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Home My WebLink About20161887.tiff/D `L75 CONTRACT AGREEMENT AMENDMENT BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND REFLECTIONS FOR YOUTH, INC. (Core) This Agreement Amendment, made and entered intoo��day o I , 1 16 by and between the Board of Weld County Commissioners, on behalf of the Weld Coun 1 Department of Human Services, hereinafter referred to as the "Department", and Reflections for Youth, Inc., hereinafter referred to as the "Contractor". WHEREAS the parties entered into an Agreement for Day Treatment Services and Permanency Services, (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 renewed for the term of June 1, 2015 -May 31, 2016. The Agreement Amendment is identified by the Weld County Clerk to the Board of County Commissioners as document No. 2015-1849(3), approved on June 24, 2015. • The Amendments, together with the Original Agreement, constitutes the entire understanding between the parties. The following change is hereby made to the Contract Documents: I. Term This agreement shall become effective on June 1, 2016, upon proper execution of this Agreement and shall expire May 31, 2017, unless sooner terminated as provided herein. 2. Exhibit B, Scope of Services, is hereby amended to include: Mental Health Services (Neurofeedback): Contractor will provide Neurofeedback services to youth referred by the Department who are currently participating in Day Treatment Services, Permanency Services or Residential programming. Neurofeedback services require authorization from the Department. 2016-1887 ei6.7L6 110 Youth not enrolled in RFY programming are not eligible to be referred to Contractor for Neurofeedback services. Contractor utilizes NeurOptimal equipment to provide Neurofeedback services. Services will only be provided by Joni Martin, LPC, under this agreement. 3. Exhibit B, Scope of Services, Paragraph 2b, is hereby amended as follows: Contractor will provide services in Loveland, Colorado, at 1000 South Lincoln Avenue, #200. Contractor is licensed by the Colorado Department of Human Services State Child Care Licensing (1545846). 4. Exhibit B, Scope of Services, Paragraph 2d, is hereby amended as follows: ii. Enhanced Day Treatment: Comprehensive, highly structured educational program that incorporates therapeutic components and optional enhancements (up to three [3] enhancements at one time.) Optional enhancements include Substance Abuse Treatment, In -Home Family Therapy, Equine Therapy, or In - home Family Therapy with Substance Abuse Treatment. Enhancements can be combined to meet the needs of the client and any one enhancement may be doubled. 1. Substance Abuse Treatment: Consists of a weekly substance abuse group and individual therapy with a LPC, CACII clinician. The curriculum utilized is approved by the Office of Behavioral Health. The goal of this enhancement is to assess precursors to abuse/dependence, decrease sobriety -interfering behaviors, increase internal motivation towards sobriety, and increase the youth's ability to make decisions that promote a healthy lifestyle. 2. In -Home Family Therapy: Consists of family therapy in the family home to address issues with transportation, sickness, disabilities, and assists families who struggle with the therapeutic process outside of the home. The goal of this enhancement is to ensure the family is consistently participating in the therapeutic process, and that the home is a safe and supportive environment. 3. Equine Therapy: Contractor collaborates with Hearts & Horses in Loveland, Colorado, to provide equine therapy to youth throughout the year. Programming is usually six (6) weeks in length. 4. In -home Family Therapy and Substance Abuse Treatment: When both enhancements are needed, enhancements can be combined as one enhancement. Services further include, but are not limited to, assessment and evaluation, development and implementation of a treatment plan, therapy, daily information to parent and/or caretaker regarding homework and treatment goal progress, staffings as needed (at least monthly), a discharge plan and aftercare. Parents and/or caretakers are expected to participate in the above progression of services and will be provided detailed information at the time of discharge. 5. Exhibit C, Payment Schedule, Item 2 — Fees for Services: Day Treatment: $115.00/Day (Regular Day Treatment) $140.00/Day (Regular Day Treatment with One Enhancement) $160.00/Day (Regular Day Treatment with Two Enhancements) $180.00/Day (Regular Day Treatment with Three Enhancements) Home Based Intensive Services: $30.00/Day (5 Hours/Week YFA, No Therapy) $40.00/Day (5 Hours/Week YFA, Up to 1 Contact Hour/Up to 3 Hours Therapist Time) $55.00/Day (10 Hours/Week YFA, No Therapy) $80.00/Day (10 Hours/Week YFA, Up to 1 Contact Hour/Up to 3 Hours Therapist Time) $75.00/Day (15 Hours/Week YFA, No Therapy) $95.00/Day (15 Hours/Week YFA, Up to I Contact Hour/Up to 4 Hours Therapist Time) $95.00/Day (20 Hours/Week YFA, No Therapy) $113.00/Day (20 Hours/Week YFA, Up to 2 Contact Hours/Up to 4 Hours Therapist Time) $138.00/Day (25 Hours/Week YFA, Up to 3 Contact Hours/Up to 5 Hours Therapist Time) $155.00/Day (30 Hours/Week YFA, Up to 3 Contact Hours/Up to 5 Hours Therapist Time) $15.00/Day (Additional charge for enhance contact hours or therapist time.) Mental Health Services: $85.00/Hour (Neurofeedback Session — Only for referred Weld County youth already enrolled in RFY programming. Prior approval of Department is required.) • All other terms and conditions of the Original Agreement remain unchanged. IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. COUNTY: ATTEST:AtithAi ''_ BOARD OF COUNTY COMMISSIONERS Weld Co . ty Clerk to the B. and WELD COUNTY, COLORADO By: Mike Freeman, Chair JUN 2 0 2016 eflections for Youth, Inc. 1000 South Lincoln Avenue, #200 Loveland, Colorado 80537 (970) 218-36.0 By: Date: aird, Executive Director vet 020/ - itf7 AR I® CERTIFICATE OF LIABILITY INSURANCE DATE 5) 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 CoWest Insurance Group, Inc. P.O. Box 910 Castle Rock CO 80104 CONTACT CoWest Corporate NAME: rP PHONE ro.E:t): (303) 688-9597 I A%C,No1: (303)688-8058 E-MAIL i ADDRESS: nfo8 cowest. corn INSURER(S) AFFORDING COVERAGE NAIC 0 INSURERA:COlOT1y Insurance CO INSURED Reflections for Youth, Inc. 1000 S Lincoln Ave Unit 200 Loveland CO 80537 INSURER B:At tiSan & Truckers Casualty 10194 INSURERc:Pinnacol Assurance 41190 INSURER D: INSURERS: INSURERF: S CERTIFICATE NUMBER:15-16 REV MASTER CERT 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 LTR TYPE OF INSURANCE ADDL INSR SUBR NND POLICY NUMBER POLICY EFF (MMIDDNYYY) POLICY EXP ,IMM/DD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY ANP202062 12/20/2015 12/20/2016 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) SO 000 $ r MED EXP (Any one person) $ 2 , 500 X ( CLAIMS -MADE OCCUR PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 PRODUCTS - COMP/OP AGG $ Included GEN'L AGGREGATE LIMIT APPLIES PER: POLICY n JE Fl_ LOC $ B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED X - SCHEDULED AUTOS NO OWNED AUTOS 07640120-5 9/24/2015 _ 9/24/2016 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ Policy Fee $ UMBRELLA LIAB EXCESS LIAB —, OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED I I RETENTION $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y I N Y N/A 4085090 10/1/2015 10/1/2016 II X 1 TORY LIMITS I IOER .L E. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000I A PROFESSIONAL LIABILITY "CLAIMS MADE" COVERAGE ANP202062 RETRO DATE 9/20/2004 12/20/2015 12/20/2016 LIMITS INCLD IN GL DEDUCTIBLE $2,500 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION WELD COUNTY DEPARTMENT OF SOCIAL SERVICES P.O. BOX A 315 NORTH 11TH AVENUE 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 G "Gus" Albrecht/AJM ACORD 25 (2010/05) INS025 (201005).01 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Hello