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Home My WebLink About20161896.tiff/2 4/9( CONTRACT AGREEMENT AMENDMENT BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND PAID IN FULL, INC. (Core) This Agreement Amendment, made and entered into f� day of 2016, by and between the Board of Weld County Commissioners, on behalf of the Weld unty Department of Human Services, hereinafter referred to as the "Department", and Paid in Full, Inc., hereinafter referred to as the "Contractor". WHEREAS the parties entered into an Agreement for Role Model Mentoring (R.M.M.), (the "Original Agreement") identified by the Weld County Clerk to the Board of County Commissioners as document No. 2014-3847, approved on December 15, 2014. WHEREAS the parties hereby agree to amend the term of the Original Agreement in accordance with the terms of the Original Agreement, which is incorporated by reference herein, as well as the terms provided herein. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: • The Original Agreement ended on May 31, 2015. • The Original Agreement was renewed for the term of June 1, 2015 -May 31, 2016. The Agreement Amendment is identified by the Weld County Clerk to the Board of County Commissioners as document No. 2015-1935(1), approved on July 1, 2015. • The Amendment, together with the Original Agreement, constitutes the entire understanding between the parties. The following change is hereby made to the Contract Documents: 1. Term This agreement shall become effective on June 1, 2014, upon proper execution of this Agreement and shall expire May 31, 2017, unless sooner terminated as provided herein. 2. Exhibit B, Scope of Services, is hereby amended as attached. 3. Exhibit C, Rate Schedule, is hereby amended as attached. OAAelva /s1) ar-1-4---' 6, - 16, 2016-1896 geoof7 IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. COUNTY: ATTEST: ita/ j ` D•tA BOARD OF COUNTY COMMISSIONERS Weld Co my Clerk to the Board WELD COUNTY, COLORADO By: Deputy Cle Mike Freeman, Chair JUN 2 0 2016 CONTRACTOR: Paid in Full, Inc. 7691 Hygiene Road, #3 Longmont, Colorado 80503 (720) 226-3558 7 Jams, H. McDonald, Executive Director By: Date: °6/C,-/ 96, EXHIBIT B SCOPE OF SERVICES 1. Contractor will provide Role Model Mentoring (R.M.M.) services to children and youth referred by the Department, between the ages of six (6) and eighteen (18), who have a) either lost or been abandoned by a parent, and/or; 2) are currently clients of Compass, Youth Services, Child Welfare or Adoption. 2. Contractor and the Department will collaboratively deliver and refine Role Model Mentor services and evidence -informed practices and outcomes in the areas of: • A community -wide system to meet the needs of youth who have lost or been abandoned by a parent and are in need of positive relationships. • Specific mentoring plans will incorporate the Role Model Mentor steps to include individualized parenting support sessions, family alliance building, and "Best Day Ever!" events. • Contractor is responsible for all organization, implementation and staffing entire program. • Case management services include interviewing, assessing, making appropriate side -by -side home visits, accepting the assignment of specific cases for the purposes of delivering the Role Model Mentor program, documenting progress of goals listed in individual family services plans and follow-up contact. Case management also encompasses IT support, training of Life Coaches, planning/scheduling and travel time. 3. Each referred youth will begin services at Level 1 and progress to a higher level at the discretion of the Department. Services are individual to the referred youth but will include the activities and/or supplies identified below. a. Level 1— Intro to RMM 12 Core Values (4 Sessions) • Intro to Best Effort (Explain and demonstrate Best Effort through RMM Challenges) • Intro to Camaraderie (Explain and demonstrate Camaraderie through RMM Challenges) • Intro to Work as a Team (Explain and demonstrate Teamwork through RMM Challenges) • Prep and Test for Level 2 (List and Demonstrate RMM 12 Core Values) • Administration (Scheduling, communication, web support, travel) b. Level 2 — RMM Family Club (12 sessions) • RMM Family Club 1-4 sessions (RMM Best Effort: Give YOUR best effort, make every effort count, keep the main thing the main thing, do your best and forget the rest) • RMM Family Club 5-8 sessions (RMM Camaraderie: Meet new people, build strong community, invest time with family, demonstrate appropriate social skills) 1 • RMM Family Club 9-12 sessions (RMM Work as a Team: Create a game, plan discuss results, problem solve, execute a game plan) • RMM Mini Camp (Food and activity supplies) • Administration (Scheduling, communication, web support, travel) c. Level 3 — Pass On RMM 12 Core Values (4-6 sessions) • Special Guest at Club (4 times) • Dare to be Great Project (Activity supplies and costs) • Administration (Scheduling, communication, web support, travel) 4. At a minimum, the Role Model Mentor program, through its collaboration between Contractor and the Department, will document if: a. The project successfully focused resources within Department and CONTRACTOR to continue the Role Model Mentor program. b. The project successfully developed a better system design to meet the needs of youth and families in regards and, at a minimum, to: • Better utilization of strengths within the family to promote protective factors. • Increase attendance rates of youth in school. • 85% of youth who successfully discharge from the program will continue to reside at home and have not entered the juvenile justice system at the time of discharge. 5. Referral Process: a. Contractor will access all referrals through an intake interview with the family in order to ensure that the family will commit to the necessary time resources in order to support a successful intervention. 6. Role of Department: a. Department will assign its Supervisor(s) to screen referrals, oversee client staffing and supervision, family service plan and service plan approvals. b. Department will be responsible for the identification and referral of youth and families to the Role Model Mentor program. c. Department case managers/workers will be responsible for ensuring potential clients fully understand the program before they are referred. d. Department case managers/workers may participate in Best Day Ever development plans and events with their client. 7. Role of Contractor: a. Contractor agrees to participate in the functions of the project as follows: • As a policy and program developer and planning partner for the project by attending meetings and utilizing other forms of communication. 2 • As the case manager to provide intervention and connection skills for program services and post -participation services, as appropriate. b. Contractor agrees not to transport any of the youth or their families. c. Contractor agrees to screen, train and complete criminal background checks on all of their volunteer mentors who associate with youth in the Role Model Mentor program who meet with youth outside the presence of the family, case worker or Role Model Mentor program employee. d. Contractor agrees to serve up to 75 youth under this agreement. The number of eligible youth and families will be prorated based on the time period that Contractor provided Role Model Mentor (R.M.M.) programming. 8. 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 Prevention Services Unit Supervisor. 9. 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. 10. 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. 11. 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. 12. 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. 13. Contractor understands that the Department will not reimburse Contractor for "no shows" or cancelled appointments, either on the part of the client or the Contractor. 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. 3 EXHIBIT C 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 $195.00/Episode (One-time fee/client. Level 1- Intro to Best Effort $195.00/Episode (One-time fee/client. Level 1 - Intro to Camaraderie $195.00/Episode (One-time fee/client. Level 1 - Intro to Work as a Team) $90.00/Episode (One-time fee/client. Level 1- Prep and Test for Level 2) $1,165.00/Episode (One-time fee/client. Level 2 — R.M.M. Family Club 1-12 sessions) $200.00/Episode (One-time fee/client. Level 2 — 2nd R.M.M. Family Club 1-12 sessions) $610.00/Episode (Level 2 — R.M.M. Mini Camp) $42.00/Episode (Level 3 - Special Guest at Club, Up to 4 times) $158.00/Episode (Level 3 - Dare to be Great Project) $30.00/Session (Additional Fee. Individual R.M.M. Sessions) 1 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. c. For Monitored Sobriety services, proof of services rendered shall be the test result. 2 ACOR0® CERTIFICATE OF LIABILITY INSURANCE �� DATE(MM/DD/YYYY) 6/3/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Colorado Insurance Sales and Services, Inc. 7901 Southpark Plaza Suite 208 Littleton CO 80120 INSURED Paid in Full Inc 7691 Hygiene Rd Apt 3 Longmont CO 80503 CONTACT The Darkside NAME: (720) 263-1726 I NAIC # 11000 I rt I A/C. No. Extl: ONE (720)283-1722 FA/C, Noj: --- ADDRIESS:matt.travis@buycoloradoinsurance.com INSURER(S) AFFORDING COVERAGE INSURER A:Hartford Sentinal INSURER B : INSURER C : INSURER D : - INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:CL166302152 REVISION NUMBER: THIS IS TO CERTIFY THAT INDICATED. NOTWITHSTANDING CERTIFICATE MAY BE ISSUED EXCLUSIONS AND CONDITIONS INSR LTR � TYPE OF INSURANCE THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. THE POLICY PERIOD TO WHICH THIS ALL THE TERMS, ,ADDL'SUBR POLICY EFF POLICY EXP I I INSD WVD ' POLICY NUMBER . IMMIDD/YYYY) ; (MM/DDfYYYY) • LIMITS GENERAL t A I CLAIMS -MADE j _ _ _ AGGREGATE LIMIT APPLIES GEN'L PRO- POLICY--- _ _ JECT I OTHER: LIABILITY EACH OCCURRENCE l' $ 1,000,000 � 1,000,000 $__-. I DAMAGE TO RENTED XJ OCCUR I ! I PREMISES (Ea occurrence) X 34SBMII7091 1 6/17/2016 6/17/2017 MED EXP (Any one person) $ 10,000 � PERSONAL & ADV INJURY $ 1,000,000 PER: GENERALAGGREGATE$ 2,000 000 ! LOC2,000,000 i PRODUCTS - COMP/OP AGG _-_- $ 2 , 000 000 Non -owned I $ 1,000,000 AUTOMOBILE LIABILITY ----- _ ANY AUTO _, AUTOS OWNED - J HIRED AUTOS _ -_ COMBINED SINGLE LIMIT ! (Ea accident) $ $ - --- - _ $ BODILY INJURY (Per person) I SCHEDULEDBODILY (Per l �� PR0PERINJURY TY DAMAGEacGdent) (Per accident _ I '$ ___.J UMBRELLA ------- • EXCESS LIABAB L DED I , RETENTION OCCUR I EACH OCCURRENCE I — !, AGGREGATE CLAIMS -MADE $ -- --_- -__- $ $ - ! $ WORKERS AND EMPLOYERS' ELIABILITY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/ME ' I ANY MBER (Mandatory in NH) ff yes, describe under DESCRIPTION OF OPERATIONS I PER OTH I STATUTE I ER j $ __ - $ --- ----- $ YIN •i_ I : N / AEXCLUDED? , ' I I E.L. EACH ACCIDENT --�- --- • I E.L. DISEASE - EA EMPLOYE �'------- below I E.L. DISEASE POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION County of Weld 1150 'O' Street Greeley, CO 80631 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Matt Travis ACORD 25 (2014/01) INS025 (701401 ) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Hello