HomeMy WebLinkAbout20172595.tiffRESOLUTION
RE: APPROVE AGREEMENT FOR SUBSTANCE ABUSE TREATMENT SERVICES FOR
CHILD WELFARE CLIENTS AND AUTHORIZE CHAIR TO SIGN - SIGNAL
BEHAVIORAL HEALTH NETWORK
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 Substance Abuse
Treatment Services for Child Welfare Clients 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 Signal Behavioral Health Network, commencing June 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 Substance Abuse Treatment Services for Child Welfare
Clients 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 Signal
Behavioral Health Network, be and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair Pro-Tem 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 26th day of July, A.D., 2016, nunc pro tunc June 1, 2017.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST: d� jdo4; EXCUSED
Julie A. Cozad, Chair
Weld County Clerk to the Board
BY:
ty Clerk to the Board
APPROVED AS T
/County attorney
Date of signature: (ell ? ( (7
Steve Moreno, Pro-Tem
Pte_
Sean P. Conway
ike Freeman
-Barbara Kirkmey
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2017-2595
HR0088
SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2017/2018
CHILD WELFARE CLIENTS
This Agreement is between the Weld County Department of Human Services, hereinafter
referred to as "WCDHS" and Signal Behavioral Health Network, and hereinafter referred to as
"Signal."
WHEREAS, the Colorado Department of Human Services has provided Colorado Core
Services substance abuse treatment funding to Human Services for outpatient and residential
core services for families, children, and adolescents; and
WHEREAS, WCDHS requires the services of a substance abuse treatment provider to
assist the County in delivering substance abuse treatment services to child welfare clients, and
Signal is willing and able to coordinate and manage such services; and
WHEREAS, Signal is a Colorado not -for-profit corporation organized for the purpose of
managing and coordinating high quality, cost efficient, integrated chemical dependency and
related behavioral health care services in the State of Colorado.
NOW, THEREFORE, it is mutually agreed as follows:
I. SERVICES:
A. Responsibilities of Signal
1. Signal agrees and desires to participate as the service provider coordinator for
WCDHS qualified child welfare clients under the definition set forth in the Child
Welfare Lawsuit Settlement Agreement (David Littman vs. State of Colorado).
2. Signal will ensure the delivery of a high quality of clinical care to clients in a delivery
system of limited resources and public funding. The full continuum of care
(Outpatient, Intensive Outpatient, Transitional Residential, Intensive Residential,
Therapeutic Community, or comparable alternatives as mutually agreed upon) will
be available to clients. The client's clinical needs will determine the level of care
Signal is to provide and Signal will meet those needs regardless of "modality."
3. Signal will assure that all eligible child welfare clients referred by WCDHS in need
of treatment will receive such in accordance with ASAM PPC-II R level of care, as
reimbursed by the State of Colorado, Office of Behavioral Health.
4. Signal will give priority service to child welfare clients (parents and children) who
comply with the following criteria as WCDHS refers:
a. Case is active on TRAILS, and
b. Case meets the State DHS program category criteria 4, 5, or 6, and
c. Case meets the definition of "imminent risk for out -of -home
placement/reunification" set forth by the State of Colorado. Signal will
secondarily evaluate and treat Colorado Works/TANF/Employment First clients
as referred by WCDHS.
5. Signal will include the following provisions in all subcontracts with providers:
a. The Provider shall submit a treatment plan to WCDHS within 30 days
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b. The Provider shall enter monthly progress reports into the Signal system no
later than the 10th calendar day of the month following the month during in
which the service was rendered. Services submitted without monthly progress
reports will be pended for official billing and utilization against AFS funds until
such reports are submitted.
c. Signal, or their designee, agrees to provide Human Services monitoring results
(UA, BA, patch, tox trap) by faxing said results to Human Services at (970)
346-7667 or via access to online system no later than 72 hours after the day
of service.
d. Signal agrees to make available Core and AFS Utilization Reports to WCDHS
each month by the 3rd Wednesday of each month.
e. Signal agrees to cooperate with WCDHS to resolve any duplicated fees and/or
errors identified by the WCDHS billing review process.
6. Signal will also make monthly progress reports available on its website for each
WCDHS client in treatment.
7. Signal will provide training and technical support, as necessary, for WCDHS staff
in accessing data reports and on the use of the child welfare referral system.
9. Signal shall reconcile all treatment providers' claims to AFS funds within 90 days
from the date of service delivery. Claims not properly submitted to Signal within
this time line will be denied.
10. Signal will assure that the providers in its network give timely notice of cancelled
appointments to the clients and will reschedule such appointments as soon as
practical.
11. At all times from the effective date of this Contract until completion of this
Contract, Signal 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 the
Child Welfare Services and Family and Children's Program funding must conform
to the Single Audit Act of 1984 and OMB Circular A-133.
B. Responsibilities of WCDHS:
1. WCDHS will work cooperatively with Signal and its Providers to deliver quality,
efficient and cost-effective substance abuse treatment services to WCDHS
qualified clients.
2. WCDHS will make every effort to inform Signal and its Providers in a timely manner
of system issues, developments, and complications so that Signal and the Provider
can make informed choices in its role as the managed service organization and
treatment agency respectively.
3. WCDHS will assure that all referrals under this contract meet the eligibility criteria
expressed in Section l(A)(5) above.
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SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2017/2018
CHILD WELFARE CLIENTS
4. WCDHS agrees to provide Signal with the name of a primary contact person who
will be responsible for interacting with Signal's accounting and information systems
departments.
5. WCDHS, or its authorized designee(s), will be responsible for electronically
authorizing services to various providers.
6. WCDHS will review monthly AFS actual reports and determine any duplicate
charges pursuant to Core or other previously paid services. WCDHS will report
monthly any discrepancies in duplication and/or errors to Signal, and in
cooperation with Signal, work with Signal to resolve any conflicts of billed services
or fees.
7. WCDHS will complete the Signal remittance advice and return to Signal within 5
business days of completion of each month's TRAILS payroll date. Each
remittance advice shall detail reasons for denial of any and all services. WCDHS
shall work with Signal and other counties to develop standard claims denial criteria.
WCDHS shall reimburse Signal for all complete services invoiced within 45
calendar days from the date of receipt of Signal's invoice.
8. WCDHS shall inform Signal of the county primary contacts along with contact
information. WCDHS shall provide such contact information for all contract, data
and billing related matters.
11. PERIOD OF PERFORMANCE
Due to different State funding cycles, the period of performance under this Agreement will
overlap. For the County Core Services the period of performance
shall be for the 12 -month period beginning, June 1, 2017 through May 31, 2018, unless
sooner terminated. The Signal Additional Family Service (AFS) period of performance
under this Agreement shall be for the 12 -month period beginning July 1, 2017 through
June 30, 2018, unless sooner terminated. Either party hereto may terminate this
Agreement at any time by giving not less than 45 days advance written notice to the other
party.
As a condition of continuing to render services under this Agreement, it is understood that
Signal will report any limitation or restriction of their license or insurance or the ability to
perform the services covered by this Agreement under any condition of impairment.
In the absence of any formal agreement beyond the term of this agreement, Signal agrees
to continue providing treatment, under the terms of this agreement, for clients that are in
treatment or referred by WCDHS for treatment. This is with the further understanding that
service delivery and payment are subject to the termination terms mentioned above.
Signal reserves the right to suspend services to clients if funding is no longer available.
WCDHS acknowledges financial responsibility for all services authorized and performed
before the effective date of termination.
111. COMPENSATION
See Exhibit A.
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SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2017/2018
CHILD WELFARE CLIENTS
IV. CLIENT FEES OR CO -PAYS
Neither Signal nor their network Providers shall assess a client fee or co -pay to child
welfare clients served under this contract, unless the client is required to pay for any
positive urine screen as a condition of their Family Service Plan or through court order
for monitored sobriety and/or treatment as a condition of their treatment plan. Any such
client fees or co -pays shall be outside the scope of this contract, and Signal shall have
no responsibility for accounting for such fees and co -pays.
V. ATTACHMENTS
Signal and WCDHS agree to adopt herein Exhibit A, - Memorandum of Understanding,
Exhibit B — Signal Remittance Advice, Exhibit C — Qualified Service Organization
Agreement, Exhibit D — Scope of Services, Exhibit E — Assurances, and Exhibit F —
Standards of Responsibility for Core Services.
VI. INDEPENDENT CONTRACTOR
Signal and its providers shall be providing services hereunder as an independent
contractor and the relationship of employer and employee does not exist between WCDHS
and Signal.
None of the provisions of this Agreement are intended to create, nor shall they be deemed
or construed to create, any relationship among Signal, Providers, or WCDHS other than
that of independent entities contracting solely for the purpose of effecting the provisions
of this Agreement.
Signal and Providers shall pay when due all required employment taxes and income
withholding taxes, shall provide and keep in force worker's compensation (and show proof
of such insurance as requested) and unemployment compensation insurance in the
amounts required by law, and shall be solely responsible for the acts for Signal, its
employees and agents.
VII. ASSURANCES
Signal shall abide by all assurances as set forth in the attached Exhibit E, which is attached
hereto and incorporated herein by reference.
VIII. COMPLIANCE WITH APPLICABLE LAWS
At all times during the performance of this contract, Signal shall strictly adhere to all
applicable federal and state laws, orders, and all applicable standards, regulations,
interpretations or guidelines issued pursuant thereto. This includes the 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 Contract.
Signal acknowledges that the following laws are included:
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
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. Sections 6101 et. seq. and its implementation
regulations, 45 C.F.R. Part 91; and
Title VII of the Civil Rights Act of 1964; and
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WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2017/2018
CHILD WELFARE CLIENTS
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
All regulations applicable to these laws prohibiting discrimination because of race, color,
national origin, and 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, Signal and Human
Services will resist in judicial proceedings any efforts to obtain access to client records
except as permitted by 42 CFR Part 2.
Human Services and Signal shall sign a Qualified Service Organization Agreement in
compliance with 42 CFR Part 2, and attached hereto as Exhibit F.
Included is 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 and all federal and/or state financial assistance.
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 U.S.
Department of Health and Human Services, Office for Civil Rights.
EMPLOYMENT OR CONTRACTING WITH ILLEGAL ALIENS UNDER COLORADO
LAW
Contractor certifies that it shall comply with the provisions of Section 8-17.5-101, et seq.,
C.R.S., 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 comply with the requirements of Section 81-.5-
102(2)(b),C.R.S. Contractor shall comply with all reasonable requests made in the course
of an investigation under Section 8-17,5-102,G.R.S., by the Colorado Department of Labor
and Employment. If Contractor fails to comply with any requirements of this provision or
Section 8-17.5-101. et seq.,C.R.S., 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 Section 24-76/5-103(3),
C.R.S, if Contractor receives federal or state funds under this Contract, Contractor must
confirm that any individual natural person eighteen (18) years of age or older is lawfully
present in the United States pursuant to Section 24-76.5-103(4), C.R.S., 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
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CHILD WELFARE CLIENTS
lawfully present in the United States pursuant to federal law, (b) shall product one of the
forms of identification required by Section 24-76/5-101. et seq., C.R.S., and (c) shall
produce one of the forms of identification required by Section 24-76.5-103, C.R.S., prior
to the effective date of this Contract.
IX. CERTIFICATIONS
Signal certifies that, at the time of entering into this Contract, it has currently in effect all
necessary licenses, approvals, insurance, etc. required to properly provide the services
and/or supplies covered by this contract.
X. MONITORING AND EVALUATION
Signal and Human Services agree that monitoring and evaluation of the performance of
this Agreement shall be conducted by Signal and Human Services. The results of the
monitoring and evaluation shall be provided to the Board of Weld County Commissioners
and Signal.
Signal shall permit Human Services, and any other duly authorized agent or governmental
agency, to monitor all activities conducted by Signal 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 agreement work.
XI. MODIFICATION OF AGREEMENT
All modifications to this agreement shall be in writing and signed by both parties.
XII. REMEDIES
A. Signal and Human Services shall exhaust all remedies as provided in Exhibit F,
"Standards of Responsibility for Core Services", prior to the remedy provided in Item
XII, B, of this Agreement.
B. The Director of Human Services or designee may exercise the following remedial
actions should s/he find Signal 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 Signal. These remedial actions are as follows:
Provide reasonable advance written notice of perceived failure to satisfy the scope
of work. After Signal receives such notice and a reasonable opportunity to cure
WCDHS may withhold payment of Signal until the necessary services or corrections
in performance are satisfactorily completed; and
2. Deny payment or recover reimbursement for those services or deliverables, which
have not been performed and which due to circumstances caused by Signal
cannot be performed or if performed would be of no value to the Human Services.
Denial of the amount of payment shall be reasonably related to the amount of work
or deliverables lost to Human Services; and
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SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2017/2018
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3. Incorrect payment to Signal due to omission, error, fraud, and/or defalcation shall be
recovered from Signal by deduction from subsequent payments under this
Agreement or other agreements between Human Services and Signal, or by Human
Services as a debt due to Human Services or otherwise as provided by law.
C. Signal may appeal the decision of the Director of Human Services or designee, as
provided in Item XII, B, of the Agreement, by submitting, within thirty (30) calendar
days of the Director's action, and basis of such appeal to the Board of County
Commissioners.
XIII. NON-DISCRIMINATION
It is the policy of Signal to provide equal opportunity without discrimination based on race,
color, sex, religion, age, sexual orientation, national origin, veteran status, or individual
handicap in any aspect of employment, training or services offered. All Signal programs,
activities, and services are administered on a non-discriminatory basis subject to the
provisions of:
Title VI and VII of the Civil Rights Act of 1964
Executive Order 11246, as amended
Title VII and VIII of the Public Health Services Act
Rehabilitation Act of 1973 (Section 503 and 504)
Equal Pay Act of 1963, as amended
Title IX of the Education Amendments of 1972
Vietnam Era Veteran's Readjustment Assistance Act of 1974
Age Discrimination in Employment Act of 1967
Age Discrimination Act of 1975
Non -Discrimination Laws of the State of Colorado.
XIV. ACCESS TO RECORDS
Signal, its Providers and WCDHS agree to make available in a timely manner, all books,
documents, and records pertinent to this contract for the purpose of billing for services,
audit, and compliance with requirements and regulations of federal and state agencies
and commercial insurance carriers.
Signal acknowledges that in reviewing, storing, processing, or otherwise dealing with any
client records dealing with any client seen by a Signal provider or the on -site substance
abuse counselor is bound by the confidentiality provisions of 42 CFR Part 2. If necessary,
Signal shall resist in judicial proceedings any efforts to obtain access to client records
except as permitted by 42 CFR Part 2. WCDHS and Signal shall sign a Qualified Service
Organization Agreement in compliance with 42 CFR, Part 2.
XV. OBLIGATIONS
Obligations of WCDHS and Signal are contingent upon funds for that purpose being
appropriated, budgeted and otherwise made available.
XVI. PROVISIONS
This Agreement may be amended only by written agreement signed by each of the parties
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WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2017/2018
CHILD WELFARE CLIENTS
hereto. This Agreement shall be binding upon, and shall inure to the benefit of the
respective parties hereto and shall not be assigned without the consent of all parties
hereto.
XVII. NOTICES:
Any notice required to be given pursuant to the terms and provisions hereof shall be in
writing and shall be sent by certified mail, return receipt requested;
To Signal at:
Daniel Darting
CEO
Signal Behavioral Health Network
6130 Greenwood Plaza Blvd., Suite 150
Greenwood Village, CO 80111
To WCDHS at:
Judy A. Griego
Director
Weld County Department of Human Services
P.O. Box A
Greeley, CO 80632
XVIII. LITIGATION
Signal shall promptly notify Human Services in the event that Signal learns of any actual
litigation in which it is a party defendant in a case that involves services provided under
this Agreement. Signal, 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 Human Services
Director. The term litigation" includes an assignment for the benefit of creditors, and
filings in bankruptcy, reorganization and/or foreclosure.
XIX. TERMINATION
This Agreement may be terminated at any time by either party given thirty (30) days written
notice and is subject to the availability of funding, subject to the provisions of Item XI and
Item XIX. Signal reserves the right to suspend services to clients if funding is no longer
available. Human Services acknowledges financial responsibility for clients authorized under
the terms of the Agreement.
XX. DISPUTE RESOLUTION
It is the desire of all parties to resolve conflicts at the Signal/County level through
cooperation. Internally, the County Directors and the Signal provider shall attempt to
resolve all conflicts and disputes. If the issue cannot be resolved, either party may request
that Signal intervene and mediate the situation. If the county, Signal and the provider are
unable to resolve the dispute, the State may be requested by any party to intervene (OHS
Child Welfare and ADAD). Any further unresolved issues may be submitted to the Director
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CHILD WELFARE CLIENTS
of the Office of Health and Rehabilitation Services or their designee(s) for case
presentation and review.
Should the above efforts fail, Signal, its provider(s) and WCDHS hereby agree to submit
all unresolved controversies, claims, and disputes arising out of this Agreement to
mediation in Denver, Colorado, according to the commercial rules and practices of the
American Arbitration Association then in force, or pursuant to other rules or procedures
as to which the parties may agree. Regardless of the outcome, each party agrees to fund
their own litigation expenses.
This Agreement shall be governed by and construed in accordance with the laws of the
State of Colorado.
XXI. MISCELLANEOUS PROVISIONS
A. Headings. The headings of the sections and subsections of this Agreement
are inserted solely for ease of reference and shall not in any way affect the
meaning or interpretation of this Agreement.
B. Non -Assignment. None of the parties shall have the right to assign the benefits
or delegate the obligations in this Agreement without prior written consent of the
other parties. Subject to the foregoing, this Agreement shall be binding upon and
inure to the benefit of the parties and their respective heirs, successors, legal or
personal representatives and permitted assigns.
C. Waiver of Breach. The waiver of any party of a breach or violation of any
provision of this Agreement shall not operate as, or be construed to be, a waiver
of any subsequent breach of the same or any other provision thereof.
D. Gender and Number. Whenever the context of this Agreement requires, the
gender of all words shall include the masculine, feminine and neuter, and the
number of all words shall include singular and plural.
E. Severability. If any provision of this Agreement is held to be unenforceable for
any reason, the unenforceability thereof shall not affect the remainder of this
Agreement, which shall remain in full force and effect and be enforceable in
accordance with its terms.
F. Counterparts. This Agreement may be executed in duplicate originals, each of
which shall be an original instrument but both of which taken together shall
constitute one and the same instrument.
G. Entire Agreement. This Agreement constitutes the entire understanding and
agreement between the parties with respect to its subject matter and supersedes
all prior agreements or understandings, whether written or unwritten, with respect
to the same subject matter.
H. Non -Exclusivity. Participation in this Agreement shall be non-exclusive in
nature and either party may enter into other Agreements other than through Signal
or WCDHS. The only restriction is on the amount of funding included in this
Agreement. Either party may not enter into other Agreements that may dilute the
funding base in this Agreement.
I. Hold Harmless. To the extent authorized by law each party agrees to
defend, hold harmless, and indemnify the other party and its affiliates, directors,
trustees, officers, and employees from and against all claims, demands, suits,
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judgments, expenses, and costs of any and all kinds arising as a result of damages
or injuries arising out of, or incident to, the performance or failure of performance
of this Agreement by such indemnifying party or its agents of its duties, obligations,
or rights hereunder.
J. Negligence/Malpractice. In the event that negligence or malpractice of Signal or
an employee of Signal shall subject County to potential or actual liability, Signal
shall hold the Weld County Department of Human Services harmless from all
monetary loss resulting from such liability. This obligation to hold harmless shall,
in addition to any other obligations commonly associated with it, would obligate
Signal to pay all reasonable attorney fees, costs, expenses, and damages incurred
as a result of such liability. Signal acknowledges that the Weld County Department
of Human Services is a department of Weld County and, thus, to the extent
authorized by law, Signal agrees to indemnify, save, and hold harmless the Board
of County Commissioners of Weld County, or Weld County, or both, against any
and all claims, damages, liability, and the like as above set forth.
The indemnities and assumptions of liabilities and obligations herein provided for
shall continue in full force and effect notwithstanding the expiration or termination
of this Agreement.
K. 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
actions 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.
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WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2017/2018
CHILD WELFARE CLIENTS
APPROVED BY
Daniel Darting, Chief ExecuOfficer
SIGNAL BEHAVIORAL HEALTH NETWORK
Steve Moreno, Chair Pro-Tem
WELD COIJN rr BOARD OF COUNTY COMMISSIONERS
JyA. G
LD CO
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NT OF HUMAN SERVICES
JUL 2 6 2017
Date
JUL 262017
Date
°Z° ,259O"
SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2017/2018
CHILD WELFARE CLIENTS
EXHIBIT A
This Memorandum of Understanding (MOU) shall act as an attachment to the contract between
Signal Behavioral Health Network (Signal) and Weld County Department of Human Services
(WCDHS). The term of the contract and this MOU is from June 1, 2017 to June 30, 2018, unless
terminated otherwise.
Compensation
WCDHS agrees to contract with Signal for a maximum of $300,000 from their Core Service
Funding.
Signal agrees to contribute a maximum of $150,000 annually from designated OBH Additional
Family Service (AFS) funds to serve eligible clients in accordance with the terms herein.
Signal's administration fee shall be calculated as five percent of the service fees, salaries, and
other authorized costs that are actually incurred in the delivery of treatment services.
Signal's administration fee shall obligate Signal to perform, or deliver, the responsibilities,
services, and reports specifically mentioned in this agreement. Other requested services or
reports may be considered outside the scope of this agreement and, therefore, subject to an
additional fee.
Payment
A. Responsibilities
1 Signal shall submit an itemized monthly bill to Human Services for all costs
incurred and services provided in accordance with criteria established by
Human Services and Signal. Requests to modify criteria must be provided with
30 days advance notice. Signal shall submit all itemized monthly billings to
Human Services no later than the 3rd Wednesday of the month following the
current month plus the previous 60 days for the month the cost was incurred
in accordance with the Trails payroll calendar.
2. Signal shall make available, on its web site, monthly billing reports in
accordance with the billing criteria established by Human Services no later
than the 3n° Wednesday of the month following the month of service. Monthly
client progress reports must be made available to the Core Services
Caseworker, in the format provided by the Department (see attached Exhibit
B). In the alternative, the information contained on Exhibit B will be available
to the Core Services Caseworker for download from the Signal database by
the 3rd Wednesday of the month following the date of service. Arapahoe House,
North Range Behavioral Health and Larimer Center for Mental Health will be
required by Signal to input the monthly progress information into the Signal
database prior to their ability to bill service charges for that client. Any
incomplete progress report will be deemed incomplete and all such associated
services will be pended.
3. Failure to submit monthly billings and/or monthly client reports in accordance
with the terms of this agreement may result in Signal's forfeiture of all rights to
be reimbursed for such expenses. In the event of a forfeiture of
12 of 33
SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2017/2018
CHILD WELFARE CLIENTS
reimbursement, Signal may appeal such circumstance to the Director of
Human Services, after all remedies described in Item XII, A of the Agreement
are exhausted. The Director of Human Services shall render a decision. The
decision of the Director of Human Services may be appealed to the Board of
County Commissioners according to the provisions of Item XII of the
Agreement.
4. Payments of costs incurred pursuant to this Agreement are expressly
contingent upon the availability of Colorado Core Services substance abuse
treatment funding to Human Services. WCDHS shall be liable for all services
authorized and provided up to the date of receipt by Signal of revocation of
such authorization.
5. Human Services shall not be billed for, and reimbursement shall not be made
for, time involved in activities outside of those defined in Exhibit D, "Scope of
Services" and Exhibit A, "Weld County 13/14 AFS and Core Fee Schedule."
Work performed prior to the execution of this Contract shall not be reimbursed
or considered part of this Agreement.
6. Signal shall provide training and technical support, as necessary and as
resources allow, for Human Services staff in accessing Signal's data and billing
reports and on the use of the child welfare referral system.
B. Unless otherwise provided in the Scope of Services and Payment Schedule:
1 Signal shall provide proper monthly invoices, make available monthly progress
reports for each client incurring charges, and verification of services performed
for costs incurred in the performance of the agreement.
2. Human Services may withhold any payment if Signal has failed to comply
materially with the Financial Management Requirements, program objectives,
contractual terms, or reporting requirements. In the event of a withhold of
reimbursements, Signal may appeal such circumstance to the Director of
Human Services, after all remedies described in Item XII, A of the Agreement
are exhausted. The Director of Human Services shall render a decision. The
decision of the Director of Human Services may be appealed to the Board of
County Commissioners according to the provisions of Item XII of the
Agreement.
3. WCDHS will complete the Signal remittance advice and return to Signal within
5 business days of completion of each month's TRAILS payroll date. Each
remittance advice shall detail reasons for denial of any and all services.
WCDHS shall work with Signal and other counties to develop standard claims
denial criteria. WCDHS shall reimburse Signal for all complete services
invoiced within 45 calendar days from the date of receipt of Signal's invoice.
4. WCDHS shall identify the individuals Signal should communicate with for
clinical, data and billing needs.
13 of 33
SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2017/2018
CHILD WELFARE CLIENTS
AFS and Core Services Reimbursement
Funding Sources
AFS
Core
Total
On -Site Salaries and Benefits
-
-
-
Supplies, Supervision and Travel
-
-
-
Subtotal-Onsite Costs
-
-
-
Admin Fee
-
-
-
Total Onsite Costs
-
-
-
Fee -for -service funding
142,857
285,714
428,571
Signal Fee
7,143
14,286
21,429
Total fee -for -service
150,000
300,000
450,000
Total Contract Costs
150,000
300,000
450,000
Fee -For -Service Reimbursement
County Core Services and Signal AFS funding will be responsible for purchasing services in
accordance with the schedule below (to a maximum funding specified in the contract language).
Rate
Schedule
FY17-18
Service
Code
Service Code Description
80101 AC UA - 5 panel w/auto confirmation
81002 UA - Multi -panel Instant
82055 Oral Swab Instant
L82075 Breathalyzer
14 of 33
Units Meas. Payer Rate
each
each
15.75
12.60
each
15.75
each 5.25
SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2017/2018
CHILD WELFARE CLIENTS
82541 UA - GC/MS - Qualitative
82542
94664
UA - GC/MS - Quantitative
each
each
36.75
36.75
Hair Testing
each
105.00
Vapor Inhalations Evaluation
each
63.00
99075 Medical Testimony (Inc. travel, wait & prep time)
99199 Court Case Consultation
80100:HF
80101:AO
80101:CF
UA - Ethyl Glucuronide (EtG)
UA - Optional Add-on Panel (Oxycodone or
Buprehorphine)
UA - 7 Panel w/Auto-confirmation
UA - Single Panel EtG Add-on Test
82055:OF Oral Fluid - 6 Drug Panel
82055:OS Oral Swab - Synthetic Cannabinoids (Spice)
each
each
per 15 min.
per 15 min.
session(s)
18.38
7.88
each 31.50
2.10
21.00
each 2.10
82055:SC UA - Synthetic Cannabinoids (Spice) each
83000:81 I MDPV, Mephedrone, & Methylone - 3 panel
83000:80 Expanded Designer Stimulants - 14 panel
H0001:HH
H
Evaluation: Ill
H0001:II Evaluation: II
H0004 Individual Counseling
H0005
Group Counseling
each
each
each
each
17.85
36.75
36.75
36.75 j
52.50
262.50
r - {
151.20
per 15 min.
hour(s)
18.38
26.29
H0005:HR j Group counseling: Family/couple with client present per 15 min.
H0005:HS < Group counseling: Family/couple without client present
H0006
Case Management
H0011 ; Detox
per 15 min.
each
15 of 33
283.50
day(s)
6.56',
6.56
SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2017/2018
CHILD WELFARE CLIENTS
H0018:HA Intensive Short -Term Residential:Adolescent
H0018_HB Intensive Short -Term Residential:Adult
H0019
Transitional Long -Term Residential
H0019:HD ! Transitional Long -Term Residential:Preg/Parent (NDF)
H0020 Opioid Replacement (Methadone)
H0038:CG Peer Services Recovery Groups
H0048:HF Drug Patch Monitoring
H2012:
HB ! Day Treatment:Adult
H2012:HA Day Treatment:Adolescent
days)
day(s)
} day(s)
day(s)
{ month(s)
per 15 min.
each
s -
hour(s)
hour(s)
239.40
178.50
138.60
183.75
435.75
6.56
52.50
7.25
10.36
H0019:HA Therapeutic Behavioral Srvcs:Adolescent
day(s)
131.25
H0019:HB
H0019:HD
H2033:F
H2033:M
H3000:
HL
H3000: LL
Therapeutic Behavioral Srvcs:Adult w/o Infant
Therapeutic Behavioral Srvc:Preg/Parent
Functional Family Therapy (FFT)
Multisystemic Therapy (MST)
In -home Addictions Treatment: High Level
In -home Addictions Treatment: Low Level
T1006 Family Counseling
day(s) 61.95
day(s)
day(s)
day(s)
104.48
21.00
60.38
day(s) 56.00
day(s)
hour(s)
The County and Signal acknowledge that all UA services MUST be physically monitored/observed
by an individual in order for payment to be considered.
The County and Signal further acknowledge that any and all monitoring beyond standard
urinalysis or breathalyzer tests must be approved by the County prior to administration.
Signal, in accordance with Federal HIPAA regulations, adopted a standard transaction code set
for all treatment services on October 16, 2003, which are subject to change throughout each
contract year. Even though this compliance changed the service labels and groupings (shown
above), the net amount of the fees associated with those services has not changed.
16 of 33
28.00
88.20
SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2017/2018
CHILD WELFARE CLIENTS
The following services are available exclusively through AFS funds and must be purchased in
conjunction with the residential treatment services described in the fee -for -service schedule
above:
Service
Code
Service Code Description
Units Measured
Payer Rate
S9976:HA
Room & Board: Adolescent: ARTS
Daily
Daily
40.43 I
S9976:HA
Room & Board: Adolescent: Arapahoe House
38.12
36.75
S9976:HA
Room & Board: Adolescent: North Range Beh. Health
Daily
59976:HB
Room & Board: Adult: ARTS
Daily
17.72
S9976:148
Room & Board: Adult: Arapahoe House
Daily
47.49-
59976:149
Room & Board: Adult: Crossroads
! Daily
42.00 I
59976:HB
Room & Board: Adult: North Range Beh. Health
Daily
31.50I
S9976:HB
Room & Board: Adult: RESADA
i Daily
18.90 I
59976:H8
Room & Board: Adult: Sobriety House
Daily
23.10
S9976:H9
Room & Board: Adult: Stout Street
Daily
30.00 I
S9976140
Room & Board: Preg/Parent: ARTS
Daily
17.72
S9976:HD
Room & Board: Preg/Parent: Arapahoe House
Daily
52.68
S9976:HD
Room & Board: Preg/Parent: Crossroads
Daily
52.50
18.90
S9976:HD
Room & Board: Preg/Parent: RESADA
Daily
17 of 33
SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2017/2018
CHILD WELFARE CLIENTS
APPROVED BY:
Daniel Darting, Chief Executi Officer
SIGNAL BEHAVIORAL HFAI TH NETWORK
Steve Moreno, Chair Pro-Tem
WELD COUNTY BOARD OF COUNTY COMMISSIONERS
W
A. Gringo, Direct r
D COUNTY DEPARTMENT OF HUMAN SERVICES
18 of 33
Ci/Ite
Dat
'JUL 262017
Date
JUL 26 351
Date
o?o / 7- a.5'97
SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2017/2018
CHILD WELFARE CLIENTS
EXHIBIT B - CORE Monthly Remittance Advice for Signal:
Instructions: Please remit this report to Signal each month with your Trails Remittance Payroll Report.
Mail to: Signal Behavioral Health Network
Attn: Tiffany Scroggins
6130 Greenwood Plaza Blvd. Suite 150
Greenwood Village, CO 80111
County Name:
Date of Invoice:
Fund Type (i.e.
AFS or Core)
Original Amount
of Invoice:
**If you are submitting payments from prior month's bills
with the current month's payment, please enter "$0.00"
for the "Amount Billed" and then the amount paid in the
"Amount Paid" column.
Denied/Additional Services Report*":
Sponsor Name
Client
Name
I.D
} . #
Dates of
Service
! Service
' Type
Amount Billed
Amount
Paid
Reason
Denied:
{
I
Totals:
Total Amount Denied
Services:
Total Amount of
County Remittance:
Have Questions? Signal Tiffany Scroggins, Ph. 720-263-4860
Contacts: Email: tcroggins@signalbhn.org
19 of 33
(this
amount
should
equal the
amount
of the
county's
EFT)
SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2017/2018
CHILD WELFARE CLIENTS
EXHIBIT C
SIGNAL BEHAVIORAL HEALTH NETWORK
QUALIFIED SERVICE ORGANIZATION AGREEMENT
Signal Behavioral Health Network (MSO) and Weld County (County or Counties) Department of
Human Services hereby enter into a Qualified Service Organization Agreement whereby the MSO
agrees to accept and serve Counties' clients substance abuse treatment needs. In light of the
relationship between County and the MSO, County requires client identifying information and data
and information related to the services furnished to the clients. County and MSO will have this
relationship from June 1, 2017 - June 30, 2018, thus the QSOA will be in effect during this period.
Furthermore, the County:
1. acknowledges that in receiving, storing, processing, or otherwise dealing with any
information from the MSO about the clients in the MSO's program, it is fully bound by the
provisions of the federal regulations governing Confidentiality of Alcohol and Drug Abuse Patient
Records, 42 CFR Part 2; and
2. undertakes to resist in judicial proceedings any effort to obtain access to information
pertaining to clients otherwise than as expressly provided for in the federal confidentiality
regulations, 42 CFR Part 2.
4.
Executed th•is OZr� day of
Daniel Darting
Chief Executive Officer
Signal Behavioral Health Network
20 of 33
, 2017.
dy A. C riego
rector
eld County Department of Human
Services
oho /% O2?•"-
SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2017/2018
CHILD WELFARE CLIENTS
EXHIBIT D
SCOPE OF SERVICES
Turning Point
Substance Abuse Treatment
Scope of Services for State Fiscal Year 2017-2018
The In -Home Addictions Treatment Program (IHAT) is an intensive in -home therapy program
designed to serve at -risk families that have come to the attention of the Department due to
drug/alcohol concerns. Clients referred to the IHAT program typically have a mental health
and/or substance abuse disorder, and are continuing to struggle despite having been treated at
lower levels of care such as outpatient therapy. Families served in the program often have a
history that may include inpatient substance abuse treatment, trauma, criminal and/or
delinquent behaviors, verbal or physical aggression, or attachment difficulties.
Features of the program include:
• Intensive short-term treatment, averaging 4 to 5 months in duration
• Two sessions per week in -home (or 1 session and phone consultation, dependent on
client need)
• Availability of on —call services 24 hours a day 7 days a week
• Case consultation with collaterals such as treatment providers (SA and MH), school
personnel, probation, DHS, etc.
• Therapist flexibility in terms of drawing from a variety of evidence -informed treatment
models including: Seeking Safety, Dialectical Behavioral Therapy, Trauma Informed
Cognitive Behavioral Therapy, Cognitive Behavioral Therapy, Solution Focused
Therapy, and behavior management techniques
• Drug testing of clients as therapeutically necessary
• Therapist flexibility in terms of modality of treatment used (parents -only sessions, family
therapy, occasional individual therapy, or some of each)
• Focus of treatment that is highly parent/family oriented and interventions designed to be
sustainablefor the family
• Support in linking to other therapeutic services as appropriate including coaching,
medication evaluation and management, substance abuse treatment, DBT
programming, trauma focused services, etc.
• Integrating social supports into family treatment planning. Establishing positive daily life
routines. Develop family stable patterns: Rules, Roes, Rituals, Routines, Relationships
(Barnes, 1995)
• Additional interventions for parents of delinquent adolescents around
monitoring/supervision, holding youth accountable for behavior and choices, and
therapists will collaborate closely with the juvenile justice system.
Rate of Payment (to Turning Point) and Service Description:
High -end Service 4-6 hours a week of Therapist intervention $1600/month per family OR
2-3 hours a week of Case Manager $53.33/day per family
Low -end Service 2-3 hours a week of Therapist Intervention $800/rrionth per family OR
1-2 hours a week of Case Manager $26.67/day per family
21 of 33
SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2017/2018
CHILD WELFARE CLIENTS
A. ASSESSMENTS
1. Alcohol and Drug Differential Assessment (3 -Hours)
Assessment will evaluate alcohol/drug involvement as well as mental health status,
history of mental health issues, sexual history, legal history, and certain standard
tests (ASAP, ASAM PPC-2, ASI, SOCRATE, AODUI, Drinking History
Questionnaire, Family Environment Scale) may be given. Signal will provide two
collateral contacts as part of the Assessment.
2. Co -Occurring Alcohol and Drug with Domestic Violence Assessment (3 -Hours)
Summary of assessment with recommendations sent to referring agency. The
following areas will be assessed:
Criminal History
Profile of Client's Violent
Behaviors
Mental Health Status
Substance Abuse History
Millon Test, if needed
Potential for Violence
Client's Medical History
Suicidal/Psychological/Cultural
History
3. Substance Abuse Forensic Evaluation (3 hours, as staff expertise permits)
A forensic evaluation is specifically geared toward the substance -abusing offender.
It involves additional testing to determine the crimogenic aspect of the person to be
taken into consideration when developing treatment recommendations. Testing will
be comprised of CVI, ASUS, SASSI, Millon Clinical Multiaxial Inventory (MCMI-III),
a clinical interview, and a behavioral profile. The testing is cross-referenced with the
clinical interview, and in relation to collateral data.
4. Evaluation: II - Level II Assessment
A Level II Assessment is the initial diagnostic interview enrolling a client in
services. It is conducted by a Master's Level Therapist (OR AT THE MINIMUM A
CAC II OR III). A Level II is typically completed in 1-1.5 hours.
Areas addressed:
Referral information and Chief Complaint / Precipitating Event(s)
Presenting Problem
Psychosocial History
Legal History
Abuse and/or Victimization History
Strengths, Resources and Needs
Prior Treatment History
Drug and Alcohol History and Assessment
Medical History
Mental Status
DSM Diagnosis and Rationale
22 of 33
SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2017/2018
CHILD WELFARE CLIENTS
Risk Assessment
Level of Care Assessment
Disposition and Recommendations for treatment
5. Evaluation: III - Level III Assessment
In addition to all areas identified in the Level II assessment, a Level III may include
the use of assessment tools and/or include extensive history review and collateral
input as appropriate. A Level III Assessment is always completed by a dually
trained and credentialed (license and certification) Behavioral Health Therapist so
that, if necessary he or she can act as an expert witness. A Level III is typically
completed over the course of 2-3 hours. All Co -Occurring Alcohol or Drug with
Domestic Violence or Anger Management assessments will be billed at the
Evaluation: Ill rate.
The primary difference between a level II and level III assessment is the amount of time involved
(2-3 hours for a level III versus 1-2 hours for a level II). A level III assessment requires more time
and is more in-depth than a level II assessment. A level III assessment also includes more lengthy
documentation, typically will involve more collateral contacts, and is suitable for court
purposes. Both assessments assess substance abuse and mental health
issues/concerns. However, we do not dictate which tools are used for each level of
assessment. As indicated in the contract, a level III assessment is always conducted by a duly
trained and certified/licensed individual who can act as an expert witness if necessary.
Level III assessments are typically requested by outside agencies for the purposes of obtaining
clear information on treatment recommendations and prognoses (e.g., likelihood of continued
risky behaviors). Collateral information/contacts are required (not just typical) in order to better
understand the reason for the referring parties request for an evaluation, and a more formal written
report is provided (e.g., no abbreviations or jargon, more comprehensive psychosocial history) so
the referral source better understands the issues, and treatment recommendations and
prognoses (e.g., likelihood of continued risky behaviors) are more formally addressed, as they
pertain to the reason for the referral. Formal psychological testing is not administered for a Level
III assessment.
B. TREATMENT OPTIONS
1. Co -Occurring Alcohol and Drug with Domestic Violence Group Therapy (average
length of treatment, 24 to 36 weeks): Groups for both men and women are offered.
The group addresses anger management, healthy relationships, male and female
roles, and boundaries. As needed, a Milton Test may be given, a standardized
psychological test which measures functioning level in 22 personality disorders
and clinical syndromes for adults (8th grade reading level: > 18; available in
Spanish).
2. Family Therapy (average length of treatment, 8 to 16 sessions): Involves two
or more family members and provides therapeutic intervention to improve family
23 of 33
SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2017/2018
CHILD WELFARE CLIENTS
communications, functioning, and relationships. Length of participation is
dependent on client goals and progress toward meeting goals.
3. Individual Counseling (average length of treatment, 6 to 12 sessions):
Primary client is seen on an individual basis. Length of participation is dependent
on client goals and progress toward goals.
4 Substance Abuse Therapy (average length of treatment, 12 to 20 sessions):
A group to enhance positive coping skills by focusing on their lifestyle dealing with
use and abuse of chemicals.
5. Adult Intensive Outpatient (average length of treatment, 4 to 12 weeks): An
intensive outpatient group therapy track that offers groups every evening, Monday
through Friday, with a family program component. This program will include
medical aspects of addiction and adult relapse education components focusing on
understanding the relapse process as well as group process (focuses on individual
issues relating to their abuse of alcohol). The program length and participation
level will be individualized based on the presenting issues and other factors.
6. Women's Group (average length of treatment, 12-20 sessions): A gender -
specific group addressing issues affecting women and their relationships, such as
family violence, co-dependency, self-esteem and stress management.
7. Motivational Enhancement Therapy and Cognitive Behavioral Therapy for
Adolescent Cannabis Users (MET/CBT5 average length of treatment 5-8
weeks): The MET/CBT5 is a brief treatment approach for cannabis abusing
adolescents. Treatment consists of two individual motivational enhancement
therapy sessions (MET) Sessions, followed by participation in three group
cognitive behavioral therapy (CBT) sessions. The assessment includes a
psychosocial history and data from the Global Assessment of Individual Needs
(GAIN), and a personalized feedback report.
8. Adolescent Intensive Outpatient (length of treatment - 3 to 12 weeks): This
intensive outpatient track offers therapy and education groups utilizing the Matrix
Model for Youth and Young adults curriculum. Groups are offered Monday
through Friday. This program also provides individual and family therapy as well
as family group therapy. Topics addressed include the medical aspects of
addiction and relapse -prevention education focusing on understanding the
relapse process. The program length and participation level will be individualized
based on the presenting issues and other factors.
C. SPECIAL PROGRAM OPTION
Special Connections (through pregnancy and up to one year postpartum): A
gender -specific program that focuses on healthy babies, appropriate child care,
prenatal care, birth control, developmental stages of the baby, parenting skills,
relationship issues, and other issues as identified by the counselor. Services
include group and individual therapy, case management and family health
education.
24 of 33
SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2017/2018
CHILD WELFARE CLIENTS
D. MISCELLANEOUS SERVICE OPTIONS
1. Extended Detoxify Stay: This is an option when case management goals require
that the person be in a stable environment until they can be referred to the next
level of care.
2. Enhanced Services: Enhanced services as approved services that are
requested by Human Services for specific cases, which fall outside of the
definitions, listed above in the description of the DBH menu of services. Enhanced
services may be services not described on the menu, services not included in the
definition or due to lack of economy of scale, or rural location, or result in additional
costs to Signal. In order for Signal to provide enhanced service, the cost would be
outside of the approved rates. Any additional fees would be negotiated on a case -
by -case basis.
Signal can arrange for services outside of the approved definitions, but Human
Services will be charged an additional fee that would be negotiated on a case -by -
case basis by the designated representative listed in the contract.
E. MEASURABLE OUTCOMES AND OBJECTIVES
Signal shall abide by Human Services outcome indicators of Safety, Permanency and
Child and Family Well -Being, which are provided under Adoption and Safe Families Act
(ASFA), 1997; Colorado Child and Family Services Plan 2000 -2004; and ACF Reviews
(Reference: Federal Register, Volume 65, Number 16: 45 CRF Parts 1355, 1356, and
1357), March 25, 2000.
1. Outcome Reports as Prescribed by Human Services
2. Outcome reports will be developed and provided as mutually agreed upon
by the parties.
3. Client Objectives
The Human Services caseworker will identify a maximum of three child welfare
objectives to be addressed within each client's treatment plan. Signal shall
develop action steps to reach the identified child welfare objectives. Signal shall
report monthly on each client's progress in meeting the three identified objectives
while the client is receiving treatment services
4. Overall Program Objectives
Signal and Human Services agree to monitor the ability of the substance abuse
program offered by Signal to achieve objectives as follows:
a. Demonstrate Abstinence with the use of UA/Patch Monitoring Only.
b. Improve parental capabilities currently impaired by substance abuse.
c. Develop the capacity to ask for help and assistance without resorting back
to substance abuse
d. Develop or increase the ability to recognize, prioritize and meet child(ren)'s
needs
25 of 33
SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2017/2018
CHILD WELFARE CLIENTS
e. Parent will identify how their substance use has affected their parenting
f. Parent will identify how their substance use got them involved with Human
Services
g. Parent will identify how their substance use helped them parent
h. Parent will identify relapse triggers and develop a safety plan for their
children
Parent will identify whom they consider to be a support in their recovery
j. Parent will identify who will care for their children should they relapse
k. Parent will identify what they enjoy about parenting sober
Improve parent -child functioning to lower the risk of out of home placement
m. Parent will support their children in speaking about how living in a
substance -effected family has impacted them
n. Parents will demonstrate increased verbal skills, empathy and
accountability with child(ren)
o. Parent will identify their parenting strengths
p. Family members including significant other, children and extended family
will increase ability to communicate more effectively
q. Family members will identify how they can support the identified client in
their recovery
r. Family members will identify the positive parenting changes the substance -
effected person is making
s. Family members will identify who will care for the children in the event of a
relapse
t. Family members will identify relapse systems of the identified client
u. Family members will identify how they can reach out for help if a relapse
occurs
v. Increase level of functioning currently impaired by living in a substance
affected family
w. Identify how living in substance affected family has impacted their life
x. Improve level of functioning currently impaired by substance abuse issues
y. Decrease aggressive behaviors at home and/or school and in the
community
z. Learn how to socialize without the use of substances
aa. Identify relapse triggers
bb. Create a sober support network
F. STAFF QUALIFICATIONS
Signal staff members who will provide services to Human Services clients will have
credentials and/or certifications as required by the Colorado Department of Human
Services, Colorado Board of Education, Division of Behavioral Health, and the Colorado
Board of Medical Examiners.
26 of 33
SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2017/2018
CHILD WELFARE CLIENTS
EXHIBIT E
1 Signal agrees it is an independent contractor and that its officers and employees do not
become employees of Weld County, nor are they entitled to any employee benefits as
Weld County employees, as the result of the execution of this Agreement.
2. 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 Signal or its employees, volunteers, or agents while performing duties as
described in this Agreement. Signal shall indemnify, defend, and hold harmless Weld
County, the Board of County Commissioners of Weld County, its employees, volunteers,
and agents. Signal shall provide adequate liability and worker's compensation insurance
for all its employees, volunteers, and agents engaged in the performance of the
Agreement upon request, Signal shall provide Human Services with the acceptable
evidence that such coverage is in effect.
3. No portion of this Contract shall be deemed to constitute a waiver of any immunities the
parties or their officers or employees may possess, not shall any portion of this Agreement
be deemed to have created a duty of care with respect to any persons not a party of this
Agreement.
4. No portion of this Contract 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.
5. If any section, subsections, paragraph, sentence, clause, or phrase of this Contract 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 Contract 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.
6. 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.
7. Signal assures that they will comply with the Title VI of the Civil Rights Act of 1986 and
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 this approved Contract.
8. Signal assures that sufficient, auditable, and otherwise adequate records that will provide
accurate, current, separate, and complete disclosure of the status of the funds received
under the Contract are maintained for three (3) years or the completion and resolution of
an audit. Such records shall be sufficient to allow authorized local, Federal, and State
auditors, and representatives to audit and monitor Signal.
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WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2017/2018
CHILD WELFARE CLIENTS
9 All such records, documents, communications, and other materials shall be the property
of Human Services and shall be maintained by Signal, in a central location and custodian,
in behalf of Human Services, for a period of four (4) years from the date of final payment
under this Contract, 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 four (4) year period, or if audit findings have not
been resolved after a four (4) year period, the materials shall be retained until the
resolution of the audit finding.
10. Signal assures that authorized local, federal, and state auditors and representatives shall,
during business hours, have access to inspect any copy records, and shall be allowed to
monitor and review through on -site visits, all contract activities, supported with funds under
this Contract 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.
11. This Contract shall be binding upon the parties hereto, their successors, heirs, legal
representatives, and assigns. Signal or Human Services may not assign any of its rights
nor obligations hereunder without the prior written consent of both parties.
12. Signal certifies that federal appropriated funds have not been paid or will be paid, by or on
behalf of Signal, 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 any Federal contract, loan, grant, or cooperative agreement.
13. Signal assures that it will fully comply with all other applicable federal and state laws.
Signal understands that the source of funds to be used under this Contract is: Colorado
Core Services substance abuse treatment funds.
14, Signal assures and certifies that it and its principals:
A. Are not presently debarred, suspended, proposed for debarment, declared
ineligible, or voluntarily excluded from covered transaction by a federal department
of agency.
B. Have not, within a three-year period of preceding this Agreement, been convicted
of, or had a civil judgment rendered against them for commission of fraud or a
criminal offense in connection with obtaining, attempting to obtain, or performing a
public (federal, state, or local) transaction or contract under a public transaction;
violation of federal or state antitrust statutes or commission of embezzlement, theft,
forgery, bribery, falsification or destruction of records, making false statements, or
receiving stolen property;
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WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2017/2018
CHILD WELFARE CLIENTS
C. Are not presently indicted for or otherwise criminally or civilly charged by a
government entity (federal, state, or local) with commission of any of the offenses
enumerated in paragraph 11(b) of this certification; and
D. Have not within a three-year period preceding this Contract, had one or more
public transactions (federal, state, and local) terminated for cause or default.
15. The Appearance of Conflict of Interest applies to the relationship of Signal with Human
Services when Signal 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 Signal to gain from knowledge of these opposing interests. It is only
necessary that Signal know that the two relationships are in opposition. During the term
of the Contract, Signal shall not enter 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, Signal shall submit to Human Services, 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 Human Services' termination, for cause, of its contract with Signal.
16. Signal shall protect the confidentiality of all applicant records and other materials that are
maintained in accordance with this Contract. Except for purposes directly connected to
the administration of Child Protection, no information about or obtained from any
applicant/recipient in possession of Signal shall be disclosed in a form identifiable with the
applicant/recipient or a minor's parent or guardian unless in accordance with Signal written
policies governing access to, duplication and dissemination of, all such information. Signal
shall advise its employees, agents, and sub -providers of Signal, if any, that they are
subject to these confidentiality requirements. Signal shall provide its employees, agents,
and sub -providers of Signal, if any, with a copy or written explanation of these
confidentiality requirements before access to confidential data is permitted.
17. Proprietary information for the purposes of this contract 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 Contract. Any proprietary
information removed from the State's site by Signal in the course of providing services
under this Contract will be accorded at least the same precautions as are employed by
Signal for similar information in the course of its own business.
18. Signal certifies it will abide by Colorado Revised Statue (C.R.S.) 26-6-104, requiring
criminal background record checks for all employees, contractors, and sub -contractors.
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SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2017/2018
CHILD WELFARE CLIENTS
EXHIBIT F
Signal and Human Services agree to develop a case management plan (aka substance
abuse treatment plan) on each referred family within 30 days of the date the Signal
received the referral. The case management plan will be monitored and modified monthly
to measure progress toward goals. Copies of the case management plan must be sent to
the caseworker, program area supervisor, and Core and Service Contract Coordinator at
Weld County Department of Human Services, P. O. Box A, 315 B N 11 Avenue, Greeley,
Colorado 80632. The case management plan will include, at a minimum, goals, timelines,
and measurement of success.
2. Signal and Human Services agree to resolve level of care conflicts at the Signal/County
level through cooperation. Human Services and Signal shall attempt to resolve all levels
of care conflicts and disputes at the lowest level possible within each organization. Should
Human Services and/or Signal fail to agree upon the level of care offered by Signal, they
may appeal the case directly to the County Director, or designee, and the Signal Chief
Operating Officer. Both Signal and Human Services will have an opportunity to provide
consultation and documentation regarding the appeal. Appeals are to be resolved within
72 working hours, unless good cause justifies an extension.
3. Signal agrees that payments for levels of care are not authorized for reimbursement by
Human Services until a referral from Human Services is provided to Signal prior to services
rendered by Signal. Furthermore, Signal and its providers agree that any monitoring in
conjunction with treatment beyond standard urinalysis and breathalyzer tests, as well as
changes in level of care are not authorized for reimbursement by Human Services until
staffed with designated Human Services staff. Human Services agrees to identify
designated staff that may provide this authorization.
4. Signal agrees not to accept any referral from Human Services unless the referral contains
all information required on the form and necessary for reimbursement by Human Services
and authorized for reimbursement. If Signal accepts the referral without all data fields
required on the referral form or authorization, Signal may assume fiscal responsibility for
the services provided under the incomplete referral. Inaccurate information listed on the
referral form by Human Services will be excluded as a fiscal responsibility for Signal.
5. Signal agrees to provide access to all monthly client progress reports for clients with
treatment charges by the 3rd Wednesday after the month of service, via the Signal website.
The monthly progress report for each client must be entered into the Signal Service
Management website by the provider previous to the monthly billing claims in order for
payment to be honored. Failure to submit such monthly reports will result in delays or
forfeiture of payment. It is expected, at a minimum, that these reports will reflect all
information requested on the Monthly Progress Report
6. Signal agrees to submit a final discharge summary of client outcomes to Human Services
within thirty (30) calendar days after the completion date.
7. Signal agrees to report expenditures and case disbursement at agreed upon times.
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WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2017/2018
CHILD WELFARE CLIENTS
8. Signal agrees to assume fiscal responsibility for expenses incurred by Signal that do not
meet the requirements of Exhibit F of this Agreement. Those expenses incurred by Signal
outside of the scope of Exhibit F requirements are not eligible Human Services
expenditures and shall not be reimbursed by Human Services.
9. Signal agrees to the definition of a complete and timely billing form for purposes of
submitting an original bill under Exhibit F, 8. A complete and timely billing form must
include the following elements.
A. The billing must include all forms designed for Core Services reimbursement and
approved by Human Services; Core Services Authorization of Funds, Project Report,
Update Report, and original signed client verification forms for therapy and group
services. Additionally, Signal agrees to provide Human Services monitoring results
(UA, BA, patch, tox trap swab) by faxing said results to Human Services at 970.346-
7667 or via access to online system no later than 72 hours after the day of service.
B. The Department will determine billed services not eligible for payment by identifying
conflicts in the following:
1. Details provided in client referrals and renewals, including approved hours of
service, begin and end dates of service, client name, and Case ID.
2. Details in supporting documentation provided by the Provider and submitted
with the original bill, including, but not limited to, original signed client
verifications, receipt of monitoring results, time of service and units or hours
of service provided, and names of clients receiving the services, and monthly
progress reports with all the information specified on the Monthly Progress
Report.
3. Details provided in the current approved contract and Notification of Financial
Assistance, including, but not limited to unit of service, cost per unit of
service, and special conditions and/or revisions to said contract.
The above items, 9 C, 1, 2, and 3, will supersede all requests from Signal for review
of billing errors. Items submitted for billing will be processed according to the criteria
established by the above documentation.
The Department will make obvious corrections to minor errors in the bill in order to
expedite processing the claims for payment. Minor errors include missing or
transposed digits in Household Numbers, TRAILS Case ID, or other Department -
generated information.
D. An Administrative fee will be assessed to all fees reimbursed through County only
funding. Such fees include, but are not limited to, those service fees previously billed
and determined by the Department to be not eligible for payment.
10. Signal will develop and utilize evaluation tools (pre- and post -assessment test
instruments) to collect necessary data in cooperation with Human Services staff to monitor
effectiveness of program.
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SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2017/2018
CHILD WELFARE CLIENTS
11 Signal will meet with the Human Services designated supervisor quarterly and/or the Core
Services Coordinator (more if needed) to review program usage and effectiveness to
discuss necessary improvements to better serve families or increase referrals.
12. Signal will be available to meet with Human Services staff to explain program, time lines
of response to referrals and answer questions to enhance program.
13. Signal, or their authorized designee, will be available for the Families, Youth and Children
(FYC) Commission review and attendance at the FYC meetings.
14. Regarding all forms referenced herein in the Agreement, Signal shall replicate these forms
in format, content and according to the specifications of Human Services or as mutually
agreed upon by Signal and Human Services. Signal agrees to modify these treatment
authorization forms according to Human Services specifications and requirements.
15. Human Services will be responsible for electronically authorizing services to various
Signal providers and initially designating if Core funds shall be used for payment. Human
Services shall assure that the authorization will have all information required for
reimbursement from the county.
16. Human Services agrees to provide Signal with the name of a primary contact who will be
responsible for interacting with Signal's data system.
17. Human Services agrees to provide TRAILS Remittance Advice and a Signal Remittance
Summary (Exhibit B) to Signal within five (5) business days of the monthly TRAILS Core
Main Payroll date.
18. Human Services agrees to render payment for one full billing invoice at a time, as billed
monthly by Signal, and not to submit payment for a mixture of separate invoices within
one payment.
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SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF HUMAN SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT - FY 2017/2018
CHILD WELFARE CLIENTS
APPROVED BY:
Daniel Darting, CEO
SIGNAL BEHAVIORAL HEALTH NETWORK ['late
Steve Moreno, Chair Pro-Tem
WELD COUNTY BOARD OF COUNTY COMMISSIONERS
Jud . Grie4o, Directo
W COUNTY DEPA - THE OF HUMAN SERVICES Date
JUL 2 6 2011
Date
JUL 2 6 201?
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