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HomeMy WebLinkAbout20162723.tiff/ 6 (3' lq MEMORANDUM DATE: May 23, 2016 TO: Board of County Commissioners — Pass -Around FR: Judy A. Griego, Director, Human Services RE: Weld County Department of Human Services' Child Welfare PY2016-17—Core and Non -Core Contracted Providers Please review and indicate if you would like a work session prior to placing this item on the Board's agenda. Request Board Approval of the Department's Child Welfare PY2016-17-Core and Non - Core Contracted Providers. The briefing document (attached) reflects the contractors that have been selected to provide services during the coming program year. Core and Non -Core (Child Welfare) contracts listed in document are effective June 1, 2016. The document reflects contractors who are renewing their original contract with new rates and/or services and new contractors awarded through the bid process. The Families, Youth and Children Commission reviewed and approved the contractors and rates on April 29, 2016. Please note, the Department is still in the process of negotiation with, or obtaining additional information from, a few additional contractors. Contractors not included on the attached document at this time will be sent through at a later date. Upon Board approval of the contractors listed on the Briefing Document, signed agreements or agreement addendums will be obtained from contractors and submitted through Contract Management System (CMS) for final Board approval. l do not recommend a Work Session. I recommend approval of Contracted Providers. Sean Conway Steve Moreno Barbara Kirkmeyer Mike Freeman Julie Cozad Approve BOCC Agenda Work Session Request Pass -Around Memorandum; May 23, 16 CMS kk Page 1 027,2 3 f,aa.2-/( / y�02,a-i� Coad. CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND ANDREA SHINDLE This Agreement, made and entered into thday of , 2016, by and between the Board of Weld County Commissioners, on behalf of the Weld County Department of Human Services, hereinafter referred to as the "Department' and Andrea Shindle, hereinafter referred to as the "Contractor". The parties to this Agreement understand and agree that the provisions of this Agreement specifically include the following documents: Exhibit A, Weld County's Request for Proposal, Exhibit B, Contractor's Proposal, Exhibit C, Scope of Services, and Exhibit D, Payment Schedule. Each of these documents is attached hereto and incorporated herein by this reference. WITNESSETH WHEREAS, required approval, clearance, and coordination have been accomplished from and with appropriate agencies; and WHEREAS, the Colorado Department of Human Services has provided Core Services funding to the Department for Foster Parent Consultation. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: 1. Term This agreement shall become effective on June 1, 2016, upon proper execution of this Agreement and shall expire May 31, 2017, unless sooner terminated as provided herein. The agreement is for a period of three years. However, the agreement must be renewed by both parties, in writing, on an annual basis. 2. Scope of Services Services shall be provided by the Contractor to any person(s) eligible for services in compliance with Exhibit B, Contractor's Proposal and Exhibit C, Scope of Services. 3. Referrals, Billing and Tracking a. Contractor understands and will comply with all aspects of the referral authorization, billing and tracking requirements as set forth by the Department. Failure to comply with all aspects may result in a forfeiture of payment. b. Contractor agrees to receive referrals for services through e-mail and will provide an identified e- mail address prior to the start of this Agreement. Contractor acknowledges that services are not authorized until the Contractor has received an authorized referral form from the Department. Contractor further acknowledges that services provided prior to the authorized start date or outside the scope of services on the referral form will not be eligible for reimbursement. Contractor acknowledges that any and all modifications to an existing referral must be approved through the Department's Resource Manager, Child Welfare Contract and Services Coordinator, or through a Team Decision Making (TDM) meeting or Family Team Meeting (FTM). No other Department staff or other party to the case may authorize services or modifications to services. c. Contractor agrees to submit an itemized complete billing statement by the 7th of the month, following the month of service, utilizing billing forms required by the Department. ate. 8-d,2-aoi6 1 2016-2723 Rom d. Contractor agrees to submit a monthly report with the billing statement by the 7th of the month following the month of service for each client receiving ongoing services. One-time services will be verified through receipt of the completed product (ex. psychological evaluation, substance abuse evaluation). Verification of Monitored Sobriety Services will be the test result. Contractor will document in detail any and all observed or verbalized concerns regarding any child whom the Contractor is working with under the Agreement. Areas of concern may include, but are not limited to, any physical, emotional, educational or behavioral issues. Areas of concern should be reported immediately to the caseworker AND on the required monthly report. Monthly reports will be submitted through the Department's online reporting system, unless otherwise directed or agreed to by the Department. 4. Payment a. The Department and the Contractor agree that all benefits from private insurance and/or other funding sources such as Medicaid (if Contractor is a Medicaid eligible provider) or Victim's Compensation must be exhausted before Core Services or other Department funds can be accessed for services. b. Payment shall be made in accordance with Exhibit A, Weld County's Request for Proposal, Exhibit B, Contractor's Proposal, Exhibit C, Scope of Services, and Exhibit D, Payment Schedule, attached hereto and incorporated herein by reference, so long as services are rendered satisfactorily and in accordance with the Agreement. c. Payment pursuant to this Agreement, whether in whole or in part, is subject to, and contingent upon, the continuing availability of said funds for the purposes hereof. d. The Department may withhold reimbursement if Contractor has failed to comply with any part of the Agreement, including the Financial Management requirements, program objectives, contractual terms, or reporting requirements. In the event of forfeiture of reimbursement, Contractor may appeal such circumstance in writing to the Director of Human Services. The decision of the Director of Human Services shall be final. 5. Financial Management At all times from the effective date of the Agreement until completion of the Agreement, Contractor shall comply with the administrative requirements, cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under this Agreement must conform to the Single Audit Act of 1984 and OMG Circular A-133. 6. Payment Method Unless otherwise provided in Exhibit B, Contractor's Proposal, Exhibit C, Scope of Services, and Exhibit D, Payment Schedule: a. If services are funded through Core Services, Contractor agrees to accept reimbursement through ACH direct deposit one time per month. b. If Contractor is not currently set up with the State of Colorado to accept direct deposit, Contractor agrees to complete and submit an ACH Form for Colorado Providers, which will be provided by the Department. Contractor is solely responsible to submit the ACH Form to the State of 2 Colorado per the directions on the form. Failure to complete and submit this form in a timely and accurate manner may result in a delay of payment. c. Contractor agrees to accept payment through county warrant when funding source does not allow for direct deposit. 7. Compliance with Applicable Laws a. At all times during the performance of this Agreement, Contractor will strictly adhere to all applicable Federal and State laws, order, and applicable standards, regulations, interpretations and/or guidelines issued pursuant thereto. This includes protection of the confidentiality of all applicant/recipient records, papers, documents, tapes and any other materials that have been or may hereafter be established which relate to the Agreement. Contractor shall abide by all applicable laws and regulations, including, but not limited to the following: - Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d-1 Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d-1 et. seq. and its implementing regulation, 45 C.F.R. Part 80 et. seq.; and - all provisions of the Civil Rights Act of 1986 so that no person shall, on the grounds of race, creed, color, sex, or national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under the approved Agreement. - Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 794, and its implementing regulations, 45 C.F.R. Part 84; and - the Age Discrimination Act of 1975, 42 U.S.C. Section 6101 et. seq. and its implementation regulations, 45 C.F.R. Part 91; and - Title VII of the Civil Rights Act of 1964; and the Age Discrimination in Employment Act of 1967; and the Equal Pay Act of 1963; and the Education Amendments of 1972; and Immigration Reform and Control Act of 1986, P.L. 99-603, 42 C.F.R. Part 2; and - all regulations applicable to these laws prohibiting discrimination because of race, color, national origin, sex, religion, and handicap, including Acquired Immune Deficiency Syndrome (AIDS) or AIDS related conditions covered under Section 504 of the Rehabilitation Act of 1973, as amended, cited above. If necessary, Contractor and the Department will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 C.F.R. Part 2. 45 C.F.R. Part 74, Appendix G 9, which requires that affirmative steps be taken to assure that small and minority businesses are utilized, when possible, as sources of supplies, equipment, construction and services. This assurance is given in consideration of and for the purpose of obtaining any all Federal and/or State financial assistance. - Colorado Revised Statute (C.R.S.) 26-6-104, requiring criminal background record checks for all employees, contractors and sub -contractors. 3 b. Contractor is further charged with the knowledge that any person who feels that s/he has been discriminated against has the right to file a complaint either with the Colorado Department of Human Services or with the United States Department of Health and Human Services, Office for Civil Rights. c. Contractor assures that it will fully comply with all other applicable Federal and State laws which may govern the ability of the Department to comply with the relevant funding requirements. Contractor understands the source of funds to be accessed under the Agreement is Core Services. d. Contractor assures and certifies that it and its principals: Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transaction by a Federal or State department or agency; and - have not, within a three-year period preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or Local) transaction or contract under public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; and - are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state or local) with commission of any of the offenses enumerated in this certification; and - have not, within a three-year period preceding this Agreement, had one or more public transactions (federal, state, or local) terminated for cause or default. e. Public Contracts for Services C.R.S. §8-17.5-101. Contract Professional certifies, warrants, and agrees that it does not knowingly employ or contract with an illegal alien who will perform work under this contract. Contract Professional will confirm the employment eligibility of all employees who are newly hired for employment in the United States to perform work under this Agreement, through participation in the E -Verify program or the State of Colorado program established pursuant to C.R.S. §8-17.5-102(5)(c). Contract Professional shall not knowingly employ or contract with an illegal alien to perform work under this Agreement or enter into a contract with a subcontractor that fails to certify with Contract Professional that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this Agreement. Contract Professional shall not use E -Verify Program or State of Colorado program procedures to undertake pre -employment screening or job applicants while this Agreement is being performed. If Contract Professional obtains actual knowledge that a subcontractor performing work under the public contract for services knowingly employs or contracts with an illegal alien Contract Professional shall notify the subcontractor and County within three (3) days that Contract Professional has actual knowledge that a subcontractor is employing or contracting with an illegal alien and shall terminate the subcontract if a subcontractor does not stop employing or , contracting with the illegal alien within three (3) days of receiving notice. Contract Professional shall not terminate the contract if within three days the subcontractor provides information to establish that the subcontractor has not knowingly employed or contracted with an illegal alien. Contract Professional shall comply with reasonable requests made in the course of an investigation, undertaken pursuant to C.R.S. §8-17.5-102(5), by the Colorado Department of Labor and Employment. If Contract Professional participates in the State of Colorado program, Contract Professional shall, within twenty days after hiring a new employee to perform work under the contract, affirm that Contract Professional has examined the legal work status of such employee, retained file copies of the documents, and not altered or falsified the identification documents for such employees. Contract Professional shall deliver to County, a written notarized affirmation that it has examined the legal work status of such employee, and shall comply with all of the other requirements of the State of Colorado program. If Contract Professional fails to comply with any requirement of this provision or of C.R.S. §8-17.5-101 et seq., County, may terminate this Agreement for breach, and if so terminated, Contract Professional shall be liable for actual and consequential damages. f. Except where exempted by federal law and except as provided in C.R.S. § 24-76.5-103(3), if Contract Professional receives federal or state funds under the contract, Contract Professional must confirm that any individual natural person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. § 24-76.5-103(4), if such individual applies for public benefits provided under the contract. If Contract Professional operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it: (a) is a citizen of the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall produce one of the forms of identification required by C.R.S. § 24-76.5-101, et seq., and (c) shall produce one of the forms of identification required by C.R.S. § 24-76.5-103 prior to the effective date of the contract. 8. Compliance with Child and Family Services Review The Child and Family Services Review (CFSR) examines child welfare service outcomes in three areas; Safety, Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's performance according to national standards and monitor progress over time. Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance services to families. Contractor agrees to continually strive for positive outcomes in the areas of Safety, Permanency and Well Being. Contractor will ensure that any employee or subcontractor of Contractor providing services under this Agreement will work towards positive outcomes in the aforementioned three areas as outlined under the Child and Family Services Review (CFSR), and will address the aforementioned three areas when completing monthly reports as required by Paragraph 3(d) of this Agreement. 9. Insurance Requirements Contractor and Department agree that Weld County, the Board of County Commissioners of Weld County, its officers and employees, shall not be held liable for injuries or damages caused by any negligent acts or omissions of the Contractor, it subcontractor, or their employees, volunteers, or agents while performing duties described in this Agreement. Contractor shall indemnify, defend and hold harmless Weld County, the Board of County Commissioners of Weld County, its employees, volunteers and agents. Contractor shall provide the liability insurances (including professional liability insurances where necessary) and worker's compensation insurances for all its employees, volunteers, and agents engaged in the performance of this Agreement which are required under Weld County's Request for Proposal, and required by the Colorado Worker's Compensation Act. Contractor shall provide the Department with the acceptable evidence that such coverage is in effect within seven (7) days of the date of this Agreement. At a minimum, Contractor shall procure, either personally or through its employer as applicable to the Contractor's business, at its own expense, and maintain for the duration of the work, the following insurance coverage. Weld County, State of Colorado, by and through the Board of County Commissioners of Weld County, its employees and agents, shall be named as additional named insured on the insurance, where permissible the insurance provider. a. General Requirements: Contractors/Contract Professionals must secure, at or before the time of execution of any agreement or commencement of any work, the following insurance covering all operations, goods or services provided pursuant to this request. Contractors/Contract Professionals shall keep the required insurance coverage in force at all times during the term of 5 the Agreement, or any extension thereof, and during any warranty period. The required insurance shall be underwritten by an insurer licensed to do business in Colorado and rated by A.M. Best Company as "A"VIII or better. Each policy shall contain a valid provision or endorsement stating "Should any of the above -described policies by canceled or should any coverage be reduced before the expiration date thereof, the issuing company shall send written notice to the Weld County Director of General Services by certified mail, return receipt requested. Such written notice shall be sent thirty (30) days prior to such cancellation or reduction unless due to non- payment of premiums for which notice shall be sent ten (10) days prior. If any policy is in excess of a deductible or self -insured retention, County must be notified by the Contractor/Contract Professional. Contractor/Contract Professional shall be responsible for the payment of any deductible or self -insured retention. County reserves the right to require Contractor/Contract Professional to provide a bond, at no cost to County, in the amount of the deductible or self - insured retention to guarantee payment of claims. The insurance coverages specified in this Agreement are the minimum requirements, and these requirements do not decrease or limit the liability of Contractor/Contract Professional. Contractor/Contract Professional shall maintain, at its own expense, any additional kinds or amounts of insurance that it may deem necessary to cover its obligations and liabilities under this Agreement. b. Types of Insurance: Contractor/Contract Professional shall obtain, and maintain at all times during the term of any Agreement, insurance in the following kinds and amounts: Workers' Compensation Insurance as required by state statute, and Employer's Liability Insurance covering all of Contractor's Contract Professional's employees acting within the course and scope of their employment. If Contractor is an Independent Contractor, as defined by the Colorado Worker's Compensation Act, this requirement shall not apply. Contractor must submit to the Department a Declaration of Independent Contractor Status Form prior to the start of this agreement. ii. Commercial General Liability Insurance written on ISO occurrence form CG 00 01 10/93 or equivalent, covering premises operations, fire damage, independent Contractors, products and completed operations, blanket contractual liability, personal injury, and advertising liability with minimum limits as follows: - $1,000,000 each occurrence; - $2,000,000 general aggregate; - $50,000 any one fire; and $500,000 errors and omissions. Automobile Liability: Contractor/Contract Professional shall maintain limits of $1,000,000 for bodily injury per person, $1,000,000 for bodily injury for each accident, and $1,000,000 for property damage applicable to all vehicles operating both on County property and elsewhere. iv. Additional Provisions: Policies for all general liability, excess/umbrella liability, liquor liability and pollution liability must provide the following: If any aggregate limit is reduce by twenty-five percent (25%) or more by paid or reserved claims, Contractor shall notify County within ten (10) days and reinstate the aggregates required; - Unlimited defense costs in excess of policy limits; Contractual liability covering the indemnification provisions of this Agreement; A severability of interests provision; Waiver of exclusion for lawsuits by one insured against another; - A provision that coverage is primary; and - A provision that coverage is non-contributory with other coverage or self-insurance provided by County. v. For all general liability, excess/umbrella liability, liquor liability, pollution liability and professional liability policies, if the policy is a claims -made policy, the retroactive date must be on or before the contract date or the first date when any goods or services were provided to County, whichever is earlier. c. Contractors/Contract Professionals shall secure and deliver to County's Risk Administrator ("Administrator") at or before the time of execution of this Agreement, and shall keep in force at all times during the term of the Agreement as the same may be extended as herein provided, a commercial general liability insurance policy, including public liability and property damage, in form and company acceptable to and approved by said Administrator, covering all operations hereunder set forth in the related Bid or Request for Proposal. d. Proof of Insurance: Contractor/Contract Professional shall provide a copy of this information to its insurance agent or broker, and shall have its agent or broker provide proof of Contractor/Contract Professional's required insurance. County reserves the right to require Contractor/Contract Professional to provide a certificate of insurance, a policy, or other proof of insurance as required by the County's Risk Administrator in his sole discretion. e. Additional Insureds: For general liability, excess/umbrella liability, pollution legal liability, liquor liability, and inland marine, Contractor/Contract Professional's insurer shall name County as an additional insured as follows f. Waiver of Subrogation: For all coverages, Contractor/Contract Professional's insurer shall waive subrogation rights against County. B. Subcontractors: All subcontractors, subcontractors, independent contractors, sub - vendors, suppliers or other entities providing goods or services required by this Agreement shall be subject to all of the requirements herein and shall procure and maintain the same coverages required of Contractor/Contract Professional. Contractor/Contract Professional shall include all such subcontractors, independent contractors, sub -vendors suppliers or other entities as insureds under its policies or shall ensure that all subcontractors maintain the required coverages. Contractor/Contract Professional agrees to provide proof of insurance for all such subcontractors, independent contractors, sub -vendors suppliers or other entities upon request by the County. A provider of Professional Services (as defined in the Bid or RFP) shall provide the following coverage: Professional Liability: Contract Professional shall maintain limits of $1,000,000 for each claim, and $2,000,000 aggregate limit for all claims. 10. Certification Contractor certifies that, at the time of entering into this Agreement, it has currently in effect all necessary licenses, approvals, insurance, etc., required to properly provide the services and/or supplies covered by this Agreement. Copies of all necessary licenses shall be provided to the Department by the Contractor prior to the start of any Agreement. 7 11. Training Contractor may be required to attend training that the request of the Department specific to services provided under this Agreement. The Department will not compensate the Contractor for said training in the form of registration fees, time spent traveling to and from training, attending the training or any other associated costs unless otherwise agreed to by the Department. 12. Subpoenas Contractor will, on behalf of its employees and/or officers, accept any subpoena for testimony from the Weld County Attorney's Office by e-mail and will return a waiver of services within 72 business hours. For this purpose, Contractor will designate an e-mail address prior to the start of this Agreement. If the Contractor receives a subpoena via e-mail but will only accept personal service, the Contractor will contact the Weld County Attorney's Office immediately at 970-352-1551, x6503, and advise that the subpoena must be personally served. 13. Monitoring and Evaluation Contractor and the Department agree that monitoring and evaluation of the performance of this Agreement shall be conducted by the Contractor and the Department. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners, the Department and the Contractor. Contractor shall permit the Department, and any other duly authorized agent or governmental agency, to monitor all activities conducted by the Contractor pursuant to the terms of this Agreement. As the monitoring agency may in its sole discretion deem necessary or appropriate, such program data, special analyses, on -site checking, formal audit examinations, or any other reasonable procedures. All such monitoring shall be performed in a manner that will not unduly interfere with the work conducted under this Agreement. 14. Modification of Agreement All modifications to this Agreement shall be in writing and signed by both parties. 15. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: - Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed. - Deny payment or recover reimbursement for those services or deliverables, which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Department. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to the Department. - Incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation shall be recovered from Contractor by deduction from subsequent payments under this Agreement or other agreements between the Department and Contractor, or by the 8 Department as a debt due to the Department or otherwise as provided by law. 16. Representatives For the purpose of this Agreement, the individuals identified below are hereby designated representatives of the respective parties. Either party may from time to time designate in writing a new or substitute representative(s). For Department: Heather Walker, Administrator 17. Notice For Contractor: Andrea Shindle All notices required to be given by the parties hereunder shall be given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing a substitute person(s) or address to whom such notices shall be sent. For Department: Judy A. Griego, Director P.O. Box A Greeley, CO 80632 (970) 352-1551 18. Litigation For Contractor: Andrea Shindle 4625 West 20th Street, Suite 202 Greeley, Colorado 80634 1970) 475-0471 Contractor shall promptly notify the Department in the event that Contractor learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement. Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any Federal or State court or administrative agency, shall deliver copies of such document(s) to the Director of Human Services. The term "litigation" includes an assignment for the benefit of creditors, and filings of bankruptcy, reorganization and/or foreclosure. 19. Termination This Agreement may be terminated at any time by either party giving thirty (30) days written notice to the individuals identified in paragraph 18. No portion of this Agreement shall be deemed to create an obligation on the part of the County of Weld, State of Colorado, to expend funds not otherwise appropriated in each succeeding year, as this Agreement is subject to the availability of funding. Therefore, the Department may terminate this Agreement at any time if the source of funding for the services made available to the Contractor is no longer available to the Department, or for any other reason. Contractor reserves the right to suspend services to clients if funding is no longer available. 20. No Third Party Beneficiary Enforcement It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 9 21. 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 of §§24-10-101 et. seq. as applicable now or hereafter amended. 22. Partial Invalidity of Agreement If any section, subsection, paragraph, sentence, clause, or phrase of this Agreement is for any reason held or decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The parties hereto declare that they would have entered into this Agreement and each and every section, subsection, paragraph, sentence, clause, and phrase thereof irrespective of the fact that any one or more sections, subsections, paragraphs, sentences, clauses, or phrases might be declared to be unconstitutional or invalid. 23. Improprieties/Conflict of Interest No officer, member or employee of Weld County and no member of their governing bodies shall have any pecuniary interest, direct or indirect, in the approved Agreement or the proceeds thereof. The Appearance of Conflict of Interest applies to the relationship of a Contractor with the Department when the Contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest, it is not necessary for the Contractor to gain from knowledge of these opposing interests. It is only necessary that the Contractor know that the two relationships are in opposition. During the term of the Agreement, Contractor shall not enter into any third party relationship that gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation, Contractor shall submit to the Department, a full disclosure statement setting forth the details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for the Department's termination, for cause, of its Agreement with the Contractor. Contractor certifies that Federal appropriated funds have not been paid or will be paid, by or on behalf of Contractor, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of an Federal contract, loan, grant, or cooperative agreement. 24. Storage, Availability and Retention of Records Contractor agrees that authorized local, Federal, and State auditors and representatives shall, during business hours, have access to inspect and copy records, and shall be allowed to monitor and review through on -site visits, all activities related to this Agreement, supported with funds under this Agreement, to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. All such records, documents, communications, and other materials created pursuant or related to this Agreement shall be maintained by the Contractor in a central location and shall be made available to the Department upon its request, for a period of seven (7) years from the date of final payment under this Agreement, or for such further period as may be necessary to resolve any matters which may be pending, 10 or until an audit has been completed with the following qualifications: If an audit by or on behalf of the Federal and/or State government has begun but is not completed at the end of the seven (7) year period, or if audit findings have not been resolved after a seven (7) period, the materials shall be retained until the resolution of the audit finding. 25. Confidentiality of Records Contractor shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Agreement except for purposes directly connected with the administration of Child Protection. No information about or obtained from any applicant/recipient in possession of Contractor shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with the Contractor's written policy governing access to, duplication and dissemination of, all such information, in any form, including social networks. Contractor shall advise its employees, agents, and subcontractor, if any, that they are subject to these confidentiality requirements. Contractor shall provide its employees, agents, and subcontractors, if any, with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. Contractor shall have its employees, agents, and subcontractors, if any, sign a written confidentiality agreement and shall provide a copy of such agreement to the Department, if requested. 26. Proprietary Information Proprietary information for the purposes of this Agreement is information relating to a party's research, development, trade secrets, business affairs, internal operations and management procedures and those of its customers, clients or affiliates, but does not include information (1) lawfully obtained from third parties, (2) that which is in the public domain, or (3) that which is developed independently. Neither party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of this Agreement. Any proprietary information removed from the Department's site by the Contractor in the course of providing services under this Agreement will be accorded at least the same precautions as are employed by the Contractor for similar information in the course of its own business. 27. Independence of Contractor: Not an Employee of Weld County Contract Professional agrees that it is an independent Contract Professional and that Contract Professional's officers, agents or employees will not become employees of County, nor entitled to any employee benefits from County as a result of the execution of this Agreement. Contract Professional shall perform its duties hereunder as an independent Contract Professional. Contract Professional shall be solely responsible for its acts and those of its agents and employees for all acts performed pursuant to this Agreement. Contract Professional, its employees and agents are not entitled to unemployment insurance or workers' compensation benefits through County and County shall not pay for or otherwise provide such coverage for Contract Professional or any of its agents or employees. Unemployment insurance benefits will be available to Contract Professional and its employees and agents only if such coverage is made available by Contract Professional or a third party. Contract Professional shall pay when due all applicable employment taxes and income taxes and local head taxes (if applicable) incurred pursuant to this Agreement. Contract Professional shall not have authorization, express or implied, to bind County to any agreement, liability or understanding, except as expressly set forth in this Agreement. Contract Professional shall have the following responsibilities with regard to workers' compensation and unemployment compensation insurance matters: (a) provide and keep in force workers' compensation and unemployment compensation insurance in the amounts required by law (and as set forth in Exhibit A provide proof thereof when requested to do so by County. 11 28. Entire Agreement This Agreement, together with all attachments hereto, constitutes the entire understanding between the parties with respect to the subject matter hereof, and may not be changed or modified except as state in Paragraph 14 herein. This Agreement shall be binding upon the parties hereto, their successors, heirs, legal representatives, and assigns. The Contractor and the Department may not assign any of its rights or obligations hereunder without the prior consent of both parties. 29. Agreement Nonexclusive This Agreement does not guarantee any work nor does it create an exclusive agreement for services. 30. Warranty The Contractor warrants that services performed under this Agreement will be performed in a manner consistent with the professional standards governing such services and the provisions of this Agreement. The Contractor shall faithfully perform the work in accordance with the standards of care, skill, training, diligence and judgment provided by highly competent individuals and entities that perform services of a similar nature to those described in this Agreement including Exhibits A, B, C, and D. 31. Acceptance of Services Not a Waiver Upon completion of the work, the Contractor shall submit to Department originals of all tests and results, reports, etc., generated during completion of this work. Acceptance by Department of reports and incidental material(s) furnished under this Agreement shall not in any way relieve the Contractor of responsibility for the quality and accuracy of the services. In no event shall any action by the Department hereunder constitute or be construed to be a waiver by the Department of any breach of covenant or default which may then exist on the part of the Contractor, and the Department's action or inaction when any such breach or default shall exist shall not impair or prejudice any right or remedy available to the Department with respect to such breach or default; and no assent, expressed or implied, to any breach of any one or more covenants, provisions or conditions of the Agreement shall be deemed or taken to be a waiver of any other breach. Acceptance by the Department of, or payment for, any services performed under this Agreement shall not be construed as a waiver of any of the Department's rights under this Agreement or under the law generally. 32. Employee Financial Interest/Conflict of Interest. C.R.S. §§24-18-201 et seq. and §24-50-507 The signatories to this Agreement aver that to their knowledge, no employee of Weld County has any personal or beneficial interest whatsoever in the service or property which is the subject matter of this Agreement. The Contractor has no interest and shall not acquire any interest direct or indirect, which would in any manner or degree with the performance of the Contractor's services and the Contractor, shall not employ any person having such known interests. During the term of this Agreement, the Contractor shall not engage in any in any business or personal activities or practices or maintain any relationships which actually conflict with or in any way appear to conflict with the full performance of its obligations under this Agreement. Failure by the Contractor to ensure compliance with this provision may result, in the Department's sole discretion, in immediate termination of this Agreement. No employee of the Contractor nor any member of the Contractor's family shall serve on a County Board, committee or hold any such position which either by rule, practice or action nominates, recommends, supervises Contract Professional's operations, or authorizes funding to the Contractor. 12 33. Board of County Commissioners of Weld County Approval This Agreement shall not be valid until it has been approved by the Board of County Commissioners of Weld County, Colorado. 34. Choice of Law/Jurisdiction Colorado law, and rules and regulations established pursuant thereto, shall be applied in the interpretation, execution, and enforcement of this Agreement. Any provision included or incorporated herein by reference which conflicts with said laws, rules and/or regulations shall be null and void. In the event of a legal dispute between the parties, Contract Professional agrees that the Weld County District Court shall have exclusive jurisdiction to resolve said dispute. 35. Subcontractors Contract Professional acknowledges that County has entered into this Agreement in reliance upon the particular reputation and expertise of Contract Professional. Contract Professional shall not enter into any subcontractor agreements for the completion of this project without County's prior written consent, which may be withheld in County's sole discretion. 36. Attorneys Fees/Legal Costs In the event of a dispute between County and Contract Professional, concerning this Agreement, the parties agree that each party shall be responsible for the payment of attorney fees and/or legal costs incurred by or on its own behalf. 37. Ownershi All work and information obtained by Contract Professional under this Agreement or individual work order shall become or remain (as applicable), the property of County. In addition, all reports, documents, data, plans, drawings, records and computer files generated by Contract Professional in relation to this Agreement and all reports, test results and all other tangible materials obtained and/or produced in connection with the performance of this Agreement, whether or not such materials are in completed form, shall at all times be considered the property of the County. Contract Professional shall not make use of such material for purposes other than in connection with this Agreement without prior written approval of County. 38. Interruptions Neither party to this Agreement shall be liable to the other for delays in delivery or failure to deliver or otherwise to perform any obligation under this Agreement, where such failure is due to any cause beyond its reasonable control, including but not limited to Acts of God, fires, strikes, war, flood, earthquakes or Governmental actions. 39. Severability If any term or condition of this Agreement shall be held to be invalid, illegal, or unenforceable by a court of competent jurisdiction, this Agreement shall be construed and enforced without such provision, to the extent that this Agreement is then capable of execution within the original intent of the parties. 13 IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. Meat ATTEST: rf , Weld County Clerk to the Board WELD COUNTY, COLORADO BOARD OF COUNTY COMMISSIONERS By Dephty Clerk to the Board Cu. vvecQ 14 Mike Freeman, Olaf e, 2016 1 Andrea Shindle 4625 West 20'" Street, Suite 202 Greeley, Colorado 80634 (970) 475-0471 By: Date: 'Mgr 372.3 EXHIBIT A WELD COUNTY'S REQUEST FOR PROPOSAL Bid No.: B1600047 BOARD OF COUNTY COMMISSIONERS OF THE COUNTY OF WELD, STATE OF COLORADO, BY AND THROUGH THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES DATE: MARCH 9, 2016 PAGES 1-10 OF THIS REQUEST FOR PROPOSAL CONTAIN GENERAL INFORMATION. NOT ALL OF THE INFORMATION CONTAINED IN PAGES 1-10 MAY BE APPLICABLE. SPECIFICATIONS UNIQUE TO THIS REQUEST FOR PROPOSAL FOLLOW PAGE 11. NOTICE TO BIDDERS A. The Families, Youth and Children's Commission, on behalf of the Weld County Department of Human Services, by and through the Board of Weld County Commissioners, wishes to purchase the following: VARIOUS ENGLISH AND BILINGUAL (ENGLISH/SPANISH) SERVICES (AS DEFINED ON PAGES 15-17) B. Bids for' the stated services will be received by the Weld County Department of Human Services, Resource Unit, Attn: Tobi Vegter at vegterta@weldgov.com or P.O. Box A, 315 A North 11th Avenue, Greeley, CO 80631, through: FRIDAY. MARCH 25, 2016, AT 5:00 P.M. (WELD COUNTY DEPARTMENT OF HUMAN SERVICES, RESOURCE UNIT TIME CLOCK). II. INVITATION TO BID A. The Families, Youth and Children's Commission, on behalf of the Weld County Department of Human Services, by and through the board of Weld County Commissioners requests bids for the purchase of Various Services (as described on pages 15-17). B. Bids shall include any and all charges for service(s) applied for by the bidder, and shall, in every way, be the total net price which the bidder will expect the Board of County Commissioners of Weld County to pay if awarded the bid. C. Emailed Bids Are Preferred. Emailed (fully typed) bids are preferred. However, if the bidder is unable to submit an emailed bid, the bidder must comply with the requirements set forth in Paragraph II D below. An emailed bid must contain the following statement: "I hereby waive my right to a sealed bid." D. Unless the Bid is emailed, one original and one copy of the Bid must be submitted. One complete bid document, which will be the only official copy of the bid, shall be filed at the Weld County Department of Human Services, Resource Unit. After certification of the bid, the other copy will be routed for applicable review. An e-mail confirmation will be sent when we receive your bid/proposal. Page 1 Bid No.: B1600047 III. INSTRUCTIONS TO BIDDERS A. Bids shall be typewritten. Each bid must give the full business address of the bidder and be signed by him with his usual signature. Bids by partnerships must furnish the full names of all partners and must be signed with the partnership name by one of the partners of the partnership or by an authorized representative, followed by the signature and title of the person signing. Bids by corporations must be signed with the legal name of the corporation, followed by the name of the state of the incorporation and by the signature and title of the president, secretary, or other person authorized to bind it in this matter. Bids submitted by limited liability companies must furnish the full names of all members and managers and must be signed by a manager or by an authorized representative, followed by the signature and title of the person signing. The name of each person signing shall also be typed or printed below the signature. A bid by a person who affixes to his signature the word "president," "secretary," "agent," or other title without disclosing his principal, may be held to be the bid of the individual signing. When requested, satisfactory evidence of the authority of the officer signing in behalf of a corporation shall be furnished. All corrections or erasures shall be initialed by the person signing the bid. All bidders shall agree to comply with all of the conditions, requirements, specifications, and/or instructions of this bid as stated or implied herein. All designations and prices shall be fully and clearly set forth. B. Bids may be withdrawn upon written request to the Weld County Department of Human Services received from bidders prior to the submission deadline. Negligence on the part of bidder in preparing the bid confers no right for the withdrawal of the bid after it has been opened. C. Bidders are expected to examine the conditions, specifications, and all instructions contained herein. Failure to do so will be at the bidder's risk. D. Bidders shall not stipulate in their proposals any conditions not contained in the instructions and specifications herein unless specifically requested by the special instructions attached hereto. Any proposal which fails to comply with the letter of the instructions and specifications herein may be rejected. E. Late or unsigned bids shall not be accepted or considered. It is the responsibility of the bidder to ensure that the bid arrives in the Weld County Department of Human Services, Resource Unit, on or prior to the time indicated in Section I., entitled "Notice to Bidders." F. When approximate quantities are stated, Weld County reserves the right to increase or decrease quantity as best fits its needs. G. Whenever requested, samples or descriptive matter shall be filed prior to the opening of bids. H. In accordance with Section 14-9(3) of the Weld County Home Rule Charter, the Board of County Commissioners of Weld County will give preference to resident Page 2 Bid No.: B1600047 Weld County bidders in all cases where said bids are competitive in price and quality. It is also understood that the Board of County Commissioners of Weld County will give preference to suppliers from the State of Colorado, in accordance with Section 30-11-110, CRS, when it is accepting bids for the purchase of any books, stationery, records, printing, lithographing or other supplies for any officer of Weld County. All discounts shall be figured from the date of delivery and acceptance of the articles, or in the case of an incorrect invoice, from the date of receipt of corrected invoice, if this be subsequent to delivery and acceptance. J. Substitutions or modifications to any of the terms, conditions, or specifications of this bid package which are made by Weld County, Colorado, after the bids have been distributed to prospective bidders, and prior to the date and time of bid opening, will be made in writing and signed by the Families, Youth and Children's Commission. No employee of Weld County, Colorado, is authorized in any way to modify any of the terms, conditions, or specifications of this bid without written approval of Families, Youth and Children's Commission. This is not to imply that bids will not be accepted or considered with specifications which are different from those herein. Any item which does not meet all the terms, conditions, or specifications of this bid, must be clearly indicated on a separate sheet of paper, attached to the bid specification and proposal sheets and returned with the bid. K. The successful bidder shall indemnify and hold harmless Weld County, Colorado, against all claims for royalties, for patents or suit for infringement thereon, which may be involved in the manufacture or use of the material to be furnished. L. Successful bidder certifies, warrants, and agrees that it does not knowingly employ or contract with an illegal alien who will perform work under this contract. Successful bidder will confirm the employment eligibility of all employees who are newly hired for employment in the United States to perform work under this Agreement, through participation in the E -Verify program or the State of Colorado program established pursuant to C.R.S. §8-17.5- 102(5)(c). Successful bidder shall not knowingly employ or contract with an illegal alien to perform work under this Agreement or enter into a contract with a subcontractor that fails to certify with Successful bidder that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this Agreement. Successful bidder shall not use E -Verify Program or State of Colorado program procedures to undertake pre -employment screening or job applicants while this Agreement is being performed. If Successful bidder obtains actual knowledge that a subcontractor performing work under the public contract for services knowingly employs or contracts with an illegal alien Successful bidder shall notify the subcontractor and County within three (3) days that Successful bidder has actual knowledge that a subcontractor is employing or contracting with an illegal alien and shall terminate the subcontract if a subcontractor does not stop employing or contracting with the illegal alien within three (3) days of receiving notice. Successful bidder shall not terminate Page 3 Bid No.: B1600047 the contract if within three days the subcontractor provides information to establish that the subcontractor has not knowingly employed or contracted with an illegal alien. Successful bidder shall comply with reasonable requests made in the course of an investigation, undertaken pursuant to C.R.S. §8-17.5-102(5), by the Colorado Department of Labor and Employment. If Successful bidder participates in the State of Colorado program, Successful bidder shall, within twenty days after hiring a new employee to perform work under the contract, affirm that Successful bidder has examined the legal work status of such employee, retained file copies of the documents, and not altered or falsified the identification documents for such employees. Successful bidder shall deliver to County, a written notarized affirmation that it has examined the legal work status of such employee, and shall comply with all of the other requirements of the State of Colorado program. If Successful bidder fails to comply with any requirement of this provision or of C.R.S. §8-17.5-101 et seq., County, may terminate this Agreement for breach, and if so terminated, Successful bidder shall be liable for actual and consequential damages. Except where exempted by federal law and except as provided in C.R.S. § 24- 76.5-103(3), if Successful bidder receives federal or state funds under the contract, Successful bidder must confirm that any individual natural person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. § 24-76.5-103(4), if such individual applies for public benefits provided under the contract. If Successful bidder operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it: (a) is a citizen of the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall produce one of the forms of identification required by C.R.S. § 24-76.5-101, et seq., and (c) shall produce one of the forms of identification required by C.R.S. § 24-76.5-103 prior to the effective date of the contract. M. All goods shall remain the property of the seller until delivered to and accepted by Weld County, Colorado. N. Late or unsigned bids shall not be accepted or considered. Bids received prior to the time of opening will be kept unopened in a secure place. No responsibility will attach to the Families, Youth and Children Commission, the Weld County Department of Human Services, or the Board of Weld County Commissioners, for the premature opening of a bid not properly addressed and identified. O. In submitting the bid, the bidder agrees that the acceptance of any and all bids by the Board of County Commissioners of Weld County within a reasonable time or period does not constitute a contract. The Board of County Commissioners of Weld County, Colorado, reserves the right to reject any and all bids, to waive any informality in the bids, and to accept the bid, or part of a bid, that, in the opinion of the Board, is in the best interests of the Board and of the County of Weld, Page 4 Bid No.: B1600047 State of Colorado. P. These instructions, the proposal forms, and specifications have been developed with the hope of raising the standard of purchasing negotiations to a level wherein all transactions will be mutually satisfactory. Your cooperation is invited. Q. Substitutions or modifications to any of the terms, conditions, or specifications of this which are made by Weld County after the bids have been distributed to prospective bidders and prior to the date and time of bid opening, will be made in writing. No employee of Weld County is authorized in any way to modify any of the terms, conditions, or specifications of this bid without written approval of said Director of the Weld County Department of Human Services. This is not to imply that bids will not be accepted or considered with specifications which are different from those herein. Any item which does not meet all the terms, conditions, or specifications of this bid, must be clearly indicated on a separate sheet of paper, attached to the bid specification and proposal sheets and returned with the bid. IV. General Specifications. A. Fund Availability: Financial obligations of the Weld County payable after the current fiscal year are contingent upon funds for that purpose being appropriated, budgeted and otherwise made available. By acceptance of the bid, Weld County does not warrant that funds will be available to fund the contract beyond the current fiscal year. B. Confidential Information: Confidential financial information of the bidder should be transmitted separately from the main bid submittal, clearly denoting in red on the financial information at the top the word, and "CONFIDENTIAL." However, the successful bidder is advised that as a public entity, Weld County must comply with the provisions of C.R.S. 24-72-201, et seq., with regard to public records, and cannot guarantee the confidentiality of all documents. C. Governmental Immunity: No term or condition of the 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 §§24-10-101 et seq., as applicable now or hereafter amended. D. Independent Contractor: The successful bidder shall perform its duties hereunder as an independent contractor and not as an employee. He or she shall be solely responsible for its acts and those of its agents and employees for all acts performed pursuant to the contract. Neither the successful bidder nor any agent or employee thereof shall be deemed to be an agent or employee of Weld County. The successful bidder and its employees and agents are not entitled to unemployment insurance or workers' compensation benefits through Weld County and Weld County shall not pay for or otherwise provide such coverage for the successful bidder or any of its agents or employees. Unemployment insurance benefits will be available to the successful bidder and its employees and agents only if such coverage is made available by the successful bidder or a third party. The successful Page 5 Bid No.: B1600047 bidder shall pay when due all applicable employment taxes and income taxes and local head taxes (if applicable) incurred pursuant to the contract. The successful bidder shall not have authorization, express or implied, to bind Weld County to any agreement, liability or understanding, except as expressly set forth in the contract. The successful bidder shall have the following responsibilities with regard to workers' compensation and unemployment compensation insurance matters: (a) provide and keep in force workers' compensation and unemployment compensation insurance in the amounts required by law, and (b) provide proof thereof when requested to do so by Weld County. E. Compliance with Law: The successful bidder 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. F. Choice of Law: Colorado law, and rules and regulations established pursuant thereto, shall be applied in the interpretation, execution, and enforcement of the contract. Any provision included or incorporated herein by reference which conflicts with said laws, rules and/or regulations shall be null and void. G. Binding Arbitration Prohibited: Weld County does not agree to binding arbitration by any extra -judicial body or person. Any provision to the contrary in the contract or incorporated herein by reference shall be null and void. H. No Third Party Beneficiary Enforcement: It is expressly understood and agreed that the enforcement of the terms and conditions of the contract, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in the contract shall give or allow any claim or right of action whatsoever by any other person not included in the contract. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under the contract shall be an incidental beneficiary only. Attorneys Fees/Legal Costs: In the event of a dispute between Weld County and the successful bidder, concerning the contract, the parties agree that Weld County shall not be liable to or responsible for the payment of attorney fees and/or legal costs incurred by or on behalf of the successful bidder. J. Procurement and Performance: The successful bidder agrees to procure the materials, equipment and/or products necessary for the project and agrees to diligently provide all services, labor, personnel and materials necessary to perform and complete the project. The successful bidder shall further be responsible for the timely completion, and acknowledges that a failure to comply with the standards and requirements outlined in the Bid within the time limits prescribed by County may result in County's decision to withhold payment or to terminate this Agreement. K. Term: The term of this Agreement begins upon the date of the execution of this Page 6 Bid No.: B1600047 Agreement by County, and shall continue for three years. However, the agreement must be renewed by both parties, in writing, on an annual basis. L. Termination: County has the right to terminate this Agreement, with or without cause on thirty (30) days written notice. Furthermore, this Agreement may be terminated at any time without notice upon a material breach of the terms of the Agreement. M. Subcontractors: The successful bidder acknowledges that County has entered into this Agreement in reliance upon the particular reputation and expertise of the successful bidder. The successful bidder shall not enter into any subcontractor agreements for the completion of this Project without County's prior written consent, which may be withheld in County's sole discretion. N. Non -Assignment: The successful bidder may not assign or transfer this Agreement or any interest therein or claim thereunder, without the prior written approval of County. Any attempts by the successful bidder to assign or transfer its rights hereunder without such prior approval by County shall, at the option of County, automatically terminate this Agreement and all rights of the successful bidder hereunder. Such consent may be granted or denied at the sole and absolute discretion of County. O. Insurance Requirements. i. General Requirements: Contractors/Contract Professionals must secure, at or before the time of execution of any agreement or commencement of any work, the following insurance covering all operations, goods or services provided pursuant to this request. Contractors/Contract Professionals shall keep the required insurance coverage in force at all times during the term of the Agreement, or any extension thereof, and during any warranty period. The required insurance shall be underwritten by an insurer licensed to do business in Colorado and rated by A.M. Best Company as "A"VIII or better. Each policy shall contain a valid provision or endorsement stating "Should any of the above -described policies by canceled or should any coverage be reduced before the expiration date thereof, the issuing company shall send written notice to the Weld County Director of General Services by certified mail, return receipt requested. Such written notice shall be sent thirty (30) days prior to such cancellation or reduction unless due to non-payment of premiums for which notice shall be sent ten (10) days prior. If any policy is in excess of a deductible or self -insured retention, County must be notified by the Contractor/Contract Professional. Contractor/Contract Professional shall be responsible for the payment of any deductible or self -insured retention. County reserves the right to require Contractor/Contract Professional to provide a bond, at no cost to County, in the amount of the deductible or self -insured retention to guarantee payment of claims. The insurance coverages specified in this Agreement are the minimum requirements, and these requirements do not decrease or limit the liability of Contractor/Contract Professional. Contractor/Contract Professional shall maintain, at its own expense, any additional kinds or amounts of insurance that it may deem necessary to cover its obligations and liabilities under this Agreement. Page 7 Bid No.: B1600047 ii. Types of Insurance: Contractor/Contract Professional shall obtain, and maintain at all times during the term of any Agreement, insurance in the following kinds and amounts: (a). Workers' Compensation Insurance as required by state statute, and Employer's Liability Insurance covering all of Contractor's Contract Professional's employees acting within the course and scope of their employment. If Contractor is an Independent Contractor, as defined by the Colorado Worker's Compensation Act, this requirement shall not apply. Contractor must submit to the Department a Declaration of Independent Contractor Status Form prior to the start of this agreement. (b). Commercial General Liability Insurance written on ISO occurrence form CG 00 01 10/93 or equivalent, covering premises operations, fire damage, independent Contractors, products and completed operations, blanket contractual liability, personal injury, and advertising liability with minimum limits as follows: * $1,000,000 each occurrence; * $2,000,000 general aggregate; * $50,000 any one fire; and * $500,000 errors and omissions. (c). Automobile Liability: Contractor/Contract Professional shall maintain limits of $1,000,000 for bodily injury per person, $1,000,000 for bodily injury for each accident, and $1,000,000 for property damage applicable to all vehicles operating both on County property and elsewhere. (d). Additional Provisions: * Policies for all general liability, excess/umbrella liability, liquor liability and pollution liability must provide the following: * If any aggregate limit is reduce by twenty-five percent (25%) or more by paid or reserved claims, Contractor shall notify County within ten (10) days and reinstate the aggregates required; * Unlimited defense costs in excess of policy limits; * Contractual liability covering the indemnification provisions of this Agreement; * A severability of interests' provision; * Waiver of exclusion for lawsuits by one insured against another; * A provision that coverage is primary; and Page 8 Bid No.: B1600047 * A provision that coverage is non-contributory with other coverage or self- insurance provided by County. (e). For all general liability, excess/umbrella liability, liquor liability, pollution liability and professional liability policies, if the policy is a claims -made policy, the retroactive date must be on or before the contract date or the first date when any goods or services were provided to County, whichever is earlier. Contractors/Contract Professionals shall secure and deliver to County's Risk Administrator ("Administrator") at or before the time of execution of this Agreement, and shall keep in force at all times during the term of the Agreement as the same may be extended as herein provided, a commercial general liability insurance policy, including public liability and property damage, in form and company acceptable to and approved by said Administrator, covering all operations hereunder set forth in the related Bid or Request for Proposal. iv. Proof of Insurance: Contractor/Contract Professional shall provide a copy of this information to its insurance agent or broker, and shall have its agent or broker provide proof of Contractor/Contract Professional's required insurance to the County. County reserves the right to require Contractor/Contract Professional to provide a certificate of insurance, a policy, or other proof of insurance as required by the County's Risk Administrator in his sole discretion. v. Additional Insureds: For general liability, excess/umbrella liability, pollution legal liability, liquor liability, and inland marine, Contractor/Contract Professional's insurer shall name County as an additional insured. vi. Waiver of Subrogation: For all coverages, Contractor/Contract Professional's insurer shall waive subrogation rights against County. vii. Subcontractors: All subcontractors, subcontractors, independent contractors, sub - vendors, suppliers or other entities providing goods or services required by this Agreement shall be subject to all of the requirements herein and shall procure and maintain the same coverages required of Contractor/Contract Professional. Contractor/Contract Professional shall include all such subcontractors, independent contractors, sub -vendors suppliers or other entities as insureds under its policies or shall ensure that all subcontractors maintain the required coverages. Contractor/Contract Professional agrees to provide proof of insurance for all such subcontractors, independent contractors, sub -vendors suppliers or other entities upon request by the County. Page 9 Bid No.: B1600047 A provider of Professional Services (as defined in the Bid or RFP) shall provide the following coverage: Professional Liability: Contract Professional shall maintain limits of $1,000,000 for each claim, and $2,000,000 aggregate limit for all claims. V. Warranty. The successful bidder shall warrant that: A. The services to be supplied pursuant to this bid are fit and sufficient for the purpose intended; B. The services sold to Weld County, Colorado pursuant to this bid conform to the minimum Weld County specifications as established herein. Page 10 Bid No.: B1600047 Protect Overview: The Weld County Department of Human Services (WCDHS) is seeking qualified English-speaking and bilingual (English/Spanish) providers in various service areas under various funding sources. Service areas include, but are not limited to, Anger Management/Domestic Violence, Day Treatment, Foster Parent Consultation, Foster Parent Training, Functional Family Therapy, Kinship Services (Therapeutic), Home Studies/Relinquishment Counseling, Life Skills, Mediation, Mental Health, Monitored Sobriety, Multi -Systemic Therapy, Home Based Intervention including 24/7 Crisis Intervention, Sexual Abuse Treatment, and Substance Abuse Treatment Services and Aftercare Services. Refer to pages 15-17 for specific definitions related to the above -mentioned service areas. Qualifications: To be considered, a bidder must meet the following minimum qualifications: 1) If submitting to provide bilingual services, a bidder must demonstrate language proficiency at Full Professional Proficiency or higher, as defined by the U.S. Department of State, and as noted below. • Full Professional Proficiency: Able to use and read the language fluently and accurately on all levels pertinent to professional needs • Native or Bilingual Proficiency: Equivalent to that of an educated native speaker (both speaking and reading). 2) Bidder must agree to language proficiency testing that may include assessment of reading, writing and comprehension of Spanish, as well as a face-to-face conversation with a known native or proficient Spanish speaker selected by Weld County. 3) A bidder must submit a one page or less cover letter that introduces the bidder, the bidder's location(s) of practice and target area, his or her experience and qualifications, and staff, if applicable. A bidder must include current contact information including physical address, mailing address, phone number, email address and website, if applicable. 4) A bidder must submit sufficient information concerning each proposed service for Weld County to evaluate whether or not the bidder meets "minimum qualifications" for all bidders. Each service must be submitted as its own proposal, inclusive of scope of services and rate information. Page 11 Bid No.: B1600047 5) Bidders should avoid elaborate artwork, graphics, binding, presentation or other artifice that does not directly address the requirements set forth in this Request for Proposal. 6) A bidder must demonstrate the knowledge, training and expertise to conduct the proposed service(s). 7) A bidder must provide a current resume, as well as proof of licensure, for self, staff members and contractors of the bidder. Additionally, a bidder must include proof of inclusion on State vendor lists if applicable to the proposed service (ex. Home Study Providers, Sex Offender Management Board Providers). 8) Bidder should clearly outline the supervisory structure of staff members and/or contractors of the bidder. This should include the ratio of supervisor to staff and/or contractors, frequency and duration of supervision, credentials of supervisor and length of time as a supervisor. 9) A bidder must demonstrate familiarity with Trauma Informed Care. Bidder must provide copies of applicable training certificates, or proof of registration for training, for all staff members who manage and/or administer services under this proposal. 10) A bidder must demonstrate prior and current capacity to be organized, responsive and to quickly and successfully schedule services as requested. 11) A bidder must agree to enter into a contract, attached as Exhibit A, with the Weld County Department of Human Services and comply with all requirements of the contract. Contract Period and Pricing: 1) The initial contract period is to be determined and shall continue as allowable by the funding source, so long as both parties are satisfied. The selected vendor(s) will have the opportunity to resubmit annually. 2) The initial contract will be funded through Core Services Program or Child Welfare Administration funding, so long as funding is made available. Page 12 Bid No.: B1600047 3) The selected vendor will bill the Weld County Department of Human Services monthly according to billing requirements set forth by the Weld County Department of Human Services. Submittal Requirements for All Proposals: A bidder must submit according to requirements set forth in this Request for Proposal. All proposals must contain the following specific information: 1) Identification of language(s) and proficiency level, if applying to provide bilingual (English/Spanish) services. 2) One page or less cover letter that introduces the bidder, the bidder's location(s) of practice, his or her experience and qualifications, and staff, if applicable. 3) Sufficient information concerning each proposed service for Weld County to evaluate whether or not the bidder meets "minimum qualifications" for all bidders. Each service must be submitted as its own proposal, inclusive of scope of services and rate information. 4) Bidders should avoid elaborate artwork, graphics, binding, presentation or other artifice that does not directly address the requirements set forth in this Request for Proposal. 5) Current resume, proof of licensure and copies of applicable training certificates for all staff members who will manage and/or administer services under this proposal. 6) Supervisory structure of staff members and/or contractors of the bidder. This should include the ratio of supervisor to staff and/or contractors, frequency and duration of supervision, credentials of supervisor and length of time as a supervisor. 7) All proposals must demonstrate the bidder has the ability to deliver the services as proposed, and comply with the specific requirements set forth by the Weld County Department of Human Services. 8) All proposals must include a clear and concise rate schedule that accurately correlates to the proposed services and is inclusive of all possible charges related to the proposed service(s). The rate schedule must demonstrate an exact fee for the described service (s). Approximate rates or a range of rates for a service will not be accepted. Page 13 Bid No.: B1600047 9) Each bidder must submit a Standard Certificate of Insurance, or letter of intent from an insurance company authorized to do business in the State of Colorado stating its willingness to insure the bidder pursuant to the terms of this Request for Proposal. Evaluation of Proposals: All proposals that meet the basic proposal, service and qualification requirements will be reviewed by the Families, Youth and Children (FYC) Commission. The FYC Commission will make recommendations to the Board of Weld County Commissioners by and through the Weld County Department of Human Services. The Weld County Department of Human Services will make its award of contract to the successful bidders upon final approval of the Board of Weld County Commissioners. Page 14 Bid No.: B1600047 SERVICE AREA DEFINITIONS (NOT LIMITED TO THIS LIST - OTHER SERVICES WILL BE CONSIDERED) Program Area a a & : tiu� `` fli ration w Il h t. ` f I'll _ _ h y, Aftercare Services Services provided to prepare a child for reunification with his/her family or other permanent placement and to prevent future out - of -home placement of the child. Anger Management/Domestic Violence Diagnostic and/or therapeutic services to assist in the development of the family services plan, to assess and/or improve family communication, functioning and relationships, and to prevent further domestic violence. Crisis Intervention and Stabilization Services Services that provide an immediate, in-person/in- home response to families, youth and children, in *crisis, 24 hours a day, seven (7) days a week. *A "crisis" is further defined as a situation or circumstance, usually acute (recent) in nature, which breaks down the normal functioning of an individual and/or family, and results in the inability of the individual and/or family to resolve the crisis through normal coping behaviors, or without immediate intervention. Day Treatment Comprehensive, highly structured services that provide education to children and therapy to children and their families. Foster Parent Consultation Services provided to foster and group home families caring for WCDSS children and youth in their homes to enhance and improve the quality of care being provided. Foster Parent Training Core training for new Weld County foster parents. Page 15 Bid No.: B1600047 wPro rghamArea,'> ti rr , Defimtion" *` �' # P f $.r}�.�� �44S'"'",* d Functional Family Therapy Intensive family -based treatment that addresses the pervasive patterns of relational dysfunction known to be determinants of conduct disorder, violent acting out, and substance abuse among youth 10-18 years old. Home -Based Intervention Services provided primarily in the home of the client that include a variety of services which can include therapeutic services, concrete services, collateral services and *crisis intervention directed to meet the needs of the child and family. *Crisis Intervention is defined as 24/7 phone access and in -home counseling. Kinship Services (Therapeutic) Kinship services in the areas of (1) consultation and kinship parent support specific to a child placed in a kinship home, (2) corrective consultation specific to a child placed in a kinship home, and (3) critical care consultation specific to a child placed in a kinship home. Children placed in kinship care are maintained in the lowest level of care and least restrictive setting when out -of -home placement is necessary. Life Skills Visitation (both in -home and in -office) and services provided primarily in the home that teach household management, effective access to community resources, parenting techniques and family conflict management. Page 16 Bid No.: 81600047 Pr grarriTArea ry ' isiberfinifion �- mo" ,.. Mediation/Intensive Family Therapy Therapeutic intervention typically with all family members to improve family communication, functioning and relationships. Mental Health Services Diagnostic and/or therapeutic services to assist in the development of family services plan, to assess and/or improve family communication, functioning and relationships. Multisystemic Therapy Intensive family- and community -based treatment program designed to make positive changes in the various social systems (home, school, community, peer relations) that contribute to the serious antisocial behaviors of children and adolescents who are at risk for out -of -home placement. Relinquishment Counseling Relinquishment counseling for parents considering relinquishment of their children. Substance Abuse Treatment Services Diagnostic and/or therapeutic services to assist in the development of the Family Service Plan (FSP), to assess and/or improve family communication, functioning and relationships, and to prevent further abuse of drugs or alcohol. Page 17 EXHIBIT A CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND This Agreement, made and entered into the _ day of 2016 by and between the Board of Weld County Commissioners, on behalf of the Weld County Department of Human Services, hereinafter referred to as the "Department' and «Contractor», hereinafter referred to as the "Contractor". The parties to this Agreement understand and agree that the provisions of this Agreement specifically include the following documents: Exhibit A, Weld County's Request for Proposal, Exhibit B, Contractor's Proposal, Exhibit C, Scope of Services, and Exhibit D, Payment Schedule. Each of these documents is attached hereto and incorporated herein by this reference. WITNESSETH WHEREAS, required approval, clearance, and coordination have been accom ished from and with appropriate agencies; and for WHEREAS, the Colorado Department of Human Services has provideid fun' ing to the Department NOW THEREFORE, in consideration of the premises, the parts venant and agree as follows: 1. Term This agreement shall become effective on upon * . A: ecution of this Agreement and shall expire J unless sooner terminated as pro d herein:" e agreement is for a period of three years. However, the agreement must be renewed o } arties, in writing, on an annual basis. 2. Scope of Services Services shall be provided by the . .ttor t8any person(s) eligible for services in compliance with Exhibit B, Contractor's Proposa Rapd tit C, Scope of Services. 3. Referrals, Billin a. Contract r un9ds and will comply with all aspects of the referral authorization, billing and tracking r ire a as set forth by the Department. Failure to comply with all aspects may result in a forfei p ment. b. Contractor agrees to receive referrals for services through e-mail and will provide an identified e- mail address prior to the start of this Agreement. Contractor acknowledges that services are not authorized until the Contractor has received an authorized referral form from the Department. Contractor further acknowledges that services provided prior to the authorized start date or outside the scope of services on the referral form will not be eligible for reimbursement. Contractor acknowledges that any and all modifications to an existing referral must be approved through the Department's Resource Manager, Child Welfare Contract and Services Coordinator, or through a Team Decision Making (TDM) meeting or Family Team Meeting (FTM). No other Department staff or other party to the case may authorize services or modifications to services. c. Contractor agrees to submit an itemized complete billing statement by the 7th of the month, following the month of service, utilizing billing forms required by the Department. 1 d. Contractor agrees to submit a monthly report with the billing statement by the 7th of the month following the month of service for each client receiving ongoing services. One-time services will be verified through receipt of the completed product (ex. psychological evaluation, substance abuse evaluation). Verification of Monitored Sobriety Services will be the test result. Contractor will document in detail any and all observed or verbalized concerns regarding any child whom the Contractor is working with under the Agreement. Areas of concern may include, but are not limited to, any physical, emotional, educational or behavioral issues. Areas of concern should be reported immediately to the caseworker AND on the required monthly report. Monthly reports will be submitted through the Department's online reporting system, unless otherwise directed or agreed to by the Department. 4. 5. Payment a. The Department and the Contractor agree that all benefits from pr i to insurance and/or other funding sources such as Medicaid (if Contractor is a Medicaid eligib der) or Victim's Compensation must be exhausted before Core Services or other Departme funds can be accessed for services. b. Payment shall be made in accordance with Exhibit A, B, Contractor's Proposal, Exhibit C, Scope of Service hereto and incorporated herein by reference, so accordance with the Agreement. fy's Request for Proposal, Exhibit it D, Payment Schedule, attached s are rendered satisfactorily and in c. Payment pursuant to this Agreeme w er in whole or in part, is subject to, and contingent upon, the continuing availability of said fu foie purposes hereof. d. The Department may with the Agreement, including the terms, or reporting requireem�6 appeal such circumstn4p in of Human Services sha ment if Contractor has failed to comply with any part of al M 'nagement requirements, program objectives, contractual In the event of forfeiture of reimbursement, Contractor may to the Director of Human Services. The decision of the Director At all times fro`.n `e elective date of the Agreement until completion of the Agreement, Contractor shall comply with the .. i.9 istrative requirements, cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under this Agreement must conform to the Single Audit Act of 1984 and OMG Circular A-133. 6. Payment Method Unless otherwise provided in Exhibit B, Contractor's Proposal, Exhibit C, Scope of Services, and Exhibit D, Payment Schedule: a. If services are funded through Core Services, Contractor agrees to accept reimbursement through ACH direct deposit one time per month. b. If Contractor is not currently set up with the State of Colorado to accept direct deposit, Contractor agrees to complete and submit an ACH Form for Colorado Providers, which will be provided by the Department. Contractor is solely responsible to submit the ACH Form to the State of 2 Colorado per the directions on the form. Failure to complete and submit this form in a timely and accurate manner may result in a delay of payment. c. Contractor agrees to accept payment through county warrant when funding source does not allow for direct deposit. 7. Compliance with Applicable Laws a. At all times during the performance of this Agreement, Contractor will strictly adhere to all applicable Federal and State laws, order, and applicable standards, regulations, interpretations and/or guidelines issued pursuant thereto. This includes protection of the confidentiality of all applicant/recipient records, papers, documents, tapes and any other materials that have been or may hereafter be established which relate to the Agreement. Contractor shall abide by all applicable laws and regulations, including, but not limited to the following: - Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 20 d-1 Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d-1 et. seq. andmenting regulation, 45 C.F.R. Part 80 et. seq.; and - all provisions of the Civil Rights Act of 1986 so th race, creed, color, sex, or national origin, be exc benefits of, or be otherwise subjected to d' - Section 504 of the Rehabilitation Act implementing regulations, 45 C.F.Part 84; a - the Age Discrimination Act o e •n shall, on the grounds of participation in, be denied the n under the approved Agreement. 9 U.S.C. Section 794, and its U.S.C. Section 6101 et. seq. and its implementation regulation si45 C.F. art 91; and - Title VII of the 'ts Aof 1964; and - the Age ' cri 'o ` in Employment Act of 1967; and - the Pa ct of 1963; and tion Amendments of 1972; and gration Reform and Control Act of 1986, P.L. 99-603, 42 C.F.R. Part 2; and - all regulations applicable to these laws prohibiting discrimination because of race, color, national origin, sex, religion, and handicap, including Acquired Immune Deficiency Syndrome (AIDS) or AIDS related conditions covered under Section 504 of the Rehabilitation Act of 1973, as amended, cited above. If necessary, Contractor and the Department will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 C.F.R. Part 2. 45 C.F.R. Part 74, Appendix G 9, which requires that affirmative steps be taken to assure that small and minority businesses are utilized, when possible, as sources of supplies, equipment, construction and services. This assurance is given in consideration of and for the purpose of obtaining any all Federal and/or State financial assistance. - Colorado Revised Statute (C.R.S.) 26-6-104, requiring criminal background record checks for all employees, contractors and sub -contractors. 3 b. Contractor is further charged with the knowledge that any person who feels that s/he has been discriminated against has the right to file a complaint either with the Colorado Department of Human Services or with the United States Department of Health and Human Services, Office for Civil Rights. c. Contractor assures that it will fully comply with all other applicable Federal and State laws which may govern the ability of the Department to comply with the relevant funding requirements. Contractor understands the source of funds to be accessed under the Agreement is Core Services. d. Contractor assures and certifies that it and its principals: - Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transaction by a Federal or State department or agency; and - have not, within a three-year period preceding this Agreem nt, been convicted of or had a civil judgment rendered against them for commission of f ud or criminal offense in connection with obtaining, attempting to obtain, or perforrti ublic (Federal, State or Local) transaction or contract under public transaction violation o deral or state antitrust statutes or commission of embezzlement, theft, for ggr riber falsification or destruction of records, making false statements, or receiving stol p y; and - are not presently indicted for or othe se. ally or civilly charged by a government entity (federal, state or local) with commiFssion o�ny f the offenses enumerated in this certification; and fr - have not, within a three -ye e d preceding this Agreement, had one or more public transactions (federal, state, or loc ter Sated for cause or default. e. Public Contracts for Serv' R.. 7.5-101. Contract Professional certifies, warrants, and agrees that it does not knowi ploy r contract with an illegal alien who will perform work under this contract. Contract Pr I will confirm the employment eligibility of all employees who are newly hired for empl e h United States to perform work under this Agreement, through participation in the E gram or the State of Colorado program established pursuant to C.R.S. §8-17.5-102(5)(c ra rofessional shall not knowingly employ or contract with an illegal alien to perform wor un i greement or enter into a contract with a subcontractor that fails to certify with Contr t r e jonal that the subcontractor shall not knowingly employ or contract with an illegal alien to p & rm rk under this Agreement. Contract Professional shall not use E -Verify Program or State of Color rogramprocedures toundertake pre -employment screening or job applicants while this Agreement is being performed. If Contract Professional obtains actual knowledge that a subcontractor performing work under the public contract for services knowingly employs or contracts with an illegal alien Contract Professional shall notify the subcontractor and County within three (3) days that Contract Professional has actual knowledge that a subcontractor is employing or contracting with an illegal alien and shall terminate the subcontract if a subcontractor does not stop employing or contracting with the illegal alien within three (3) days of receiving notice. Contract Professional shall not terminate the contract if within three days the subcontractor provides information to establish that the subcontractor has not knowingly employed or contracted with an illegal alien. Contract Professional shall comply with reasonable requests made in the course of an investigation, undertaken pursuant to C.R.S. §8-17.5-102(5), by the Colorado Department of Labor and Employment. If Contract Professional participates in the State of Colorado program, Contract Professional shall, within twenty days after hiring a new employee to perform work under the contract, affirm that Contract Professional has examined the legal work status of such employee, retained file copies of the documents, and not altered or falsified the identification documents for such employees. Contract Professional shall deliver to County, a written notarized affirmation that it has examined the legal work status of such employee, 4 and shall comply with all of the other requirements of the State of Colorado program. If Contract Professional fails to comply with any requirement of this provision or of C.R.S. §8-17.5-101 et seq., County, may terminate this Agreement for breach, and if so terminated, Contract Professional shall be liable for actual and consequential damages. f. Except where exempted by federal law and except as provided in C.R.S. § 24-76.5-103(3), if Contract Professional receives federal or state funds under the contract, Contract Professional must confirm that any individual natural person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. § 24-76.5-103(4), if such individual applies for public benefits provided under the contract. If Contract Professional operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it: (a) is a citizen of the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall produce one of the forms of identification required by C.R.S. § 24-76.5-101, et seq., and (c) shall produce one of the forms of identification required by C.R.S. § 24-76.5-103 prior to the effective date of the contract. 8. Compliance with Child and Family Services Review The Child and Family Services Review (CFSR) examines child welfare service out es in three areas; Safety, Permanency and Well Being of families. For each outcom and erformance indicators measure each state's performance according to national standard o for progress over time. Following the review, a Program Improvement Plan (PIP) will'Prir7lrinted for the state to enhance services to families. Contractor agrees to continually strive for positive outc+ to • ,ut he areas of Safety, Permanency and Well Being. Contractor will ensure that any employ r subcont actor of Contractor providing services under this Agreement will work towards positive o o in the aforementioned three areas as outlined under the Child and Family Services Review (CFSR), an ill dress the aforementioned three areas when completing monthly reports as require d%t Paragr p 3(d) of this Agreement. 9. Insurance Requirements Contractor and Departme its officers and employees, omissions of the Con duties described in thi the Board of C 1 Weld County, the Board of County Commissioners of Weld County, be held liable for injuries or damages caused by any negligent acts or bcontractor, or their employees, volunteers, or agents while performing ent. Contractor shall indemnify, defend and hold harmless Weld County, issioners of Weld County, its employees, volunteers and agents. Contractor shall pm d fe the liability insurances (including professional liability insurances where necessary) and worker's compensation insurances for all its employees, volunteers, and agents engaged in the performance of this Agreement which are required under Weld County's Request for Proposal, and required by the Colorado Worker's Compensation Act. Contractor shall provide the Department with the acceptable evidence that such coverage is in effect within seven (7) days of the date of this Agreement. At a minimum, Contractor shall procure, either personally or through its employer as applicable to the Contractor's business, at its own expense, and maintain for the duration of the work, the following insurance coverage. Weld County, State of Colorado, by and through the Board of County Commissioners of Weld County, its employees and agents, shall be named as additional named insured on the insurance, where permissible the insurance provider. a. General Requirements: Contractors/Contract Professionals must secure, at or before the time of execution of any agreement or commencement of any work, the following insurance covering all operations, goods or services provided pursuant to this request. Contractors/Contract Professionals shall keep the required insurance coverage in force at all times during the term of 5 the Agreement, or any extension thereof, and during any warranty period. The required insurance shall be underwritten by an insurer licensed to do business in Colorado and rated by A.M. Best Company as "A"VIII or better. Each policy shall contain a valid provision or endorsement stating "Should any of the above -described policies by canceled or should any coverage be reduced before the expiration date thereof, the issuing company shall send written notice to the Weld County Director of General Services by certified mail, return receipt requested. Such written notice shall be sent thirty (30) days prior to such cancellation or reduction unless due to non- payment of premiums for which notice shall be sent ten (10) days prior. If any policy is in excess of a deductible or self -insured retention, County must be notified by the Contractor/Contract Professional. Contractor/Contract Professional shall be responsible for the payment of any deductible or self -insured retention. County reserves the right to require Contractor/Contract Professional to provide a bond, at no cost to County, in the amount of the deductible or self - insured retention to guarantee payment of claims. The insurance coverages specified in this Agreement are the minimum requirements, and these requirements do not decrease or limit the liability of Contractor/Contract Professional. Contractor/Contract Pr fessional shall maintain, at its own expense, any additional kinds or amounts of insurance that ifrnay deem necessary to cover its obligations and liabilities under this Agreement. b. Types of Insurance: Contractor/Contract Profeio tshall„gbtain, and maintain at all times during the term of any Agreement, insurance in the jlo in Inds and amounts: Workers' Compensation Insur,�• �,y.,s�'quired by state statute, and Employer's Liability Insurance covering all of Con actor' oiftract Professional's employees acting within the course and scope of their e" .loytp -nt. If Contractor is an Independent Contractor, as defined by the orado i r er's Compensation Act, this requirement shall not apply. Contractor us bmit to the Department a Declaration of Independent Contractor Status Form prior heQ,art of this agreement. ii. Commer, a 't4•nbility Insurance written on ISO occurrence form CG 00 0110/93 or e ui le9�' coy ring premises operations, fire damage, independent Contractors, wisp and completed operations, blanket contractual liability, personal injury, aprl adv ip:' iability with minimum limits as follows: $1,000,000 each occurrence; $2,000,000 general aggregate; $50,000 any one fire; and $500,000 errors and omissions. Automobile Liability: Contractor/Contract Professional shall maintain limits of $1,000,000 for bodily injury per person, $1,000,000 for bodily injury for each accident, and $1,000,000 for property damage applicable to all vehicles operating both on County property and elsewhere. iv. Additional Provisions: Policies for all general liability, excess/umbrella liability, liquor liability and pollution liability must provide the following: - If any aggregate limit is reduce by twenty-five percent (25%) or more by paid or reserved claims, Contractor shall notify County within ten (10) days and reinstate the aggregates required; Unlimited defense costs in excess of policy limits; - Contractual liability covering the indemnification provisions of this Agreement; - A severability of interests provision; - Waiver of exclusion for lawsuits by one insured against another; A provision that coverage is primary; and - A provision that coverage is non-contributory with other coverage or self-insurance provided by County. v. For all general liability, excess/umbrella liability, liquor liability, pollution liability and professional liability policies, if the policy is a claims -made policy, the retroactive date must be on or before the contract date or the first date when any goods or services were provided to County, whichever is earlier. c. Contractors/Contract Professionals shall secure and deliver to County's Risk Administrator ("Administrator") at or before the time of execution of this Agreement, and shall keep in force at all times during the term of the Agreement as the same may be extended as herein provided, a commercial general liability insurance policy, incl ding public liability and property damage, in form and company acceptable to and approve.(.y said Administrator, covering all operations hereunder set forth in the related Bid o _•.�.,,Lst for Proposal. d. Proof of Insurance: Contractor/Contract Profes„ona shall rovide a copy of this information to its insurance agent or broker, and shall ha or broker provide proof of Contractor/Contract Professional's required insuran .1r, eserves the right to require Contractor/Contract Professional to provide a f insurance, a policy, or other proof of insurance as required by the County's Risk Ad inistra r I his sole discretion. e. Additional Insureds: For genliability, cess/umbrella liability, pollution legal liability, liquor liability, and inland marine, C an additional insured as follows f. Waiver of Subr shall waive subrogation :..t,c:ainsYCounty. ar/Contract Professional's insurer shall name County as overages, Contractor/Contract Professional's insurer B. Subcont a tor 'contractors, subcontractors, independent contractors, sub - vendors, suppliers . .r' entities providing goods or services required by this Agreement shall be subject t th requirements herein and shall procure and maintain the same coverages required f C c /Contract Professional. Contractor/Contract Professional shall include all such co a - ors, independent contractors, sub -vendors suppliers or other entities as insureds unde oli r s or shall ensure that all subcontractors maintain the required coverages. Contractor ntract Professional agrees to provide proof of insurance for all such subcontractors, independent contractors, sub -vendors suppliers or other entities upon request by the County. A provider of Professional Services (as defined in the Bid or RFP) shall provide the following coverage: Professional Liability: Contract Professional shall maintain limits of $1,000,000 for each claim, and $2,000,000 aggregate limit for all claims. 10. Certification Contractor certifies that, at the time of entering into this Agreement, it has currently in effect all necessary licenses, approvals, insurance, etc., required to properly provide the services and/or supplies covered by this Agreement. Copies of all necessary licenses shall be provided to the Department by the Contractor prior to the start of any Agreement. 11. Training 7 Contractor may be required to attend training that the request of the Department specific to services provided under this Agreement. The Department will not compensate the Contractor for said training in the form of registration fees, time spent traveling to and from training, attending the training or any other associated costs unless otherwise agreed to by the Department. 12. Subpoenas Contractor will, on behalf of its employees and/or officers, accept any subpoena for testimony from the Weld County Attorney's Office by e-mail and will return a waiver of services within 72 business hours. For this purpose, Contractor will designate an e-mail address prior to the start of this Agreement. If the Contractor receives a subpoena via e-mail but will only accept personal service, the Contractor will contact the Weld County Attorney's Office immediately at 970-352-1551, x6503, and advise that the subpoena must be personally served. 13. Monitoring and Evaluation Contractor and the Department agree that monitoring and evaluation o rformance of this Agreement shall be conducted by the Contractor and the Department. The res of the monitoring and evaluation shall be provided to the Board of Weld County Commibsio ers, th Department and the Contractor. Contractor shall permit the Department, and any other Y i.,zed agent or governmental agency, to monitor all activities conducted by the Contractor purs ant to ererms of this Agreement. As the monitoring agency may in its sole discretion deem nece ry r ppropriate, such program data, special analyses, on -site checking, formal audit examin tons, or a other reasonable procedures. All such monitoring shall be performed in a manner thitt w IPilot unduly interfere with the work conducted under this Agreement. 14. Modification of Agreement All modifications to this Agree r>ii sfl be in writing and signed by both parties. 15. Remedies The Director of H and i'* or designee may exercise the following remedial actions should s/he find the Contractor bs t ly failed to satisfy the scope of work found in this Agreement. Substantial failure to satis sc pe of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. T remedial actions are as follows: - Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed. - Deny payment or recover reimbursement for those services or deliverables, which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Department. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to the Department. - Incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation shall be recovered from Contractor by deduction from subsequent payments under this Agreement or other agreements between the Department and Contractor, or by the Department as a debt due to the Department or otherwise as provided by law. 8 For Department: Judy A. Griego, Director P.O. Box A Greeley, CO 80632 1970) 352-1551 18. Litigation Contractor shall promptly notify the Departme litigation in which it is a party defendant in a Contractor, within five (5) calendar days after which has been filed in any Federal or S document(s) to the Director of Hu benefit of creditors, and filings of kzrjlptcy, 19. Termination 16. Representatives For the purpose of this Agreement, the individuals identified below are hereby designated representatives of the respective parties. Either party may from time to time designate in writing a new or substitute representative(s). For Department: Heather Walker, Administrator 17. Notice For Contractor: CONTRACTOR, TITLE All notices required to be given by the parties hereunder shall be given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing a substitute person(s) or address to whom such notices shall be sent. ask For Contractor: h the eve" that Contractor learns of any actual involves services provided under this Agreement. ed with a summons, complaint, or other pleading administrative agency, shall deliver copies of such he term "litigation" includes an assignment for the eorganization and/or foreclosure. This Agreement may iced at any time by either party giving thirty (30) days written notice to the individuals identif d i ph 18. No portion of this Agreement shall be deemed to create an obligation on t o e County of Weld, State of Colorado, to expend funds not otherwise appropriated i s c eeding year, as this Agreement is subject to the availability of funding. Therefore, the D ent may terminate this Agreement at any time if the source of funding for the services made available to the Contractor is no longer available to the Department, or for any other reason. Contractor reserves the right to suspend services to clients if funding is no longer available. 20. No Third Party Beneficiary Enforcement It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 21. Governmental Immunity No term or condition of this contract shall be construed or interpreted as a waiver, express or implied, of 9 any of the immunities, rights, benefits, protections or other provisions, of the Colorado Governmental Immunity Act of §§24-10-101 et. seq. as applicable now or hereafter amended. 22. Partial Invalidity of Agreement If any section, subsection, paragraph, sentence, clause, or phrase of this Agreement is for any reason held or decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The parties hereto declare that they would have entered into this Agreement and each and every section, subsection, paragraph, sentence, clause, and phrase thereof irrespective of the fact that any one or more sections, subsections, paragraphs, sentences, clauses, or phrases might be declared to be unconstitutional or invalid. 23. Improprieties/Conflict of Interest No officer, member or employee of Weld County and no member of their go rning bodies shall have any pecuniary interest, direct or indirect, in the approved Agreement or the procds thereof. The Appearance of Conflict of Interest applies to the relationship of a Contract r. ith the Department when the Contractor also maintains a relationship with a third pally d the wo relationships are in opposition. In order to create the appearance of a conflict of inte? t i t necessar for the Contractor to gain from knowledge of these opposing interes { necessary that the Contractor know that the two relationships are in opposition. Duri of the Agreement, Contractor shall not enter into any third party relationship that gives th appea n of creating a conflict of interest. Upon learning of an existing appearance of a conflict o i ere situation, Contractor shall submit to the Department, a full disclosure statement settin rth the tails that create the appearance of a conflict of interest. Failure to promptly submit a disc ur tatement required by this paragraph shall constitute grounds for the Department's termination, for se,4{its Agreement with the Contractor. Contractor certifies that Federal app, .. �af�fii ds have not been paid or will be paid, by or on behalf of Contractor, to any person for inn :' or ate" emoting to influence an officer or employee of an agency, a Member of Congress, an offi r t .loyee of Congress, or an employee of a Member of Congress in connection with the away t o eeral contract, the making of any Federal grant, the making of any Federal loan, the entering i y cooperative agreement, and the extension, continuation, renewal, amendment, or modif igCo n Federal contract, loan, grant, or cooperative agreement. 24. Stora ity and Retention of Records Contractor agrees thvt'authorized local, Federal, and State auditors and representatives shall, during business hours, have access to inspect and copy records, and shall be allowed to monitor and review through on -site visits, all activities related to this Agreement, supported with funds under this Agreement, to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. All such records, documents, communications, and other materials created pursuant or related to this Agreement shall be maintained by the Contractor in a central location and shall be made available to the Department upon its request, for a period of seven (7) years from the date of final payment under this Agreement, or for such further period as may be necessary to resolve any matters which may be pending, or until an audit has been completed with the following qualifications: If an audit by or on behalf of the Federal and/or State government has begun but is not completed at the end of the seven (7) year period, or if audit findings have not been resolved after a seven (7) period, the materials shall be retained until the resolution of the audit finding. 10 25. Confidentiality of Records Contractor shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Agreement except for purposes directly connected with the administration of Child Protection. No information about or obtained from any applicant/recipient in possession of Contractor shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with the Contractor's written policy governing access to, duplication and dissemination of, all such information, in any form, including social networks. Contractor shall advise its employees, agents, and subcontractor, if any, that they are subject to these confidentiality requirements. Contractor shall provide its employees, agents, and subcontractors, if any, with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. Contractor shall have its employees, agents, and subcontractors, if any, sign written confidentiality agreement and shall provide a copy of such agreement to the Department, if quested. 26. Proprietary Information Proprietary information for the purposes of this Agreement is info Lo acing to a party's research, development, trade secrets, business affairs, internal operate nagement procedures and those of its customers, clients or affiliates, but does not includ n 'on (1) lawfully obtained from third parties, (2) that which is in the public domain, or (3) th whit veloped independently. Neither party shall use or disclose directly or indirectly without 'or ten authorization any proprietary information concerning the other party obtain s a resu this Agreement. Any proprietary information removed from the Department' to the Contractor in the course of providing services under this Agreement will be accorded at least s e precautions as are employed by the Contractor for similar information in the course of Own bust ess. 27. Independence of Contra c`tb(:,tt¢6t an Employee of Weld County Contract Professional agr e tha ar?independent Contract Professional and that Contract Professional's officers, age p ogees will not become employees of County, nor entitled to any employee benefits free frac a result of the execution of this Agreement. Contract Professional shall perform its dutie erat an independent Contract Professional. Contract Professional shall be solely respons' e o 'ts cts and those of its agents and employees for all acts performed pursuant to this Agreemen tr t Professional, its employees and agents are not entitled to unemployment insurance or work ompensation benefits through County and County shall not pay for or otherwise provide such coverage for Contract Professional or any of its agents or employees. Unemployment insurance benefits will be available to Contract Professional and its employees and agents only if such coverage is made available by Contract Professional or a third party. Contract Professional shall pay when due all applicable employment taxes and income taxes and local head taxes (if applicable) incurred pursuant to this Agreement. Contract Professional shall not have authorization, express or implied, to bind County to any agreement, liability or understanding, except as expressly set forth in this Agreement. Contract Professional shall have the following responsibilities with regard to workers' compensation and unemployment compensation insurance matters: (a) provide and keep in force workers' compensation and unemployment compensation insurance in the amounts required by law (and as set forth in Exhibit provide proof thereof when requested to do so by County. 28. Entire Agreement This Agreement, together with all attachments hereto, constitutes the entire understanding between the parties with respect to the subject matter hereof, and may not be changed or modified except as state in 11 Paragraph 14 herein. This Agreement shall be binding upon the parties hereto, their successors, heirs, legal representatives, and assigns. The Contractor and the Department may not assign any of its rights or obligations hereunder without the prior consent of both parties. 29. Agreement Nonexclusive This Agreement does not guarantee any work nor does it create an exclusive agreement for services. 30. Warranty The Contractor warrants that services performed under this Agreement will be performed in a manner consistent with the professional standards governing such services and the provisions of this Agreement. The Contractor shall faithfully perform the work in accordance with the standards of care, skill, training, diligence and judgment provided by highly competent individuals and entities that perform services of a similar nature to those described in this Agreement including Exhibits A, B, C,, nd D. 31. Acceptance of Services Not a Waiver Upon completion of the work, the Contractor shall submit to Dep&�rt •cnt orkinals of all tests and results, reports, etc., generated during completion of this work. Acceptancbt �y�;r. rtment of reports and incidental material(s) furnished under this Agreement shall n y relieve the Contractor of responsibility for the quality and accuracy of the service,p .• nt shall any action by the Department hereunder constitute or be construed to be a waiver b �' he Dee�:rt ent of any breach of covenant or default which may then exist on the part of the Contrac ., anyl' he Department's action or inaction when any such breach or default shall exist shall not i air or pr- dice any right or remedy available to the Department with respect to such breach or au nd no assent, expressed or implied, to any breach of any one or more covenants, provisions or con ns Qhe Agreement shall be deemed or taken to be a waiver of any other breach. Acceptance the Dep rtment of, or payment for, any services performed under this Agreement shall not be waiver of any of the Department's rights under this Agreement or under the law gen 32. Employee FinanciaLlnte..es^t 5�' flict of Interest. C.R.S. Q§24-18-201 et seq. and §24-50-507 ol The signatories to chi er�t aver that to their knowledge, no employee of Weld County has any personal or benef' ial hatsoever in the service or property which is the subject matter of this Agreement. T o r has no interest and shall not acquire any interest direct or indirect, which would in any r o egree with the performance of the Contractor's services and the Contractor, shall not employ erson having such known interests. During the term of this Agreement, the Contractor shall not engage in any in any business or personal activities or practices or maintain any relationships which actually conflict with or in any way appear to conflict with the full performance of its obligations under this Agreement. Failure by the Contractor to ensure compliance with this provision may result, in the Department's sole discretion, in immediate termination of this Agreement. No employee of the Contractor nor any member of the Contractor's family shall serve on a County Board, committee or hold any such position which either by rule, practice or action nominates, recommends, supervises Contract Professional's operations, or authorizes funding to the Contractor. 33. Board of County Commissioners of Weld County Approval This Agreement shall not be valid until it has been approved by the Board of County Commissioners of Weld County, Colorado. 12 34. Choice of Law/Jurisdiction Colorado law, and rules and regulations established pursuant thereto, shall be applied in the interpretation, execution, and enforcement of this Agreement. Any provision included or incorporated herein by reference which conflicts with said laws, rules and/or regulations shall be null and void. In the event of a legal dispute between the parties, Contract Professional agrees that the Weld County District Court shall have exclusive jurisdiction to resolve said dispute. 35. Subcontractors Contract Professional acknowledges that County has entered into this Agreement in reliance upon the particular reputation and expertise of Contract Professional. Contract Professional shall not enter into any subcontractor agreements for the completion of this project without County's prior written consent, which may be withheld in County's sole discretion. 36. Attorneys Fees/Legal Costs In the event of a dispute between County and Contract Professional concern inghis Agreement, the parties agree that each party shall be responsible for the paymenfees and/or legal costs incurred by or on its own behalf. 37. Ownership All work and information obtained by Contract Professthis Agreement or individual work order shall become or remain (as applicable), the pr rty of Co ty. In addition, all reports, documents, data, plans, drawings, records and computer fi erated by Contract Professional in relation to this Agreement and all reports, test results and of tangible materials obtained and/or produced in connection with the performance of thi reeme , whether or not such materials are in completed form, shall at all times be considered the County. Contract Professional shall not make use of such material for purposes other the `i. .T nett on with this Agreement without prior written approval of County. 38. Interruptions Neither party to is otherwise to p its reasonable Governmental ac 39. Severability t shall be liable to the other for delays in delivery or failure to deliver or obligation under this Agreement, where such failure is due to any cause beyond ncluding but not limited to Acts of God, fires, strikes, war, flood, earthquakes or If any term or condition of this Agreement shall be held to be invalid, illegal, or unenforceable by a court of competent jurisdiction, this Agreement shall be construed and enforced without such provision, to the extent that this Agreement is then capable of execution within the original intent of the parties. 13 IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. ATTEST: BOARD OF COUNTY COMMISSIONERS Weld County Clerk to the Board WELD COUNTY, COLORADO BY: Deputy Clerk to the Board , Chair APPROVED AS TO FUNDING: APPROVED AS TO SUBSTANCE: Controller Elected Official or Department Head APPROVED AS TO FORM: Director of General Ser County Attorney 14 EXHIBIT B CONTRACTOR'S PROPOSAL PROVIDER INFORMATION FORM (Proposal Cover Sheet) Weld County Department of Human Services Andrea Shindle AGENCY OR PRIVATE PRACTICE TRAITS PROVIDER ID (If Known) Andrea Shindle FamilyfndMdual therapist PRIMARY CONTACT- FULL NAME PRIMARY CONTACT -ME 1970 475-0471 PHONE NUMBER acord3shands@yahoo.com EXT. FAX NUMBER PRIMARY CONTACT- E-MAIL ADDRESS AGENCY/PRACTICE WEB ADDRESS (IF APPLICABLE) 4625 W. 20th Street Suite 202 AGENCY MAIUNG ADDRESS Greeley CO art ZIP REFFERAL CONTACT- FULL NAME (IF DIFFERENTTNAN PRIMARY CONTACT) REFERRAL CONTACT - Thu I I REFERRAL CONTACT- PHONE NUMBER REFERRAL CONTACT- E-MAILADDRESS I certify that the services offered for intended use by Weld County will meet all the specifications it has so indicated in this bid form. The Board of Weld County Commissioners reserves the right to reject any or all bids, to waive any informality in the bids, and to accept the bid, or part of a bid, that, in the opinion of the Board, is in the best intetests of the Board and of the County of Weld, State of Colorado. The Board of Weld County Commissioners shall give preference to resident Weld County bidders in all cases where the bids are competitive in price and quality. Signature of Authorized Representative: Date of Signature: 3194:4111p QA . L. 51,cL,LncLa Please indicate the program area(s) you wish to be considered for: ❑❑EI❑❑J❑ Aftercare Services Anger Management/Domestic Violence Crisis Intervention and Stabilization Services Day Treatment Foster Parent Consultation Foster Parent Training Functional Family Therapy Home -Based Intensive Services Home Studies Kinship Services !il Life Skills ❑ Mediation El Mental Health Services ❑ Monitored Sobriety Only ❑ Multi -Systemic Therapy ❑ Relinquishment Counseling ❑ Sexual Abuse Treatment ❑ Substance Abuse Evaluation and Treatment • Other: \ppnr+ `(-srny Tnarnp r q ❑ Other: LJ ❑ Other: Andrea Shindle, NCC, Masters Candidate in Clinical Counseling, Family and Couples 1561 41st Avenue Ct Greeley, CO 80634 (970)475-0471 acord3strands@yahoo.com March 25, 2016 Ms. Tobi Vegter, Weld County Department of Human Services Dear Ms. Vegter, When one of the twelve children we fostered over a span of four years arrived at our home that very first day, our eyes were opened to a look at mental health we could not fathom prior to that experience. He was distant and withdrawn - a picture of distrust that only a child in his position could truly understand. After effective holistic and therapeutic treatment, trauma -informed care and community support, we learned that not only can children and adults survive, they can heal and thrive. Without a doubt, my roles as an educator, therapist and adoptive mother have been my driving force to continue working with those impacted by trauma as a professional. For some, becoming educated in clinical counseling leads professionals to become passionate about attachment and trauma. For me, witnessing firsthand how attachment is a reciprocal relationship that is fostered through the safety of consistent and, often times, creative treatment steered me to become a mental healthcare provider. As a foster parent, I discovered the bridge to healing can be a long and exhausting one for both the child and the caregivers. Prior to placement, families are educated on the impact of addiction, familial patterns of abuse and neglect, and domestic violence, however, what many couldn't understand prior to placement was the day to day exhaustion of coping with the behaviors that resulted from all of the devastation that the child displaying in an attempt to control and cope with his trauma. Each professional can offer unique insight into the needs of families who need a variety of services that can lead to healing and family preservation; I believe I offer a unique perspective given my background and trauma - informed training along with access to private office treatment as well as in home services. I am privately supervised bimonthly by a wonderful licensed psychologist, Dr. Arvind Karwan, who works with some of the highest risk clients for out of home placement in the state referred by DYC. • Specialized training in developmental trauma mental health care, Dyadic Developmental Psychotherapy by Dr. Daniel Hughes himself. 10 years of experience working with non-profit, public sector, law enforcement and human services Experience in facilitating post adoptive, adoptee and foster care support/group therapy for adults, teens and children • Specialized training in facilitating community growth, support groups and leadership development • Speaker/presenter on topics of trauma -informed care, attachment, co -parenting, social justice and foster care/adoption • Experience in permanency planning, treatment planning, child welfare and family preservation services • Research experience in collecting and analyzing doctorate level study on emotional regulation and autism • Graduate of Couples and Family Clinical Masters Graduate University of Northern Colorado [ am dedicated to working with those who are walking the journey of trauma and attachment repair. I am committed to providing effective training and services that will reduce family disruption, provide trauma -informed care and that empower professionals, educators and families; in fact, I recently spoke at the Courage to Risk Conference on the impact of trauma on the brain and how to meet the needs of students in the classroom. The power and influence of strong family connections and healing practices can impact the community, and most importantly the individual in ways that no other resources can offer these special clients. I hope to work with your team of progressive professionals and advocates who are integrative in serving some of our communities' most vulnerable. Attached to this document, you will find a proposal of services along with fees (I am not a Medicaid provider) that I can effectively provide families and children in Weld County. Thank you so much for your time. Warmly, Andrea Shindle, BA, NCC, Masters Candidate in Clinical Counseling, Family and Couples ANDREA SIIINDLE9 FAMILY THERAPIST PROPOSAL FOR SERVICES independent Contractor 1. Provider Information: Andrea Shindle, MA, Registered Psychotherapist (NLC.0106099) 4625 W. 20th Street Suite 202 Greeley, CO 80634 Supervision: Arvind Karwan, PhD., Licensed Psychologist (PSY.0004149) 1502 S. College Ave., Suite 3, Fort Collins, CO 80524 Phone (970)6315400 2. Provider Credentials: Registered Psychotherapist (NLC.0106099) B.A., Psychology, University of Northern Colorado, 2005 M.A., Clinical Counseling, Couples and Family Counseling, University of Northern Colorado, 5/2016 Special training: Level 1 Dyadic Developmental Psychotherapy, 2015, Therapeutic Crisis Intervention, 2015 FAMILY & INDIVIDUAL THERAPY Andrea Shindle can provide private office session as well as in -home services to support Weld County Department of Human Services in achieving its goals for permanency of children in placed into foster and kinship care. Andrea is specifically trained in a modality of therapy that allows the child to access emotions that are difficult to process without assistance. Children who have experienced trauma early In life benefit from seeking comfort from trusted caregivers. Using Dyadic Developmental Psychotherapy, Andrea utilizes the caregiving abilities of the primary parents/guardians of the child to receive secure attachment cycles that are often missed due to issues of abuse and/or neglect in the family of origin. For kinship, foster and adoptive parents, Andrea is able to provide the mental health support to assist parents in developing new interactional patterns that are difficult to maintain with children who have experienced trauma or attachment concerns. Behaviors that arise as a result of trauma can be extreme and often add to the isolation that both the child and caregivers experience in the home. Andrea is able to effectively build alliances with both the caregivers and children in order to decrease triangulation as well as extreme acting out that many mental health providers overlook. Sessions last 50 minutes with 10 minutes reserved at the end for treatment planning. Sessions costs $75.00 and are often recommended at least once weekly depending on the level of needs of the child. Some families benefit from twice weekly sessions that are directed at caregiving support and also trauma processing for the child. Children are given opportunities to develop a narrative of their loss and trauma experiences in a manner that is age appropriate and are provided emotional support by the therapist and caregivers both in session and at home. The Objective Caregivers are often reporting the following: <Need #1: Family members report high conflict in the home and are not able to help identify behaviors that indicate trauma or maladaptive patterns. <Need #2: Behaviors are present that are unmanageable in the home setting and require creative and out of the box thinking to understand how to reconnect a child's emotions, behaviors and trauma experiences. <Need #3: Attachment and/or trauma history of the caregivers are often overlooked and contribute to the negative interaction cycles that occur in the home. 1 What the family can expect Provide families with a treatment that is effective, meets the attachment needs of both caregiver and child as well as identifies strategies to decrease unhealthy patterns of behavior and increase bonding capabilities of both caregiver and child. Techniques are integrative including attachment skills, narrative therapy, psychoeducation of developmental stages, trauma reprocessing, play therapy, case management, and follow-up care. • <Goal #1: Family members will seek comfort during times of distress and receive appropriate levels of nurturance from the caregiver in return. • <Goal #2: Family members will be able to connect history of trauma to current emotional state in order to decrease self -blame and increase self-esteem. ▪ <Goal #3: Family members will increase ability to advocate for emotional and physical needs in a manner that is age appropriate. Recommendations and Results Sessions are recommended to occur at least once per week for at least 6-12 month. Once family members are able to report stabilization, families can decrease therapy in hopes of solidifying new skills and practices. Families often benefit from follow-up sessions up to 18 months after the onset of treatment. <Recommendation #1: Caregivers/family members are present at all sessions in order to practice and facilitate secure attachment behaviors with the child. <Recommendation #2: Family members are given time to identify triggers and personal attachment history in order to provide support for all family members. <Recommendation #3: Family members are given opportunities to process intense emotions in a manner that is safe and requires caregiver attention to build missed bonding from early in development. FEES The following table details the pricing for delivery of the services outlined in this proposal. Services Cost In -home family therapy Price One hour session (50 minute direct client time) Client home must be located within 10 $75.00 driving miles of therapist office located at 4625 W. 20th Street Greeley, CO 80634 One hour session (50 minute direct client time) Client home must be located within 25 $98.50 driving miles of therapist office located at 4625 W. 20th Street Greeley, CO 80634 One hour session (50 minute direct client time) Client home must be located within 60 $131.40 driving miles of therapist office located at 4625 W. 20th Street Greeley, CO 80634 Any home located outside of a 60 driving miles of the therapist office will be charged at $0.47 per mile. Services Cost Office family therapy One hour session (50 minute direct client time) located at provider's office 4625 W. 20th $75.00 Street Suite 202 Greeley, CO 80634 FOSTER PARENT CONSULTATION Andrea Shindle can provide private office session as well as in -home services to support Weld County Department of Human Services in achieving its goals for permanency of children in placed into foster and kinship care. Andrea is able to provide consultation to foster parents who may be seeking support in behavior management, processing individual emotional needs, and utilizing solution -focused strategies to maintain child placement in the group or foster home Consultation costs $75.00 and are often recommended at least once weekly depending on the level of needs of the child. Some families benefit from twice weekly sessions that can be child/sibling specific. Parents are given opportunities to process their unique experiences as a foster care provider and are provided emotional support by the therapist. Additionally, the therapist is able to access for safety concerns and make recommendations on course of treatment and tools that may foster further security for the child in placement. The Objective Caregivers are often reporting the following: <Need #1: Caregivers are often exhausted and report that they may not be able to care the child in placement without intensive support. • <Need #2: Behaviors are present that are unmanageable in the home setting and require creative and out of the box thinking to understand how to reconnect a child's emotions, behaviors and trauma experiences. <Need #3: Attachment history of the caregivers are often overlooked and contribute to the negative interaction cycles that occur in the home. What the caregiver can expect Provide foster care providers with support and consultation that is effective, meets the attachment needs of both caregiver and child as well as identifies strategies to decrease unhealthy patterns of behavior and increase bonding capabilities of both caregiver and child. Techniques are integrative including solution focused strategies, attachment skills, narrative therapy, psychoeducation of developmental stages, trauma reprocessing, play therapy, case management, and follow-up care. • <Goal #1: Caregiver will increase ability to meet child's emotional needs during times of distress. • <Goal #2: Caregiver will be able to connect history of trauma to current emotional state in order to decrease self - blame and increase awareness of the effects of trauma on the child and family. <Goal #3: Caregiver will increase ability to advocate for the needs of self and child and identify community resources that can encourage permanency of the child. Recommendations and Results Consultations are recommended to occur at least once per week for at least 3-6 months. Once family members are able to report stabilization, families can decrease consultation in hopes of solidifying new skills and practices. Families often benefit from follow-up sessions up to 18 months after the onset of treatment. <Recommendation #1: Caregivers are present at all consultations in order to receive adequate support. <Recommendation #2: Therapist will provide psychoeducation and community resources in order to provide support for all family members. <Recommendation #3: Caregiver is given opportunities to process intense emotions in a manner that is safe and confidential. 3 FEES The following table details the pricing for delivery of the services outlined in this proposal. Services Cost In -home foster parent consultation Price One hour session (50 minute direct client time) Client home must be located within 10 driving miles of therapist office located at 4625 W. 20'h Street Greeley, CO 80634 $75.00 One hour session (50 minute direct client time) Client home must be located within 25 $98.50 driving miles of therapist office located at 4625 W. 20'" Street Greeley, CO 80634 One hour session (50 minute direct client time) Client home must be located within 60 $131.40 driving miles of therapist office located at 4625 W. 20th Street Greeley, CO 80634 Any home located outside of a 60 driving miles of the therapist office will be charged at $0.47 per mile. Services Cost Office foster parent consultation One hour session (50 minute direct client time) located at provider's office 4625 W. 20th $75.00 Street Suite 202 Greeley, CO 80634 GROUP SUPPORT Foster parents, adoptive parents, kinship, foster children, adoptees, and family of origin Families and children who have experienced trauma early in life benefit from seeking support from others who have traveled a similar journey. Using group therapy, Andrea utilizes the dynamics of the group to provide relief of isolation and increase feelings of efficacy that are often decreased during times of distress or transition. Andrea is able to effectively build alliances with all members of the adoption triad and validate their unique experiences with the specialized language and psychoeducation that is not only trauma -informed but sensitive to the needs of each perspective. Group sessions last 50 minutes with 10 minutes reserved at the end for treatment planning. Group therapy is a closed group lasting 8 weeks with a maximum of 8 group members. Topics include parenting skills, adoption support, trauma informed care, child development and varies depending on the needs of the group. Members are also encouraged to seek individual counseling as needed. Adults are placed in groups that are specifically designated to their role in the family. For example, foster parents will not be placed into a support group for birth parents who have relinquished their parental rights. Teens/children are given opportunities to develop a narrative of their loss and trauma experiences in a manner that is age appropriate and are provided emotional support by the therapist and group members both in session and at home. Group members will be assessed by therapist for appropriateness for group. Final decisions will be made by the therapist. Materials and curriculum are provided by Andrea. Schedule will be determined by therapist to accommodate group members. The Objective Caregivers are often reporting the following: <Need #1: Group members report that they are not able to relate well to those who have not experienced foster care, kinship care or adoption. <Need #2: Group members are able to collaborate and develop creative and out of the box thinking to understand how to support their emotions, behaviors and trauma experiences. <Need #3: Therapist is able to provide experiential opportunities to practice new skills that facilitate healthy communication and relationships. 4 What the group can expect Provide families with a treatment that is effective, meets the attachment needs of both caregiver and child as well as identifies strategies to decrease unhealthy patterns of behavior and increase bonding capabilities of both caregiver and child. Techniques are integrative including attachment skills, narrative therapy, psychoeducation of developmental stages, trauma reprocessing, play therapy, case management, and follow-up care. <Goal #1: Members will seek support during times of distress and receive appropriate feedback and collaborations from group members. <Goal #2: Members will be able to connect history of trauma to current emotional state in order to decrease self - blame and increase self-esteem. • <Goal #3: Members will increase ability to advocate for emotional and psychical needs in a manner that is age appropriate. Recommendations and Results Sessions are once weekly for 8 weeks. Members are able to start group therapy at onset of 8 weeks and may not join group after the start. Members work toward solidifying new skills and practices. Members often benefit from follow-up individual/family sessions up to 18 months after the onset of treatment. ▪ <Recommendation #1: Members are present at all sessions in order to practice and facilitate safety and consistency in the group. • <Recommendation #2: Members are expected to maintain group confidentiality in order to provide support for all members. <Recommendation #3: Members are given opportunities to process intense emotions in a manner that is appropriate for the group. FEES The following table details the pricing for delivery of the services outlined in this proposal. Services Cost Group Therapy 1 session per week for 8 weeks Price per member 1 4. ]�t�'-.kri_-'CIi [1X'-1-S+`e.t2�n�cr:&' C.ti. tr,rstly ., 5 (1IELt`LPe '. I I 1 COLORADO Department of Regulatory Agencies Division of Professions and Occupations Congratulations! Below are your electronic wallet cards to use as proof of your license. You can also print your license at any time through your Online Services account by visiting our homepage at www.dora.colorado.gov/professions and clicking on the "Print your License" link under the label "Quick Links". If you would like a more durable wallet card option, you can order one for a fee by visiting www.nasbastore.org and selecting the "Colorado License Cards" link on the left hand side of the page. If you prefer, you can also contact NASBA by phone at 1-888-925-5237 or by email at nasbastore@nasba.org. Should you have questions about your credential, or need other information, please contact our Customer Service Team at 303-894-7800 or dora_registrations@state.co.us. Colorado Department of Regulatory Agencies Division of Professions and Occupations State Board of Registered Psychotherapists Andrea Lyn Shindle Registered Psychotherapist NLC.0106099 Number Active Credential Status 12/30/2015 Issue Date 08/31/2017 Expire Date Verify this credential at www.doratolorado.gov/professlons Division Director enLarson Credential Holder Signature Cutalong the fine Colorado Department of Regulatory Agencies Division of Professions and Occupations State Board of Registered Prychotheiapists Andrea Lyn Shindle Registered Psychotherapist NLC.D106099 12/30/2015 Number Issue Date Active 08/31/2017 Credential Status Expire Date Verify this credential at: vnvw.dora.colorado.g ov/profession s division Director on Credential Holder Signature 1560 Broadway, Suite 1350, Denver, CO 80202 P 303.894.7800 F 303.894.7693 www.dora.colorado.gov/professions t,<<i,; . I vFi�,�-•dam%.� HEALTHCARE PROVIDERS ORGANIZATION PURCHASING - , Certificate of OCCURRENCE POLICY PRODUCER BRANCH PREFIX POLICY NUMBER SERVICE GROUP 3ln≤urance FORM Policy Period: S° 018098 970 HPG 0622364700-8 I I I Named Insured From 02/23/16 to 02/23/17 at 12:01 AM Standard Time Program Administered by: Andrea L Shindle 1561 41st Avenue Ct Greeley, CO 80634-2758 . Medical Specialty Code Healthcare Providers Service Organization 159 E. County Line Road Hatboro, PA 19040-1218 1-800-982-9491 www.hpso.com Insurance is provided by: Psychologist/Psychotherapist 80723 Excludes Cosmetic Procedures Professional Liability $1,000,000 American Casualty Company of Reading, Pennsylvania 333 South Wabash Avenue Chicago, Illinois 60604 each claim $5,000,000 aggregate Your professional liability limits shown above include the following: • Good Samaritan Liability • Malplacement Liability • Personal Injury Liability • Sexual Misconduct included in the PL Limit shown above subject to $25,000 aggregate sublimit Coverage Extensions License Protection $ 25,000 per proceeding $ 25,000 aggregate Defendant Expense Benefit $ 1,000 per day limit $ 25,000 aggregate Deposition Representation $ 10,000 per deposition $ 10.000 aggregate Assault $ 25,000 per incident $ 25,000 aggregate Includes Workplace Violence Counseling Medical Payments $ 25,000 per person $ 100,000 aggregate First Aid $ 10,000 per incident $ 10,000 aggregate Damage to Property of Others $ 10.000 per incident $ 10,000 aggregate Information Privacy (HIPAA) Fines & Penalties $ 25,000 per incident $ 25,000 aggregate Workplace Liability Workplace Liability Included in Professional Liability Limit shown above Fire and Water Legal Liability Included in the PL limit above subject to $150,000 aggregate sublimit Personal Liability $1,000,000 aggregate Total: $43200 Premium reflects self-employed, part-time rate with ACA Membership discount Policy Forms & Endorsements (Please see attached list for a general description of many common policy forms and endorsements.) G -121500-D G -121501-C G -121503-C CNA82011 G -145184-A G -147292-A CNA81753 CNA81758 GSL13424 GSL15563 GSL15564 GSL15565: GSL17101 CNA80052 CNA80051 G -123846-005 CNA79575 Chairman of the Board Secretary Keep this Certificate of Insurance in a safe place. This Certificate of Insurance and proof of payment are your proof of coverage. There is no coverage in force unless the premium is paid in full. In order to activate your coverage, please remit premium in full by the effective date of this Certificate of Insurance. Form #: G-141241-8 (3/2010) Master Policy: 188711433 IPSM150SNC0hh1 20160224701 POLICY FORMS & ENDORSEMENTS The list below contains general descriptions of the policy forms and endorsements that mayor may not apply to your professional liability insurance policy. State specific policy forms and endorsements are not included in the list below. Should you require descriptions or samples of these documents, please visit us online at www.hpso.corWpolicyfonns. Please refer to your Certificate of Insurance for the policy forms & endorsements specific to your state and your policy period. All products and services may not be available in all states and may be subject to change without notice. Think Green — expanded definitions and copies of these policy forms and endorsements are available online at www.hpso.conb'policyforms. COMMON POLICY FORMS & ENDORSEMENTS FORM # DESCRIPTION G-121500.0 Common Policy Conditions 6-121501-C Occurrence Policy Form G -121503-C Workplace Liability Form CNA82011 Healthcare Providers Related Claims Endorsement 6-145184-A Policyholder Notice - OFAC Compliance Notice 6-147292-A Policyholder Notice - Silica Mold & Asbestos Disclosure CNA81753 Cap on Losses from Certified Acts of Terrorism CNA81758 Offer of Terrorism Coverage - Disclosure of Premium GSL13424 Services to Animals GSL15563 Information Privacy Coverage Endorsement HIPAA Fines Penalties & Notification Costs GSL15564 Sexual Misconduct Sublimits of Liability Professional Liability & Sexual Misconduct Exclusion GSL15565 Healthcare Providers Professional Liability Assault Coverage GSL17101 Exclusion of Specified Activities Reuse of Parenteral Devices and Supplies CNA80052 Distribution or Recording of Material or Information in Violation of Law Exclusion Endorsement CNA80051 Amended Definition of Personal Injury Endorsement G -123846-005 Colorado Cancellation and Non -Renewal CNA79575 Exclusion of Cosmetic Procedures PLEASE REFER TO YOUR CERTIFICATE OF INSURANCE FOR THE POLICY mums & ENDORSEMENTS SPECIFIC TO YOUR STATE AND YOUR POLICY PERIOD. Self-employed individuals may be eligible for General Liability coverage subject to underwriting approval. Should an individual practitioner's status change from self-employed to employed, general liability coverage will be deleted and replaced with workplace liability. Please contact Healthcare Providers Service Organization for details. Form #: G -141241-B Named Insured: Andrea L Shindle Master Policy #: 188711433 Policy #: 0622364700-8 H10412 Andrea Lyn Shindle, MA Family Therapist 1561 41st Avenue Court Greeley, CO 80634 US 970-475-0471 acord3strands@yahoo.com Education: University of Northern Colorado Graduate School (CACREP accredited) Master of Arts in Couples and Family Counseling - Degree 05/2016 GPA: 4.0 of a maximum 4.0 Credits Earned: 72 Semester hours Specialty: Professional Counseling, Couples and Family Therapy Relevant Coursework, Licenses and Certifications: - Trauma and Intervention -Lifespan Development -Child and Adolescent Development -Graduate Research -Group Dynamics and Facilitation -Advanced Methods of Family Therapy -Individual Counseling Practicum/Suicide Assessment - Understand Diverse Populations -Contemporary Family Issues -Assessment and Appraisal/Substance Abuse and Addictions -Diagnosis and Treatment Planning University of Northern Colorado Greeley, CO United States Bachelor of Art in Psychology Degree 08/05/2005 GPA: 3.1 of a maximum 4.0 Major. Psychology Relevant Coursework, Licenses and Certifications: -4 semesters of college Spanish -College Algebra, Calculus, Biology, Chemistry, Physiological psychology -Women's and Gender Studies -Psychology Statistics and Design -Research Design and Analysis - Human Development/Child Development -Gerontology -Field work as a preschool teacher Work Experience: Andrea Shindle Professional Counseling (970)475-0471 4625 West 20th Street Greeley, CO 80634 United States Hours per week: By appointment Therapist Duties, Accomplishments and Related Skills: -Specializing in attachment and trauma -focused treatment -Issues of permanency including foster care, kinship care and adoptions -Facilitate parenting skills, mental health and substance abuse groups Address daily therapeutic, social and mental health needs of offense -specific youth placed into custody of the Department of Youth Correction, foster care and private admit - Provide progress monitoring support to program directors in order to successfully offer effective individualized treatment to clients who enter with issues of substance abuse, violence, and sexual offenses - Weekly behavior assessments and scales - Collaborate with program directors, therapists, clinical staff and families to provide integrative patient/family treatment. University of Northern Colorado Stryker Institute for Leadership Development Graduate Facilitator Scott-Willcoxon Hall Campus Box 97 Greeley, CO 80639 United States 07/2013 — 05/2015 Hours per week: 13 Duties, Accomplishments and Related Skills: - 2 time recipient of $11,000 tuition scholarship 2013-2014 and 2014-2015 Facilitate workshops focusing on social justice, issues of identity and life span development, diversity appreciation, gender equity, advocacy and activism - Groups include large and small group activities identifying strengths, passions, areas of concern utilizing formal and informal assessment - Collaborate with fellow student and faculty to set goals of development and success in education as well as community outreach and advocacy. Research Assistant Autism and Emotional Regulation 09/2014 —12/2014 Rebecca Jesionowicz, PhD 5711 North 127th Street Omaha, NE 68164 United States Duties, Accomplishments and Related Skills: Collect data through conducting animal assisted therapy sessions to study how children diagnosed with autism can reduce aggressive behaviors and increase emotional regulation Perform analytical work by making observations and collecting data from caregivers with weekly assessments Draft research documents on results, discussion, literature reviews of previous studies as well as provide data analysis once the study is complete and all participants have received treatment. Child Advocacy Resources and Education 3700 Golden Street Evans, CO 80620 United States 0812009 -1212011 Hours per week: Varied Parent Educator Duties, Accomplishments and Related Skills: Strengthening Families Curriculum - Facilitated weekly education to parents identified as having a history of domestic violence, substance abuse or patterns of abuse/neglect Provided weekly support groups for families/couples identified as being homeless and in need of temporary residence of the Greeley Transitional House Addressed psychosocial educational needs of children ages 0-18 to prevent child abuse and reduce the risk of out of home placement in foster care/residential treatment care - Referrals for crisis/emergency intervention services to increase functioning and stability of the family Assessment support to program directors - Created curriculum presentations on how divorce affects children and adolescents for court mandated clients - Community outreach events to provide access, education and equity for families of low socioeconomic status Grace Church 6400 West 20th Street Greeley, CO 80634 United States 02/2006 - 03/2008 Hours per week: 15 Children's Ministry Director Duties, Accomplishments and Related Skills: Weekly education to children and families on spiritual and emotional development - Supervised a team of 45 volunteer members and facilitated volunteer teacher/caregiver training on issues of developmental needs, family bonding and spiritual growth Consultation to ministry staff and pastoral staff to provide and advocate for progressive and innovative programs for children and community outreach - Implemented new curriculum for children and families of a diverse community Job Related Training/Skills Certifications: Developmental Dyadic Psychotherapy Level One -June 2015 -Framework for therapy and parenting developmentally traumatized children -Developmental trauma treatment to repair attachment and process grief/loss Couples and Family Therapy UNC Psychological Services Clinic — Summer 2015 -Gottman assessment focus, Emotionally focused therapy to repair attachment Therapeutic Crisis Intervention certified- January 2015 UNC Women's Conference: Intersectionality Presenter— Fall 2014 Stryker Institute for Leadership Development Facilitator Training 2012-2015 Informed Supervisor for sexual offenses - March 2014 Social Justice Catalyst Training - January 2014 CPR/First Aid Certification - May 2014 Trauma -Based Cognitive Behavioral Therapy training - January 2013 Victim's Advocate Compensation training - February 2011 Language Skills: Language Spanish Spoken Written Intermediate Intermediate Read Intermediate Affiliations: Stryker Institute for Leadership Development - Graduate Facilitator Courage to Risk - Presenter/Guest Speaker 2015, 2016 Chi Sigma Iota, Rho Epsilon Chapter Honor Society American Counseling Association UNC Professional Counseling Leadership Fellow References: Name Employer Jeffrey Rings,University of PhD, LP (t) Northern Colorado Arvind Alternative Karwan, Homes for PhD, LP (t) Youth Yvette University of Lucero- Northern Nguyen, MA Colorado (*) (*) Indicates professional reference Title Phone Professor, 970 -351 - Professional 1639 Counseling_ Licensed 970 -531 - Psychologist, 5400 Supervisor Director, Stryker 970 -351 - Institute for 1492 Leadership Development Email jeffrev inqs@unco.edu arvind@insightpsychologicalservices.org vvette.lu ceronquvenee.unco.edu Additional Honors/Awards: Information: North Range Behavioral Health Internship/Scholarship Recipient 2015-2016 Recipient of a paid internship as well as a tuition scholarship Work with some of the highest risk adolescents in the community Commitment to community health and public policy Advocate in a field that seeks to provide quality treatment with limited resources University of Northern Colorado Inspiring Woman Nominee 2015 -Nominated by peers/colleagues -Recognized for my efforts in community service, advocacy for high risk/foster children, and strong leadership skills 2014-2016 Professional Counseling Graduate Program Leadership Fellow -Nominated and confirmed by faculty -Only 5 students chosen out of 85 graduate students -work with a team of fellow students who act as liaisons between students and faculty in order to provide an equitable and accountable environment for graduate students -attend meetings with faculty to bring concerns and ideas to grow collaboration and team approach -chosen for my ability to facilitate discussion as well as problem solve with fellow students -assist students prepare for admission, internship and graduation 2013-2014 Stryker Institute for Leadership Development Graduate Scholarship Recipient -Facilitate workshops focusing on social justice, issues of identity development, diversity appreciation, gender equity, advocacy and activism 2014-2015 Stryker Institute for Leadership Development Graduate Scholarship Recipient -Only graduate student asked to return for a second year position as a graduate facilitator 2014 University of Northern Colorado Graduate Recipient of Scholarship for Hispanic Association of Colleges and Universities National Conference - Selected to promote and improve access to and the quality of postsecondary educational opportunities for Hispanic students through the development and sharing of resources, information and expertise International Experience: Lima, Peru - June 2012 to meet with officials working the Ministerio de la Mujer y Poblaciones Vulnerables - Identify the needs in Lima and surrounding areas regarding extreme poverty, orphan care, domestic violence as well as cultural expectations of gender roles. - Returned to the US to obtain education regarding advocacy, public policy, democratic societies and effective mental health care practices would be a start to being a part of the growing community of Peruvians and Americans who are invested in protecting their citizens. - Invited to join a team to provide family rehabilitation services Additional Community Outreach: Weld County Foster Care Parent April 2008 - April 2012 As a foster parent, I provided daily psychosocial care to children and families in need of intensive treatment, support and shelter. I administered formal and informal measures of assessment to provide appropriate therapeutic interventions for children ages 0-16. I collaborated and consulted with the Department of Human Services, mental health professionals, educational professionals, law enforcement and family of origin to create treatment plans with the intention of assisting in reunification efforts by the courts. Additionally, I assisted with risk and threat assessment procedures for teenagers experiencing a need for further treatment and services. As a result of being a foster parent, my husband and I adopted three children from foster care and have since been inspired to further the efforts of family of origin preservation, rehabilitation for trauma survivors and become advocates for ethical orphan care internationally. Divorce Care Community Support Group Facilitator - Fall 2012 As a facilitator, I provided a safe environment for individuals to process and discuss issues of abuse, parenting, financial crisis as well as mental health care. This was a weekly meeting provided for individuals who benefited from a 12 week curriculum focused on recovery and family goal setting. COUNTRY +` FINANCIAL. / COUNTRY Preferred Insurance Cbmpanvre 21003 P.O. Box 2100, Bloomington, Illinois 61702-2 [00 COLORADO INSURANCE CARD SHINDLE DANNY R JR & ANDREA L POUCY NUMBER P05A7753975 2007 CHEVR SUBURB EFFECTIVE DATE Oct 08, 2015 EXPIRATION DATE Apr 08, 2016 VIN 3GNFK16387G290612 COVERAGE BODILY INJURY UABILITY PROPERTY DAMAGE LIABILITY FOR SERVICE CALL YOUR FINANCIAL REPRESENTATIVE : JONATHAN M CAESAR AT (970)682-1180 THIS CARD MUST BE CARRIED IN THE INSURED MOTOR VEHICLE FOR PRODUCTION UPON DEMAND. THE COVERAGE PROVIDED BY THIS POLICY MEETS THE MINIMUM LIABILITY INSURANCE LIMITS PRESCRIBED BY LAW. COUNTRY FINANCIAL. VOID EXHIBIT C SCOPE OF SERVICES 1. Contractor will provide time -limited Foster Parent Consultation (FPC) services to children and youth residing in Weld County foster homes, or in office, as referred by the Department. 2. The goal of FPC services is to enhance and improve the quality of care being provided to Weld County's children and youth. 3. Contractor will work collaboratively with children, foster parents, caseworkers, foster care coordinators and other service providers to identify and address issues, in a solution -focused manner, which could potentially disrupt placements. 4. Contractor will make recommendations to foster family following assessment of the child. Contractor will document recommendations and follow through of foster family with regard to recommendations. 5. Contractor will assess foster families abilities and capacity on an ongoing basis to appropriately care for the foster children in their home and report this information on a monthly basis to the Department. 6. Contractor is sensitive to family ethnicity, culture, values and beliefs. 7. Contractor will make at least three (3) attempts to contact the client and set up services. The first attempt will occur within 24 hours of receiving the referral (excluding weekends and holidays). Contractor will document efforts to engage client in referred services. If after three (3) attempts the client does not respond the Contractor will notify the caseworker and the Child Welfare Contract and Services Coordinator immediately. 8. Contractor will identify in detail areas of continued concern and make recommendations to the Department regarding continuation of services and/or the need for additional services. 9. Contractor will document in detail any and all observed or verbalized concerns regarding any child whom the Contractor is working with under an active referral. Areas of concern may include, but are not limited to, any physical, emotional, educational or behavioral issues. Areas of concern should be reported immediately AND on the required monthly report. 10. Contractor will submit reports on a monthly basis for each active referral for ongoing services. Reports will be submitted per the online format required by the Department, unless otherwise directed by the Department. 11. Contractor agrees any change to an existing referral must be pre -approved through the Child Welfare Contract and Services Coordinator, a Department -facilitated Team Decision Making (TDM) or Family Team Meeting (FTM), or by court order. A change is defined as anything outside of the approved documented service on the initial authorized referral form. This may include an increase or decrease in services hours, change in frequency, change in location of services, transportation needs, or any change to the initial referral or subsequent authorizations. 12. Contractor understands that the Department will not reimburse Contractor for "no shows" after two (2) consecutive "no shows". It is the responsibility of the Contractor to communicate "no shows" to the Department in a timely manner to determine continuation of services. 1 13. Contractor understands that the Department does not reimburse for cancelled appointments, either on the part of the client or the Contractor. 14. Contractor agrees to attend meetings when available and as requested by the Department. Such meetings include Court Facilitations, Court Staffings, Family Team Meetings and/or Team Decision Making meetings. 2 EXHIBIT D PAYMENT SCHEDULE 1. Funding and Method of Payment The Department agrees to reimburse the Contractor in consideration of the work and services performed under this Agreement at the rate specified in Paragraph 2, below. The total amount to be paid to the Contractor during the term of this Agreement shall be reported by the Department in Trails after May 31, 2017. Expenses incurred by the Contractor prior to the term of this agreement are not eligible Department expenditures and shall not be reimbursed by the Department. Payment pursuant to this Agreement, whether in whole or in part, is subject to and contingent upon the continuing availability of said funds for the purposes hereof. In the event that said funds, or any part thereof, become unavailable as determined by the Department, the Department may immediately terminate the Agreement or amend it accordingly. 2. Fees for Services $75.00/Hour (In -home, within 10 miles of 4625 West 20th Street, Greeley, Colorado 80634) $98.50/Hour (In -home, within 25 miles of 4625 West 20th Street, Greeley, Colorado 80634) $131.40/Hour (In -home, within 60 miles of 4625 West 20th Street, Greeley, Colorado 80634) Contractor may not attempt to collect co -pays and/or fees for services for which a Department client is responsible, but which a particular client refuses or fails to pay. Contractor will collect any applicable sliding scale co -pays and credit the Department for any payment received on the monthly billing. 3. Submittal of Vouchers Contractor shall prepare and submit monthly an itemized voucher, and signed monthly report if applicable, certifying that services authorized were provided on the date(s) indicated and the charges made were pursuant to the terms and conditions of Paragraph 3 and Exhibit A. Contractor shall submit all monthly billings and applicable reports to the Department by the 7th day of the month following the month the cost was incurred. Failure to submit by the aforementioned deadline may result in forfeiture of payment. a. For ongoing services, proof of services rendered shall be a Client Verification Form signed by the client and a monthly report submitted in accordance with Paragraph 3(d) of this Agreement. b. For one-time services, proof of services rendered shall be receipt of the completed product. 1 c. For Monitored Sobriety services, proof of services rendered shall be the test result. 2 HEALTHCARE PROVIDERS ORGANIZATION PURCHASING CIZA Certificate of OCCURRENCE POLICY PRODUCER BRANCH PREFIX POLICY NUMBER SERVICE GROUP 31uourauce FORM Policy Period: HP.SO 018098 970 HPG 0622364700-8 I I I Named Insured From 02/23/16 to 02/23/17 at 12:01 AM Standard Time Program Administered by: Andrea L Shindle 1561 41st Avenue Ct Greeley, CO 80634-2758 Medical Specialty Code Healthcare Providers Service Organization 159 E. County Line Road Hatboro, PA 1 9040-1 21 8 1-800-982-9491 www.hpso.com Insurance is provided by: Psychologist/Psychotherapist 80723 Excludes Cosmetic Procedures Professional Liability $1,000,000 American Casualty Company of Reading, Pennsylvania 333 South Wabash Avenue Chicago, Illinois 60604 each claim $5,000,000 aggregate • Personal Injury Liability subject to $25,000 aggregate sublimit Your professional liability limits shown above include the following: • Good Samaritan Liability • Malplacement Liability • Sexual Misconduct included in the PL Limit shown above Coverage Extensions License Protection $ 25,000 per proceeding $ 25,000 aggregate Defendant Expense Benefit $ 1,000 per day limit $ 25,000 aggregate Deposition Representation $ 10,000 per deposition $ 10,000 aggregate Assault $ 25,000 per incident $ 25,000 aggregate Includes Workplace Violence Counseling Medical Payments $ 25,000 per person $ 100,000 aggregate First Aid $ 10,000 per incident $ 10,000 aggregate Damage to Property of Others $ 10,000 per incident $ 10,000 aggregate Information Privacy (HIPAA) Fines & Penalties $ 25,000 per incident $ 25,000 aggregate Workplace Liability Workplace Liability Included in Professional Liability Limit shown above Fire and Water Legal Liability Included in the PL limit above subject to $150,000 aggregate sublimit Personal Liability $1,000,000 aggregate Total: $432.00 Premium reflects self-employed, part-time rate with ACA Membership discount Policy Forms & Endorsements (Please see attached list for a general description of many common policy forms and endorsements.) G -121500-D G -121501-C G -121503-C CNA82011 G -145184-A G -147292-A CNA81753 CNA81758 GSL13424 GSL15563 GSL15584 GSL15565 GSL17101 CNA80052 CNA80051 G -123846-005 CNA79575 Chairman of the Board Secretary Keep this Certificate of Insurance in a safe place. This Certificate of Insurance and proof of payment are your proof of coverage. There is no coverage in force unless the premium is paid in full. In order to activate your coverage, please remit premium in full by the effective date of this Certificate of Insurance. Form ft: G -141241-B (3/2010) Master Policy: 188711433 lPsa5UsNCON-H1 2➢16022LM1 POLICY FORMS & ENDORSEMENTS The list below contains general descriptions of the policy forms and endorsements that may or may not apply to your professional liability insurance policy. State specific policy forms and endorsements are not included in the list below. Should you require descriptions or samples of these documents, please visit us online at www.hpso.comtpolicyfonns. Please refer to your Certificate of Insurance for the policy forms & endorsements specific to your state and your policy period. All products and services may not be available in all states and may be subject to change without notice. Think Green —expanded definitions and copies of these policy forms and endorsements are available online at www.hpso.com/policyforms. COMMON POLICY FORMS & ENDORSEMENTS FORM # DESCRIPTION G -121500-D Common Policy Conditions G -121501-C Occurrence Policy Form G -121503-C Workplace Liability Form CNA82011 Healthcare Providers Related Claims Endorsement G -145184-A Policyholder Notice- OFAC Compliance Notice G -147292-A Policyholder Notice - Silica Mold & Asbestos Disclosure CNA81753 Cap on Losses from Certified Acts of Terrorism CNA81758 Offer of Terrorism Coverage - Disclosure of Premium GSL13424 Services to Animals G5L15563 Information Privacy Coverage Endorsement HIPAA Fines Penalties & Notification Costs GSL15564 Sexual Misconduct Sublimits of Liability Professional Liability & Sexual Misconduct Exclusion GSL15565 Healthcare Providers Professional Liability Assault Coverage GSL17101 Exclusion of Specified Activities Reuse of Parenteral Devices and Supplies CNA80052 Distribution or Recording of Material or Information in Violation of Law Exclusion Endorsement CNA80051 Amended Definition of Personal Injury Endorsement G -123846-005 Colorado Cancellation and Non -Renewal CNA79575 Exclusion of Cosmetic Procedures PLEASE REFER TO YOUR CERTIFICATE OF INSURANCE FOR THE POLICY FORMS & ENDORSEMENTS SPECIFIC TO YOUR STATE AND YOUR POLICY PERIOD. Self-employed individuals may be eligible for General Liability coverage subject to underwriting approval. Should an individual practitioners status change from self-employed to employed, general liability coverage will be deleted and replaced with workplace liability. Please contact Healthcare Providers Service Organization for details. Form #: G-141241-9 Master Policy #: 188711433 H10412 Named Insured: Andrea L Shindle Policy #: 0622364700-8 Must Be Completed ENDT. NO. POLICY NO. 1 622364790 G -123827-B (07/2001) T.O 813116 HEALTHCARE PROVIDERS PROFESSIONAL LIABILITY INSURANCE ENDORSEMENT Additional Insured — General Liability In consideration of the premium paid, and subject to the General Liability limit of liability shown on the certificate of insurance, it is agreed that the GENERAL LIABILITY COVERAGE PART is amended as follows: The person or entity named below (the "Additional Insured") is an insured under this Coverage Pare but only as respects its liability arising out of named insured's operations, or premises owned by or rented by the named insured and solely to the extent that: 1. a general liability claim is made against the named insured and the additional insured; and 2. in any ensuing litigation arising out of such claim, the named insured and the additional insured remain as co-defendants. In no event is there any coverage provided under this policy for an occurrence that is the direct liability of the additional insured. Additional Insured: County of Weld 1150 O Street Greeley. CO 80631 This endorsement is a part of your policy and takes effect on the effective date of your policy, unless another effective date is shown below. All other provisions of the policy remain unchanged. Complete Only When This Endorsement Is Not Prepared with the Policy Or Is Not to be Effective with the Policy ISSUED TO Andrea L. Shindle ENDORSEMENT EFFECTIVE DATE 8/3/16 Hello