give preference to suppliers from the State of Colorado, in accordance with Section 30-11-110, CRS, when it is accepting bids for the purchase of any books, stationery, records, printing, lithographing or other supplies for any officer of Weld County. I. All discounts shall be figured from the date of delivery and acceptance of the articles, or in the case of an incorrect invoice, from the date of receipt of corrected invoice, if this be subsequent to delivery and acceptance. J. Substitutions or modifications to any of the terms, conditions, or specifications of this bid package which are made by Weld County, Colorado, after the bids have been distributed to prospective bidders, and prior to the date and time of bid opening, will be made in writing and signed by the Human Services Advisory Commission. No employee of Weld County, Colorado, is authorized in any way to modify any of the terms, conditions, or specifications of this bid without written approval of Human Services Advisory Commission. This is not to imply that bids will not be accepted or considered with specifications which are different from those herein. Any item which does not meet all the terms, conditions, or specifications of this bid, must be clearly indicated on a separate sheet of paper, attached to the bid specification and proposal sheets and returned with the bid. K. The successful bidder shall indemnify and hold harmless Weld County, Colorado, against all claims for royalties, for patents or suit for infringement thereon, which may be involved in the manufacture or use of the material to be furnished. L. Contractor certifies that it shall comply with the provisions of Colorado Revised Statutes (C.R.S.) 8-17.5-101, et seq. Contractor shall not knowingly employ or contract with an illegal alien to perform work under this Contract or enter into a contract with a subcontractor that fails to certify to Contractor that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this Contract. Contractor represents, warrants, and agrees that it (a) has verified that it does not employ any illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by the Social Security Administration and Department of Homeland Security, and (b) otherwise will comply with the requirements of C.R.S. 8-17.5-102(2)(b). Contractor shall comply with all reasonable requests made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and Employment. If Contractor fails to comply with any requirement of this provision or C.R.S. 8-17.5- 101, et seq., Weld County may terminate this Contract for breach and Contractor shall be liable for actual and consequential damages to Contractor. 3 Weld County Department of Human Services Bid No. B1800058 Except where exempted by federal law and except as provided in C.R.S. 24-76.5- 103(3), if Contractor receives federal or state funds under this Contract, Contractor must confirm that any individual natural person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. 24-76.5-103(4) if such individual applies for public benefits provided under this Contract. If Contractor operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it (a) is a citizen of the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall produce one of the forms of identification required by C.R.S. 24-76.5-101, et seq., and (c) shall produce one of the forms of identification required by C.R.S. 24-76.5-103 prior to the effective date of a Contract. M. All goods shall remain the property of the seller until delivered to and accepted by Weld County, Colorado. N. Bids received prior to the time of opening will be kept unopened in a secure place. No responsibility will attach to the Families, Youth and Children Commission, the Weld County Department of Human Services, or the Board of Weld County Commissioners, for the premature opening of a bid not properly addressed and identified. O. In submitting the bid, the bidder agrees that the acceptance of any and all bids by the Board of County Commissioners of Weld County within a reasonable time or period does not constitute a contract. The Board of County Commissioners of Weld County, Colorado, reserves the right to reject any and all bids, to waive any informality in the bids, and to accept the bid, or part of a bid, that, in the opinion of the Board, is in the best interests of the Board and of the County of Weld, State of Colorado. P. These instructions, the proposal forms, and specifications have been developed with the hope of raising the standard of purchasing negotiations to a level wherein all transactions will be mutually satisfactory. Your cooperation is invited. Q. Substitutions or modifications to any of the terms, conditions, or specifications of this which are made by Weld County after the bids have been distributed to prospective bidders and prior to the date and time of bid opening, will be made in writing. No employee of Weld County is authorized in any way to modify any of the terms, conditions, or specifications of this bid without written approval of said Director of the Weld County Department of Human Services. This is not to imply that bids will not be accepted or considered with specifications which are different from those herein. Any item which does not meet all the terms, conditions, or specifications of this bid, must be clearly indicated on a separate sheet of paper, attached to the bid specification and proposal sheets and returned with the bid. 4 Weld County Department of Human Services Bid No. B1800058 IV. General Specifications. A. Fund Availability: Financial obligations of the Weld County payable after the current fiscal year are contingent upon funds for that purpose being appropriated, budgeted and otherwise made available. By acceptance of the bid, Weld County does not warrant that funds will be available to fund the contract beyond the current fiscal year. B. Governmental Immunity: No term or condition of the contract shall be construed or interpreted as a waiver, express or implied, of any of the immunities, rights, benefits, protections or other provisions, of the Colorado Governmental Immunity Act §§24-10-101 et seq., as applicable now or hereafter amended. C. Independent Contractor: The successful bidder shall perform its duties hereunder as an independent contractor and not as an employee. He or she shall be solely responsible for its acts and those of its agents and employees for all acts performed pursuant to the contract. Neither the successful bidder nor any agent or employee thereof shall be deemed to be an agent or employee of Weld County. The successful bidder and its employees and agents are not entitled to unemployment insurance or workers' compensation benefits through Weld County and Weld County shall not pay for or otherwise provide such coverage for the successful bidder or any of its agents or employees. Unemployment insurance benefits will be available to the successful bidder and its employees and agents only if such coverage is made available by the successful bidder or a third party. The successful bidder shall pay when due all applicable employment taxes and income taxes and local head taxes (if applicable) incurred pursuant to the contract. The successful bidder shall not have authorization, express or implied, to bind Weld County to any agreement, liability or understanding, except as expressly set forth in the contract. The successful bidder shall have the following responsibilities with regard to workers' compensation and unemployment compensation insurance matters: (a) provide and keep in force workers' compensation and unemployment compensation insurance in the amounts required by law, and (b) provide proof thereof when requested to do so by Weld County. D. Compliance with Law: The successful bidder shall strictly comply with all applicable federal and State laws, rules and regulations in effect or hereafter established, including without limitation, laws applicable to discrimination and unfair employment practices. E. Choice of Law: Colorado law, and rules and regulations established pursuant thereto, shall be applied in the interpretation, execution, and enforcement of the contract. Any provision included or incorporated herein by reference which conflicts with said laws, rules and/or regulations shall be null and void. F. Binding Arbitration Prohibited: Weld County does not agree to binding arbitration by any extra -judicial body or person. Any provision to the contrary in the contract 5 Weld County Department of Human Services Bid No. B1800058 or incorporated herein by reference shall be null and void. G. No Third -Party Beneficiary Enforcement: It is expressly understood and agreed that the enforcement of the terms and conditions of the contract, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in the contract shall give or allow any claim or right of action whatsoever by any other person not included in the contract. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under the contract shall be an incidental beneficiary only. H. Attorneys Fees/Legal Costs: In the event of a dispute between Weld County and the successful bidder, concerning the contract, the parties agree that Weld County shall not be liable to or responsible for the payment of attorney fees and/or legal costs incurred by or on behalf of the successful bidder. I. Insurance Requirements. i. General Requirements: Contractors/Contract Professionals must secure, at or before the time of execution of any agreement or commencement of any work, the following insurance covering all operations, goods or services provided pursuant to this request. Contractors/Contract Professionals shall keep the required insurance coverage in force at all times during the term of the Agreement, or any extension thereof, during any warranty period, and for three (3) years after termination of the Agreement. The required insurance shall be underwritten by an insurer licensed to do business in Colorado and rated by A.M. Best Company as "A"VIII or better. Each policy shall contain a valid provision or endorsement stating "Should any of the above -described policies by canceled or should any coverage be reduced before the expiration date thereof, the issuing company shall send written notice to the Weld County Director of General Services by certified mail, return receipt requested. Such written notice shall be sent thirty (30) days prior to such cancellation or reduction unless due to non-payment of premiums for which notice shall be sent ten (10) days prior. If any policy is in excess of a deductible or self -insured retention, County must be notified by the Contractor/Contract Professional. Contractor/Contract Professional shall be responsible for the payment of any deductible or self -insured retention. County reserves the right to require Contractor/Contract Professional to provide a bond, at no cost to County, in the amount of the deductible or self -insured retention to guarantee payment of claims. The insurance coverages specified in this Agreement are the minimum requirements, and these requirements do not decrease or limit the liability of Contractor/Contract Professional. Contractor/Contract Professional shall maintain, at its own expense, any additional kinds or amounts of insurance that it may deem necessary to cover its obligations and liabilities under this Agreement. ii. Types of Insurance: Contractor/Contract Professional shall obtain, and maintain at all times during the term of any Agreement, insurance in the following kinds and amounts: 6 Weld County Department of Human Services Bid No. B1800058 (a). Workers' Compensation Insurance as required by state statute, and Employer's Liability Insurance covering all of Contractor's Contract Professional's employees acting within the course and scope of their employment. If Contractor is an Independent Contractor, as defined by the Colorado Worker's Compensation Act, this requirement shall not apply. Contractor must submit to the Department a Declaration of Independent Contractor Status Form prior to the start of this agreement. (b). Commercial General Liability Insurance written on ISO occurrence form CG 00 01 10/93 or equivalent, covering premises operations, fire damage, independent Contractors, products and completed operations, blanket contractual liability, personal injury, and advertising liability with minimum limits as follows: * $1,000,000 each occurrence; * $2,000,000 general aggregate; * $50,000 any one fire; and * $500,000 errors and omissions. (c). Automobile Liability: Contractor/Contract Professional shall maintain limits of $1,000,000 for bodily injury per person, $1,000,000 for bodily injury for each accident, and $1,000,000 for property damage applicable to all vehicles operating both on County property and elsewhere. (d). Additional Provisions: * Policies for all general liability, excess/umbrella liability, liquor liability and pollution liability must provide the following: * If any aggregate limit is reduce by twenty-five percent (25%) or more by paid or reserved claims, Contractor shall notify County within ten (10) days and reinstate the aggregates required; * Unlimited defense costs in excess of policy limits; * Contractual liability covering the indemnification provisions of this Agreement; * A severability of interests provision; * Waiver of exclusion for lawsuits by one insured against another; * A provision that coverage is primary; and * A provision that coverage is non-contributory with other coverage or self- insurance provided by County. (e). For all general liability, excess/umbrella liability, liquor liability, pollution liability and professional liability policies, if the policy is a claims -made policy, the 7 Weld County Department of Human Services Bid No. B1800058 retroactive date must be on or before the contract date or the first date when any goods or services were provided to County, whichever is earlier. iii. Contractors/Contract Professionals shall secure and deliver to County's Risk Administrator ("Administrator") at or before the time of execution of this Agreement, and shall keep in force at all times during the term of the Agreement as the same may be extended as herein provided, a commercial general liability insurance policy, including public liability and property damage, in form and company acceptable to and approved by said Administrator, covering all operations hereunder set forth in the related Bid or Request for Proposal. iv. Proof of Insurance: Contractor/Contract Professional shall provide a copy of this information to its insurance agent or broker, and shall have its agent or broker provide proof of Contractor/Contract Professional's required insurance to the County. County reserves the right to require Contractor/Contract Professional to provide a certificate of insurance, a policy, or other proof of insurance as required by the County's Risk Administrator in his sole discretion. v. Additional Insureds: For general liability, excess/umbrella liability, pollution legal liability, liquor liability, and inland marine, Contractor/Contract Professional's insurer shall name County as an additional insured. vi. Waiver of Subrogation: For all coverages, Contractor/Contract Professional's insurer shall waive subrogation rights against County. vii. Subcontractors: All subcontractors, subcontractors, independent contractors, sub - vendors, suppliers or other entities providing goods or services required by this Agreement shall be subject to all of the requirements herein and shall procure and maintain the same coverages required of Contractor/Contract Professional. Contractor/Contract Professional shall include all such subcontractors, independent contractors, sub -vendors suppliers or other entities as insureds under its policies or shall ensure that all subcontractors maintain the required coverages. Contractor/Contract Professional agrees to provide proof of insurance for all such subcontractors, independent contractors, sub -vendors suppliers or other entities upon request by the County. A provider of Professional Services (as defined in the Bid or RFP) shall provide the following coverage: Professional Liability: Contract Professional shall maintain limits of $1,000,000 for each claim, and $2,000,000 aggregate limit for all claims. V. Warranty. The successful bidder shall warrant that: A. The services to be supplied pursuant to this bid are fit and sufficient for the purpose intended; 8 Weld County Department of Human Services Bid No. B1800058 B. The services sold to Weld County, Colorado pursuant to this bid conform to the minimum Weld County specifications as established herein. VI. Confidential Information: Confidential financial information of the bidder should be transmitted separately from the main bid submittal, clearly denoting in red on the financial information at the top the word, "CONFIDENTIAL." However, the successful bidder is advised that as a public entity, Weld County must comply with the provisions of C.R.S. 24-72-201, et seq. the Colorado Open Records Act (CORA), with regard to public records, and cannot guarantee the confidentiality of all documents. If Weld County receives a CORA request for bid information marked "CONFIDENTIAL", staff will attempt to contact the bidder in order to allow the bidder to seek an appropriate court order preventing disclosure. Without such an order, Weld County will release the requested information in accordance with CORA. 9 Weld County Department of Human Services Bid No. B1800058 BID SPECIFICATIONS I. PROJECT OVERVIEW The Weld County Department of Human Services (WCDHS) is seeking qualified providers in various service areas under various funding sources. Service areas include, but are not limited to Aftercare, Anger Management/Domestic Violence, Crisis Intervention and Stabilization Services, Day Treatment, Foster Parent Consultation, Foster Parent Training, Functional Family Therapy, Home Based Intervention including 24/7 Crisis Intervention, Kinship Services (Therapeutic), Home Studies, Life Skills, Mediation, Mental Health Services, Monitored Sobriety, Multisystemic Therapy, Relinquishment Counseling, Sexual Abuse Treatment, and Substance Abuse Treatment Services. Refer to pages 13-15 for specific definitions related to the above -mentioned service areas. II. CONTRACT PERIOD AND PRICING 1) The initial contract period is to be determined and shall continue as allowable by the funding source, so long as both parties are satisfied. The agreement, if awarded, shall be for a period of three years, but shall require renewal by both parties, in writing, on an annual basis. 2) The initial contract will be funded through Core Services Program, Child Welfare Administration, or other funding, so long as funding is made available. 3) Selected vendors will be required to bill the WCDHS monthly according to billing requirements set forth in Exhibit A, Sample Agreement, and by the applicable funding source. III. DUE DATE All bids must be submitted electronically to the Weld County Department of Human Service at HS Contract Management@weldgov.com, Attn: Tobi Vegter, Contract and Services Coordinator. Proposals will be accepted through Friday, March 16, 2018, at 5:00 p.m. 10 Weld County Department of Human Services Bid No. B1800058 IV. QUESTIONS All questions regarding the requirements in this Request for Proposal must be submitted in writing to HS Contract Management@weldgov.com, Attn: Tobi Vegter, Contract and Services Coordinator. To guarantee sufficient time to provide bidders with a response, all questions must be received by Friday, March 9, 2018 at 5:00 p.m. V. INTRODUCTION LETTER A bidder must submit a one (1) page or less letter in Microsoft Word that introduces the bidder and addresses, at a minimum, the following: 1) Ability to deliver the service(s) as proposed and comply with the specific requirements set forth by the Weld County, as stated in the Request for Proposal (RFP) and in Exhibit A, Sample Agreement. 2) Capacity to be organized, responsive and to quickly and successfully schedule services as requested. VI. PROVIDER INFORMATION FORM 1) Bidder must complete and submit one (1) Provider Information Form, herein attached as Exhibit B. The form is available at https://www.weldgov.comLdepartmentlpurchasing/bids proposals/. VII. PROPOSAL CONTENT 1) Proposal content must be submitted in Microsoft Word and may not exceed three (3) pages per proposed services. 2) A bidder must utilize the Proposal Template, herein attached as Exhibit C, for each service being proposed. All questions noted on the template must be addressed for each service proposed by the bidder. The template is available at htt_ps://www_weldgov.comLdepartmentsJpurchasing/bids proposals/. 3) If submitting to provide services in a language other than English, a bidder must demonstrate language proficiency at Full Professional Proficiency or higher, as defined by the U.S. Department of State, and as noted below. a. Full Professional Proficiency: Able to use and read the language fluently and accurately on all levels pertinent to professional needs. b. Native or Bilingual Proficiency: Equivalent to that of an educated native speaker (both speaking and reading). 11 Weld County Department of Human Services Bid No. B1800058 VIII. STAFF INFORMATION 1) Bidder must attach a list of applicable staff and/or contractors who will manage and/or administer the proposed service(s), utilizing the Staff Data Sheet. Bidder should submit one Staff Data Sheet per proposed service. Bidder should not combine services. Resumes and/or Curriculum Vitae should not be submitted with the proposal, but may be requested later if bidder is awarded a contract. 2) The Staff Data Sheet is herein attached as Exhibit D. It is available at https://www.weldgov.com/departments/purchasing/bids proposals/. IX. CERTIFICATE OF INSURANCE (COI) Bidder must attach a standard Certificate of Insurance (Col), or letter of intent from an insurance company authorized to do business in the State of Colorado stating its willingness to insure the bidder pursuant to the terms of this Request for Proposal. If awarded a contract, bidder will be required to provide a Standard COI that meets the requirements set forth by Weld County in the Sample Agreement, herein attached as Exhibit A, and list Weld County on the COI as an Additional Insured. X. EVALUATION OF PROPOSALS All proposals that meet the requirements will be reviewed by the Division of Child Welfare and the Human Services Advisory Commission (HSAC), Contracted Services Workgroup. The HSAC will make recommendations regarding bid awards to the Board of Weld County Commissioners by and through the Weld County Department of Human Services. The Weld County Department of Human Services will make its award of contract to the successful bidders upon final approval of the Board of Weld County Commissioners. 12 Weld County Department of Human Services Bid No. B1800058 XI. SERVICE AREA DEFINITIONS (NOT LIMITED TO THIS LIST - OTHER SERVICES WILL BE CONSIDERED) Program Area , Definition Aftercare Services Services provided to prepare a child for reunification with his/her family or other permanent placement and to prevent future out - of -home placement of the child. Anger Management/Domestic Violence Diagnostic and/or therapeutic services to assist in the development of the family services plan, to assess and/or improve family communication, functioning and relationships, and to prevent further domestic violence. Crisis Intervention and Stabilization Services Services that provide an immediate, in-person/in- home response to families, youth and children, in *crisis, 24 hours a day, seven (7) days a week. *A "crisis" is further defined as a situation or circumstance, usually acute (recent) in nature, which breaks down the normal functioning of an individual and/or family, and results in the inability of the individual and/or family to resolve the crisis through normal coping behaviors, or without immediate intervention. Day Treatment Comprehensive, highly structured services that provide education to children and therapy to children and their families. Foster Parent Consultation Services provided to foster and group home families caring for WCDSS children and youth in their homes to enhance and improve the quality of care being provided. Foster Parent Training Topic specific training for new Weld County foster parents. 13 Weld County Department of Human Services Bid No. B1800058 Program Area Definition Functional Family Therapy Intensive family -based treatment that addresses the pervasive patterns of relational dysfunction known to be determinants of conduct disorder, violent acting out, and substance abuse among youth 10-18 years old. Home -Based Intervention Services provided primarily in the home of the client that include a variety of services which can include therapeutic services, concrete services, collateral services and *crisis intervention directed to meet the needs of the child and family. *Crisis Intervention is defined as 24/7 phone access and in -home counseling. Home Studies Structured Analysis Family Evaluation (SAFE) for the purpose of foster home certification, kinship placement, and/or adoption. Kinship Services (Therapeutic) Kinship services in the areas of (1) consultation and kinship parent support specific to a child placed in a kinship home, (2) corrective consultation specific to a child placed in a kinship home, and (3) critical care consultation specific to a child placed in a kinship home. Children placed in kinship care are maintained in the lowest level of care and least restrictive setting when out -of -home placement is necessary. Life Skills Visitation (both in -home and in -office) and services provided primarily in the home that teach household management, effective access to community resources, parenting techniques and family conflict management. 14 Weld County Department of Human Services Bid No. B1800058 Program Area Definition Mediation Intervention typically with all family members to improve family communication, functioning and relationships. Mental Health Services Diagnostic and/or therapeutic services to assist in the development of family services plan, to assess and/or improve family communication, functioning and relationships. Multisystemic Therapy Intensive family- and community -based treatment program designed to make positive changes in the various social systems (home, school, community, peer relations) that contribute to the serious antisocial behaviors of children and adolescents who are at risk for out -of -home placement. Relinquishment Counseling Relinquishment counseling for parents considering relinquishment of their children. Sexual Abuse Treatment Therapeutic intervention designed to address issues and behaviors related to sexual abuse victimization, sexual dysfunction, sexual abuse perpetration, and to prevent further sexual abuse and victimization. Substance Abuse Treatment Services Diagnostic and/or therapeutic services to assist in the development of the Family Service Plan (FSP), to assess and/or improve family communication, functioning and relationships, and to prevent further abuse of drugs or alcohol. 15 EXHIBIT A SAMPLE AGREEMENT CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND This Agreement, made and entered into the _ day of , 201, by and between the Board of Weld County Commissioners, on behalf of the Weld County Department of Human Services, hereinafter referred to as the "Department' and «Contractor», hereinafter referred to as the "Contractor". The parties to this Agreement understand and agree that the provisions of this Agreement specifically include the following documents: Exhibit A, Weld County's Request for Proposal, Exhibit B, Contractor's Proposal, Exhibit C, Scope of Services, and Exhibit D, Payment Schedule. Each of these documents is attached hereto and incorporated herein by this reference. WITNESSETH WHEREAS, required approval, clearance, and coordination have been accomplished from and with appropriate agencies; and WHEREAS, the Colorado Department of Human Services has provided funding to the Department for NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: 1. Term This agreement shall become effective on , upon proper execution of this Agreement and shall expire , unless sooner terminated as provided herein. The agreement is for a period of three years. However, the agreement must be renewed by both parties, in writing, on an annual basis. 2. Scope of Services Services shall be provided by the Contractor to any person(s) eligible for services in compliance with Exhibit B, Contractor's Proposal and Exhibit C, Scope of Services. 3. Referrals, Billing and Tracking a. Contractor understands and will comply with all aspects of the referral authorization, billing and tracking requirements as set forth by the Department. Failure to comply with all aspects may result in a forfeiture of payment. b. Contractor agrees to receive referrals for services through e-mail and will provide an identified e- mail address prior to the start of this Agreement. Contractor acknowledges that services are not authorized until the Contractor has received an authorized referral form from the Department. Contractor further acknowledges that services provided prior to the authorized start date or outside the scope of services on the referral form will not be eligible for reimbursement. Contractor acknowledges that any and all modifications to an existing referral must be approved through the Department's Resource Manager, Child Welfare Contract and Services Coordinator, or through a Team Decision Making (TDM) meeting or Family Team Meeting (FTM). No other Department staff or other party to the case may authorize services or modifications to services. c. Contractor agrees to submit an itemized complete billing statement by the 7`h of the month, following the month of service, utilizing billing forms required by the Department. 1 EXHIBIT A SAMPLE AGREEMENT d. Contractor agrees to submit a monthly report with the billing statement by the 7th of the month following the month of service for each client receiving ongoing services. One-time services will be verified through receipt of the completed product (ex. psychological evaluation, substance abuse evaluation). Verification of Monitored Sobriety Services will be the test result. Contractor will document in detail any and all observed or verbalized concerns regarding any child whom the Contractor is working with under the Agreement. Areas of concern may include, but are not limited to, any physical, emotional, educational or behavioral issues. Areas of concern should be reported immediately to the caseworker AND on the required monthly report. Monthly reports will be submitted through the Department's online reporting system, unless otherwise directed or agreed to by the Department. 4. Payment a. The Department and the Contractor agree that all benefits from private insurance and/or other funding sources such as Medicaid (if Contractor is a Medicaid eligible provider) or Victim's Compensation must be exhausted before Core Services or other Department funds can be accessed for services. b. Payment shall be made in accordance with Exhibit A, Weld County's Request for Proposal, Exhibit B, Contractor's Proposal, Exhibit C, Scope of Services, and Exhibit D, Payment Schedule, attached hereto and incorporated herein by reference, so long as services are rendered satisfactorily and in accordance with the Agreement. c. Payment pursuant to this Agreement, whether in whole or in part, is subject to, and contingent upon, the continuing availability of said funds for the purposes hereof. d. The Department may withhold reimbursement if Contractor has failed to comply with any part of the Agreement, including the Financial Management requirements, program objectives, contractual terms, or reporting requirements. In the event of forfeiture of reimbursement, Contractor may appeal such circumstance in writing to the Director of Human Services. The decision of the Director of Human Services shall be final. 5. Financial Management At all times from the effective date of the Agreement until completion of the Agreement, Contractor shall comply with the administrative requirements, cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under this Agreement must conform to the Single Audit Act of 1984 and 0MG Circular A-133. 6. Payment Method Unless otherwise provided in Exhibit B, Contractor's Proposal, Exhibit C, Scope of Services , and Exhibit D, Payment Schedule: a. If services are funded through Core Services, Contractor agrees to accept reimbursement through ACH direct deposit one time per month. b. If Contractor is not currently set up with the State of Colorado to accept direct deposit, Contractor agrees to complete and submit an ACH Form for Colorado Providers, which will be provided by the Department. Contractor is solely responsible to submit the ACH Form to the State of 2 EXHIBIT A SAMPLE AGREEMENT Colorado per the directions on the form. Failure to complete and submit this form in a timely and accurate manner may result in a delay of payment. c. Contractor agrees to accept payment through county warrant when funding source does not allow for direct deposit. 7. Compliance with Applicable Laws a. At all times during the performance of this Agreement, Contractor will strictly adhere to all applicable Federal and State laws, order, and applicable standards, regulations, interpretations and/or guidelines issued pursuant thereto. This includes protection of the confidentiality of all applicant/recipient records, papers, documents, tapes and any other materials that have been or may hereafter be established which relate to the Agreement. Contractor shall abide by all applicable laws and regulations, including, but not limited to the following: - Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d-1 Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d-1 et. seq. and its implementing regulation, 45 C.F.R. Part 80 et. seq.; and - all provisions of the Civil Rights Act of 1986 so that no person shall, on the grounds of race, creed, color, sex, or national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under the approved Agreement. - Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 794, and its implementing regulations, 45 C.F.R. Part 84; and - the Age Discrimination Act of 1975, 42 U.S.C. Section 6101 et. seq. and its implementation regulations, 45 C.F.R. Part 91; and Title VII of the Civil Rights Act of 1964; and the Age Discrimination in Employment Act of 1967; and the Equal Pay Act of 1963; and the Education Amendments of 1972; and Immigration Reform and Control Act of 1986, P.L. 99-603, 42 C.F.R. Part 2; and - all regulations applicable to these laws prohibiting discrimination because of race, color, national origin, sex, religion, and handicap, including Acquired Immune Deficiency Syndrome (AIDS) or AIDS related conditions covered under Section 504 of the Rehabilitation Act of 1973, as amended, cited above. If necessary, Contractor and the Department will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 C.F.R. Part 2. 45 C.F.R. Part 74, Appendix G 9, which requires that affirmative steps be taken to assure that small and minority businesses are utilized, when possible, as sources of supplies, equipment, construction and services. This assurance is given in consideration of and for the purpose of obtaining any all Federal and/or State financial assistance. - Colorado Revised Statute (C.R.S.) 26-6-104, requiring criminal background record checks for all employees, contractors and sub -contractors. 3 EXHIBIT A SAMPLE AGREEMENT b. Contractor is further charged with the knowledge that any person who feels that s/he has been discriminated against has the right to file a complaint either with the Colorado Department of Human Services or with the United States Department of Health and Human Services, Office for Civil Rights. c. Contractor assures that it will fully comply with all other applicable Federal and State laws which may govern the ability of the Department to comply with the relevant funding requirements. Contractor understands the source of funds to be accessed under the Agreement is Core Services. d. Contractor assures and certifies that it and its principals: - Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transaction by a Federal or State department or agency; and - have not, within a three-year period preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or Local) transaction or contract under public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; and - are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state or local) with commission of any of the offenses enumerated in this certification; and - have not, within a three-year period preceding this Agreement, had one or more public transactions (federal, state, or local) terminated for cause or default. e. Public Contracts for Services C.R.S. §8-17.5-101. 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 a 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, 4 EXHIBIT A SAMPLE AGREEMENT 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. f. 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. 8. Compliance with Child and Family Services Review The Child and Family Services Review (CFSR) examines child welfare service outcomes in three areas; Safety, Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's performance according to national standards and monitor progress over time. Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance services to families. Contractor agrees to continually strive for positive outcomes in the areas of Safety, Permanency and Well Being. Contractor will ensure that any employee or subcontractor of Contractor providing services under this Agreement will work towards positive outcomes in the aforementioned three areas as outlined under the Child and Family Services Review (CFSR), and will address the aforementioned three areas when completing monthly reports as required by Paragraph 3(d) of this Agreement. 9. Insurance Requirements Contractor and Department agree that Weld County, the Board of County Commissioners of Weld County, its officers and employees, shall not be held liable for injuries or damages caused by any negligent acts or omissions of the Contractor, it subcontractor, or their employees, volunteers, or agents while performing duties described in this Agreement. Contractor shall indemnify, defend and hold harmless Weld County, the Board of County Commissioners of Weld County, its employees, volunteers and agents. Contractor shall provide the liability insurances (including professional liability insurances where necessary) and worker's compensation insurances for all its employees, volunteers, and agents engaged in the performance of this Agreement which are required under Weld County's Request for Proposal, and required by the Colorado Worker's Compensation Act. Contractor shall provide the Department with the acceptable evidence that such coverage is in effect within seven (7) days of the date of this Agreement. At a minimum, Contractor shall procure, either personally or through its employer as applicable to the Contractor's business, at its own expense, and maintain for the duration of the work, the following insurance coverage. Weld County, State of Colorado, by and through the Board of County Commissioners of Weld County, its employees and agents, shall be named as additional named insured on the insurance, where permissible the insurance provider. a. General Requirements: Contractors/Contract Professionals must secure, at or before the time of execution of any agreement or commencement of any work, the following insurance covering all operations, goods or services provided pursuant to this request. Contractors/Contract Professionals shall keep the required insurance coverage in force at all times during the term of 5 EXHIBIT A SAMPLE AGREEMENT the Agreement, or any extension thereof, and during any warranty period. The required insurance shall be underwritten by an insurer licensed to do business in Colorado and rated by A.M. Best Company as "A"VIII or better. Each policy shall contain a valid provision or endorsement stating "Should any of the above -described policies by canceled or should any coverage be reduced before the expiration date thereof, the issuing company shall send written notice to the Weld County Director of General Services by certified mail, return receipt requested. Such written notice shall be sent thirty (30) days prior to such cancellation or reduction unless due to non- payment of premiums for which notice shall be sent ten (10) days prior. If any policy is in excess of a deductible or self -insured retention, County must be notified by the Contractor/Contract Professional. Contractor/Contract Professional shall be responsible for the payment of any deductible or self -insured retention. County reserves the right to require Contractor/Contract Professional to provide a bond, at no cost to County, in the amount of the deductible or self - insured retention to guarantee payment of claims. The insurance coverages specified in this Agreement are the minimum requirements, and these requirements do not decrease or limit the liability of Contractor/Contract Professional. Contractor/Contract Professional shall maintain, at its own expense, any additional kinds or amounts of insurance that it may deem necessary to cover its obligations and liabilities under this Agreement. b. Types of Insurance: Contractor/Contract Professional shall obtain, and maintain at all times during the term of any Agreement, insurance in the following kinds and amounts: i.Workers' Compensation Insurance as required by state statute, and Employer's Liability Insurance covering all of Contractor's Contract Professional's employees acting within the course and scope of their employment. If Contractor is an Independent Contractor, as defined by the Colorado Worker's Compensation Act, this requirement shall not apply. Contractor must submit to the Department a Declaration of Independent Contractor Status Form prior to the start of this agreement. ii.Commercial General Liability Insurance written on ISO occurrence form CG 00 01 10/93 or equivalent, covering premises operations, fire damage, independent Contractors, products and completed operations, blanket contractual liability, personal injury, and advertising liability with minimum limits as follows: $1,000,000 each occurrence; $2,000,000 general aggregate; $50,000 any one fire; and $500,000 errors and omissions. iii.Automobile Liability: Contractor/Contract Professional shall maintain limits of $1,000,000 for bodily injury per person, $1,000,000 for bodily injury for each accident, and $1,000,000 for property damage applicable to all vehicles operating both on County property and elsewhere. iv.Additional Provisions: Policies for all general liability, excess/umbrella liability, liquor liability and pollution liability must provide the following: - If any aggregate limit is reduce by twenty-five percent (25%) or more by paid or reserved claims, Contractor shall notify County within ten (10) days and reinstate the aggregates required; - Unlimited defense costs in excess of policy limits; - Contractual liability covering the indemnification provisions of this Agreement; EXHIBIT A SAMPLE AGREEMENT A severability of interests provision; Waiver of exclusion for lawsuits by one insured against another; A provision that coverage is primary; and A provision that coverage is non-contributory with other coverage or self-insurance provided by County. v.For all general liability, excess/umbrella liability, liquor liability, pollution liability and professional liability policies, if the policy is a claims -made policy, the retroactive date must be on or before the contract date or the first date when any goods or services were provided to County, whichever is earlier. c. Contractors/Contract Professionals shall secure and deliver to County's Risk Administrator ("Administrator") at or before the time of execution of this Agreement, and shall keep in force at all times during the term of the Agreement as the same may be extended as herein provided, a commercial general liability insurance policy, including public liability and property damage, in form and company acceptable to and approved by said Administrator, covering all operations hereunder set forth in the related Bid or Request for Proposal. d. Proof of Insurance: Contractor/Contract Professional shall provide a copy of this information to its insurance agent or broker, and shall have its agent or broker provide proof of Contractor/Contract Professional's required insurance. County reserves the right to require Contractor/Contract Professional to provide a certificate of insurance, a policy, or other proof of insurance as required by the County's Risk Administrator in his sole discretion. e. Additional Insureds: For general liability, excess/umbrella liability, pollution legal liability, liquor liability, and inland marine, Contractor/Contract Professional's insurer shall name County as an additional insured as follows f. Waiver of Subrogation: For all coverages, Contractor/Contract Professional's insurer shall waive subrogation rights against County. g. Subcontractors: All subcontractors, subcontractors, independent contractors, sub - vendors, suppliers or other entities providing goods or services required by this Agreement shall be subject to all of the requirements herein and shall procure and maintain the same coverages required of Contractor/Contract Professional. Contractor/Contract Professional shall include all such subcontractors, independent contractors, sub -vendors suppliers or other entities as insureds under its policies or shall ensure that all subcontractors maintain the required coverages. Contractor/Contract Professional agrees to provide proof of insurance for all such subcontractors, independent contractors, sub -vendors suppliers or other entities upon request by the County. A provider of Professional Services (as defined in the Bid or RFP) shall provide the following coverage: Professional Liability: Contract Professional shall maintain limits of $1,000,000 for each claim, and $2,000,000 aggregate limit for all claims. 10. Certification Contractor certifies that, at the time of entering into this Agreement, it has currently in effect all necessary licenses, approvals, insurance, etc., required to properly provide the services and/or supplies covered by this Agreement. Copies of all necessary licenses shall be provided to the Department by the Contractor prior to the start of any Agreement. 11. Training 7 EXHIBIT A SAMPLE AGREEMENT Contractor may be required to attend training that the request of the Department specific to services provided under this Agreement. The Department will not compensate the Contractor for said training in the form of registration fees, time spent traveling to and from training, attending the training or any other associated costs unless otherwise agreed to by the Department. 12. Subpoenas Contractor will, on behalf of its employees and/or officers, accept any subpoena for testimony from the Weld County Attorney's Office by e-mail and will return a waiver of services within 72 business hours. For this purpose, Contractor will designate an e-mail address prior to the start of this Agreement. If the Contractor receives a subpoena via e-mail but will only accept personal service, the Contractor will contact the Weld County Attorney's Office immediately at 970-352-1551, x6503, and advise that the subpoena must be personally served. 13. Monitoring and Evaluation Contractor and the Department agree that monitoring and evaluation of the performance of this Agreement shall be conducted by the Contractor and the Department. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners, the Department and the Contractor. Contractor shall permit the Department, and any other duly authorized agent or governmental agency, to monitor all activities conducted by the Contractor pursuant to the terms of this Agreement. As the monitoring agency may in its sole discretion deem necessary or appropriate, such program data, special analyses, on -site checking, formal audit examinations, or any other reasonable procedures. All such monitoring shall be performed in a manner that will not unduly interfere with the work conducted under this Agreement. 14. Modification of Agreement All modifications to this Agreement shall be in writing and signed by both parties. 15. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: - Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed. - Deny payment or recover reimbursement for those services or deliverables, which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Department. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to the Department. - Incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation shall be recovered from Contractor by deduction from subsequent payments under this Agreement or other agreements between the Department and Contractor, or by the Department as a debt due to the Department or otherwise as provided by law. 8 EXHIBIT A SAMPLE AGREEMENT 16. Representatives For the purpose of this Agreement, the individuals identified below are hereby designated representatives of the respective parties. Either party may from time to time designate in writing a new or substitute representative(s). For Department: For Contractor: Heather Walker, Administrator CONTRACTOR, TITLE 17. Notice All notices required to be given by the parties hereunder shall be given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing a substitute person(s) or address to whom such notices shall be sent. For Department: Judy A. Griego, Director P.O. Box A Greeley, CO 80632 (970) 352-1551 18. Litigation For Contractor: Contractor shall promptly notify the Department in the event that Contractor learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement. Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any Federal or State court or administrative agency, shall deliver copies of such document(s) to the Director of Human Services. The term "litigation" includes an assignment for the benefit of creditors, and filings of bankruptcy, reorganization and/or foreclosure. 19. Termination This Agreement may be terminated at any time by either party giving thirty (30) days written notice to the individuals identified in paragraph 18. No portion of this Agreement shall be deemed to create an obligation on the part of the County of Weld, State of Colorado, to expend funds not otherwise appropriated in each succeeding year, as this Agreement is subject to the availability of funding. Therefore, the Department may terminate this Agreement at any time if the source of funding for the services made available to the Contractor is no longer available to the Department, or for any other reason. Contractor reserves the right to suspend services to clients if funding is no longer available. 20. No Third Party Beneficiary Enforcement It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 21. Governmental Immunity No term or condition of this contract shall be construed or interpreted as a waiver, express or implied, of 9 EXHIBIT A SAMPLE AGREEMENT any of the immunities, rights, benefits, protections or other provisions, of the Colorado Governmental Immunity Act of §§24-10-101 et. seq., as applicable now or hereafter amended. 22. Partial Invalidity of Agreement If any section, subsection, paragraph, sentence, clause, or phrase of this Agreement is for any reason held or decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The parties hereto declare that they would have entered into this Agreement and each and every section, subsection, paragraph, sentence, clause, and phrase thereof irrespective of the fact that any one or more sections, subsections, paragraphs, sentences, clauses, or phrases might be declared to be unconstitutional or invalid. 23. Improprieties/Conflict of Interest No officer, member or employee of Weld County and no member of their governing bodies shall have any pecuniary interest, direct or indirect, in the approved Agreement or the proceeds thereof. The Appearance of Conflict of Interest applies to the relationship of a Contractor with the Department when the Contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest, it is not necessary for the Contractor to gain from knowledge of these opposing interests. It is only necessary that the Contractor know that the two relationships are in opposition. During the term of the Agreement, Contractor shall not enter into any third party relationship that gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation, Contractor shall submit to the Department, a full disclosure statement setting forth the details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for the Department's termination, for cause, of its Agreement with the Contractor. Contractor certifies that Federal appropriated funds have not been paid or will be paid, by or on behalf of Contractor, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of an Federal contract, loan, grant, or cooperative agreement. 24. Storage, Availability and Retention of Records Contractor agrees that authorized local, Federal, and State auditors and representatives shall, during business hours, have access to inspect and copy records, and shall be allowed to monitor and review through on -site visits, all activities related to this Agreement, supported with funds under this Agreement, to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. All such records, documents, communications, and other materials created pursuant or related to this Agreement shall be maintained by the Contractor in a central location and shall be made available to the Department upon its request, for a period of seven (7) years from the date of final payment under this Agreement, or for such further period as may be necessary to resolve any matters which may be pending, or until an audit has been completed with the following qualifications: If an audit by or on behalf of the Federal and/or State government has begun but is not completed at the end of the seven (7) year period, or if audit findings have not been resolved after a seven (7) period, the materials shall be retained until the resolution of the audit finding. 10 EXHIBIT A SAMPLE AGREEMENT 25. Confidentiality of Records Contractor shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Agreement except for purposes directly connected with the administration of Child Protection. No information about or obtained from any applicant/recipient in possession of Contractor shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with the Contractor's written policy governing access to, duplication and dissemination of, all such information, in any form, including social networks. Contractor shall advise its employees, agents, and subcontractor, if any, that they are subject to these confidentiality requirements. Contractor shall provide its employees, agents, and subcontractors, if any, with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. Contractor shall have its employees, agents, and subcontractors, if any, sign a written confidentiality agreement and shall provide a copy of such agreement to the Department, if requested. 26. Proprietary Information Proprietary information for the purposes of this Agreement is information relating to a party's research, development, trade secrets, business affairs, internal operations and management procedures and those of its customers, clients or affiliates, but does not include information (1) lawfully obtained from third parties, (2) that which is in the public domain, or (3) that which is developed independently. Neither party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of this Agreement. Any proprietary information removed from the Department's site by the Contractor in the course of providing services under this Agreement will be accorded at least the same precautions as are employed by the Contractor for similar information in the course of its own business. 27. Independence of Contractor: Not an Employee of Weld County Contract Professional agrees that it is an independent Contract Professional and that Contract Professional'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. Contract Professional shall perform its duties hereunder as an independent Contract Professional. Contract Professional shall be solely responsible for its acts and those of its agents and employees for all acts performed pursuant to this Agreement. Contract Professional, 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 Contract Professional or any of its agents or employees. Unemployment insurance benefits will be available to Contract Professional and its employees and agents only if such coverage is made available by Contract Professional or a third party. Contract Professional shall pay when due all applicable employment taxes and income taxes and local head taxes (if applicable) incurred pursuant to this Agreement. Contract Professional shall not have authorization, express or implied, to bind County to any agreement, liability or understanding, except as expressly set forth in this Agreement. Contract Professional shall have the following responsibilities with regard to workers' compensation and unemployment compensation insurance matters: (a) provide and keep in force workers' compensation and unemployment compensation insurance in the amounts required by law (and as set forth in Exhibit provide proof thereof when requested to do so by County. 28. Entire Agreement This Agreement, together with all attachments hereto, constitutes the entire understanding between the parties with respect to the subject matter hereof, and may not be changed or modified except as state in 11 EXHIBIT A SAMPLE AGREEMENT Paragraph 14 herein. This Agreement shall be binding upon the parties hereto, their successors, heirs, legal representatives, and assigns. The Contractor and the Department may not assign any of its rights or obligations hereunder without the prior consent of both parties. 29. Agreement Nonexclusive This Agreement does not guarantee any work nor does it create an exclusive agreement for services. 30. Warranty The Contractor warrants that services performed under this Agreement will be performed in a manner consistent with the professional standards governing such services and the provisions of this Agreement. The Contractor shall faithfully perform the work in accordance with the standards of care, skill, training, diligence and judgment provided by highly competent individuals and entities that perform services of a similar nature to those described in this Agreement including Exhibits A, B, C, and D. 31. Acceptance of Services Not a Waiver Upon completion of the work, the Contractor shall submit to Department originals of all tests and results, reports, etc., generated during completion of this work. Acceptance by Department of reports and incidental material(s) furnished under this Agreement shall not in any way relieve the Contractor of responsibility for the quality and accuracy of the services. In no event shall any action by the Department hereunder constitute or be construed to be a waiver by the Department of any breach of covenant or default which may then exist on the part of the Contractor, and the Department's action or inaction when any such breach or default shall exist shall not impair or prejudice any right or remedy available to the Department with respect to such breach or default; and no assent, expressed or implied, to any breach of any one or more covenants, provisions or conditions of the Agreement shall be deemed or taken to be a waiver of any other breach. Acceptance by the Department of, or payment for, any services performed under this Agreement shall not be construed as a waiver of any of the Department's rights under this Agreement or under the law generally. 32. Employee Financial Interest/Conflict of Interest. C.R.S. §§24-18-201 et seq. and §24-50-507 The signatories to this Agreement aver that to their knowledge, no employee of Weld County has any personal or beneficial interest whatsoever in the service or property which is the subject matter of this Agreement. The Contractor has no interest and shall not acquire any interest direct or indirect, which would in any manner or degree with the performance of the Contractor's services and the Contractor, shall not employ any person having such known interests. During the term of this Agreement, the Contractor shall not engage in any in any business or personal activities or practices or maintain any relationships which actually conflict with or in any way appear to conflict with the full performance of its obligations under this Agreement. Failure by the Contractor to ensure compliance with this provision may result, in the Department's sole discretion, in immediate termination of this Agreement. No employee of the Contractor nor any member of the Contractor's family shall serve on a County Board, committee or hold any such position which either by rule, practice or action nominates, recommends, supervises Contract Professional's operations, or authorizes funding to the Contractor. 33. Board of County Commissioners of Weld County Approval This Agreement shall not be valid until it has been approved by the Board of County Commissioners of Weld County, Colorado. 12 EXHIBIT A SAMPLE AGREEMENT 34. Choice of Law/Jurisdiction Colorado law, and rules and regulations established pursuant thereto, shall be applied in the interpretation, execution, and enforcement of this Agreement. Any provision included or incorporated herein by reference which conflicts with said laws, rules and/or regulations shall be null and void. In the event of a legal dispute between the parties, Contract Professional agrees that the Weld County District Court shall have exclusive jurisdiction to resolve said dispute. 35. Subcontractors Contract Professional acknowledges that County has entered into this Agreement in reliance upon the particular reputation and expertise of Contract Professional. Contract Professional shall not enter into any subcontractor agreements for the completion of this project without County's prior written consent, which may be withheld in County's sole discretion. 36. Attorneys Fees/Legal Costs In the event of a dispute between County and Contract Professional, concerning this Agreement, the parties agree that each party shall be responsible for the payment of attorney fees and/or legal costs incurred by or on its own behalf. 37. Ownership All work and information obtained by Contract Professional under this Agreement or individual work order shall become or remain (as applicable), the property of County. In addition, all reports, documents, data, plans, drawings, records and computer files generated by Contract Professional in relation to this Agreement and all reports, test results and all other tangible materials obtained and/or produced in connection with the performance of this Agreement, whether or not such materials are in completed form, shall at all times be considered the property of the County. Contract Professional shall not make use of such material for purposes other than in connection with this Agreement without prior written approval of County. 38. Interruptions Neither party to this Agreement shall be liable to the other for delays in delivery or failure to deliver or otherwise to perform any obligation under this Agreement, where such failure is due to any cause beyond its reasonable control, including but not limited to Acts of God, fires, strikes, war, flood, earthquakes or Governmental actions. 39. Severability If any term or condition of this Agreement shall be held to be invalid, illegal, or unenforceable by a court of competent jurisdiction, this Agreement shall be construed and enforced without such provision, to the extent that this Agreement is then capable of execution within the original intent of the parties. 13 EXHIBIT A SAMPLE AGREEMENT IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. ATTEST: BOARD OF COUNTY COMMISSIONERS Weld County Clerk to the Board WELD COUNTY, COLORADO BY: Deputy Clerk to the Board , Chair APPROVED AS TO FUNDING: APPROVED AS TO SUBSTANCE: Controller Elected Official or Department Head APPROVED AS TO FORM: Director of General Services County Attorney CONTRACTOR Contractor, Title 14 EXHIBIT B CONTRACTOR'S BID CONTINUING OUR LEGACY COLORADO BOYS RANCH FOUNDATION March 16, 2018 Board of County Commissioners WELD County Department of Human Services Families, Youth and Children's Commission RE: Bid No.: 81800058 Child Welfare CORE SERVICES 2018-2019 CBR YouthConnect (CBRYC) is the operating entity of Colorado Boys Ranch Foundation and a current WELD County provider of CORE services. Each service proposed with this submission fits the County's request for innovative CORE services with proven impact. All services can be blended, as needed. The proposed services also meet the definition and criteria for more than one CORE service area. Each proposed service and rate information is detailed on separate EXHIBIT C template forms. CBRYC is fully able to deliver the proposed services and comply with County requirements set forth in the Request for Proposal and Exhibit A. All services focus on child protection and family preservation; prevention of out -of -home placement; and prevention of re-entry. And, all services emphasize to clients the importance of civic responsibility. Over 58 years, CBRYC has served more than 18,000 youth plus families. CBRYC exclusively provides an array of unique and high -impact in -home and community -based CORE services. Our highly skilled, trauma - focused social work approach includes strong educational capabilities and innovation. Services are offered at intensive or less -intensive levels. They can be fully customized and "blended" together, as needed. CBRYC ascribes to the NASW Code of Ethics and has received several awards. Currently, we are not a Medicaid provider. However, we have initiated communication with several BHO's and will make every effort to pursue Medicaid eligibility and determine if our services meet criteria. Additionally, we are actively staying updated on the changes in the Medicaid system, Phase II of the Accountable Care Collaborative, the implementation of RAE's and the goals outlined in the Family First Prevention Services Act. CBRYC services are designed to be responsive to quickly scheduling services as requested. There are no offices or office appointments. Staff members "go to" the families, their schools, their neighborhoods, and other special settings. Services emphasize family "empowerment, encouragement and accountability". The goal is to achieve permanency while helping youth and families transition from county resources and develop of their own personal and community resources. In prior years, CBRYC has been able to subsidize the county by filling the reimbursement gap with private donor funds. We can no longer provide the same level of private subsidy. We look forward to again providing-ser-u Sincerely, b 147 Charles M. (Chuck) Thompson, LCSW President ces to Weld County in 2018-2019. ref,,, bf1t AGENCY OR PRIVATE PRACTICE EXHIBIT B PROVIDER INFORMATION FORM Weld County Department of Human Services CAD. �yS R47t/G-f- Pottifia9-70 ;5/o 7 d.6.4. CB,e- y403lcomdeer TRAILS PROVIDER ID (If Knowni d/44,eeb-3" , ,'lpIMJ R s /deA /moo PRIMARY CONTACT — FULL NAME PRIMARY CONTACT - TITLE 303 PHONE NUMBER 69/-609.5 , 303 374- &37.2- EXT -AX NUMBER C 11140/44/754,7( y/ ih044€C o(, /e1:14 0 G 6ryoi 4 e & .- 0f"9 PRIMARY CONTACT - E-MAIL ADDREtS AGENCY/PRACTICE WEB ADDRESS (IF APPLICABLE /25G 7 It) . 5 € 2'a Letlexeod fozz, AGENCY MAILING ADDRESS CITY ZIP REFERRAL CONTACT 11-rx a4.d4._ e o0 REFFERAL CONTACT - FULL NAME REFERRAL CONTACT - TITLE 3D3 , 4 5 - 1//09 REFERRAL CONTACT - PHONE NUMBER ‘ti ereYitaiXellne7eO EXT REFERRAL CONTACT - E-MAADDRESS BILLING CONTACT /5144r- e„0. BILLING CONTACT - FULL NAME 13031 q0c-4/DI BILLING CONTACT-- PHONE NUMBER BILLING CONTACT - TITLE Q ,6 ae,-.6 yettAcewee EXT BILLING CONTACT - E-MAIL ADDRESS I certify that the services proposed for intended use by the Weld County Department of Human Services will meet all the specifications it has so indicated in this hid form. I further affirm intention to enter into an agreement with Weld County, on behalf of the Weld County Department of Human Services, and comply with all requirements of the contract, if awarded. The Board of Weld County Commissioners reserve the right to reject any or all bids, to waive any informality in the bids, and to accept the hid, or part of a bid, that, in the opinion of the Board- is in the best interests of the Board and of the County of Weld. State of Colorado. The Board of Weld County Commissioners shall give preference to resident Weld County bidders in all cases where the bid§ -are competitive in price -at i quality. l( '-"Pk) Signature of Authorized Representative: Date of Signature: •/ / /f 2t''/ K] SUUum5 EXHIBIT C PROPOSAL TEMPLATE PREVENTATIVE AFTERCARE Bid No.: 81800058 1. Bidder's legal entity name: Colorado Boys Ranch Foundation, d.b.a. CBR YouthConnect 2. Program name or service type being proposed: PREVENTATIVE AFTERCARE (PAC) — Service Types: Home-Based/Aftercare/Life Skills/County Designated Service (via BID definitions) 3. Modalities, curriculum or tools that will be utilized in the delivery of the service. The PAC approach involves highly skilled, trauma -informed, social work practices integrated with social - emotional learning principles. Supported by formal independent research, the PAC approach utilizes evidence -based principles, promising practices, on -going professional guidance, standards and training. And, all services emphasize to clients the importance of civic responsibility. PAC Family Service Providers give guidance and support for managing family dynamics; addressing conflicts and special needs. Providers also teach family life skills and routines; help the family access medical and mental health services; bridge with the school systems to help youth stay in school and avoid delinquency; and address confounding issues that stress the youth and family system. PAC services focus on empowerment, encouragement and accountability. Mobile PAC staff is called "Family Service Providers". This strength -based, motivational approach helps build relationships and engagement with youth and families. Caseloads are 7 to 10 families with identified clients' ages ranging from infancy to age 21. Priorities include building concrete supports in times of need and establishing reliable social and community connections. PAC Family Service Providers document all direct contacts with the youth, family and community supports; attend staffing's and court sessions; maintain weekly contact with the referring agency; collaborate with the educational and other various systems the referred youth are involved; network with and develops community resources; and make every attempt to help locate a youth if AWOL. Feedback from clients, families, schools, and served agencies is collected and used for on -going quality improvement. PAC and all CBRYC services adhere to the NASW Code of Ethics and are rooted in trauma -focused principles. 4. Anticipated frequency of the service (ex. 4 hours/week). PAC involves 3-5 hours of frequent, weekly contact with clients/families in their homes and places of convenience rather than office appointments. PAC Family Service Providers make at least weekly contact with referring colleagues; court/team meeting appearances; actively network within the community for on- going resources and supports; and are available 24 hours for crises. 5. Anticipated duration of the service (ex. 3-4 months). The anticipated duration and intensity of services (length, frequency and amount of contact time) are discussed with the county representative at time of referral as part of the case plan and permanency plan. The duration can be flexible and adapted to fit specific needs or changing conditions with the youth and d "!�; 5 ,Thst Ldi 'or (:ases ove! 'oi pds_ t me`years months. 6. Goals of the service. Consistent with CORE funding objectives, PAC service goals are to: • Achieve permanency and family preservation • Improve child and family protective factors • Prevent children/youth removal from the home • Reduce the length of any separations or placements • Prevent re-entry 7. Outcomes of service. • Active Engagement. Youth and family actively and compliantly engaged in services vs. resist and avoid. • Stage -4 Change. Youth and family progressed to Stage 4 (Stages of Change continuum) on critical issues related to safety, unification and "real life" problem solving skills • Empowerment, Encouragement and Accountability. Family protective factors improved; youth and family take more responsibility for their own futures 8. Target population for service PAC is designed to serve and positively impact all types of families with children/youth of all ages, abilities and disabilities. It is a very adaptive service utilizing professional social work practice and social work interventions. PAC is also very collaborative and focuses on developing sustainable community supports and resource networks. Because PAC Family Service Providers offer structure, support, supervision, and professionally skilled interventions within the home, at school and community, it is used by many counties across the state for a variety of youth and family circumstances such as: • Families with infants, young children and low protective factors • Teen parenting skills and safe care support • Special needs and handicapping conditions • Family conflicts, dependency/neglect and child protection concerns • Youth adjudication, homelessness and emancipation skills • School truancy and drop -out prevention • Prevention of out -of -home placement • Transition and reunification from congregate care and foster placement • Permanency preservation of Kinship and Foster Care placement 9. Service access. PAC staff and services are mobile and not office -based. There are no offices or office appointments. They go to the youth and family, the school, the neighborhood, various community settings and get into the flow of their lives and daily challenges. With an adequate and inclusive rate, travel can occur anywhere in the county. Staff is available 24/7. 10. Languages service is available in. English, at present. We actively recruit for Spanish/hi-lingual staff. When available, we will determine level of proficiency and notify the county 11 Medicaid eligibility of service. Apr VV..'ha' e initiat d : . nn)L I i' ation viith RHO'c �nrl iii ri.akc pv n, eff:,;-r �, ?ea t. r a.ddi7ionan'y stayrne updated on the changes in the Medicaid system, Phase II of the Accountable Care Collaborative and implementation of RAE's. 12. Transportation of clients Staff is insured and available to provide transportation to clients. Transportation is provided when it benefits a service goal. Transportation assistance, as long as not enabling, can help overcome significant barriers to referred youth and families successfully completing DHS and judicial mandates. With an adequate and inclusive rate, travel can occur anywhere in the county. 13. Rates of service. By the end of this current year (in order to cover actual costs) CBRYC will have provided $65,000 in private subsidy to the county by filling the reimbursement gap with private donor funds for this service. We can no longer provide this level of private subsidy. Request Home -based Preventative Aftercare (PAC) rate: $54 per Diem NOTE: This requested rate remains less than actual costs. However, it makes the level of needed private subsidy more manageable. SPECIAL NOTE: Mileage costs and travel time is significant. Geographically, several cases have been located in rural areas or out -of -county. This is complicated by the reality that some clients have to overcome distance and transportation barriers in order to comply with court and county requirements. Without this support, they are further at -risk for continued county involvement. The table below shows the number of cases and locations to date. Service Northern Southern Outliers Total Cases Comments: Outlier Case Locations PAC 36 14 12 62 Westminster, Denver, Centennial, Aurora, Longmont, Commerce City, Littleton, Boulder; Thornton STAFF DATA SHEET EXHIBIT D (Bidder must list all applicable staff who will manage and/or administer the proposed service. One Staff Data Sheet per proposed service. Bidder should not combine services.) PROPOSED SERVICE OR SERVICE PREVENTATIVE AFTERCARE (PAC) BIDDER LEGAL ENTITY NAME: OLORADO BOYS RANCH FOUNDATION d.b.a. CBR YouthConnect APPLICABLE STAFF MEMBER OR CONTRACTOR INFORMATION SUPERVISOR INFORMATION No. First Name World' Work Email Education Level Degree Focus Licensure/ Credentials DORA # (If App) Last Name First Name Work U Air Work Email Last Name 1 Case Emily 720-556-3720 ecase@youthconnect.org MA Social Work Active Bicker Amanda 303-905-4109 abicker@youthconnect.org. 2 Gardiner Samantha 720-556-3576 sgardinerP youthconnect.ort MA Clinical Mental Health Bicker Amanda 303-905-4109 abicker@vouthconnect.org 3 Miller Aaron 720-520-1313 amiiler@youthconnect.org MA Family Counseling Bicker Amanda 303-905 4109 abicker@youthconnect.org 4 Seaman Brianna 720-724-0526 bseamarn@vouthconnect.org BA Psychology Bicker Amanda 303-905-4109 abicker( a �youthconnect.org 5 Sturtevant Danny 720-402 4162 dsturtevant@vouthconnect.urg BS Intesrated Studies Bicker Amanda 303-905-4109 abicker@youthconnect.QM 6 Wangaard Andrea 303-945-9372 awangaard@youthconnect.org MA Social Work Active Bicker Amanda 303-905-4109 abicker@vouthconnectorg 7 West Kaitlyn 720-471-7908 kwest@vouthconnect.org BS Psychology Bicker Amanda 303-905-4109 abicker@youthconnect.org 8 Winslow Philip 720-402-6056 pwinslow@youthconnect.org BA Social Studies Bicker Amanda 303-905-4109 abicker@vouthconnect.org 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 - - _ 26 21 28 81800058 C poUiH(ONNEC? EXHIBIT C PROPOSAL TEMPLATE Specialized Mentoring Bid No.: B1800058 1. Bidder's legal entity name: Colorado Boys Ranch Foundation, d.b.a. CBR YouthConnect 2. Program name or service type being proposed: SPECIALIZED MENTORING. Service Types: Life SKILLS / County Designated Service 3. Modalities, curriculum or tools that will be utilized in the delivery of the service. Using social -emotional learning principles, the "Specialized Mentor" offers a neutral and supportive role; takes the youth's lead; helps the youth explore their personal interests and aspirations; models and shares insights; connects youth to community resources; and inspires hope. The focus is to grow a unique person not treat a diagnosis. Specialized Mentoring emphasizes to clients the importance of civic responsibility. Through conversations, purposeful community experiences and creative projects (including i-Pads with APPS and other technologies), youth are encouraged to creatively express their own personal STORY and think through the values and beliefs they want to live by. They are helped to discover their own power to live their best personal story and guide their own lives no matter their personal circumstances. The process takes their lead and moves at their pace. It involves friendliness -- food, nurturing, conversation during projects and activities and candid sharing of viewpoints and life experiences. Session notes are written in an interactive -conversational format, making it easy to track the youth's thoughts, interactions and views on life. Specialized Mentoring is a highly skilled, trauma -informed process for inspiring and helping youth to build resilience and positive character. Specialized Mentoring offers youth repetitive coaching and feedback; normalized socialization; purposeful community experiences; and opportunities to explore their interests, their talents, values and beliefs. Specialized Mentoring was developed following a multi -year demonstration project of the STORY Program funded by the DANNIELS FUND involving 250 risk -laden youth from alternative schools, day treatment centers, dysfunctional families, juvenile diversion and homelessness. Since this demonstration project, an additional 200* youth from multiple counties, SB 94 and judicial districts have received specialized mentoring services. SM can be flexibly adapted to fit a variety of schedules, circumstances and conditions. Youth in placement can receive mentoring both on -site at their placement and during off -site community -based experiences the build social skills and community connections. Summary • Focus is to grow a unique person not treat a diagnosis - their future STORY • Mentor role is nurturing and non -judgmental - not a therapist or controlling adult • Mentor models friendship making and social skills • Youth in placement or youth at home • VG'he,1 pcsslble wee,: twice per week for about two hours each session -- 16 hours 1 month e' is - ., 'In•iruty exp'ence'; • Take youth's lead and move at youth's pace re: what you do / talk about / when • Include other people and have social experiences in the community • Mentor shares some of their own life experiences and viewpoints when asked • Documentation in an interactive/conversational format 4. Anticipated frequency of the service (ex. 4 hours/week) Frequency is determined by the county which sets a capitated number of hours per month and a flexible weekly allocation of those hours to accommodate the schedule and availability of the youth and family. Statistically, the frequency for this year's cases, have ranged between 1-3 hours per week and 8-16 hours per month with referrals as intense as 10 hours per week. 5. Anticipated duration of the service (ex. 3-4 months). Duration is determined by the county per the case plan and permanency goals. It is our responsibility to scale the service to fit the expected duration. 6. Goals of the service. Goals are consistent with CORE funding objectives for LIFE SKILLS and permanency planning • Support the permanency plan • Prevent OOH Placement and/or school disruption • Support reunification following placement • Prevent Re -Entry to placement 7. Outcomes of service. A LOGIC Model is developed for this program with anticipated short-term and mid-term results related to essential life skills. It does not fit into the 3 -page limit but can be provided as needed. The model focuses on the following deliverables: • "Civic Engagement" -- Citizenship skills are part of the design via volunteering and community service projects and developing a set of personal principles to live by. • Stage -4 Change -- Youth has progressed to Stage 4 (Stages of Change continuum) on critical issues and needs that led to the Specialized Mentoring referral. • Insights -- Gained new insights about their life, personal beliefs and potential • Friendship -- Built a friendship and identified some positive role models • Life Story -- Produced a creative project expressing what he/she wants their personal life story to be • Commitment to Act -- Made a commitment to at least two measureable goals and personal principles • Spark of Hope -- Gained a spark of hope that there is value and potential within themselves 8. Target population for service. Specialized mentoring is a highly adaptable and customized service that is highly motivating and engaging. Youth who benefit include but are not limited to: • Youth ages 10-21 • Youth who need specifically targeted support in addition to family intervention • Youth experiencing trauma and loss without a sufficient support system • Youth who resist therapy and dislike being labeled as a "diagnosis" • Youth facing issues/deficits that will be life-long challenges • Youth who are isolates and without friends or self-confidence • Youth will alternative lifestyles and personal identities who need affirmation and support • Ycuth who have experienced a disrupted adoption • Vol:ti- Fit -rick of placement. drop -n it or homelessness • Combinations of the above, plus..... 9. Service access. Specialized Mentors are mobile and not office -based. There are no offices or office appointments. They go to the youth and family, the school, the neighborhood, various community settings and get into the flow of the youth's life. With an adequate and inclusive rate, travel can occur anywhere in the county. 10. Languages service is available in. English, at present. We actively recruit for Spanish/bi-lingual staff. When available, we will determine level of proficiency and notify the county. 11. Medicaid eligibility of service. SPECIAL NOTE: We have initiated communication with several BHO's and will make every effort to pursue Medicaid eligibility, if feasible. However, the Medicaid approach that most approximates mentoring is a "behavior coaching" process built upon different principles and relationship building methods. Our experience and feedback from over 300 youth from multiple counties, special settings and demonstration projects, affirms that the "life skills" and relational approach of Specialized Mentoring motivates youth and teaches valuable social -emotional skills including friendship. 12. Transportation of clients. Staff is insured and available to provide transportation to clients. Transportation is provided when it benefits a service goal. Transportation assistance, as long as not enabling, can help overcome significant barriers to referred youth and families. The requested rate includes the projected cost for travel and transportation. 13. Rates of service. By the end of this current year (in order to cover actual costs) CBRYC will have provided $15,000 in private subsidy to the county by filling the reimbursement gap with private donor funds for this service. We can no longer provide this level of private subsidy. Request Specialized Mentoring rate: $55 per hour STAFF DATA SHEET EXHIBIT D (Bidder must list all applicable staff who will manage and/or administer the proposed service. One Staff Data Sheet per proposed service. Bidder should not combine services.) PROPOSED SERVICE OR SERVICE PECIALIZED MENTORING (SM) BIDDER LEGAL ENTITY NAME COLORADO BOYS RANCH FOUNDATION d.b.a. CBR YouthConnect APPLICABLE STAFF MEMBER OR CONTRACTOR INFORMATION SUPERVISOR INFORMATION No. Last Name First Name Work* Work Email Education Level Degree Focus Licensure/ Credentials DORA It (If App) Last Name First Name Work # Work Email 1 Fennick John 303-909-3707 jfennick@youthconnect.Qrg, BA Criminal Justice 4 Bicker Amanda 303-905-4109 abicker@youthconnect.or2. 2 Jones Jodi 720-646-1058 jfones@youthconnect.org MA Social Work Bicker Amanda 303-905-4109 abicker@youthconnect.org 3 Miller Aaron 720-520-1313 amiller@vouthconnect.org MA Family Counseling Bicker Amanda 303-905-4109 abicker@youthconnect.org 4 Seaman Brianna 720-724-0526 bseaman@youthconnect.org BA Psychology Bicker Amanda 303-905-4109 abicker@youthconnect.org S Sturtevant X Danny 720-402-4162 dsturtevant@youthconnect.org BS Integrated Studies Bicker Amanda 303-905-4109 abicker@youthconnect.org 6 West Kaitlyn 720-471-7908 kwest@youthconnect.or& BS Psychology Bicker Amanda 303-905-4109 abickei@vouthconnect.org 7 Winslow Philip 720-402-6056 pwinslow@yQuthconnect.org BA Social Studies Bicker Amanda 303-905-4109 abicker@youthconnert.or-g 9 10 11 12 13 14 15 16 17 18 19 20 21 22 _ 23 24 25 26 _ 27 28 B1800058 EXHIBIT C PROPOSAL TEMPLATE SUPERVISED VISITATON Bid No.: B1800058 1. Bidder's legal entity name: Colorado Boys Ranch Foundation, d.b.a. CBR YouthConnect 2. Program name or service type being proposed: SUPERVISED VISITATION. Service Type: County Designated Service 3. Modalities, curriculum or tools that will be utilized in the delivery of the service. Soper✓sed Visitation is conjoint parent -child interaction conducted by a staff trained to provide visitation services. The role of the visitation supervisor is interactive and uses psychoeducation. Coaching and support to address parent -child interactions. This level of service includes both the direct observation; documentation of visits as well as targeted intervention with parents to improve parenting skills, eliminate safety concerns and accelerate reunification. The visitation supervisor provides immediate support. feedback and interventions for parents when interacting with their children. The trained supervisor remains present as an active participant throughout the visit offering skills to build on the family's strengths and correct observed 'weaknesses the :'isit-iscn n supei"vico tisi; cnslire that the guidelines. set by the Court or reterral agencv are st hn its t' es reports d:.ilreLommemdations to the efer a: svur _ as r_uci-=Id. t o fi_Clis is on Parenting Skills Development in ivht h families receive individual iriStiurtiun with Sil eilipnasc ctn attachment and bonding, aiteinatives to rhvsical discipline the impact of trauma. hoir, 'hnid nsatent del very of rules, effective communication skills, consequences and rewards, knowledge of developmental milestones and nutrition. l) „omen tation consists of individualsession flutes tor each achieved visit detailing- observed '�tiengths. dllnrp n_,•, niunent f?;errdre lrec', interventions used, et, Additionally, at the Sd 6k'. and 90day mark ,Are estahlish pa'enl hid f J,eliee and gauge progress over tJnte kra't are vlaster s Level or u:1 le` e `.vlih Master s Salipetvision All pr-'cierdin s rpe,vrvio!a is provided Ps a I'Vi a�tt'r •: LeSel ti, coseil Professional Coonselur (LP l,' a L.{c.enserl SOr..lal Worker (L5W' a Licensed (.11nli_al Social Worker ('SW; The supervision ratio does not steed 1 1;) Supervision involves frequent Cooiinnticatlora and Dversieht, dot unlentation review case consultation and periodic evaluations- On Staff training;;peer Interaction support/ collabor_atior and employee feedback IS always 4. Anticipated frequency of the service (ex. 4 hours/week). Frequency is determined by the courts, county and GAL's which sets a capitated number of hours per week and, at times. designates the number of days per week visits are expected to occur. 5. Anticipated duration of the service (ex. 3-4 months). Duration is determined by the courts and county per the case plan and reunification/perrnanencv 6. Goals of the service. Visitation Services provide a safe environment for children to spend time and interact with their parentis) though supervised visits or therapeutic supervised visits Our goo! i to obse`ve, r'ier 0 rind pr'eseI ;`- the parent -c' rid Ieiationship_ 7. Outcomes of service. Visitation services support face to face contact between parents and their children in out -of -home care. Supervised Visitation maintains parent -child relationships necessary for successful family reunification while maintaining child safety. Research that has been conducted on supervised visitation identifies the following outcomes: enhancing effective parenting skills, providing psychoeducation for trauma to the parents, maintaining and rebuilding parent -child and other family attachments, in addition to, reducing the sense of abandonment that children experience during placement as potential benefits of this type of service. 8. Target population for service. Families with children in out -of -home placement through the child welfare system who are pursuing reunification for whom supervised parenting time has been court ordered. 9. Service access. CBR YouthConnect does not have an office. Visitation referrals should be community and/or in - based approved. Should a case require facility -based visits, CBR YouthConnect staff would require access to Weld County's designated visitation rooms. With an adequate and inclusive rate, travel can occur anywhere in the county. 10. Languages service is available in. English, at present. We actively recruit for Spanish/bi-lingual staff. When available, we will determine level of proficiency and notify the county. 11.Medicaid eligibility of service. SPECIAL NOTE: We have initiated communication with several BHO's and will make every effort to pursue Medicaid eligibility, if feasible. However, it is understood that County Designated Services under which Visitation is detailed is exclusively a CORE funded service. 12. Transportation of clients. Staff are insured and available to provide transportation to clients. Transportation is provided when it benefits a service goal. Transportation assistance, as long as not enabling, can help overcome significant barriers to referred parents and/or kinship -foster placements. The transportation specified rate is listed below. 13. Rates of service. Request Visitation Service rate: $68 per hour Transportation rate: $40 per hour STAFF DATA SHEET EXHIBIT D (Bidder must list all applicable staff who will manage and/or administer the proposed service. One Staff Data Sheet per proposed service. Bidder should not combine services.) PROPOSED SERVICE OR SERVICE TY UPERVISED VISITATION (SV) BIDDER LEGAL ENTITY NAME: OLORADO BOYS RANCH FOUNDATION d.b.a. CUR YouthConnect APPLICABLE STAFF MEMBER OR CONTRACTOR INFORMATION SUPERVISOR INFORMATION No. Last Name First Name World Work Email Education Level Degree Focus Licensure/ Credentials DORA it (if App) Last Name First Name Work I Work Email 1 La)e Emily 720-556-3720 ecyouthconrr'. j.org MA Social Work Active Bicker Amanda 303 905-4109 abicker LouthsLonnect.orR 2 Gardiner Samantha 720-556-3576 fir, Jrner@youthconnect.org MA Clinical Mental Health Bicker Amanda 303 905 4109 abicker@youthconnect.org 3 Miller Aaron 720-520-1313 amiller@vouthconnect.org MA FamilyCounseling Bicker Amanda 303 9054109 abicker@youthconnect.org 4 Seaman Brianna 720174-0526 bseaman@vouthconng BA Psychology Bicker Amanda 303 905 4109 abicker@youthconnect.org 5 Sturtevant Danny 720-402 4162 dsturtg-v_ant@youthconnect.org BS Integrated Studies Bicker Amanda 303-905-4109 abicker@youthconnect_org 6 Wangaard Andrea 303-945--9372 awangaard(aDyouthconnect.org MA Social Work Active Bicker Amanda 303-905 4109 abicker@vouthconnect.orR 7 West Kaitlyn 720-471-7908 kwest@vouthconnect.orR BS Psychology Bicker Amanda 303 905 4109 abicker@youthconnect.org 8 Winslow Philip 720-402 6056 pw pslow(h7youthconnect•org BA Social Studies Bicker Amanda 303-905 4109 abickerPyouthconnect.org 9 A - -- 10 11 12 13 14 15 16 17 18 1 19 20 21 22 23 24 25 - 26 27 28 B1800058 EXHIBIT C PROPOSAL TEMPLATE SMALL GROUP OPTIONS Bid No.: B1800058 1. Bidder's legal entity name: Colorado Boys Ranch Foundation, d.b.a. CBR YouthConnect 2. Program name or service type being proposed: SMALL GROUP OPTIONS — Service Types: Aftercare/Life Skills/ County Designated Service (via BID definitions) 3. Modalities, curriculum or tools that will be utilized in the delivery of the service. Customized small group opportunities designed to improve peer support and improve essential life skills. Through the use of creative projects using I -Pad technologies with visioning boards, journaling, music, art, story boarding and movie making, youth share common experiences, interests and issues with natural affinity groups such as: gender identity, homelessness, social isolation, body image, separation/loss, adoption adjustment and traumatic experiences. The approach also fits the social media driven environment in which these youth live and interact daily. Animal and nature connections are also available. NOTE: "Civic Engagement" and citizenship skills are part of the design via volunteering and community service projects and developing a set of personal principles to live by. The small group designs are built upon social -emotional learning principles; life skills for adolescents; multiple -intelligence learning theory: and trauma informed principles. The focus is on building protective factors and resilience. Amidst their confusion and life turmoil, children and youth are vulnerable to the negative influences of our culture and social media. Yet, they are starving for meaningful conversation and reflection on what is important to them. They want to talk about their life, their personal aspirations and express their personal story. The approach also fits the social media driven world in which these youth live and interact daily. Each of the group options has graduation/celebration activities where youth receive certificates of accomplishment and a gift certificate. The approach also fits the social media driven world in which these youth live and interact daily. Each of the group options has graduation/celebration activities where youth receive certificates of accomplishment and a gift certificate. Examples of Small Group Options with demonstrated outcomes serving over 800 youth include: • PAWSITIVEConnection--A highly successful, small group human/animal connection approach to creating a therapeutic environment where children and youth of all ages are able to learn and practice healthy relationships and regulate emotions while also developing character skills including respect. responsibility and empathy while working with dogs and other animals • STORY Program — A personal development approach focused on inspiring youth to be all they can be. it offers a safe and uplifting opportunity for youth to reflect on their personal story and those around them... Youth learn '': iilsunvef and express their story through ,Pad telo_ e �A./f`� _ �t� ?;- ';a l'r ,is a:t tnn boarding and movie making. Youth are also exposed to key life principles such as the Code of the West and helped to create their own personal code. • AFFINITY Groups — Customized small groups that focus on specific issues and life situations that youth share in common such as adoption, gender identity, abuse and neglect, school isolation, missing life skills. These groups incorporate the principles and methods highlighted in the other small group options. • FAMILY Resiliency — This is a multi -generational approach to addresses the family's needs for inspiration, hope and resilience. It occurs right in the home, around the kitchen table and the living room or during a community -based activity. Sometimes, we will bring the meal!! Over an approved period of time and with guided reflection, the family completes several interesting exercises and projects that inspire parents and their children to grow together as a family. 4. Anticipated frequency of the service (ex. 4 hours/week). Group sessions can occur as frequently as needed and in a variety of home or community locations. 5. Anticipated duration of the service (ex. 3-4 months). The group options can be on -going with a continual flow of youth in and out as needed. OR, they can be designed for a specific number of sessions. This is determined by the county case plan, referral guidelines and pre -authorization process. 6. Goals of the service. Goals are consistent with CORE funding objectives for LIFE SKILLS and permanency planning • Support the permanency plan • Prevent OOH Placement and/or school disruption • Support reunification following placement • Prevent Re -Entry to placement 7. Outcomes of service. A. LOGIC Model is developed for Small Group Options with anticipated short-term and mid-term results related to essential life skills. It does not fit into the 3 -page limit but can be provided as needed. The model focuses on the following deliverables similar to the mentoring process • "Civic Engagement" and citizenship skills are part of the design via volunteering and community service projects and developing a set of personal principles to live by. • Stage -4 Change -- Youth has progressed to Stage 4 (Stages of Change continuum) on critical issues and needs that led to the Specialized Mentoring referral. • Insights -- Gained new insights about their life, personal beliefs and potential • Friendship -- Built a friendship and identified some positive role models • Life Story -- Produced a creative project expressing what he/she wants their personal life story to be • Commitment to Act -- Made a commitment to at least two measureable goals and personal principles • Spark of Hope -- Gained a spark of hope that there is value and potential within themselves Specialized Small Group Options inspire youth to be all they can be and offer safe and uplifting opportunities for them reflect on their lives and the stories of those around them. Youth learn to discover and express themselves through creative projects, community involvement and helping others. 8. Target population for service. Very helpful for all youth who need healthy peer experiences and supports; are facing issues that will be life-long challenges; are isolates, need affinity support; are missing important life skills; lack motivation and inspiration for future direction. The program is proven helpful for • Youth of all ages (groups can be clustered by age ranges) • Youth experiencing trauma and loss without a sufficient support system • Youth facing issues/deficits that will be life-long challenges • Youth who are isolates and without friends or self-confidence • Youth at -risk of placement, drop -out or homelessness • Youth who have risk -laden lifestyles and need self-confidence • Youth who need a peer group with similar life experiences and needs such as adoption issues/disruption, gender identity, ethnicity, homelessness, body image, school avoidance, bullying 9. Service access. Specialized Mentors are mobile and not office -based. There are no offices or office appointments. They go to the youth and family, the school, the neighborhood, various community settings and get into the flow of the youth's life. With an adequate and inclusive rate, travel can occur anywhere in the county. 10. Languages service is available in. English, at present. We actively recruit for Spanish/bi-lingual staff. When available, we will determine level of proficiency and notify the county. 11. Medicaid eligibility of service. We have initiated communication with several BHO's and will make every effort to pursue Medicaid eligibility, if feasible. However, Small Group Options is a LIFE SKILLS service. Our experience and feedback affirms that the "life skills" and relational approach of Specialized Mentoring motivates youth and teaches valuable social -emotional skills including friendship. 12. Transportation of clients. Staff is insured and available to provide transportation to clients. Transportation is provided when it benefits a service goal. Transportation assistance, as long as not enabling, can help overcome significant barriers to referred youth and families. The requested rate includes the projected cost for travel and transportation. 13. Rates of service. Requested rate: $42 per hour SPECIAL NOTE: We can no longer provide private subsidy to cover unreimbursed costs. Certificate of Compfetson non 4 W CMWe list Kann ..+."It t .irsats INS Ys a*era thermr Mns '••ir Melissa :gm Yea a. F'lis+w• Lv . 1 ,w . ids* flt STAFF DATA SHEET EXHIBIT D (Bidder must list all applicable staff who will manage and/or administer the proposed service. One Staff Data Sheet per proposed service. Bidder should not combine services.) PROPOSED SERVICE OR SERVICE TYALL GROUP OPTIONS (SGO) BIDDER LEGAL ENTITY NAME: COLORADO BOYS RANCH FOUNDATION d.b.a. CBR YouthConnect APPLICABLE STAFF MEMBER OR CONTRACTOR INFORMATION SUPERVISOR INFORMATION No. Last Name First Name Work# Work Email Education Level Degree Focus Licensure/ Credentials DORA # (If App) Last Name First Name YYor Work Email 1 Fen nick John 303-909-3707 1fennick@vouthconnect.org BA Criminal Justice Bicker Amanda 303-905-4109 abidcertOyoythconnect2% 2 Miller Aaron 720-52O1313 a millergbyouthconnect.urg MA Family Counseling Bicker Amanda 303-905-4109 4bickccravouthconnect.org 3 Seaman Brianna 720-724-0526 bseaman@vouthcOnnect.0g. BA Psychology Bicker Amanda 303-905-4109 abicker@YQUAbcon_ntcln 4 Sturtevant Danny 720 402 4162 dsturtevant@youthconnect.or& BS Integrated Studies Bicker Amanda 303-905-4109 a bicker@y:outhconnect.org, 5 West Kaitlyn 720 471 7908 kwe t@ygtttcgnota i. BS Psychology Bicker Amanda 303-905-4109 obIc trCaavouthconnect..grg 6 Winslow Philip 720-402-6056 pwinsiowta youthconnect.org BA Social Studies Bicker Amanda 303 905 4109 atmker@youthconnect.orR 7 8 9 10 11 12 13 14 15 16 17 18 19 - y 20 21 22 ~ 23 24 25 26 27 28 81800058 - YOUTHCONNECT EXHIBIT C PROPOSAL TEMPLATE COMMUNITY CONNECTIONS Bid No.: B1800058 1. Bidder's legal entity name: Colorado Boys Ranch Foundation, d.b.a. CBR YouthConnect 2. Program name or service type being proposed: COMMUNITY CONNECTIONS Service Types: Aftercare/Life Skills/ County Designated Service (via BID definitions) 3. Modalities, curriculum or tools that will be utilized in the delivery of the service. Description of Services "Community Connections" is a brief service (30-90 days). The permanency plan and court requirements drive the process. It is a short-term, resource -generating service designed to promote "connectedness" between a youth and their community during transitions home from OOH placement or to prevent disruption of permanency. Community Connections is a brief intervention that fills an important gap in services needed for successful reunification to home/community from OOH placement. It does the problem -solving and connecting needed to help reduce lengths of OOH placement, improve reunification; and reduce re- entry by establishing the community connections needed for success. A Community Connections Specialist identifies and develops all types of "community connectedness" that fit the interests and life situation of the youth in transition or at -risk of home and school disruption. The permanency plan and court requirements drive the process. After referral, a Community Connections Specialist will • Help the youth/family discuss and assess their interests and needs for community support, then set personal goals • Coordinate with system -of -care providers and introduce the youth/family to various individuals/groups/organizations in the community that offer resources and opportunities that fit the interests/needs • Help the youth/family develop a plan for taking advantage of the community supports/resources The Community Connections process begins with an inventory of needs and interests plus an inventory of possible contacts and resources. Next, potential matches in the community are coordinated and accountabilities are set. Then, communication, coordination, cooperation occurs over and over and over again. Filling the Cap Healthy and sustainable community connections are essential to preventing re-entry. During reunification to home/community, there are many uncertainties. Youth often view themselves as disconcerted or „on the fringe" of their community They need predictable and reliable communit i e - adults and othe, `-iibports Congregate care providers offer short-term stabilization. And, multi -disciplinary review teams, navigators and facilitators work hard to coordinate services during OOH placement. However, in both public and private sectors, there is significant turnover in adult caregivers (staff and volunteers) and unclear accountabilities during the time of transition. This disrupts the communication and coordination needed to organize the community supports that prevent re-entry. "Community Connections" helps fill this gap. Sustainable community supports are identified. 4. Anticipated frequency of the service (ex. 4 hours/week). The anticipated range of time and frequency is 3-5 hours per week. This is ultimately determined by the referral process and logistics involved such as: youth/family schedule and location, level of need and life situation and the amount of time required to identify and connect the youth and family to sustainable community resources. 5. Anticipated duration of the service (ex. 3-4 months). 30-90 days. 6. Goals of the service. Goals are consistent with CORE funding objectives for LIFE SKILLS and permanency planning • Support the permanency plan • Prevent OOH Placement and/or school disruption • Support reunification following placement • Prevent Re -Entry to placement 7. Outcomes of service. • Identified and established case specific community supports and connectedness that fit the needs, interests and life situation of the youth in transition (at -risk) and the family. • Delivery of a customized community resource guide plus personal introductions in the following two domains: • Within the existing system -of -care such as: caseworkers, teachers, GALs, probation officers, mental health therapists and school navigators. • Within the community such as: community non -profits, local support groups, special interest and affinity groups, potential employers, local support groups and more. 8. Target population for service. All children, youth and families identified by the county as needing transitional support and the development of sustainable community supports following reunification from placement or as a prevention tool for placement or re-entry. 9. Service access. Community Connections staff is mobile and not office -based. There are no offices or office appointments. They go to the youth and family, the school, the neighborhood, various community settings and get into the flow of the youth's life. With an adequate and inclusive rate, travel can occur anywhere in the county. 10. Languages service is available in. English, at present. We actively recruit for Spanish/bi-lingual staff. When available, we will determine level 7t proficv:'ncy and notify the county 11. Medicaid eligibility of service. We have initiated communication with several BHO's and will make every effort to pursue Medicaid eligibility, if feasible. However, Community Connections is an AFTERCARE and LIFE SKILLS service. This is not a therapeutic service but a community resource development service to fill the gap of coordination among systems to establish sustainable community supports. 12. Transportation of clients. Staff is insured and available to provide transportation to clients. Transportation is provided when it benefits a service goal. Transportation assistance, as long as not enabling, can help overcome significant barriers to referred youth and families. The requested rate includes the projected cost for travel and transportation. 13. Rates of service. Requested rate: $55 per hour SPECIAL NOTE: We can no longer provide private subsidy to cover unreimbursed costs. STAFF DATA SHEET EXHIBIT D (Bidder must list all applicable staff who will manage and/or administer the proposed service. One Staff Data Sheet per proposed service. Bidder should not combine services. PROPOSED SERVICE OR SERVICE T OMMUNITY CONNECTIONS (CC) BIDDER LEGAL ENTITY NAME: COLORADO BOYS RANCH FOUNDATION d.b.a. CBR YouthConnect APPLICABLE STAFF MEMBER OR CONTRACTOR INFORMATION _ SUPERVISOR INFORMATION No. Last Name First Name Work* Work Email Education Level Degree Focus Licensure/ Credentials DORA it (If App) Last Name First Name Work is Work Email 1 Fenmck John 303-909-3707 hnnick(awouthconnect.orR BA Criminal Justice Bicker Amanda 303-9054109 abicker@youthconnect.•_ 2 Miller Aaron 720 520-1313 amiller@youthconnectQg MA Family Counseling Bicker Amanda 303 905-4109 abrckerOyouthconnect.oit, 3 Seaman Brianna 720 724 0526 bseaman(youtnconnect.org BA Psychology Bicker Amanda 303 905 4109 abickerPyouthconnect.oit 4 Sturtevant Danny 720-402 4162 dsturtevant@youthconnect-off BS Integrated Studies Bicker Amanda 303 905 4109 abcker@youthconnect_orb-, 5 West Kaitlyn 720-471-7908 k westErouthcon nista& BA Social Work Bicker Amanda 303-905-4109 abickertayouthconnect.ori 6 Winslow Philip 720-402 6056 pwinslow(youthconnect.org BA Social Studies Bicker Amanda 303 905-4109 abicker@youthconnect.ork 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 _ p 26 27 28 81800058 ACS D CERTIFICATE OF LIABILITY INSURANCE 4/1/2018 DATi3i 20 17 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Lockton Companies 8110 E Union Avenue Suite 700 Denver CO 80237 (303) 414-6000 CONTACT e,); I iac. Nol: &Ass: INSURERISI AFFORDING COVERAGE NAIC a INSURER A : Philadelphia Indemnity Insurance Co. 18058 INSURED Colorado Boys Ranch 1031807 14143 Denver West Parkway, Suite 100 Golden, CO 80401 INSURER e: Pinnacol Assurance INSURER c : INSURER O : INSURER E : INSURER F : CERTIFICATE NUMBER: 13389649 REVISION NUMBER: XXXXXXX THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR A A A X X X GEN'L AGGREGATE LIMIT APPLIES PER: —I POLICY PRC- n LOC JECT TYPE OF INSURANCE COMMERCIAL GENERAL LIABILITY (CLAIMS -MADE n OCCUR Prof Lie, Claim I Made 10 000 Ded AU X X X OTHER: OMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY HIED AUTOS RONLY $500 Comp X X AUTOSNQN-OW AUTOS ONLY $1,000 Coll ADDL IWO Y N SUER /D N N POLICY NUMBER PHPKI632618 $I MM EA Acc./$3 MM AGG PHPKI6326(8 ASIA; 4/1/2017 4/1/2017 4/1/2018 4/1/2018 LIMITS EACH OCCURRENCE Aaro PREMISES (Ea occa RE NTED nce) MED EXP (Any one person) PERSONAL & ADV INJURY $ 1,000,000 s 1,000,000 $ 20,000 s 1,000,000 $ 3,000,000 s 3,000,000 GENERAL AGGREGATE PRODUCTS - COMP/OP AGG 0 e i fergt INGLE LIMIT BODILY INJURY (Per person) $ s 1,000,000 $ XXXXXXX $ XXXXXXX sXXXXXXX $ XXXXXXX $ 4,000,000 $ 4,000,000 EXXXXXXX BODILY INJURY (Per aceldent PROPERTY DAMAGE (Per accident) A B X UMBRELLA LIA EXCESS UAB DED I X 1 RETENTION S 10,000 X OCCUR CLAIMS -MADE WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFF CER/MEMBER EXCLUDED? IMandatory in NH) ((yes, deandbe under DESCRIPTION OF OPERATIONS below YIN ❑ N N NIA N N PHUB578365 451672 4/1/2017 4/1/2017 4/1/2018 4/1/2018 EACH OCCURRENCE AGGREGATE X I STA1 1OTH- STATUTE TUTE I E.L. EACH ACCIDENT s 500,000 $ 500,000 $ 500,000 E.L. DISEASE - EA EMPLOYEE A Property, RC, Incl. Theft N N PFIPK1632618 4/1/2O17 4/1/2018 E.L. DISEASE - POLICY UMIT Contonts: 510,000, Dcd. $1,000 B1: $300,000; Dcd. 72 hrs DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedu e, may be attached If more space Is required) Professional Liability Retroactive Date 4/1/2002; Sexual Abuse Liability— Policy Number PHPK1632618, Effective 4/1/2017-2018 - $1M limit. CERTIFICATE HOLDER CANCELLATION 13389649 County of Wele 1150 0" Street Greeley, CO 80631 ACORD 25 (2016/03) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Cse./ci_ IP/ /4/t` ©1988 2015 ACORD CORPOKATION. All rights reserved The ACORD name and logo are registered marks of ACORD Form W-9 ',Rev. December 2014) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not send to the IRS. Print or type See Specific Instructions on page 2. I Narne (as shown on your income tax return). Name is required on this line; do not leave this line blank. CAD , > �(AA%C/7/- l?‘;(t/d 77G11/ 2 B siness ram /disregarded entity name, if different from above I -8k a1/1;77./(‘V/1/7 3 Check appropriate box for federal tax classification; check only one of the following seven boxes: 4 Exemptions certain instructions ons Exempt payee Exemption code CIf any) (Applies to accounts (codes apply only to n not individuals; see on page 3). code (if any) Individual/sole proprietor or ❑ C Corporation • S Corporation Partnership Trust/estate single -member LLC Li Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) Note. For a single -member LLC that is disregarded, do not check LLC; check the appropriate box in the tax classification of the single -member owner. \ laKt/her (see instructions)). r--" 1/(1)(3) ► from FATCA reporting the line above for maintainedouts,dethe US.i 5 Address number, street, and apt. or suite no.) i �- / '? e• L' 7),9A1 /2L/ j /T7 ?7 Requester's name and address (optional) 6 City, state, and ZIP code r /_I4d/)/ C' (1 . -(- ' (YU Z2x 7 List account number(s) here (optional) Part I Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for guidelines on whose number to enter. Social security number or Employer identification number .4 3- 0 3 7 Jr Part II Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); anc 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. I am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt Certification instructions. You must cross out item 2 above if you have been because you nave failed to report all interest and dividends on your tax return. interest paid, acquisition or abandonment of secured property, cancellation of generally, payments other than intgr)}st and dividends, y2y are not required to instructions on page 3. Sign Signature of Here U.S. person ► from FATCA reporting is correct. notified by the IRS that you are currently subject to backup withholding For real estate transactions, item 2 does not apply. For mortgage debt, contributions to an individual retirement arrangement (IRA), and sign the certification, but you must provide your correct TIN. See the Date ► General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. Information about developments affecting Form W-9 (such as legislation enacted after we release it) is at www.irs.gov/fw9. Purpose of Form An individual or entity (Form W-9 requester) wno is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) wnich may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification numoer (ATIN(, or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not lirnitec to. the following: • Form :099-INT (interest earned or paid) • (corm 1099- DIV (dividends. including those from stocks or mutual funds) • Fore-, t099-MISC (various types of ;ncome, prizes. swards. or gross proceeds) • (corm 1099-8 (stock or mutua fund sales and certain other transactions by brokers) • Fonn 1099-3;proceeds 'i%;ii real estate transactions: • ,,.r'i ;a9 -K (rnerr •.ar-t ''.r^ and Omni ;hart./ ri ivn rk harsar,t r]ris, • Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding? on cage 2. By signing the filled -out form, you: 1. Certify that the TIN you are giving is correct (or you are waiting `or a number to be issued), 2. Certify that you are riot subject to backup withholding. or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. if applicable, you are also certifying that as a U.S. person, your allocable share of any carnership income from a U.S. trade or business is net subject to the withholding tax on foreign partners' share of effectively connected ncome. and 4. Certify teat r•ATCA code(s) entered a., this form (if anyi neicating that you are exempt from, tee FATCA reporting, is correct See What rs hATCA reporting? oc cage 2 nor 'urther r'formatlon. EXHIBIT C SCOPE OF SERVICES 1. Contractor will provide Preventative Aftercare (PAC), Specialized Mentoring, Supervised Visitation, Small Group Options, and Community Connections services to families with children and youth, all ages, referred by the Department. 2. Preventative Aftercare (PAC): Involves highly skilled, trauma -informed, social work practices integrated with social -emotional learning principles. Contractor will provide guidance and support managing family dynamics; addressing conflicts and special needs. Contractor will family life skills and routines; help the family access medical and mental health services; bridge with the school systems to help youth stay in school and void delinquency; and address confounding issues that stress the youth and family system. a. Anticipated Frequency of Service: Three (3) to five (5) hours of frequency, weekly contact in the home or in the community. Contractor is available 24/7 for crisis support. b. Anticipated Duration of Service: Average of five (5) months but varies based on the case plan and permanency plan. c. Goals of Service: i. Achieve permanency and family preservation ii. Improve child and family protective factors iii. Prevent children/youth removal from the home iv. Reduce the length of any separations or placements v. Prevent re-entry d. Anticipated Outcomes of Service: i. Active Engagement: Youth and family demonstrate active engagement and compliance with services, versus resistance and avoidance. ii. State -4 Change: Youth and family progress to State 4 (States of Change continuum) on critical issues related to safety, unification and problem -solving skills. iii. Empowerment, Encouragement and Accountability: Family protective factors improve, and youth and family take more responsibility for their own futures. e. Target Population: Available to families with children and youth of all ages, abilities and disabilities. f. Accessibility of Services: Services are available in the home or in the community throughout Weld County, and are not office based. g. Bilingual Capacity: English. Contractor does not have bilingual capacity at this time. h. Medicaid Eligibility: Services are not currently Medicaid eligible. i. Transportation of Clients: Contractor can transport clients. 3. Specialized Mentoring: a. Anticipated Frequency of Services: Based on the needs of the referred family and child/youth. Average of one (1) to three (3) hours per week. b. Anticipated Duration of Services: Based on the needs of the referred family and child/youth, as determined by the Department. c. Goals of Service: i. Support the permanency plan ii. Prevent OOH placement and/or school disruption iii. Support reunification following placement iv. Prevention re-entry to placement d. Anticipated Outcomes of Service: i. "Civic Engagement": Youth will demonstrate citizenship skills through volunteering and community service projects and developing a set of personal principles to live by. ii. Stage 4 Change: Youth will progress to Stage 4 (Stages of Change continuum) on critical issues and needs that led to the referral. iii. Insights — Youth will show insights about their life, personal beliefs and potential. iv. Friendship — Youth will build a friendship and identified some positive role models. v. Life Story — Produce a creative project expressing what he/she wants their personal life story to be. vi. Commitment to Act: Youth will commit to at least two measurable goals and personal principles. vii. Spark of Hope: Gained a spark of hope that there is value and potential within themselves. e. Target Population: Services are highly adaptable and customizable. Youth who may benefit from the service include, but are not limited to: i. Youth ages 10-21 ii. Youth who need specifically targeted support in addition to family intervention iii. Youth experiencing trauma and loss without a sufficient support system iv. Youth who resist therapy and dislike being labeled as a "diagnosis" v. Youth facing issues/deficits that will be life-long challenges vi. Youth who are isolates and without friends or self-confidence vii. Youth with alternative lifestyles and personal identifies who need affirmation and support viii. Youth who have experienced a disrupted adoption ix. Youth at risk of placement, drop -out or homelessness x. Youth in placements who have "plateaued" and/or need support to transition home f. Accessibility of Services: Services are not office -based and occur in the home or in the community. g. Bilingual Capacity: English. Contractor does not have bilingual capacity at this time. h. Medicaid Eligibility: Services are not currently Medicaid eligible. i. Transportation of Clients: Contractor can transport clients. 4. Supervised Visitation/Therapeutic Supervised Visits a. Anticipated Frequency of Services: Based on the needs of the referred family and child/youth. b. Anticipated Duration of Services: Anticipated Duration of Services: Based on the needs of the referred family and child/youth, as determined by the Department. c. Goals of Service: i. Provide a safe environment for children to spend time and interact with their parents(s). ii. Mend and preserve the parent/child relationship. d. Anticipated Outcomes of Service: i. Maintain parent/child relationship for successful family reunification while maintaining child safety ii. Enhancing effective parenting skills iii. Providing psychoeducation for trauma to the parents iv. Maintaining and rebuilding parent/child and other family attachments v. Reducing the child's sense of abandonment during placement e. Target Population: Families with children in out -of -home placement through the Child Welfare system who are pursuing reunification for whom supervised parenting time has been court ordered. f. Accessibility of Services: Services can occur in home or in the community. g. Bilingual Capacity: English. Contractor does not have bilingual capacity at this time. h. Medicaid Eligibility: Services are not currently Medicaid eligible. i. Transportation of Clients: Contractor can transport clients. S. Small Group Options a. Options PAWSITIVE Connection: A highly successful small group human/animal connection approach to creating a therapeutic environment where children and youth of all ages are able to learn and practice healthy relationships and regulate emotions while also developing character skills including respect, responsibility and empathy while working with dogs and other animals. ii. STORY Program: A personal development approach focused on inspiring youth to be all they can be. It offers a safe and uplifting opportunity for youth to reflect on their personal story and the stories around them. Youth learn to discover and express their through creative projects using iPad technologies with visioning boards, journaling, music art, story boarding, and movie making. iii. AFFINITY Groups: Customized small groups that focus on specific issues and life situations that youth share in common such as adoption, gender identity, abuse and neglect, school isolation, missing life skills. These groups incorporate the principles and methods highlighted in the other small group options. iv. FAMILY Resiliency: This is a multi -generational approach to address a family's needs for inspiration, hope and resilience. It occurs in the family home, around the kitchen table and the living room, or during a community -based activity. Contractor will sometimes bring a meal. Over an approved period of time and with guided reflection, the family completes several interesting exercise and projects that inspire parents and their children to grow together as a family. b. Anticipated Frequency of Services: Groups can occur as frequently as needed. c. Anticipated Duration of Services: Groups can be on an ongoing basis or set to a specific number of sessions, as determined by the Department. d. Goals of Service: i. Support the permanency plan ii. Prevent out -of -home placement and/or school disruption iii. Support reunification following placement iv. Prevent re-entry to placement e. Anticipated Outcomes of Service: i. "Civic Engagement": Youth will demonstrate citizenship skills through volunteering and community service projects and developing a set of personal principles to live by. ii. Stage 4 Change: Youth will progress to Stage 4 (Stages of Change continuum) on critical issues and needs that led to the referral. Hi. Insights — Youth will show insights about their life, personal beliefs and potential. iv. Friendship — Youth will build a friendship and identified some positive role models. v. Life Story — Produce a creative project expressing what he/she wants their personal life story to be. vi. Commitment to Act: Youth will commit to at least two measurable goals and personal principles. vii. Spark of Hope: Gained a spark of hope that there is value and potential within themselves. f. Target Population: Youth of all ages who require healthy peer experiences and supports; are facing issues that will be life-long challenges; are isolates; need affinity support; are missing important life skills; and/or lack motivation and inspiration for future direction. Services are highly adaptable and customizable. Youth who may benefit from the service include, but are not limited to: i. Youth of all ages ii. Youth experiencing trauma and loss without a sufficient support system iii. Youth facing issues/deficits that will be life-long challenges iv. Youth who are isolates and without friends or self-confidence v. Youth at risk of placement, drop -out or homelessness vi. Youth who have risk -laden lifestyles and need self-confidence vii. Youth who need a peer group with similar life experiences and needs such as adoption issues/disruption, gender identity, ethnicity, homelessness, body image, school avoidance, bullying g. Accessibility of Services: Services are not office -based and occur in the home or in the community. h. Bilingual Capacity: English. Contractor does not have bilingual capacity at this time. Medicaid Eligibility: Services are not currently Medicaid eligible. j. Transportation of Clients: Contractor can transport clients. 6. Community Connections a. Anticipated Frequency of Services: Average of three (3) to five (5) hours per week. b. Anticipated Duration of Services: Thirty (30) to ninety (90) days. i. Goals of Service: Support the permanency plan ii. Prevent out -of -home placement and/or school disruption iii. Support reunification following placement iv. Prevent re-entry to placement c. Anticipated Outcomes of Service: i. Identified and established case specific community supports and connectedness that fit the needs, interests and life situation of the at -risk youth and the family. ii. Delivery of a customized community resource guide plus personal introductions in the following domain: 1. Within the existing system -of -care such as: caseworkers, teachers, GALs, probation officers, mental health therapists and school navigators. 2. Within the community such as: community non -profits, local support groups, special interest and affinity groups, potential employers, location support groups and more. d. Target Population: All children, youth and families identified by the Department as needing transitional support and the development of sustainable community supports following reunifications or to prevent out -of -home placement. e. Accessibility of Services: Services occur with the youth and family, in the school, the neighborhood, and in various community settings. f. Bilingual Capacity: English. Contractor does not have bilingual capacity at this time. g. Medicaid Eligibility: Services are not currently Medicaid eligible. h. Transportation of Clients: Contractor can transport clients. 7. Contractor will offer an initial appointment within seven (7) days of receiving the referral and will make at least three (3) attempts to contact the client and set up services. The first attempt will occur within 24 hours of receiving the referral (excluding weekends and holidays). Contractor will document efforts to engage client in referred services. If after three (3) attempts the client does not respond the Contractor will notify the caseworker and the Child Welfare Contract and Services Coordinator immediately. 8. Contractor will document in detail any and all observed or verbalized concerns regarding any child whom the Contractor is working with under an active referral. Areas of concern may include, but are not limited to, any physical, emotional, educational or behavioral issues. Areas of concern should be reported immediately AND on the required monthly report. 9. Contractor will submit reports on a monthly basis for each active referral for ongoing services. Reports will be submitted per the online format required by the Department, unless otherwise directed by the Department. 10. Contractor agrees any change to an existing referral must be pre -approved through the Child Welfare Contract and Services Coordinator, a Department -facilitated Team Decision Making (TDM) or Family Team Meeting (FTM), or by court order. A change is defined as anything outside of the approved documented service on the initial authorized referral form. This may include an increase or decrease in services hours, change in frequency, change in location of services, transportation needs, or any change to the initial referral or subsequent authorizations. 11. Monthly packages include attendance at staffings, Contractor agrees to attend meetings when available and as requested by the Department. Such meetings include Court Facilitations, Court Staffings, Family Team Meetings and/or Team Decision Making meetings. Staffings and/or meetings other than those listed above are not considered reimbursable unless otherwise approved by the Child Welfare Contract and Services Coordinator. EXHIBIT D PAYMENT SCHEDULE 1. Funding and Method of Payment The Department agrees to reimburse the Contractor in consideration of the work and services performed under this Agreement at the rate specific in Paragraph 2, below. The total amount to be paid to the Contractor during the term of this Agreement shall be reported by the Department after May 31, 2019. Expenses incurred by the Contractor prior to the term of this Agreement are not eligible Department expenditures and shall not be reimbursed by the Department. Payment pursuant to this Agreement, whether in whole or in part, is subject to and contingent upon the continuing availability of said funds for the purposes hereof. In the event that said funds, or any part thereof, become unavailable as determined by the Department, the Department may immediately terminate the Agreement or amend it accordingly. 2. Fees for Services $54.00/Day (Preventative Aftercare — PAC, inclusive of client transportation when needed) $55.00/Hour (Specialized Mentoring, inclusive of client transportation when needed) $68.00/Hour (Visitation) $40.00/Hour (Transportation) $42.00/Hour (Small Group Options, inclusive of client transportation when needed) $55.00/Hour (Community Connections) 3. Submittal of Vouchers Contractor shall prepare and submit monthly an itemized voucher, and monthly report if applicable, certifying that services authorized were provided on the date(s) indicated and the charges were made pursuant to the terms and conditions of Paragraph 3 and Exhibit A. Contractor shall submit all monthly billing sand applicable reports to the Department by 7th day of the month following the month the cost was incurred. Failure to submit by the aforementioned deadline may result in forfeiture of payment. a. For ongoing services, proof of services rendered shall be a Client Verification Form signed by the client and a monthly report submitted in accordance with Paragraph 3(d) of this Agreement. b. For one-time services, proof of services rendered shall be receipt of the completed product. c. For Monitored Sobriety services, proof of services rendered shall be the test result. ACOR0' CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 412019 3'28'2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy. certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Lockton Companies 8110E Union Avenue SUlte 700(NC, Denver CO 80237 (303) 414-6000 CONTACT PHONE Exq: I FAX No): E-MAILADRESS: INSURERISI AFFORDING COVERAGE NAIC s INSURER A : Philadelphia Indemnify Insurance Co. 18058 INSURED Colorado Boys Ranch 1031807 12567 West Cedar Drive, Suite 210 Lakewood, CO 80228 INSURER B : Pinnacol Assurance INSURER C INSURER 0 : INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 13 3 89649 REVISION NUMBER: XXXXXXX THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR LTR A A X TYPE OF INSURANCE COMMERCIAL GENERAL LIABILITY X X GEN'L AGGREGATE LIMIT APPLIES PER I CLAIMS -MADE I X OCCUR Prof Liah Claim Made 10.01)0 Ued POLICY OTHER PRO- JECT X LOC ADDL INSD Y SUBR YVVD N POLICY NUMBER PI IPK1797346 SI MM EA Ace.:53 MM ALL; POLICY EFF !MM/DO/YYYY) 4, 1;2(118 POLICY EXP (MM/DDIYYYY) 4,1/2019 EACH OCCURRENCE DAMAGE TO RENTED PREMISES ;Ea occurrence) LIMITS $ 1,000,000 $ 1.000.000 $ 20.000 $ 1,000,000 $ 3,000,000 $ 3,000,000 MED EXP Any one person: PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMPiOPAGG A AUTOMOBILE LIABILITY X X ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY X SCHEDULED AUTOS NON -OWNED AUTOS ONLY N N PHPK 1797346 4 1 2018 4,1 2019 COMBINED SINGLE LIMIT (Ea acc,dent) BODILY INJURY (Per person) $ 1.000,000 $XXXXXXX $XXXXXXX BODILY INJURY (Per accident PROPERTY DAMAGE fPer accident $ XXXXXXX $XXXXXXX A t X UMBRELLA LIAB EXCESS LIAB DED [ X I RETENTION S10.000 X OCCUR 1CLAIMS-MADE WORKERS COMPENSATION AND EMPLOYERS' LIABILITY AN`! PROPRI E` OR/PARTNEF. EXEC'.;T VE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes. describe under DESCRIPTION OF OPERATIONS belcw Propene. RI. . In:.l [lieu YIN IN 1 N N/A N N N N PI IL[t5783b$ 4$1672 Pf IPK I''1 346 41 2018 4 12018 4 12018 4 1 2019 4 12019 4 1 2019 EACH OCCURRENCE S 1000,000 s -4.000.000 AGGREGATE X PER d rAiUTE E XLUH ACCIDENT OTH- ER $XXXXXXX $ 500,000 $ 500.000 EDISEASE - EA. EMPLOYEE E . DISEASE - POLICY LIMIT t3I'I' SIDed SI (X10 BI S_ Ot) COU: Dai "? hr s 500.000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Protessional Liability Retroactive pate 4; l 200?: Se',ual Abuse Llablllu - Pollee Number PHPK 179?346. litteetne 4, 1.21118-2010 - S I M limit. CERTIFICATEHOLDER CANCELLATION 13389649 County of 'Ned 1150 "0" S'reet Gree* OO 8063' ACORD 25 (201603) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE • arICj t4.( 015 ACORD CORPO ATION. All rights reserved The ACORD name and logo are registered marks of ACORD Hello