HomeMy WebLinkAbout20161524.tiff RESOLUTION
RE: APPROVE CONTRACT FOR INMATE MENTAL HEALTH SERVICES AND
AUTHORIZE CHAIR TO SIGN
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 a Contract for Inmate Mental Health
Services between the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County, on behalf of the Sheriff's Office, and the Colorado Department
of Human Services, Office of Behavioral Health, commencing upon full execution of signatures,
or on July 1, 2016, whichever is later, and ending June 30, 2017, with further terms and conditions
being as stated in said contract, and
WHEREAS, after review, the Board deems it advisable to approve said contract, 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 Contract for Inmate Mental Health Services between the County of
Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on
behalf of the Sheriff's Office, and the Colorado Department of Human Services, Office of
Behavioral Health, be and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said contract.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 4th day of May, A.D., 2016.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST: ≥ P 4IVr--
Mike Freeman, Chair
Weld County Clerk to t e Board
EXCUSED
S--n PCo way, Pro-Tern
BY:
Depu Clerk to the Board
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Date of signature: `�
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10/ 11 / 19 2016-1524
SO0037
BOCC STAFF USE
Date Set: Time:
BOARD OF COUNTY COMMISSIONERS
WORK SESSION COVER LETTER
Department/Office: Sheriff's Office Date: 04/25/2016
Person requesting work session: Jennifer Oftelie Extension: x2872
Has your commissioner coordinator/BOCC chair approved the work session?
Yes, commissioner coordinator
Yes,BOCC chair
Recommended length of time needed for discussion:
15 minutes X 20 minutes 30 minutes other(list)
In addition to yourself and the board, please list who should attend:
Captain Roger Ainsworth, Inmate Services Director Matt Elbe, County Attorney Frank Haug
Brief description of the issue: (please select one) ❑ Informational only X Action needed
The Sheriff's Office has received a new contract between the State of Colorado's Department of
Human Services, Office of Behavioral Health and the Sheriff's Office. The State of Colorado created a
program to more effectively treat inmates with mental health issues while incarcerated, to increase the
likelihood of continuing treatment once released. This contract is to offset the cost of that program,
using the services of North Range Behavioral Health and Intervention Inc., as the holders of the
Medicaid contracts able to seamlessly provide the services to the jail population upon release from
custody. This new contract term is from 07/01/2016—06/30/2017, and the reimbursement of services to
WCSO is $330,989.
The entire contract is attached, and the budget is on page 32 of the attachment. A similar
contract had been in place for the past four years, increasing in reimbursement payments each year to
the WCSO. After 2012, the State chose to exercise the option to extend the contract over the next three
years, and the agreement currently in place ends 6/30/2016, thus a new contract.
Options for the board:
1) Approve the contract and accept the funding provided.
2) Request further information before signing the contract.
3) Disapprove the contract and discuss other ways of funding mental health services for inmates.
Recommendation to the board:
We would request approval to put this contract on the Agenda for the Chairman of the Board to
approve and sign for one year.
BOARD CHAIR USE
Results/Outcomes:
2016-1524
50003
05/04 '7
RE: CONTRACT FOR INMATE MENTAL HEALTH PROGRAM - CO. DEPT. OF HUMAN
SERVICES/OFFICE OF BEHAVIORAL HEALTH
ATTEST: � V `" '(1 BOARD OF COUNTY COMMISSIONERS
Weld • my Clerk to the :oard WELD COUNTY, COLORADO
BY: A. ,,.•/�:i...►�� � '
Deputy rk to the B•!'�,��� � Mike Freeman, Chair�'S � � MAY 0 4 2016
_TED AS 70 F N N►, . ,' PP VEDAS TO SUBSTANCE:
Controller Elected Official or Department Head
ROV AS TO O /
Director of General Services
County Attorney
0Z0/‘-/5W6)
DEPARTMENT OF HUMAN SERVICES
ROUTING NO. 17 IHJA 8 7 8 1 3
CONTRACT
This contract is made and entered into by and between the named parties. In accordance with the
purposes stated herein, it is hereby agreed as follows:
STATE: CONTRACTOR:
State of Colorado for the use&benefit of the Weld County Sheriffs Office
Department of Human Services 1950 O Street
Office of Behavioral Health Greeley,Colorado 80631
3824 West Princeton Circle
Denver,CO 80236
CONTRACT MADE DATE: CONTRACTOR'S ENTITY TYPE:
03/02/2016 Government
RQS PRE-ENCUMBRANCE NUMBER
RQS IHJA 201600006417 CONTRACTOR'S STATE OF INCORPORATION:
CT/CTGG1 ENCUMBRANCE NUMBER: Colorado
CT IHJA 2017 BILLING STATEMENTS RECEIVED:
TERM: Monthly
This contract shall be effective upon approval STATUTORY AUTHORITY:
by the State Controller,or designee,or on C.R.S. §27-80-106
07/01/2016,whichever is later. The contract CONTRACT PRICE NOT TO EXCEED:
shall end on 06/30/2017.
$330,989
MAXIMUM AMOUNT AVAILABLE PER FISCAL YEAR
PROCUREMENT METHOD: FY 17: $330,989
Exempt
BID/REP/LAST PRICE AGREEMENT NUMBER
Not Applicable
LAW SPECIFIED VENDOR STATUTE: PRICE STRUCTURE:
Not Applicable Cost Reimbursement
FUND SOURCE-NAME OF FEDERAL PROGRAM/GRANT AND FUNDS ID#
STATE REPRESENTATIVE: CONTRACTOR REPRESENTATIVE:
Andrew Martinez Steven Reams
Office of Behavioral Health Weld County Sheriffs Office
3824 West Princeton Circle 1950 O Street
Denver, CO 80236 Greeley,Colorado 80631
SCOPE OF WORK:
In accordance with the provisions of this contract and its exhibits and attachments, the Contractor shall:
Provide therapeutic interventions to treat alcoholism and illicit drug use disorders as well as mental illness related to
these addictions in the county jails.
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EXHIBITS:
The following exhibits are hereby incorporated:
Exhibit A- Statement of Work
Exhibit B- Budget
Exhibit C Miscellaneous Provisions
Exhibit D Sample Option Letter
Exhibit E Performance Measures
Exhibit F HIPAA Business Associate Addendum
Exhibit G Recovery Support Services
COORDINATION:
The State warrants that required approval,clearance and coordination has been accomplished from and with
appropriate agencies.
APPROVAL:
In no event shall this contract be deemed valid until it shall have been approved by the State Controller or
his/her designee.
PROCUREMENT:
This contractor has been selected in accordance with the requirements of the Colorado Procurement Code.
PRICE PROVISIONS:
Payments pursuant to this contract shall be made as earned, in whole or in part, from available funds,
encumbered for the purchase of the described services and/or deliverables. The liability of the State at any
time for such payments shall be limited to the encumbered amount remaining of such funds.
Authority exists in the laws and funds have been budgeted, appropriated and otherwise made available, and
a sufficient unencumbered balance thereof remains available for payment.
Financial obligations of the State of Colorado payable after the current fiscal year are contingent upon funds
for that purpose being appropriated,budgeted and otherwise made available.
The Contractor understands and agrees that the State shall not be liable for payment for work or services or
for costs or expenses incurred by the Contractor prior to the proper execution and State Controller approval
of this contract.
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GENERAL PROVISIONS
The following clauses apply to this contract: this contract;4)the exhibits to this contract,except that
any exhibit entitled: "Modifications to the General
A. Governmental Immunity/Limitation of Liability: Provisions" shall take priority over the General
Notwithstanding anything herein to the contrary, no Provisions of this contract.
term or condition of this contract shall be construed E. Notice and Representatives: For the purposes of this
or interpreted as a waiver, express or implied, of any contract, the representative for each party is as
of the immunities, rights, benefits, protection, or designated herein. Any notice required or permitted
other provisions of the "Colorado Governmental
Immunity Act", C.R.S. §24 10 101, et seq., as now may be delivered in person or sent by registered or
or hereinafter amended. The parties understand and certified mail, return receipt requested, to the party at
agree that the liability of the State for claims for the address provided, and if sent by mail it is effective
injuries to persons or property arising out of when posted in a U.S. Mail Depository with sufficient
negligence of the State of Colorado, its departments, postage attached thereto. Notice of change of address
institutions, agencies, boards, officials and or change or representative shall be treated as any other
employees is controlled and limited by the provisions notice.
of C.R.S. §24-10-101, et seq., as now or hereafter F. Contractor Representations:
amended and the risk management statutes, C.R.S. 1. Licenses and Certifications: The Contractor
§24-30-1501, et seq., as now or hereafter amended. certifies that, at the time of entering into this
Any liability of the State created under any other contract, it and its agents have currently in effect
provision of this contract, whether or not all necessary licenses, certifications, approvals,
incorporated herein by reference, shall be controlled insurance, etc. required to properly provide the
by, limited to, and otherwise modified so as to services and/or supplies covered by this contract
conform with,the above cited laws. in the state of Colorado. Proof of such licenses,
B. Federal Funds Contingency: Payment pursuant to this certifications, approvals, insurance, etc. shall be
contract, if in federal funds, whether in whole or in provided upon the State's request. Any
part, is subject to and contingent upon the continuing revocation, withdrawal or nonrenewal of
availability of federal funds for the purposes hereof. necessary license, certification, approval,
In the event that said funds, or any part thereof, insurance, etc. required for the Contractor to
become unavailable, as determined by the State, the properly perform this contract, shall be grounds
State may immediately terminate this contract or for termination of this contract by the State.
amend it accordingly. 2. Qualification: Contractor certifies that it is
qualified to perform such services or provide such
C. Billing Procedures: The State shall establish billing deliverables as delineated in this contract.
procedures and requirements for payment due the 3. Exclusion, Debarment and/or Suspension:
Contractor represents and warrants that
Contractor in providing performance pursuant to this Contractor, or its employees or authorized
contract. The Contractor shall comply with the subcontractors, are not presently excluded from
established billing procedures and requirements for participation, debarred, suspended, proposed for
submission of billing statements. The State shall debarment, declared ineligible, voluntarily
comply with CRS 24-30-202(24)when paying vendors excluded,or otherwise ineligible to participate in a
upon receipt of a correct notice of the amount due for
"federal health care program" as defined in 42
goods or services provided hereunder. U.S.C. § 1320a-7b(f) or in any other government
D. Exhibits- Interpretation: Unless otherwise stated, all payment program by any federal or State of
referenced exhibits are incorporated herein and made a Colorado department or agency. In the event
part of this contract. And, unless otherwise stated, in
Contractor, or one of its employees or authorized
the event of conflicts or inconsistencies between this subcontractors, is excluded from participation, or
contract and its exhibits or attachments, such conflicts becomes otherwise ineligible to participate in any
shall be resolved by reference to the documents in the such program during the Term, Contractor will
following order of priority: 1)the Special Provisions of notify the State in writing within three (3) days
after such event. Upon the occurrence of such
this contract shall always be controlling over other event, whether or not such notice is given to
provisions in the contract or amendments; 2) the
contract "cover" pages; 3) the General Provisions of
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Contractor, the State reserves the right to 101, et seq., as amended (the "GIA"), then
immediately cease contracting with Contractor. Contractor shall maintain at all times during
4. Work Performed Outside the United States or the term of this Contract such liability
Colorado, pursuant to C.R.S. §24-102-206: The insurance, by commercial policy or self-
Contractor certifies all work performed under this insurance, as is necessary to meet its liabilities
Contract,including any subcontracts,is anticipated under the GIA. Contractor shall show proof of
to be and will be performed within the United such insurance satisfactory to the State, if
States or Colorado, unless otherwise specified in requested by the State. Contractor shall require
the Statement of Work. If work under this each contract with a Subcontractor that is a
Contract is anticipated to be or will be performed public entity, to include the insurance
outside the United States or Colorado, the requirements necessary to meet such
countries and/or states where work will be Subcontractor's liabilities under the GIA.
performed, and the reasons it is necessary or b. Non-Public Entities: If Contractor is not a
advantageous to go outside the United States or "public entity" within the meaning of the GIA,
Colorado to perform the work are also specified in Contractor shall obtain and maintain during
the Statement of Work. the term of this Contract insurance coverage
and policies meeting the same requirements
G. Legal Authority: The Contractor warrants that it set forth in provision 1.2 below with respect to
possesses the legal authority to enter into this Subcontractors that are not"public entities".
contract and that it has taken all actions required by 2. Contractors—Subcontractors
its procedures, by-laws, and/or applicable law to Contractor shall require each contract with
exercise that authority, and to lawfully authorize its Subcontractors other than those that are public
undersigned signatory to execute this contract and entities, providing Goods or Services in
bind the Contractor to its terms. The person(s) connection with this Contract, to include
executing this contract on behalf of the Contractor insurance requirements substantially similar to
warrant(s) that such person(s) have full authorization the following:
to execute this contract. a.Worker's Compensation: Worker's
Compensation Insurance as required by State
H. Indemnification: Contractor shall indemnify, statute, and Employer's Liability Insurance
save, and hold harmless the State, its employees and covering all of Contractor or Subcontractor
agents, against any and all claims, damages, liability employees acting within the course and scope
and court awards including costs, expenses, and of their employment.
attorney fees and related costs, incurred as a result of b.General Liability: Commercial General
any act or omission by Contractor, or its employees, Liability Insurance written on ISO occurrence
agents, subcontractors, or assignees pursuant to the form CG 00 01 10/93 or equivalent, covering
terms of this contract. premises operations, fire damage, independent
contractors, products and completed
[Applicable Only to Intergovernmental Contracts] operations, blanket contractual liability,
No term or condition of this contract shall be personal injury, and advertising liability with
construed or interpreted as a waiver, express or minimum limits as follows:
implied, of any of the immunities, rights, benefits, (a)$1,000,000 each occurrence;
protection, or other provisions, of the Colorado (b)$1,000,000 general aggregate;
Governmental Immunity Act, CRS §24-10-101 et (c) $1,000,000 products and completed
seq., or the Federal Tort Claims Act, 28 U.S.C. 2671 operations aggregate;and
et seq.,as applicable,as now or hereafter amended. (d)$50,000 any one fire.
I. Insurance: Contractor and its Subcontractors shall If any aggregate limit is reduced below
obtain and maintain insurance as specified in this $1,000,000 because of claims made or paid,
section at all times during the term of this Contract. Subcontractor shall immediately obtain
All policies evidencing the insurance coverage additional insurance to restore the full
required hereunder shall be issued by insurance aggregate limit and furnish to Contractor a
companies satisfactory to Contractor and the State. certificate or other document satisfactory to
1. Contractor Contractor showing compliance with this
a. Public Entities: If Contractor is a "public provision.
entity" within the meaning of the Colorado c.Automobile Liability: Automobile Liability
Governmental Immunity Act, CRS §24-10- Insurance covering any auto (including
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owned, hired and non-owned autos) with a State at any other time during the term of this
minimum limit of $1,000,000 each accident Contract or any subcontract, Contractor and each
combined single limit. Subcontractor shall, within 10 days of such
d. Professional Liability: Professional liability request,supply to the State evidence satisfactory to
insurance with minimum limits of liability of the State of compliance with the provisions of this
not less than$1,000,000,unless waived by the provision I.
State.
e.Privacy Insurance J. Disaster Planning and Pandemic Outbreaks: The
If this Contract includes a HIPAA Business State may require the Contractor to submit a Disaster
Associates Addendum exhibit, Contractor Response Plan (Plan) to ensure the delivery
shall obtain and maintain during the term of hereunder of essential government services during a
this Contract liability insurance covering all disaster, declared emergency, and/or pandemic
loss of Protected Health Information data and outbreak. The Plan would take precedence over and
claims based upon alleged violations of nullify any contractual provision relating to force
privacy rights through improper use or majeure or "Acts of God." Accordingly, should the
disclosure of Protected Health Information work performed by the Contractor under this contract
with a minimum annual limit of$1,000,000. include the provision of any essential government
f. Additional Insured: The State shall be named services, the State may request a Plan from the
as additional insured on all Commercial Contractor, and, upon such request, the Contractor
General Liability and Automobile Liability shall forthwith submit a Plan, and the Contractor
Insurance policies (leases and construction shall be bound to perform hereunder in accordance
contracts require additional insured coverage therewith.
for completed operations on endorsements CG
2010 11/85, CG 2037, or equivalent) required K. Rights in Data, Documents and Computer Software
of Contractor and any Subcontractors or Other Intellectual Property:
hereunder. All intellectual property including without limitation,
g. Primacy of Coverage: Coverage required of databases, software, documents, research, programs
Contractor and Subcontractor shall be primary and codes, as well as all, reports, studies, data,
over any insurance or self-insurance program photographs, negatives or other documents,drawings
carried by Contractor or the State. or materials prepared by the contractor in the
h. Cancellation: The above insurance policies performance of its obligations under this contract
shall include provisions preventing shall be the exclusive property of the State. Unless
cancellation or non-renewal without at least 30 otherwise stated, all such materials shall be delivered
days prior notice to Contractor and Contractor to the State by the contractor upon completion,
shall forward such notice to the State in termination, or cancellation of this contract.
accordance with provision E. Notice and Contractor shall not use, willingly allow or cause to
Representatives within seven days of have such materials used for any purpose other than
Contractor's receipt of such notice. the performance of the contractor's obligations under
i. Subrogation Waiver: All insurance policies in this contract without a prior written consent of the
any way related to this Contract and secured State. All documentation, accompanying the
and maintained by Contractor or its intellectual property or otherwise, shall comply with
Subcontractors as required herein shall include the State requirements which include but is not
clauses stating that each carrier shall waive all limited to all documentation being in a paper,human
rights of recovery, under subrogation or readable format which is useable by one who is
otherwise, against Contractor or the State, its reasonably proficient in the given subject area.
agencies, institutions, organizations, officers,
agents,employees,and volunteers. L. Proprietary Information: Proprietary information for
3.Certificates: Contractor and all Subcontractors the purpose of this contract is information relating to a
shall provide certificates showing insurance party's research, development, trade secrets, business
coverage required hereunder to the State within affairs,internal operations and management procedures
seven business days of the Effective Date of this and those of its customers,clients or affiliates,but does
Contract. No later than 15 days prior to the not include information lawfully obtained by third
expiration date of any such coverage, Contractor parties, which is in the public domain, or which is
and each Subcontractor shall deliver to the State or developed independently.
Contractor certificates of insurance evidencing
renewals thereof. In addition, upon request by the
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Neither party shall use or disclose directly or indirectly submission of the final federal expenditure report
without prior written authorization any proprietary under this contract, unless the State requests that the
information concerning the other party obtained as a records be retained for a longer period, or until an
result of this contract. Any proprietary information audit has been completed with the following
removed from the State's site by the Contractor in the qualification. If an audit by or on behalf of the
course of providing services under this contract will be federal and/or state government has begun but is not
accorded at least the same precautions as are employed completed at the end of the three(3)year period,or if
by the Contractor for similar information in the course audit findings have not been resolved after a three(3)
of its own business. year period, the materials shall be retained until the
resolution of the audit findings.
M. Records Maintenance, Performance Monitoring &
Audits: The Contractor shall maintain a complete file The Contractor shall permit the State, any other
of all records,documents,communications,and other governmental agency authorized by law, or an
materials that pertain to the operation of the authorized designee thereof, in its sole discretion, to
program/project or the delivery of services under this monitor all activities conducted by the Contractor
contract. Such files shall be sufficient to properly pursuant to the terms of this contract. Monitoring
reflect all direct and indirect costs of labor,materials, may consist of internal evaluation procedures,
equipment, supplies and services, and other costs of reexamination of program data, special analyses,
whatever nature for which a contract payment was on-site verification, formal audit examinations, or
made.These records shall be maintained according to any other procedures as deemed reasonable and
generally accepted accounting principles and shall be relevant. All such monitoring shall be performed in a
easily separable from other Contractor records. manner that will not unduly interfere with contract
work.
The Contractor shall protect the confidentiality of all
records and other materials containing personally N. Taxes: The State, as purchaser, is exempt from all
identifying information that are maintained in federal excise taxes under Chapter 32 of the Internal
accordance with this contract. Except as provided by Revenue Code [No. 84-730123K] and from all state
law, no information in possession of the Contractor and local government use taxes [C.R.S. §39- 26-
about any individual constituent shall be disclosed in 114(a) and 203, as amended]. The contractor is
a form including identifying information without the hereby notified that when materials are purchased for
prior written consent of the person in interest, a the benefit of the State, such exemptions apply
minor's parent,guardian, or the State. The Contractor except that in certain political subdivisions the
shall have written policies governing access to, vendor may be required to pay sales or use taxes
duplication and dissemination of, all such even though the ultimate product or service is
information and advise its agents,if any,that they are provided to the State. These sales or use taxes will
subject to these confidentiality requirements. The not be reimbursed by the State.
Contractor shall provide its agents, if any, with a
copy or written explanation of these confidentiality O. Conflict of Interest: During the term of this contract,
requirements before access to confidential data is the Contractor shall not engage in any business or
permitted. personal activities or practices or maintain any
relationships which conflict in any way with the
The Contractor authorizes the State, the federal Contractor fully performing his/her obligations under
government or their designee, to perform audits this contract.
and/or inspections of its records, at any reasonable
time, to assure compliance with the state or federal Additionally, the Contractor acknowledges that, in
government's terms and/or to evaluate the governmental contracting, even the appearance of a
Contractor's performance. Any amounts the State conflict of interest is harmful to the interests of the
paid improperly shall be immediately returned to the State. Thus, the Contractor agrees to refrain from
State or may be recovered in accordance with other any practices, activities or relationships which could
remedies. reasonably be considered to be in conflict with the
Contractor's fully performing his/her obligations to
All such records, documents, communications, and the State under the terms of this contract, without the
other materials shall be the property of the State prior written approval of the State.
unless otherwise specified herein and shall be
maintained by the Contractor, for a period of three In the event that the Contractor is uncertain whether
(3) years from the date of final payment or the appearance of a conflict of interest may
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reasonably exist, the Contractor shall submit to the • Titles VI&VII of the Civil Rights Act of 1964,42
State a full disclosure statement setting forth the U.S.C.2000(d)&(e);
relevant details for the State's consideration and • The Personal Responsibility and Work
direction. Failure to promptly submit a disclosure Opportunity Reconciliation Act of 1996, 42 USC
statement or to follow the State's direction in regard 604a,PL 104-193. See also State Executive Order
to the apparent conflict shall be grounds for D 015 00;
termination of the contract. • Title IX of the Education Amendments of 1972,
20 U.S.C. 1681 et seq.;
Further, the Contractor shall maintain a written code • The Uniform Administrative Requirements for
of standards governing the performance of its Grants and Cooperative Agreements to State and
agent(s) engaged in the award and administration of Local Governments (Common Rule), at 45 CFR,
contracts. Neither the Contractor nor its agent(s) Part 92;
shall participate in the selection, or in the award or • The Uniform Administrative Requirements for
administration of a contract or subcontract supported Awards and Subawards to Institutions of Higher
by Federal funds if a conflict of interest, real or Education, Hospitals, Other Non-Profit
apparent, would be involved. Such a conflict would Organizations, and Commercial Organizations
arise when: (Common Rule),at 2 CFR 215;
1. The employee,officer or agent; • Office of Management and Budget Circulars A-87,
2. Any member of the employee's immediate A-21 or A-122,and A-102 or A-110,whichever is
family; applicable.
3. The employee's partner;or • OFFICE OF MANAGEMENT AND BUDGET
4. An organization which employees, or is about to GUIDANCE FOR GRANTS AND
employ,any of the above, AGREEMENTS,2 CFR Part 200.
has a financial or other interest in the firm selected • The Hatch Act (5 USC 1501-1508) and Civil
for award. Neither the Contractor nor its agent(s) Service Reform Act, Public Law 95-454 Section
will solicit nor accept gratuities, favors, or anything 4728
of monetary value from Contractor's potential • Departments of Labor, Health and Human
contractors,or parties to subagreements. Services, and Education and Related Agencies
P. Conformance with Law: The Contractor and its Appropriations Act, 1990, PL 101-166, Section
agent(s) shall at all times during the term of this 511.
contract strictly adhere to all applicable federal laws, • 45 CFR Subtitle A, Department of Health and
state laws, Executive Orders and implementing Human Services regulations.
regulations as they currently exist and may hereafter • The Single Audit Act Amendments of 1996, 31
be amended. Without limitation, these federal laws USC 7501, Public Law 104-156, OMB Circular
and regulations include: A 133,and 45 CRF 74.26.
• Age Discrimination Act of 1975, 42 U.S.C. • The Federal Funding Accountability and
Section 6101 et seq. and its implementing Transparency Act of 2006 (Public Law 109-
regulation,45 C.F.R.Part 91; 282), as amended by §6062 of Public Law 110-
• Age Discrimination in Employment Act of 1967, 252, including without limitation all data
29 U.S.C.621 et seq.; reporting requirements required thereunder.
• Americans with Disabilities Act of 1990 (ADA), This Act is also referred to as FFATA.
42 U.S.C. 12101 et se • The American Recovery and Reinvestment Act
q' of 2009 (Public Law 111-5), including without
• The Drug Free Workplace Act of 1988,41 U.S.C. limitation all data reporting requirements
701 et seq.; required thereunder. This Act is also referred to
• Equal Pay Act of 1963,29 U.S.C.206; as ARRA.
• Health Insurance Portability and Accountability
Act of 1996, 42 U.S.C. § 1320d et seq. and Q. Restrictions on Public Benefits: Pursuant to House Bill
implementing regulations, 45 C.F.R. Parts 160 06S-1023, as codified at C.R.S. § 24-76.5-101 et seq.,
and 164; except as otherwise provided therein or where exempt
• Immigration Reform and Control Act of 1986, 8 by federal law,the State is required to verify the lawful
U.S.C. 1324b; presence in the United States of each natural person 18
• Pro-Children Act of 1994,20 U.S.C.6081 et seq.; years of age or older who applies for state or local
• Section 504 of the Rehabilitation Act of 1973, 29 public benefits or for federal public benefits for the
U.S.C. 794, as amended, and implementing applicant. Accordingly, should the work performed by
regulation 45 C.F.R.Part 84;
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the Contractor under this contract include the provision 4. Gross Failure to Meet Performance Measures.
of any of said benefits to any natural person 18 years of Should the final performance Evaluation and
age or older who applies therefore for the applicant,the Review determine that Contractor demonstrated
Contractor shall follow the requirements of said law in a gross failure to meet the performance measures
the provision of said benefits as if it were the State. established hereunder, the Executive Director of
The State will provide the Contractor with specific the Colorado Department of Personnel and
instruction on the identification documentation Administration (Executive Director), upon
required and the process to be followed by the request by the Department of Human Services,
Contractor to properly comply with the law if the work for good cause shown,may debar Contractor and
done under this contract is subject to these prohibit Contractor from bidding on future
requirements. contracts. Contractor may contest the final
Evaluation and Review and Rating by: (a) filing
R. Statewide Contract Management System: rebuttal statement(s), which may result in either
1. When Applicable. If the maximum amount removal or correction of the evaluation (CRS
payable to Contractor under this Contract is §24-105-102(6)), or (b) under CRS §24-105-
$100,000 or greater, either on the Effective Date 102(6), exercising the debarment protest and
or at anytime thereafter,this provision applies. appeal rights provided in CRS §§24-109-106,
2. Governing State Statutes. Contractor agrees to 107,201 or 202,which may result in the reversal
be governed, and to abide, by the provisions of of the debarment and reinstatement of
CRS §24-102-205, §24-102-206, §24-103-601, Contractor by the Executive Director upon
§24-103.5-101 and §24-105-102 concerning the showing of good cause.
monitoring of vendor performance on state 5. CORA Disclosure: To the extent not prohibited
contracts and inclusion of contract performance by federal law, this Contract and the
information in a statewide contract management performance measures and standards under CRS
system. §24-103.5-101 are subject to public release
3. Performance Evaluation and Review. through the Colorado Open Records Act, CRS
Contractor's performance shall be subject to §24-72-101,et seq.
Evaluation and Review in accordance with the
terms and conditions of this Contract, State law S. Performance Ratings and Guidelines:
(including without limitation CRS §24-103.5- The Contractor will be given a Final Contractor
101), and State Fiscal Rules, Policies and Performance Evaluation at the end of the contract
Guidance. Evaluation and Review of term in accordance with C.R.S. §24-102-205(6) and
Contractor's performance shall be part of the General Provision R. above. The list of available
normal contract administration process and Performance Ratings, along with guidelines for what
Contractor's performance will be systematically final rating will be given,are as follows:
recorded in the statewide Contract Management 1. Above Standard:This rating may be given where
System. Areas of Evaluation and Review shall Contractor consistently performs in a manner
include without limitation quality, cost and that exceeds the requirements of this Contract,
timeliness. Collection of information relevant to and where such performance is measurable
the performance of Contractor's obligations against objective factors specifically identified
under this Contract shall be determined by the for use in achieving the purposes of this
specific requirements of such obligations and provision. If applicable to work performed under
shall include factors tailored to match the this Contract, the objective factors and
requirements of Contractor's obligations performance required to merit an "Above
hereunder. Such performance information shall Standard" rating are specified in a so dedicated
be entered into the statewide Contract Exhibit to this Contract, which may be included
Management System at intervals during the term herein from the start of the contract or
hereof determined appropriate by the State, and subsequently be added by formal contract
a final Evaluation, Review and Rating shall be amendment at any time before the end of the
rendered by the State within 30 days of the end contract term. If there is no such dedicated
of the Contract term. Contractor shall be Exhibit included or subsequently added herein,
notified following each performance Evaluation this rating is unavailable.
and Review, and shall address or correct any 2. Standard: This rating will be given where: 1.)
identified problem in a timely manner and Contractor's performance hereunder meets the
maintain work progress. requirements of this Contract in areas of quality,
cost, and timeliness; 2.) Contractor's work is
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accepted by the State; and 3.) full payment W. Disputes: Except as herein specifically provided
hereunder is made to Contractor for such otherwise, disputes concerning the performance of
performance. this contract which cannot be resolved by the
3. Below Standard: This rating may be given where designated contract representatives shall be referred
Contractor materially fails to perform the in writing to a senior departmental management staff
requirements of this Contract and such failure designated by the department and a senior manager
results in the State's invocation of contract designated by the Contractor. Failing resolution at
remedies and/or contract termination in that level, disputes shall be presented in writing to
accordance with General Provision X.below. the Executive Director and the Contractor's chief
executive officer for resolution. This process is not
T. Discrimination:The Contractor during the performance intended to supersede any other process for the
of this contract shall: resolution of controversies provided by law.
1. not discriminate against any person on the basis of
race, color, national origin, age, sex, religion and X. Remedies: Acceptance is dependent upon completion
handicap, including Acquired Immune Deficiency of all applicable inspection procedures. The State
Syndrome(AIDS)or AIDS related conditions. reserves the right to inspect the goods and/or services
2. not exclude from participation in, or deny provided under this contract at all reasonable times
benefits to any qualified individual with a and places. The Executive Director of the State or
disability,by reason of such disability. her/his designee may exercise the following remedial
Any person who thinks he/she has been actions should s/he find the Contractor substantially
discriminated against as related to the performance of failed to satisfy the scope of work found in this
this contract has the right to assert a claim, Colorado contract. Substantial failure to satisfy the scope of
Civil Rights Division,C.R.S. §24-34-302,et seq. work shall be defined to mean substantially
insufficient, incorrect or improper activities or
U. Criminal Background Check: Pursuant to C.R.S. inaction by the Contractor. Without limitation, the
§27-90-111 and Department of Human Services State has the right to:
Policy VI-2.4, any independent contractor, and its 1. withhold payment until performance is cured,
agent(s),who is designated by the Executive Director 2. require the vendor to take necessary action to
or the Executive Director's designee to be a ensure that the future performance conforms to
contracting employee under C.R.S. §27-90-111, who contract requirements,
has direct contact with vulnerable persons in a state- 3. request removal of a Contractor's agent from
operated facility, or who provides state-funded contract work,
services that involve direct contact with vulnerable 4. equitably reduce the payment due the vendor to
persons in the vulnerable person's home or residence, reflect the reduced value of the services
shall: performed,
1. submit to a criminal background check,and 5. recover payment for work that due to the
2. report any arrests, charges, or summonses for Contractor cannot be performed or would be of
any disqualifying offense as specified by C.R.S. no value to the State,
§27-90-111 to the State. 6. modify or recover payments (from payments
Any Contractor or its agent(s), who does not comply under this contract or other contracts between
with C.R.S. §27-90-111 and DHS Policy VI-2.4, the State and the vendor as a debt due to the
may, at the sole discretion of the State, be suspended State) to correct an error due to omission, error,
or terminated. fraud and/or defalcation,
7. terminate the contract.
V. Litigation: The Contractor shall within five (5)
calendar days after being served with a summons, These remedies in no way limit the remedies available
complaint, or other pleading which has been filed in to the State in the termination provisions of this
any federal or state court or administrative agency contract,or remedies otherwise available at law.
notify the State that it is a party defendant in a case
which involves services provided under this contract. Y. Termination:
The Contractor shall deliver copies of such 1. Termination for Default: The State may
document(s) to the State's Executive Director. The terminate the contract for cause. If the State
term "litigation" includes an assignment for the terminates the contract for cause,it will first give
benefit of creditors, and filings in bankruptcy, ten (10) days prior written notice to the
reorganization and/or foreclosure. Contractor, stating the reasons for cancellation,
procedures to correct problems, if any, and the
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date the contract will be terminated in the event provisions, the Contractor is entitled to submit a
problems have not been corrected. In the event termination claim within ten (10) days of the
this contract is terminated for cause, the State effective date of termination. The termination
will only reimburse the Contractor for accepted claim shall address and the State shall consider
work or deliverables received up to the date of paying the following costs:
termination. In the event this contract is a. the contract price for performance of work,
terminated for cause, final payment to the which is accepted by the State, up to the
Contractor may be withheld at the discretion of effective date of the termination.
the State until completion of final audit. b. reasonable and necessary costs incurred in
Notwithstanding the above, the Contractor may preparing to perform the terminated portion
be liable to the State for the State's damages. If it of the contract
is determined that the Contractor was not in c. reasonable profit on the completed but
default then such termination shall be treated as undelivered work up to the date of
a termination for convenience as described termination
herein. d. the costs of settling claims arising out of the
2. Termination for Convenience: The State shall termination of subcontracts or orders, not to
have the right to terminate this contract by exceed 30 days pay for each subcontractor
giving the Contractor at least twenty (20) days e. reasonable accounting, legal, clerical, and
prior written notice. If notice is so given, this other costs arising out of the termination
contract shall terminate on the expiration of the settlement.
specified time period, and the liability of the
parties hereunder for further performance of the In no event shall reimbursement under this
terms of this contract shall thereupon cease, but clause exceed the contract amount reduced by
the parties shall not be released from the duty to amounts previously paid by the State to the
perform their obligations up to the date of Contractor.
termination.
3. Immediate Termination: This contract is subject Z. Venue: The parties agree that venue for any action
to immediate termination by the State in the related to performance of this contract shall be in the
event that the State determines that the health, City and County of Denver,Colorado.
safety, or welfare of persons receiving services
may be in jeopardy. Additionally, the State may AA.Understanding of the Parties:
immediately terminate this contract upon 1. Complete Understanding: This contract is
verifying that the Contractor has engaged in or is intended as the complete integration of all
about to participate in fraudulent or other illegal understandings between the parties. No prior or
acts. contemporaneous addition, deletion, or other
4. Termination for Financial Exigency: The State amendment hereto shall have any force or effect
shall have the right to terminate this contract for whatsoever, unless embodied herein in writing.
financial exigency by giving the Contractor at No subsequent novation, renewal, addition,
least thirty(30)days prior written notice.For the deletion, or other amendment hereto shall have
purposes of this provision, a financial exigency any force or effect unless embodied in a written
shall be a determination made by the Colorado contract executed and approved pursuant to the
legislature or its Joint Budget Committee that the State Fiscal Rules. Descriptive headings as used
financial circumstances of the State are such that herein are for convenience and shall not control
it is in the best interest of the State to terminate or affect the meaning or construction of any
this contract. If notice of such termination is so provision of this contract.
given, this contract shall terminate on the 2. Severability: To the extent that this contract may
expiration of the time period specified in the be executed and performance of the obligations
notice, and the liability of the parties hereunder of the parties may be accomplished within the
for further performance of the terms of this intent of the contract, the terms of this contract
contract shall thereupon cease, but the parties are severable, and should any term or provision
shall not be released from the duty to perform hereof be declared invalid or become inoperative
their obligations up to the date of termination. for any reason, such invalidity or failure shall
not affect the validity of any other term or
In the event that the State terminates this provision hereof.
contract under the Termination for Convenience 3. Benefit and Right of Action: Except as herein
or Termination for Financial Exigency specifically provided otherwise, it is expressly
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understood and agreed that this contract shall requirements. However, this extension terminates
inure to the benefit of and be binding upon the when the replacement contract becomes effective
parties hereto and their respective successors and when signed by the State Controller or an authorized
assigns. All rights of action relating to delegate.
enforcement of the terms and conditions shall be
strictly reserved to the State and the named CC.Health Insurance Portability&Accountability Act of
Contractor. Nothing contained in this agreement 1996 ("HIPAA"). Federal law and regulations
shall give or allow any claim or right of action governing the privacy of certain health information
whatsoever by any other third person. It is the requires a"Business Associate Contract"between the
express intention of the State and the Contractor State and the Contractor. 45 C.F.R. Section
that any such person or entity, other than the 164.504(e). If applicable to this Contract, attached
State or the Contractor, receiving services or and incorporated herein by reference and agreed to
benefits under this agreement shall be deemed an by the parties is a HIPAA Business Associate
incidental beneficiary only. Addendum for HIPAA compliance. Terms of the
4. Waiver: The waiver of any breach of a term Addendum shall be considered binding upon
hereof shall not be construed as a waiver of any execution of this contract and shall remain in effect
other term, or the same term upon subsequent during the term of the contract including any
breach. extensions.
5. Survival: The State and the Contractor's
obligations under this contract shall survive DD.Colorado Department of Human Services (CDHS)
following termination or expiration to the extent Fraud Policy. The CDHS Fraud Policy addresses the
necessary to give effect to the intent and need for effective and consistent measures for
understanding of the parties. preventing, detecting, and deterring fraud. The
6. Subcontracting: Except as herein specifically relevant parties discussed in the policy include
provided otherwise,the duties and obligations of CDHS employees, CDHS management, CDHS
the Contractor arising hereunder cannot be appointees, and community partners, including
assigned, delegated, subgranted or subcontracted contractors, grantees, vendors, and other sub-
except with the express prior written consent of recipients. CDHS employees, clients, and
the State. The subgrants and subcontracts community partners will all benefit from an effective
permitted by the State shall be subject to the fraud prevention, detection, and deterrence policy
requirements of this contract. The Contractor is because fraud can damage the reputation and public
responsible for all subcontracting arrangements, trust of CDHS.
delivery of services, and performance of any
subgrantor or subcontractor. The Contractor All appointees and employees of the CDHS must
warrants and agrees that any subgrant or comply with the standards of conduct set forth in
subcontract, resulting from its performance Title 24,Article 18 of the Colorado Revised Statutes,
under the terms and conditions of this contract, known as the Code of Ethics, including exposing
shall include a provision that the said subgrantor corruption or impropriety in government, whenever
or subcontractor shall abide by the terms and discovered. The CDHS Fraud Policy outlines how
conditions hereof. Also, the Contractor warrants the CDHS employees and community partners
and agrees that all subgrants or subcontracts should report fraud and how fraud will be
shall include a provision that the subgrantor or investigated once it is reported.
subcontractor shall indemnify and hold harmless
the State. The subgrantors or subcontractors The full text of the CDHS Fraud Policy, which
must be certified to work on any equipment for Contractor hereby agrees to be subject to and abide
which their services are obtained. by, can be found on the CDHS Fraud Policy and
Training web page at:
BB.Holdover: In the event that the State desires to http://www.colorado.gov/cs/Satellite/CDHS-
continue the services provided for in this Contract Emp/CBON/1251610724004.
and a replacement contract has not been fully
executed by the expiration date of the Contract, this EE. Performance Outside the State of Colorado and/or
Contract may be extended unilaterally by the State the United States: Not applicable if Contract Funds
for a period of up to two (2) months upon written include any federal funds] Following the Effective
notice to the Contractor under the same terms and Date, Contractor shall provide written notice to the
conditions of the original Contract including, but not State, in accordance with General Provision E.
limited to, prices, rates, and service delivery (Notices and Representatives), within 20 days of the
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earlier to occur of Contractor's decision to perform,
or its execution of an agreement with a Subcontractor
to perform, Services outside the State of Colorado
and/or the United States. Such notice shall specify
the type of Services to be performed outside the State
of Colorado and/or the United States and the reason
why it is necessary or advantageous to perform such
Services at such location or locations. All notices
received by the State pursuant to this requirement
shall be posted on the Colorado Department of
Personnel & Administration's website. Knowing
failure by Contractor to provide notice to the State
under this requirement shall constitute a material
breach of this Contract
FF. C-Stat-Performance Based Program Analysis and
Management Strategy(C-Stat Strategy): For the sole
purpose of providing support to the State's internal
C-Stat Strategy,the parties understand and agree that
upon request from the State,and without any
additional cost to the State,the Contractor shall
collect,maintain,and provide to the State certain
contract performance data determined by the State
during the term hereof to assist the State to measure
and assess the programmatic effectiveness of the
Contractor's performance hereunder,all in support of
the State's internal continuous quality improvement
working towards positive outcomes and managing its
performance for the betterment of all Colorado
residents.
The parties understand and agree that the exercise of
the requirements of this provision shall not be used
by the State to effect unilateral changes to the
performance requirements of the Contractor
hereunder.
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SPECIAL PROVISIONS
These Special Provisions apply to all contracts except where noted in italics.
1. CONTROLLER'S APPROVAL. CRS §24-30-202(1). This contract shall not be valid until it has been
approved by the Colorado State Controller or designee.
2. FUND AVAILABILITY. CRS §24-30-202(5.5). Financial obligations of the State payable after the current
fiscal year are contingent upon funds for that purpose being appropriated,budgeted, and otherwise made
available.
3. GOVERNMENTAL IMMUNITY.No term or condition of this contract shall be construed or interpreted as
a waiver, express or implied, of any of the immunities,rights,benefits,protections, or other provisions, of the
Colorado Governmental Immunity Act, CRS §24-10-101 et seq., or the Federal Tort Claims Act, 28 U.S.C.
§§1346(b) and 2671 et seq., as applicable now or hereafter amended.
4. INDEPENDENT CONTRACTOR. Contractor shall perform its duties hereunder as an independent
contractor and not as an employee.Neither Contractor nor any agent or employee of Contractor shall be deemed
to be an agent or employee of the State. Contractor and its employees and agents are not entitled to
unemployment insurance or workers compensation benefits through the State and the State shall not pay for or
otherwise provide such coverage for Contractor or any of its agents or employees.Unemployment insurance
benefits will be available to Contractor and its employees and agents only if such coverage is made available by
Contractor or a third party. Contractor shall pay when due all applicable employment taxes and income taxes and
local head taxes incurred pursuant to this contract. Contractor shall not have authorization, express or implied, to
bind the State to any agreement, liability or understanding, except as expressly set forth herein. Contractor shall
(a)provide and keep in force workers'compensation and unemployment compensation insurance in the amounts
required by law, (b)provide proof thereof when requested by the State, and(c)be solely responsible for its acts
and those of its employees and agents.
5. COMPLIANCE WITH LAW. Contractor shall strictly comply with all applicable federal and State laws,
rules, and regulations in effect or hereafter established, including, without limitation, laws applicable to
discrimination and unfair employment practices.
6. CHOICE OF LAW. Colorado law, and rules and regulations issued pursuant thereto, shall be applied in the
interpretation, execution, and enforcement of this contract. Any provision included or incorporated herein by
reference which conflicts with said laws,rules, and regulations shall be null and void. Any provision incorporated
herein by reference which purports to negate this or any other Special Provision in whole or in part shall not be
valid or enforceable or available in any action at law,whether by way of complaint, defense, or otherwise. Any
provision rendered null and void by the operation of this provision shall not invalidate the remainder of this
contract, to the extent capable of execution.
7. BINDING ARBITRATION PROHIBITED. The State of Colorado does not agree to binding arbitration by
any extra judicial body or person. Any provision to the contrary in this contact or incorporated herein by
reference shall be null and void.
8. SOFTWARE PIRACY PROHIBITION. Governor's Executive Order D 002 00. State or other public
funds payable under this contract shall not be used for the acquisition,operation, or maintenance of computer
software in violation of federal copyright laws or applicable licensing restrictions. Contractor hereby certifies and
warrants that, during the term of this contract and any extensions, Contractor has and shall maintain in place
appropriate systems and controls to prevent such improper use of public funds. If the State determines that
Contractor is in violation of this provision,the State may exercise any remedy available at law or in equity or
under this contract, including, without limitation, immediate termination of this contract and any remedy
consistent with federal copyright laws or applicable licensing restrictions.
9. EMPLOYEE FINANCIAL INTEREST/CONFLICT OF INTEREST. CRS §§24-18-201 and 24-50-507.
The signatories aver that to their knowledge,no employee of the State has any personal or beneficial interest
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whatsoever in the service or property described in this contract. Contractor has no interest and shall not acquire
any interest, direct or indirect,that would conflict in any manner or degree with the performance of Contractor's
services and Contractor shall not employ any person having such known interests.
10. VENDOR OFFSET. CRS §§24-30-202 (1) and 24-30-202.4. [Not Applicable to intergovernmental
agreements] Subject to CRS §24-30-202.4 (3.5),the State Controller may withhold payment under the State's
vendor offset intercept system for debts owed to State agencies for: (a)unpaid child support debts or child
support arrearages; (b)unpaid balances of tax, accrued interest, or other charges specified in CRS §39-21-101, et
seq.; (c)unpaid loans due to the Student Loan Division of the Department of Higher Education; (d) amounts
required to be paid to the Unemployment Compensation Fund; and(e)other unpaid debts owing to the State as a
result of final agency determination or judicial action.
11. PUBLIC CONTRACTS FOR SERVICES. CRS §8-17.5-101. [Not Applicable to agreements relating to
the offer, issuance, or sale of securities, investment advisory services or fund management services,sponsored
projects, intergovernmental agreements, or information technology services or products and services]
Contractor certifies, warrants, and agrees that it does not knowingly employ or contract with an illegal alien who
will perform work under this contract and will confirm the employment eligibility of all employees who are
newly hired for employment in the United States to perform work under this contract,through participation in the
E-Verify Program or the Department program established pursuant to CRS §8-17.5-102(5)(c), 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(a) shall not use E-Verify Program
or Department program procedures to undertake pre-employment screening of job applicants while this contract
is being performed, (b) shall notify the subcontractor and the contracting State agency within three days if
Contractor has actual knowledge that a subcontractor is employing or contracting with an illegal alien for work
under this contract, (c) shall terminate the subcontract if a subcontractor does not stop employing or contracting
with the illegal alien within three days of receiving the notice, and(d) shall comply with reasonable requests
made in the course of an investigation,undertaken pursuant to CRS §8-17.5-102(5),by the Colorado Department
of Labor and Employment. If Contractor participates in the Department program, Contractor shall deliver to the
contracting State agency, Institution of Higher Education or political subdivision a written,notarized affirmation,
affirming that Contractor has examined the legal work status of such employee, and shall comply with all of the
other requirements of the Department program. If Contractor fails to comply with any requirement of this
provision or CRS §8-17.5-101 et seq.,the contracting State agency, institution of higher education or political
subdivision may terminate this contract for breach and, if so terminated, Contractor shall be liable for damages.
12. PUBLIC CONTRACTS WITH NATURAL PERSONS. CRS §24-76.5-101. Contractor, if a natural
person eighteen(18)years of age or older,hereby swears and affirms under penalty of perjury that he or she(a)is
a citizen or otherwise lawfully present in the United States pursuant to federal law, (b) shall comply with the
provisions of CRS §24-76.5-101 et seq., and(c)has produced one form of identification required by CRS §24-
76.5-103 prior to the effective date of this contract.
Revised 1-1-09
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Contract Routing Number: 17 IHJA 87813
THE PARTIES HERETO HAVE EXECUTED THIS CONTRACT
* Persons signing for Contractor hereby swear and affirm that they are authorized to act on Contractor's behalf and acknowledge
that the State is relying on their representations to that effect.
CONTRACTOR i STATE OF COLORADO
Weld County Sheriffs Office John W.Hickenlooper,Governor
By: Mike Freeman Department of Human Services
Title: County Commissioner - eggie Ilichakijxe ti ' girecior
T11t-14-3' - t
*Signature By:Andrew Ma finer
2016 Community Programs CFO,O cc of Behavioral Health
Date: MAY 0 4 Signatory avers to the State Controller or delegate that
Contractor has not begun performance or that a Statutory
Violation waiver has he i req .sited un{cr Fiscal Rules
Date: _ 3 0
By: Steven Reams LEGAL REVIEW
"\ 'l'itl•: Sheriff Cynthia H.Coffman,Attorney General
- //�
rey i3}.
*Signature
Signature-Assistant Attorney General
Signature
Date: MAY 0 4 2016
Date:
ALL CONTRACTS REQUIRE APPROVAL BY THE STATE CONTROLLER
CRS§24-30-202 requires the State Controller to approve all State Contracts.This Contract Is not valid until signed and dated below
by the State Controller or delegate.Contractor Is not authorized to begin performance until such time.If Contractor begins
performing prior thereto,the State of Colorado is not obligated to pay Contractor for such performance or for any goods and/or
services provided hereunder.
—
STATE CONTROLLER
Robert Jaros,CPA,MBA,JD
By: fethe---•
Clint Woodruff/Vain Gimple
Date:--- ea.__._
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Exhibit A
Statement of Work
I. Sheriff's Department Requirements
A. Propose an organizational structure designed to facilitate and promote effective
administration of the program.
• Ideally, a staff person from the Sheriff's Department should be in the role of a Program
Manager to oversee the operations of the treatment subcontractors and should be well
versed in the program's contractual requirements and participate in the JBBS Quarterly
Meetings.
• Sheriff's Departments are encouraged to account for this administrative position in their
budgets.
The Weld County Sheriff's Office (WCSO) has approved the Director of Inmate Services to be in
the role of Program Manager for the Jail Based Behavioral Health Services(JBBS) program.This
is a position already accounted for in the WCSO's budget.The Director of Inmate Services has
been in the role of JBBS Program Manager since the WCSO was first awarded JBBS funds in
2013.With this previous experience,the Director has an effective working understanding of the
JBBS contract and processes and is able to guide and direct the program through a collaborative
approach with all stakeholders.The Director is committed to participate in the JBBS Quarterly
Meetings to gain additional insights and contribute to the other JBBS programs and overall
goals.
The Weld County JBBS program has an administrative steering committee comprised of
administrative staff from WCSO, North Range Behavioral Health (NRBH)and Behavioral
Treatment Services(BTS).This committee meets monthly to address concerns and provide
guidance to the JBBS program.This committee will also meet as needed to improve the program
and remove barriers to effective and efficient services.
B. Demonstrate financial resources and fiscal management skills to perform the work proposed.
• The Sheriff's Department is responsible for submitting budgets, budget modifications, and
invoices to the OBH in the template format provided by the OBH.
• In the event of a fiscal audit, the Sheriff's Department Accounting staff must be able to
provide documentation supporting the reimbursement to treatment subcontractors and
administrative costs incurred.
The WCSO will be the fiduciary agent for the JBBS funds and has a long standing history of
receiving and managing federal and state grants.Thus,the WCSO uses state of the art
information systems and are closely audited around their record keeping and accountability
methods. All accounting activities are guided by accounting policies and procedures that are
prepared using time tested accounting practices and guidelines. Monthly financial statements
are prepared and compared against the current budget and prior years for appropriateness.The
JBBS Program Manager works closely with the WCSO Budget Manager on this project and
others, having forged a solid and transparent relationship.
Page 1 of 16
Exhibit A
C. Demonstrate capacity of efforts to screen all individuals booked into the jail facility for
mental health, suicidality and substance use histories and needs. The screening date will be
reported annually to OBH.
• OBH and many stakeholders are interested in the prevalence of mental illness and substance
use disorders in the jails.
• Each jail applying for these funds must demonstrate efforts or existing processes to screen
individuals for mental illness,suicidality and substance use histories at booking.
• OBH will provide an Annual Reporting Template that shall be used for this reporting
requirement.
The WCSO prides itself on its processes in place for screening inmates upon admission for
mental health, suicidality and substance use histories and needs.This process starts with WCSO
staff gathering information in these areas from the arresting officer through a questionnaire and
then conducting an interview themselves that focusses in part on inmates' suicidality, mental
health history, current symptoms, psychiatric medication needs, substance use history and
current level of intoxication. Within eight hours of incarceration, all inmates are screened by
nursing staff and are asked additional and more specific questions regarding their suicidality,
mental health history, current symptoms, psychiatric medication needs, substance use histories
and needs.Within forty-eight hours of incarceration, all inmates still in custody are classified.
Part of this process includes an in depth interview that again in large part focusses on suicidality,
mental health history, current symptoms, psychiatric medication needs, substance use histories
and needs. All of this information is gathered for the purpose of internal referral processes to
ensure inmate safety, security and intervention needs.The information is not gathered for
quantification and dissemination purposes.The WCSO does not currently have a system in place
to accommodate this and is unable to meet the recording and reporting requirement in this
area. With future potential systems the WCSO is looking into, this may be an area that could be
expanded if the capacity and technology is present.
D. Demonstrate capacity and resources to pay for psychotropic medications by the individuals
in the facility. These funds are not intended to offset for the jail's psychotropic medication
costs.
The WCSO has a contracted medical provider to provide medication interventions for medical
and psychiatric diagnoses.These medication interventions will be provided out of the funds
associated with the standing medical provider contract with Weld County for all inmates,
including JBBS clients.The medical provider has a board certified psychiatrist conducting rounds
in the jail,to include rounds with JBBS clients when warranted, on a weekly or twice a week
basis depending on needs.JBBS staff are able to consult directly with the psychiatrist regarding
JBBS clients to afford for the most effective intervention strategies for the needs they may have.
E. Demonstrate the ability to offer medication assisted treatment (MAT) if indicated to the
individuals in the jail facility.
The WCSO does not provide methadone to the inmate population and will medically detoxify
inmates from this upon admission to the jail (special circumstances do exist with pregnant
inmates where it will be continued and monitored by a community health care provider during
prenatal visits).The WCSO does not have the capacity to safely monitor and administer
methadone in the facility or the capacity or funds to transport inmates to an approved
Page 2 of 16
Exhibit A
methadone clinic.There have been no inmates admitted to the Weld County jail since 2012 who
have reported the use of methadone.
F. Exhibit the ability to meet the needs of individuals who are physically challenged, deaf or
hearing impaired, or blind.
The WCSO meets the needs of inmates who are physically challenged, deaf or hearing impaired,
or blind within state and national standards in accordance with the American with Disabilities
Act.All jail security, mental health and medical staff complete ADA training upon hiring and the
JBBS Program Manager has attended additional training in this area as well as many other
administrative staff within the agency.All housing areas have ADA compliant cells and
accommodations. Inmates identified with a disability are assigned to jail counseling staff for
case management services. Inmates with disabilities will be afforded the same access to services
as other inmates.
G. Demonstrate an ability to provide services in a manner that respects and protects client
rights.
All employees with WCSO, NRBH and BTS who have direct contact with inmates treat them
respectfully and courteously. Employees are aware of and protect inmate rights, both civil and
legal, according to set standards that include:
• Freedom from discrimination based on race, religion, national origin, sex, disability, or
political beliefs.
• Equal access to program and work assignments and involvement in decisions based on their
classification level.
• Protection from personal abuse, corporal punishment, personal injury, disease, property
damage, and harassment.
• Freedom from reprisals or penalties as a result of seeking administrative or judicial redress.
H. The funds associated with this RFA may increase or decrease depending upon state
appropriations.As a result of this, the state may require the contractor to increase or
decrease services and budgets.
The WCSO, NRBH and BTS have been operating under this premise for the past few years and
are prepared to make modifications as needed to satisfy budgetary needs and requirements.
II. Licensed Substance Use Disorder Treatment Requirements
A. Provide the OBH-license information for substance use disorder treatment provider(s) to
deliver appropriate behavioral health care to inmates.
Through the Colorado Department of Human Services, Office of Behavioral Health, NRBH holds
one of multiple licenses. Both the Adult Outpatient and Behavioral Alternative Services in the
Community Program at 1260 H Street in Greeley, Colorado are license under the number 1386-
05.This document allows NRBH to provide substance abuse disorder treatment in accordance
with the rules and regulations in the State of Colorado. (See attachment).
BTS holds an outpatient license (#175009) and a residential license (#175003)through the State
of Colorado Department of Human Services, Office of Behavioral Health.
Page 3 of 16
Exhibit A
B. Exhibit ability to identify inmates with active duty or veteran military status.
• This information should be used in treatment and discharge planning.
NRBH uses a comprehensive intake process that includes questions that assist the clinician in
identifying veterans.This process helps to establish their military status. When appropriate,
referrals can be made from this information into the Veteran's Administration.Additionally,this
background data also drives our treatment and discharge planning for veterans. Behavioral
Treatment Services (BTS) provides comprehensive clinical case management services to JBBS
clients, in collaboration with mental health and substance use services provided by North Range
Behavioral Health (NRBH). BTS ensures that client information, history, and demographics are
obtained to appropriately determine resources and support needed within the community upon
discharge from county jail.This includes veteran and military status;veterans and their families
can face unique challenges that should be met with integrity, respect, and assistance. For
purposes of both treatment planning and transition/discharge planning, BTS case managers are
required to identify veteran and military status, both of which are included as
exhibits/attachments.
C. Exhibit the ability to provide culturally competent and appropriate services.
NRBH requires ongoing training requirements for clinical staff around the provision of culturally
competent services.There are also standard aspects to our intake process that address and
identify cultural issues.This allows for the development of ongoing treatment planning with the
appropriate culturally-related services. BTS is committed to providing culturally responsive and
inclusive services at all levels of programming to support the changing needs of clients in
custody and in the community. BTS complies with all ADA requirements and ensures
accessibility and accommodation of services to all clients, regardless of identity or disability. In
addition to inclusive efforts for clients, BTS is committed to a workplace and workforce that is
culturally competent and diverse.This is reflected in recruitment and hiring of BTS staff and
administration, and benefits offered to employees and their partners/families.
D. Demonstrate the ability to provide treatment based on an individualized treatment and/or
transition plan based on an assessment completed for the client within the past 6 months.
The transition/treatment plan should incorporate the client's natural communities and pro-
social supports.
Individualized treatment planning at NRBH includes the following elements:
• It is a collaborative process which requires that the client has input in determining the
content of their treatment.Thus, it is a client-centered process with mutually-agreed upon
goals.
• It is medically necessary.
• It is individualized.
• It is culturally-sensitive.
• It is strength-based.
• It is incorporated into the concept of the golden thread,where the therapeutic content is
connected throughout the clinical assessment,the diagnosis, into the treatment plan,to the
progress notes, and finally,through the discharge plan.
• It identifies significant-other-systems that are already in play for the client; and,
Page 4 of 16
Exhibit A
• It develops the necessary level of care and course of treatment that supports structure and
activities that promote growth and development.
In addition to JBBS screening, BTS clinical case managers complete the Standardized Offender
Assessment Revised (SOA-R) assessments upon intake into the JBBS program.The SOA-R
provides initial conceptualization of client's risk and protective factors that will need to be
reflected in treatment and services provided both in custody and in the community. BTS clinical
case managers work collaboratively with clients to develop individualized treatment and
transition plans,that are evidenced and recovery informed,to address re-entry needs, with
goals of decreasing recidivism and increasing/strengthening interpersonal support.This includes
referral to, and collaboration with, NRBH and mental health and substance use treatment
opportunities. BTS clinical case managers complete initial transition and treatment plans within
first three case management sessions.Treatment and transition plans are then reviewed at least
7 days within discharge from WCJ.
E. Demonstrate either available capacity for community based treatment through other
funding streams to continue with the same provider in the community following release;or
demonstrate an ability to interface with other agencies serving persons with substance use
disorders or co-occurring mental illnesses, i.e., community mental health centers, substance
use disorder treatment programs, service programs for Veterans and other community
service agencies to meet the client's treatment needs.
NRBH as the local community mental health center contracts to provide services in Weld County
through numerous funding sources.This includes:
• Private insurance
• Medicaid
• Medicare
• Employee Assistance Programs
• Third party contracts such as with Probation, Parole and/or Department of Human Services
• Indigent funding through the State of Colorado Office of Behavioral Health
• Priority population funding through the State of Colorado Division of Drug and Alcohol
• Sliding fee scale for self-pay clients based on income and the number of people supported
by that income.
Thus, inmates who are released from jail will be able to access care in a seamless and timely
manner via these different funding streams. Additionally,this planning is incorporated into the
case management activities that occur while the inmate is still incarcerated, so a plan can be
implemented upon their release without creating delays or barriers to care. NRBH case
managers are all trained and able to assist all of our clients around benefit acquisition.
BTS has demonstrated ability to provide community-based services to clients during transition
from jail to their communities.This includes strong partnerships with community providers such
as NRBH and Intervention Inc., to ensure that all client needs are addressed and supported. BTS
currently collaborates with local community mental health centers to provide psychiatric and
medication management services. BTS also collaborates with community providers for state
approved SOMB and DVOMB services, ensuring continuity of care across all spectrums of need.
BTS is dedicated to offering equitable services to clients in need, especially those involved in the
Page 5 of 16
Exhibit A
criminal justice system. Clients are supported in respect to funding of services through
probation/parole and self-pay, to include sliding scale opportunities. BTS is in process of
Medicaid credentialing and expects to have all 15 of its locations Medicaid ready by Spring 2016.
BTS will assess indigent care on case-by-case basis, ensuring that client needs are met or
referred to appropriate opportunities.
F. Demonstrate the ability to transition individuals from jail based services to appropriate
behavioral health and other needed community services upon release from incarceration.
• Performance Based Incentives will be paid out to programs meeting or outperforming
benchmarks for the number of clients engaging in treatment services upon release from the
jail in the contracts resulting from this RFA. (See Section D. Cost Proposal for more
information.)
• The benchmark for programs to earn their Performance Incentive is a total of 30%of the
clients released from the program will be "In Treatment"or "Treatment Completed"at the 1
month Transition Tracking interval. This data shall be pulled after the end of the fiscal year
from the Civicore JBBHS Database.
NRBH provides a comprehensive assessment to the inmate at the time of first contact in the jail.
This intake process allows NRBH to determine the appropriate level of care and the course of
treatment that dictates the services to be provided. In the community, NRBH has an array of
services available.Thus, as the inmate moves toward their release, a Transitional Meeting
occurs with community providers of NRBH to create an appropriate community-based plan.
NRBH has a continuum of care that can includes:
• Crisis Response
• Respite Care
• Residential Programming for mental health and/or substance abuse
• Acute Treatment Unit/Detox
• Traditional Outpatient Services
• Intensive Outpatient Services
• Case Management
• Peer Specialists
• Forensic Services
• Medication
• Integrated physical and behavioral health clinics
• Child and family services
• Accredited Clubhouse
• Recovery Services
• Vocational Services
• Assertive Community Team
BTS is qualified to provide effective intensive and clinical case management services to clients
involved in the criminal justice system. In collaboration with Intervention and Intervention
Community Correctional Services, BTS has established a strong network of community
partnerships and linkages. BTS clinical case managers begin assessing for re-entry needs
Page 6 of 16
Exhibit A
immediately upon admission to JBBS programming.Through creation of both an individualized
transition and treatment plan, clients collaboratively plan for effective community reintegration
and decreased risk of recidivism.
BTS case managers ensure that all bio-psycho-social factors are assessed and addressed:
identification/documentation, housing,financial, transportation,employment, education,
legal/civil, medical, mental health, substance use,vision, dental, and pro-social
relationships/supports. BTS works collaboratively with NRBH both in the jail and in the
community.This includes specific partnership with their on-site pharmacy and integrated care
clinic Sunrise/Genoa, where BTS has direct funding/invoicing capability to ensure clients have
necessary medications upon discharge.
BTS clinical case managers will support clients in determining mental health and substance use
treatment upon re-entry.This includes supporting clients upon admission to community
providers and ensuring continuity of care through appropriate follow up (to include Transition
Tracking in Civicore).
G. Demonstrate an ability to provide OBH with the required data submissions as defined below
under Section B—Monitoring and Data Collection.
BTS clinical case managers utilize the following screening tools to assess substance use, mental
health, trauma,TBI and criminogenic risk factors: SSI, CCJMHS-A, PTSD checklist, HELPS Brain
Injury Screen, LSI, and SOAR. Information from all intakes and assessments will be used to
successfully document all required information into the JBBS database for reporting purposes.
The Weld County JBBS program has a perfect track record of proving this information in years
past.
III. Sheriff's Department Requirements
A. Indicate the counties to be served.
Weld County,Colorado will be served with JBBS funds.
B. The response will identify existing treatment resources available at the jail and resources the
Sheriff's Department is intending to develop or enhance with the JBBS funds.
• The application shall provide a list of treatment service options available at the jail facility.
The Weld County Sheriffs Office (WCSO)employs four Bachelor's level Registered
Psychotherapists and three Master's level licensed mental health staff(Licensed Professional
Counselor or Licensed Clinical Social Worker).Two of these staff members are also Certified
Addictions Counselor Ills (CACIII). The main objectives of these staff members are:
- Suicide Assessment, both initial and ongoing
- Follow-up counseling services for those inmates currently or previously deemed to be a
suicide risk
- Mental health screenings for referral purposes
- Crisis intervention with the inmate population
- One on one counseling for inmates in segregation
Page 7 of 16
Exhibit A
- One on one counseling services with the inmate population who identify problems of a
mental health and/or substance abuse nature
- Group counseling services—mostly psychoeducational
- Consultation with psychiatrist for medication interventions
JBBS funds allow the WCSO to enhance the above services by targeting inmates who are
motivated to participate in treatment services while in jail and specifically, after release.JBBS
staff serves as the crucial link to the community providers for inmates wishing to pursue
treatment after their release; something that is not able to be mirrored as effectively by jail
counseling staff. Having JBBS staff embedded in the Weld County Jail for the last few years has
substantiated how the gap in services between the jail and the community can be greatly
diminished and provide community members with more immediate access to have their needs
addressed.
C. The response will identify how the Sheriff's Department at each jail in the application is
implementing the Affordable Care Act.
• The response must describe what efforts are in place to enroll individuals in Medicaid or
private insurance upon release from the jail. If there are no current efforts, what is the
county's plan to implement such benefits?
• For counties where there are existing efforts, how will the individuals served under the JBS
program be included in the efforts?
The WCSO is currently engaged with Colorado Access to develop the most effective and efficient
mode of working with the inmate population regarding the attainment of Medicaid and/or other
insurance options upon release from jail. Preliminarily,the general inmate population will be
provided with necessary materials to advise them how to register and where to go to complete
this process.The WCSO will be actively looking at other options to afford the inmate population
in this area which may potentially involve strengthening relationships with the Human Services
Department to assist in this endeavor.
JBBS clients will be provided with specific applications/paperwork close to their release from jail,
when deemed appropriate, and be assisted by Case Management staff in filling out the
necessary paperwork in an effort to be prepared for filing upon their release.
D. The response will provide the number of incarcerated consumers with substance use
disorders or co-occurring substance use disorders and mental health disorders, and how
many individuals will actually be enrolled in JBBS.
The number of incarcerated consumers with substance use disorders or co-occurring substance
use and mental health disorders is not quantified by the WCSO. If the Weld County JBBS
program is fully funded, the goal is to provide effective treatment for at least 200 clients in fiscal
year 2016-17.
E. The application should detail the jail's policies on Medication Assisted Treatment.
• The response should include the jail's protocol for working with individuals who are on
methadone and how the jail will be able to continue to receive methadone for individuals
and distribute the prescribed dose.
Page 8 of 16
Exhibit A
• These funds may be used to purchase Naloxone kits to be provided to individuals who are
high risk of overdosing post release from the jail. The jail's Medical Team would be
responsible for determining the individual's need, training the individual to use the kit and
distributing the medication when released from the facility.
Note: OBH is able to provide assistance with training the Medical Team staff regarding the
Naloxone protocol if the Sheriff's Department has in interest in offering this service.
• Due to the heroin and opioid use prevalence in the state and across the country;programs
proposing to consider the Naloxone distribution services will be given priority when the
county has data supporting a higher prevalence of abuse in their region.
The WCSO does not continue methadone for the inmate population (special circumstances do
exist with pregnant inmates where it will be continued and monitored by a community health
care provider during prenatal visits). Inmates are medically detoxified from this upon admission
to the jail facility.The administration and monitoring of methadone is considered to be a
significantly specialized area that requires a certified methadone program that the jail does not
have access to. Naloxone kits will not be considered by the WCSO at this time.
IV. Licensed Substance Use Disorder Treatment Requirements epidemic
A. The applicant's response will explain how they will identify individuals to provide services in
the jail.
• The application must also state the program's admission criteria.
• The response must include how many clients will be admitted to the program and screened
each fiscal year.
Inmates are selected for the program on a voluntary basis.JBBS Case Managers meet initially
with all referrals.The admission criteria for entering the JBBS program includes:
• The inmate must have a substance use disorder or co-occurring substance use and mental
health disorder.
• The inmate must commit to have follow-up phone calls when in the community for
statistical purposes.
• Inmates must be considered for a non-DOC sentence by the sentencing court.
The number of clients to be admitted to the program over a year's time is contingent upon the
number of JBBS clinicians on staff. However,when fully staff,the number of admissions will be
at least 200 and the number to be screened is estimated at approximately the same number of
admissions as there is only a small percentage screened but not admitted.
B. The application shall detail the screening process for all inmates referred to the program for
presence of substance use disorders, mental health disorders, trauma and traumatic brain
injury.
• For clients admitted to the program, a risk assessment(Level of Supervision Inventory-
LSI/LSI-R)shall also be completed. The response shall provide details on how many clinicians
and case managers are trained to administer the LSI/LSI-R. For staff not trained, what is the
provider's training plan?
Page 9 of 16
Exhibit A
• A list of the approved screening and assessment tool options is detailed under Section V-
Data and Monitoring. The response shall include which screening tools will be used by the
program.
• The response shall detail which positions from the program's organizational structure shall
be responsible for completing the screening.
• In cases where more than one treatment subcontractor is proposed, how will the client
caseloads be assigned amongst the providers?Programs in this scenario will require a
Business Associates Agreement or Confidentiality Agreements to share assessments and
screening. The response should provide details on the plan for making the agreements.
The screening process for entering the JBBS program includes the following tools:
• LSI (Completed by BTS Case Manager)
• SOAR (Completed by BTS Case Manager)
• SSI (Completed by BTS Case Manager)
• PTSD Checklist (Completed by BTS Case Manager)
• HELPS(Completed by BTS Case Manager)
• CCJMHSA(Completed by BTS Case Manager)
All JBBS clinicians and case managers can complete these instruments. As of spring 2015, it was
a requirement that all BTS staff be trained to administer and interpret the SOA-R through the
Colorado Division of Criminal Justice (DCJ). Per new assessment and state standards, all BTS case
managers and JBBS clinicians will continue to be trained in the SOA-R, specifically the LSI/LSI-R,
upon hire.This training need is supported in BTS onboarding and supervisory requirements. At
this time, there is no plan necessary for training staff in the LSI or any other instrument.
Weld County will have two entities providing services to JBBS clients. BTS staff will provide Case
management services and NRBH will provide psychotherapy services.There has been a Business
Associates Agreement in place between the Sheriff's Office, NRBH and BTS since 2013 and if
awarded JBBS funds for fiscal year 2016-17, another one will be signed and effective with the
new contract.
C. Services must be rendered by OBH licensed agencies; therefore the response shall include
the provider's OBH Substance Use Treatment Provider number for the agency location the JBBS
program will operate under.
• The response must document existing policies and procedures on how the treatment
provider manages and maintains clinical records for the clients served at the outpatient
community location. The provider must follow the same protocols and policies for record
management for services offered in the jail since the program is being authorized to operate
under the provider's OBH outpatient services license.
For NRBH, please see the attachment labeled under Section XXIII of the "Privacy and Procedures
Manual for North Range Behavioral Health" as the "Protected Health Information: Off-Site" from
9/23/13. NRBH holds license#1386-05 as a substance use disorder treatment provider.
Page 10 of 16
Exhibit A
BTS employs a Clinical Quality Assurance Manager responsible for maintaining compliance with
the Office of Behavioral Health, and all federal and state statutes and regulations. This includes
client records, documentation, reporting, auditing and improvement. The quality assurance
manager also participates within an agency compliance and outcomes subcommittee that
ensures best practices and implementation and review of ongoing quality improvement plan.
BTS utilizes a HIPAA compliant electronic management system to manage and maintain clinical
and case management records for all clients,to include JBBS programs.This system and practice
standards are the same for both JBBS inmate clients and those in outpatient services in the
community. BTS managers and staff ensure that documentation meets jail reporting standards
in their internal system, Spillman. BTS Case managers complete necessary documentation for
JBBS clients: disclosure statement, client rights and responsibilities, HIPAA Notice of Privacy
Practices, and ROls to appropriate parties (i.e.WCSO, North Range Behavioral Health, Correct
Care Solutions). In addition, they complete the HELPS Brain Injury Screening Tool, PTSD checklist
and SOA-Rs assessments along with a transition plan for successful re-entry.Additionally, BTS
case managers complete all required client tracking and data entry for agency,jail, and
JBBS/OBH compliance and outcomes. BTS quality assurance manager reviews and audits JBBS
programming, documentation, and compliance on a quarterly basis. Please see attachment for
policy.
BTS's licensing numbers are#175009 for outpatient services and #175003 for residential
services.
D. Programs shall have clinician positions to offer screenings, assessment and treatment in the
jail and case manager positions dedicated to transitional care and a seamless re-entry to
treatment services in the community.
Note: Treatment services in the community will not be funded by JBB5. The program may design
the case manager position to partially offer services in the community.
• Applications should provide a detailed list of which specific services will be offered in the jail.
Priority will be given to agencies that look to implement effective treatment approaches that
are gender responsive and proven strategies for assuring continuity of care into the
community.
Clinical JBBS staff offer screenings, assessments and treatment with the assistance of JBBS Case
Managers.The case managers set up transitional plans for re-entry into the community.The
goal is to create timely and seamless community services once the inmate is released from the
jail. Specific services offered in the jail include:
• Mental health and substance abuse treatment services
• Group Therapy: MRT; SSC; and Relapse Prevention
• Evidence-Based Practices: Motivational Interviewing; EMDR; CBT; and DBT
• Inmates are asked at intake for their preference around the gender of their provider.Thus,
we are able to be gender-responsive in our care as the inmate will be able to see either a
male or a female clinician.
• Transitional Planning Meetings occur before an inmate is released from jail.This assures
Page 11 of 16
Exhibit A
that the inmate and the community provider(s) are creating a smooth and effective "warm
hand-off".
• Medication services are coordinated and set up in advance of release to assist all clients in
receiving their medication within a timely fashion.
• Referrals to the community may also include: housing; employment; other treatment
providers; TBI services; and/or DD services; etc.
Additionally, BTS provides clinical case management services in collaboration with mental health
and substance use services through NRBH. BTS leads MRT groups and co-facilitates MRT groups
with a North Range Behavioral Health therapist on a weekly basis. BTS case managers identify
needs and protective factors through the aforementioned screening and assessment tools.
During their third session in the jail, case managers develop a transition plan in collaboration
with the client to address the client's re-entry needs. Case managers also work to prepare
clients for re-entry by assisting clients with the completion of the following in the jail:
applications and referrals for community resources(i.e. identification/documentation, Medicaid,
housing resources, education programs, employment resources, etc.),employment applications,
resumes, and personalized budgets. In addition, prior to release case managers set-up
appointments for continued treatment (i.e. mental health, substance abuse,offense-specific,
medication evaluation, etc.) in the community depending on the client's needs. BTS case
managers also identify the client's local support system, client hobbies and interests, as well as
plans for pro-social activities in the community.
In order to provide a seamless transition to treatment services in the community, clients are
provided with a discharge instruction sheet detailing the date/time/location of their community
treatment appointments. In addition, they are provided with an extensive list of community
resources to address basic needs including food, clothing, housing, employment,transportation,
and medical concerns should they arise post-release.
E. Describe how staff providing services to the target population will be sensitive to diversity
issues. Indicate the extent to which staff is representative of diversity and receive periodic
training in cultural competence.
• New Employee Orientation covers some aspects of cultural competency in their program.
• Additionally, staff are required to complete on-line training through a program called Relias.
• On-going clinical supervision emphasizes cultural issues, i.e., language barriers; gang-related
issues; religious background; sexual preference; etc.
• Required training of NRBH staff includes culturally-oriented services.
BTS is committed to providing culturally responsive and inclusive services at all levels of
programming to support the changing needs of clients in custody and in the community. BTS
complies with all ADA requirements and ensures accessibility and accommodation of services to
all clients, regardless of identity or disability. In addition to inclusive efforts for clients, BTS is
committed to a workplace and workforce that is culturally competent and diverse.This is
reflected in recruitment and hiring of BTS staff and administration, and benefits offered to
employees and their partners/families.
At this time,JBBS staff includes both genders of a mixed cultural background.
Page 12 of 16
Exhibit A
F. Describe the service array available within the community to program participants upon
their release from jail, including behavioral health services.
• The application must detail existing programs available to the clients upon release at the
provider's agency locations in the community. The agency's programs available should be
able to take on clients who are awaiting Medicaid approval or other funds to pay for initial
treatment services.
• For services that are not available through the treatment provider,for example, traumatic
brain injury array of services, the application must illustrate the provider's ability to partner
with required resources.
The Weld County JBBS program starts the transition to the community at the first contact.They
do so by developing individualized Transitional Plans and eventually set up a Transitional
Planning Meeting to hand off the inmate to community providers. Upon release from jail, NRBH
has the capacity to take on clients with pending Medicaid approval or other funding sources.
NRBH provides the following community-based services:
• Crisis Response
• Respite Care
• Residential Programming for mental health and/or substance abuse
• Acute Treatment Unit/Detox
• Traditional Outpatient Services
• Intensive Outpatient Services
• Case Management
• Forensic Services
• Medication
• Integrated physical and behavioral health clinics
• Child and family services
• Accredited Clubhouse
• Recovery Services
• Vocational Services
• Assertive Community Team
• Crisis Response
• Respite Care
• Residential Programming for mental health and/or substance abuse
• Acute Treatment Unit/Detox
• Traditional Outpatient Services
• Intensive Outpatient Services
• Case Management
• Peer Specialists
• Forensic Services
• Medication
• Integrated physical and behavioral health clinics
• Child and family services
• Accredited Clubhouse
• Recovery Services
Page 13 of 16
Exhibit A
• Vocational Services
• Assertive Community Team
Clients who require services outside of NRBH service area, such as brain injured or
developmentally disabled clients, are referred to our community partners.This includes the
local National TBI Services and their support groups or to Envision, our DD provider.Also, NRBH
has a clinical staff member embedded at Envision for those clients that interface with both
systems.
G. The response shall indicate how services needed upon release shall be identified and detail
how the offender shall be linked to the appropriate services in the community without a
break in services. Responses may attach sample Transition Worksheet as an attachment to
the application. Priority will be given to proposals that demonstrate an effort to combine
planning for treatment and transition.
Following admission into the JBBS program, BTS clinical case managers immediately begin to
assess and address the client's re-entry needs.Through the creation of an individualized
transition plan in their third case management session, clients collaboratively plan for effective
community reintegration,thereby reducing the risk of recidivism. BTS case managers work to
assess and address needs on an ongoing basis in the following areas:
identification/documentation, housing,financial,transportation, employment, education,
legal/civil, medical, mental health, substance use,vision, dental, and pro-social
relationships/supports. As needs are addressed and/or new needs arise,the transition plan is
reviewed and updated. Please see attached example Transition Plan Worksheet.
BTS also works collaboratively with NRBH in the jail and in the community to ensure continuity
of mental health, psychiatric and substance abuse services. For instance, the NRBH on site
pharmacy and integrated care clinic Sunrise/Genoa has the ability to directly invoice BTS for
JBBS clients to ensure that they have any necessary medications upon discharge from the jail. In
addition, case managers schedule initial community-based treatment appointments in
collaboration with the client prior to their release and provide detailed discharge instructions to
ensure a seamless transition to treatment in the community.
H. The proposal should describe what Recovery Support Services (approved list is attached)are
most needed in the catchment area and how the provider or Sheriff's Department will use a
portion of their budget to meet these needs.
The following need areas are identified through the collaborative development of a transition
plan and addressed through the use of recovery support funds:
• Identification/Documentation: If a client does not have a photo ID and social security card
BTS case managers assist with the application process and can cover the cost(if necessary)
using recovery support services (if they need their birth certificate BTS case managers also
try to obtain this)
• Housing: If a client requires emergency housing post-release, BTS case managers refer them
to NRBH housing or work on getting them a bed at a sober living house if there is a bed
available and cover the cost(if necessary) using recovery support services
Page 14 of 16
Exhibit A
• Transportation: If a client identifies transportation needs, BTS case managers provide them
with a bus pass purchased using recovery support services and also have the ability to
complete a referral to a bike donation program in Weld County.
• Education: if a client identifies educational needs, BTS case managers provide them with
information on an Adult Basic Education Program in Weld County and inform them BTS case
managers can help cover the cost of a GED program/testing using the recovery support
services
• Medical: If a client has medical concerns and they need help covering the cost of an
appointment, medication (either physical or mental health related), or testing post-release,
BTS case managers can cover that using recovery support services
• Mental Health: If a client has been prescribed psychotropic medications while incarcerated,
BTS case managers schedule a medication evaluation in the community and ensure that the
client can continue their current medications until that appointment post-release (cost
covered by the recovery support services).
• Vision: If the client identifies vision needs, BTS case managers will submit a referral to the
Lions Club so a low-cost vision exam and glasses.The cost of this appointment can be
covered with recovery support service funds.
• Dental: If a client identifies dental care needs, BTS case managers will set up an
appointment with their dentist or a community dental provider prior to their release.The
cost of this appointment can be covered with recovery support service funds.
V. Monitoring and Data Collection
A. The response shall be written with the intent to comply with the requirement to collect, maintain
and submit certain data to be reported on an ongoing basis throughout the contract. This
information shall include:
o Basic demographic information about the persons receiving services with these funds
o Numbers of clients served
o The types and quantities of services delivered
o Number and percentage who successfully transition to community based services upon release
o Program discharge outcomes
o Prevalence data gathered from administering mental health, substance use disorder, risk
assessment, trauma and traumatic brain injury screens
In an effort to create similar requirements to meet program eligibility criteria across the state, one of the
following screening tools for should be used for the 5 areas listed below for all individuals referred to
JBBS.
OBH will require all programs to submit the above data on a web-based database. The data
must be submitted and maintained on an ongoing basis but must be current at least on a
quarterly basis. Detailed information regarding this requirement shall be provided upon contract
implementation.
Licensed SUD treatment providers will submit DACODS and CCAR data to the Office of Behavioral
Health. Providers will have to submit DACODS and CCAR reports for services offered in jails with
these funds. When these clients engage in services after release from jail, the provider who
Page 15 of 16
Exhibit A
delivers services will need to submit either DACODS, CCAR, or both, depending on what that
provider typically would have to submit for the services being provided. The JBBS Special Studies
codes must be used to identify clients receiving services under this funding source.
NRBH is a State licensed SUD and MH treatment provider. Therefore, NRBH submits to the State on a
regular basis all DACODS and CCARS reports required. Special Study codes on those reports indicate the
type of services being provided. NRBH also submits the admission and discharge reports as required by
the State. BTS clinical case managers utilize the following screening tools to assess substance use,
mental health,trauma,TBI and criminogenic risk factors: SSI-R, CCJMHS-A, PTSD checklist, HELPS Brain
Injury Screen, and the LSI-R. BTS case managers are responsible for inputting all the necessary data into
the JBBS database on a regular basis and have always been in compliance with this during the previous
contract period.
Page 16 of 16
Exhibit B-Budget
Weld County
Time Period: 7/1/16 through 6/30/17
JBBS Program
Match Total Program
FTE* 1352 Dollars
Dollars Costs
Direct Personnel Cost
Employee compensation:
Behavioral Health Professional (CJS-
1 $ 58,866 $ 58,866
master's level clinician or CAC III) NRBH
Benefits, Taxes, Unemployment $ 17,660 $ 17,660
Behavioral Health Professional (CJS-
1 $ 43,721 $ 43,721
master's level clinician or CACIII) NRBH
Benefits,Taxes, Unemployment $ 13,116 $ 13,116
Behavioral Health Professional (CJS 1 $ 47,719 $ 47,719
master's level clinician or CAC) NRBH
Benefits, Taxes, Unemployment $ 15,345 $ 15,345
Case Manager Salary(CJCM-bachelor level) 1 $ 38,192 $ 38,192
BTS
Benefits, Taxes, Unemployment $ 10,678 $ 10,678
Case Manager Salary (CJCM-bachelor level) 1 $ 37,080 $ 37,080
BTS
Benefits Taxes, Unemployment $ 10,526 $ 10,526
Subtotal 5 $ 292,903 $ - $ 292,903
Operating
Telephone Fees $ 1,100 $ 1,100
Client Outreach Travel $ 800 $ 800
Subtotal 0 $ 1,900 $ - $ 1,900
Recovery Support Services
Emergency housing, medications,
applications for ID/Birth certificates, bus
passes,
Hygiene items, phone cards, GED
3,087 3,087
program/testing, medical assistance, clothing $
vouchers,
UA/BA's, transportation to residential
treatment, food assistance, backpacks.
Subtotal 0 $ 3,087 $ - $ 3,087
Administration
Aggregate in one line item and describe in
narrative $ 33,099 $ 33,099
ADM FEE
Subtotal 0 $ 33,099 $ - $ 33,099
Total Cost 5 $ 330,989 $ - $ 330,989
1 of 2
Exhibit B- Budget
Performance Incentive 10%of Total Amount
($33,099) ($33,099)
Requested
Estimated number of clients to be served 200 200
Estimated cost per client 1,655 0 1,655
Budget Narrative:The 5.0 FTE described below is for 3 Behavioral Health Professionals (CJS)
employed by NRBH. These positions would be a State of Colorado licensed, master level clinicians
with a CAC II. CAC clinicians would be considered based on experience and reviewed by the
administrative team.The 2 Case Managers (CJCM) would be employed by BTS.The positions would
be a bachelor level position.
Operating expenses cover staff training,travel,therapeutic materials and curriculum, and operating
supplies and fees.
Recovery Support Services will include: Emergency housing, medications, applications for ID/Birth
certificates, bus passes, hygiene items, phone cards, GED program/testing, medical assistance,
clothing vouchers, UA/BA's, transportation to residential treatment,food assistance, backpacks.
Administrative costs are set at^'10% of the overall budget and are split in half between NRBH and
BTS, the two treatment providers.
The JBBS Program will have contact with 200 clients at a $1,654.95 per client cost.
2 of 2
Exhibit C
Miscellaneous Provisions
1. PROVIDE SERVICES
The contractor shall provide the services according to the plans submitted in the
"Statement of Work", attached and, incorporated herein by this reference as
Exhibit A. In all cases, the descriptions, plans, timetables, tasks, duties, and
responsibilities of the Contractor as described in the Statement of Work, shall be
adhered to in the performance of the requirements of this contract. In the event of
conflict, the terms and conditions of this contract shall control over the Statement
of Work.
2. GOALS & OBJECTIVE
The Contractor shall be responsible for the achievement of goals and objectives as
specified within the "Statement of Work" (Exhibit A) of this contract unless
written notice of modifications thereto is furnished by the State to the Contractor
allowing adequate time for compliance during the term of this contract.
3. SEMI STATUS REPORTS
The Contractor shall prepare and submit to the State, semi evaluation reports,
which shall include information relative to the progress in achievement of goals
specified in the aforementioned approved Statement of Work. Report templates
will be made available to the Contract by the State or its designee. Reports shall
be delivered to the State or its designee, not later than last working day after the
end of the month each January (services July through December) and July
(services January through June).
4. COPY OF PROPOSED SUBCONTRACT
The Contractor shall provide to the State a copy of any proposed subcontract
between the Contractor and any potential provider of services to fulfill any
requirements of this contract.
5. REPORTING SYSTEMS
The Contractor, or its subcontractor shall be responsible for participating in any
reporting systems (DACODS, CCAR, and Civicore JBBHS Database) on the
management and evaluation of the program as may be required by the State.
6. PAYMENT
In consideration of the provision of services and reporting as set forth herein and
subject to all payment and price provisions herein and further subject to
verification by the State of full and satisfactory compliance with the terms of this
contract, the State shall cause to be paid to the Contractor an amount not to
exceed the amount specified in the "Budget", Exhibit B, of this contract, in the
following manner.
a. The State shall pay up to the amounts shown in Exhibit B for purchase of jail
based behavioral health services for substance use and co-occurring disorders.
Page 1 of 4
Exhibit C
b. The Contractor shall submit monthly requests for payment for on forms
prescribed by the State by the 20th of the month in which expenses occur.
c. Payment will normally be made in arrears for services rendered. Advances
will not be approved except in documented situations of cash flow emergency,
for a specified term, with the prior written approval of the State, and in
accordance with State fiscal rules and procedures.
d. In no case will a contract be reduced without first allowing the Contractor an
opportunity to present relevant information and explanation and giving due
consideration to events beyond the Contractor's control with may have
impacted the Contractor's ability to satisfy the terms of this contract.
e. Both parties agree that the State has the right to offset against funds otherwise
payable pursuant to this contract based on discovery of overpayment or
improper use of funds pursuant to any contracts between the parties.
"Overpayment or improper use of funds" is interpreted to apply to specific
terms of prior year contracts, and includes without limitation requirements of
the Office of Behavioral Health's A and A Guidelines, Generally Accepted
Accounting Principles issued by the American Institute of Certified Public
Accountants, and applicable sections of the Colorado Revised Statutes.
f. Contractor is eligible for any increases as appropriated by the Colorado
General Assembly and approved by the Department of Human Services.
7. OPTION LETTER
The State may require continued performance for an incremental period of one
year at the same rates and same terms specified in the Contract. If the State
exercises the option, it will provide written notice to Contractor at least 30 days
prior to the end of the current contract term in a form substantially equivalent to
Exhibit D, "Option Letter." If exercised, the provisions of the Option Letter shall
become part of and be incorporated into the original contract. The total duration
of this Contract, including the exercise of any options under this clause, shall not
exceed 5 years.
The State may increase or decrease the quantity of goods/services described in
Exhibits A, "Statement of Work," and Exhibit B, "Admission Requirements,"
based upon the rates established in the Contract. If the State exercises the option,
it will provide written notice to Contractor as least 30 days prior to the end of the
current contract term in a form substantially equivalent to Exhibit D, "Option
Letter." Delivery/performance of the goods/service shall continue at the same
rates and terms. If exercised, the provisions of the Option Letter shall become
part of and be incorporated into the original contract.
The State may increase or decrease the rates established in the Contract in Exhibit
B, "Budget," based upon a cost of living adjustment for the Jail-based Behavioral
Health Services lines in the Long Bill through an option letter. If the State
Page 2 of 4
Exhibit C
exercises the option, it will provide written notice to Contractor as least 30 days
prior to the end of the current contract term in a form substantially equivalent to
Exhibit D, "Option Letter." Delivery/performance of the goods/service shall
continue at the same terms. If exercised, the provisions of the Option Letter shall
become part of and be incorporated into the original contract.
8. PARTICIPATION
The contractor is expected to participate in OBH-sponsored meetings on a
quarterly basis.
9. REQUIREMENTS AS SPECIFIED IN THE "REQUEST FOR APPLICATION"
The contractor and subcontractors shall provide services as specified in their
request for application including:
a) Partnership with OBH-licensed substance use disorder treatment
providers,
b) The OBH-licensed substance use disorder provider must have the ability
to offer continued treatment and transition services in the community and
must assist individuals with alternative means to pay for the continued
services
c) Provide culturally competent and appropriate services,
d) Meet the needs of individuals who are physically challenged, deaf or
hearing impaired, or blind,
e) Provider services in a manor that respects and protects client's rights,
f) Have support by local probation departments,
10. NOT SUPPLANT
Payments made to the Contractor under this contract will supplement and not
supplant state or local expenditures for substance use disorder or co-occurring
substance use and mental health disorder treatment that would have been made in
the absence of such payments.
11. NOT ASSIGNABLE
This contract is not assignable without prior written consent of the State.
12. BUDGET CHANGES
Any changes in the budget, Exhibit B of this contract, shall be made only with the
prior written approval of the State and shall not exceed the total amount of the
contract as described on page one of the contract.
13. OBH FINANCE & DATA PROTOCOLS
Contractor shall comply with the most recent versions of the Office of Behavioral
Health Finance & Data Protocols available on OBH's website.
14. FUNDS FOR PURCHASE OF NALOXONE KITS
Payment for the purchase of naloxone kits to all Contractors will be made as
earned, in whole or in part, from the available funds encumbered in an amount not
to exceed $136,500 for the JBBS program. Each Contractor/county is limited to a
Page 3 of 4
Exhibit C
maximum of$10,500 per contract period. It is further understood and agreed that
the maximum amount of funds available for payment to all programs state wide
for the current fiscal year for this purpose is $136,500 except as this amount may
be modified by the Office of Behavioral Health. At any time, the liability of the
State for such payment shall be limited to the encumbered amount remaining of
such funds
Page 4 of 4
•
Exhibit D
SAMPLE OPTION LETTER
Date: State Fiscal Year: Option Letter No. CMS Routing#
1) OPTIONS: Choose all applicable options listed in §1 and in §2 and delete the rest [also delete all
yellow highlighted text].
a.Option to renew only (for an additional term)
b.Change in the amount of goods within current term
c. Change in amount of goods in conjunction with renewal for additional term
d.Level of service change within current term
e. Level of service change in conjunction with renewal for additional term
f. Option to initiate next phase of a contract
2) REQUIRED PROVISIONS. All Option Letters shall contain the appropriate provisions set forth below:
a. For use with Options 1(a-e): In accordance with Section(s) of the Original Contract
routing number between the State of Colorado, Department of Human Services, and
Contractor's Name, the State hereby exercises its option for an additional term beginning Insert
start date and ending on Insert ending date at a cost/price specified in Section , AND/OR
an increase/decrease in the amount of goods/services at the same rate(s) as specified in Identify
the Section, Schedule, Attachment, Exhibit etc.
b. For use with Option 1(f), please use the following: In accordance with Section(s) of the
Original Contract routing number between the State of Colorado, Department of Human
Services, and Contractor's Name, the State hereby exercises its option to initiate Phase indicate
which Phase: 2, 3, 4, etc for the term beginning Insert start date and ending on Insert ending date
at the cost/price specified in Section
c. For use with all Options: The amount of the current Fiscal Year contract value is
increased/decreased by$ amount of change to a new contract value of Insert New$Amt to as
consideration for services/goods ordered under the contract for the current fiscal year indicate
Fiscal Year. The first sentence in Section is hereby modified accordingly. The total
contract value including all previous amendments, option letters, etc. is Insert New$Amt.
3) Effective Date. The effective date of this Option Letter is upon approval of the State Controller or
, whichever is later.
STATE OF COLORADO
John W. Hickenlooper, GOVERNOR
Department of Human Services
Reggie Bicha, Executive Director
By: Insert Name&Title of Person Signing for Agency or IHE
Date:
ALL CONTRACTS REQUIRE APPROVAL BY THE STATE CONTROLLER
CRS§24-30-202 requires the State Controller to approve all State Contracts.This Contract is not valid until
signed and dated below by the State Controller or delegate. Contractor is not authorized to begin
performance until such time. If Contractor begins performing prior thereto,the State of Colorado is not
obligated to pay Contractor for such performance or for any goods and/or services provided hereunder.
STATE CONTROLLER
Robert Jaros, CPA, MBA, JD
By:
Date:
Page 1 of 1 Effective Date:1/6/09-Rev 8/25/09
Exhibit E
JBBS Performance Incentive
Program Goal: The goal of the Jail Based Behavioral Health Services program is to
provide appropriate behavioral health services to inmates while supporting continuity of
care within the community after release from incarceration.
JBBS Programs are required to demonstrate the ability to transition individuals from jail
based services to appropriate behavioral health and other needed community services
upon release from incarceration.
Performance Measure: Programs are required to follow-up with all clients who are
successfully discharged from the program and released to the community at 1, 2, 6 and
12 months after release. Clinicians are required to either call the client or track
treatment engagement at the community-based treatment provider to which the client
was referred. The outcome of the transition tracking attempt is required to be logged
into the Civicore JBBHS Database.
The following options are the transition tracking outcome status options in the database:
1. Deceased- In the event of client death post release
2. In Treatment- Client is engaged in community-based treatment services as
recommended on the transition plan
3. New Crime/Regressed- Client returned to jail for violations or committed a new
crime
4. Not Applicable- Client sentenced to Department of Corrections or client not
tracked
5. Not In Treatment- Client is tracked via the community-based treatment agency or
the client reports to not be in treatment services as recommended on the
transition plan
6. Status Unknown- Client cannot be reached or tracked
7. Treatment Completed- Client completed treatment as recommended at release
from jail
Performance Based Incentives will be paid out to programs meeting or outperforming
benchmarks for the number of clients engaging in treatment services upon release from
the jail.
The benchmark for programs to earn their Performance Incentive is a total of 30% of the
clients released from the program will be "In Treatment" or "Treatment Completed" at
the 1 month Transition Tracking interval. This data shall be pulled after the end of the
fiscal year(June 30th) from the Civicore JBBHS Database. The benchmark was
determined based on the statewide average number of successfully discharged
individuals tracked to be "In Treatment" at the 1 month tracking interval in FY 15's
annual data.
Page 1 of 2
Exhibit E
Methodology:
1. All JBBS Programs are required to submit budgets reflecting a 10% withhold
from the total contract award amount for the performance incentive payout.
For example, if the program is requesting a total of$100,000; the Direct Personnel,
Client, Recovery Support Funds, Operating, Other and Administration must total
$90,000. $10,000 is to be withheld for the performance incentive payout and cannot be
invoiced during the fiscal year.
2. The Annual Report data shall be pulled from the Civicore JBBHS Database after
the fiscal year (June 30th) ends. The performance shall be based on the
Transition Tracking Outcomes of the total number of individuals eligible to be
tracked at the 1 month interval who have a transition tracking status of "In
Treatment" or"Treatment Completed".
Note: the eligible individuals to be tracked will exclude the number of clients tracked as
"Not Applicable" or "Deceased" since these individuals are will not be eligible to engage
in treatment services due to being sentenced to the Department of Corrections or due to
client death.
For JBBS programs designed to have multiple county partnerships in their program; the
performance will be based on the average the all counties.
3. The outcome data shall be shared with all programs by the end of August and
10% incentive payment withhold will be paid out to programs that meet or exceed
30% benchmark.
Programs who do not meet the performance outcome shall be asked to submit a plan of
action to improve program outcomes for the next fiscal year. The un-earned portion of
the contract funds shall be reverted.
Page 2 of 2
Exhibit F
HIPAA BUSINESS ASSOCIATE ADDENDUM
This Business Associate Addendum ("Addendum") is a part of the Contract dated March
2, 2016 between the Department of Human Services, Office of Behavioral Health and Weld
County Sheriffs Office, contract number 17 IHJA 87813. For purposes of this Addendum, the
State is referred to as "Covered Entity"or"CE" and the Contractor is referred to as "Associate".
Unless the context clearly requires a distinction between the Contract document and this
Addendum, all references herein to "the Contract" or"this Contract"include this Addendum.
RECITALS
A. CE wishes to disclose certain information to Associate pursuant to the terms of the
Contract, some of which may constitute Protected Health Information ("PHI") (defined
below).
B. CE and Associate intend to protect the privacy and provide for the security of PHI
disclosed to Associate pursuant to this Contract in compliance with the Health Insurance
Portability and Accountability Act of 1996, 42 U.S.C. § 1320d— 1320d-8 ("HIPAA") as
amended by the American Recovery and Reinvestment Act of 2009 ("ARRA")/HITECH
Act (P.L. 111-005), and its implementing regulations promulgated by the U.S.
Department of Health and Human Services, 45 C.F.R. Parts 160, 162 and 164 (the
"HIPAA Rules") and other applicable laws, as amended.
C. As part of the HIPAA Rules, the CE is required to enter into a written contract containing
specific requirements with Associate prior to the disclosure of PHI, as set forth in, but not
limited to, Title 45, Sections 160.103, 164.502(e) and 164.504(e) of the Code of Federal
Regulations ("C.F.R.") and contained in this Addendum.
The parties agree as follows:
1. Definitions.
a. Except as otherwise defined herein, capitalized terms in this Addendum shall have
the definitions set forth in the HIPAA Rules at 45 C.F.R. Parts 160, 162 and 164, as amended.
In the event of any conflict between the mandatory provisions of the HIPAA Rules and the
provisions of this Contract, the HIPAA Rules shall control. Where the provisions of this
Contract differ from those mandated by the HIPAA Rules, but are nonetheless permitted by the
HIPAA Rules, the provisions of this Contract shall control.
b. "Protected Health Information" or"PHI"means any information, whether oral or
recorded in any form or medium: (i) that relates to the past, present or future physical or mental
condition of an individual; the provision of health care to an individual; or the past, present or
future payment for the provision of health care to an individual; and (ii) that identifies the
individual or with respect to which there is a reasonable basis to believe the information can be
Page 1 of 9
Colorado Model BA Provision and
Addendum For New or Amended Contracts
Rev.May 2013
Exhibit F
used to identify the individual, and shall have the meaning given to such term under the HIPAA
Rules, including, but not limited to, 45 C.F.R. Section 164.501.
c. "Protected Information" shall mean PHI provided by CE to Associate or created
received, maintained or transmitted by Associate on CE's behalf. To the extent Associate is a
covered entity under HIPAA and creates or obtains its own PHI for treatment, payment and
health care operations, Protected Information under this Contract does not include any PHI
created or obtained by Associate as a covered entity and Associate shall follow its own policies
and procedures for accounting, access and amendment of Associate's PHI.
d. "Subcontractor" shall mean a third party to whom Associate delegates a function,
activity, or service that involves CE's Protected Information, in order to carry out the
responsibilities of this Agreement.
2. Obligations of Associate.
a. Permitted Uses. Associate shall not use Protected Information except for the
purpose of performing Associate's obligations under this Contract and as permitted under this
Addendum. Further, Associate shall not use Protected Information in any manner that would
constitute a violation of the HIPAA Rules if so used by CE, except that Associate may use
Protected Information: (i) for the proper management and administration of Associate; (ii) to
carry out the legal responsibilities of Associate; or(iii) for Data Aggregation purposes for the
Health Care Operations of CE. Additional provisions, if any, governing permitted uses of
Protected Information are set forth in Attachment A to this Addendum. Associate accepts full
responsibility for any penalties incurred as a result of Associate's breach of the HIPAA Rules.
b. Permitted Disclosures. Associate shall not disclose Protected Information in any
manner that would constitute a violation of the HIPAA Rules if disclosed by CE, except that
Associate may disclose Protected Information: (i) in a manner permitted pursuant to this
Contract; (ii) for the proper management and administration of Associate; (iii) as required by
law; (iv) for Data Aggregation purposes for the Health Care Operations of CE; or(v) to report
violations of law to appropriate federal or state authorities, consistent with 45 C.F.R. Section
164.502(j)(1). To the extent that Associate discloses Protected Information to a third party
Subcontractor, Associate must obtain, prior to making any such disclosure: (i) reasonable
assurances through execution of a written agreement with such third party that such Protected
Information will be held confidential as provided pursuant to this Addendum and only disclosed
as required by law or for the purposes for which it was disclosed to such third party; and that
such third party will notify Associate within two (2)business days of any breaches of
confidentiality of the Protected Information, to the extent it has obtained knowledge of such
breach. Additional provisions, if any, governing permitted disclosures of Protected Information
are set forth in Attachment A.
c. Appropriate Safeguards. Associate shall implement appropriate safeguards as are
necessary to prevent the use or disclosure of Protected Information other than as permitted by
this Contract. Associate shall comply with the requirements of the HIPAA Security Rule at 45
C.F.R. Sections 164.308, 164.310, 164.312, and 164.316. Associate shall maintain a
Page 2 of 9
Colorado Model BA Provision and
Addendum For New or Amended Contracts
Rev.May 2013
Exhibit F
comprehensive written information privacy and security program that includes administrative,
technical and physical safeguards appropriate to the size and complexity of the Associate's
operations and the nature and scope of its activities. Associate shall review, modify, and update
documentation of, its safeguards as needed to ensure continued provision of reasonable and
appropriate protection of Protected Information.
d. Reporting of Improper Use or Disclosure. Associate shall report to CE in writing
any use or disclosure of Protected Information other than as provided for by this Contract within
five(5)business days of becoming aware of such use or disclosure.
e. Associate's Agents. If Associate uses one or more Subcontractors or agents to
provide services under the Contract, and such Subcontractors or agents receive or have access to
Protected Information, each Subcontractor or agent shall sign an agreement with Associate
containing the same provisions as this Addendum and further identifying CE as a third party
beneficiary with rights of enforcement and indemnification from such Subcontractors or agents
in the event of any violation of such Subcontractor or agent agreement. The Agreement between
the Associate and Subcontractor or agent shall ensure that the Subcontractor or agent agrees to at
least the same restrictions and conditions that apply to Associate with respect to such Protected
Information. Associate shall implement and maintain sanctions against agents and
Subcontractors that violate such restrictions and conditions and shall mitigate the effects of any
such violation.
f. Access to Protected Information. If Associate maintains Protected Information
contained within CE's Designated Record Set, Associate shall make Protected Information
maintained by Associate or its agents or Subcontractors in such Designated Record Sets
available to CE for inspection and copying within ten(10)business days of a request by CE to
enable CE to fulfill its obligations to permit individual access to PHI under the HIPAA Rules,
including, but not limited to, 45 C.F.R. Section 164.524. If such Protected Information is
maintained by Associate in an electronic form or format, Associate must make such Protected
Information available to CE in a mutually agreed upon electronic form or format.
g. Amendment of PHI. If Associate maintains Protected Information contained
within CE's Designated Record Set, Associate or its agents or Subcontractors shall make such
Protected Information available to CE for amendment within ten(10)business days of receipt of
a request from CE for an amendment of Protected Information or a record about an individual
contained in a Designated Record Set, and shall incorporate any such amendment to enable CE
to fulfill its obligations with respect to requests by individuals to amend their PHI under the
HIPAA Rules, including, but not limited to, 45 C.F.R. Section 164.526. If any individual
requests an amendment of Protected Information directly from Associate or its agents or
Subcontractors, Associate must notify CE in writing within five(5)business days of receipt of
the request. Any denial of amendment of Protected Information maintained by Associate or its
agents or Subcontractors shall be the responsibility of CE.
h. Accounting Rights. If Associate maintains Protected Information contained
within CE's Designated Record Set, Associate and its agents or Subcontractors shall make
available to CE within ten (10)business days of notice by CE, the information required to
Page 3 of 9
Colorado Model BA Provision and
Addendum For New or Amended Contracts
Rev.May 2013
Exhibit F
provide an accounting of disclosures to enable CE to fulfill its obligations under the HIPAA
Rules, including, but not limited to, 45 C.F.R. Section 164.528. In the event that the request for
an accounting is delivered directly to Associate or its agents or Subcontractors, Associate shall
within five(5) business days of the receipt of the request forward it to CE in writing. It shall be
CE's responsibility to prepare and deliver any such accounting requested. Associate shall not
disclose any Protected Information except as set forth in Section 2(b) of this Addendum.
i. Governmental Access to Records. Associate shall keep records and make its
internal practices, books and records relating to the use and disclosure of Protected Information
available to the Secretary of the U.S. Department of Health and Human Services (the
"Secretary"), in a time and manner designated by the Secretary, for purposes of determining
CE's or Associate's compliance with the HIPAA Rules. Associate shall provide to CE a copy of
any Protected Information that Associate provides to the Secretary concurrently with providing
such Protected Information to the Secretary when the Secretary is investigating CE. Associate
shall cooperate with the Secretary if the Secretary undertakes an investigation or compliance
review of Associate's policies, procedures or practices to determine whether Associate is
complying with the HIPAA Rules, and permit access by the Secretary during normal business
hours to its facilities, books, records, accounts, and other sources of information, including
Protected Information, that are pertinent to ascertaining compliance.
j. Minimum Necessary. Associate (and its agents or subcontractors) shall only
request, use and disclose the minimum amount of Protected Information necessary to accomplish
the purpose of the request, use or disclosure, in accordance with the Minimum Necessary
requirements of the HIPAA Rules including, but not limited to 45 C.F.R. Sections 164.502(b)
and 164.514(d).
k. Data Ownership. Associate acknowledges that Associate has no ownership rights
with respect to the Protected Information.
1. Retention of Protected Information. Except upon termination of the Contract as
provided in Section 4(d) of this Addendum, Associate and its Subcontractors or agents shall
retain all Protected Information throughout the term of this Contract and shall continue to
maintain the information required under Section 2(h) of this Addendum for a period of six (6)
years.
m. Associate's Insurance. Associate shall maintain insurance to cover loss of PHI
data and claims based upon alleged violations of privacy rights through improper use or
disclosure of PHI. All such policies shall meet or exceed the minimum insurance requirements
of the Contract(e.g., occurrence basis, combined single dollar limits, annual aggregate dollar
limits, additional insured status and notice of cancellation).
n. Notice of Privacy Practices. Associate shall be responsible for reviewing CE's
Notice of Privacy Practices, available on CE's external website, to determine any requirements
applicable to Associate per this Contract.
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Exhibit F
o. Notification of Breach. During the term of this Contract, Associate shall notify
CE within two (2)business days of any suspected or actual breach of security, intrusion or
unauthorized use or disclosure of PHI and/or any actual or suspected use or disclosure of data in
violation of any applicable federal or state laws or regulations. Associate shall not initiate
notification to affected individuals per the HIPAA Rules without prior notification and approval
of CE. Information provided to CE shall include the identification of each individual whose
unsecured PHI has been, or is reasonably believed to have been accessed, acquired or disclosed
during the breach. Associate shall take (i)prompt corrective action to cure any such deficiencies
and (ii) any action pertaining to such unauthorized disclosure required by applicable federal and
state laws and regulations.
p. Audits, Inspection and Enforcement. Within ten(10)business days of a written
request by CE, Associate and its agents or subcontractors shall allow CE to conduct a reasonable
inspection of the facilities, systems,books, records, agreements, policies and procedures relating
to the use or disclosure of Protected Information pursuant to this Addendum for the purpose of
determining whether Associate has complied with this Addendum; provided, however, that: (i)
Associate and CE shall mutually agree in advance upon the scope, timing and location of such an
inspection; and (ii) CE shall protect the confidentiality of all confidential and proprietary
information of Associate to which CE has access during the course of such inspection. The fact
that CE inspects, or fails to inspect, or has the right to inspect, Associate's facilities, systems,
books, records, agreements, policies and procedures does not relieve Associate of its
responsibility to comply with this Addendum, nor does CE's (i) failure to detect or(ii) detection,
but failure to notify Associate or require Associate's remediation of any unsatisfactory practices,
constitute acceptance of such practice or a waiver of CE's enforcement rights under the Contract.
q. Safeguards During Transmission. Associate shall be responsible for using
appropriate safeguards, including encryption of PHI, to maintain and ensure the confidentiality,
integrity and security of Protected Information transmitted pursuant to the Contract, in
accordance with the standards and requirements of the HIPAA Rules.
r. Restrictions and Confidential Communications. Within ten (10) business days of
notice by CE of a restriction upon uses or disclosures or request for confidential communications
pursuant to 45 C.F.R. Section 164.522, Associate will restrict the use or disclosure of an
individual's Protected Information. Associate will not respond directly to an individual's
requests to restrict the use or disclosure of Protected Information or to send all communication of
Protect Information to an alternate address. Associate will refer such requests to the CE so that
the CE can coordinate and prepare a timely response to the requesting individual and provide
direction to Associate.
3. Obligations of CE.
a. Safeguards During Transmission. CE shall be responsible for using appropriate
safeguards, including encryption of PHI, to maintain and ensure the confidentiality, integrity and
security of Protected Information transmitted pursuant to the Contract, in accordance with the
standards and requirements of the HIPAA Rules.
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Exhibit F
b. Notice of Changes. CE maintains a copy of its Notice of Privacy Practices on its
website. CE shall provide Associate with any changes in, or revocation of, permission to use or
disclose Protected Information, to the extent that it may affect Associate's permitted or required
uses or disclosures. To the extent that it may affect Associate's permitted use or disclosure of
PHI, CE shall notify Associate of any restriction on the use or disclosure of Protected
Information that CE has agreed to in accordance with 45 C.F.R. Section 164.522.
4. Termination.
a. Material Breach. In addition to any other provisions in the Contract regarding
breach, a breach by Associate of any provision of this Addendum, as determined by CE, shall
constitute a material breach of this Contract and shall provide grounds for immediate termination
of this Contract by CE pursuant to the provisions of the Contract covering termination for cause,
if any. If the Contract contains no express provisions regarding termination for cause, the
following terms and conditions shall apply:
(1) Default. If Associate refuses or fails to timely perform any of the
provisions of this Contract, CE may notify Associate in writing of the non-performance, and if
not promptly corrected within the time specified, CE may terminate this Contract. Associate
shall continue performance of this Contract to the extent it is not terminated and shall be liable
for excess costs incurred in procuring similar goods or services elsewhere.
(2) Associate's Duties. Notwithstanding termination of this Contract, and
subject to any directions from CE, Associate shall take timely, reasonable and necessary action
to protect and preserve property in the possession of Associate in which CE has an interest.
(3) Compensation. Payment for completed supplies delivered and accepted
by CE shall be at the Contract price. In the event of a material breach under paragraph 4a, CE
may withhold amounts due Associate as CE deems necessary to protect CE against loss from
third party claims of improper use or disclosure and to reimburse CE for the excess costs
incurred in procuring similar goods and services elsewhere.
(4) Erroneous Termination for Default. If after such termination it is
determined, for any reason, that Associate was not in default, or that Associate's action/inaction
was excusable, such termination shall be treated as a termination for convenience, and the rights
and obligations of the parties shall be the same as if this Contract had been terminated for
convenience, as described in this Contract.
b. Reasonable Steps to Cure Breach. If CE knows of a pattern of activity or practice
of Associate that constitutes a material breach or violation of the Associate's obligations under
the provisions of this Addendum or another arrangement and does not terminate this Contract
pursuant to Section 4(a), then CE shall take reasonable steps to cure such breach or end such
violation.. If CE's efforts to cure such breach or end such violation are unsuccessful, CE shall
either(i) terminate the Contract, if feasible or(ii) if termination of this Contract is not feasible,
CE shall report Associate's breach or violation to the Secretary of the Department of Health and
Human Services. If Associate knows of a pattern of activity or practice of a Subcontractor or
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Colorado Model BA Provision and
Addendum For New or Amended Contracts
Rev.May 2013
Exhibit F
agent that constitutes a material breach or violation of the Subcontractor's or agent's obligations
under the written agreement between Associate and the Subcontractor or agent, Associate shall
take reasonable steps to cure such breach or end such violation, if feasible.
c. Judicial or Administrative Proceedings. Either party may terminate the
Contract, effective immediately, if(i) the other party is named as a defendant in a criminal
proceeding for a violation of the HIPAA Rules or other security or privacy laws or(ii) a finding
or stipulation that the other party has violated any standard or requirement of the HIPAA Rules
or other security or privacy laws is made in any administrative or civil proceeding in which the
party has been joined.
d. Effect of Termination.
(1) Except as provided in paragraph(2) of this subsection, upon termination
of this Contract, for any reason, Associate shall return or destroy all Protected Information that
Associate or its agents or Subcontractors still maintain in any form, and shall retain no copies of
such Protected Information. If Associate elects to destroy the PHI, Associate shall certify in
writing to CE that such PHI has been destroyed.
(2) If Associate believes that returning or destroying the Protected
Information is not feasible, Associate shall promptly provide CE notice of the conditions making
return or destruction infeasible. Associate shall continue to extend the protections of Sections
2(a), 2(b), 2(c), 2(d) and 2(e) of this Addendum to such Protected Information, and shall limit
further use of such PHI to those purposes that make the return or destruction of such PHI
infeasible.
5. Injunctive Relief. CE shall have the right to injunctive and other equitable and legal
relief against Associate or any of its Subcontractors or agents in the event of any use or
disclosure of Protected Information in violation of this Contract or applicable law.
6. No Waiver of Immunity. No term or condition of this Contract shall be construed or
interpreted as a waiver, express or implied, of any of the immunities, rights, benefits, protection,
or other provisions of the Colorado Governmental Immunity Act, CRS 24-10-101 et seq. or the
Federal Tort Claims Act, 28 U.S.C. 2671 et seq. as applicable, as now in effect or hereafter
amended.
7. Limitation of Liability. Any limitation of Associate's liability in the Contract shall be
inapplicable to the terms and conditions of this Addendum.
8. Disclaimer. CE makes no warranty or representation that compliance by Associate with
this Contractor the HIPAA Rules will be adequate or satisfactory for Associate's own purposes.
Associate is solely responsible for all decisions made by Associate regarding the safeguarding of
PHI.
9. Certification. To the extent that CE determines an examination is necessary in order to
comply with CE's legal obligations pursuant to the HIPAA Rules relating to certification of its
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Rev.May 2013
Exhibit F
security practices, CE or its authorized agents or contractors, may, at CE's expense, examine
Associate's facilities, systems, procedures and records as may be necessary for such agents or
contractors to certify to CE the extent to which Associate's security safeguards comply with the
HIPAA Rules or this Addendum.
10. Amendment.
a. Amendment to Comply with Law. The parties acknowledge that state and federal
laws relating to data security and privacy are rapidly evolving and that amendment of this
Addendum may be required to provide for procedures to ensure compliance with such
developments. The parties specifically agree to take such action as is necessary to implement the
standards and requirements of the HIPAA Rules and other applicable laws relating to the
confidentiality, integrity, availability and security of PHI. The parties understand and agree that
CE must receive satisfactory written assurance from Associate that Associate will adequately
safeguard all Protected Information and that it is Associate's responsibility to receive satisfactory
written assurances from Associate's Subcontractors and agents. Upon the request of either party,
the other party agrees to promptly enter into negotiations concerning the terms of an amendment
to this Addendum embodying written assurances consistent with the standards and requirements
of the HIPAA Rules or other applicable laws. CE may terminate this Contract upon thirty(30)
days written notice in the event(i) Associate does not promptly enter into negotiations to amend
this Contract when requested by CE pursuant to this Section, or(ii) Associate does not enter into
an amendment to this Contract providing assurances regarding the safeguarding of PHI that CE,
in its sole discretion, deems sufficient to satisfy the standards and requirements of the HIPAA
Rules.
b. Amendment of Attachment A. Attachment A may be modified or amended by
mutual agreement of the parties in writing from time to time without formal amendment of this
Addendum.
11. Assistance in Litigation or Administrative Proceedings. Associate shall make itself, and
any Subcontractors, employees or agents assisting Associate in the performance of its obligations
under the Contract, available to CE, at no cost to CE up to a maximum of 30 hours, to testify as
witnesses, or otherwise, in the event of litigation or administrative proceedings being
commenced against CE, its directors, officers or employees based upon a claimed violation of
the HIPAA Rules or other laws relating to security and privacy or PHI, except where Associate
or its Subcontractor, employee or agent is a named adverse party.
12. No Third Party Beneficiaries. Nothing express or implied in this Contract is intended to
confer, nor shall anything herein confer, upon any person other than CE, Associate and their
respective successors or assigns, any rights, remedies, obligations or liabilities whatsoever.
13. Interpretation and Order of Precedence. The provisions of this Addendum shall prevail
over any provisions in the Contract that may conflict or appear inconsistent with any provision in
this Addendum. Together, the Contract and this Addendum shall be interpreted as broadly as
necessary to implement and comply with the HIPAA Rules. The parties agree that any
ambiguity in this Contract shall be resolved in favor of a meaning that complies and is consistent
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Addendum For New or Amended Contracts
Rev.May 2013
Exhibit F
with the HIPAA Rules. This Contract supercedes and replaces any previous separately executed
HIPAA addendum between the parties.
14. Survival of Certain Contract Terms. Notwithstanding anything herein to the contrary,
Associate's obligations under Section 4(d) ("Effect of Termination") and Section 12 ("No Third
Party Beneficiaries") shall survive termination of this Contract and shall be enforceable by CE as
provided herein in the event of such failure to perform or comply by the Associate. This
Addendum shall remain in effect during the term of the Contract including any extensions.
15. Representatives and Notice.
a. Representatives. For the purpose of the Contract, the individuals identified
elsewhere in this Contract shall be the representatives of the respective parties. If no
representatives are identified in the Contract, the individuals listed below are hereby designated
as the parties' respective representatives for purposes of this Contract. Either party may from
time to time designate in writing new or substitute representatives.
b. Notices. All required notices shall be in writing and shall be hand delivered or
given by certified or registered mail to the representatives at the addresses set forth below.
State/Covered Entity Representative:
Name: Andrew Martinez
Title: Community Programs CFO
Department and Division: Office of Behavioral Health
Address: 3824 West Princeton Circle
Denver, CO 80236
Contractor/Business Associate Representative:
Name: Steven Reams
Title: Sheriff
Department and Division: Weld County Sheriffs Office
Address: 1950 O Street
Greeley, Colorado 80631
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Addendum For New or Amended Contracts
Rev. May 2013
Exhibit F
ATTACHMENT A
This Attachment sets forth additional terms to the HIPAA Business Associate
Addendum, which is part of the Contract dated March 2, 2016, between the Department of
Human Services, Office of Behavioral Health and Weld County Sheriffs Office, contract number
17 IHJA 87813 ("Contract") and is effective as of July 1, 2016 (the "Attachment Effective
Date"). This Attachment may be amended from time to time as provided in Section 10(b) of the
Addendum.
1. Additional Permitted Uses. In addition to those purposes set forth in Section 2(a) of the
Addendum, Associate may use Protected Information as follows:
None except as otherwise directed in writing by the State
2. Additional Permitted Disclosures. In addition to those purposes set forth in Section 2(b)
of the Addendum, Associate may disclose Protected Information as follows:
None except as otherwise directed in writing by the State
3. Subcontractor(s). The parties acknowledge that the following subcontractors or agents of
Associate shall receive Protected Information in the course of assisting Associate in the
performance of its obligations under this Contract:
None except as otherwise directed in writing by the State
4. Receipt. Associate's receipt of Protected Information pursuant to this Contract shall be
deemed to occur as follows, and Associate's obligations under the Addendum shall commence
with respect to such PHI upon such receipt:
Upon the effective date of the contract
5. Additional Restrictions on Use of Data. CE is a Business Associate of certain other
Covered Entities and, pursuant to such obligations of CE, Associate shall comply with the
following restrictions on the use and disclosure of Protected Information:
As may be directed in writing by the State
6. Additional Terms. [This section may include specifications for disclosure format,
method of transmission, use of an intermediary, use of digital signatures or PKI, authentication,
additional security of privacy specifications, de-identification or re-identification of data and
other additional terms.]
None
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Addendum For New or Amended Contracts
Rev.May 2013
Exhibit G—Recovery Support Services
In addition to the statement of work outlined in Exhibit A of this contract, Contractor shall also
provide recovery support services to clients during the contract period, including, but not limited
to:
• Application Fees—IDs/ Birth certificates,
• Backpacks,
• Basic hygiene items,
• Bus passes (daily/monthly),
• Child care,
• Clothing vouchers,
• Education costs (books, supplies, and fees),
• Emergency housing,
• Food assistance,
• Job training,
• Gas vouchers,
• GED program/testing,
• Life skills training,
• Medical assistance—copays/infectious disease testing,
• Medications,
• Personal hygiene care,
• Phone cards,
• Print brochures to referral sources,
• Taxi,
• Transportation to residential treatment,
• UA/Bas,
• Utilities
The budget for these expenses is outlined in Exhibit B of this contract.
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