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HomeMy WebLinkAbout20181192.tiffRESOLUTION RE: APPROVE AGREEMENT FOR PROFESSIONAL SERVICES FOR CLIENT -SPECIFIC DOMESTIC VIOLENCE TREATMENT AND AUTHORIZE CHAIR TO SIGN - A TURNING POINT OF COLORADO SPRINGS, INC. WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with an Agreement for Professional Services for Client -Specific Domestic Violence Treatment between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Human Services, and A Turning Point of Colorado Springs, Inc., commencing March 1, 2018, and ending December 31, 2018, with further terms and conditions being as stated in said agreement, and WHEREAS, after review, the Board deems it advisable to approve said agreement, a copy of which is attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the Agreement for Professional Services for Client -Specific Domestic Violence Treatment between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Human Services, and A Turning Point of Colorado Springs, Inc., be and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said agreement. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 18th day of April, A.D., 2018, nunc pro tunc March 1, 2018. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO ATTEST: dj„Qrk%) .,l�p.�� EXCUSED St ve Moreno, Chair Weld County Clerk to the Board BY: Deputy Clerk to the APPR ount ttomey Mike Freeman Date of signature: OS -g2 /8 arbara Kirkmeye?, Pro-Tem Sean P. Conway EXCUSED Julie A. Cozad riftA.P4.1 e.0 c -c : HSD O5-23-tg 2018-1192 HR0089 /orcc*d ID4i 17a.1 PRIVILEGED AND CONFIDENTIAL MEMORANDUM DATE: March 13, 2018 TO: Board of County Commissioners — Pass -Around FR: Judy A. Griego, Director, Human Services RE: Agreement for Professional Services with A Turning Point of Colorado Springs, Inc. Please review and indicate if you would like a work session prior to placing this item on the Board's agenda. Request Board Approval of the Departments' Agreement for Professional Services with A Turning Point of Colorado Springs, Inc. This case specific agreement is for court -ordered domestic violence treatment services. The major provisions of the Agreement are as follows: No. Term Service/Funding Rate 1 March 1 -December 31, 2018 Domestic Violence Treatment CW Admin $35.77/Episode (Domestic Violence Group, 1.5 Hours/Episode) $22.35/Episode (In -person Staffing, 15 Minutes/Episode) $17.87/Episode (Phone Staffing, 15 Minutes/Episode) I do not recommend a Work Session. I recommend approval of this Agreement. Approve Schedule Recommendation Work Session Sean P. Conway Julie A. Cozad Mike Freeman r4 Barbara Kirkmeyer, Pro-Tem Y.. Steve Moreno, Chair Other/Comments: Pass -Around Memorandum; March 13, 2018 — CMS 1721 2018-1192 HRoo��' WELD COUNTY AGREEMENT FOR PROFESSIONAL SERVICES BETWEEN WELD COUNTY & A TURNING POINT OF COLORADO SPRINGS, INC. (DOMESTIC VIOLENCE TREATMENT - CLIENT SPECIFIC THIS AGREEMENT is made and entered into this 1 ' ' day of «pr'., 2018, by and between the County of Weld, a body corporate and politic of the State of Colorado, by and through its Board of County Commissioners, whose address is 1150 "O" Street, Greeley, Colorado 80631 hereinafter referred to as "County," and A Turning Point of Colorado Springs, Inc., a corporation, who whose address is 5460 North Union Boulevard, Colorado Springs, CO 80918, hereinafter referred to as "Contractor". WHEREAS, County desires to retain Contract Professional as an independent Contract Professional to perform services as more particularly set forth below; and WHEREAS, Contract Professional has the ability, qualifications, and time available to timely perform the services, and is willing to perform the services according to the terms of this Agreement. WHEREAS, Contract Professional is authorized to do business in the State of Colorado and has the time, skill, expertise, and experience necessary to provide the services as set forth below; NOW, THEREFORE, in consideration of the mutual promises and covenants contained herein, the parties hereto agree as follows: 1. Introduction. The terms of this Agreement are contained in the terms recited in this document and in Exhibits A, B and C, which forms an integral part of this Agreement. Exhibits A, B, and C are specifically incorporated herein by this reference. 2. Service or Work. Contractor agrees to procure the materials, equipment and/or products necessary for the Project and agrees to diligently provide all services, labor, personnel and materials necessary to perform and complete the Project described in Exhibit B. 3. Term. The term of this Agreement begins March 1, 2018, and shall continue through and until December 31, 2018. 4. Termination. County has the right to terminate this Agreement, with or without cause on thirty (30) days written notice. Furthermore, this Agreement may be terminated at any time without notice upon a material breach of the terms of the Agreement. 5. Extension or Modification. Any amendments or modifications to this agreement shall be in writing signed by both parties. No additional services or work performed by Contractor shall be the basis for additional compensation unless and until Contractor has obtained written authorization and acknowledgement by County for such additional services. ozoif- //�,2- 6. Compensation/Contract Amount. Upon Contractor's successful completion of the Project, and County's acceptance of the same, County agrees to pay an amount no greater than $$35.77/Hour (Domestic Violence Group, 1.5 Hours/Group)/$22.35/Episode (In -Person Staffing, 15 Minutes/Episode)/$17.87/Episode (Phone Staffing, 15 Minutes/Episode), which is the amount set forth in Exhibit C. County will not withhold any taxes from monies paid to the Contractor hereunder and Contractor agrees to be solely responsible for the accurate reporting and payment of any taxes related to payments made pursuant to the terms of this Agreement. 7. Independent Contractor. Contractor agrees that it is an independent Contractor and that Contractor's officers, agents or employees will not become employees of County, nor entitled to any employee benefits from County as a result of the execution of this Agreement. Contractor shall perform its duties hereunder as an independent Contractor. Contractor shall be solely responsible for its acts and those of its agents and employees for all acts performed pursuant to this Agreement. Contractor, its employees and agents are not entitled to unemployment insurance or workers' compensation benefits through County and County shall not pay for or otherwise provide such coverage for Contractor or any of its agents or employees. 8. Subcontractors. Contractor acknowledges that County has entered into this Agreement in reliance upon the particular reputation and expertise of Contractor. Contractor shall not enter into any subcontractor agreements for the completion of this Project without County's prior written consent, which may be withheld in County's sole discretion. 9. Ownership. All work and information obtained by Contractor under this Agreement or individual work order shall become or remain (as applicable), the property of County. 10. Confidentiality. Contractor agrees to keep confidential all of County's confidential information. Contractor agrees not to sell, assign, distribute, or disclose any such confidential information to any other person or entity without seeking written permission from the County. Contractor agrees to advise its employees, agents, and consultants, of the confidential and proprietary nature of this confidential information and of the restrictions imposed by this agreement. 11. Warranty_ Contractor warrants that the services performed under this Agreement will be performed in a manner consistent with the standards governing such services and the provisions of this Agreement. Contractor further represents and warrants that all services shall be performed by qualified personnel in a professional and workmanlike manner, consistent with industry standards, and that all services will conform to applicable specifications. 12. Acceptance of Services Not a Waiver. In no event shall any action by County hereunder constitute or be construed to be a waiver by County of any breach of this Agreement or default which may then exist on the part of Contractor. Acceptance by the County of, or payment for, the services completed under this Agreement shall not be construed as a waiver of any of the County's rights under this Agreement or under the law generally. 13. Insurance and Indemnification. Contractor shall procure at least the minimum amount of automobile liability insurance required by the State of Colorado for the use of any personal vehicle. Proof of said automobile liability insurance shall be provided to County prior to the performance of any services under this Agreement. Professional Liability (Errors and Omissions Liability) The policy shall cover professional misconduct or lack of ordinary skill for those positions defined in the Scope of Services of this contract. Contract Professional shall maintain limits for all claims covering wrongful acts, errors and/or omissions, including design errors, if applicable, for damage sustained by reason of or in the course of operations under this Contract resulting from professional services. In the event that the professional liability insurance required by this Contract is written on a claims -made basis, Contract Professional warrants that any retroactive date under the policy shall precede the effective date of this Contract; and that either continuous coverage will be maintained or an extended discovery period will be exercised for a period of two (2) years beginning at the time work under this Contract is completed. Minimum Limits: Per Loss Aggregate $ 1,000,000 $ 2,000,000 14. Indemnity. The Contractor shall defend, indemnify and hold harmless County, its officers, agents, and employees, from and against injury, loss damage, liability, suits, actions, or claims of any type or character arising out of the work done in fulfillment of the terms of this Contract or on account of any act, claim or amount arising or recovered under workers' compensation law or arising out of the failure of the Contractor to conform to any statutes, ordinances, regulation, law or court decree. 15. Non -Assignment. Contractor may not assign or transfer this Agreement or any interest therein or claim thereunder, without the prior written approval of County. 16. 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. 17. Compliance with Law. Contractor 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. 18. Non -Exclusive Agreement. This Agreement is nonexclusive and County may engage or use other Contractors or persons to perform services of the same or similar nature. 19. Entire Agreement/Modifications. This Agreement including the Exhibits attached hereto and incorporated herein, contains the entire agreement between the parties with respect to the subject matter contained in this Agreement. This instrument supersedes all prior negotiations, representations, and understandings or agreements with respect to the subject matter contained in this Agreement. This Agreement may be changed or supplemented only by a written instrument signed by both parties. 20. Fund Availability. Financial obligations of the County payable after the current fiscal year are contingent upon funds for that purpose being appropriated, budgeted and otherwise made available. Execution of this Agreement by County does not create an obligation on the part of County to expend funds not otherwise appropriated in each succeeding year. 21. Employee Financial Interest/Conflict of Interest — C.R.S. §§24-18-201 et seq. and §24- 50-507. The signatories to this Agreement state 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. 22. 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. 23. Governmental Immunity. No term or condition of this contract shall be construed or interpreted as a waiver, express or implied, of any of the immunities, rights, benefits, protections or other provisions, of the Colorado Governmental Immunity Act §§24-10-101 et seq., as applicable now or hereafter amended. 24. No Third -Party Beneficiary. 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. 25. 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 or its designee. 26. Choice of Law/Jurisdiction. Colorado law, and rules and regulations established pursuant thereto, shall be applied in the interpretation, execution, and enforcement of this Agreement. Any provision included or incorporated herein by reference which conflicts with said laws, rules and/or regulations shall be null and void. In the event of a legal dispute between the parties, Contractor agrees that the Weld County District Court shall have exclusive jurisdiction to resolve said dispute. 27. Public Employment Retirement Program. Contractor is responsible for notifying Weld County of any previous participation in the Colorado Public Employee Retirement Program. Contractor must notify Weld county of the most recent employment for a PERA contributing employer. 28. Public Contracts for Services C.R.S. §8-17.5-101. Contractor certifies, warrants, and agrees that it does not knowingly employ or contract with an illegal alien who will perform work under this contract. Contractor will confirm the employment eligibility of all employees who are newly hired for employment in the United States to perform work under this Agreement, through participation in the E -Verify program or the State of Colorado program established pursuant to C.R.S. §8-17.5-102(5)(c). Contractor shall not knowingly employ or contract with an illegal alien to perform work under this Agreement or enter into a contract with a subcontractor that fails to certify with Contractor that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this Agreement. Contractor shall not use E -Verify Program or State of Colorado program procedures to undertake pre -employment screening or job applicants while this Agreement is being performed. If Contractor obtains actual knowledge that a subcontractor performing work under the public contract for services knowingly employs or contracts with an illegal alien Contractor shall notify the subcontractor and County within three (3) days that Contractor has actual knowledge that a subcontractor is employing or contracting with an illegal alien and shall terminate the subcontract if a subcontractor does not stop employing or contracting with the illegal alien within three (3) days of receiving notice. Contractor shall not terminate the contract if within three days the subcontractor provides information to establish that the subcontractor has not knowingly employed or contracted with an illegal alien. Contractor shall comply with reasonable requests made in the course of an investigation, undertaken pursuant to C.R.S. §8-17.5-102(5), by the Colorado Department of Labor and Employment. If Contractor participates in the State of Colorado program, Contractor shall, within twenty days after hiring a new employee to perform work under the contract, affirm that Contractor has examined the legal work status of such employee, retained file copies of the documents, and not altered or falsified the identification documents for such employees. Contractor shall deliver to 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 Contractor 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, Contractor shall be liable for actual and consequential damages. Except where exempted by federal law and except as provided in C.R.S. § 24-76.5-103(3), if Contractor receives federal or state funds under the contract, Contractor must confirm that any individual natural person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. § 24-76.5-103(4), if such individual applies for public benefits provided under the contract. If Contractor operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it: (a) is a citizen of the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall produce one of the forms of identification required by C.R.S. § 24-76.5-101, et seq., and (c) shall produce one of the forms of identification required by C.R.S. § 24-76.5-103 prior to the effective date of the contract. 29. Acknowledgment. County and Contractor acknowledge that each has read this Agreement, understands it and agrees to be bound by its terms. Both parties further agree that this Agreement, with the attached Exhibits A, B and C, is the complete and exclusive statement of agreement between the parties and supersedes all proposals or prior agreements, oral or written, and any other communications between the parties relating to the subject matter of this Agreement. IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. COUNTY: ATTEST: BOARD OF COUNTY COMMISSIONERS Weld 'o i ,Clerk to the Bo d WELD COUNTY, CO ORADO By: Deputy Cl:s' tot T:o. ��: �:arbara Kirkmey r, Chair ro-Tem APR 18 2018 A Turning Point of Colorado Springs, Inc. 5160 North Union Boulevard Colorado Springs, CO 80918j (719) 550-1011 By: Kathye Pebley, Owner/Clinica Y Supervisor Date: 3/%A O20/ 6?, // EXHIBIT A CONTRACTOR'S INFORMATION CONTRACT MANAGEMENT SCOPE OF SERVICES CONTENT CHECKLIST ❑ Name of service or service type Domestic violence offender treatment ❑ Applicable modalities, curriculum or tools utilized Various curriculum utilized aimed at behavior modification and the mastering of core competencies. ❑ Anticipated frequency of service (ex. 4 hours/week) Frequency of service is one and a half hours per week. ❑ Anticipated duration of service (ex. 3-4 months) Duration of service is typically 24 to 36 weeks depending on the progress of the individual, as well as treatment plan reviews and input from all applicable sources ❑ Goals of service The ability to master core competencies and to take accountability for their actions while developing an acceptable personal change plan. ❑ Anticipated outcomes of serViCeNoted changes in attitude as well as beliefs around violence and the use of force to resolve issues, as well as an understanding of the dynamics of power and control, as well as the effects of violence on children. ❑ Target population including: o Age range 18-70 o Gender all genders -separated by specific genders into specific groups o Specific characteristics or needs, if applicable ❑ Location where service will be provided. If office -based, vendor should provide address and include all location if multiple sites exist. If provided outside the office, vendor should note home -based and/or community -based, and geographical area(s) vendor is willing to travel to. Office: either 1221 Lake plaza Drive Suite A C/S CO 80906 or 5160 N. Union Blvd. C/S CO 80918 ❑ Bilingual capacity and available language. If submitting to provide bilingual services, a vendor must demonstrate language proficiency at Full Professional Proficiency or higher, as defined by the U.S. Department of State, and as noted below. Spanish Provider -Jesus Garcia o Full Professional Proficiency: Able to use and read the language fluently and accurately on all levels pertinent to professional needs o Native or Bilingual Proficiency: Equivalent to that of an educated native speaker (both speaking and reading). ❑ Medicaid eligibility. If only a portion of the service is billable to Medicaid, please note the specific portion. Vendor should note that all Medicaid -eligible services will be required to be billed to Medicaid first before other funding sources are accessed. Medicaid for substance abuse services if the client is deemed eligable following agency screening ❑ Ability to transport clients to and from services, and specific transportation range/radius. ❑ All applicable rates for provision of the service, including fee for service, staffing, mileage, or other applicable costs. Rates must be an exact amount and must include the unit if cost (i.e., hour, day, month, episode). Approximate rates or a range of rates for a service will not be accepted. ❑ List of applicable staff and/or contractors who will manage and/or administer the service(s). The list must include the following information for each person: See attached roster o Full name, work phone number and work email address. o Current Education Level and Degree Focus (ex. MA, Psychology). Resumes and/or Curriculum Vitae should not be submitted with the proposal, but may be requested later if vendor is awarded a contract. o Current Licensure and/or Credentialing, including applicable number. o Current Supervisor, including supervisor's full name, phone number and email address. Weld County Department of Human Services CTD: 01/26/18, tav From: Doug Hainlev To: Tobi Vegter Subject: FW: New email Date: Friday, March 2, 2018 12:56:29 PM Attachments: jmage001.pnq jmage005.pnq Hi Tobi, Below is the rate information regarding scopes of service for A Turning Point for DV treatment. Thank you. Doug 3-tainley Family Engagement Supervisor Weld County Department of 3-uman Services 822 7th St. Ste. 15o reeCey, CO 80632 970-400-6210 State ChiCd Abuse 3fotline 1-844-CO-43Cids (1-844-264-5437) Vision: The people of Weld County are connected to the resources needed to thrive in the community and feel safe and empowered. Mission: Engaging and partnering with the community to improve the safety, health and well- being of individuals and families through the delivery of responsive and collaborative services. Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. From: jennifer@aturningpointcs.org[mailto:jennifer@aturningpointcs.org] Sent: Friday, March 2, 2018 12:55 PM To: Doug Hainley <Hainlejd@weldgov.com> Subject: FW: New email Jennifer Cherok A Turning Point Of Colorado Springs INC. 5160 N Union Blvd, Colorado Springs, CO 80918 (719) 550-1011 Confidentiality Statement: This email message and any attachments from A Turning Point of Colorado Springs, are confidential and intended solely for the use of the individual or entity to which it is addressed. The information contained herein may include protected or otherwise privileged information. Unauthorized review, forwarding, printing, copying, distributing, or using such information is strictly prohibited and may be unlawful. If you have received this message in error, please notify the sender by replying to this message, and delete the email without disclosure. Thank you. From: jenniferPaturningpointcs.org<jenniferPaturningpointcs.org> Sent: Tuesday, January 23, 2018 12:17 PM To: 'Doug Hainley'.<HainlejdCaweldgov.com> Subject: RE: New email These are the 4 therapists we have that do DV groups, Kathye Pebley MA, LPC, CAC III Jesus Garcia BS, CAC III Jack Logie MA, CACIII Carrie Watson MA, LPC, CAC II They are all certified under the DVOMB Our Legal entity name: A Turning Point of Colorado Springs Inc Taxpayer Identification 84-1309228 Address: 5160 N. Union Blvd. C/S CO. 80918 AND 1221 Lake Plaza Dr. C/S CO. 80906 Contract Representative is Kathye Pebley- changesmadePearthlink.net 719-550-1011 She is the owner, clinical supervisor. She would be the person reviewing the agreement. DV groups are held once a week The classes are 1 1/2 hour DV class cost are 35.77 an hour Staffing cost 22.35 per 15 minutes in person 17.87 per 15 minutes over the phone Client gets to choose which office is best for them. If they live closer to the south office then they can attend there. And if the North is better then they choose a group at the North office. They will attend this class every week. There is no set amount of groups. It could be 30-40 weeks more or less. I think I have everything you requested. If not please let me know what I have missed. I hope this helps, Jennifer Cherok A Turning Point Of Colorado Springs INC. 5160 N Union Blvd, Colorado Springs, CO 80918 (719) 550-1011 Confidentiality Statement: This email message and any attachments from A Turning Point of Colorado Springs, are confidential and intended solely for the use of the individual or entity to which it is addressed. The information contained herein may include protected or otherwise privileged information. Unauthorized review, forwarding, printing, copying, distributing, or using such information is strictly prohibited and may be unlawful. If you have received this message in error, please notify the sender by replying to this message, and delete the email without disclosure. Thank you. From: Doug Hainley [mailto:Hainlejd(aweldgov.com] Sent: Monday, January 22, 2018 4:07 PM To: jenniferPaturningpointcs.org Subject: RE: New email Hi Jennifer, Below is the needed information, if you have any question please do not hesitate to ask. Here's the needed information for a contract again... • Legal entity name (as they would list themselves on a W-9) • Legal entity address • Contract representative name, title, address, email and phone number (this should be the person that DHS can agreement in the future for contract information) • Signature authority name, title, address, email and phone number (this should be the person that will sign the agreement) • Scope of service that outlines the service(s) to be provided in detail and includes the following: • Speciic description of service(s) to be provided o Location where services will occur (physical address) o Expected frequency of each service (if applicable) o Specific goals and outcomes of service(s) • Staff - Who will provide the services? Provide full name, credentials including DORA if applicable, and supervisor information • Rate/Unit Schedule o All rates applicable to the provision of the service (including any charges for staffing, etc.) o What is the unit (hourly, monthly, episode, etc.) Thank you. Doug 3-laintey Family Engagement Supervisor -Weld County Department of 3-uman Services 822 7th St. Ste. 15o Greeley, CO 80632 970-400-6210 State Child Abuse 3Cotline 1-844-CO-4Xids (1-844-264-5437) • Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. From: jenniferPaturninRpointcs.org[mailto:jenniferPaturningpointcs.org] Sent: Monday, January 22, 2018 3:24 PM To: Doug Hainley <HainlejdPweldgov.com> Subject: New email Here I am with my new email. Jennifer Cherok A Turning Point Of Colorado Springs INC. 5160 N Union Blvd, Colorado Springs, CO 80918 (719) 550-1011 Confidentiality Statement: This email message and any attachments from A Turning Point of Colorado Springs, are confidential and intended solely for the use of the individual or entity to which it is addressed. The information contained herein may include protected or otherwise privileged information. Unauthorized review, forwarding, printing, copying, distributing, or using such information is strictly prohibited and may be unlawful. If you have received this message in error, please notify the sender by replying to this message, and delete the email without disclosure. Thank you. I'OINTEEE Staff Roster Information -2017 Organization Name: A Turning Point of Colorado Springs INC. Staff Name Job Title Degree Licensure Discipline and Number (if applicable) Employment Status** 1. Beyak, Mathew Counselor MA NLC.0106234 F/T 2. Brady, James Counselor BA ADVP P/T 3. Brady, Tim Counselor BA ADVP P/T 4. Bustamante, Frank Reception F/T 5. Cherok, Jennifer Billing F/T 6. Coleman, Margo Counselor MA CAC III ACC.0004112 P/T 7. Eronilde, Shores Intern ACD.0000874 P/T 8. Garcia, Jesus Counselor BS CAC III 5247; ADVP F/T 9. Haynes, Christopher Reception F/T 10. Hoffman, Lisa Counselor MA ACB.0008032 F/T 11. Jones, Shelley Counselor BA ACC.0005890 P/T 12. Lechuga, Lose Counselor NLC.0106303 P/T 13. Lenzini, Neesha Counselor NLC.0104786 F/T 14. Logie, Jack Counselor MA ACC.0005341 F/T 15. Manthei, Jean Counselor MA CACIII 4104, LPC 2381 FIT 16. Manus, Tom Counselor BA ACC.0020859 F/T 17. Sullivan, Daniel Intake P/T 18. Paulsen, Ahlene Office Manager F/T 19. Paxton, Cherll Counselor MA NLC.0013419 P/T 20. Pebley, Kathye Director MA CACIII 2780; ADVP; LPC 5833 F/T ** Please designate: F/T = Full Time, P/T= Part Time, I/S=Independent subcontractor AsPER FOINTE 21. Pebley, Lorren Office Manager F/T 22. Pierce, Jennifer Counselor NLC.0104909 F/T 23. Sanders, Caroll Counselor MA CAC II # ACB-7217 F/T 24. Schwiem, Laurie Counselor MA ACB.0006933 F/T 25. Scott, Victoria Reception F/T 26. Torres, Rafael Counselor ACC.0007305 F/T 27. Watson, Carrie Counselor MA NLC 104019, ADVP P/T 28. Henderson, Luther Counselor BA CAC III #ACC.0004741 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. ** Please designate: F/T = Full Time, P/T= Part Time, I/S=Independent subcontractor EXHIBIT B SCOPE OF SERVICES 1. Contractor will provide Domestic Violence Offender Treatment to client R.V. (Trails Case ID 1634775), as referred by the Department. 2. Services will be provided at 1221 Lake Plaza Drive, Suite A, or 5160 North Union Boulevard, in Colorado Springs, Colorado. 3. Contractor utilizes various curriculum aimed at behavior modification and the mastering of core competencies as outline by the Domestic Violence Offender Management Board (DVOMB). 4. Contractor will provide 1.5 hours of gender -specific group per week for 24-36 weeks. Duration of services is dependent upon the individual client as well as treatment plan reviews and input from applicable sources. 5. Goal of Service: Client will master core competencies and take accountability for their actions while developing an acceptable personal change plan. 6. Anticipated Outcomes of Service: a. Noted changes in attitude b. Noted changes in beliefs around violence and the use of force to resolve issues c. Understanding of the dynamics of power and control d. Understanding of the impact of domestic violence on children 7. Contractor does have bilingual capacity (Spanish). 8. Contractor 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 immediately. 9. Contractor will document in detail all observed or verbalized concerns regarding any child whom the Contractor is working with under an active referral. Areas of concern may include, but are not limited to, any physical, emotional, educational or behavioral issues. Areas of concern should be reported immediately. 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. Contractor understands that the Department will not reimburse Contractor for "no shows" or cancelled appointments, either on the part of the client or the Contractor. 12. Contractor agrees to attend meetings when available and as requested by the Department. Such meetings include Court Facilitations, Court Staffings, Family Team Meetings and/or Team Decision Making meetings. The Department will reimburse for actual participation in the meeting only so long as the meeting is at least one hour in length, the Contractor obtains the Facilitator's signature on the Client Verification Form at the time of the meeting and participation in the meeting is deemed appropriate and necessary by the Department. Staffings and/or meetings other than those listed above are not considered reimbursable unless otherwise approved by the Child Welfare Contract and Services Coordinator. EXHIBIT C 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 specified 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 in Trails after June 30, 2018. 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 $35.77/Episode (Domestic Violence Group, 1.5 Hours/Episode) $22.35/Episode (In -person Staffing, 15 Minutes/Episode) $17.87/Episode (Phone Staffing, 15 Minutes/Episode) Contractor may not attempt to collect co -pays and/or fees for services for which a Department client is responsible, but which a particular client refuses or fails to pay. Contractor will collect any applicable sliding scale co -pays and credit the Department for any payment received on the monthly billing. 3. Submittal of Vouchers Contractor shall prepare and submit monthly an itemized voucher, and signed monthly report if applicable, certifying that services authorized were provided on the date(s) indicated and the charges made were pursuant to the terms and conditions of Exhibit B. Contractor shall submit all monthly billings and applicable reports to the Department by the 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. CERTIFICATE OF INSURANCE SHELTER MUTUAL INSURANCE COMPANY A MUTUAL COMPANY SHELTER GENERAL INSURANCE COMPANY A STOCK COMPANY Name & Address To Whom Issued: Name & Address of the Named Insured: County of Weld 11500 St Greeley. CO 80631 A Turning Point of Colorado Springs Inc. 5160 N Union Blvd Colorado Springs. CO 80018-2033 This Certificate of Insurance neither affirmatively nor negatively amends, alters or extends the coverage afforded by the policy(s) listed. The Certificate is issued for informational purposes only and confers no rights to the certificate holder. This is to certify that insurance policies shown below by policy number have been issued for the policy period(s) indicated: Company Type of Insurance Policy Number Policy Inception Policy Expiration Limits of Liability Shelter Mutual General Liability: Premises & Operations PerOccurmtce A881rgate Products/Completed Operations For. (Describe) _ Products/Completed Operations Provided Shelter — Mutual Automobile All Owned or Leased Autos Combined Single Limit BI Per Person RI Per Accident PD Per Accident Shelter — General (described in declarations of a Shelter issued policy) Scheduled Autos Hired Autos Non Owned Autos Shelter Mutual Apartment Owner's/ Rental Dwelling Per Occurrence Per Aggregate Shelter Mutual1.000.000 Business 05-78-3381384-1 8/28/2017 8/28/2018 1,000,000 Per Occurrence Per Aggregate Shelter Mutual Other: Shelter — General REMARKS: Date 03/08,2018 M-5 I.26 .M By Authorized Representative 1817 WEST BROADWAY • COLUMBIA, MISSOURI • 65218-0001 • 1-800-743-5837 Hello