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Home My WebLink About20173180RESOLUTION RE: APPROVE AGREEMENT FOR CHILD PROTECTION SERVICES AND AUTHORIZE CHAIR TO SIGN - LUTHERAN FAMILY SERVICES ROCKY MOUNTAINS 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 Child Protection Services between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Human Services, and Lutheran Family Services Rocky Mountains, commencing July 1, 2017, and ending June 30, 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 Child Protection Services between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Human Services, and Lutheran Family Services Rocky Mountains, 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 13th day of September, A.D., 2017. ATTEST: detityv &C 4e;eA Weld County Clerk tothe Board BY: C• APPR putt' Clerk to the Board bunty A ttorney Date of signature: `1 (08-t BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO Julie Cozad, Chair Steve Moreno, Pro -Tern Sean P. Conway C- ke Freeman Kirkmeyer rbara cc' (-(SO Con+mc+ alrhatn.n+ 10(9/ f 7 V 2017-3180 HR0088 11.tirl) MEMORANDUM 0i2)o-i-rac+ = t3s� DATE: August 29, 2017 TO: Board of County Commissioners — Pass -Around FR: Judy A. Griego, Director, Human Services R1: Weld County Department of Human Services' Child Protection Agreement for Services with Lutheran Family Services Rocky Mountains for the Parent Education and Support Program, and SafeTouch 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' Child Protection Agreement for Services with Lutheran Family Services Rocky Mountains for the Parent Education and Support Program, and SafeTouch. The major provisions of the Agreement are as follows: No. 1 Term July 1, 2017 -June 30, 2018 Service/Funding Parent Education and Support Program/SafeTouch Child Welfare Administration Rate $135.00/Class - Nurturing Parenting (Drop -In Sessions) $97.50/Class - Nurturing Parenting (Teen Parents) $197.00/Class - Nurturing Parenting (English) $213.00/Class - Nurturing Parenting (Spanish) $ 120.00/Class - Parenting Your Teen $105.00/Class - RETHINK: Anger Management for Parents $139.00/Class - Strengthening Latino Families $25.00/Per Class (SafeTouch - per classroom presentation) Pass -Around Memorandum; August 29, 2017 — ID 1387 Paac I `x/13 2017-3180 1--IROOgg' PRIVILEGED AND CONFIDENTIAL I do not recommend a Work Session. I recommend approval of the Agreement. Sean P. Conway Julie A. Cozad, Chair Mike Freeman Barbara Kirkmeyer Steve Moreno, Pro-Tem Approve Recommendation Work Session Schedule ittt Other/Comments: Pass -Around Memorandum; August 29, 2017 — ID 1387 Page 2 (tact lb 41321 CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND LUTHERAN FAMILY SERVIES RO KY MOUNTAINS This Agreement, made and entered into thed day of _�Ji 4, 2017, by and between the Board of Weld County Commissioners, on behalf of the Weld County D-.artr"ent of Human Services, hereinafter referred to as the "Department' and Lutheran Family Services Rocky Mountains, 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 Child Welfare Administration funding to the Department for Parent Education and Support Program, and SafeTouch Program. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: 1. Term This agreement shall become effective on July 1, 2017, upon proper execution of this Agreement and shall expire June 30, 2018, 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 7th of the month, following the month of service, utilizing billing forms required by the Department. 1 020 / 7 -Sim 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 OMG 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 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 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 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 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; 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: 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. 7 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 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. 8 - 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 James Barclay, 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: James Barclay, President/CEO 363 South Harlan Street, Suite 200 Denver, CO 80226 (303) 922-3433 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 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. 9 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. 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, 10 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 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 11 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 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 12 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. 39. Severability 13 If any term or condition of this Agreement shall be held to be invalid, illegal, or unenforceable by a court of competent jurisdiction, this Agreement shall be construed and enforced without such provision, to the extent that this Agreement is then capable of execution within the original intent of the parties. 14 IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written COUNTY: ATTEST: iddt fd "i614414 BOARD OF COUNTY COMMISSIONERS Weld Co - ty Clerk to the Board WELD COUNTY, COLORADO By: Deputy Clerk to th _(: oard 15 Julie Cozad, Chair CONTRACTOR: SEP 2017 Lutheran Family Services Rocky Mountains 363 South Harlan Street, Suite 200 Denver, Colorado 802 (303) 922-343 By: Date: O/7- 34i EXHIBIT A WELD COUNTY'S REQUEST FOR PROPOSAL REQUEST FOR BIDS AND PROPOSALS WELD COUNTY, COLORADO 1150 O STREET GREELEY, CO 80634 DATE: April 3, 2017 BID NUMBER: B1700080 DESCRIPTION: Annual Request for Various Services DEPARTMENT: Human Services MANDATORY PRE -BID CONFERENCE DATE: N/A BID OPENING DATE: APRIL 24, 2017 PAGES 1-9 OF THIS DOCUMENT CONTAINS GENERAL INFORMATION. NOT ALL OF THE INFORMATION CONTAINED IN PAGES 1-9 MAY BE APPLICABLE. THE SCOPE OF WORK AND SPECIFICATIONS UNIQUE TO THIS REQUEST FOR BID FOLLOW PAGE9. I. NOTICE TO BIDDERS A. The Families, Youth and Children's Commission, on behalf of the Weld County Department of Human Services, by and through the Board of Weld County Commissioners, wishes to purchase the following: VARIOUS ENGLISH AND BILINGUAL(ENGLISH/SPANISH) SERVICES (SERVICE AREAS INCLUDED IN THIS PROPOSAL INCLUDE, BUT ARE NOT LIMITED TO THE BELOW LIST. OTHER SERVICES WILL BE CONSIDERED AND BIDDERS ARE ENCOURAGED TO SUBMIT FOR UNIQUE AND CREATIVE SERVICES.) Program area' ccaaSi„� �' .re,,scw: .x swm �e initi• N. -tea ,s'T AftercareServices 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 familycommunication, functioning and relationships, and to prevent further domesticviolence. 1 Pro�tav 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, orwithout DayTreatment Comprehensive, highly structured services that provide education to children and therapy to children and theirfamilies. Foster ParentConsultation Services provided to foster and group home families caring for Weld County children and youth in their homes to enhance and improve the quality of care being provided. Foster ParentTraining Core training for new Weld County foster parents. 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 yearsold. Home -Based Intervention Services provided primarily in the home of the client services which can include therapeutic services, services and *crisis intervention directed to meet family. *Crisis Intervention is defined as 24/7 phone access counseling. that include a variety of concrete services, collateral the needs of the child and and in -home 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 accessto community resources, parenting techniques and family conflictmanagement. Mediation/Intensive Family Therapy Therapeutic intervention typically with all family members to improve familycommunication, functioning and relationships. 2 ..a...,.,.... .a,rp r Y" a "r} .. ,%y, ,, w *� m,a. re$i'S�'tS •`t: q^a _ «"rr—'~b+ s.a r.,. 7�i" r .„#du§ _ _ ,i a. ri� '! ,t siro za aC3ry 3. . , n} w. i'r b°3° .. n., v y 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. Multi systemicTherapy 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. Relinq uishment Counseling Relinquishment counseling for parents considering relinquishment of their children. 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. Other Creative and unique services designed to meet the needs of children, youth and families interacting with the Child Welfare system through a prevention or traditional case. B. Bids for the stated services will be received by the Weld County Department of Human Services, Resource Unit, Attn: Tobi Vegter, through: MONDAY, APRIL 24, 2017, AT 5:00 P.M. (WELD COUNTY DEPARTMENT OF HUMAN SERVICES, RESOURCE UNIT TIME CLOCK). Acceptable bid delivery methods are as follows: Email. Emailed bids are preferred. Bids should be emailed to: vegterta@weldgov.com. Emailed bids must include the following statement on the email: "I hereby waive my right to a sealed bid". An email confirmation will be sent when we receive your bid/proposal. Mail. Mailed bids should be sent in a sealed envelope with the bid title and bid number on it. Bids must include the following statement on the email: "Ihereby waive my right to a sealed bid". Mailed bids should be addressed to: Weld County Department of Human Services, Attn: Tobi Vegter, Division of Child Welfare, Financial Unit, P.O. Box A, Greeley, CO 80632. Please call or email Tobi Vegter at 970-400-6392 or vegterta@weldgov.com if you have any questions. Hand Delivery. Hand -delivered bids should be submitted in a sealed envelopewith the bid title and bid number on it. Bids must include the following statement on the email: "I hereby waive my right to a sealed bid". Hand - delivered bids can be dropped off at: Weld County Department of Human Services, Attn: Tobi Vegter, Financial Unit, 822 7th Street, Suite 150, Greeley, CO 80631. Please call or email Tobi Vegter at 970-400-6392 or vegterta@weldgov.com if you have any questions. 3 II. INVITATION TO BID A. The Families, Youth and Children's 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 (as described above). 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. C. Emailed Bids Are Preferred. Emailed (fully typed) bids are preferred. However, if the bidder is unable to submit an emailed bid, the bidder must comply with the requirements set forth in Paragraph I, B. An emailed bid must contain the following statement: "I hereby waive my right to a sealed bid." D. Unless the Bid is emailed, one original and one copy of the Bid must be submitted. One complete bid document, which will be the only official copy of the bid, shall be filed at the Weld County Department of Human Services, Resource Unit. 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 with his 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. 4 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 Families, Youth and Children's 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 Families, Youth and Children's 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. 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 orolder 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. 5 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. 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 6 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 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. Attorney 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. V. 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 tothis 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: (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: 7 • $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 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 Bid. 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. 8 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. VI.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; 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 SCOPE OF SERVICES PURPOSE: The Weld County Department of Human Services (WCDHS) is seeking qualified English- speaking and bilingual (English/Spanish) providers in various service areas under various funding sources. Service areas include, but are not limited to, Anger Management/Domestic Violence, Day Treatment, Foster Parent Consultation, Foster Parent Training, Functional Family Therapy, Kinship Services (Therapeutic), Home Studies/Relinquishment Counseling, Life Skills, Mediation, Mental Health, Monitored Sobriety, Multi -Systemic Therapy, Home Based Intervention including 24/7 Crisis Intervention, Sexual Abuse Treatment, and Substance Abuse Treatment Services and Aftercare Services. SERVICE AREAS ARE NOTED BEGINNING ON PAGE 1 OFTHIS REQUEST FOR BID, BUT ARE NOT LIMITED TO THOSE LISTED. OTHER SERVICES WILL BE CONSIDERED AND BIDDERS ARE ENCOURAGED TO SUBMIT FOR UNIQUE AND CREATIVESERVICES. Qualifications: To be considered, a bidder must meet the following minimum qualifications: 1) Complete a Provider Information Form (PIF). 2) If submitting to provide bilingual services, 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. • Full Professional Proficiency: Able to use and read the language fluently and accurately on all levels pertinent to professional needs • Native or Bilingual Proficiency: Equivalent to that of an educated native speaker (both speaking and reading). 3) A bidder must agree to language proficiency testing that may include assessment of reading, writing and comprehension of Spanish, as well as a face-to-face conversation with a known native or proficient Spanish speaker selected by Weld County. 4) A bidder must submit a one page or less cover letter that introduces the bidder, the bidder's location(s) of practice and target area, his or her experience and qualifications, and staff, if applicable. A bidder must include current contact information including physical address, mailing address, phone number, email address and website, if applicable. 5) A bidder must submit sufficient information concerning each proposed service for Weld County to evaluate whether or not the bidder meets "minimum qualifications" for all bidders. Each service must be submitted as its own proposal, inclusive of scope of services and rate information. The scope of service should include at a minimum the following information for each service proposed: • Detailed description of service components, modalities used, appropriate use of service, etc. • Target population including age range, specific population characteristics, area of service, etc. • Whether or not the service is billable to Medicaid and if bidder is currently able to bill Medicaid. Bidders are strongly encouraged to become Medicaid certified. Medicaid -billable services are preferred. • Clear rate schedule inclusive of all costs bidder wishes to charge for the provision of the service. 6) A bidder should avoid elaborate artwork, graphics, binding, presentation or other artifice that does not directly address the requirements set forth in this Request for Bid. 7) A bidder must demonstrate the knowledge, training and expertise to conduct the proposed service(s). 8) A bidder must provide a current resume, as well as proof of licensure, for self, staff members and contractors of the bidder. Additionally, a bidder must include proof of inclusion on State vendor lists if applicable to the proposed service (ex. Home Study Providers, Sex Offender Management Board Providers). 9) A bidder should clearly outline the supervisory structure of staff members and/or contractors of the bidder. This should include the ratio of supervisor to staffand/or contractors, frequency and duration of supervision, credentials of supervisor and length of time as a supervisor. 10) A bidder should clearly outline the bidder's internal referral acceptance and assignment protocol, including communication to the referring agency. 11) A bidder must demonstrate familiarity with Trauma Informed Care. Bidder must provide copies of applicable training certificates, or proof of registration for training, for all staff members who manage and/or administer services under this proposal. 12) A bidder must demonstrate prior and current capacity to be organized, responsive and to quickly and successfully schedule services as requested. 13) A bidder must agree to track outcome data related to services proposed if awarded a contract and report outcomes upon request. 14) A bidder must agree to enter into an agreement, attached as Exhibit A, with the Weld County Department of Human Services and comply with all requirements of the agreement. 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 selected vendor(s) will have the opportunity to resubmit annually. 2) The initial contract will be funded through Core Services Program or other funding, so long as funding is made available. 3) The selected vendor will bill the Weld County Department of Human Services monthly according to billing requirements set forth by the Weld County Department of Human Services. Submittal Requirements for All Proposals: A bidder must submit according to requirements set forth in this Request for Bid - Qualifications. All proposals must contain the following specific information: 1) Provider Information Form (PIF). 2) Identification of language(s) and proficiency level, if applying to provide bilingual (English/Spanish) services. 3) One page or less cover letter that introduces the bidder, the bidder's location(s) of practice, his or her experience and qualifications, and staff, if applicable. 4) A bidder must submit sufficient information concerning each proposed service for Weld County to evaluate whether or not the bidder meets"minimum qualifications" for all bidders. Each service must be submitted as its own proposal, inclusive of scope of services and rate information. The scope of service should include at a minimum the following information for each service proposed: • Detailed description of service components, modalities used, appropriate use of service, etc. • Target population including age range, specific population characteristics, area of service, etc. • Whether or not the service is billable to Medicaid and if bidder is currently able to bill Medicaid. Bidders are strongly encouraged to become Medicaid certified. Medicaid -billable services are preferred. • Clear rate schedule inclusive of all costs bidder wishes to charge for the provision of the service. 5) Bidders should avoid elaborate artwork, graphics, binding, presentation or other artifice that does not directly address the requirements set forth in this Request for Bid. 6) Current resume, proof of licensure and copies of applicable training certificates for all staff members who will manage and/or administer services under this proposal. 7) Supervisory structure of staff members and/or contractors of the bidder. This should include the ratio of supervisor to staff and/or contractors, frequency and duration of supervision, credentials of supervisor and length of time as a supervisor. 8) Internal referral acceptance and assignment protocol, including communication to the referring agency. 9) All proposals must demonstrate the bidder has the ability to deliver the services as proposed, and comply with the specific requirements set forth by the Weld County Department of Human Services. 10) All proposals must include a clear and concise rate schedule that accurately correlates to the proposed services and is inclusive of all possible charges related to the proposed service(s). The rate schedule must demonstrate an exact fee for the described service (s). Approximate rates or a range of rates for a service will not be accepted. 11) Each bidder must submit a Standard Certificate of Insurance, 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 Bid. Evaluation of Proposals: All proposals that meet the basic proposal, service and qualification requirements will be reviewed by the Families, Youth and Children (FYC) Commission. Criteria for review, include but are not limited to the following: • Qualifications, appropriate licensure, and experience. • Cost structure. • Relationships and collaboration. • Organizational experience and past performance. The FYC Commission will make recommendations 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. 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 , 2015, 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 Reuquest 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 for WHEREAS, the Colorado Department of Human Services has provided funding to the Department 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 7th of the month, following the month of service, utilizing billing forms required by the Department. 1 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 OMG 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 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 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 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 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: 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; 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 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 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 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 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 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 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 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 April 24, 2017 Families, Youth, and Children's Commission Weld County Department of Human Services 315 A. North 11th Ave. Greeley, CO 90631 Dear Commission Members: On behalf of Lutheran Family Services Rocky Mountains (LFS), I am pleased to present the attached proposal in response to the Commission's call for Various English and Bilingual Services. We are applying in order to continue to offer the Parent Education and Support Program to parents and caregivers in Weld County. LFS's Parenting Education and Support Program supports child abuse prevention by providing four parenting education classes designed to help parents identify and develop the protective factors known to reduce the incidence of child maltreatment. Our classes preserve and strengthen families, with a focus on building parental resiliency, knowledge, skills, and support systems so that parents do not resort to violence out of frustration and learned negative behaviors during times of stress. The Parent Education and Services Coordinator, Casey Peirce has been working for LFS for six years and managing the program for two years. The LFS Weld County building is located: 800 8th Avenue Suite 225 Greeley, CO 80631 The LFS headquarters and mailing address is: 363 S. Harlan St. Suite 200 Denver, CO 80226 If you have questions or need additional information, please do not hesitate to contact Kim Penney, Foster Care and Prevention Services Director, at 970-232-1156 or kim.penney@Ifsrm.org, or visit www.lfsrm.org. Sincere James . .i clay President and CEO 3 Table of Contents Cover Letter Parent Education and Support Program Proposal 4 Certificate of Insurance 10 Resumes, Licenses, and Training Certificates 12 Lutheran Family Services Rocky Mountains agrees to enter into an agreement with Weld County Department of Human Services. 2 EXHIBIT B CONTRACTOR'S PROPOSAL Parent Education and Support Program Lutheran Family Services Rocky Mountains April 24, 2017 Description: To help prevent child abuse and neglect, Lutheran Family Services Rocky Mountains (LFS) offers the Parenting Education and Support Program. The program supports child abuse prevention by teaching parents safe and effective discipline methods, appropriate developmental expectations, and healthy communication practices. Presented in a group setting with classes accommodating 15-30 adult participants, the parenting education classes are offered on -site at our location in Greeley or other community locations, including the Greeley Transitional House and local elementary schools. LFS offers an assortment of classes designed to reach a wide -range of parenting needs. Spanish classes are available. In addition, LFS offers children's groups and/or childcare in conjunction with some parenting classes. Serving as child care and learning environment combined, the children's groups focus on building social skills, enhancing self-esteem, anger management, and decision making skills. These skills are exhibited to the children through facilitator modeling, craft projects, games, puppets, storybooks, and songs. These classes preserve and strengthen families, with a focus on building coping techniques and resiliency so parents can safely parent instead of resorting to violence out of frustration or learned negative behaviors. LFS offers the following parenting classes: • RETHINK: Anger Management for Parents: Recognizing anger, Empathizing with the other person, Thinking about the situation, Hearing what is said, Integrating respect and love, Noticing your body's reactions, and Keeping your attention on the problem. RETHINK is designed to help parents have a more positive response to their children's challenging behaviors, identify anger triggers, and understand child development. The class is offered 2 to 5 times per year, and meets for 4, 2 -hour sessions. • Strengthening Latino Families. The Strengthening Latino Families class is a group - based, culturally appropriate curriculum for Spanish-speaking families interested in enhancing their parenting skills. Focusing on positive and respectful discipline, communication strategies, child development, and addressing issues of sexuality, Strengthening Latino Families includes 10 weeks of classes for 2 hours per week. LFS offers the program 2 to 3 times per year. • Nurturing Parenting Program. Nurturing Parenting is a nationally renowned, evidence - based, family -centered, and trauma -informed program that focuses on empathy, self- worth, self-awareness, discipline with dignity, family roles, and child development and expectations. LFS has offered this evidence -based program for more than 13 years. LFS provides 3 to 5 14 -week classes per year for parents of children aged birth to 12 years of age. LFS also offers 10 topic -specific Nurturing Parenting presentations to groups of parents at childcare, preschool and elementary schools, churches, and community agencies throughout Northern Colorado. • Nurturing Skills for Teen Parents. LFS offers 1, 5 -session class per year of the Nurturing Skills for Teen Parents through the teen parenting program at Jefferson High School in Greeley. Designed to support teens through the pregnancy and birth of their child as they stay in school, the class focuses on issues related to infant development, 4 Shaken Baby Syndrome, alcohol and drug affected babies, infant massage, positive discipline, budgeting, nutrition, and building children's self-esteem. The class uses the evidence -based Nurturing Parenting curriculum that is geared toward the adolescent developmental level. The program offers incentives to help motivate the teenaged parents to graduate high school. • Parenting Your Teenager. The Parenting Your Teenager class helps parents develop a better understanding of adolescence and more effective methods of interacting with their teen on a daily basis. The class focusses on adolescent development, Nurturing Parenting philosophy, teen relationships, communication, helping build teen's self-esteem, family roles, challenges faced by parents and problem solving skills for teens. Parenting Your Teenager includes 4 weeks of classes. LFS offers the class 2 to 3 times per year. LFS offers classes in Spanish, which are taught by Ivonne Varela and Ruth Sandoval, both native Spanish speakers. Target Population: The LFS Parenting Education and Support Program serves parents and caregivers living in Weld County, Colorado. Participants served through the Parenting Education Program have one or more of the following characteristics: • Parents/caregivers/caring individuals responsible for a child wishing to strengthen their knowledge and skill base • Parents/caregivers/caring individuals responsible for a child who may be at high risk for abusing and/or neglecting their children due to socioeconomic or social isolation issues • Court -mandated parents who may not have custody of their children and who are working to regain custody • Parents involved in the child welfare system who are at risk of having custody of their children removed due to abuse or neglect allegations • Parents who are involved in court -mediated divorce proceedings • New and/or first time parents • Victims of domestic violence The population includes single -parent and two -parent households, as well as households in which a caregiver in the home may not be a "parent" but they are fulfilling a parenting role (such as a live-in partner or a family member). The Parenting Education and Support Program serves individuals from a variety of age ranges; those participating in the program can range anywhere from teenage parents to grandparents raising grandchildren. Recipients of parenting education and support services gain increased knowledge of appropriate and nurturing parenting attitudes, beliefs, and practices, and thus reducing their risk of abusing or neglecting their children. The Parent Education and Support Program is not billable to Medicaid. Weld County funding is an essential source of funding for the LFS Parenting Education and Support Program, funding approximately 31% of the total program budget. In addition to Weld County funds, the Parenting Education and Support Program receives grant funding from the promoting Safe and Stable Families, and the Temple Hoyne Buell Foundation. A small fee is 5 charged for all parenting classes on a sliding fee scale and scholarships are available through the use of donated and contributed funds. The corresponding children's groups are always free. Rate of Schedule: The rate of schedule for the LFS Parenting Education and Support Program is... • $135.00 per each Nurturing Parenting: Drop -In Session • $97.50 per each Nurturing Parenting: Teen Parents Class • $197.00 per each Nurturing Parenting: English class • $213.00 per each Nurturing Parenting: Spanish class • $120.00 per each Parenting Your Teen class • $105.00 per each RETHINK: Anger Management for Parents class • $139.00 per each Strengthening Latino Families class Expertise of Staff: The LFS Parenting Education and Support Program staff and contractors have a broad range of skills and expertise, which help make the program successful. All staff members and contractors have post -secondary education; these range from Bachelor to Masters level (one contractor will receive her Bachelor degree in May 2017). The staff and contractor knowledge and training include but are not limited to: o Nurturing Parenting Facilitator Training -12 contact hours • Provided by The Family Nurturing Center of Colorado o Nurturing Healthy Sexual Development Facilitator Training -8 contact hours • Provided by Prevent Child Abuse & Illuminate o Strengthening Colorado Families and Communities Conference-- 18 contact hours • Sponsored by Illuminate o Human Trafficking Awareness, Prevention & Response-- 1.5 contact hours • Provided by Free Our Girls o Mental Health First Aid USA -8 contact hours • Provided by the National Council for Behavioral Health o The Hidden Realities of Technology -6 contact hours • Provided by The Coordinating Committee for Victims of Crime o Stewards of Children -2 contact hours • Provided through Darkness to Light • Taught by Darkness to Light Authorized Facilitator: Chelsey Lehmkuhl o Children with Disabilities: Challenges, Strategies, and Resources —I contact hour • Taught by Harold Johnson & Christine Pawelski o Executive Functions and ADHD in Children and Adolescents: Proven Techniques to Increase Learning and Manage Attention -6.25 contact hours • Provided by PEST o Youth and Young Adult Development -21 contact hours • Provided by Youth and Families Bridges Project 6 In addition to the current education and training that each staff member is equipped with, all staff members and contractors are encouraged to seek continuing education. Staff members and contractors regularly attend training sessions, webinars, seminars, etc. pertaining to Parenting Education and Support. LFS requires all licensed staff to be registered with the Colorado Department of Regulatory Agencies. Supervisory Structure: The supervisory structure for the LFS Parenting Education and Support Program is as follows: The Parenting Education and Support Program is overseen by a Program Director. The Program Director oversees the Prevention Services Supervisor. The Prevention Services Supervisor oversees the Parenting Education and Support Program Coordinator; four contractors are overseen by the Program Coordinator. Each supervisor provides direct supervision on a regular basis, with supervision sessions occurring a minimum of once per week. Referral Acceptance: The LFS Parenting Education and Support Program welcomes all parents and caregivers but many are referred from local agencies within the community. Various case workers and supervisors within the Weld County Department of Human Services refer their clientele to the program. Additionally the Parenting Education and Support program receives referrals from the 19th Judicial District (including the Weld County Courts and Weld County Probation), local domestic violence class instructors, therapists, and many other professionals within the community. Referrals to the program can be made in a variety of methods; this includes telephone, email, website inquiry, appointment, or walk-ins. Individuals speak directly with the Parenting Education and Support Program Coordinator, and are registered for the appropriate parenting class(es). Individuals who contact the Program Coordinator, receive return contact within two business days regarding their inquiry. Class registration is based upon the client's specific situation or need, any orders or referrals made on their behalf from other agencies, as well as class capacity. The Parenting Education and Support Program regularly communicates with outside agencies that are also working with program clients. In order to communicate with outside agencies regarding a client, the Program Coordinator requires written release forms signed by the client; the forms must specify information to be shared, as well as with whom the information can be shared. Trauma Informed Care: The LFS Parenting Education and Support Program staff apply Trauma Informed Care in a variety of ways. First, The Nurturing Parenting Program is an evidence -based and trauma -informed curriculum; this curriculum is utilized to teach multiple classes within the Parenting Education and Support Program. Program staff and contractors take pride in staying up to date on current research, techniques, and concepts related to trauma informed care. Staff members and contractors regularly attend training sessions, webinars, seminars, etc. pertaining to trauma informed care. Current trainings staff and contractors have obtained include: o Trauma Informed Primary Care Practice -2 contact hours ■ Taught by Dr. Mark Sloane and Dr. Aaron Meng ■ Sponsored by Larimer County Department of Human Service o Strengthening Colorado Families and Communities Conference-- 18 contact hours ■ Various workshops, including two trauma specific workshops: • Implementing Trauma Informed Concepts in the Home • What Are Little Boys Made Of o The Impact of Trauma and Neglect on the Developing Child -5.5. contact hours o Parenting Teens from Trauma -6 contact hours ■ Provided by The Adoption Exchange ■ Trained by Denice Rice o Caring for Children Who Have Experienced Trauma: A Workshop for Resource Parents ■ Taught by Dr. James Henry ■ From the National Child Traumatic Stress Network Capacity: LFS has noted an increase in clients since the last contracting cycle, and therefore anticipates serving slightly more individuals during the upcoming fiscal year. LFS anticipates serving 165 parents and caregivers and 40 children through the Parenting Education and Support Program by the end of this current fiscal year. Outcomes are measured through the use of curriculum specific pre- and post -class tests that measure parenting skills, practices, and beliefs. During the 2017-2018 grant period, class objectives are as follows: • 90% of parents who graduate from the parent education courses will complete the appropriate, specific pre- and post-tests for the respective class they completed • 70% of parents who complete pre- and post-test evaluations will demonstrate one or more of the following: o Reduced anger responses to children's behaviors o Use of more appropriate and safer parenting techniques o Decreased family stress levels o Increased positive intra-family communications o Increased knowledge of child/youth development LFS approaches the prevention of child abuse and neglect using parenting education classes because past research has demonstrated the effectiveness of parenting education classes to promote family wellbeing. The curricula used by LFS are either evidence -based or incorporate factors that are strong predictors of program effectiveness —strengths -based and family -centered programs that target populations with clear program goals (Children's Bureau, 2013). Data Tracking: LFS employs both process- and outcomes -based evaluations to assess program impact. Evaluation results are used to make empirically -based decisions in regards to program continuation and improvement, to ensure that services provided have been in the best interest of the client, and to determine whether the desired goals and objectives are met. As its primary measure of success, LFS strives to improve every client's condition as a result of the agency program(s) in which he/she participated. Consumer feedback is elicited through annual mail surveys of clients, significant others, and pertinent professionals to determine their satisfaction 8 with the organization, its staff, timeliness and helpfulness of services received, the extent to which their needs were met, and their perception of their current condition and/or situation. The LFS parenting classes include curriculum specific pre- and post-test evaluations to measure whether the participants' parenting knowledge and skills improved as a result of the information and activities presented during class. Additionally, participants are asked to complete questionnaires at the end of each multi -week session to help the staff assess the instructors, curriculum, class meeting times, and locations. The information is used to determine if any changes need to be made to the class procedures, curriculum, outreach, or clarity. Please refer to the attached Interim Report for an overview of outcomes from the previous six months. The following will be used for monitoring and evaluating the success of the purchase of services agreement: A. Quarterly report and invoices will be submitted to Weld County Department of Human Services by the 15th of the month following the end of each quarter. B. Review of evaluation materials and correspondence from outside agencies regarding services received. C. Ongoing consultation with supervising staff through Weld County Department of Human Services concerning development and implementation of programs. 9 ACOREP CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 06/23/2016 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 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 ights to the certificate holder in lieu of such endorsement(s). PRODUCER 1-303-534-4567 IMA, Inc. - Colorado Division 1705 17th Street Suite 100 Denver, CO 80202 INSURED Lutheran Social Services of CO Lutheran Family Services Rocky Mountain 363 South Harlan, Ste 200 Denver, CO 80226 CONTACT NAME PHONE (NC No. Ext): ADDRESS: denaccounttechslimacorp. com FAX I (A/C, No): INSURER(S) AFFORDING COVERAGE INSURERA: PHILADELPHIA INS CO �V INSURERB: ZURICH AMER INS CO(Pinnno) INSURERC: PINNACOL ASSUR INSURER D : INSURER E : INSURER F : 0 NAIC # 23850 16535 41190 COVERAGES CERTIFICATE NUMBER: 47188534 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE IN NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR" TH UMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POL XRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUC :Y PA LAWS. INSR LTR A A A B C X TYPE OF INSURANCE COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO X JECT LOC OTHER: AUTOMOBILE LIABILITY X X X ANY AUTO ALL OWNED AUTOS HIRED AUTOS UMBRELLA LIAB X SCHEDULED AUTOS NON -OWNED AUTOS X OCCUR EXCESS LIAB CLAIMS -MADE DED X RETENTON$ 10,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / ANY PROPRIETOR/PARTNER/EXECUTIV OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATI A Cyber Liability Privacy Liability Security DESCRIPTION OF CER bel ents Costs ADDL SUER INSD WVD POLICY NUMBE PHPR1507449 PHPR150.411114114 R POLIO FF PO (M DD (MM/ � X1/17 07/01/16 07/01/17 Y EXP /YYYY) 4 .31 07/01/16 07/01/17 WC969160405 - NM ONLY 4040538 - CO ONLY PHSD1151651 03/01/16 03/01/17 03/01/16 03/01/17 07/01/16 07/01/17 usins EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY $ 1,000,000 $ 1,000,000 $ 20,000 $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 PRODUCTS - COMP/OP AGG $ 3,000,000 COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) $ 1,000,000 $ BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) EACH OCCURRENCE $ 4,000,000 AGGREGATE X PER STATUTE OTH- ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ 4,000,000 $ 500,000 $ 500,000 E.L. DISEASE -POLICY LIMIT $ 500, 000 Deductible Limit Limit AT*INSIA,QQATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) ICATE HOLDER CANCELLATION $10,000 $1,000,000 $500,000 For Information Only 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 //,>4'; ACORD 25 (2014/01) ashmcclain 47188534 © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 10 SUPPLEMENT TO CERTIFICATE OF INSURANCE DATE 06/23/2016 NAME OF INSURED: Lutheran Social Services Lutheran Family Services of CO Rocky Mountain Additional Description of Operations/Remarks from Page 1: alliSill‘ aICIIIIIIII\I A\\* *\S%* Additional Information: a^"; K1507449 rer A Se Above 000 °=gregate Limit :'`" a Limit(Sexual abuse & Molestation Coverage is not Excluded) Professional Liability Coverage: Eff Date: 07/01/16-07/01/17 I $1,000,000 Each Occurrence; '•,0«7t $1,000,000 Sexual and/or si 1 liiiiilli lileCI:"(LIIIP SUPP (05/04) 11 Kimberly Penney, LCSW (#992640) 2032 Lowe Street, Suite 200 Fort Collins, CO 80525 970-232-1156 work 970-222-7410 cell kim.penney@lfsrm.org EDUCATION University of Denver —Denver, CO Master of Social Work; Graduated 1996; Emphasis: Mental Health • First year field placement at Colorado Mental Health Institute at Fort Logan: Constructed psychosocial histories including clinical assessment of adolescents with psychiatric diagnoses and provided individual, family and group therapy • Second year field placement at Catholic Charities Samaritan House homeless shelter : Provided case management and counseling services to chronically homeless men, women and families and conducted assessment of mental health /substance abuse University of Missouri -Columbia, MO Bachelor of Arts in Psychology; Graduated 1992; Emphasis: Human Development/Family Services and Educational/Counseling Psychology • Field placements at The Shelter for women who were battered and their children and the Partners in Education Program for developmentally disabled youth WORK HISTORY Lutheran Family Services Rocky Mountains -Fort Collins, CO Director of Foster Care North, Family Preservation and Prevention; 2015 to present • Supervise all Northern Colorado programming for children and families including domestic foster care, unaccompanied refugee minor foster care, family preservation services, a visitation program for families who are DHS-involved or Domestic Relations Court -involved, prevention programs regarding body safety and parenting education, High Level Trauma Assessment Services, Post -Adoption Counseling and therapeutic services through Medicaid • Budget management • Grant management of all funds supporting Northern Colorado LFS programming for children and families and evaluation of each program • Contract negotiation with Denver, Larimer and Weld Counties in addition to smaller Northern Colorado counties • Ongoing training in areas of leadership and trauma -informed care, which are both infused into all areas of practice 12 Kimberly Penney, LCSW (#992640) 2032 Lowe Street, Suite 200 Fort Collins, CO 80525 970-232-1156 work 970-222-7410 cell kim.penney@Ifsrm.org Lutheran Family Services Rocky Mountains -Fort Collins, CO Coordinator/Educator for Ready or Not? Teen Pregnancy Prevention; 2012 to 2015 • Schedule over 1,500 students to participate in the program each academic year in Weld and Larimer counties • Develop curriculum appropriate to middle school and high school aged adolescents • Research teen pregnancy and related risk and protective factors • Submit ongoing grant reports to multiple funding sources • Conduct bi-annual program evaluation • Supervise bachelor level interns • Participate in monthly community committee meetings • Conduct weekly group lessons in the classroom regarding the use of infant simulators as an experiential learning tool, pregnancy risk and protective factors, limit setting and parent -child communication techniques WORK HISTORY Arapahoe County Department of Human Services -Littleton, CO Ongoing Social Caseworker; 1996 to 2001 • Provided case management to children, adolescents, and families • Constructed and implemented treatment plans after needs assessment • Secured and supported all treatment and placement • Provided expert documentation and testimonial to the court system • Worked in conjunction with multiple systems, including mental health, educational and criminal justice • Served as lead caseworker and county liaison for the Arapahoe Mental Health Center therapeutic day treatment program, the Adolescent Day Resource Center • Served as lead caseworker and county liaison for the Arapahoe County District Attorney's Office's Serious Habitual Offender Directed Intervention Program with youth engage in criminally delinquent behavior and facing commitments to the Department of Youth Corrections 13 Kimberly Penney, LCSW (#992640) 2032 Lowe Street, Suite 200 Fort Collins, CO 80525 970-232-1156 work Excelsior Youth Center- Aurora, CO Group Living Counselor; 1992 to 1995 970-222-7410 cell kim.penneyPlfsrm.org • Supervised in -patient female adolescents with psychiatric diagnoses • Implemented individual treatment plans • Provided individual counseling and group therapy • Coordinated recreational therapy groups • Worked in conjunction with a team of mental health counselors and clinical therapists to meet the mental health needs of residents • Managed acute and unsafe physical behavior of residents through CPI methods LICENSURE I have been a Licensed Clinical Social Worker in the State of Colorado since 2001: License #992640. I received approval for credentialing with Colorado Access in 2015, which allows for Medicaid billing. TRAININGS AND CONFERENCES • Nurturing Parenting Training of Parent Educators, presented by the Family Nurturing Center of Colorado in Boulder on 6-13-12 and 6-14-12 • Child Abuse Symposium, presented by the Child Advocacy Center of Larimer County on 4-18-13 • DSM-5: Understanding and Diagnosing Mental Disorders, presented by Dr. Jean Keim of the University of New Mexico on 1-18-14 • The 12 Core Concepts: Concepts for Understanding Traumatic Stress Responses in Children and Families , presented by Dr. Susan Hansen of The National Child Traumatic Stress Network on 6-19-14 and 6-20-14 • Fundamentals of Trauma Processing, course completed through Continuing Education for Social Workers independent coursework 7-1-14 • Trauma 101, presented by Dr. James Henry of the Southwest Michigan Children's Trauma Assessment Center on 9-4-14 • Trauma Informed Care, presented by Dr. Jerry Yager, childhood trauma expert and fellow with the Child Trauma Academy, in a private LFSRM conference on 9-9-14 14 Kimberly Penney, LCSW (#992640) 2032 Lowe Street, Suite 200 Fort Collins, CO 80525 970-232-1156 work 970-222-7410 cell kim.penney@lfsrm.org • Trauma 201: Resiliency in Case Planning and Trauma -Informed Assessments, presented by Dr. James Henry on 10-20-14 and 10-21-14 • Trauma, Attachment, and Neuroscience: New Psychotherapeutic Treatments, presented by Dr. Bessel van der Kolk, Professor of Psychiatry at Boston University School of Medicine and Medical Director of the Trauma Center, on 11-13-14 • Trauma Assessment, presented by Dr. James Henry, on 1-5-15 and 1-6-15 • Coordinating and Intervening with Trauma Care in the Home and Larger Systems, presented by Dr. James Henry 2/9/16 • Monthly case consults with Dr. Jerry Yager, psychologist and fellow of Dr. Bruce Perry 2016 to present • The Impact of Trauma and Neglect on the Developing Child, Dr. Bruce Perry on 4-11-17 • Animal -assisted Interventions: Enhancing Treatment in Clinical Practice by Brooke Wimer of CMHI-Pueblo Inpatient Forensic Psych Unit on 4/17/17 COMMUNITY COMMITTEE MEMBERSHIP • Larimer County Trauma Practice Group 2015 to present • 7 County Trauma Consortium 2016 to present 15 COLORADO Department of Regulatory Agencies Division of Professions and Occupations 'Cb1 ratUlations Below are your electronic wallet cards to use as proof of your license. You can also print your license at any time through your Online Services account by visiting our homepage at www.dora.colorado.gov/professions and clicking on the "Print your License" link under the label "Quick Links". If you would like a more durable wallet card option, you can order one for a fee by visiting www.nasbastore.org and selecting the "Colorado License Cards" link on the left hand side of the page. If you prefer, you can also contact NASBA by phone at 1-888-925-5237 or by email at nasbastore@nasba.org. Should you have questions about your credential, or need other information, please contact our Customer Service Team at 303-894-7800 or dora_registrations@state.co.us. Colorado Department of Regulatory Agencies Division of Professions and Occupations Social Work Examiners Board Kimberly A. Penney Licensed Clinical Social Worker CSW.00992640 Number Active Credential Status Verify this credential at: www.dora.colorado.g ov%profession s 09/01/2015 Issue Date DtGisi�Director�on Credential Holder Signature Cut along the line Colorado Department of Regulatory Agencies Division of Professions and Occu ations Social Work Examiners Board Kimberly A. Penney Licensed Clinical Social Worker CSW.00992640 09/01/2015 Number Issue Date Active 08/31/2017 Credential Status Expire Date Verify this credential at: www dora.colorado.govjprofession s Division Director: Lauren Larson Credential Holder Signature 1560 Broadway, Suite 1350, Denver, CO 80202 P 303.894.7800 F 303.894.7693 www.dora.colorado.gov/professions /876 16 Nia r r r r or r r r r r r r r 1 Nii 1 Niii Nqg '1 -11 ili OF TRAINING COMPLI i DOCUM CERTIFIES THAT 1 1 -4, N NI NI '1 r Dr r r r r r rrrrrrrrrrrrrrr 8l LARIMER COUNTY DEPARTMENT OF HUMAN SERVICES O 'O L 3 " O t __ C L C of •0 3-5 m eo 00 y 1° `O To 3 " c u o_ o O = n E o in =00 u = O � u .- no c 3 O C 3 O 3.0(1) O '5 -c4-, L C co E a' C u v ID d 10 .O U H 2 O p oo 13 cu a ciao a O W 0 3 eo O CD C a o ca L O in •O a C c 'O O d = = ` VI O O N_ !0 E c o m ai n w c co O. In v O " 'O - a) .0 O r GJ ca ci) C -c ca c g Q O t4 O -O C a) v tn ct A. � Q Z O O . U +`j ai ct cd `—i a� w 0 O LA, 34 cn 04 O U (V cu 4-4 O U O e° N ctl I a) C'S N • v 4.4 4.4 a w E a) -n c/p U 6 5 Presented t V tin C. 0 U O O d.r V w4U MCL cu co m E co ar� C V E W W Certificate of Successful Completion IE•u.i u Ed4Nurses Psychotherapy, Animal -Assisted Interventions: Integrate Animals to Enhance Treatment in Clinical Practice Speaker(s): BROOKE WIMER, MOT. OTR/L Fort Collins, CO - 4:17'2017 The following participant Kim Penney (License #, if applicable) has completed the above -referenced educational activity in its entirety or as indicated below. This certificate provides sponsor verification of individual attendance and may be used for your records or for any licensing not listed below. We maintain attendance records for 7 years. ADDICTION COUNSELORS: This course has been approved by PESI. Inc., as a NAADAC Approved Education Provider, for 6.0 CE in the Counseling Services skill group. NAADAC Provider k77553. PESI, Inc. is responsible for all aspects of their programming. Full attendance is required; no partial credit will be awarded for partial attendance. COUNSELORS: This intermediate activity consists of regulations. Please save the course outline, the certific requirements. ock hours of continuing education instruction. Credit requirements and approvals vary per state board lesion you receive from the activity and contact your state board or organization to determine specific filing EDUCATORS TEACHERS: This course consists of 6.25 clock hours. This certificate is proof of your attendance. Please retain it in your records or use for submission as proof of completion when required. MARRIAGE & FAMILY THERAPISTS: This activity consisted of 380 minutes of continuing education instruction. Credit requirements and approvals vary per state board regulations. Please save the course outline, this certificate of completion and contact your state board or organization to determine specific filing requirements. NURSE/NURSE PRAL I I ITONERS CLINICAL NURSE SPECIALISTS: This activity meets the criteria for an American Nurses Credentialing Center (ANCO Activtn PESI, Inc, is an approved sponsor by the American Psychological Association, which is recognized by the ANCC for behavioral health related activities. Full attendance is required; no partial credit will be awarded for partial anendance. This actnity qualifies for 6.25 contact hours. NURSING HOME ADMINISTRATORS. This educational offering has been reviewed by die National Continuing Education Review Service (LACERS) of the National Association of Long Term Care Administrator Boards (NAB) and approved for 6.25 clock hours and 6.25 participant hours. Program Approval Number. 20I80305-6.25-SOVi-[N. OCCUPATIONAL THERAPISTS & OCCUPATIONAL THERAPY ASSISTANTS: PESI, Inc. is an AOTA Approved Provider of continuing education. Provider k: 3322. Full attendance at this course qualifies for 6.0 contact hours or .6 CEUs in the Category of Domain of OT and Occupational Therapy Process. Partial credit will be issued for partial attendance. The assignment of AOTA CEUs does not imply endorsement of specific course content, products, or clinical procedures by AOTA. Course Level: Intermediate. PHYSICAL THERAPISTS & PHYSICAL THERAPIST ASSISTANTS: This activity consists of 6.25 dock hours of instruction that is applicable for physical therapists. This certificate is proof of your attendance. Please retain it in your records or use for submission as proof of completion when required. PSYCHOLOGISTS: PESI, Inc. is approved by the American Psychological Association to sponsor continuing education for psychologists. PESI maintains responsibility for this program and its content. PESI is offering this activity for 6.25 hours of continuing education credit. Full attendance is required; no partial credits will be offered for partial attendance. SPEECH -LANGUAGE PATHOLOGISTS: This course provided 6.0 contact hours. This certificate neither awards ASHA CEUs nor verifies that .ASHA CEUs have been awarded to the person named above. ASHA CEUs are awarded by the ASHA CE Registry upon receipt of the CEU Post Reporting from the ASHA Approved CE Provider. SOCIAL WORKERS: PESI, Inc. Provider k:1062, is approved as a provider for social work continuing education by the Association of Social Work Boards (AS\1B), www.asw{t.org through the Approved Continuing Education (ACE) Program. PESI, Inc. maintains responsibility for the program..AS\\•B Approval Period: January27, 2017 - January 27, 2020. Social workers should contact their regulatory board to determine course approval for continuing education credits. Social workers participating in this course will receive 6.25 (Clinical) continuing education clock hours for this intermediate course. The back of this certificate may contain additional information Kristine Cleasby, Senior Continuing Education Administrator PESI, Inc. 1-800-844-8260 P.O. Box 1000, Eau Claire, WI 54702-1000 20 Certificate of Successful Completion *mss *PESI' Heaet+C re Rehab ❑£ACTH ---Eu.• • Ed4Nurses Psy[hothernpy Animal -Assisted Interventions: Integrate Animals to Enhance Treatment in Clinical Practice COLORADO SOCIAL WORKERS: PESI. Inc. is an approved provider with the Colorado Chapter of the National Association of Social Workers. Provider sl413. This course has been approved for 6.3 continuing education hours. OTHER PROFESSIONS: This activity qualifies for 380 minutes of instructional content as required by many national, state and local licensing boards and professional organizations. Retain your certificate of completion and contact your board or organization for specific filing requirements. DISCLAIMERS: "It is your ethical responsibility to report accurate hours to your licensing board. If you are in partial attendance a revised certificate will be sent to you, upon your request, after the activity. Please allow 3045 days. • though you have received this Certificate of Attendance, if you have a balance due, the balance must be paid in full within 30 days, or your hours may be retracted. • A11 participants are provided a post-test/evaluation form that is to be completed and turned in at the conclusion of the seminar. IS you require a copy of the test/evaluation, please have a copy made at the seminar. Or you may call our customer service department and a copy of your test/evaluation will be emailed to you. Please allow 30-15 days. PESI, Inc. offers continuing education programs and products under the brand names PEST, PESI HealthCare, PESI Rehab, MEDS-PDN, HealthEd and Ed4Nurses. Kristine Cleasby, Senior Continuing Education Administrator PESI, Inc. 1-800-844-8260 P.O. Bbx 1000, Eau Claire, WI 54702-1000 21 Lutheran Family Services Foster Care Training Documentation and Approval Form (Please use ONLY when certificate is not provided) Name: K. Penney, J. Bohannon, and T. Carlson Date: 4-26-16 Title of Training: TF-CBT, coping skills for hypo -arousal, breathing and relaxation techniques Name of presenter or author: Dr. Jerry Yager, LFS Clinical Consultant ['Book EAudio ❑Video ['Workshop ❑ Internet ❑ Other (list) group consultation Please list number of pages, minutes, or hours of training: n/a (# of hours granted will be hour -for -hour, actual workshop length, or 1 hour per 30 pages.) Report Outline (Use back or additional sheets as needed) What was the training material about? 1. Narratives during TF-CBT 2. Dissociation with hypo -aroused kids and other coping skills 3. Helping increase the capacity to tolerate positive affect What new information did you gain? 1. Kids need repetitive interactions to build capacity to tolerate stress or even positive affect. Our kids externally regulate (with others, not on their own) 2. Always start by validating negative feelings. With TF-CBT narratives, best if co - created with adult but they discover on their own. Okay to give examples and ask "do any of these fit"...even with EMDR and negative cognitions 3. Foster parents need to limit set without shaving. Know that kids wiring to inhibit is not well developed. How will you use it in fostering children? This information was shared in context of case presentation with 2 former foster children who were exposed neglect and domestic violence. Understanding how to set limits without shaming, begin narratives and teach coping skills such as breathing and activity will be useful during psycho -education in therapy sessions and with caregivers. Number of training credit hours granted: Date: Approved by LFS staff member: Signature of staff: H:\Staff Training\Training Documentation 4.26.16 Yager consult.doc In Accordance with Rule #7.708.65.C&D Rev. 9/9/2013 22 Lutheran Family Services Foster Care Training Documentation and Approval Form (Please use ONLY when certificate is not provided) Name: K. Penney, J. Bohannon, and T. Carlson, Richel Hubbard; Date: 7.19.16 Title of Training: coping with STS Name of presenter or author: Dr. Jerry Yager, LFS Clinical Consultant ['Book ❑Audio ❑Video ['Workshop ❑ Internet ❑ Other (list) group consultation Please list number of pages, minutes, or hours of training: n/a (# of hours granted will be hour -for -hour, actual workshop length, or 1 hour per 30 pages.) Report Outline (Use back or additional sheets as needed) What was the training material about? 1. How to cope with the stress of what we do plus administrative stressors 2. Be realistic about the treatment of children; only a small number of kids are abused 3. How to team build What new information did you gain? 1. There is no way to eliminate stress 2. Stress is tolerated through relationships 3. Build relationships/trust as a team so that you can navigate stressful situations that are a part of life and will never NOT be a part of life How will you use it in fostering children? The better relationships we can build and support as a team, the more we can tolerate stress of jobs and STS that is particular to child welfare. We help foster children when we are regulating our own STS. Number of training credit hours granted: Date: Approved by LFS staff member: Signature of staff: H:\Staff Training\Training Documentation 7.19.16 Yager consult.doc In Accordance with Rule #7.708.65.C&D Rev. 9/9/2013 23 Lutheran Family Services Foster Care Training Documentation and Approval Form (Please use ONLY when certificate is not provided) Name: K. Penney, J. Bohannon, and T. Carlson Date: 5-17-16 Title of Training: sexual compulsion in abuse victims and windows of tolerance Name of presenter or author: Dr. Jerry Yager, LFS Clinical Consultant ❑Book ['Audio ❑Video ❑Workshop ❑ Internet ❑ Other (list) group consultation Please list number of pages, minutes, or hours of training: n/a (# of hours granted will be hour -for -hour, actual workshop length, or .1 hour per 30 pages_) Report Outline (Use back or additional sheets as needed) What was the training material about? 1. Sexual compulsion v sexual addiction 2. Safety planning for adult victims of sa and their resulting compulsion 3. What to address regarding these issues in family therapy What new information did you gain? 1. We need to honor children for their solutions; they are creative survivors even if we worry about their coping skills 2. Need success experiences; we develop sense of self based on how we are feeling 3. Any type of arousal for sa victims can become sexual in nature How will you use it in fostering children? This information was shared in context of case presentation of a therapy case in which an older teen was developing sexual compulsion and dangerous situations were resulting. We can apply knowledge of how healing occurs in context of present relationships (in home and in tx) and not going back to past relationships. Tips for increasing her ability to ID feelings will be useful to caregivers. Number of training credit hours granted: Date: Approved by LFS staff member: Signature of staff: H:\Staff Training\Training Documentation 5.17.16 Yager consult.doc In Accordance with Rule tk7.708.65.C&D Rev. 9/9/2013 24 Lutheran Family Services Foster Care Training Documentation and Approval Form (Please use ONLY when certificate is not provided) Name: K. Penney, J. Bohannon, and T. Carlson Date: 3-8-16 Title of Training: confidentiality laws, mandatory reporting, executive functioning and trauma Name of presenter or author: Dr. Jerry Yager, LFS Clinical Consultant ['Book ['Audio [Video Workshop ❑ Internet ❑ Other (list) group consultation Please list number of pages, minutes, or hours of training: n/a (*` of hours granted will be hour -for -hour, actual workshop length, or 1 hour per 30 pages.) Report Outline (Use back or additional sheets as needed) What was the training material about? 1. How trauma affects executive functioning in youth. 2. Tips for channeling energy due to sensory issues 3. 1:1 relationships build abilities to navigate social environments What new information did you pain? 1. Education re: children experiencing various levels of arousal, from shut down to high energy and adults needing to help reduce associated stress as kids are unable. 2. Limit setting creates states that the kids cannot tolerate 3. Environments need to be created that help a child learn to self -regulate; these environments establish implantation of neurons that can now be wired into their brains. How will you use it in fostering children? This information was shared in context of case presentation with 2 male children who were exposed to drug use in utero as well as domestic violence. Understanding how to set limits while supporting the children and their inability to tolerate limit setting was discussed. We have concrete ideas re: how to manage sensory overload and complex social environments. Number of training credit hours granted: Date: Approved by LFS staff member: Signature of staff: H:\Staff Training\Training Documentation 3.8.16 Yager consult.doc In Accordance with Rule #7.708.65.C&D Rev. 9/9/2013 25 Lutheran Family Services Foster Care Training Documentation and Approval Form (Please use ONLY when certificate is not provided) Name: K. Penney, J. Bohannon, and T. Carlson, Richel Hubbard, Julie Robbins, Brittany Foster, McKenzie Gunderson, Ashley Shaw Title of Training: neglect Date: 10-25-16 Name of presenter or author: Dr. Jerry Yager, LFS Clinical Consultant Book ['Audio ['Video ❑Workshop ❑ Internet ❑ Other (list) group consultation Please list number of pages, minutes, or hours of training: n/a (# of hours granted will be hour -for -hour, actual workshop length, or 1 hour per 30 pages.) Report Outline (Use back or additional sheets as needed) What was the training material about? 1. Neglect vs. abuse: Neglect is far worse on the brain and relationships. 2. Skills of the neglected child are very primitive. 3. They may see in you what they can get to meet their own needs and not know how you are feeling 4. There is a push-pull that is innate. They can't tolerate closeness nor can they tolerate being separate from the caregiver. What new information did you gain? See detailed attached notes. How will you use it in fostering children? We presented case of 3 siblings coming from extensive neglect. Knowing that they need repetition and pleasurable experiences in addition to the fact that nothing will be learned or improved in the absence of a relationship with foster parents was good psychoeducation that we can now share with foster parents. Number of training credit hours granted: Date: Approved by LFS staff member: Signature of staff: H:\Staff Training\Training Documentation 10.25.16 Yager consult.doc In Accordance with Rule #7.708.65.C&D Rev. 9/9/2013 26 Lutheran Family Services Foster Care Training Documentation and Approval Form (Please use ONLY when certificate is not provided) Name: K. Penney, J. Bohannon, and T. Carlson, Richel Hubbard, Julie Robbins, Brittany Foster ; Date: 9-6-16 Title of Training: Symptoms of PTSD Name of presenter or author: Dr. Jerry Yager, LFS Clinical Consultant ['Book EAudio ['Video ['Workshop ❑ Internet ❑ Other (list) group consultation Please list number of pages, minutes, or hours of training: n/a (# of hours granted will be hour -for -hour, actual workshop length, or 1 hour per 30 pages.) Report Outline (Use back or additional sheets as needed) What was the training material about? 1. Dysregulation as a symptom of PTSD 2. Hospitalizations and how to provide psychoeducation about how they may be unavoidable 3. Why do people do better in school v home? What new information did you gain? See detailed attached notes. How will you use it in fostering children? We presented case of 14 year old URM from Burma. We have approaches we can teach foster parents and know how to look for and plan for dysregulation Number of training credit hours granted: Date: Approved by LFS staff member: Signature of staff: H:\Staff Training\Training Documentation 9.6.16 Yager consult.doc In Accordance with Rule #7.708.65.C&D Rev. 9/9/2013 27 Certificate of Training Completion HR 101 In Depth Supervisor Training for Lutheran Family Services Rocky Mountains Presented by Forte - HUMAN RESOURCES The SafeGuard System February 22, 2017 This certificate confirms the employee listed below successfully completed an 8 hour training class named above. Kim Penney Print Name Trainer Signature 28 Casey L. Peirce 1033 East 25th Street Road, Greele CO 80631 Phone: (970)520-5573 Email:beck2695@bears.unco.edu Professional Summary: Hard working, adaptable, self -motivated, organized, collaborative, public health professional, backed by eight years of professional experience among various public health populations; with a desire to continue working to educate and empower women and children by addressing all aspects of their health and well-being. Education: Master of Public Health Colorado School of Public Health at University of Northern Colorado • Concentration: Community Health Education Bachelor of Science in Human Services University of Northern Colorado • Emphasis: Community Health • Minor: School Health Education Greeley, CO May 2015 Greeley, CO May 2012 Certifications, Licensures & Professional Memberships: • Certified Health Education Specialist (CHES): April 2015 -March 2017 • Nurturing Parent Education Facilitator: June 2012 -present • Resource Parent Curriculum (Trauma Informed Care): March 2016 Professional Experience: Lutheran Family Services: Parenting Education & Support Program August 2015 to present -Parenting Education & Support Program Coordinator • Implement program's operational philosophy, goals and objectives congruent with Lutheran Family Services mission, values and vision • Stay abreast of evolving practices and community needs in parent education, family services, and outreach to related prevention services • Prepare monthly date reports, and reports regarding program objectives and outcomes to grants and funders • Develop and maintain strong relationships with community partners, referring agencies, funding organizations, and more • Accountable for program budget adherence, volunteer and employee supervision, and program scheduling • Provide direct teaching services Lutheran Family Services: SafeTouch Program January 2015 to May 2015- Master's Level Internship: Practicum & Capstone • Conduct literature reviews to determine current research and programs utilized to address child sexual abuse prevention education for parents • Identify the need for child sexual abuse prevention education program for parents of young children and adolescents, via a needs assessment • Create a curriculum providing child sexual abuse prevention education programs for parents of young children and adolescents • Market the education program, receive community feedback and revise program 29 Lutheran Family Services: Parent Education & Support Program March 2015 to December 2015 -Parent Educator • Utilize various parenting styles, techniques and theories including nurturing parenting, the theory of attachment, and trauma informed practices to educate parents with children who are going through divorce. • Provide materials via a mixed lecture/feedback format to groups of 3-20 people • Develop rapport with attendees, local non-profit organizations, and local law enforcement agencies University of Northern Colorado: Dr. Alena Clark, RD CLC January 2014 to May 2014- Master's Level Independent Study: Creation of a Breastfeeding Toolkit • Conduct a literature review examining recommendations, benefits and barriers to breastfeeding support on college campuses • Develop "Supporting Breastfeeding on College Campuses" toolkit via evidence based research, qualitative research, professional interviews and surveys, and policy reviews • Toolkit provided to Dr. Alena Clark for further review, revision, and distribution • Maintain contact with Dr. Clark, and support University Lactation Station and events Lutheran Family Services: careHouse January 2011 to December 2015- Visitation Supervisor • Observe parent and child interactions during visits; objectively document interactions • Intervene and redirect behaviors as needed • Utilize evidence based parenting techniques, and direct parents in such techniques • Document events of visitation, debrief parents, report information and statistics to reporting agencies A Woman's Place November 2011 to May 2012 -Legal Advocate Assistant: Undergraduate Internship • Assist victims in the legal process of obtaining protection orders • Provide silent support for victims in the court room • Advocate for victims, helping them work toward self-reliance and empowerment • Educate the community about domestic violence via presentations and workshops Envision April 2009 to November 2012- Direct Care Provider and Case Manager • Provide personal care to individuals with developmental disabilities • Document daily activities, medications and behaviors • Facilitate communication between client providers, including billing and appointments • Follow State and Federal policies and guidelines to provide appropriate services • Utilize State HCPFF website to determine funding and benefits for clients • Advocate for and empower clients to meet their needs & wants; provide continual ongoing support 30 NCHEC National Commission for Health Education Credentialing. Inc Credentialing Excellence in Health Education Dear CHES/MCHES: 1541 Alta Drive, Suite 303 Whitehall PA 18052-5642 Toll Free Phone (888) 624-3248 Toll Freee Fax. (800) 813-0727 Website http://www.nchec org Thank you for your continued commitment to the health education profession. Below is your CHES/MCHES card, which lists your identification number and its expiration date. This card will be useful when registering for continuing education contact hours at conferences/events, when seeking employment and when identifying yourself in calls and letters to the NCHEC office, Credentialing reflects your commitment to expanding your skills and knowledge through health education continuing education. We encourage you to see your recertification goal of 75 continuing education contact hours (CECH) in terms of five incremental goals of 15 CECH a year. The number of NCHEC "Designated Providers" of approved programs is growing; so is the number of accessible and affordable CECH opportunities. CECH can be earned attending conferences; reading NCHEC approved journal articles; participating in teleconferences, video/audio taped presentations and Internet events; giving presentations; taking graduate level health education courses; and authoring artides published in peer -reviewed journals. For a complete listing of NCHEC-approved continuing education programs and providers, and a thorough description of continuing education policies and procedures, please visit our website at ;r ti t.�.. izarc-urti r. Again, congratulations on your continued commitment to the profession of health education. Sincerely, 4 Linda Lysoby, MS, MCHES, CAE Executive Director NATIONAL COMMISSION FOR HEALTH EDUCATION CREDENTIALING, INC, This Card Certifies Renewal/Recertification for: NAME Casey L Peirce CH ES it 24864 Exp. Date 04/01/2018 STATUS: Active Reminders Requirements for recertification (5 year cycle) • Need to accumulate 75 CECH a. Minimum of 45 CECH in Category I b. Maximum of 30 CECH in Category II Annual Renewal fee is $55.00 For questions refer to website. www,nchec,org or call 888-624.3245 31 32 33 LARIMER COUNTY DEPARTMENT OF HUMAN SERVICES V u Cu a a) L Cu U A L Cu E .` a a) E 8 C fC fa I- nricw of trauma based medication Cl 4. 44 Cl E Cl b 60 H CA h n C 7 U II Cl u y a Cl S r 3 U Cl u o ct, -a M \r..) C O L uU n coo0 a. U C .S , U • , C w u n c U V •.--• u 5 tUi r. Cl U C t~ - J 0 G C . C O G ;n 7 u W n� o• 2 J C uv. a o U co -, D E cs r Q C U to I - r g 2 el'G' V. 14 a o -0 r C C' c h u w c u0 -0 c — u 0 a ° }e% o U E r i �-0 Z .S m to u v u r. y a„inc.:, u aC 5 n C c: 'E rJ C Cl a E t—, Cl c C c4. E C,O .... •� 0 gig xi C C u fir' I7 I� o > ou aS L.0 I b in ai �Zqo a` June 13, 2016 — 2:30 — 4:30 (2 hour of trauma training) s y L� u Cl iv c r. C E s 4 0 "a c Vl L•' — 4.4 r. u 0 U 4 Cl a., O 7 t- 34 a Acknowledges that u • ■ IMO L O I C5 • CD CS D (C a) o a) W E N ccs' O� EO CD —a U >, a) O U v W 0 Vic/} G) C) aL L z Johanna Straavaldsen, MSW Healthy Relationships Project Director PO Box 829, Montpelier, VT 05601 (802) 229-5724 O co 0 v Contact Hours: 8 C e, • Bilingual -Spanish (read/write) • Knowledge in all MS Office programs • Time management Rum SANDovAL 3420 w 13th St. Apt 123, Greeley, CO 80634♦ C: 9706461115 ♦ ruth_sandoval90@live.com PROFESSIONAL SUMMARY Visitation supervisor, Family Advocate and Parent Educator Facilitator with excellent time management anc punctuality. Organizational skills such as filing, organizing and collection of information in an effective manner. Family advocacy and providing resources to victims. SKILLS • Excellent people skills • Good people handling skills • Excellent verbal communications WORK HISTORY Parent Educator Facilitator, 01/2016 to Current Lutheran Family Services — 800 8th Ave #225, Greeley,CO 80631 Instruct the Nurturing Parenting program by following a twelve week curriculum, provide information and referrals as needed during the classes as well as being a support system for the parents. Bilingual Family Advocate, 04/2015 to Current Life Stories — 1610 29`h Ave Place, Greeley,CO 80634 Greet families as they arrive at the center, provide information about therapy and referrals. Talk about Darkne: Light organization and how to prevent sexual abuse, what they can expect after the interview and internet safe Follow up with the families a couple of weeks after the forensic interview and continue to follow up until case closed or no further follow up is needed. Visitation Supervisor, 08/2014 to Current Lutheran Family Services — 800 8th Ave #225, Greeley,CO 80631 Monitor visitations between parents and children. Record all interactions between families and report any suspect of abuse towards the children. Supervision of children during parenting classes. Filling and clerical duties. Maintain Office and rooms clean and disinfected. Sales Consultant, 09/2012 to 11/2014 Sears — 2800 Greeley Mall Greeley,Co 80631 Assisted customers and persuaded sales. Answered questions about the product and help the customer get the product that is right for them. Operated a cash register for cash, check and credit card transactions, and at the end of the night count down the registrars and return the money to the safe. Sales Associate, 09/2010 to 04/2012 Maurices — 1511 N Kansas Ave, Liberal, KS 67901 Greeted customers and recommended merchandise based on their needs and preferences. Cleaned and organized store, including the checkout desk and displays. Operated a cash register for cash, check and credit card transact 37 EDUCATION Post -Baccalaureate Certification: Health Psychology, 2015 Northcentral University Bachelor of Arts: Psychology, 2014 University of Northern Colorado - 501 20th St, Greeley,CO 80639 Associate of Arts: Psychology, 2011 Seward County Community College - 1801 N Kansas Ave, Liberal, KS 67901 38 39 LARIMER COUNTY DEPARTMENT OF HUMAN SERVICES 0) U co"' L Q dJ fC U Co E N E O v—. (13 C z Co co 0 .2 G C O n .J CU .• &'. 0 ct U U 0 t, r C C o O O u o C p u 0 0 Intersection Description: •a 0 u g e. Presented by: June 13, 2016 — 2:30 — 4:30 (2 hour of trauma training) Andrea Fotsch G :J rip C r. E C T 0 E — a J Q C C 0 U U cs a 0 7 ii 40 4-4 O • � • 1-1 U V U crj 43 U Ruth Sandoval E4 SA ir MENTAL HEALTH FIRST AID Certificate Ruth Sandoval has completed the 8 -hour course and is now certified in Mental Health First Aid USA And has been trained to provide initial help to people experiencing mental health problems such as depression, anxiety disorders, psychosis and substance use disorders. This certification became effective on: This certification expires on: Dale February 21, 2017 c�a N/A Luke Moore, LPC, CAC III Evan Page, MA, LPC Instructor Instructor MENTAL HEALTH 21;6 NATIONAL COUNCIL FOR BEHAVIORAL HEALTH MENTAL HEALTH F1RST AID Rills Mental Health First Aid USA is coordinated by the National Council for Community Behavioral Healthcare, the Maryland Department of Health and Mental Hyg,ene, and the Missouri Department of Mental Health. %NI a) 4.• c .O E CD 4-z E.E • o L V -� � co CD C 0�. Q CDO CL= a) y o = 1 E a) CO ttl5 C °IP - C7i a) i v O v bm CD o -o C W O LL ni a) o .g (2) tf) ._ C >, O •E2 -0 a) O N N 0 -Adoption Resource Center a) V v Put on by The Adoption Exchange. Trained by Denise Rice, LCSW, LAC. tD N a C3 0 a 44 Si, Certificate of Attendance STEWARDS OF CHILDREN TRAINING q Presented To: W a CO.10 D M C CA O O co Ln a) . C co co C —o - o > V 0 O Q. a o s a) a C 0 o o cv _o 0 0 a) > o o Q. 0 0_ D O N . N E Q o o 8.)o Q_ Z c a) _c 4- a c > O 0 > Ci Q x Ww' CV t_ 0 v C "c• O 0 O Y a) li 12) C U) C Q a)a) U) O W •- C RS Cs - WC Z ;liltO LV as a; V .- 0 N a ._ is Val a is DI 444, CI X _ .- CD T ca April 24, 2015 Youth Mental Health First Aid USA Certificate Ruth Sandoval MEND HEALTH FIRST AID" has completed the 8 hour course and is now certified in Mental Health First Aid USA And has been trained to provide initial help to young people experiencing mental health problems such as depression, anxiety disorders, psychosis, and substance use disorders_ This c ertEcaticn became affective on: June 8, 2016 N/A This cettiFication mtp&as on. DOM Janis Pottorff LCSW, IMH-Ee III ciaa�. MENTAL NTAL HEALTIT Clas Suzann Pfeifer, MS biZISICON NATIONAL COUNCIL FOR BEHAVIORAL HEALTH poMINtA1 H1ALTF! BMMAIMEE lirslepidisis. Youth Menasi lilt Rest Intl LISA is caaarasead birth" tasaarai Cana' for iBar�aetord die Mwyload Dep.iinr * at nnab aad Hamm Boma, and rie hraaoui aap er ient of Mena i Weak 48 OS icrav2015 NCAC Virtual Training Center 11 National Children's Advocacy Center CERTIFICATE of COMPLETION THIS ACKNOWLEDGES THAT Ruth Sandoval HAS SUCCESSFULLY COMPLETED THE ONLINE TRAINING Children with Disabilities: Challenges, Strategies, and Resources Harold Johnson & Christine Pawelski 59 Minutes 10/30/2015 x 124,4.• Chris Newlin, Executive Directr, r National Children's Advocacy Centex Huntsville Alabama aiat Qdru''' Pamela D. Jones, Training Director National Children's Advocacy Center Huntsville_ Alabama A hops)/ncacvlc.orglikxurseslcourself6519fa2-0245-4a77-89f4.9849 b4ba8 2/3 I, I I I I I I I I I I I I I I I I A Kid's Place a) U C 03 CD o ° U For attendance at the training on: Daniel Steele, Sargent Denver Police Department nnocence Lost Task Force m U- June 23, 2015 M C O Q W I. O CU C.) C CU -a C a) Q O IL 1 a) a) a) e2 E (n O •E CO U O >c O O O O a) Human Sex Trafficking April 15, 2016 a) L z O District Attorney Michae 451 Mio u c H a— �a. E Co = O .C 41 P- o o -ate a: L O O oU V is hereby granted to C 0 .N V) CD o U U V) �o "� O O .— u "0 a O I' ' Q O U V)> U O .E a LL Marisa Wood 1616 13th Avenue, Greeley, CO, 80631 Phone: 719-304-1633 E-mail: marisawood37@gmail.com Work Experience Lutheran Family Services Greeley, CO Children's Program Teacher October 2016 -present • Provide structured child care for children ranging from infancy to 12 years old while parents are attending parenting class • Teach curriculum based on social and emotional development • Provide activities for children that encompass the curriculum • Provide safe and nurturing environment for children Lutheran Family Services Greeley, CO Intern May 2016- August 2016 • Visitation Supervisor- objectively document visits and interactions between parents and children • Assist in teaching Children's Program, updating curriculum, and researched suggested reading materials • Provide administrative assistance by ensuring office files were organized and updated Cinemark 12 Greeley, CO Assistant Manager April 2016 -present • Train and mentor employees • Assign and assist tasks given to employees • Responsible for handling and counting large amounts of money • Ability to answer and address customer questions, concerns, and complaints Cinemark 12 Greeley, CO Box Office/Usher/Concessions September 2014 -April 2016 • Handle money, sell concessions and tickets • Maintain theatre cleanliness and appearance • Knowledge of theatre, company policies, and services Nanny Colorado Springs, CO August 2012 -May 2013 • After school and weekend child care provider of three children ages four, ten, and twelve • Responsible for all transportation to activities 54 • Ensure completion of children's chores and homework • Complete housework and meal preparation for the family Education University of Northern Colorado Greeley, CO • Candidate for Bachelor's in Psychology and minor in Early Childhood Education • Expected graduation date of May 2017 • Cumulative GPA of 3.4 Volunteer Work Bethel Baptist Church Greeley, CO Nursery Volunteer 2015 -present • Responsible for the care of infants and toddlers during church service; activities, snacks, supervision Diocesan Youth Board Colorado Springs, CO Peer Leader August 2011 -May 2013 • Plan events and activities for youth and mentor for middle school and high school youth Jackson Elementary School Greeley, CO Kid's Hope Mentor October 2016 -present • Mentor for an at -risk child identified by the school • Provide fun activities, tutor in school work, and maintain positive interactions and relationship with student Achievements Psi Chi Psychology Honor Society May 2015 -Present Expanding Quality in Infant Toddler Care Training Certificate Recipient Department of Human Services May 2015 Certificate of Completion for Mandated Reporter Training Department of Human Services 2015 University of Northern Colorado Dean's List 2015-2016 55 '•� W"JJ�' Y W�fWW l L. 4➢ Local EQIT Community Training COI "--_,v,07,44.,eviv,...5-_,Pvt,mAtiv-,wi-m-m-Ait,"'Atir--,tiz, it - 57 9S v ▪ E E • e a 0.0 c a2 8 "a O O `s3 of • Td u'5 ca u ea sc U L U a t O C ✓ 0 C ca CO aco .17 'University of Northern Co(oraio 0 0 o v 2 a lot N C C Loretta Hoff Parent Educator, Counselor 801 Kingston Dr. 970-222-4274 Fort Collins, CO 80525 IorethoffPrnsn.com Education Master of Arts in Counseling Regis University, Denver, Colorado Chi Sigma Lota December 2008 December 2007 Bachelor of Science, Human Nutrition and Dietetics Colorado State University, Fort Collins, Colorado December 1994 Relevant Experience Larimer County Community Corrections: Ft. Collins, Colorado January 2016 -present Parent Educator • Teach principles and objectives of parenting skills through class material and discussion • Utilize nurturing parenting course material for educating parents on parenting skills • Present 12 -week sessions in conjunction with client's 90 -day treatment program • Provide documentation for each individual's participation and progression within the group Lutheran Family Services: Greeley, Colorado January 2012 -present Parent Educator • Facilitate 4 week anger management class for parents • Facilitate 4 week parenting your teen class for parents • Utilize the principles from nurturing parenting for parenting skill classes • Assess parent's educational needs for their knowledge on parenting skills • Provide parenting education for court -ordered and incarcerated parents Care: Evans, Colorado May -October 2011 Parent Educator • Instruct parents on adolescent development and their challenges • Prepare and evaluate class material for parents knowledge on parenting skills • Provide parenting education for parent mandated to comply with Weld county Courts 59 Pathway Hospice: Fort Collins, Colorado August 2008 -October 2011 Medical Records Clerk/Grief Supporter • Provide companionship for bereaved family members • Provide the client information on the process of grief when appropriate • Maintain confidentiality Care Net: Denver, Colorado January -December 2008 Internist/Counselor • Provide psycho -educational classes for male sex offenders addressing topics on communication skills, boundaries, victim empathy and shame • Assist clients develop personal safety plans and complete homework assignments • Participated in group counseling • Provide individual Counseling • Evaluate and document clients progress • Collect payments Additional Education 4/2017 The Impact of Trauma and Neglect on the Developing Child, Facilitated by Dr. Bruce Perry,M.D., Ph.D; United Way of Weld County 4/2016 Executive Functions and ADHD in Children & Adolescents: Proven Techniques to Increase Learning and Manage Attention, facilitated by Cindy Goldrich, M.ED, ACAC; PEST 4/2015 Youth and Young Adult Development, facilitated by Kim Bappe, LCSW, LAC; Bridges Project 10/2014-2016 Colorado Counselor Training for addiction counseling, facilitated by Kim Bappe, LCSW, LAC 6/2012 Nurturing Parenting Program -Training for Parent Educators, facilitated by Linda Quigley, Parent Education Specialist 1/2009 Patient & Family volunteer training, facilitated by Sarah van Etten, Director of Volunteer Services; Pathways Hospices, Fort Collins, CO License/Certificates 4/2010 -Colorado State Database Certificate of Training- Motivational Interviewing, Infectious Diseases in Addiction Treatment, Professional Ethics II, and Principles of Addiction Treatment 60 L9 Certificate of Successful Completion F:ZSIncL x H Eint. Ed4Nurses mPD1 a PSYihOtimOgY, Executive Functions and ADl ID in Children & Adolescents: Proven Techniques to increase Learning and Manage Attention Speaker(s): CINDY GOLDRICH. M.ED.. ACAC Cheyenne. WY - 4/18/2016 The following participant Loretta Hoff (License 8, d applicable) has completed the above -referenced educational activity, in its entire[} or as indicated below. This certificate provides sponsor verification of individual attendance and may be used for your records or for any licensing not listed below. We maintain attendance records for 7 years. COUNSELORS: This intermediate activity consists of 6.23 clock hours of continuing education alswction Credit requirements and approvals vary per state board regulations. Please save the course outline. the certificate of completion you receive from the action: and contact sour state board or organization to deternune specific filing requirements. SOCIAL WORKERS: PESI, Inc. Provider N:I06w is approved as a provider for social work colt rung education by the Association of Social Work Boards (AS\\'B), nmv.aswb.otg tlirougli die Approved Continuing Education (ACE) Pr garn. PEST. Inc. maintains responsibility for the prom AS\\'B Approval Period .lanuary 27, 2014 -January 27, 2017. Social workers should contact their regulatory board to determine course approval for continuing education credits. Social workers participating in this course will receive 6.25 (Chiliad) continuing education clock hours in participating in dais intermediate course PSYCHOLOGISTS: PESI, Inc. is approved by die American Psychological Association io sponsor continuing education for psychologists. PEST maintains responsibihn for this program and its content_ Tins seminar awards 6.23 credits to participating professionals. Full attendance is required. No partial credit will be offered for partial attendance. MARRlr10E AND FAMILY THERAPISTS: This activity consisted of 380 minutes of continuing education instruction. Credit requirements and approvals van per state board regulations. Please save the course outline, this certificate of completion and contact your state board or organization to den:m inne specific fling requirements TEACHERS/EDUCATORS Tins course consists of 6.23 clock hours. This certificate is proof of your auertdance. Please retain the certificate in sour records or use for submission as proof of completion when required. SPEECH -LANGUAGE PATHOLOGISTS: This course provided 6.0 contact hours. This certificate neither awards ASHA CEUs nor verifies that ASHA CEUs have been awarded to die person named above ASHA CElis arc awarded by die ASHA CE Registry upon receipt oldie CEU Post Reporting from die ASHA Approved CE Provider. OCCUPATIONAL THERAPISTS & OCCUPATIONAL THERAPY ASSISTANTS: PESI. Inc.. is an AOTA Approved Provider of continuing education. Provider N: 3322. Full attendance at this course qualifies for &29 contact hours or .625 CEUs. Partial credit will be issued for partial attendance. The assignment of AOTA CEUs does not imp's. endorsement of specific course content. products. or clinical procedures by .AO'i'A. Course Level Intermediate. COLORADO SOCLAL WORKERS: PESI, Inc. us an approved provider with die Colorado Chapter oldie National Association of Social Workers. Provider 01413. This course has been approved for 6.3 continuing education hours. NEBRASKA COUNSELORS: This interucdiate activity is approved for 6.2S clock hours of continuing educaton instruction. The Nebraska Depavnent of Health and Hunan Services recognizes courses and providers that are approved by die :VA. A certificate of attendance will be awarded at the end of the program to counselors who complete die prrgriun evaluation, to subnut to their state board. The back of this ceniftcate ma} contain additional information Knstine Cleasby, Senior Continuing Education Administrator PEST, Inc 1-800-844-8250 62 & Families Bridges Project Certificate of Training Awarded to Loretta Hoff For Youth and Young Adult Development Method of Delivery: ❑ In -Person X� On-Une O Hybrid Hours of Office of Behavioral Health Approved Credit: 21 Date(s): OBH Exam Passed April 27 - May 18, 2015 Kim Bappe, LCSW, 10iLAC m u��•-_ OBH Approved Trainer 63 cell: 970-413-2718 cepling02(a omail.com Education M.Ed. in School Counseling & Guidance May 2007 BA in Psychology and Criminal Justice May 2003 University of Arizona, Tucson, AZ University of Delaware, Newark, DE Certification/License CDE Special Services Provider: School Counselor Skills/Traininq Victim Witness Crisis Response Training Ethical & Legal Issues in School Counseling Trauma and the Developing Brain Trauma Informed Lens for Educators Experience Christine Epling Mental Health Specialist, Poudre School District, Fort Collins, CO Supervisor: Melanie Voegeli-Morris August 2014 — Present Provide therapeutic interventions for high -risk students in the school setting; teach coping skills to students with trauma history and/or other mental illness; facilitate community connections and services for families in need; consult with and educate school staff on appropriate interventions for students with trauma and mental illness; conduct suicide assessments and refer to appropriate community resources; provide community education and parent training around adolescent mental health issues Parent Educator/Safe Touch, Lutheran Family Services, Fort Collins/Greeley, CO Supervisor: Casey Peirce July 2013 — Present Parent Educator: Facilitate child abuse prevention parent education classes for high risk families in the community and in a teen parent program at an alternative high school. Safe Touch: Conduct Safe Touch presentations (classroom based presentations discussing stranger danger, physical abuse and sexual abuse) to grades K-5 in Weld County elementary schools. Parent Educator, Larimer County Community Corrections, Fort Collins, CO July 2013 — Present Facilitate child abuse prevention parent education classes for adults in a residential treatment program. Secondary School Counselor, Marana Unified School District, Marana & Tucson AZ Tortolita Middle School, Supervisor: Michael Bauschka Marana High School, Supervisor: Jim Doty Implement a comprehensive guidance program following the ASCA National Model for students, • Individual counseling and guidance for students and families • Communicate regularly with parents, students, and staff regarding student progress, concerns • Assist administrators, teachers, & staff as needed • Design and deliver classroom guidance lessons • Facilitate small support group counseling • Facilitate student conferences and 504 meetings/plans • Assist in standardized testing coordination • Course selection/registration; student transition • Master schedule building and student scheduling Leadership Positions/Committees: Department Lead Building Leadership Team PBIS Site & District Committee Student Assistance Team District Crisis Team Additional Departmental Responsibilities: Peer Mediation Program Master Schedule Team Freshman registration August 2007 - May 2013 August 2011- May 2013 August 2007 - May 2011 including: , and community resource information Support Groups: Grief/Loss Study Skills Freshman Transition Substance Abuse Prevention Mental Health Technician, Cottonwood de Tucson, Tucson, AZ July 2003 - October 2007 Worked with adolescent girls, aged 13-17, in -patient dual diagnosis behavioral health facility, dealing with depression, anxiety, ADD/ADHD, bi-polar disorder, substance abuse/addiction, cutting, eating disorders, trauma, abuse, grief, PTSD; facilitated small groups; worked closely one-on-one with clients; maintained safety and structure; assisted in management of family meetings; assisted clients with schoolwork as well as treatment related assignments; shift supervisor. 64 I z t0 E O v E O I C W SPECIALIZED SERVICE PROFESSIONALS (SSP) Certificate of Successful Completion HEAD II Ed4Nurses NpUI a Psychothe.ropy, Psychopharmacology: What You Need to Know Today About Psychiatric Medications Speaker(s): SHARON M FREEMAN CLEVENGER, MSN. MA, PMHCNS-BC Boulder, CO - 2/23/2017 The following participant Christine Epling (License #, ifapplicable) has completed the above -referenced educational activity in its entirety or as indicated below. This certificate provides sponsor verification of individual attendance and may be used for your records or for any licensing not listed below. We maintain attendance records for 7 years. ADDICTION COUNSELORS: This course has been approved by PESI, Inc., as a NAADAC Approved Education Provider, for 6.0 CE in the Treatment Plan skill group. NAADAC Provider #77553. PESI, Inc. is responsible for all aspects of their programming. Full attendance is required; no partial credit will be awarded for partial attendance. COUNSELORS: This intermediate activity consists of 6.25 dock hours of continuing education instruction. Credit requirements and approvals van' per state board regulations. Please save the course outline, the certificate of completion you receive from the activity and contact your state board or organization to determine specific filing requirements. NEBRASKA COUNSELORS: This intermediate activity is approved for 6.25 clock hours of continuing education instruction. The Nebraska Department of Health and Human Services recognizes courses and providers that are approved by the APA. A certificate of attendance will be awarded at the end of the program to counselors who complete the program evaluation, to submit to their state board. MARRIAGE & FAMILY THERAPISTS: This activity consisted of 380 minutes of continuing education instruction. Credit requirements and approvals vary per state board regulations. Please save the course outline, this veitific to of completion and contact your state board or organization to determine specific filing requirements. NURSES./.NURSE PRACI I IIONER/CLLNICAL NURSE SPECIALISTS: PESI, Inc. is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. Nurses in full attendance will earn 6.3 contact hours. NURSE PRACI 1 fIONERS: This program offers 380 instructional minutes of pharmacology^ content which is designed to qualify for 6.3 contact hours toward your pharmacology requirement to receive credit. It is your responsibility to submit your certificate of successful completion and a copy of doe seminar brochure to your licensing board. PHARMACISTS: PESI, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. Successful completion of this Knowledge -based activity qualifies for 6.3 contact hours. ACPE Universal Program Number: 0289-000(116.001-1.01-P. Full attendance is required. No partial contact hours will be awarded for partial attendance. PSYCHOLOGISTS: PEST, Inc. is approved by the American Psychological Association to sponsor continuing education for psychologists. PESI maintains responsibility for this program and its content. PESI is offering this activity for 6.2.5 hours of continuing education credit. Full attendance is required; no partial credits will be offered for partial attendance. SOCIAL WORKERS: PER, Inc. Provider #:1062, is approved as a provider for social work continuing education by the Association of Social Work Boards (ASAA'B), wsvwaswb.orgtr.rough the Approved Continuing Education (.ACE) Program. PESL Inc. maintains responsibility for the program. ASWB Approval Period: January'27, 2017 - January 27, 2020. Social workers should contact their regulatory hoard to determine course approval for continuing education credits. Social workers participating in this course will receive 6.25 (Clinical) continuing education dock hours for this intermediate course, COLORADO SOCIAL WORKERS: YES', Inc. is an approved provider with the Colorado Chapter course has been approved for 6.3 continuing education hours. The back of this certificate may contain additional information Kristine Cleasby, Senior Continuing Education Administrator PESI, Inc 1-800-844-8260 P.O. Box 1000, Eau Claire, WI 54702-.1000 II ,iC r er JR Of IC aki •e t* C Certificate of Successful Completion aic *,,PEISUHa m Ed4Nurses "ilia PiychnthergPy . AC Brain -Based Strategies for Children and Adolescents: Anxiety, ADHD, Emotion Regulation, Executive Function and Other Challenging Behaviors Speaker(s): TINA PAYNE BRYSON, PH.D. Denver, CO - 5/16/2016 The following participant Christine Epling (License #, if applicable) has completed the above -referenced educational activity in its entirety or as indicated below. This certificate provides sponsor verification of individual attendance and may be used for your records or for any licensing not listed below. V4 maintain attendance records for 7 years. COUNSELORS: This intermediate activity consists of 6.2.5 clock hours of continuing education instruction. Credit requirements and approvals vary per state board regulations. Please saw the course outline, the certificate of completion you receive from the activity and contact your state board or organization to determine specific filing requirements. SOCIAL WORKERS: PESI, Inc. Provider #:1062, is approved as a provider for social work continuing education by the Association of Social \Fork Boards (ASWB), www.aswb.otg through the Approved Continuing Education (ACE) Program. PESI, Inc. maintains responsibility for the program. AS\\B Approval Period: January 27, 2014 -January 27, 2017. Social workers should contact their regulatory board to determine course approval for continuing education credits. Social workers participating in this course will receive 6.25 (Clinical) continuing education dock hours in participating in this intermediate course. MARRIAGE AND FAMILY THERAPISTS: This activity consisted of 380 minutes of continuing education instruction. Credit requirements and approvals vary per state board regulations. Please saw the course outline, this certificate of completion and contact your state board or organization to determine specific filing requirements. PSYCHOLOGISTS: PESI, Inc. is approved by the American Psychological Association to sponsor continuing education for psychologists. PEST maintains responsibility for this program and its content. This seminar awards 6.25 credits to participating professionals. Full attendance is required. No partial credit will be offered for partial attendance. TEACHERSrEDUCATORS: This course consists of 6.25 clock hours. This certificate is proof of your attendance. Please retain the certificate in your records or use for submission as proof of completion when required. SPEECH -LANGUAGE PATHOLOGISTS: This course provided 6.0 contact hours. This certificate neither awards ASHA CEUs nor verifies that ASHA CEOs have been awarded to the person named above. ASHA CEUs are awarded by the ASHA CE Registry upon receipt of the CEU Post Reporting from the ASHA Approved CE Provider. OCCUPATIONAL THERAPISTS & OCCUPATIONAL THERAPY ASSISTANTS: PEST, Inc., is an AOTA Approved Provider of continuing education. Provider It; 3322. Full attendance at this course qualifies for 6.25 contact hours or .625 CEt's Partial credit will be issued for partial attendance. The assignment of AOTA CEUs does not imply endorsement of specific course content, products, or clinical procedures In AOTA. Course Level: Intermediate. NURSES/NURSE PRAC I'1'IIONERS/CLINJCAL NURSE SPECIALISTS: This activity meets the criteria for an American Nurses Credentialing Center (ANCC) Activity. PESI, Inc, is an approved sponsor by the American Psychological Association, which is recognized by the AN CC for behavioral health related activities. Full attendance is required; no partial credit will be awarded for partial attendance. This activity qualifies for 6.2.5 contact hours. COLORADO SOCIAL WORKERS: PESL Inc. is an approved provider with the Colorado Chapter of the National Association of Social Workers. Provider #1413. This course has been approved for 6.3 continuing education hours. The back of this certificate ma' contain additional information Kristine Cleasby. Senior Continuing Education Admini PESI: Inc. 1-800-844-8260 P.O. Box 1000, Eau Claire, WI 54702-1000 Ivonne Varela 707 Campbell Street Kersey, CO 60644 1 970.371.7406 I Personal: vare2297@gmail.cont Objective I am seeking to learn as much as possible and gain experience in order to be an asset to your company. I would like to excel in a professional setting through hard work and dedication. Education HIGH SCHOOL DIPLOMA I MAY 2012 I PLATTE VALLEY BACHELOR'S ( AUGUST 2012 - MAY 2016 I UNIVERSITY OF NORTHERN COLORADO • Major: Psychology • Minor: Criminal Justice Skills & Abilities • Bilingual (English and Spanish) • Proficient on PC platform • Proficient on Microsoft Office (Word, PowerPoint, Outlook, Excel) • Quick learner • Good communication skills (Written and Oral) Experience SAFETOUCH PROGRAM I LUTHERAN FAMILY SERVICES ROCKY MOUNTAIN I AUGUST 2016 - PRESENT • Delivers training and education for SafeTouch. • Manages the collection and maintenance of client demographic information and program statistics. • Provides assistance in the evaluation of SafeTouch. PARENTING EDUCATION FACILITATOR I LUTHERAN FAMILY SERVICES ROCKY MOUNTAIN I MAY 2016 • PRESENT Co -Parenting After Divorce Class (English and Spanish) • Nurturing Parenting Class (English and Spanish) • Strengthening Latino Families (Spanish) • RETHINK: Anger Management for parents (English and Spanish) VISITATION SUPERVISOR I LUTHERAN FAMILY SERVICES ROCKY MOUNTAIN I 2015 • PRESENT • Supervise visits between parents and children to insure that there is nothing inappropriate said/done • Complete documentation during visits • Assist in Children's Program COSTODIAN I BOOTH LAND AND LIVESTOCK 12012 • PRESENT • Clean desks • Vacuum 70 • Broom/mop COOLER STOCKER I KRAMER'S WEDGE I 2O09 - 2010 • Stock the coolers Bag ice • Throw away trashes Certificates and Trainings • Mental Health First Aid USA (June 6, 2016) • Trauma Informed Primary Care Practice Oune 13, 2016) • Sex Offenders and Their Victims: Connecting the Dots (July 19, 2016) • Darkness To Light's Stewards of Children (July 20, 2016) REFERENCES • Gary Booth, Booth Land and Livestock, 970.353.7055 • Brad Jones, Platte Valley High School, 970.336.8700 71 ZL Certificate of Attendance This certifies that O a O O a, O 'O a - a 0 In tn U U O ct C U O f. 'C Gi N N +, vi • b • O CO U � f(0 . }C▪ iG. • U) U C y U v) ~ fd • c0 vi Cl) O U 11) u I) O E OLD O to a CL ra ▪ c > - o▪ w • on • w • 0 ra CU 04 'Au • O h a) O 'C .--. o yes X O " cn -d E 1 .y .E Q With Jim Tanner, Ph.D. and Amber McDonald , LCSW Presented by Voices Carry Child Advocacy Center on July 19, 2016 Forensic Interviewer Voices Carry Child Advocacy Center £L z W Cd 0 J Certificate of Attendance z STEWARDS OF CHILDREN TRAIN Presented To: C 0 O U 0 0 • N a a • CO CO -0 in CU v 0>`4 c co w c `c a o > O o o a a N Q • 0 r �( O ✓ O N O N o a) o 0 a `0 a 0 0 N N Q 0 0 0 a `o N Z s 0 I - 0) cw 0 O L LARIMER COUNTY DEPARTMENT OF HUMAN SERVICES ■2 c / u C 2 % § B / •t ) °= C _CC 1:1 § u •) N c /f 2 2 7 % ) 2 k S ) g 0 c o s ' a § •( § I- / •c o 14 / c ) CS k 2 k E - 2 d 7 o a U :k/ k / X CJ C•a. _ Vi a ( 0 b — C 2 e /� �2 cam 0 .a 7) ■ , o 0 o 2 E7ce® % 7 § . 2 § « ce �?2 0 \' O c / 7 k •� § 2 r ° - -0 2 o ° ` / % ,2� 5 { u § 4 7° §e @OI § ' c ; •2 . _ c ) / § % , § o �0abtt.. d�b9aou� & E -0 2 / -F,,,..,..,.41 2F�973§§ .7 c CJ $ 9 2 c Z O a Youth Mental Health First Aid USA YOUTH MENTAL HEALTH FIRST AID" Certificate Ivonne Varela has completed the 8 hour course and is now certified in Mental Health First Aid USA And has been trained to provide initial help to young people experiencing mental health problems such as depression, anxiety disorders, psychosis, and substance use disorders. This cartiTicat n L rta iffuctivn art June 8, 2016 This csrtTicat an bras on N/A Janis Pottorff LCSW, IMH-E• III MENTAL HEALTH nava Suzann Pfeifer, MS NATIONAL COUNCIL FOR BEHAVIORAL HEALTH INIMENTAt EMLTA nut AW 'fauth Nrnah Fast kCt USA a areadirated Win Wnm CD,.ns J. Seh a+cral Heath, tha Maryland Dapaan rre a! Health and Mama) I aom o.. and the Ma. orporr.mi of Modal drat +. 75 oia"" ■tA LUTHERAN FAMILY SERVICES Ai±r k; ,';ini;nrni+ls April 24, 2017 Families, Youth, and Children's Commission Weld County Department of Human Services 315 A. North 11th Ave. Greeley, CO 90631 Dear Commission Members: On behalf of Lutheran Family Services Rocky Mountains (LFS), I am pleased to present the attached proposal in response to the Commission's call for Various English and Bilingual Services. We are applying in order to continue to offer the SafeTouch program, a body safety awareness program presented to more than 11,500 students ages 5-12, in 25-30 elementary schools in Weld County. SafeTouch teaches children personal and body safety awareness using an engaging, child friendly curriculum which includes group activities, age/developmentally appropriate discussions, role-play, puppets, and videos. The activities help children learn to say "no" and get away and tell a trusted adult if confronted with unsafe situations. The program also teaches students how to recognize inappropriate and abusive situations. SafeTouch is presented as a single session of varying times with the presenters meeting with each class separately. The Prevention Services Coordinator, Chelsey Lehmkuhl has been teaching and managing the program for five years. The LFS Weld County building is located: 800 8th Avenue Suite 225 Greeley, CO 80631 The LFS headquarters and mailing address is: 363 S. Harlan St. Suite 200 Denver, CO 80226 If you have questions or need additional information, please do not hesitate to contact Kim Penney, Foster Care and Prevention Services Director, at 970-232-1156 or kim.penney@Ifsrm.org, or visit www.lfsrm.org. Sincerely, ames D. a�3,y�cfay President and CEO 3 Table of Contents Cover Letter 3 SafeTouch: Body Safety Awareness Program Proposal 4 Certificate of Insurance 8 Resumes, Licenses, and Training Certificates I 0 Lutheran Family Services Rocky Mountains agrees to enter into an agreement with Weld County Department of Human Services. 2 SafeTouch: Body Safety Program Lutheran Family Services Rocky Mountains April 24, 2017 Description: Lutheran Family Services Rocky Mountains (LFS) is requesting funds for the SafeTouch: Body Safety Program ("SafeTouch"). SafeTouch is an elementary school -based abuse prevention program for students in kindergarten through fifth grade. The goal of the interactive, multi -modal curriculum is to help reduce youth's vulnerability to abuse and unwanted touch. The program teaches the three -Rs" of sexual assault prevention: recognize, resist, and report. Children are taught to understand the difference between appropriate and inappropriate touch; how to respond to inappropriate touch by saying "no," running away, and telling an adult; and how to identify feelings associated with unsafe situations. Furthermore, SafeTouch teaches children how to identify trusted adults to whom they can talk and who understand the circumstances. The message is taught and practiced through the use of pictures, songs, puppets, videos, and discussions. The messages remain constant from year to year, but examples and depth of discussion advance each year to be developmentally appropriate for the age group being taught. Interpretation and translation is provided by schools during presentations to Spanish-speaking students. SafeTouch is presented as a single session of varying times with the presenters meeting with each class separately. Should the children report physical abuse, sexual abuse, or domestic violence during one of these sessions, the teachers, counselors, or presenters, as mandatory reporters, make referrals to law enforcement or social services as required by the Colorado Revised Statutes. According to The Prevention of Child Sexual Abuse publication (Finkelhor 2009, The Future of Children, Princeton University), children of all ages who participated in school based sexual abuse prevention programs were six to seven times more likely to demonstrate protective behavior in simulated situations than children who had not. LFS defines success in offering SafeTouch as having the participating kindergarten through fifth graders demonstrate that they can: (1) Recognize and react to unsafe touches by saying -No" and getting help; and (2) Name a safe adult that they can tell if they experience abuse. This is measured through the use of an age -appropriate, pre-test distributed to all students at a random selection of the schools (sample represents 20% of all students served) an immediate post-test, followed by a longer term follow-up post-test with the same sample of children two weeks after the class. LFS offers classes in Spanish, which are taught by Ivonne Varela, a native Spanish speaker. Target Population: SafeTouch was introduced to Weld County schools in 1987 and is presented to approximately 11,500 students each year. Classes are catered to the grade level, which range from Kindergarten through fifth grade and serving ages 5 to 12 years old. The program is offered to schools located in Weld County at no cost. Last year (2015-2016 school year), LFS offered SafeTouch to 11,652 students in 25 schools. 4 The SafeTouch program is not billable to Medicaid. Weld County funding is an essential source of funding for the LFS SafeTouch, funding approximately 12.5% of the program budget. In addition to Weld County funds, the SafeTouch Program receives grant funding from the United Way of Weld County, United Way Youth Allocations Committee, the Community Foundation Littler Youth Fund, and VALE 19th Judicial District. SafeTouch is also largely funded by revenue raised through the annual Taste of Weld County fundraiser. Rate of Schedule: The rate of schedule for the LFS SafeTouch Program is $25.00 per classroom presentation. Expertise of Staff: The LFS SafeTouch Program staff have a broad range of skills and expertise, which help make the program successful. The staff knowledge and training includes: • Child Sexualized Behaviors: From Normal to Problematic and Abusive — 3 training hours o Presented by Dr. Gizane Indart, PsyD. o Sponsored by Denver Children's Advocacy Center • Creating a Community Action Plan for the Prevention of Child Sexual Abuse —16 training hours o Presented by the Office of Juvenile Justice and Delinquency Prevention • Bullying Prevention —6 training hours o Presented by Christine Harms, M.S., Director of the Colorado School Safety Resource Center o Sponsored by The Colorado Legacy Foundation, Colorado Department of Education, Colorado School Safety Resource Center, Colorado Department of Public Safety • Colorado Child Welfare System —2.75 training hours o Presented by Ann Scheuermann o Sponsored by the Division of Child Welfare, Colorado Department of Human Services • Human Sex Trafficking —6 training hours o Presented by The Coordinating Committee For Victims of Crime • The Hidden Realities of Technology —6 training hours o Presented by The Coordinating Committee For Victims of Crime • Authorized Facilitator Workshop for Darkness to Light's Stewards of Children -7 training hours o Sponsored by S.A.F.E (Sexual Assault Forever Ending) • Nurturing Healthy Sexual Development Facilitator Training —8 training hours o Presented by Johanna Straavaldsen, MSW Healthy Relationships Project Director o Sponsored by Prevent Child Abuse Colorado & Illuminate • Mental Health First Aid —8 training hours o Presented by Noelle Hause EdD, LPC, & Pamela Collins Vaughn, MA, LPC o Sponsored by North Range Behavioral Health 5 • Sex Offenders and Their Victims: Connecting the Dots —6 training hours o Presented by Jim Tanner, Ph.D. & Amber McDonald, LCSW o Sponsored by Voices Carry Child Advocacy Center LFS requires all licensed staff to be registered with the Colorado Department of Regulatory Agencies. Supervisory Structure: The LFS SafeTouch Program is overseen by a program director who meets weekly with the Prevention Services Supervisor. The SafeTouch program coordinator and educator was promoted to Prevention Services Supervisor in July of 2015. The Prevention Services Supervisor continues to coordinate the program and provide services as an educator. Additionally, the SafeTouch program hired a part-time bi-lingual educator in August of 2016 who is overseen by the Prevention Services Supervisor and meets weekly to go over programming matters. Referral Acceptance: The LFS SafeTouch Program works with schools in Weld County and manages assignments by sending program packets with information on presentation content and scheduling guidelines to every school located in Weld County. After receiving the program packet, school personnel (i.e., school counselor, school social worker, principal, health clerk, and/or lead teachers) contact the program coordinator and schedule dates for presentations. Once a school has requested dates for the program, they are added to the master calendar. Additional resources and program materials are then sent to schools that have been added to the master calendar. Trauma Informed Care: The LFS SafeTouch Program staff apply Trauma Informed Care by staying up-to-date on current research, techniques, and concepts related to trauma informed care. The program coordinator is also a member of a coalition that supports the creation of trauma - sensitive schools. The coalition members are part of an online learning community through the Trauma and Learning Policy Initiative with other educators, schools and districts that are embarking on the process of creating trauma -sensitive schools. Furthermore, staff members regularly attend training sessions, webinars, seminars, etc. pertaining to trauma informed care. Current trainings staff have obtained include: • Trauma Informed Primary Care Practice —2 training hours o Presented by Dr. Mark Sloane and Dr. Aaron Meng o Sponsored by Larimer County Department of Human Services • The Impact of Trauma and Neglect on the Developing Child —5.5 training hours o Presented by Dr. Bruce Perry, M.D., Ph.D o Sponsored by Weld County Department of Human Services & United Way of Weld County Capacity: The SafeTouch program is presented to approximately 11,500 students each year. Last year (2015-2016 school year), LFS offered SafeTouch to 11,652 students in 25 schools. The program has one full time employee and one part-time employee dedicated to teaching the program material. The number of schools we serve is limited to the number of weeks that students are in school. The program follows the school calendar and is limited to roughly 30 6 weeks in a school year. Most schools take a week to complete presentations for all grade levels; therefore our capacity is roughly 11,500 students in about 30 schools. Data Tracking: Prior to each SafeTouch session, the presenters distribute questionnaires to a random sample of children who participate in the program, varying the schools from year to year. The pre -session questionnaire is designed to assess the children's knowledge before a SafeTouch session. A post -session questionnaire using similar questions is given to the same children two weeks after the session to determine how well the information has been retained. Questionnaires are designed specifically for the different grade levels, for example, using happy and sad faces to denote "yes" or "no" responses for kindergarten through third grades. The same sample of students are surveyed two weeks after the class to determine whether the information has been retained. The outcomes that LFS strives to accomplish include: • 75 percent will demonstrate the ability to recognize save versus unsafe touches prior to receiving the presentation • 90 percent will demonstrate the ability to recognize safe versus unsafe touches immediately following the presentation • 90 percent will be able to identify examples of adults they would tell if the experience an unsafe situation • 90 percent will demonstrate subject matter retention two weeks after the presentation. • The results of the pre -session and post -session questionnaires are compiled throughout the school year. Results are used to determine what if any changes need to be made to the presentations, topics, or environment. The following will be used for monitoring and evaluating the success of the purchase of services agreement: A. Quarterly report and invoices will be submitted to Weld County Department of Human Services by the 15th of the month following the end of each quarter. B. Review of evaluation materials and correspondence from outside agencies regarding services received. C. Ongoing consultation with supervising staff through Weld County Department of Human Services concerning development and implementation of programs. ACORO - CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 06/23/2016 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 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 1-303-534-4567 IMA, Inc. - Colorado Division 1705 17th Street Suite 100 Denver, CO 80202 INSURED Lutheran Social Services of CO Lutheran Family Services Rocky Mountain 363 South Harlan, Ste 200 Denver, CO 80226 CONTACT NAME: PHONE (A/C. No. Extl: E-MAIL ADDRESS: denaccounttechs@imacorp.cora INSURER(S) AFFORDING COVERAGE INSURER A: PHILADELPHIA INS CO FAX (NC, No): INSURER B: ZURICH AMER INS CO(Pinnnce) INSURER C: PINNACOL ASSUR INSURER D : INSURER E : INSURER F : 0 NAIC # 23850 16535 41190 COVERAGES CERTIFICATE NUMBER: 47188534 • •` THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT 0 UMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POL - IBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUC : Y PA S INSR LTR TYPE OF INSURANCE ADDL INS') SUBR WVD POLICY NUMBER POLIC FF (M DO PO Y EXP (NM/ LIMITS A X COMMERCIAL GENERAL LIABILITY PHPX1507449 k !. X1/17 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO NTED PREM SES (Ea Eoccurrence) $ 1,000,000 MED EXP (Anyone person) $ 20,000 PERSONALS ADV INJURY $ 1,000,000 GE_N'L AGGREGATE LIMIT APPLIES PRO- JECT X PER: LOC GENERAL AGGREGATE $ 3,000,000 PRODUCTS - COMP/OPAGG $ 3,000,000 $ A AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED tTcUR SCHEDULED PHPX1507. 07/01/16 07/01/17 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) DAMAGE $ A X UMELLALAB EXCESS LIAB CLAIMS -MADE PH#543931 07/01/16 07/01/17 EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 DED X RETENT ON $ 10,000 $ 8 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY V/ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATI be WC969160405 - NM ONLY 4040538 - CO ONLY 03/01/16 03/01/16 03/01/17 03/01/17 H X ;MUTE ER TAT E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ 500,000 $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500,000 A Cyber Liability Privacy Liab' ity Security ent i Costs PHSD1151651 07/01/16 '07/01/17 Deductible $ 10,000 Limit $1,000,000 Limit $500,000 DESCRIPTION OF - TIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Cil) te CERiICATE HOLDER For Information Only CANCELLATION 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 i ACORD 25 (2014/01) ashmcclain 47188534 © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 8 SUPPLEMENT TO CERTIFICATE OF INSURANCE DATE 06/23/2016 NAME OF INSURED: Lutheran Social Services of CO Lutheran Family Services Rocky Mountain Additional Description of Operations/Remarks from Page 1: Ow Additional Information: Professional Liability Coverage: ":gin K1507449 Eff Date: 07/01/16-07/01/17 I ¢`° rer A Se' Above $1,000,000 Each Occurrence; ;•,0� 000 ;gregate Limit $1,000,000 Sexual and/or psi +1 =e Limit(Sexual abuse & Molestation Coverage is not Excluded) SUPP (05/04) 9 Kimberly Penney, LCSW (#992640) 2032 Lowe Street, Suite 200 Fort Collins, CO 80525 970-232-1156 work 970-222-7410 cell kim.penney@lfsrm.org EDUCATION University of Denver —Denver, CO Master of Social Work; Graduated 1996; Emphasis: Mental Health • First year field placement at Colorado Mental Health Institute at Fort Logan: Constructed psychosocial histories including clinical assessment of adolescents with psychiatric diagnoses and provided individual, family and group therapy • Second year field placement at Catholic Charities Samaritan House homeless shelter : Provided case management and counseling services to chronically homeless men, women and families and conducted assessment of mental health /substance abuse University of Missouri -Columbia, MO Bachelor of Arts in Psychology; Graduated 1992; Emphasis: Human Development/Family Services and Educational/Counseling Psychology • Field placements at The Shelter for women who were battered and their children and the Partners in Education Program for developmentally disabled youth WORK HISTORY Lutheran Family Services Rocky Mountains -Fort Collins, CO Director of Foster Care North, Family Preservation and Prevention; 2015 to present • Supervise all Northern Colorado programming for children and families including domestic foster care, unaccompanied refugee minor foster care, family preservation services, a visitation program for families who are DHS-involved or Domestic Relations Court -involved, prevention programs regarding body safety and parenting education, High Level Trauma Assessment Services, Post -Adoption Counseling and therapeutic services through Medicaid • Budget management • Grant management of all funds supporting Northern Colorado LFS programming for children and families and evaluation of each program • Contract negotiation with Denver, Larimer and Weld Counties in addition to smaller Northern Colorado counties • Ongoing training in areas of leadership and trauma -informed care, which are both infused into all areas of practice 10 Kimberly Penney, LCSW (#992640) 2032 Lowe Street, Suite 200 Fort Collins, CO 80525 970-232-1156 work 970-222-7410 cell kim.penney@Ifsrm.org Lutheran Family Services Rocky Mountains -Fort Collins, CO Coordinator/Educator for Ready or Not? Teen Pregnancy Prevention; 2012 to 2015 • Schedule over 1,500 students to participate in the program each academic year in Weld and Larimer counties • Develop curriculum appropriate to middle school and high school aged adolescents • Research teen pregnancy and related risk and protective factors • Submit ongoing grant reports to multiple funding sources • Conduct bi-annual program evaluation • Supervise bachelor level interns • Participate in monthly community committee meetings • Conduct weekly group lessons in the classroom regarding the use of infant simulators as an experiential learning tool, pregnancy risk and protective factors, limit setting and parent -child communication techniques WORK HISTORY Arapahoe County Department of Human Services -Littleton, CO Ongoing Social Caseworker; 1996 to 2001 • Provided case management to children, adolescents, and families • Constructed and implemented treatment plans after needs assessment • Secured and supported all treatment and placement • Provided expert documentation and testimonial to the court system • Worked in conjunction with multiple systems, including mental health, educational and criminal justice • Served as lead caseworker and county liaison for the Arapahoe Mental Health Center therapeutic day treatment program, the Adolescent Day Resource Center • Served as lead caseworker and county liaison for the Arapahoe County District Attorney's Office's Serious Habitual Offender Directed Intervention Program with youth engage in criminally delinquent behavior and facing commitments to the Department of Youth Corrections 11 Kimberly Penney, LCSW (#992640) 2032 Lowe Street, Suite 200 Fort Collins, CO 80525 970-232-1156 work Excelsior Youth Center- Aurora, CO Group Living Counselor; 1992 to 1995 970-222-7410 cell kim.penney@Ifsrm.org • Supervised in -patient female adolescents with psychiatric diagnoses • Implemented individual treatment plans • Provided individual counseling and group therapy • Coordinated recreational therapy groups • Worked in conjunction with a team of mental health counselors and clinical therapists to meet the mental health needs of residents • Managed acute and unsafe physical behavior of residents through CPI methods LICENSURE I have been a Licensed Clinical Social Worker in the State of Colorado since 2001: License #992640. I received approval for credentialing with Colorado Access in 2015, which allows for Medicaid billing. TRAININGS AND CONFERENCES • Nurturing Parenting Training of Parent Educators, presented by the Family Nurturing Center of Colorado in Boulder on 6-13-12 and 6-14-12 • Child Abuse Symposium, presented by the Child Advocacy Center of Larimer County on 4-18-13 • DSM-5: Understanding and Diagnosing Mental Disorders, presented by Dr. Jean Keim of the University of New Mexico on 1-18-14 • The 12 Core Concepts: Concepts for Understanding Traumatic Stress Responses in Children and Families , presented by Dr. Susan Hansen of The National Child Traumatic Stress Network on 6-19-14 and 6-20-14 • Fundamentals of Trauma Processing, course completed through Continuing Education for Social Workers independent coursework 7-1-14 • Trauma 101, presented by Dr. James Henry of the Southwest Michigan Children's Trauma Assessment Center on 9-4-14 • Trauma Informed Care, presented by Dr. Jerry Yager, childhood trauma expert and fellow with the Child Trauma Academy, in a private LFSRM conference on 9-9-14 12 Kimberly Penney, LCSW (#992640) 2032 Lowe Street, Suite 200 Fort Collins, CO 80525 970-232-1156 work 970-222-7410 cell kim.penney@Ifsrm.org • Trauma 201: Resiliency in Case Planning and Trauma -Informed Assessments, presented by Dr. James Henry on 10-20-14 and 10-21-14 • Trauma, Attachment, and Neuroscience: New Psychotherapeutic Treatments, presented by Dr. Besse) van der Kolk, Professor of Psychiatry at Boston University School of Medicine and Medical Director of the Trauma Center, on 11-13-14 • Trauma Assessment, presented by Dr. James Henry, on 1-5-15 and 1-6-15 • Coordinating and Intervening with Trauma Care in the Home and Larger Systems, presented by Dr. James Henry 2/9/16 • Monthly case consults with Dr. Jerry Yager, psychologist and fellow of Dr. Bruce Perry 2016 to present • The Impact of Trauma and Neglect on the Developing Child, Dr. Bruce Perry on 4-11-17 • Animal -assisted Interventions: Enhancing Treatment in Clinical Practice by Brooke Wimer of CMHI-Pueblo Inpatient Forensic Psych Unit on 4/17/17 COMMUNITY COMMITTEE MEMBERSHIP • Larimer County Trauma Practice Group 2015 to present • 7 County Trauma Consortium 2016 to present 13 (COLORADO Department of Regulatory Agencies Division of Professions and Occupations Congratulations! -Below are your electronic wallet cards to use as proof of your license. You can also print your license at any time through your Online Services account by visiting our homepage at www.dora.colorado.gov/professions and clicking on the "Print your License" link under the label "Quick Links". If you would like a more durable wallet card option, you can order one for a fee by visiting www.nasbastore.org and selecting the "Colorado License Cards" link on the left hand side of the page. If you prefer, you can also contact NASBA by phone at 1-888-925-5237 or by email at nasbastore@nasba.org. Should you have questions about your credential, or need other information, please contact our Customer Service Team at 303-894-7800 or dora_registrations@state.co.us. Colorado Department of Regulatory Agencies Division of Professions and Occupations Social Work Examiners Board CSW.00992640 Number Active Credential Status Kimberly A. Penney Licensed Clinical Social Worker 09/01/2015 Issue Date :08/31/2017` xaire Date' .' Verify this credential at: www.dora.colorado.g Ov/profession s DtGision Director: Lauren Larson Credential Holder Signature Cut along the line Colorado Department of Regulatory Agencies Division of Professions and Occu ations Social Work Examiners Board Kimberly A. Penney Licensed Clinical Social Worker CSW.00992640 09/01/2015 Number Issue Date Active 08/31/2017 Credential Status Expire Date (�J(�Verfy this credential at www dora.colorado.g ovjprofession s D•i,sion Director: Lauren Larson Credential Holder Signature 1560 Broadway, Suite 1350, Denver, CO 80202 P 303.894.7800 F 303.894.7693 www.dora.colorado.gov/professions 14 ►►►►►►►►►►►►►►► Ng r r Pr - r r r r r r r r r r r r r or r r r ,44 Ng NO NI NI HAS SUCCESSFULLY COIVLETED THE COORDINATING AND INTERVEN'I`NG WITH TRA CARE IN THE HOME AND LARGER SYSTEM! DESCRIPTION: DR. JAMES HENRY AND AMY P E R R I C O N E' S TRAINING FORT MENT N T PROVIDERS ON TRAUMA TREATMENT COORDINATOR SERVICES. AN IN INTENSIVE SERVICE FOR CHILDREN WHO HAVE HAD A TRAUMA ASSESSMEN S E S S M E N IMPLEMENTING THE TRAUMA ASSESSMENT RECOMMENDATIONS 3 HOURS OF TRAUMA FOCUSED TRAINING 1 :OO-4:OOPM 2/9/ 1 6 ISSUED BY: ANDREA FOTSCI TRAUMA CARE COORD LARIMER COUNTY DEPARTMENT OF HUMAN SE '1 -14 '44 Ng -4 N Nii N \ rrrrrrrrrrrrrrr 9L LARIMER COUNTY DEPARTMENT OF HUMAN SERVICES • N 4,4 ti z o II c To 00 w • O is u " c o--, O o 0 arc .c Le) E U _c 0 V1 00 1V,, Q Z c cu E co c = O .3 cu o to- N y eca c E a• c, u u o d' to 0 0 00 t 3 W OD o. C a (15 0 3 ao 0 co c +r O 3 r 0 0 .0 o " a- "0 0. C o. c • 'o o W •N E " J 0 0 C 4,1 >.V c r c v u ro ro VI 0 N •v • 5 'O u_ < ers Documentar Ll Certificate of Successful Completion r Hadtharer� P s tte,vu ti Ed4Nurses Psy0otherupy, Animal -Assisted Interventions: Integrate Animals to Enhance Treatment in Clinical Practice Speaker(s): BROOKE WIMER, MOT. OTR/L Fort Collins, CO - 417 2017 The following participant Kim Penney (License #, if applicable) has completed the above -referenced educational activity in its entirety or as indicated below. This certificate provides sponsor verification of individual attendance and may be used for your records or for any licensing not listed below. We maintain attendance records for 7 years. ADDICTION COUNSELORS: This course has been approved by PESI. Inc., as a NAADAC Approved Education Provider, for 6.0 CE in the Counseling Services skill group. NAADAC Provider #77553. PESI, Inc. is responsible for all aspects of their programming. Full attendance is required; no partial credit will be awarded for partial attendance. COUNSELORS: This intermediate activity consists of regulations. Please save the course outline, the certific requirements. ock hours of continuing education instruction. Credit requirements and approvals vary per state board lotion you receive from the activity and contact your state hoard or organization to determine specific filing EDUCATORS TEACHERS: This course consists of 6.25 clock hours. This certificate is proof of vour attendance. Please retain it in your records or use for submission as proof of completion when required. MARRIAGE & FAMILY THERAPISTS: This activity consisted of 380 minutes of continuing education instruction. Credit requirements and approvals vary per state board regulations. Please save the course outline, this certificate of completion and contact your state board or organization to determine specific filing requirements. NURSE/NURSE PRACI I IlONERS CLINICAL NURSE SPECLALISTS: This activity meets the criteria for an American Nurses Credenrialing Center (.ANCC) Actium PESI, Inc, is an approved sponsor by the American Psychological Association, which is recognized by the ANCC for behavioral health related activities. Full attendance is required; no partial credit will be awarded for partial attendance. This activity qualifies for 6.25 contact hours. NURSING HOME ADMINISTRATORS. This educational offering has been reviewed by die National Continuing Education Review Service (LACERS) of the National Association of Long Term Care Administrator Boards (NAB) and approved for 6.25 clock hours and 6.25 participant hours. Program Approval Number. 20180305-6.23SOVi-LN. OCCUPATIONAL THERAPISTS & OCCUPATIONAL THERAPY ASSISTANTS: PESI, Inc. is an AOTA Approved Provider of continuing education. Provider #: 3322. Full attendance at this course qualifies for 6.0 contact hours or .6 CEUs in the Category of Domain of OT and Occupational Therapy Process. Partial credit will be issued for partial attendance. The assignment of AOTA CEUs does not imply endorsement of specific course content, products, or clinical procedures by AOTA. Course Level: Intermediate. PHYSICAL THERAPISTS & PHYSICAL THERAPIST ASSISTANTS: This activity consists of 6.25 dock hours of instruction that is applicable for physical therapists. This certificate is proof of your attendance. Please retain it in your records or use for submission as proof of completion when required. PSYCHOLOGISTS: PESI, Inc. is approved by the American Psychological Association to sponsor continuing education for psychologists. PESI maintains responsibility for this program and its content. PESI is offering this activity for 6.25 hours of continuing education credit. Full attendance is required; no partial credits will be offered for partial attendance. SPEECH -LANGUAGE PATHOLOGISTS: This course provided 6.0 contact hours. This certificate neither awards ASHA CEUs nor verifies that ASHA CEUs have been awarded to the person named above. ASHA CEUs are awarded by die ASHA CE Registry upon receipt of the CEU Post Reporting from the ASHA Approved CE Provider. SOCLAL WORKERS: PESI, Inc. Provider #:1062, is approved as a provider for social work continuing education by the Association of Social Work Boards (ASWB), www.aswii.org through the Approved Continuing Education (ACE) Program. PESI, Inc. maintains responsibility for the program. ASWTB Approval Period: January 27, 2017 - January 27, 2020, Social workers should contact their regulator board to determine course approval for continuing education credits. Social workers participating in this course will receive 6.25 (Clinical) continuing education clock hours for this intermediate course. The back of this certificate may contain additional information Kristine Cleasby, Senior Continuing Education Administrator PESI, Inc. 1-800-844-8260 P.O Box 1000, Eau Claire, WI 54702-1000 18 Certificate of Successful Completion xPES1' *PESI' HEALTH Ed4Nurses Psy[hotherapy, , Animal -Assisted Interventions. Integrate Animals to Enhance Treatment in Clinical Practice COLORADO SOCIAL WORKERS: PEST. Inc. is an approved provider with the Colorado Chapter of the National Association of Social Workers. Provider #14l 3. This course has been approved for 6.3 continuing education hours. OTHER PROFESSIONS: This activity qualifies for 380 minutes of instructional content as required by many national, state and local licensing boards and professional organizations. Retain your certificate of completion and contact your board or organization for specific filing requirements. DISCLAIMERS: "It is your ethical responsibility to report accurate hours to your licensing board. If you are in partial attendance a revised certificate will be sent to you, upon your request, after the activity. Please allow 3045 days. ' -Even though you have received this Certificate of Attendance, if you have a balance due, the balance must be paid tit full within 30 days, or your hours may be retracted. • All participants are provided a post-test/evaluation form that is to be completed and turned in at the conclusion of the seminar. If you require a copy of the testievaluation, please have a copy made at the seminar. Or you may call our customer service department and a copy of your test/evaluation will be emailed to you. Please allow 30.45 days. PEST, Inc. offers continuing education programs and products under the brand names PESI, PESI HealthCare, PEST Rehab, MEDS-PDN, HealthEd and Ed4Nurses. Kristine Cleasby, Senior Continuing Education Administrator PESI, Inc. 1-800-844-8260 P.O. Box 1000, Eau Claire, WI 54702-1000 19 Lutheran Family Services Foster Care Training Documentation and Approval Form (Please use ONLY when certificate is not provided) Name: K. Penney, J. Bohannon, and T. Carlson Date: 4-26-16 Title of Training: TF-CBT, coping skills for hypo -arousal, breathing and relaxation techniques Name of presenter or author: Dr. Jerry Yager, LFS Clinical Consultant ❑Book ❑Audio ❑Video ❑Workshop ❑ Internet ❑ Other (list) group consultation Please list number of pages, minutes, or hours of training: n/a (# of hours granted will be hour -for -hour, actual workshop length, or 1 hour per 30 pages.) Report Outline (Use back or additional sheets as needed) What was the training material about? 1. Narratives during TF-CBT 2. Dissociation with hypo -aroused kids and other coping skills 3. Helping increase the capacity to tolerate positive affect What new information did you gain? 1. Kids need repetitive interactions to build capacity to tolerate stress or even positive affect. Our kids externally regulate (with others, not on their own) 2. Always start by validating negative feelings. With TF-CBT narratives, best if co - created with adult but they discover on their own. Okay to give examples and ask "do any of these fit"...even with EMDR and negative cognitions 3. Foster parents need to limit set without shaving. Know that kids wiring to inhibit is not well developed. How will you use it in fostering children? This information was shared in context of case presentation with 2 former foster children who were exposed neglect and domestic violence. Understanding how to set limits without shaming, begin narratives and teach coping skills such as breathing and activity will be useful during psycho -education in therapy sessions and with caregivers. Number of training credit hours granted: Date: Approved by LFS staff member: Signature of staff: H:\Staff Training\Training Documentation 4.26.16 Yager consult.doc In Accordance with Rule #7.708.65.C&D Rev. 9/9/2013 20 Lutheran Family Services Foster Care Training Documentation and Approval Form (Please use ONLY when certificate is not provided) Name: K. Penney, J. Bohannon, and T. Carlson, Richel Hubbard; Date: 7.19.16 Title of Training: coping with STS Name of presenter or author: Dr. Jerry Yager, LFS Clinical Consultant Book Audio Video ❑Workshop ❑ Internet ❑ Other (list) group consultation Please list number of pages, minutes, or hours of training: n/a (# of hours granted will be hour -for -hour, actual workshop length, or 1 hour per 30 pages.) Report Outline (Use back or additional sheets as needed) What was the training material about? 1. How to cope with the stress of what we do plus administrative stressors 2. Be realistic about the treatment of children; only a small number of kids are abused 3. How to team build What new information did you gain? 1. There is no way to eliminate stress 2. Stress is tolerated through relationships 3. Build relationships/trust as a team so that you can navigate stressful situations that are a part of life and will never NOT be a part of life How will you use it in fostering children? The better relationships we can build and support as a team, the more we can tolerate stress of jobs and STS that is particular to child welfare. We help foster children when we are regulating our own STS. Number of training credit hours granted: Date: Approved by LFS staff member: Signature of staff: H:\Staff Training\Training Documentation 7.19.16 Yager consult.doc In Accordance with Rule #7.708.65.C&D Rev. 9/9/2013 21 Lutheran Family Services Foster Care Training Documentation and Approval Form (Please use ONLY when certificate is not provided) Name: K. Penney, J. Bohannon, and T. Carlson Date: 5-17-16 Title of Training: sexual compulsion in abuse victims and windows of tolerance Name of presenter or author: Dr. Jerry Yager, LFS Clinical Consultant ['Book ❑Audio ❑Video ❑Workshop ❑ Internet ❑ Other (list) group consultation Please list number of pages, minutes, or hours of training: n/a (# of hours granted will be hour -for -hour, actual workshop length, or .1 hour per 30 pages.) Report Outline (Use back or additional sheets as needed) What was the training material about? 1. Sexual compulsion v sexual addiction 2. Safety planning for adult victims of sa and their resulting compulsion 3. What to address regarding these issues in family therapy What new information did you gain? 1. We need to honor children for their solutions; they are creative survivors even if we worry about their coping skills 2. Need success experiences; we develop sense of self based on how we are feeling 3. Any type of arousal for sa victims can become sexual in nature How will you use it in fostering children? This information was shared in context of case presentation of a therapy case in which an older teen was developing sexual compulsion and dangerous situations were resulting. We can apply knowledge of how healing occurs in context of present relationships (in home and in tx) and not going back to past relationships. Tips for increasing her ability to ID feelings will be useful to caregivers. Number of training credit hours granted: Date: Approved by LFS staff member: Signature of staff: H:\Staff Training\Training Documentation 5.17.16 Yager consult.doc In Accordance with Rule #7.708.65.C&D Rev. 9/9/2013 22 Lutheran Family Services Foster Care Training Documentation and Approval Form (Please use ONLY when certificate is not provided) Name: K. Penney, J. Bohannon, and T. Carlson Date: 3-8-16 Title of Training: confidentiality laws, mandatory reporting, executive functioning and trauma Name of presenter or author: Dr. Jerry Yager, LFS Clinical Consultant ['Book ❑Audio ['Video ['Workshop ❑ Internet ❑ Other (list) group consultation Please list number of pages, minutes, or hours of training: n/a (# of hours granted will be hour -for -hour, actual workshop length, or 1 hour per 30 pages.) Report Outline (Use back or additional sheets as needed) What was the training material about? 1. How trauma affects executive functioning in youth. 2. Tips for channeling energy due to sensory issues 3. 1:1 relationships build abilities to navigate social environments What new information did you gain? 1. Education re: children experiencing various levels of arousal, from shut down to high energy and adults needing to help reduce associated stress as kids are unable. 2. Limit setting creates states that the kids cannot tolerate 3. Environments need to be created that help a child learn to self -regulate; these environments establish implantation of neurons that can now be wired into their brains. How will you use it in fostering children? This information was shared in context of case presentation with 2 male children who were exposed to drug use in utero as well as domestic violence. Understanding how to set limits while supporting the children and their inability to tolerate limit setting was discussed. We have concrete ideas re: how to manage sensory overload and complex social environments. Number of training credit hours granted: Date: Approved by LFS staff member: Signature of staff: H:\Staff Training\Training Documentation 3.8.16 Yager consult.doc In Accordance with Rule #7.708.65.C&D Rev. 9/9/2013 23 Lutheran Family Services Foster Care Training Documentation and Approval Form (Please use ONLY when certificate is not provided) Name: K. Penney, J. Bohannon, and T. Carlson, Richel Hubbard, Julie Robbins, Brittany Foster, McKenzie Gunderson, Ashley Shaw Date: 10-25-16 Title of Training: neglect Name of presenter or author: Dr. Jerry Yager, LFS Clinical Consultant ['Book ❑Audio ❑Video ['Workshop ❑ Internet ❑ Other (list) group consultation Please list number of pages, minutes, or hours of training: n/a (# of hours granted will be hour -for -hour, actual workshop length, or 1 hour per 30 pages.) Report Outline (Use back or additional sheets as needed) What was the training material about? 1. Neglect vs. abuse: Neglect is far worse on the brain and relationships. 2. Skills of the neglected child are very primitive. 3. They may see in you what they can get to meet their own needs and not know how you are feeling 4. There is a push-pull that is innate. They can't tolerate closeness nor can they tolerate being separate from the caregiver. What new information did you gain? See detailed attached notes. How will you use it in fostering children? We presented case of 3 siblings coming from extensive neglect. Knowing that they need repetition and pleasurable experiences in addition to the fact that nothing will be learned or improved in the absence of a relationship with foster parents was good psychoeducation that we can now share with foster parents. Number of training credit hours granted: Date: Approved by LFS staff member: Signature of staff: H:\Staff Training\Training Documentation 10.25.16 Yager consult.doc In Accordance with Rule #7.708.65.C&D Rev. 9/9/2013 24 Lutheran Family Services Foster Care Training Documentation and Approval Form (Please use ONLY when certificate is not provided) Name: K. Penney, J. Bohannon, and T. Carlson, Richel Hubbard, Julie Robbins, Brittany Foster ; Date: 9-6-16 Title of Training: Symptoms of PTSD Name of presenter or author: Dr. Jerry Yager, LFS Clinical Consultant ❑Book ❑Audio ❑Video ❑Workshop ❑ Internet ❑ Other (list) group consultation Please list number of pages, minutes, or hours of training: n/a (# of hours granted will be hour -for -hour, actual workshop length, or 1 hour per 30 pages.) Report Outline (Use back or additional sheets as needed) What was the training material about? 1. Dysregulation as a symptom of PTSD 2. Hospitalizations and how to provide psychoeducation about how they may be unavoidable 3. Why do people do better in school v home? What new information did you gain? See detailed attached notes. How will you use it in fostering children? We presented case of 14 year old URM from Burma. We have approaches we can teach foster parents and know how to look for and plan for dysregulation Number of training credit hours granted: Date: Approved by LFS staff member: Signature of staff: H:\Staff Training\Training Documentation 9.6.16 Yager consult.doc In Accordance with Rule #7.708.65 C&D Rev. 9/9/2013 25 Certificate of Training Completion HR 101 In Depth Supervisor Training for Lutheran Family Services Rocky Mountains Presented by 0 Forte HUMAN RESOURCES The SafeGuard System February 22, 2017 This certificate confirms the employee listed below successfully completed an 8 hour training class named above. Kim Penney Print Name Trainer Signature 26 Chelsey Lehmkuhl Work Experience 120120d Street Phone: (970) 571.1200 Greeley, CO 80631 chelseybauder@live.com, January 2012- Present Lutheran Family Services Rocky Mountains Greeley, CO Prevention Services Supervisor • Develops, interprets, and implements program operational philosophy, goals and objectives. • Provides day-to-day administrative and clinical and case management supervision. • Recruits, trains, and assists program personnel in setting individual goals and objectives. • Develops and maintains strong relationships with community partners and funding organizations. • Develops and administers the annual budget for the Prevention Programs. • Oversees the collection and maintenance of client demographic information, program service statistics and case records. Analyzes information and makes periodic statistical moons. December 2010-Deceeber 2011 Child Advocacy Resource and Education Evans, CO Prevention Educator • Facilitate the SaleTouch program in the school and community. • Plan classroom presentations as it pertains to the established goats and objectives of the program. • Establish and maintain a protessionat rapport with school arid community professionals. • Facilitate collection and documentation of all evaluative measurement procedures. • Maintain communication with the Coordinator and other professionals on issues pertinent to the Program. Report any suspected child abuse to the appropriate agencies as required of mandated reporters, as directed by the Weld County Child Abuse Reporting Protocol. Assist with agency functions as desired or as funding allows. February 2010 -November 2010 Mt Child Enrichment Center Greeley, CO Preschool Teacher • Plan and implement activities with preschool children • Plan and maintain a safe, dean, learning environment • Develop and implement weekly lesson plans that are consistent with the program curriculum • Supervise, guide, and model appropriate behavior and teacher techniques for teacher assistant • Encourage and model language expansion, extended learning and problem solving strategies throughout the day • Guide children's behavior with positive guidance techniques • Maintain accurate and current assessment inlarmalion noting child's progress across all developmental domains Accurately complete all paperwork, parent/teacher conference forms, lesson plans and transition forms • Maintain ongoing communication with parents and families • Implement behavior plans designed by the mental health specialist. • Sil with children during all meal limes and eat the same lunch as the children, providing a model for good nutritional habits. September 2009 -February 2010 Monfort Early Childhood Education Center Greeley, CO Lead Teacher • Prepare play and teaming materials • Implement developmentally appropriate practices • Set up children's environment • Ensure children's physical safety at all times • Assist in the daily execution of lesson pians • Assist with group time and teaming centers • Help children with daily routines such as hand and lace washing, loileting, dressing. eating and sleeping. • Guide children's behavior and social development • Engage in activities with children • Serve snacks and meals • Maintain sale, clean, and appealing environment • Sanitize and disinfect toys and lumilure 27 Augus12007-July 2009 Denver Public Schools Kaleidoscope Corner ChNd Care Program Greeley, CO Lead Teacher • implement developmentally appropriate practices • Organize play and learning materials • Assisted in the directing and implementing of classroom guidelines as well as Slate guidelines. • Utilize age appropriate activities for children • Prepared community service and student affairs activities • Operate computer and other oNice equipment • Assist In planning of chridren's programs Education References 2006-2009 Metropolitan State College Denver, CO • Major. Sociology • Minor Psychology • Graduation date: July 2009 with a $.A. 2005-20O6 Scottsdale Community College • Major Sociology 2004-2005 Northeastern Junior College a Major Early Childhood Education 2000.2004 Sterling High School • Graduation dale: May 2004 Kedy Saucedo Child Care Center Director (970) 580-0641 Julie Witkowski Supervisor Weld County Human Services (970) 443-5440 Janet Johnson Program Special st Kaleidoscope Corner (719)684.5721 Scottsdale AZ Sterling, CO Sterling, CO 28 6Z OE LARIMER COUNTY DEPARTMENT OF HUMAN SERVICES » o c \ / 2 > 7 § $ E c/) '§ 7 ou -5 J ^O | 2 •2 / k .O .. I 9 0 2 k /2 % ) / B r2, ] •b \% , ao , VI / / O ■ . s / / E § c a u u /e„, 2 § // #/ / 0. , u a x % & .� U / § O. - ® u 2 �� §t'� C .G § ® O W �k % of / 7 / 1.0 % $ &a G. c § a a O $ 7 « / § \ c 6 E ® O C. ■ ) 3 .g u c 5? �c2/2 J- /(a?ji .7 §2 w$\ Int ; •g -5 3 e % o § _ § o 0 ) » § , & $ .E o / 1 \ d �� G , 2 b © ■ .§ , 0 _ A �//\ 0. June 13, 2016 — 2:30 — 4:30 (2 hour of trauma training) Mental I ealth First Aid USA Certificate Chelsey Lehmkuhl has completed the 8 -hour course and is now certified in USA PIF MENTAL HEALTH FIRST AID Mental Health First Aid USA And has been trained to provide initial help to people experiencing mental health problems such as depression, anxiety disorders, psychosis and substance use disorders. This certification became effective on March 25, 2014 This certification expires on. Date Ogg N/A Noelle Hause EdD, LPC, IMH-E® (IV) Pamela Collins Vaughn, MA, LPC Instructor Instructor MENTAL HEALTH NATI•NAL COUNCIL FOR BEHAVIORAL HEALTH gm MENTAL HEALTH FIRST AID Mental Health First Aid USA is coordinated by the National Council for Community Behavioral Healthcare, the Maryland Department of Health and Mental Hygiene, and the Missouri Department of Mental Health. 31 ze Acknowledges that Chelsey Lehmkuhl C) L L O +.+ co ui u_ C a W O E N o� U O CD >,wO U c U CD cc a) . _ Z V IU. 6 61 .O r IIL O l0 y o F- 0 s Tu cd O- x 0 2 vi CD > x m O c a s O (802) 229-5724 co U ££ Lia Ce O 414) Certificate of Completion AUTHORIZED FACILITATOR WORKSHOP Presented To: C 0 .42 0 CC) a) 4- 0 N Z s w s _ c E 0 a rn 1 �C _ C� U 0 C O .O O 0 Darkness to light 843.965.5444 v 0 O U w a, E O 4.0 Of O = y •- _ .7+ •- u O O. 0 CD s I a, mr. 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I would like to excel in a professional setting through hard work and dedication. Education HIGH SCHOOL DIPLOMA I MAY 2012 ( PLATTE VALLEY BACHELOR'S I AUGUST 2012 - MAY 20161 UNIVERSITY OF NORTHERN COLORADO • Major: Psychology • Minor: Criminal Justice Skills & Abilities • Bilingual (English and Spanish) • Proficient on PC platform • Proficient on Microsoft Office (Word, PowerPoint, Outlook, Excel) • Quick learner Good communication skills (Written and Oral) Experience SAFETOUCH PROGRAM j LUTHERAN FAMILY SERVICES ROCKY MOUNTAIN j AUGUST 2016 - PRESENT • Delivers training and education for SafeTouch. Manages the collection and maintenance of client demographic information and program statistics. • Provides assistance in the evaluation of SafeTouch. PARENTING EDUCATION FACILITATOR ( LUTHERAN FAMILY SERVICES ROCKY MOUNTAIN j MAY 2016 - PRESENT Co -Parenting After Divorce Class (English and Spanish) • Nurturing Parenting Class (English and Spanish) • Strengthening Latino Families (Spanish) • RETHINK: Anger Management for parents (English and Spanish) VISITATION SUPERVISOR j LUTHERAN FAMILY SERVICES ROCKY MOUNTAIN 12015 - PRESENT • Supervise visits between parents and children to insure that there is nothing inappropriate said/done • Complete documentation during visits • Assist in Children's Program COSTODIAN I BOOTH LAND AND LIVESTOCK12012 2012 - PRESENT • Clean desks • Vacuum 40 • [Broom/mop COOLER STOCKER ( KRAMER'S WEDGE 1 2009 - 2010 • Stock the coolers • Bag ice • Throw away trashes Certificates and Trainings • Mental Health First Aid USA (►une 0, 2016) • Trauma Informed Primary Care Practice (June 13, 2016) • Sex Offenders and Their Victims: Connecting the Dots (July 19, 2016) • Darkness To Light's Stewards of Children (July 20, 2016) REFERENCES • Gary [Booth, Booth Land and Livestock, 970.353.7055 • Brad Jones, Platte Valley High School, 970.336.8700 41 Zb Certificate of Attendance This certifies that y O N TO 34-4 O cC O U O _ rjrz O▪ . 'Q a) a) iii •5 cii u b O Q O O 16 U c .5 4.°' � A �cuv, O ▪ • terr N 3 cl) N'—, = cII�� rtl • C y 'N N • U v CU O MG N ▪ EOO w t▪ t • a.▪ =IV f CD tea) 5c c> O O C •a ra (1:1i • w0 N tnO cd 1. O a) too • y "C O vJ "al v 034 c° O .O � O U X C)) iv to 'G CC c r. I. 'N .. v i. aJ 4. CC E In. to U With Jim Tanner, Ph.D. and Amber McDonald , LCSW Presented by Voices Carry Child Advocacy Center on July 19, 2016 i a) V U O a):3 U _U U • CC .N 1. • .0 O O E4 I o Li/ LL1 cd Imo VI Certificate of Attendance CD Z a) a) N a) 8.7 0 := a U 0 J CO c cv O O% co -0 'n a� v M `a C co co c O O_ Q Q O s u a 0 v p cat 'u O {y N -p O m c O a a a o N N •� Q O p OJ 0 O ,O a `a Z s m c a C 0 E O s C O 1 Q) _ 0 0 n x o --pN N o -0 o c(� 0 rr LARIMER COUNTY DEPARTMENT OF HUMAN SERVICRS ucij V co L U (V E -L d U E C is I- in • z vs c o - b z . • G b '.Ce • O t +r W L=] W E GCl O Ts, q v 0 c v y .C u C . "O 2 • ^ N V d 0CS au. E 'n . S O S I u C. • ' U Se v H E Q •SY)U c u C (V a. C u g 1 rimi00 ee cm, v V C0 00 W • El W 5 O u • 0 cv u O m(2 c.,-; O I- V ra u E u a • C .a• te 0.5 u tJ C u a H • ^O CO A+ 421 L., y C u u ill u y 0 C '49 e C Num to vi a L �p • Z u V. T1 h r, u 0 Q w• 4.,..,_. 0 ti C 34'' E 0 O.S h u •E O v W C ?• E cCs r u O {Cud g S Cl v ... d •c ate. p -C • •V u G c..,-7 °,.. E d .5 N u u in ri cz7ra0 a` h Mo L., ai • Cl) • 2 0 46 !J tH 0 CU a Q v O 0 aV� a es w Youth Mental Health First Aid USA MENTAL HEALTH FIRST AID" Certificate Ivonne Varela has completed the 8 hour course and is now certified in Mental Health First Aid USA And has been trained w provide initial help -to young people experiencing mental health problems such as depression, anxiety disorders. psychosis, and substance use disorders. This ,canon . affective on June 8, 2016 This c ant icauon =peas on N/A Janis Pottorff LCSW, IMH-E• III MENTAL HEALTH Wiral Suzann Pfeifer, MS NATIONAL COUNCIL FOR BEHAVIORAL HEALTH imeMDrrez gmuT:M rn n AM YYad, %into Illealth tirsikd USA a raathrated Who Antacid Card ter Goturriond Heigh, do Monte,d oepa+zwas at Fleatth aryl %Arad kepere_ and the Missouri nopr..+ieM of Mental 1ieaitk. 45 EXHIBIT C SCOPE OF SERVICES Contractor will coordinate, facilitate and conduct Parenting Education Classes and the SafeTouch program in Weld County as outlined below. Parenting Education Classes: The Parenting Education Program of Lutheran Family Services Rocky Mountains (LFSRM) provides an opportunity for parents/families in Weld County to participate in a variety of parent education classes. The overall goal of the Parenting Education Program is to support child abuse prevention by strengthening healthy interaction skills within families. Presented in a group setting with classes accommodating 15-30 adult participants, the parent education classes are offered on -site at our location in Greeley or other community locations, including the south Weld County area and the Weld County Jail. LFSRM offers an assortment of classes designed to reach a wide -range of parenting needs. Spanish classes are available. In addition, LFSRM offers children's groups and/or childcare in conjunction with the parenting classes. Serving as child care and learning environment, the children's groups focus on building social skills, enhancing self-esteem, anger management, and decision making skills. These skills are exhibited to the children through facilitator modeling, craft projects, games, puppets, storybooks, and songs. Parenting classes include: • RETHINK: Anger Management for Parents This program includes role play, video clips and discussion based on the concepts behind the title "RETHINK" —Recognizing Anger, Empathizing with the other person, Thinking about the situation, Hearing what is said, Integrating respect and love, Noticing your body's reactions, and Keeping your attention on the problem. The class is designed to teach parents how to have a more positive response to their children's challenging behaviors, identify their own as well as their children's anger triggers, and to understand related child development. The class is offered two to five times per year, and meets for a total of eight hours (usually four, two hour sessions). RETHINK is available in both English and Spanish. • Nurturing Parenting The Nurturing Parenting program is a nationally renowned curriculum that focuses on the development of empathy, self-worth, self-awareness, discipline with dignity, family roles, and child development and expectations. This class is designed for parents of 0-12 year olds. One class session is dedicated to education about Shaken Baby Syndrome and includes a shaken baby simulator and video. LFSRM has offered this evidence -based program since 1984 throughout northern Colorado. The Nurturing Parenting curriculum is offered two to four times per year and meets for two hours a week for 12 -weeks. In addition, LFSRM has been invited to present the Nurturing Parenting Community -based curriculum once a month to groups of parents at Greeley Transitional House. • Parenting Your Teenager This class is designed to help parents develop a greater understanding of their teen's behavior and learn more effective techniques of interaction and communication with youth during the adolescent stages of development. This is of particular importance as the teens are testing boundaries, being tempted to experiment with alcohol and drugs, and dealing with their own "raging hormones." Meeting for two hours per week for four weeks, Parenting Your Teenager is offered three to five times per year. • Strengthening Latino Families Taking a culturally appropriate approach, this program is a group -based class specifically designed for Latino/Spanish-speaking families interested in enhancing their parenting skills. The class focuses on positive and respectful discipline, communication strategies, child development, and addressing issues of sexuality. Strengthening Latino Families is offered at least two, but up to three times per year and meets for two hours per week for ten weeks. The class is available only in Spanish. • Nurturing Skills for Teen Parents. This class is designed to support pregnant teens through the pregnancy and birth of their child as they stay in school. Both mothers and fathers are welcome to attend. Using the Nurturing Parenting teen curriculum that is geared toward the adolescent development level, this class focuses on issues related to infant development, Shaken Baby Syndrome, Fetal Alcohol Syndrome, drug affected children, infant massage, positive and nurturing discipline, budgeting, nutrition, and building children's self-esteem. LFSRM offers Nurturing Skills for Teen Parents at Jefferson High school once a year. Each session includes five (5) to six (6) 90 -minute presentations. Parenting Education Target Population: The population to be served through the Parenting Education Program will have one or more of the following characteristics: • Parents/caregivers/caring individuals responsible for a child wishing to strengthen their knowledge and skill base. • Parents/caregivers/caring individuals responsible for a child who may be at high risk for abusing and/or neglecting their children due to socioeconomic or social isolation issues. • Court -mandated parents who may not have custody of their children and who are working to regain custody. • Parents involved in the child welfare system who are at risk of having custody of their children removed due to abuse or neglect allegations. • Parents who are involved in court -mediated divorce proceedings. • New and/or first time parents. • Victims of domestic violence. The population includes single -parent and two -parent households, as well as households in which a caregiver in the home may not be a "parent" but they are fulfilling a parenting role (such as a live-in partner or a family member). Recipients of parenting education and support services gain increased knowledge of appropriate and nurturing parenting attitudes, beliefs, and practices, and thus reducing their risk of abusing or neglecting their children. SafeTouch Prevention Program: SafeTouch was introduced to Weld County schools in 1987 and is presented to approximately 11,500 students each year. SafeTouch is a progressive program where children in kindergarten through fifth grade learn what constitutes emotional and sexual abuse, inappropriate sexual advances, and sexual violence in age -appropriate levels of comprehension and context. The goal of SafeTouch is to help reduce children's vulnerability to abuse and unwanted touch. The program teaches the three "Rs" of sexual assault prevention: recognize, resist and report. Children are taught to understand the difference between appropriate and inappropriate touch, and how to respond to inappropriate touch by saying "No," running away, and telling an adult. Furthermore, the program teaches children how to identify trusted adults to whom they can talk and who understand the circumstances. The message is taught and practiced through the use of pictures, songs, puppets, videos, and discussions. The messages remain constant from year to year, but examples and depth of discussion advance each year to be developmentally appropriate for the age group being taught. Interpretation and translation is provided by schools during presentations to Spanish-speaking students. This is a program that nurtures a child's physical, emotional, and intellectual health and well-being. SafeTouch is presented as a single session of varying times with the presenters meeting with each class separately. The school counselors, teachers, and SafeTouch presenters collaborate to create a comfortable environment for the presentation that allows the children to share information and ask for help. Should the children report physical abuse, sexual abuse, or domestic violence during one of these sessions, the teachers, counselors, or presenters, as mandatory reporters, make referrals to law enforcement or social services as required by the Colorado Revised Statutes. SafeTouch was developed in 1987 at the request of Weld County educators using primarily the evidenced -based Stewards for Children Curriculum from the Darkness to Light Organization. The Darkness to Light core principals are to: prevent, recognize, and react responsibly to child sexual abuse. In addition, the SafeTouch Program utilizes a puppet of McGruff, the crime prevention dog, from the National Crime Prevention Council, to deliver messages that address bullying, conflict management, and stranger danger. The US Department of Health and Human Services lists Darkness to Light as one of 12 emerging practices that shows effectiveness in their publication Emerging Practices in the Prevention of Child Abuse and Neglect (2001). The National Crime Prevention Council reports more than 83 percent of children, teens, and adults recognize McGruff, and over 4,000 law enforcement agencies use McGruff costumes to spread the word about prevention (July 2013). SafeTouch Target Population: SafeTouch is projected to serve 11,500 students in kindergarten through fifth grade in 20-25 Weld County elementary schools throughout the 2016-2017 school year. Program Funding: Weld County funding is an essential source of funding for both the Parenting Education and SafeTouch programs for Lutheran Family Services Rocky Mountains. In addition to Weld County funds, the Parenting Education Program receives grant funding from the Promoting Safe and Stable Families and the Temple Hoyne Buell Foundation. LFSRM has a pending grant application to the United Way of Weld County. A small fee is charged for all parenting classes on a sliding fee scale and scholarships are available through the use of donated and contributed funds. The corresponding children's groups are always free. In addition to Weld County funds, the SafeTouch Program receives grant funding from the United Way of Weld County, the United Way of Weld County Youth Allocation Committee and VALE 19th Judicial District. SafeTouch is also largely funded by revenue raised through the annual Taste of Weld County fundraiser. Anticipated 2016 Benefits: Parenting Education The Parenting Education Program offers a variety of parenting classes that educate and support a broad range of parents as they learn the parenting role through increased knowledge, positive attitudes, and skills. The classes focus on challenging times when parents may resort to family violence due to a lack of safe and nurturing parenting skills, incredible frustration, or learned negative behaviors. The anticipated benefits of the Parent Education Program are for parents to: • Increase knowledge of healthy and safe parenting skills • Demonstrate more positive and effective responses to children's challenging behaviors • Develop an increased knowledge of child development and appropriate expectations SafeTouch According to the National Sexual Violence Resource Center and the Center for Disease Control, successful techniques of teaching child sexual abuse prevention include skills practice, role playing, shaping or encouraging a child's response to a situation with physically and verbally active techniques, modeling with puppets, and the use of films and discussion. Delivered by experienced instructors, LFSRM incorporates these best practices into the SafeTouch curriculum. The anticipated benefits of the SafeTouch Program are for children to: • Recognize abusive and inappropriate situations • Decrease their vulnerability to abuse and unwanted touch • Learn to say "no," run away, and tell an adult if facing an unsafe situation • Identify trusted adults with whom they can talk about these and other difficult situations School -based child sexual abuse prevention programs have been proven to be effective, with measurable outcomes that include teaching children to recognize child sexual abuse and other types of abuse, distinguish between appropriate and inappropriate touching, tell the difference between good and bad secrets, say "no" to unwanted approaches, tell an adult, know that they are not to blame, and use strategies to reduce likelihood of being abused or reporting abuse (Topping, K., Barron, I. (2009). School -Based Child Sexual Abuse Prevention Programs: A Review of Effectiveness. Review of Educational Research). Program Effectiveness: Parenting Education LFSRM anticipates serving 165 parents and 40 children through the Parenting Education Program throughout the 2016-2017 fiscal year. Outcomes are measured through the use of curriculum specific pre- and post -class tests that measure parenting skills, practices, and beliefs. (See attached pre- and post-test samples.) Projected results are as follows: • 90% of parents who graduate from the parent education courses will complete the appropriate, specific pre- and post-tests for the respective class they completed. • 70% of parents who complete pre- and post-test evaluations will demonstrate one or more of the following: Reduced anger responses to children's behaviors i Use of more appropriate and safer parenting techniques Decreased family stress levels Increased positive intra-family communications Increased knowledge of child/youth development Additionally, participants in all classes are asked to complete evaluation questionnaires at the end of each multi - week session to help the staff assess the instructors, curriculum, class meeting times, and locations. Test and evaluation results are analyzed and compiled into semi-annual and annual reports that are provided to agency staff, management, and funders. The information is used to determine what if any changes need to be made to the class procedures, curriculum, outreach, or comprehensibility. SafeTouch According to The Prevention of Child Sexual Abuse publication (Finkelhor 2009, The Future of Children, Princeton University), children of all ages who participated in school based sexual abuse prevention programs were six to seven times more likely to demonstrate protective behavior in simulated situations than children who had not. Prior to each SafeTouch session, the presenters distribute questionnaires to a random sample of children who participate in the program, varying the schools from year to year. The pre -session questionnaire is designed to assess the children's knowledge before a SafeTouch session. A post -session questionnaire using similar questions is given to the same children two weeks after the session to determine how well the information has been retained. Questionnaires are designed specifically for the different grade levels, for example, using happy and sad faces to denote "yes" or "no" responses for kindergarten through third grades. Projected results are as follows: • 75% will demonstrate the ability to recognize safe versus unsafe touches prior to receiving the presentation. • 90% will demonstrate an ability to recognize safe versus unsafe touches immediately following the presentation. • 90% will be able to identify examples of adults they would tell if the experience an unsafe situation. • 90 % will demonstrate subject matter retention two weeks after the presentation. The results of the pre -session and post -session questionnaires are compiled throughout the school year. Results are used to determine what if any changes need to be made to the presentations, topics, or environment. Confidentiality: LFSRM agrees to comply with CRS 19-1-120, which requires that reports of child abuse and any identifying information in reports are strictly confidential. Eligible Client Cases: Weld County Human Services shall be responsible for selecting cases to be reviewed and staffed by LFSRM. Monitoring and Evaluation: The following will be used for monitoring and evaluating the success of the purchase of services agreement: A. Quarterly report and invoices will be submitted to Weld County Department of Human Services by the 15th of the month following the end of each quarter. B. Review of evaluation materials and correspondence from outside agencies regarding services received. C. Ongoing consultation with supervising staff through Weld County Department of Human Services concerning development and implementation of programs. 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 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 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 Parenting Education Program: $135.00/Class - Nurturing Parenting (Drop -In Sessions) $97.50/Class - Nurturing Parenting (Teen Parents) $197.00/Class - Nurturing Parenting (English) $213.00/Class - Nurturing Parenting (Spanish) $120.00/Class - Parenting Your Teen $105.00/Class - RETHINK: Anger Management for Parents $139.00/Class - Strengthening Latino Families SafeTouch: $25.00/Per Class (per classroom presentation) 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 quarterly an itemized voucher, and signed quarterly report 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, Scope of Services, and Exhibit C, Payment Schedule. The itemized quarterly billing will be submitted no later than the fifteenth (15th) of the month following the month of service, as follows: 1 • First Quarter (July 1 -September 30) - Due October 15tH • Second Quarter (October 1 -December 31) - Due January 15th • Third Quarter (January 1 -March 31) — Due April 15th • Fourth Quarter (April 1 -June 30) — Due July 15tH Billings must be signed by the Contractor. Failure to submit by the aforementioned deadlines may result in forfeiture of payment. 2 AC RD CERTIFICATE OF LIABILITY INSURANCE oTEI UOol'` I 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 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 1-303-534-4567 Inc. - Colorado Division 1705 17th Street Suite 100 Deaver, CO 80202 CONTACT NAMEIMA, PHONE FAX _itYC.NQ.Exil A/C No EMAIL noDREss denaccotmttecha®imacorp.com INSURER(S) AFFORDING COVERAGE NAIL a INSURER PHILADELPHIA INS CO 23850 INSURED Lutheran Social Services of CO Lutheran Family Services Rocky Mountain 363 South Harlan, Ste 200 Denver, CO 80226 INSURERS PINNACOL ASSUR 41190 INSURERC ZURICH AMER INS CO(Pinnacol Assurance? 16535 INSURERD INSURER E INSURERF. :50648339 • THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. 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AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE s 3,000,000 PRODUCTS - COMPIOP AGG S 3,000,000 S A AUTOMOBILELIABIIJY X X A ANY AUTO ALL ,._,- X SCHEDULED AUTOS NON -OWNED AUTOS PHPR1669529 07/01/17 07/01/18 COMBINeoSINGLE WAIT jga aa70enq S 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per acc enti S PROPERTY DAMAGE (Per amdenll S $ UMBRELLAUAB EXCESS LIAB ,_, OCCUR CLAIMS -MADE EACHOCCURRENCE S AGGREGATE S DEO I I RETENTIONS , S B 'WORKERS C COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE � OFFICER/MEMBER EXCLUDED? I- 1 (Mandatory in NH) If yes. describe under DESCRIPTION OF OPERATIONS below N I A 4040538 - CO ONLY WC969160406 - NM ONLY 03/01/17 03/01/18 { ' X I PER STATUTE.2 I ERH 03/01/17 03/01/18 EL EACH ACCIDENT s 500,000 E DISEASE - EA EMPLOYEE S 500,000 E.L. DISEASE • POLICY LIMIT $ 500,000 A Professional Liability PHPR1669517 07/01/17 107/01/18 Hach Occurrence $ 1,000,000 Aggregate $3,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached iI more space is required) County of Weld is included as Additional Insured on the General Liability Policy if required by written contract or agreement subject to the policy terms and conditions. A Waiver of Subrogation is provided in favor of Additional Insures on the General Liability and Workers Compensation Policies if required by written contract or agreement subject to the policy terms and conditions. CERTIFICATE HOLDER County of Weld 1150 '0' Street Greeley, CO 80631 USA I/�/[t 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 //2f /4 ACORD 25 (2014/01) sadie55 50648339 z91988-2014 ACORD CORPORATION. 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