HomeMy WebLinkAbout20162158.tiffedvittati lb 5;29
•
I
I
I
I
INDIVIDUAL PROVIDER CONTRACT
FOR PURPOSE OF FOSTER CARE SERVICES
AND
FOSTER CARE FACILITY AGREEMENT
THIS AGREEMENT is made this (�day of 20/ and
�,
by
between the Board of County Commissioners of Weld Coun on b if of the Weld County
Department of Human Services, whose address is P.O. Box A, Greeley, CO, 80632, hereinafter
referred to as, "County," and Risler, Jason and Hadley-Risler, Tamara, whose address is
4321 Buffalo Mt. Drive, Loveland, CO 80538, hereinafter referred to as, "Contractor." This
Agreement covers all children placed by County with Contractor.
WITNESSETH:
WHEREAS, the Provider has read and is fully familiar with the Minimum Rules and
Regulations for Family Foster Homes and/or Specialized Group Care Facilities issued by the
Colorado Department of Humans Services and holds a valid certificate/license as a Family Foster
Home with which such certification standards that shall be maintained during the term hereof
and
WHEREAS, County may, but shall not be obligated to, purchase foster care services, and
the County or any duly authorized agent may request such services to be provided to any child at
any time within the limits of the certificate/license and without prior notice.
NOW, THEREFORE, in consideration of the mutual promises and covenants made
herein, County and Contractor agree as follows:
I. TERM:
A. The term of this Agreement shall be from June 23, 2016, to and until June 30,
2016, or until the facility certificate/license is revoked or suspended.
B. Each party shall have the right to terminate this Agreement by giving the other party
written notice received at least thirty (30) days prior to the intended date of
termination. If notice is so given, this Agreement shall terminate upon the expiration
of thirty (30) days, or until the eligible children) may be placed elsewhere,
whichever occurs first, and the liability of the parties hereunder for further
performance of the terms of this Agreement shall thereupon cease; however, the
parties shall not be released from the duty to perform their obligations up to the date
of termination.
II. AGREEMENTS OF THE PARTIES:
A. Contractor agrees:
1. To furnish foster care services to eligible children at the established rate based on
type of facility and individual child rates negotiated between the county and the
provider.
2. To safely provide the 24 -hour physical care and supervision of Pnrh (h;1A 1,f'1f'; i
removed or until the agreement is renewed.
CWS-7A individual Provider Contract
derfrZeistti
L - 02O/1O
e&ifiattaJk
14,
2016-2158
Pka 00g11
Revised 6/2015
3. To accept children only with the approval of the certifying/licensing agency.
4. To cooperate fully with the County Department or its representatives, and
participate in the development of the Family Service Plans for children in
placement, including visits with their parents, siblings, and relatives, or transition
to another foster care facility.
5. To maintain approved standards of care as set by the State Department of Human
Services.
6. To keep confidential the information shared about the child and his/her family.
7. Not to accept money from parents or guardians.
8. Not to make any independent agreement with parents or guardians.
9. Not to release the child to anyone without prior authorization from the
Department.
10. To allow representatives of the County Department to visit the foster home and to
see the child at any reasonable time.
11. To give the County Department two weeks notice, except in an emergency, to
remove a child for placement elsewhere and to work with the County Department
as requested in preparing the child for the next placement.
12. To provide transportation to the child to enable the utilization of professional
services when necessary. The amount of transportation to be provided will be
agreed upon at placement and may be changed upon mutual agreement of the
provider and the County Department, as recorded in the Family Services Plan.
13. To report promptly to the Department:
a. Any unplanned absence of the child from provider's care.
b. Any major illness of the child.
c. Any serious injury to the child.
d. Any significant change in the child's sleeping arrangement.
e. Any contemplated change of address or change of household members.
f. Any conflict the child may have with law enforcement, school officials, or
other persons in the authority.
g. Any emergency.
h. Any pertinent discussion with parents or guardians about the child or
supervising agency.
i. Any information received regarding a change of address of the parents or
guardians.
CWS-7A Individual Provider Contract
2 Revised 6/2015
14. To comply with the Civil Rights Act of 1964, Section 504, Rehabilitation Act of
1973, and the ADA of 1990, concerning discrimination on the basis of race, color,
sex, age, religion, political beliefs, national origin, or handicap, and to provide
confidentiality of information concerning the child in compliance with the Health
Insurance Portability and Accountability Act (HIPAA).
15. To attend core certification training prior to the placement of any child.
16. To attend on -going training as required by State Department regulations.
17. To attend Administrative Reviews for children in placement.
18. To fully comply with the Minimum Rules and Regulations for Foster Family
Homes or Specialized Group Facilities.
19. Not to enter into any subordinate subcontract hereunder.
20. To keep such records as are necessary for audit purposes by state and federal
personnel. The records shall document the type of care and the term during which
care is provided for each child. In addition, medical, educational, and progress
summary records shall be maintained for each child in accordance with Volume 7
requirements.
21. To maintain medical, dental and educational records for each child/youth and
supply updated information to the County Department.
22. To conform with and abide by all rules and regulations of the Colorado
Department of Human Services, the Colorado Department of Health Care Policy
and Financing (if appropriate), the State of Colorado and any applicable federal
laws and regulations, as such, which may be amended from time to time, and shall
be binding on Contractor and control any disputes in this Agreement.
23. To maintain a current license and maintain license requirements as specified
under State law and rule.
24. Not to charge any fees to children or families of children referred by County for
any services provided under this Agreement.
25. Not to assign the obligations under this Agreement nor enter into any sub -
Agreement without the express written approval of the Director of the County
Department or his/her appointed designee.
26. To maintain at all times during the term of this Agreement a liability insurance
policy of at least $25,000 for property damage liability, $150,000 for injury
and/or damage to any one person, and $500,000 for total injuries arising from any
one accident. Contractor shall provide a certificate of insurance provided by its
insurer upon request by County.
27. To indemnify County and the State Department against any and loss against all
claims and actions based upon or arising out of damage or injury, including death,
to persons or property caused or sustained in connection with the performance of
this Agreement or by conditions created thereby, or based upon any violations of
CWS-7A individual Provider Contract 3 Revised 6%2015
any statute, ordinance, or regulation and the defense of any such claims or
actions.
28. To maintain service program records, fiscal records, documentation and other
records, which will sufficiently and properly reflect all direct and indirect costs of
any nature incurred in the performance of this Agreement. The above shall be
subject at all reasonable times to inspection, review or audit by federal, State
Department, or County personnel, and other persons authorized in writing by the
State Department Executive Director.
B. County agrees:
1. To share all available information about the child, including relevant social,
medical and educational history, behavior problems, court involvement, parental,
sibling and relative visitation plans, and other specific characteristics of the child,
with the provider before placement and to share additional information when
obtained.
2. To inform the provider of expectations regarding the care of the child, such as
meeting medical needs, handling special psychological needs, and separation/loss
issues.
3. To arrange for a medical examination of the child before placement or within 14
days after placement and give a copy of the completed form to the out -of -home
provider.
4. To give the provider a written record of the child's admission to the home at the
time of placement.
5. To give the provider a written procedure or authorization for obtaining medical
care for the child.
6. To involve the provider in service planning for the child as part of the overall
treatment team.
7. To give the provider a copy of the Family Services Plan for the child at the time
of placement or as soon as it is completed following placement.
8. To give at least two weeks notice of plans to remove a child from the facility. The
two-week notice may be waived by mutual consent to allow immediate removal
of said child for placement elsewhere, or without such waiver in the event of an
emergency. An emergency is defined as any situation in which a provider's
inability to provide services threatens the health, safety or welfare of children.
9. To pay the provider at the rates established by the State Department of Human
Services or as negotiated between the provider and the county. The rate of
payment per month shall be based on the type of facility and individual rates.
Payment shall be by warrant drawn by the duly authorized county officer.
10. To provide or arrange through statewide contracted training a minimum of twelve
hours of core certification training for family foster homes. The county
department is responsible for providing information on county specific
procedures.
CWS-7A Individual Provider Contract
4 Revised 6/2015
11. To invite the provider to Administrative Reviews for Children in placement.
12. To incorporate provider information in planning for the child.
13. "To assure that the service described herein has been accomplished and a record
made thereof on a case by case basis.
14. To provide notice of hearings.
C. At such time or as soon as possible after the acceptance of a child for services, the
County Department and the Provider shall verify foster care placement of each child in
writing on the required form, which shall become an addendum to this contract,
subject to all the terms and conditions hereof.
III. GENERAL PROVISIONS:
A. Contractor agrees that Contractor is an independent contractor and that neither
Contractor nor Contractor's agents or employees are, or shall be deemed to be, agents
or employees of the County for any purpose. Contractor shall have no authorization,
express or implied, to bind the County to any agreement, liability, or understanding.
The parties agree that Contractor will not become an employee of County, nor is
Contractor entitled to any employee benefits from County as a result of the execution
of this Agreement. Contractor shall be solely and entirely responsible for its acts or of
any agent, employee, servants and sub -contractors during the performance of this
Agreement.
B. Payment pursuant to this Agreement, if in State of Colorado, county, or federal funds,
whether in whole or in part, is subject to and contingent upon the continuing
availability of State of Colorado, county, and federal funds for the purpose thereof.
C. It is agreed that if, after investigation, it is shown that reasonable care was given to
guard and protect personal items brought to Contractor by the children, Contractor
shall be released from responsibility for loss or damage to such personal items.
D. This Agreement is intended to be applied in conjunction with Exhibit A and the
Needs Based Care Addendum as the complete integration of all understandings
between the parties. No prior or contemporaneous addition, deletion or other
amendment hereto shall have any force or affect whatsoever, unless embodied herein
in writing. No subsequent notation, renewal, addition, deletion, or other amendment
hereto shall have any force or effect unless embodied as a part of this written
Agreement. This section shall not be construed as prohibiting the periodic amending
of this Agreement, Exhibit A and the Needs Based Care Addendum in writing, if
agreed to by both parties. This Agreement, Exhibit A and the Needs Based Care
Addendum are intended to be in lieu of and supersede all prior agreements between
the parties hereto and relating to the care and services herein described.
E. The State of Colorado Department of Human Services and the County shall be and
hereby is permitted to monitor service program, fiscal and other records sufficiently to
assure the purchase of services in this Agreement are carried out for the benefit of the
aforementioned client. Monitoring may occur through review of program reports, on -
site visits where applicable and other Agreements as deemed necessary. Contractor
understands that the State Department and the County may provide consultation to
CWS-7A Individual Provider Contract
5 Revised 6/2015
Contractor to assure satisfactory performance in the provision of purchased services
under this Agreement.
F. County shall have access to Contractor's financial records as they relate to this
Agreement for purposes of audit. Such records shall be complete and available for
audit 90 days after final payment hereunder and shall be retained and available for
audit purposes for at least five years after final payment hereunder.
G. Time is of the essence in each and all of the provisions of this Agreement.
H. Neither party to this Agreement shall be liable to the other for delays in delivery or
failure to deliver or otherwise to perform any obligation under this Agreement, where
such failure is due to any cause beyond its reasonable control, including but not
limited to Acts of God, fires, strikes, war, flood, earthquakes or Governmental actions.
I. Any notice required to be given under this Agreement shall be in writing and shall be
mailed or delivered to the other party at that party's address as stated above.
J. This Agreement and the provision of services hereunder shall be subject to the laws of
Colorado and be in accordance with the policies, procedures, and practices of County.
K. This Agreement is nonexclusive and County may engage or use other contractors or
persons to perform services of the same or similar nature.
L. Contract Professional certifies, warrants, and agrees that it does not knowingly employ
or contract with an illegal alien who will perform work under this contract. Contract
Professional will confirm the employment eligibility of all employees who are newly
hired for employment in the United States to perform work under this Agreement,
through participation in the E -Verify program or the State of Colorado program
established pursuant to C.R.S. §8-17.5-102(5)(c). Contract Professional shall not
knowingly employ or contract with an illegal alien to perform work under this
Agreement or enter into a contract with a subcontractor that fails to certify with
Contract Professional that the subcontractor shall not knowingly employ or contract
with an illegal alien to perform work under this Agreement. Contract Professional
shall not use E -Verify Program or State of Colorado program procedures to undertake
pre -employment screening or job applicants while this Agreement is being performed.
If Contract Professional obtains actual knowledge that a subcontractor performing
work under the public contract for services knowingly employs or contracts with an
illegal alien Contract Professional shall notify the subcontractor and County within
three (3) days that Contract Professional has actual knowledge that a subcontractor is
employing or contracting with an illegal alien and shall terminate the subcontract if a
subcontractor does not stop employing or contracting with the illegal alien within
three (3) days of receiving notice. Contract Professional shall not terminate the
contract if within three days the subcontractor provides information to establish that
the subcontractor has not knowingly employed or contracted with an illegal alien.
Contract Professional shall comply with reasonable requests made in the course of an
investigation, undertaken pursuant to C.R.S. §8-17.5-102(5), by the Colorado
Department of Labor and Employment. If Contract Professional participates in the
State of Colorado program, Contract Professional shall, within twenty days after hiring
an new employee to perform work under the contract, affirm that Contract
Professional has examined the legal work status of such employee, retained file copies
of the documents, and not altered or falsified the identification documents for such
employees. Contract Professional shall deliver to County, a written notarized
CWS-7A individual Provider Contract
6 Revised 6/2015
affirmation that it has examined the legal work status of such employee, and shall
comply with all of the other requirements of the State of Colorado program. If
Contract Professional fails to comply with any requirement of this provision or of
C.R.S. §8-17.5-101 et seq., County, may terminate this Agreement for breach, and if
so terminated, Contract Professional shall be liable for actual and consequential
damages.
Except where exempted by federal law and except as provided in C.R.S. § 24-76.5-
103(3), if Contract Professional receives federal or state funds under the contract,
Contract Professional must confirm that any individual natural person eighteen (18)
years of age or older is lawfully present in the United States pursuant to C.R.S. § 24-
76.5-103(4), if such individual applies for public benefits provided under the contract.
If Contract Professional operates as a sole proprietor, it hereby swears or affirms under
penalty of perjury that it: (a) is a citizen of the United States or is otherwise lawfully
present in the United States pursuant to federal law. (b) shall produce one of the forms
of identification required by C.R.S. § 24-76.5-101, et seq., and (c) shall produce one of
the forms of identification required by C.R.S. § 24-76.5-103 prior to the effective date
of the contract.
M. Contractor assures and certifies that it and its principals:
1 Are not presently debarred, suspended, proposed for debarment, and declared
ineligible or voluntarily excluded from covered transactions by a federal
department or agency.
2. 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:
3. 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 (B) above.
4. Have not within a three-year period preceding this Agreement, had one or more
public transactions (federal, state, and local) terminated for cause or default.
N. In addition to terminating this Agreement, in accordance with the provisions of
Section 1., above, County may exercise the following remedial actions if the County
finds and determines that the Contractor has substantially failed to satisfy the scope
of work found in this Agreement, Exhibit A or the Needs Based Care Addendum.
Substantial failure to satisfy the scope of work shall be defined to mean incorrect or
improper activities or inaction by the Contractor. These remedial actions include,
but are not limited to, any one or more of the following:
1. Withhold payment to Contractor until the necessary services or corrections in
performance are satisfactorily completed.
2. Deny payment or recover reimbursement for those services or deliverables which
have not been performed and which due to circumstances caused by Contractor
CWS-7A Individual Provider Contract 7 Revised 6/2015
cannot be performed or if performed would be of no value to County. Denial of
the amount of payment shall be reasonably related to the amount of work or
deliverables lost to County.
3. Recover from Contractor any incorrect payment to Contractor due to omission,
error, fraud, and/or defalcation by deducting from subsequent payments under this
Agreement, or other agreements between County and Contractor, or as a debt to
County, or otherwise as provided by law.
O. It is expressly understood and agreed that the enforcement of the terms and conditions
of this Agreement, and all rights of action relating to such enforcement, shall be
strictly reserved to the undersigned parties or their assignees, and nothing contained
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 or their
assignees receiving services or benefits under this Agreement shall be an incidental
beneficiary only.
P. No portion of this Agreement shall be deemed to constitute a waiver of any immunity
the parties or their officers or employees may possess, nor shall any portion of this
Agreement be deemed to have created a duty of care that did not previously exist
with respect to any person not a party to this Agreement. The parties hereto
acknowledge and agree that no part of this Agreement is intended to circumvent or
replace such immunities.
Q.
Contractor shall promptly notify County in the event in which it is a party defendant
or respondent in a case, which involves services provided under the agreement. The
Contractor, within five (5) calendar days after being served with a summons,
complaint, or other pleading which has been filed in any federal or state court or
administrative agency, shall deliver copies of such document(s) to the County
Director. The term "litigation" includes an assignment for the benefit of creditors,
and filings in bankruptcy, reorganizations and/or foreclosure.
R. Any amendments or modifications to this agreement shall be in writing signed by
both parties.
S. Neither party to this Agreement shall be liable to the other for delays in delivery or
failure to deliver or otherwise to perform any obligation under this Agreement,
where such failure is due to any cause beyond its reasonable control, including but
not limited to Acts of God, fires, strikes, war, flood, earthquakes or Governmental
actions.
T. Contractor shall strictly comply with all applicable federal and State laws, rules and
regulations in effect or hereafter established
U. Financial obligations of the County payable after the current fiscal year are
contingent upon funds for that purpose being appropriated, budgeted and otherwise
made available. Execution of this Agreement by County does not create an
obligation on the part of County to expend funds not otherwise appropriated in each
succeeding year.
CWS-7A Individual Provider Contract
8 Revised 6/2015
their hands an a ix their seas t.e. • a
WHEREFORE, the parties have herein set .� an
COUNTY:
r
ATTEST; BOARD OF COUNTY COMMIS
Weld ty Clerk to the Board WELD COUNTY, COLORADO
Mike Freeman, Chair
CONTRACTOR:
rJUL 0 6 Zo I
Hadley•Risler, Tamara and Risler, J
4321 Buffalo Mt. Drive
Loveland, CO 80538
Contrac r' r designee's) Si
and D
By: 6/23/201
ontract s (or designee's) Signatur
and Date
oZO& -0,?/51,
4 r
a
EXHIBIT A to the CWS-7A
Additional Provisions for the Agreement to Purchase
Foster Care Services and Foster Care Facility Agreement
CWS-7A
The following additional provisions apply to the agreement entitled, "Individual Contractor
Contract for Purpose of Foster Care Services and Foster Care Facility Agreement," hereinafter
referred to as, "County," and Hadley-Risler, Tamara and Risler, Jason, hereinafter referred to
as, "Contractor."
GENERAL PROVISIONS
1. County and Contractor agree that a child specific Needs Based Care Assessment,
designated within this exhibit shall be used to determine the Child Maintenance and
Medical Needs, if applicable, for each child placed with Contractor unless the child is
placed in a County certified kinship foster care home or a County foster/adoption home
as a pre -adoptive placement. Kinship foster care homes and pre -adoptive placements will
be reimbursed at the County Basic Maintenance level for Child Maintenance as indicated
on the Needs Based Care Rate Table, designated in this exhibit as, regardless of the
child's level of need.
2. County agrees to purchase and Contractor agrees to provide the care and services, which
are listed in this Agreement, based on the Needs Based Care Assessment levels
determined. The specific rate of payment will be paid for the Child Maintenance level of
service, as indicated by the Needs Based Care Rate Table, designated within this exhibit,
for children placed within the Weld County Certified Foster Care Home identified as
Provider ID# 1631808. These services will be for children who have been deemed
eligible for social services under the statutes, rules and regulations of the State of
Colorado.
3. All bed hold authorizations and payments are subject to a 7 day maximum for a child's
temporary absence from a facility, including hospitalization. Bed hold requests must
have prior written authorization from the Department Administrator before payment will
be release to Contractor.
4. Any additional costs for specialized services, which may include but are not limited to;
Co -pays, deductibles, or services not covered by Medicaid, will need to be authorized, in
writing by the Department Administrator, prior to the service being performed. Any
payment for specialized services not authorized in writing may be denied.
5. All reimbursement requests shall:
A. Be submitted in a format approved by the County. If submitted in an unapproved
format or inadequate documentation is provided, the County reserves the right to
deny payment.
B. Be submitted by the 4`" of each month following the month of service. If the
reimbursement request is not submitted within twenty-five (25) calendar days of
the month following service, it may result in forfeiture of payment.
CWS-7A Individual Provider Contract
10 Revised 6/2015
C. Placement service reimbursement shall be paid from the date of placement up to,
but not including the day of discharge.
Transportation reimbursement shall be for visitation purposes only. If medical
transportation is needed, Contractor will arrange reimbursement through
Medicaid. Any other special requests for transportation reimbursement shall
require prior approval by the Resource Manager or the Department Administrator.
E. Clothing allowance reimbursement shall be approved and reimbursed as indicated
on the clothing allowance form accessed through the Foster Parents Database On-
line System (FIDOS).
6. It is expressly understood and agreed that the enforcement of the terms and conditions of
this Agreement, and all rights of action relating to such enforcement, shall be strictly
reserved to the undersigned parties or their assignees, and nothing contained 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 or their assignees receiving
services or benefits under this Agreement shall be an incidental beneficiary only.
7. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the
parties or their officers or employees may posses, nor shall any portion of this Agreement
be deemed to have created a duty of care that did not previously exist with respect to any
person not a party to this Agreement. The parties hereto acknowledge and agree that no
part of this Agreement is intended to circumvent or replace such immunities.
CONTRACTOR SHALL:
1. Attend or participate in Family Engagement or Team Decision making meetings, if
requested by the Department. County staff shall notify the Contractor of the dates and
times attendance is requested.
2. Request a staffing if considering giving notice to remove a child, except in emergency
situations. These requests shall be made through the child's caseworker and/or the
Contractor's Foster Care Coordinator.
3. Actively participate in achieving the child's permanency goal, cooperate with any
contractors hired by the Weld County Department of Human Services to preserve
placement in the least restrictive placement appropriate, and comply with the treatment
plan of the child.
4. Have physical examinations completed within 14 days and dental examinations
completed within 8 weeks of the child being placed with Contractor. All documentation
of these examinations will be placed in the foster child's placement binder.
5. Attend all necessary school meetings and support any plan that is developed regarding
the child in order to promote educational success.
6. Immediately report to the County Department and/or local law enforcement any known
or suspected child abuse or neglect as set forth in Section 19-3-304, C.R.S.
7 Maintain, access and review information weekly on FIDOS.
CWS-7A Individual Provider Contract
I I Revised 6/2015
8. Read, be familiar with and agree to the terms and conditions as set forth in the Foster
Parent Handbook which can be accessed through FIDOS.
9. Maintain!update information in the foster child's binder. The binder will be reviewed on
a monthly basis and signed off by child's caseworker and/or the Contractor's Foster Care
Coordinator.
10. Maintain/update medication logs on a daily basis, if child is taking medications.
1 I. Maintain behavior observation notes as required by the level of care assessed for each
child.
12. Comply with all County and State certification requirements as set forth in the State
Department rules, Staff Manual Volume VII and the Weld County Department of Human
Services Policy and Procedure manual.
CWS-7A individual Provider Contract
12 Revised 6/2015
Needs Based Care Assessment
NBC (NEEDS BASED CARE ASSESSMENT)
Answers to the following questions will determine the NBC Care Payment. For each question below please select the
closest rating for this child. The following seven (7) questions are mutually exclusive.
Pl. How often does the child require transportation by the foster care provider for the following:
Therapy; Medical Treatment; Family Visitation; Extraordinary Educational Needs; etc., as outlined
in the treatment plan?
Select One
P2. How often is the foster care provider required to participate in child's therapy or counseling
sessions?
Select One
P3. How much time is the provider required to intervene at home and/or at school with the child in
conjunction with a regular or special education plan?
Select One
P4. How often does the child require special and extensive involvement by the provider in scheduling
Select One
and
monitoring of time and/or activities and/or crisis management?
P5. How much time is the provider required to assist the child because of impairments beyond age
Select One
appropriate needs with feeding, bathing, grooming, physical, and/or occupational therapy?
Ai. How often is CPA/County case management required? (Does not include therapy)
**Please Note: The Case Management level may be assessed on a combined basis if a sibling
group
or more than one County foster child is with the same provider.
Select One
T1. How often are them • services needed to address i it 's individual needs . er NBC assessment?
NBC (NEEDS BASED CARE ASSESSMENT) — Behavioral Assessment
Select One
Assessment Areas:
Comment:
Rating:
0
Aggression/Cruelty to Animals
Select One
Verbal or Physical Threatening
Select One
Destructive of Property/Fire Setting
Select One
Stealing
Select One
Self -injurious Behavior
Select One
Substance Abuse
Select One
Presence of Psychiatric Symptoms/Conditions
Select One
Enuresis/Encopresis
Select One
Runaway
Select One
Sexual Offenses
Select One
Inappropriate Sexual Behavior
Select One
Disruptive Behavior
Select One
Delinquent Behavior
Select One
C
Depressive -like Behavior
Select One
10
Needs - (If condition is rated "severe", please
complete
complete the Medically fragile NBC)
Select One
❑
Emancipation
Select One
❑
Eating Problems
Select One
■
Boundary Issues
Select One
❑
Requires Night Care
Select One
❑
Education
Select One
0
Involvement with Child's Family
Select One
Exhibit B to the Additional Provisions 13
Revised 6/2014
Needs Based Care Rate Table
Weld County Department of Human Service
(Effective 7/01/2015)
County Basic
Maintenance
Rate
1
1 %z
2
2 'h
3
3 1/2
4
Congregate
Care
Drop Down
Assessment/
Emergency
Level Rate
Age 0-10...$17.01
Age 11-14...$18.81
Age 15-21...$20.09
$27.42
$.66
P.:
$12.35
No crisis intervention, Minimal
CPA involvement, one face-to-
face visit with child per month.
Minimal crisis intervention as
needed, one face-to-face visit
per month with child. 2-3
Occasional crisis intervention as
needed, two face-to-face visits
with child, 2-3 contacts per
month
Ongoing crisis intervention as
needed, weekly face-to-face
visits with child, and intensive
coordination of multiple
services.
Ongoing crisis intervention as
needed, which includes high
level of case management and
CPA involvement with child and
provider and 2-3 face -to face
contacts per week minimum.
$19.20
$0.00
Not needed or cover
under Medicaid.
$5.14
Regularly Scheduled
therapy up to 4
hours/month.
$10.28
Weekly scheduled
therapy 5-8 hours a
month with 4 hours of
group therapy.
$15.42
Regularly scheduled
weekly, multiple
sessions, can include
more than I person,
i.e. family therapy, for
9-12 hours/monthly.
$3.45
$6.50
Negotiated
CWS-7A Individual Provider Contract 14
Revised 6/2015
CCI LEGISLATIVE ISSUE FORM
for 2017 Legislative session
CCI is soliciting potential legislative issues for the 2017 legislative session. Please answer each of the questions below for each of
your county's legislative issues. If your county submits multiple issue forms, please prioritize your issues. Submitted issues are
discussed during the summer steering committees and district meetings. We encourage you to confer with your county managers
or administrators and department heads, as well as other elected officials, to determine what issues are the most pressing in your
county and have implications for other counties. All submitted issues forms must have the support of the Board of County
Commissioners or the Mayor/City and County Council.
Please fax or email your issue forms to Jeanne DeHaven at 303.861.2818 or jdehaven@ccionline.org. Legislative Issue Forms
should be returned by Friday, July 1, 2016 in order to be discussed during the summer legislative review and steering
committee meetings.
Name: Mike Freeman Title: Weld County Commissioner
County: Weld County Phone: 970- 356-4000 ext 4200 E-mail: mfreeman@weldgov.com
Who from your county would be available to testify:
Issue: Concerning the Formation of a Child Care Assistance Program Allocations Committee and Removing Obsolete
Provisions under Section 26-2-804, Funding -allocation -maintenance of effort.
Background: 1) Currently, the Colorado Department of Human Services is the sole determinant of the child care
allocations to counties. In the past and to date, CDHS has approached county staff representatives, acting in advisory
nature, to allocate resources to counties. County Commissioners have had no role in this allocation process in the same
level as the Colorado Works Allocation Committee or the Child Welfare Allocations Committee.
2) The current statute requires the State and the committee of county representatives to consider all of the required
elements in the child care allocation formula. These factors are frequently elements that are poor predictors of county
needs. So, requiring the State (and thereby, the counties) to include them in the formula produces a less equitable
methodology. We feel that a more broad approach is needed.
Proposed Solution/Legislative Remedy: Amend Part 8, Colorado Child Care Assistance Program, Section 26-2-804,
Funding — allocation- maintenance of effort as follows:
26-2-804. Funding - allocation - maintenance of effort
(1) Subject to available appropriations, a county's block grant for CCCAP for state fiscal year 199''-98 shall be determined by the
state department and be based upon not less than one hundred percent of the state and federal moneys that the county received
in state fiscal year 1996-97 to administer and implement JOBS -related child care and CCCAP, including the administrative costs
related to such programs. The state department shall consider factors that include, but are not limited to, the following:
(a) Ifistorical expenditures on CCCAP;
(b) The number of children in the county under thirteen years of age;
(c) The number of low-income families in the county; and
(d) Provider rates in the county, as established pursuant to section 26-2-803 (2).
(2) In state fiscal years 1998-99 and thereafter, the state department, WITH THE INPUT FROM THE CHILD CARE
ASSISTANCE PROGRAM ALLOCATION COMMITTEE, may adjust the county block grant identified in subsection (1)
of this section by increasing or reducing the amount of such grants based upon factors that shall include the types of services and
rates, economic and demographic factors within the counties.
(a) The county's population and the Colorado works program caseload;
(b) The unemployment rate in the county based upon the state department of labor and employment assessment of county
unemployment rates for the prior year;
(c) The county's performance in meeting the obligations under the performance contract with the state department pursuant to
the provisions of section 26-2-715;
(d) The fact that the county received funds from the county block grant support fund, created in section 26-2-720.5, in the
previous fiscal year for allowable child care expenditures, which may indicate that the previous fiscal year's allocation was
insufficient to meet the county's needs.
(3) The moneys in a count- block grant allocated to a county pursuant to subsection (1) of this section may only be used for the
provision of child care services under rules promulgated by the state board pursuant to this part 8.
(4) and (5) Repealed.
(6) IN STATE FISCAL YEARS 1997-2018 AND THEREAFTER, THE STATE DEPARTMENT, WITH THE INPUT
FROM THE CHILD CARE ASSISTANCE PROGRAM ALLOCATION COMMITTEE, MAY ADJUST TIIE
COUNTY BLOCK GR_A\T IDE\TIFIED IN SLBSEC"IIO\ (1) OF "PHIS SECTION BY INCRE_ASING OR REDUCING
THI: AMOUNT OF SUCH GRANTS B_\Sf D UPON FACTORS 'NEVI" SHALI. INCLUDE CONSIDER FACTORS IN
THIi FORMULA THAT LF? \D TO TIIE MOST EQUITABLE. ALLOCATION OF APPROPRIATION _AMONG
COUNTIES.
(7) For state fiscal year 2005-06 and for each state fiscal year thereafter, each county is required to meet a level of county spending
for CCCAP that is equal to the county's proportionate share of the total county funds set forth in the annual general
appropriation act for CCCAP for that state fiscal year. The level of county spending is known as the county's maintenance of
effort for CCCAP for that state fiscal year. For any state fiscal year, the state department is authorized to adjust a county's
maintenance of effort, reflected as a percentage of the total county funds set forth in the annual general appropriation act for
CCCAP for that state fiscal year, so that the percentage equals the county's proportionate share of the total state and federal funds
appropriated for CCCAP for that state fiscal year, reflected as a percentage. For any state fiscal year, the sum of all counties'
maintenance of effort must be equal to or greater than the total county funds set forth in the general appropriation act for the
state fiscal year 1996-97 for employment -related child care.
(II) THERE IS HEREBY CREATED THE CHILD CARE ASSISTANCE PROGRAM ALLOCATION
COMMITTEE THAT WILL CONSIST OF ELEVEN MEMBERS, EIGHT OF WHOM SHALL BE APPOINTED BY
A STATEWIDE ASSOCIATION OF COUNTIES AND TIIREI OF \VHO\I SHALL BE APPOINTED BY THE SI'ATII
DI:P.ARTMENI'. OF THE MEMBERS APPOINTED BY 'HIE. STATEWIDE, ASSOCIATION OF COUNTIES, AT
LEAST TWO MEMBERS SI IALL BE FROM S\L\I,I. AND MEDIUM-SIZED COUNTIES, AND AT LEAST THREE
SHALL, BE FROM LARGE COUNTIES. THE APPOINTING AUTI IORIZII IS SHALL CONSULT WITH EACH
OTHER TO ENSURE THAT TI IF CHILD CARE ASSISTANCE PROGRAM ALLOCATION COMMITTEE IS
REPRESENTATIVE OF THE COUNTIES IN THE STATE. A REPRESENTATIVE FROM THE COUNTY THAT I LAS
TIIE GREAT' ?ST PERCENTAGE OF THE STATE'S CI IILD CARE CASELOAD WILL AUTOMATICALLY BE
APPOINTED, WEIIC[I _APPOINTMENT SHALL, BE CREDITED AGAINST TI IF. EIGI IT APOINTMENTS
AI,LOC_ATELD TO TIIE STATEWIDE ASSOCIATION OF COUNTIES. TI IF CHILD CARE .ASSISTANCE PROGRAM
ALLOCATION COMMITTEE SHALL DEVELOP ITS O\V'N OPFR_ATION_AI. PROCEDURES.
Supporters/Opponents: CCI HF IS supported this concept. CM IS may not support because it would curtail their control over the
allocation.
Proponents acting independently of CCI on this issue:
Anticipated Fiscal Impact:
Priority Ranking (If multiple issues submitted):
:: CCI USE ONLY *
Date Received:
Staff Assignment: Steering Committee Assignment:
Colorado Counties, Inc
Hello