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Home My WebLink About20161937.tiff/D 1.? 7 CONTRACT AGREEMENT AMENDMENT BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND TURNING POINT CENTER FOR YOUTH AND FAMILY DEVELOPMENT, INC. (Core) This Agreement Amendment, made and entered into G',21411) day o 015, by and between the Board of Weld County Commissioners, on behalf of the Weld unty Department of Human Services, hereinafter referred to as the "Department", and Turning Point Center for Youth and Family Development, Inc., hereinafter referred to as the "Contractor". WHEREAS the parties entered into an Agreement for Day Treatment Services (Day Resource Program) and Home Based Intensive Services (Coaching and Family Care Coordination) (the "Original Agreement") identified by the Weld County Clerk to the Board of County Commissioners as document No. 2014-3046, approved on October 6, 2014. WHEREAS the parties hereby agree to amend the term of the Original Agreement in accordance with the terms of the Original Agreement, which is incorporated by reference herein, as well as the terms provided herein. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: • The Original Agreement ended on May 31, 2015. • The Original Agreement was amended for an additional term of June 1, 2015 -May 31, 2016. This Agreement Amendment is identified by the Weld County Clerk to the Board of County Commissioners as document No. 2015-1849(2), approved on June 24, 2015. • The Amendment(s), together with the Original Agreement, constitutes the entire understanding between the parties. The following change is hereby made to the Contract Documents: 1. Term This agreement shall become effective on June 1, 2014, upon proper execution of this Agreement and shall expire May 31, 2017, unless sooner terminated as provided herein. 2. Exhibit C, Scope of Services, is hereby amended as attached. 3. Exhibit D, Payment Schedule, is hereby amended as attached. • All other terms and conditions of the Original Agreement remain unchanged. : ()(-430-g-e--1-Isp G, as —ice 2016-1937 /-�,200k7 IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. COUNTY: ATTEST: Weld C By: didev W.feho:ek BOARD OF COUNTY COMMISSIONERS ty Clerk to the Bo. rd WELD COUNTY, COLORADO Deputy CI Mike Freeman, Chair CONTRACTOR: JUN 2 2 201S Turning Point Center for Youth and Family Development, Inc. 1644 South College Avenue Fort Collins, Colorado 80525 (970) 567-0637 By: S • p+anie Brown, LC /Executive Director Date: k.5 ---‘3/-/(p 020/4.-/99 7 EXHIBIT C SCOPE OF SERVICES 1. Contractor will provide Day Treatment Services and Home -Based Intensive Services to male and female youth, and their families, as referred by the Department. 2. Day Treatment Services (Day Resource Program): Contractor will provide comprehensive, highly structured day treatment services, as proposed, to female and male youth, ages 10-18, as referred by the Department. a. Contractor will provide day treatment services, as proposed, at 913 11th Avenue, Greeley, CO 80631, 8:30 a.m. to 4:30 p.m., Monday through Friday. b. Contractor is licensed by the Colorado Department of Human Services State Child Care Licensing. License number 1553624. c. Admission criteria include: i. Adolescents between the age of 10-18, male or female. ii. Youth's needs cannot be met in a less restrictive environment due to emotional, family, behavioral, mental health, gang, legal and/or substance abuse issues. iii. Youth is motivated and willing to participate in the program. iv. Low to normal range of cognitive functioning. v. History of school failure and/or truancy. vi. Family is willing to participate in treatment. d. Teacher/Student ratio is 1 to 10. e. Testing and psychiatric medication evaluations and appointments will be conducted as needed to aid in case planning and ensure the appropriate treatment is utilized for the referred youth's maximum growth and benefit. f. Services will be provided by Masters' level therapists. g. Contractor will utilize a bilingual Spanish interpreter when needed. h. Referred youth will receive services for approximately four (4) to six (6) months. Length of services is dependent upon the referred youth's daily/weekly progress, individual/family needs and availability of funding. Services will include the following as appropriate: i. 30 hours per week of education approved by the Colorado Department of Education ii. Weekly individual therapy iii. Weekly in -home family therapy (if approved) iv. Weekly Drug and Alcohol Groups (Pathways Curriculum) v. Weekly Skills Groups (DBT Model) vi. Weekly community NA groups vii. Daily recreation activities viii. Vocational programming ix. Affective education x. Transition services (Connections Program) 1. Provided through a Department of Education grant 2. Utilized for students transitioning back into a public school setting 1 xi. Door to door transportation to and from program i. Contractor agrees that each referred client will be given the initial 10 days after intake to settle in without an attendance requirement. Following the initial 10 days, any five (5) unexcused absences in a 30 -day time frame would necessitate discharge. Contractor will provide individual, group and/or family therapy to all referred youth unless otherwise directed by the Department. k. Contractor is a Medicaid -approved provider. Clients eligible for Medicaid will be referred with alternate funding authorized for a short period of time to allow for the Medicaid approval process. Once approved, Medicaid will be billed for services and the alternate funding will no longer be authorized. Contractor will work with the appropriate behavioral health organization to obtain the necessary approval for Medicaid funding and will communicate with the Department regarding the approval process and outcome. 3. Home Based Intensive Services: Contractor will provide Home Based Intensive Services in the form of Coaching, Family Care Coordination (FCC) and Family Care Coordination Light (FCC Light). a. Coaching. Services can include, but are not limited to, the following: i. In -home parenting support and education ii. Assistance with appointments and transportation iii. Engaging child or youth in recreational and leisure activities in the community iv. Supervision of child or youth while parents or caregiver is unavailable v. Assisting youth with job searches vi. Mentoring and positive role modeling vii. Connect child and/or youth and family with community resources viii. Assist with housing issues ix. Homework assistance and tutoring x. Life skills coaching and education b. Family Care Coordination (FCC). FCC combines intensive family therapy, case management and overarching family support, and is designed to address risk of out -of -home placement with the goal of providing short-term intervention to stabilize and keep families intact. Services include: i. Assessment of all family members ii. Services in -home or in the community iii. Average of two (2) sessions per week; up to five (5) hours per session iv. 24/7 on -call support v. Collaboration with the Department, other providers and community members working with the family c. Family Care Coordination Light (FCC LIGHT). FCC Light provides identical services to FCC, including 24/7 on -call support, at a lower frequency of sessions. Referred clients will receive an average of one (1) session per week for up to five (5) hours. FCC Light is primarily utilized as a step-down from FCC for continuity of care. d. CONTRACTOR will work with the Department to appropriately modify services as needed to meet client(s) needs. 4. Contractor will make at least three (3) attempts to contact the client and set up services. The first attempt will occur within 24 hours of receiving the referral (excluding weekends and holidays). Contractor will document efforts to engage client in referred services. If after three (3) attempts the 2 client does not respond the Contractor will notify the caseworker and the Child Welfare Contract and Services Coordinator immediately. 5. Contractor will identify in detail areas of continued concern and make recommendations to the Department regarding continuation of services and/or the need for additional services. 6. Contractor will document in detail any and all observed or verbalized concerns regarding any child whom the Contractor is working with under an active referral. Areas of concern may include, but are not limited to, any physical, emotional, educational or behavioral issues. Areas of concern should be reported immediately AND on the required monthly report. 7. Contractor will submit reports on a monthly basis for each active referral for ongoing services. Reports will be submitted per the online format required by the Department, unless otherwise directed by the Department. 8. Contractor agrees any change to an existing referral must be pre -approved through the Child Welfare Contract and Services Coordinator, a Department -facilitated Team Decision Making (TDM) or Family Team Meeting (FTM), or by court order. A change is defined as anything outside of the approved documented service on the initial authorized referral form. This may include an increase or decrease in services hours, change in frequency, change in location of services, transportation needs, or any change to the initial referral or subsequent authorizations. 9. Contractor understands that the Department will not reimburse Contractor for "no shows" or cancelled appointments, either on the part of the client or the Contractor. 10. Contractor agrees to attend meetings when available and as requested by the Department. Such meetings include Court Facilitations, Court Staffings, Family Team Meetings and/or Team Decision Making meetings. The Department will reimburse for actual participation in the meeting only so long as the meeting is at least one hour in length, the Contractor obtains the Facilitator's signature on the Client Verification Form at the time of the meeting and participation in the meeting is deemed appropriate and necessary by the Department. Staffings and/or meetings other than those listed above are not considered reimbursable unless otherwise approved by the Child Welfare Contract and Services Coordinator. 3 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 in Trails after May 31, 2017. 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 Day Treatment Services: $110.00/Day (Regular Day Treatment - No Coaching, No In -home Family Therapy) $125.00/Day (Regular Day Treatment with In -home Family Therapy) $50.00/Hour (Court Facilitation/Court Staffing/Family Team Meeting/Team Decision Making Meeting - Master's Level) $25.00/Hour (Court Facilitation/Court Staffing/Family Team Meeting/Team Decision Making Meeting - Bachelor's Level) Home -Based Intensive Services: $32.50/Hour (Coaching-Greeley/Evans Only) $48.75/Hour (Coaching -Outside Greeley/Evans) $1,200.00/Month (Family Care Coordination - Pro -rated for partial month) $800.00/Month (Family Care Coordination Light - Pro -rated for partial month) $50.00/Hour (Court Facilitation/Court Staffing/Family Team Meeting/Team Decision Making Meeting - Master's Level) $25.00/Hour (Court Facilitation/Court Staffing/Family Team Meeting/Team Decision Making Meeting - Bachelor's Level) 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. 1 3. Submittal of Vouchers Contractor shall prepare and submit monthly an itemized voucher, and signed monthly report if applicable, certifying that services authorized were provided on the date(s) indicated and the charges made were pursuant to the terms and conditions of Paragraph 3 and Exhibit A. Contractor shall submit all monthly billings and applicable reports to the Department by the 7th day of the month following the month the cost was incurred. Failure to submit by the aforementioned deadline may result in forfeiture of payment. a. For ongoing services, proof of services rendered shall be a Client Verification Form signed by the client and a monthly report submitted in accordance with Paragraph 3(d) of this Agreement. b. For one-time services, proof of services rendered shall be receipt of the completed product. c. For Monitored Sobriety services, proof of services rendered shall be the test result. 2 ACORL7® ��. CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 10/30/2015 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 BELQW. 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 Ewing -Leavitt Insurance Agency 4025 St. Cloud Dr. Suite 100 Loveland CO 80538 CONTACT Karole Peters NAME: PHONE LA/C. No. Ext): (970)679-7355 1 (FAXA/C.No): (866)237-2178 ADIRESS:karole-peters@leavitt. COAL INSURER(S) AFFORDING COVERAGE NAIC I INsuRERA:Hanover Insurance Company 22292 INSURED Turning Point Center for Youth and Family 1644 S. College Fort Collins CO 80525 INSURER B :Pinnacol Assurance 41190 INSURER C : INSURER 0 : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:15-16 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. - INSR IADDL LTR TYPE OF INSURANCE , INSD SUER WVD POLICY NUMBER POLICY EFF (MM/DDIYYYY) POLICY EXP (MM/DD/YYTY) LIMITS X A I COMMERCIAL GENERAL LIABILITY CLAIMS -MADE . X I OCCUR ZB4-A467318-00 11/1/2015 11/1/2016 EACH OCCURRENCE I $ 1,000,000 Blanket Al and MOS when NTED PREM SES (EaEoccurrencet $ 100,000 l X I Blanket Addl Insured required by contract MED EXP (Any one person) 000 $ 20,000 F X I Blanket Waiver of Sub I PERSONAL BADVINJURY $ 1,000,000 G_E_N'L AGGREGATE LIMO' APPLIES PER: ' X ' POLICY '� I JECT ,. j LOC I OTHER: GENERAL AGGREGATE $ 3,000,000 PRODUCTS - COMP/OP AGG $ included Employee Benefits $ 1,000,000 A AUTOMOBILE ICI I X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS NON -OWNED AUTOS AW4A467335 00 11/1/2015 11/1/2016 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ A X UMBRELLALIAB EXCESS UAB X I OCCUR CLAIMS -MADE UH4-A467319-00 11/1/2015 11/1/2016 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 DED I X i RETENTION $ 0 $ B WORKERS COMPENSATION 4044167 AND EMPLOYERS' LIABILITY 10/1/2015 10/1/2016 X (STATUTE IETH Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE 7--: N / A E.L. EACH ACCIDENT $ 500 000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - EA EMPLOYE E.L. DISEASE - POLICY LIMIT $ 500,000 000 _ $ 500,000 A Professional Liability ZB4-A467318-00 11/1/2015 11/1/2015 Aggregate $3,000,000 Occurrence $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Weld County Department of Human Services in named Additional Insured on the General Liability policy per written contract. CERTIFICATE HOLDER CANCELLATION Weld County Department of Human Services 315 N. 11th Avenue Greeley, CO 80631 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Karole Peters/KAPETE ACORD 25 (2014/01) INS025 (201401) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACOR0® `� CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 10/30/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions'of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Ewing -Leavitt Insurance Agency 4025 St. Cloud Dr. Suite 100 Loveland CO 80538 CONTACT Karole Peters NAME: PHONE (970) 679-7355 FAX (866)23-7-217218 INC. No. Ext$ i ,10,/cNot ADDRESS: karole-peters@leavitt.com INSURER(S) AFFORDING COVERAGE NAIC N mums A:Hanover Insurance Company 22292 INSURED Turning Point Center for Youth and Family 1644 S. College Fort Collins CO 80525 INSURER B :Pinnacol Assurance 41190 INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:15-16 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NAMED ABOVE FOR THE POLICY PERIOD DOCUMENT WITH RESPECT TO WHICH THIS HEREIN IS SUBJECT TO ALL THE TERMS, NSA LTR TYPE OF INSURANCE ADDL INSD SUB ( POLICY EFF WVD POLICY NUMBER (MM/DD/YYYY) POLICY EXP /MM/DD/YYYY) I UMITS A X COMMERCIAL GENERAL LIABILITY OCCUR ZB4-A467318-00 Blanket AI and WOS when required by contract ! 11/1/2015 11/1/2016 EACH OCCURRENCE $ 1,000,000 I CLAIMS MADE X i_PREM SES Ee occc rrence) $ 100, 000 X XJ Blanket Addl Insured MED EXP (Any one person) $ 20,000 Blanket Waiver of Sub PERSONAL SADVINJURY $ 1,000,000 GEN'L X AGGREGATE LIMIT APPLIES PRO- POLICY PRO JECT PER: LOC GENERAL AGGREGATE $ 3,000,000 PRODUCTS - COMP/OP AGG $ included OTHER: Employee Benefits $ 1,000,000 A AUTOMOBILE X r X UABIUTY ANY AUTO ALL OWNED SCHEDULED AW4A467335 00 11/1/2015 I 11/1/2016 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ A X II UMBRELLA UAB X OCCUR CLAIMS -MADE UH4-A467319-00 11/1/2015 11/1/2016 EACH OCCURRENCE $ 2,000,000 EXCESS UAB AGGREGATE $ 2,000,000 DED II RETENTION $ 0 $ l3 WORKERS COMPENSATION AND EMPLOYERS' UABIUTY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 4044167 10/1/2015 10/1/2016 X STATUTE IOOTH E.L. EACH ACCIDENT - - $ 500,000 E.L. DISEASE - EA EMPLOYEE --- _-- $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500,000 A Professional Liability ZB4-A467318-00 11/1/2015 I 11/1/2016 Aggregate $3,000,000 Occurrence $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more apace is required) CERTIFICATE HOLDER CANCELLATION Weld County DSS PO Box A Greeley, CO 80632 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 Karole Peters/KAPETE.412?asik--44e-JkAL ACORD 25 (2014/01) INS025 (201401) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Hello