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Home My WebLink About20143263.tiff RESOLUTION RE: APPROVE TWO (2) CHILD PROTECTION AGREEMENTS FOR SERVICES WITH VARIOUS PROVIDERS AND AUTHORIZE CHAIR TO SIGN WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with two (2) Child Protection Agreements for Services between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Human Services, and various providers, commencing June 1, 2014, and ending May 31, 2015,with further terms and conditions being as stated in said agreements, and WHEREAS, after review, the Board deems it advisable to approve said Child Protection Agreements for Services, copies of which are attached hereto and incorporated herein by reference. NOW,THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the two (2) Child Protection Agreements for Services between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Human Services, and various providers be, and hereby are, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said agreements. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 22nd day of October, A.D., 2014, nunc pro tunc June 1, 2014. BOARD OF COUNTY COMMISSIONERS �,,/ COUNTY, � ORADO o,� ^ ATTEST: ((�� ,,/ L `Y GI dd.; Weld County Clerk to the Board `�-arbara Kirkmeyer, ro-Tem B O Q QLl o' er' ®` D ppii ty Clerk to the oar P. Conway �— AP" .V % AS ,-/��•�. : r w • ee . . orney William F. Garcia Date of signature ICAO 2014-3263 HR0065 /01- CC;Hsn /3i X861 MEMORANDUM „ ELDATE: October 16,2014 G 0 N T TO: Douglas Rademacher, Chair, Board of Co ty Comnssio rs FROM: Judy A. Griego, Director, Human Service epa SUBJECT: Child Protection Agreements for Services tween the Weld County Department of Human Services and Various Providers Enclosed for Board approval are Child Protection Agreements for Services between the Department and Various Providers. These Agreements were reviewed under the Board's Pass-Around Memorandum dated May 22, 2014, and approved for placement on the Board's Agenda. There are a total of 45 agreements with various providers; the following represent the next 2 agreements received leaving 1 agreement needing to be signed by the Board Chair. The last Agreement is not being processed at this time. The major provisions of these Agreements are as follows: Program Area/ No. Provider Funding Source PY14-15 Rate(s) 1 Lindstrom, Barry R Mental Health Services Ph.D., LLC $325.00/Hour(Ph.D. - Mental Health Assessmei Core Psychological Evaluation. Interactional Evaluatih 06/01/14-05/31/15 $125.00/Hour(Ph.D. - Individual Therapy. Clinical or Educational Staffings.) $65.00/Hour(M.S. - Individual Therapy) $150.00/Hour(Ph.D. - Family Therapy. Court Staffing/Court Facilitation/Family Team Meeting Team Decision Making Meetings. Case Consultation.) $75.00/Hour(M.S. - Individual Therapy. Court Staffing/Court Facilitation/Family Team Meeting /Team Decision Making Meetings. Clinical or Education Staffings.) 2 Poudre Valley Health Home Based Intensive $1,800.00/Month (Regular In-home Wraparound) Care, Inc., DBA Services $60.00/Day(Partial Monthly Services - Regular Poudre Valley Health In-home Wraparound) System (Mountain Core $1,000.00/Month (in-home Wraparound-Therapist Crest) Only) $33.00/Day (Partial Monthly Services- Therapist 06/01/14-05/31/15 Only) $800.00/Month (In-home Wraparound- Facilitator Only) $26.00/Day (Partial Monthly Services - Facilitator Only) If you have any questions, give me a call at extension 6510. 2014-3263 PY-14-15-CORE-0141 CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND BARRY R. LINDSTROM, PH.D., LLC 0.4 This Agreement, made and entered into theia day of Onirher 2014 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 Barry R. Lindstrom, Ph.D., LLC, 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 Department's Request for Proposal, Exhibit B, Scope of Services, Exhibit C, Contractors Response to the Request for Proposal, 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 Mental Health Services and . 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, 2014 upon proper execution of this Agreement and shall expire May 31, 2015 unless sooner terminated as provided herein. 2. Scope of Services Services shall be provided by the Contractor to any person(s) eligible for services in compliance with Exhibit A, Weld County's Request for Proposal,and Exhibit B, 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 1 PY-14-15-CORE-0141 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 7`h of the month, following the month of service,utilizing billing forms required by the Department. d. Contractor agrees to submit a monthly report with the billing statement by the 7`h 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 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,Department's Request for Proposal, Exhibit B, Scope of Services, Exhibit C,Contractor's Response to the Request for Proposal, 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 2 PY-14-15-CORE-0141 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 A, Department's Request for Proposal, Exhibit B, Scope of Services,, Exhibit C, Contractor's Response to the Request for Proposal, 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 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 3 PY-14-15-CORE-0141 - 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. 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. 4 PY-14-15-CORE-0141 e. Contractor certifies that it shall comply with the provision of the Colorado Revised Statutes(C.R.S.)8- 17.5-101, et. seq. Contractor 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 to the Contractor that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this Agreement. Contractor represents,warrants,and agrees that it(a) has verified that it does not employ any illegal aliens,through participation in the Basic Pilot Employment Verification Program administered by the Social Security Administration and Department of Homeland Security,and(b)otherwise will comply with the requirements of C.R.S.8-17.5-102(2)(b). Contractor shall comply with all reasonable requires made in the course of an investigation under C.R.S.8-17.5-102 by the Colorado Department of Labor and Employment. If Contractors fails to comply with any requirement of this provision or C.R.S.8-17.5-101, et.seg.,the Department may terminate this Agreement for breach and Contractor shall be liable for actual and consequential damages to the Department. Except where exempted by Federal law and except as provided in C.R.S.24-76.5-103(3),if Contractor receives federal or state funds under this Agreement,Contractor 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 this Agreement. If Contractor operates as a sole proprietor, it hereby affirms under penalty of perjury that s/he(a) is a citizen of the United States or is otherwise lawfully present in the United State 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 this Agreement. 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. 5 PY-14-15-CORE-0141 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 the Agreement,or any extension thereof,during any warranty period, and for three(3)years after termination of the Agreement.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: i. 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. 6 PY-14-15-CORE-0141 iii. 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. g. 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. 7 PY-14-15-CORE-0141 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. Trainin 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. 8 PY-14-15-CORE-0141 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 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: For Contractor: Heather Walker,Administrator Barry R. Lindstrom, Ph.D. Licensed Psychologist 17. Notice 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: For Contractor: Judy A.Griego, Director Barry R.Lindstrom, Ph.D. P.O. Box A 3211 20th Street,Suite D Greeley, CO 80632 Greeley, CO 80634 (970)352-1551 (970)356-3100 18. Litigation 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. 9 PY-14-15-CORE-0141 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. 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. sea.,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 10 PY-14-15-CORE-0141 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, 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. 11 PY-14-15-CORE-0141 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 Contractor agrees it is an independent contractor and that its officers and employees do not become employees of Weld County,nor are they entitled to any employee benefits as Weld County employees,as the result of this Agreement. 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,8,C,and D. 31. Acceptance of Services Not a Waiver 12 PY-14-15-CORE-0141 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. 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. Attorneys Fees/Legal Costs 13 PY-14-15-CORE-0141 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. 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 Wy.{#44k. WELD COUNTY, C ORADO Weld County Clerk to the Board / � (� fl 92+Plnko/v' IS R)emacher, hair i F IS L®OCT 2 2 2O14 By: Deputy Clerk to the Board 1861 I qp 404CAPPROVED AS TO FORM: APPROVED AS TO FUNDING: County Attorney Controller WELD COUNTY DEPARTMENT CONTRACTOR: OF HUMAN SERVICES By: By: d A. Grie o, Direct Barry R. Lindstrom, Ph.D 14 WELD COUNTY'S REQUEST FOR PROPOSAL Bid No. B1400069 BOARD OF COUNTY COMMISSIONERS OF THE COUNTY OF WELD, STATE OF COLORADO, BY AND THROUGH THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES DATE: 03/05/2014 PAGES 1-4 OF THIS REQUEST FOR PROPOSAL CONTAIN GENERAL INFORMATION. NOT ALL OF THE INFORMATION CONTAINED IN PAGES 1-4 MAY BE APPLICABLE. SPECIFICATIONS UNIQUE TO THIS REQUEST FOR PROPOSAL FOLLOW PAGE 4. 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 SERVICES (AS DESCRIBED ON PAGES 12-14) 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: WEDNESDAY, MARCH 21, 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 12-14). 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, Service Utilization 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. B1400069 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, Service Utilization 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. B1400069 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. Contractor certifies that it shall comply with the provisions of Colorado Revised Statutes (C.R.S.) 8-17.5-101, et seq. Contractor shall not knowingly employ or contract with an illegal alien to perform work under this Contract or enter into a contract with a subcontractor that fails to certify to Contractor that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this Contract. Contractor represents, warrants, and agrees that it (a) has verified that it does not employ any illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by the Social Security Administration and Department of Homeland Security, and (b) otherwise will comply with the requirements of C.R.S. 8-17.5-102(2)(6). Contractor shall comply with all reasonable requests made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and Employment. If Contractor fails to comply with any requirement of this provision or C.R.S. 8-17.5-101, et seq., Weld County may terminate this Contract for breach and Contractor shall be liable for actual and consequential damages to Contractor. Except where exempted by federal law and except as provided in C.R.S. 24-76.5- 103(3), if Contractor receives federal or state funds under this Contract, Contractor 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 this Contract. Page 3 Bid No. B1400069 If Contractor 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 a Contract. M. All goods shall remain the property of the seller until delivered to and accepted by Weld County, Colorado. N. 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, 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. Page 4 Bid No. B1400069 B. 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. C. 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 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. D. 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. E. 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. F. 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. expressly understood and agreed G. No Third Party Beneficiary Enforcement: It is p y g 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 Page 5 Bid No. B1400069 beneficiary only. H. 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. 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, during any warranty period, and for three (3) years after termination of the Agreement. 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. 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. (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: Page 6 Bid No. B1400069 * $1,000,000 each occurrence; * $2,000,000 general aggregate; * $2,000,000 products and completed operations 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 * 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. iii. 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 on Page 7 Bid No. 81400069 www.lns-Cert.com and link the information to 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. 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 8 Bid No. B1400069 Project Overview: The Weld County Department of Human Services (WCDHS) is seeking various services. Service areas include, but are not limited to, Anger Management/Domestic Violence, Day Treatment, Foster Parent Consultation, Foster Parent Training, Functional Family Therapy, Home Studies/Relinquishment Counseling, Life Skills, Mediation, Mental Health, Monitored Sobriety, Multi-Systemic Therapy, Home Based Intensive Services, Sexual Abuse Treatment, and Substance Abuse Treatment Services and Aftercare Services. Refer to pages 12-14 for specific definitions related to the above-mentioned service areas. Qualifications: To be considered, a bidder must meet the following minimum qualifications: 1) A bidder must submit a completed Provider Information Form. 2) 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. 1) 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. 3) 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. 4) A bidder must demonstrate the knowledge, training and expertise to conduct the proposed service(s). 5) A bidder must provide a current resume, as well as proof of licensure, for self and staff members. 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). 6) A bidder must demonstrate familiarity with Trauma Inform ed 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. Page 9 Bid No. B1400069 7) A bidder must demonstrate prior and current capacity to be organized, responsive and to quickly and successfully schedule services as requested. 8) 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 shall commence on June 1, 2014, through May 31, 2015, 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. 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: 2) Completed Provider Information Form with original signature of authorized representative. 3) 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. 4) 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. 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. Page 10 Bid No. B1400069 6) 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. 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. 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 11. Bid No. B1400069 SERVICE AREA DEFINITIONS Program.Area # = ""°� Definition , ,;.- 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. 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. 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. Page 12 Bid No. B1400069 Program Area a '{ Definition _£ ' -R. Homes Studies/Relinquishment Counseling Home studies and home study updates per the standardized SAFE home study tool for the purpose of adoption, foster care, and expedited permanency planning. Relinquishment counseling for parents considering relinquishment of their children. 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. 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. Sex Abuse Treatment Therapeutic intervention designed to address issues and behaviors related to sexual abuse victimization, sexual dysfunction, sexual abuse perpetrations, and to prevent further sexual abuse and victimization. Page 13 Bid No. B1400069 Program Area ; - 4 Definition F TVZ 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 14 Bid No. B1400069 EXHIBIT A CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND «C0NTRACT0R1» This Agreement, made and entered into the_day of , 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 «Contractors», 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 Department's Request for Proposal, Exhibit B, Scope of Services, Exhibit C, Contractor's Response to the Request for Proposal, 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 « funding»to the Department for «Services»; and NOW THEREFORE, in consideration of the premises,the parties hereto covenant and agree as follows: 1. Term This agreement shall become effective on «TermStartn, upon proper execution of this Agreement and shall expire«TermEndu, unless sooner terminated as provided herein. 2. Scope of Services Services shall be provided by the Contractor to any person(s) eligible for services in compliance with Exhibit A, Weld County's Request for Proposal, and Exhibit B, 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 1 Bid No. B1400069 through the Department's Resource Manager, Child Welfare Contract and Services Coordinator,or through a Team Decision Making(TOM)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. 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, Department's Request for Proposal, Exhibit B, Scope of Services,, Exhibit C,Contractor's Response to the Request for Proposal,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 2 Bid No. B1400069 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 A, Department's Request for Proposal, Exhibit B,Scope of Services,, Exhibit C, Contractor's Response to the Request for Proposal, 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 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 3 • Bid No. B1400069 - 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.5.) 26-6-104, requiring criminal background record checks for all employees, contractors and sub-contractors. 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«funding». 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. 4 Bid No. B1400069 e. Contractor certifies that it shall comply with the provision of the Colorado Revised Statutes(C.R.S.)8- 17.5-101, et. seq. Contractor 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 to the Contractor that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this Agreement. Contractor represents,warrants, and agrees that it (a) has verified that it does not employ any illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by the Social Security Administration and Department of Homeland Security,and (b) otherwise will comply with the requirements of C.R.S.8-17,5-102(2)(b). Contractor shall comply with all reasonable requires made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and Employment. If Contractors fails to comply with any requirement of this provision or C.R.S.8-17.5-101, et seq., the Department may terminate this Agreement for breach and Contractor shall be liable for actual and consequential • damages to the Department. Except where exempted by Federal law and except as provided in C.R.S. 24-76.5-103(3), if Contractor receives federal or state funds under this Agreement, Contractor 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 this Agreement. If Contractor operates as a sole proprietor, it hereby affirms under penalty of perjury that s/he(a) is a citizen of the United States or is otherwise lawfully present in the United State 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 this Agreement. 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 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 5 Bid No. 81400069 Commissioners of Weld County, its employees, volunteers and agents. Contractor shall provided the liability(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. 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. - Standard Workman's Compensation and Employer's Liability o As required by State statute including occupational disease,covering all employees at the work site. - General Liability(PL and PD) (Minimum) o Combined single limit-$500,000.00 written on an occurrence basis. o Additional insurance required if claims reduce the annual aggregate below$500,000.00. o Weld County, State of Colorado,to be named as additional insured on each comprehensive general liability policy. o Certificate of Insurance to be provided to Weld County. o Insurance shall include provision preventing cancellation without 60 days prior notice by certified mail to Weld County. - Automobile Liability(Minimum)for any Contractor transporting children or any party to whom Department services are being provided. - Additional coverage may be required in specific program areas. For any insurance that are required by this Agreement,a completed Standard Certificate of Insurance shall be provided to the Department by the Contractor prior to the start of any Agreement. 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 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 6 Bid No. B1400069 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. 7 Bid No. B1400069 - 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. 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: For Contractor: Heather Walker, Administrator «RepFName»«RepLName»,«RepTitle» 17. Notice 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: For Contractor: Judy A.Griego, Director «NoticeFName» «NoticeLName», P.O.Box A «Addressl», «Address2» Greeley, CO 80632 «City»,«State» «Zip» (970)352-1551 «Phone» 18. Litigation 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. 8 Bid No. 81400069 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 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 relationship 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, 9 Bid No. B1400069 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, 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 10 Bid No. B1400069 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 Contractor agrees it is an independent contractor and that its officers and employees do not become employees of Weld County, nor are they entitled to any employee benefits as Weld County employees,as the result of this Agreement. 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. 11 Bid No. B1400069 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. 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. 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. 12 Bid No. B1400069 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,COLORADO Weld County Clerk to the Board Douglas Rademacher,Chair By: Deputy Clerk to the Board APPROVED AS TO FORM: County Attorney WELD COUNTY DEPARTMENT «CONTRACTOR1» OF HUMAN SERVICES By: By: Judy A. Griego, Director «SigFName» «SigLName», «Title» 13 Bid No. B1400069 EXHIBIT A REQUEST FOR PROPOSAL Bid No. B1400069 BOARD OF COUNTY COMMISSIONERS OF THE COUNTY OF WELD, STATE OF COLORADO, BY AND THROUGH THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES DATE: 03/05/2014 PAGES 1-4 OF THIS REQUEST FOR PROPOSAL CONTAIN GENERAL INFORMATION. NOT ALL OF THE INFORMATION CONTAINED IN PAGES 1-4 MAY BE APPLICABLE. SPECIFICATIONS UNIQUE TO THIS REQUEST FOR PROPOSAL FOLLOW PAGE 4. 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 SERVICES (AS DESCRIBED ON PAGES 12-14) 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: WEDNESDAY, MARCH 21, 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 12-14). 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, Service 14 Bid No. B1400069 Utilization 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. 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, Service Utilization 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. 15 Bid No. B1400069 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 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. Contractor certifies that it shall comply with the provisions of Colorado Revised Statutes (C.R.S.) 8-17.5-101, et seq. Contractor shall not knowingly employ or contract with an illegal alien to perform work under this Contract or enter into a contract with a subcontractor that fails to certify to Contractor that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this Contract. Contractor represents, warrants, and agrees that it (a) has verified that it does not employ any illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by the Social Security Administration and Department of Homeland Security, and (b) otherwise will comply with the requirements of C.R.S. 8-17.5-102(2)(b). Contractor shall comply with all reasonable requests made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and Employment. If Contractor fails to comply with any requirement of this provision or C.R.S. 8-17.5-101, et seq., Weld County may terminate this Contract for breach and Contractor shall be liable for actual and consequential damages to Contractor. 16 Bid No. B1400069 Except where exempted by federal law and except as provided in C.R.S. 24-76.5- 103(3), if Contractor receives federal or state funds under this Contract, Contractor 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 this Contract. If Contractor 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 a Contract. M. All goods shall remain the property of the seller until delivered to and accepted by Weld County, Colorado. N. 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, 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. 17 Bid No. B1400069 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. 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. C. 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 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. D. 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. E. 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. F. 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. G. 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 18 Bid No. B1400069 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. H. 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. 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, during any warranty period, and for three (3) years after termination of the Agreement. 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. 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. 19 Bid No. B1400069 (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; * $2,000,000 products and completed operations 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: * excess/umbrella liability, liquor liability and Policies for all general liability, y, q 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. (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. iii. 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 20 Bid No. B1400069 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 on www.lns-Cert.com and link the information to 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. 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. 21 Bid No. B1400069 Project Overview: The Weld County Department of Human Services (WCDHS) is seeking various services. Service areas include, but are not limited to, Anger Management/Domestic Violence, Day Treatment, Foster Parent Consultation, Foster Parent Training, Functional Family Therapy, Home Studies/Relinquishment Counseling, Life Skills, Mediation, Mental Health, Monitored Sobriety, Multi-Systemic Therapy, Home Based Intensive Services, Sexual Abuse Treatment, and Substance Abuse Treatment Services and Aftercare Services. Refer to pages 12-14 for specific definitions related to the above-mentioned service areas. Qualifications: To be considered, a bidder must meet the following minimum qualifications: 1) A bidder must submit a completed Provider Information Form. 2) 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. 1) 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. 3) 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. 4) A bidder must demonstrate the knowledge, training and expertise to conduct the proposed service(s). 5) A bidder must provide a current resume, as well as proof of licensure, for self and staff members. 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). 6) 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. 22 Bid No. B1400069 7) A bidder must demonstrate prior and current capacity to be organized, responsive and to quickly and successfully schedule services as requested. 8) 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 shall commence on June 1, 2014, through May 31, 2015, 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. 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: 2) Completed Provider Information Form with original signature of authorized representative.ative. 3) 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. 4) Sufficient information proposed concerning each 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. 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. 23 Bid No. 61400069 6) 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. 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. 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. 24 Bid No. 81400069 SERVICE AREA DEFINITIONS Pro rarAre ; trt" 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. 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. 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. 25 Bid No. B1400069 { �' Definitions r 4; y; PragaVAr t Homes Studies/Relinquishment Counseling Home studies and home study updates per the standardized SAFE home study tool for the purpose of adoption, foster care, and expedited permanency planning. Relinquishment counseling for parents considering relinquishment of their children. 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. 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. Sex Abuse Treatment Therapeutic intervention designed to address issues and behaviors related to sexual abuse victimization, sexual dysfunction, sexual abuse perpetrations, and to prevent further sexual abuse and victimization. 26 Bid No. B1400069 . .� ter" . A' B ProgrmArea s tc, 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. 27 Bid No. B1400069 EXHIBIT B SCOPE OF SERVICE 1. 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. 2. 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. Upon receipt of an invitation from the Department,Contractor must contact the Child Welfare Contract and Services Coordinator to request approval to bill for participation if Contractor wishes to be reimbursed. The Department will reimburse for actual participation in the meeting only so long as the meeting is at least one hour in length,the Contractor requests approval to bill in advance of the meeting and participation in the meeting is deemed appropriate and necessary by the Department. Staffings and/or meetings other than those listed above are not considered reimbursable unless otherwise approved by the Child Welfare Contract and Services Coordinator. 3. 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. 28 Bid No. B1400069 EXHIBIT C CONTRACTOR'S RESPONSE TO THE REQUEST FOR PROPOSAL 29 Bid No. B1400069 EXHBIT 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, 2015. 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 «Rate Schedule» 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. 30 CONTRACTOR'S RESPONSE TO THE REQUEST FOR PROPOSAL Barry R. Lindstrom, Ph.D., LLC Licensed Psychologist 3211-20th Street, Suite D Greeley, CO 80634 (970) 356-3100 March 20, 2014 Tobi Vegter, Core and Service Contract Coordinator Service Utilization Unit Weld County Department of Human Services (WCDHS) 3I5A North 11th Avenue Greeley, CO 80632 VIA e-mail: Vegterta@weldgov.com RE: BID NO: B 1400069 WCDHS Core Contract Proposal for Mental Health; PY2014-15 Dear Ms. Vegter and Families, Youth and Children Commission reviewers: Attached are the CORE Contract Proposal and supporting documents for Barry R. Lindstrom, PhD, LLC, for the 2014-15 contract year. The proposal includes the same Mental Health Services for evaluation, treatment and consultation with no increase in rates since 2008. Barry R. Lindstrom, PhD, LLC will provide contracted Mental Health Services including: Individual Mental Health Assessments and Psychological Evaluations for children, adolescents and adults, and Family Psychological Evaluations (Parent Child Interactional, PCI; and Sibling Interactional evaluations); Individual, Couples and Family therapy; attendance at Team Decision Making (TDM), Family Team Meeting (FTM), and Court Facilitation Staffings; Expert Testimony in Court; and Consultation and Inservice training for Caseworkers and Foster Parents. Barry R. Lindstrom, PhD, LLC is the private practice of Barry Lindstrom, PhD, Licensed Psychologist in Colorado since 1989, and Bonnie S. Lindstrom, MS, LPC, Licensed Professional Counselor in Colorado since 2010. Unless otherwise indicated or arranged, all clinical services will be provided at the offices of Pathways at 3211 20"' St., Suite D, Greeley, CO 80634. Dr. Lindstrom can attend family visitation at the Parent Education Center or South County office as needed to complete portions of Parent Child Interactional Assessments. Dr. Lindstrom has over 25 years of experience in clinical assessment and intervention, and has studied and used a Trauma-informed model throughout his practice. He integrates neuro- developmental, trauma-focused, and multigenerational family systems emphases in his evaluations and clinical work. He is familiar with the work of the Chadwick Trauma-Informed Systems Project(CTTSP,) the Child Trauma Academy and the work of Dr. Bruce Perry, and the National Child Traumatic Stress Network (NCTSN). Dr. Lindstrom has presented numerous times on Trauma, PTSD and Vicarious Trauma (in caseworkers, foster parents, therapists, attorneys and judicial officers,) including the Third Cover Letter March 20, 2014 Vendor: Barry R. Lindstrom, Ph.D., LLC Page 2 BID NO: B 1400069 Program Category: Mental Health Services Colorado Summit on Children, Youth and Families for the Colorado Department of Human Services in May 2012 at Keystone, CO. Barry R. Lindstrom, PhD, LLC has demonstrated ability and reliability in providing these services in the past. We will continue to prioritize and organize our contacted services with the Department in keeping with our past capacity and responsiveness to your clients and staff We look forward, if accepted, to entering into a contract for another year of working with you and your staff. Sincerely, 17 ism , Barry R. Lindstrom, PhD Licensed Psychologist Licensed School Psychologist Barry R. Lindstrom, Ph.D., LLC Licensed Psychologist 3211-20`h Street, Suite D Greeley, CO 80634 (970) 356-3100 March 20, 2014 TO: Tobi Vegter, Core and Service Contract Coordinator Service Utilization Unit Weld County Department of Human Services (WCDHS) 315A North 11`x' Avenue Greeley, CO 80632 VIA e-mail: Vegterta@weldgov.com RE: BID NO: B1400069 WCDHS Core Contract Proposal for Mental Health; PY2014-15 INTRODUCTION: Barry R. Lindstrom, PhD, LLC is the private practice of Barry Lindstrom, PhD, Licensed Psychologist in Colorado since 1989, and Bonnie S. Lindstrom, MS, LPC, Licensed Professional Counselor in Colorado since 2010. Barry R. Lindstrom, PhD, LLC will provide contracted Mental Health Services including: Individual Mental Health Assessments and Psychological Evaluations for children, adolescents and adults, and Family Psychological Evaluations (Parent Child Interactional, PCI; and Sibling Interactional evaluations); Individual, Couples and Family therapy; attendance at Team Decision Making(TDM), Family Team Meeting (FTM), and Court Facilitation Staffings; Expert Testimony in Court; and Consultation and Inservice training for Caseworkers and Foster Parents. Dr. Lindstrom has over 25 years of experience in clinical assessment and intervention, and has studied and used a Trauma-informed model throughout his practice. He integrates neuro-developmental, trauma- ' focused, and multigenerational family systems emphases in his evaluations and clinical work. He is familiar with the work of the Chadwick Trauma-Informed Systems Project (CTISP,) the Child Trauma Academy and Dr. Bruce Perry, and the National Child Traumatic Stress Network. Mrs. Lindstrom has fewer years of experience, but works with similar probelms and maintains her license with ongoing continuing education. Dr. Lindstrom has presented numerous times on Trauma, PTSD and Vicarious Trauma (in caseworkers, foster parents, therapists, attorneys and judicial officers,) including the Third Colorado Summit on Children, Youth and Families for the Colorado Department of Human Services in May 2012 at Keystone, CO. Barry R. Lindstrom, PhD, LLC has demonstrated ability and reliability in providing these services in the past and we continue to place a priority on providing appointment times for the clients and staff of WCDHS. Caseworkers are consulted with frequently during the course of evaluation, treatment, or March 20, 2014 Vendor: Barry R. Lindstrom, Ph.D., LLC Page 2 BID NO: B 1400069 Program Category: Mental Health Services consultation and reports are completed in a timely manner to meet Court hearings and deadlines wherever possible. Unless otherwise indicated or arranged, all clinical services will be provide at the office of Pathways at 3211 20th St., Suite D, Greeley, CO 80634, where Dr. and Mrs. Lindstrom maintain their office and contract with Pathways Management, LLC, for professional business services. Dr. Lindstrom can attend family visitation at the Parent Education Center or South County office as needed to complete portions of Parent-Child or Sibling Interactional Assessments. SCOPE OF SERVICES: Mental Health Services A. Evaluation Services: Mental Health Assessments are provided for individual Children, Adolescents or Adults. These will be conducted only by Dr. Lindstrom. These are a brief(typically 2, one-hour interviews approximately 2 weeks apart, and mental health screening instruments) assessment of an individual's mental health functioning to answer diagnostic and treatment recommendation questions outlined by the Department. These assessments can typically be completed in a month or less, depending on the client's availability and cooperation. If further psychological testing is indicated, a complete Psychological Evaluation (see below) will be recommended and completed if approved. Assessments will include a review of WCDHS social history and family services plan, but minimal collateral information. Psychological screening instruments, but no formal Psychological testing will be included. For Adults this will typically include: Beck Depression Inventory, Beck Anxiety Inventory, Penn Inventory for PTSD, and Stressful Life Events Questionnaire, Rotter Incomplete Sentences, Mood Disorder Questionnaire, Adult Self-Report Scale (for ADHD), and other screening instruments as needed. For Children and Adolescents this will typically include: Behavioral Assessment System for Children-2"d Edition (BASC-2) standardized behavioral assessment for each child, completed by the child (as age appropriate), parents, foster parents, and teachers; Conners Rating scales; Stressful Life Events Questionnaire; other non-standardized behavioral assessment and developmental history forms completed by parents, foster parents, and teachers as clinically indicated. A written report will be provided summarizing the referral questions, brief case and social history, evaluation course, methods and procedures, a provisional diagnosis if appropriate, findings and conclusions, and recommendations for treatment, medication evaluations or further psychological evaluation as clinically indicated. Assessment reports will address strengths and protective factors as well as risk factors or problems related to the child's Safety, Permanence, and Well Being. Mental Health Assessments will address the following questions: 1. Does the client present with any obvious mental health disorder (e.g., anxiety, depression, psychosis, personality disorder, substance abuse) which may require therapeutic intervention? 2. What issues within the family appear to have led to involvement with DHS and/or the Courts and what interventions maybe necessary to address these issues? March 20, 2014 Vendor: Barry R. Lindstrom, Ph.D., LLC Page 3 BID NO: B 1400069 Program Category: Mental Health Services 3. If mental health treatment is recommended, what should be the focus of therapeutic intervention in order to resolve the immediate issues which are negatively impacting the client's ability to safely parent their child(ren)? 4. Does the client appear to have any identifiable trauma history or display significant maladaptive behavior which may require long-term therapeutic intervention? 5. Would a medication evaluation be recommended to address any identified mental health concerns? 6. Does the client have any presentation which would indicate that further assessment of cognitive functioning and/or personality issues is necessary? Psychological Evaluations are provided for individual Children, Adolescents, Adults and Families (Parent-Child Interactional, PCI; or Sibling interactional evaluations). These will be conducted only by Dr. Lindstrom and will, as needed to answer referral questions typically include: Interviews: Individual Clinical Interviews to obtain relevant psychosocial history and mental status evaluation with each referred family member (1 to 3 hours); Conjoint clinical interviews with all family members (including marital, parent-child, and sibling subsystems as clinically indicated; 3 to 5 hours); and Conjoint clinical interview /consultation with child and current caregivers (e.g., foster parent, relative) if child is in out of home placement at the time of evaluation. Psychological Screening and Testing: Adults: Beck Depression Inventory, Beck Anxiety Inventory, Penn Inventory for PTSD, and Stressful Life Events Questionnaire, Rotter Incomplete Sentences, Mood Disorder Questionnaire, Adult Self-Report Scale (for ADHD), and other screening instruments as needed; Minnesota Multiphasic Personality Inventory-2-restructered format (MMPI-2-RF; also available in Spanish and spoken language administrations); Millon Clinical Multiaxial Inventory-III (MCMI-III); Wechsler Abbreviated Scale of Intelligence (WASI); Wide Range Achievement Test-Fourth Edition (WRAT-4); Bender Gestalt Visual Motor Test(BGVMT); Thematic Apperception Test (TAT); Projective Drawings; Rorschach Test. Children and Adolescents: Behavioral Assessment System for Children-2nd Edition (BASC-2) standardized behavioral assessment for each child, completed by the child (as age appropriate), parents, foster parents, and teachers; Conners Rating scales; Stressful Life Events Questionnaire; other non-standardized behavioral assessment and developmental history forms completed by parents, foster parents, and teachers as clinically indicated; Minnesota Multiphasic Personality Inventory for Adolescents (MMPI-A; also available in spoken language administrations); Millon Adolescent or Pre-Adolescent Clinical Inventory, (MACI, M-PACI); Wechsler Abbreviated Scale of Intelligence (WAS!); Wide Range Achievement Test-Fourth Edition (WRAT-4); Bender Gestalt Visual Motor Test (BGVMT); Thematic Apperception Test (TAT) or Children's Apperception Test (CAT); Projective Drawings; Rorschach Test. Evaluations will include a review of WCDHS social history and family services plans, consultation with collateral sources, review of case records, previous evaluations and treatment records. Expert Court testimony or attendance at Court Facilitator Staffings will be provided as requested during or after evaluations. March 20, 2014 Vendor: Barry R. Lindstrom, Ph.D., LLC Page 4 BID NO: B1400069 Program Category: Mental Health Services Individual Evaluations will address referral questions regarding clients' diagnoses and their impact on attachment and parenting, treatment recommendations to address these issues in support of reunification, and the prognosis for change within a developmentally meaningful timeframe. Family Evaluations will address similar referral questions regarding clients' diagnoses, attachment and interaction patterns, and treatment recommendations and prognosis for reunification. Family evaluations will address the relative contributions of the child(ren), the parent(s), and their interaction and attachment patterns to the problems that led to the Department's involvement. Evaluations will assess risk factors from the Kempe Family Stress Inventory (Korfinacher, 2000) including: Parent Beaten or Deprived as a Child; Parent has history of Criminal Record, Mental Illness, or Substance Abuse; Parent Suspected of Abuse in the Past; Parent with Isolation, Low Self-Esteem or Depression; Multiple Stresses or Crises; Violent Temper Outbursts; Rigid, Unrealistic Expectations of Child's Behavior; Harsh Punishment of Child; Child Difficult or Provocative or Perceived to be by Parent; Child unwanted or at Risk for Poor Bonding/Attachment Difficulties. Family Evaluations can also assess level and intensity of visitation. Such visitation assessments can also address issues related to visitation between children and their incarcerated parents. There is a growing literature on the negative impact of parents' incarceration on children's lives and development (Arditti, 2012; Poehlmann et.al., 2010) and the need for visitation as one way to mitigate these issues. A final diagnostic feedback session will be offered to the client as part of each evaluation to discuss psychological test results and the findings and recommendations of the evaluation. Individual and Family(Interactional) Evaluations typically take from one to three months to complete. Extensions to the CORE Services referral will be requested as needed to address any extenuating circumstances. A written report will be provided for all evaluations summarizing the CORE Services goals and referral questions, brief case and social history, evaluation course, methods and procedures, findings, collateral contacts and conclusions and recommendations. Incomplete evaluations will also be documented in writing to the extent possible, outlining the limitations of any missing information. Evaluation reports will address strengths and protective factors as well as risk factors or problems related to the child's Safety, Permanence, and Well Being. Unless otherwise indicated or arranged, all clinical services will be provided at the office of Pathways at 3211 2011 St., Suite D, Greeley, CO 80634. Dr. Lindstrom can attend family visitation at the Parent Education Center or South County office as needed to complete portions of Parent Child Interactional Assessments as needed. Evaluations can be completed with locally incarcerated clients as needed. This proposal does not include Psychosexual or Sexual Offender evaluations. All evaluations will be completed following the Guidelines for Psychological Evaluations in Child Protection Matters as published by the American Psychological Association (2013, APA) and the Ethical Principles of the American Psychological Association (APA). March 20, 2014 Vendor: Barry R. Lindstrom, Ph.D., LLC Page 5 BID NO: B1400069 Program Category: Mental Health Services B. Treatment Services Treatment services will be provided by Dr. or Mrs. Lindstrom as authorized. Treatment focus and intervention will include trauma-focused, neuro-developmental, interpersonal, cognitive-behavioral, and multigenerational family systems approaches with an emphasis on a continuum of care and evidence-based practices (e.g., Trauma Focused Cognitive Behavioral Therapy, TF-CBT, Cohen et al, 2004). Treatment planning will focus on CORE services goals and family strengths through treatment services that support and strengthen the family and protect the child. Treatment efforts will be focused on: Addressing specific referral issues; Improving the clients' ability to access resources; Improving household management and competency; and Improving family conflict management. An initial clinical assessment(including interviews and screening tools as described above) and treatment plan will be completed within 30 days of the client following through on the referral. The assessment will include the presenting problems, brief family history, and an estimate of the client/family's ability to benefit from treatment and treatment goals and behavioral objectives (e.g., symptom reduction, skill development). Trauma-focused treatment will be strengths-based, focused and time-limited to address problems and needs. Where possible, clinically appropriate, and medically necessary funding from private insurance or Victim's Compensation will be sought and utilized. All treatment services will be provided within the Ethical Principals of the American Psychological Association (APA) and the American Counseling Association (ACA) and using empirically validated methods. Treatment services will be provided by Dr. or Mrs. Lindstrom as authorized. All treatment services will be provided at the office of Pathways at 3211 20`x' St., Suite D, Greeley, CO 80634. 970-356-3100. Monthly client progress reports will be provided through the on-line system to address key areas of Safety, Permanence and Well Being and including the Client(s) progress to date and anticipated discharge date and discharge planning. A discharge summary will address treatment outcomes in these three areas and a practical transition/support plan, including community resource referrals for continued therapy and support and other appropriate resources. Individual Therapy for adults, children or adolescents will be provided to address individual obstacles to reunification related to the client's symptoms, diagnosis and history with an emphasis on working through any identified trauma history. Problem Focused individual therapy, CBT, and TF-CBT will be provided in the office to assist in the resolution of the issues that led to Departmental involvement and in support of the treatment goals of Safety, Well Being, and maintaining or preserving a child's placement and reunification with or Permanency in a family. C Page e6 March 20, 2014 Vendor: Barry R. Lindstrom, Ph.D., LL g BID NO: B1400069 Program Category: Mental Health Services Family Therapy can include family of origin, foster family, or kinship placement as appropriate. Infants and young children will be treated in a family context. Interactions and interventions based on the principles of Parent Child Interaction Therapy(PCIT; Eyberg, 1988; Hembree-Kigin & McNeil, 1995) will be provided as a primary family intervention. PCIT focuses on both Child Driven Interaction (teaching the parent to follow and understand the child's needs) and Parent Driven Interaction(teaching the parent to structure and discipline the child in a developmentally appropriate and non-abusive manner). PCIT has been shown to be effective with abusive parents (Timmer et.al., 2005; Hakman et. al., 2009) and with Foster Parents (Timmer et.al., 2006). PCIT typically takes 20 sessions. We will follow the general outline and approach of PCIT in face-to-face clinical interactions and interventions without using the "bug in the ear" technology. C. Court Facilitation Staffings Court facilitator staffings with the client's participation will be attended before, during or after evaluation or treatment as requested by the Caseworker and Court facilitator to provide information and input regarding the evaluation process, findings and recommendations, or treatment progress and outcomes. D. Court preparation/testimony/travel Expert testimony regarding the evaluation process, findings and recommendations or treatment progress and outcomes will be provided as requested by the county attorney via subpoena. Expert testimony to provide information to the court regarding abuse, attachment or other psychological topics on cases not seen for evaluation or treatment can also be provided. This will include preparation, travel and court time out of the office to be billed at the contracted hourly rate. E. Case Consultation for Caseworkers & Clinical or Educational Staffings Consultation regarding specifically referred cases will be provided to caseworkers or foster parents in order to help foster children preserve or maintain placement in a clinically appropriate level of care, to minimize the number of changes or transitions, and to meet permanency goals. This is a brief consultation and not intended to replace formal evaluation of an individual or family if needed. If requested, a report can be prepared summarizing the process, findings and recommendations of the consultation. [Note: Individual consultation with Caseworkers as part of the referral, evaluation, treatment, and Core services case review process is included in the rates for evaluation or treatment.] Consultation can also include attendance at Clinical or Educational Staffings (other than TDM, FTM, or Court Facilitator Staffings) on behalf of the client at the request, and with the approval of, the Department, such as psychiatric staffings, clinical case reviews or IEP staffings. F. Inservice training. Dr. Lindstrom has presented numerous times on Trauma, PTSD and Vicarious Trauma in caseworkers, foster parents, therapists, attorneys and judicial officers, and can provided Inservice training or workshops for Caseworkers or foster parents on these and other topics as requested (e.g., specific diagnoses or interventions, sexualized or sexually reactive behaviors, etc.). March 20, 2014 Vendor: Barry R. Lindstrom, Ph.D., LLC Page 7 BID NO: B 1400069 Program Category: Mental Health Services RATES: Rate/Hr: PHD MS, LPC I. Mental Health Services A. Evaluations, with written report by Barry R. Lindstrom, PhD (Per hour for interviews and psychological testing) Mental health assessments $325 -- Individual psychological evaluations $325 -- Family: Parent-child, or Sibling-interactional evaluations $325 B. Treatment Services by Barry R. Lindstrom, PhD, or Bonnie S. Lindstrom, MS, LPC* *(When available, clinically appropriate and medically necessary funding from private insurance or Victim's Compensation will be utilized. Barry R. Lindstrom, PhD, LLC is not a Medicaid provider.) Individual: Child, Adolescent, Adult $125 $65 Family: parent/child, sibling or couples $150 $75 C. TDM, FTM, and Court Facilitator Staffings (as authorized) $150 $75 D. Expert Testimony and Court preparation/travel (with subpoena, 2 hr minimum)$175 $100 E. Case Consultation for Caseworkers $150 -- Clinical or Educational Staffings (as authorized) $125 $75 F. Inservice training for Caseworkers / foster parents (per 1/2 day workshop) $350 STAFF/ CURRICULUM VITAE: Barry R. Lindstrom, PhD, is a Licensed Psychologist in Colorado and in practice in Greeley since 1989. He has been conducting psychological and parent child interactional evaluations since 1986. He also provides individual, marital and family therapy with clients of all ages. (See attached license & Vita). Bonnie S. Lindstrom, MS, LPC is a Licensed Professional Counselor in Colorado since 2010. She earned a Master's degree in Counseling Psychology in 1986 and is an employee of Barry R. Lindstrom, PhD, LLC. Mrs. Lindstrom provides individual, marital, and family therapy with clients of all ages. (See attached license & Vita). CURRENT CERTIFICATES OF INSURANCE: See attached .pdf documents March 20, 2014 Vendor: Barry R. Lindstrom, Ph.D., LLC Page 8 BID NO: B 1400069 Program Category: Mental Health Services REFERENCES/BIBLIOGRAPHY Adams, R.E., Boscarino, J.A., & Figley, C.R. (2006). Compassion fatigue and psychological distress among social workers: A validation study. American Journal of Orthopsychiatry, 76, 1, 103-108. American Psychological Association. (2013). Guidelines for Psychological Evaluations in Child Protection Matters. American Psychologist, 68 20-31. American Psychological Association. (2002.) Ethical Principals Psychologists and code of conduct. American Psychologist, 57 1060-1073. American Counseling Association (2005) ACA Code of Ethics. Arditti, J.A. (2012). Parental Incarceration and the Family: Psychological and social effects of imprisonment on children, parents, and caregivers. New York: New York University Press. Chadwick Trauma-Informed Systems Project (CTISP). Trauma-Informed Child Welfare Practice Toolkit. Applying a trauma lens to a child welfare practice model. downloaded from www.ctisp.org Conrad, D., & Kellar-Guenther, Y. (2006). Compassion fatigue, burnout and compassion satisfaction among Colorado child protection caseworkers. Child Abuse and Neglect, 30, 1071-1080. Cohen, J. A., Deblinger, E., Mannarino, A. P., & Steer, R. (2004). A multisite, randomized controlled trial for children with sexual abuse-related PTSD symptoms. Journal of the American Academy of Child & Adolescent Psychiatry, 43, 393-402. Delaney, R. (2006). Fostering Changes: Myth, Meaning and Magic Bullets in Attachment Theory (3'd Ed.) Oklahoma City: Wood 'N' Barnes. DePanfilis, D. (2006). Compassion fatigue, burnout and compassion satisfaction: Implications for retention of workers. Child Abuse and Neglect, 30, 1067-1069. Eyberg, S. M. (1988). Parent-child interaction therapy: Integration of traditional and behavioral concerns. Child and Family Behavior Therapy, 20, 33-46. Figley, C.R. (Ed.) (2002). Treating Compassion Fatigue. New York: Brunner-Routledge Forbes, H. & Post, B (2006) Beyond Consequences, Logic, and Control: A Love-Based Approach to Helping Attachment-Challenged Children With Severe Behaviors Orlando: Beyond Consequences Institute. Gaskill, R. L. &Perry, B.D. (2012). Child sexual abuse, traumatic experiences and their effect on the developing brain in (P. Goodyear-Brown, ed.) Handbook of Child Sexual Abuse: Identification, Assessment and Treatment, pp. 29-49. Hoboken: John Wiley& Sons Hakman, M., Chaffin, M., Funderburk, B., Silovsky, J.F. (2009). Change trajectories for parent-child interaction sequences during parent-child interaction therapy for child physical abuse. Child Abuse & Neglect, 33, 461-470. March 20, 2014 Vendor: Barry R. Lindstrom, Ph.D., LLC Page 9 BID NO: B1400069 Program Category: Mental Health Services Harris, Y.R., Graham, J.A., & Oliver Carpenter, G.J. (2010). Children of Incarcerated Parents: Theoretical, developmental and Clinical Issues. New York: Springer. Hembree-Kigin, T. L., & McNeil, C. B. (1995). Parent-child interaction therapy. New York, NY: Plenum Press. Herman, J. (1992). Trauma and recovery. New York: Basic Books. Karson, M. (2001). Patterns of child abuse: How dysfunctional transactions are replicated in individuals, families, and the child welfare system. New York: Haworth Press. Korfnmcher, J. (2000). The Kempe Family Stress Inventory: A review. Child Abuse and Neglect, 24 1, 129-140. Osofsky, J.D., & Lieberman, A.F. (2011). A Call for Integrating a Mental Health Perspective into Systems of Care for Abused and Neglected Infants and Young Children. American Psychologist, 66, 120-128. Ostler, T. (2008). Assessment of Parenting Competency in Mothers with Mental Illness. Baltimore: Paul H. Brookes. Perry, B.D., & Szalavitz, M (2006). The boy who was raised as a dog: What traumatized children can teach us about loss, love and healing. New York: Basic Books. Poehlmann, J., Dallaire, D., Booker Loper, A., & Shear, L.D. (2010). Children's Contact with Their Incarcerated Parents: Research Findings and Recommendations. American Psychologist, 65, 575-598. Pollock, C., & Steele, B. (1972). A Therapeutic Approach to Parents. In C.H. Kempe & R.E. Helfer (Eds.) Helping the Battered Child and His Family. (pp 3-21). Philadelphia: Lippincott Ten, L. (1990). Too scared to cry: Psychic trauma in childhood New York: Harper & Row. Terr, L. (1994). Unchained Memories: True stories of traumatic memories lost and found. NY: Basic Books. Timmer, S.G., Urquiza, A.J., Zebell, N.M., McGrath, J.M. (2005). Parent-Child Interaction Therapy: Application to maltreating parent-child dyads. Child Abuse&Neglect, 29, 825-842 Timmer, S.G., Urquiza, A.J., Zebell, N.M. (2006). Challenging Foster caregiver-maltreated child relationships: The effectiveness of Parent-Child Interaction Therapy. Children and Youth Services Review, 28, 1-19. Respectfully submitted, 0-7 Barry R. Lindstrom, PhD Licensed Psychologist Licensed School Psychologist BARRY RICHARD LINDSTROM, Ph.D., LLC Licensed Psychologist 3211 20`" Street, Suite D Greeley, Colorado 80634 (970) 356-3100, Fax (970) 356-4827 CREDENTIALS Licensed Clinical Psychologist - Colorado (05/12/1989) Licensed School Psychologist - Colorado (since 11/01/1989) National Register of Health Service Providers in Psychology#41119 (12/1991) EDUCATION 1982 - 1987 Loyola University of Chicago, Chicago, IL Ph.D. in Clinical Psychology, January, 1988. Subspecialty in Clinical Child Psychology. M.A. in Clinical Psychology, May, 1985. 1977 - 1981 Carthage College, Kenosha, WI B.A. in Psychology, magna cum laude, Gamma Kappa Alpha Honor Society. CLINICAL EXPERIENCE 1989 - Present Psychologist in Private Practice. General practice including individual, marital and family therapy and assessment; focus on child abuse and neglect, adoption, attachment, attention deficit disorders, trauma, and sexual abuse; court evaluations and expert testimony; training and consultation to treatment programs, schools and social services agencies. 1991 - 2004 Clinical Director, Namaqua Center. Responsible for program direction and development of residential, day- and outpatient treatment and therapeutic foster care programs; hiring, training and supervision of clinical staff, assessment and treatment of seriously emotionally disturbed children and their families. Agency became COA accredited. Implemented HIPAA policies and procedures as Privacy Officer. 1987 - 1991 Psychologist, Center for Therapeutic Learning-Annex. Treatment Coordinator for severely emotionally disturbed children and adolescents in a long-term residential treatment center. Provided diagnostic and psychometric assessments, individual and family therapy, parent assessment and education, expert testimony, and consultation and supervision for childcare professionals and special education teachers. Barry R. Lindstrom,Ph.D. Page 2 1986 - 1987 Denver General Hospital, A.P.A. approved internship in Clinical Psychology. Completed six-month rotations on Adolescent Inpatient Unit and Outpatient/ Consultation- Liaison Service. 1985 - 1986 Center for Family Studies / The Family Institute of Chicago, Department of Psychiatry, Northwestern University Medical School. Externship in Family Therapy. 1982 - 1984 Doyle Center and Day School of Loyola University. Clinical Practicum in child and family psychology. HOSPITAL AFFILIATIONS 1992-2010 North Colorado Medical Center / Psychcare, Greeley, CO. 1994-1998 Mountain Crest Hospital, Fort Collins, CO. PUBLICATIONS Lindstrom, B. R. (1999). Attachment, separation and abuse outcomes: Influence of Early Life Experience and the Family of Origin. In Ryan, G. and Associates, Web of meaning: A developmental-contextual approach in sexual abuse treatment (pp 32-48). Brandon, VT: Safer Society Press. PROFESSIONAL AFFILIATIONS Member, Association of Family and Conciliation Courts since 2010 Member, International Society for Prevention of Child Abuse and Neglect since 1991. Fellow, American Orthopsychiatric Association since 1990; member since 1987. Member, Colorado Psychological Association since 1988. Member, American Psychological Association since 1988. Member, Division 53, Society of Clinical Child and Adolescent Psychology, American Psychological Association since 1985. Member, Perpetration Prevention Study Group, Kempe National Center for Prevention of Child Abuse and Neglect 1990-2007. PUBLIC SERVICE Weld County Child Welfare Collaborative / Model Court Project 2007-present subcommittee, 2007 - present Visitation Pro Bono Project, Weld County, 1992- 1998 Board Member, Children's Law Center of Larimer County, 1993-95. Member, Behavior Program Review Committee, Foothills Gateway Rehabilitation Center, 1992-1993. Vice Chairman, Larimer County Mental Health Center, Advisory Board; Chairman, Child / Adolescent Mental Health Task Force, 1989-91. Board Member, Loveland City Council, Human Relations Commission, 1989-91. Barry R. Lindstrom, Ph.D. Page 3 CONTINUING EDUCATION February 28, 2014 Should Attachment be a Determinative factor on Custody Decisions? Pamela S. Ludolph, PhD. COAFCC Winter Conference, Denver, CO December 13, 2013 Early Neutral Assessment. Robert Smith, JD, Celeste Kling, JD, & Tom Linnell, PhD. Weld County Bar Association 10th Annual Nuts and Bolts Conference, Greeley, CO. October 4, 2013 On Being a Child in a 50/50 Era: Research and Developmental Perspectives on Shared Parenting after Separation. Jennifer McIntosh, PhD. COAFCCBIDC Interdisciplinary Conference July 20, 2013 Diagnosis with DSM-5 and ICD. K. Dayle Jones, PhD. Denver, CO. Colorado Psychological Association May 6-10, 2013 Colorado Judicial Branch Child and Family Investigator Training. Laurie Clark, JD, Ruth Rinehart, MA Fort Collins, CO. March 22, 2013 Children who resist post-separation contact: A differential approach for legal and mental health professionals. Barbara Jo Fidler, PhD, C. Psych., Acc.FM, and Nicholas Bala, B.A., J.D., LL.M COAFFC Spring Conference, Broomfield, CO. November 30, 2012 Child and Family Evaluations in a Tight Economy: What are Best Practices? Philip M. Stahl, PhD, ABPP. COAFFC Fall Conference, Denver, CO. September 29, 2012 Building a caring community—Yampa Valley Wellness Conference 2012. Steamboat Springs, CO May 23-25, 2012 Doing What Works: The Third Colorado Summit on Children, Youth and Families. Keystone, CO. May 11, 2012 Boulder County Interdisciplinary Committee Annual Conference. Charlie Asher, Esq. and Barb Asher, LCSW. Beginning with the end in mind: An interdisciplinary look at families' actual needs during divorce. Joan McWilliams, Esq. Parenting plans for families after divorce. Judicial Roundtable: The changing landscape of parenting cases; What is and what may be. Arvada, CO. May 7, 2012 Kempe Center Symposium. Des Runion, MD, DrPH; Jill Korbin, PhD; Richard Barth, PhD;and Lucy Berliner, MSW. Denver, CO. Barry R. Lindstrom, Ph.D. Page 4 May 3, 2012 Evidence Based Medicine: Current Applications to Clinical Practice. Daniel Friedland, MD. Loveland , CO. November 11, 2011 Therapy with Court Involved Families: Issues, Problems and Remedies. Lyn Greenberg, PhD. Denver, CO. October 14, 2011 Race and Culture: Assumptions and Projections in the Child Welfare System. Khatib Waheed. Greeley, CO. September 16-17, 2011 Bridging the Couple Chasm: A New Research Based Approach (Level 1). John Gottman, PhD & Julie Schwartz Gottman, PhD. Colorado Association of Marriage and Family Therapy. Denver, CO. August 24-25, 2011 Northern Colorado Substance Abuse Conference: Overcoming Obstacles. Loveland, CO. May 20, 2011 Emotional Attachment and Emotional Availability (EA): An Introduction to Creating an Evidence- Based Psycholegal Practice. EA Short Clinical Version 1-day Training. Zeynep Biringen, PhD. Boulder CO October 28-30, 2010 Ninth Symposium on Child Custody Evaluations. Association of Family and Conciliation Courts. Cambridge/Boston, MA. September 24, 2010 Mental Health Law and Ethics. Leslie Matthews, BSN, JD, and Reo Leslie, LMFT, LPC, CACIII. Colorado School for Family Therapy, Denver, CO. May 25, 2010 Hearing the Voices of Our Youth. Greeley, CO. June 2-5, 2010 Traversing the Trail of Alienation: Rocky Relationships, Mountains of Emotion, Mile High Conflict. Association of Family and Conciliation Courts 47°' Annual Conference. Denver, CO. April 2, 2010 Response to Intervention for Psychologists. Karin Dittrick-Nathan, PhD, & Gloria Miller, PhD. Society for Personality Assessment. Colorado Assessment Society. University of Denver. March 26, 2010 Autism Spectrum Disorders: A Closer Look. Sally Ozonoff, PhD. The Rosenberry Conference. Children's Hospital. Denver, CO. Barry R. Lindstrom, Ph.D. Page 5 November 4, 2009 Visitation Assessment. Sue Eliertsen, LCSW &Marion Garza, LSW. El Paso County Department of Human Services. Greeley, CO October 21-23, 2009 Colorado State Foster Parent Association Conference. Making Memories, Building Dreams. Breckenridge, CO PRESENTATIONS February, 2014 &October 2013: Communication with Children, Partners and Parents. Teen Parent Program. Jefferson Alternative High School, Greeley, CO. September 27, 2012. The eyes and ears of the Court. Inservice training for Court Appointed Special Advocates (CASA). Weld County, CO. May 24, 2012. But It is Contagious! The Traumatic Effects of Working with Traumatized Clients. The 3`a Colorado Summit on Children, Youth and Families--Doing What Works: Recognizing and Implementing Best Practice for Children, Youth and Families. Colorado Department of Human Services. Keystone, CO. August 25, 2011. The Impact of Parental Substance Abuse: Teeter-Totters, Merry Go Rounds and Roller Coasters. Northern Colorado Substance Abuse Conference: Overcoming Obstacles. Loveland, CO. August 25, 2011. It is contagious! Secondary and Vicarious Trauma. Northern Colorado Substance Abuse Conference: Overcoming Obstacles. Loveland, CO. September 11, 2010. Behavioral Support and Intervention with Challenging Kids: Stump the Chump! Weld County Adoption Support Group. Greeley, CO. August 19, 2010. Attachment and Parent-Child Interactional Assessments. Inservice training for Court Appointed Special Advocates (CASA). Weld County, CO. October 22, 2009. If Mama ain't happy: The traumatic effects of living with traumatized children. Colorado State Foster Parent Association Conference. Breckenridge, CO. September 25, 2009. Middle Childhood: Between the Twos and Teens. Weld County Conference for Post—Adoptive Families. Greeley, CO. September 19, 2009. Therapeutic Parenting with Maltreated Children, Part II: Therapeutic Parenting and Secondary Trauma. Weld County Adoption Support Group. Greeley, CO. May 2, 2009. But it is contagious! The traumatic effects of living with traumatized children. Spotlight on Families Workshop. COPARC. Denver, CO April 18, 2009. Therapeutic Parenting with Maltreated Children, Part I: Attachment, Development and Adoption. Weld County Adoption Support Group. Greeley, CO. Barry R. Lindstrom, Ph.D. Page 6 September 19, 2008. PTSD and the residential milieu. Staff Inservice, Mountain Crest Hospital, Fort Collins, CO. June 25, July 16, & September 17, 2008. The Stress of Change and Transition. Weld County Department of Human Services. Greeley, CO. November 12, 2007. Mental Health Issues Associated with Autism Spectrum Disorders. Part II: Psychosocial Factors and Family Coping. Thompson Autism/Asperger's Parent/Community Group Meeting, Loveland, CO. BONNIE S. LINDSTROM, M.S., LPC Licensed Professional Counselor 3211 20th Street Greeley, CO 80634 970-356-3100 CREDENTIALS: Licensed Professional Counselor - Colorado May 19, 2010 EDUCATION: 1986 Master of Science 1980 Bachelor of Arts Counseling Psychology Self designed major: Psychology, Benedictine University Sociology, Education, Religion Lisle, Illinois Carthage College, Kenosha, Wisconsin WORK EXPERIENCE: 06-07 to present Pathways Private counseling practice with children, adolescents, adults, families and couples. 10-06 to 05-07 Kindergarten Literacy Aid Laurel Elementary School, 1000 E. Locust Ct., Fort Collins, CO Led daily literacy groups utilizing Open Court materials; Worked one on one with students needing special assistance ;Responsible for supervision of 60 children during lunch and recess 11-06 to 05-07 English Language Acquisition Test Examiner Poudre School District, 2407 Laporte Ave., Fort Collins, CO Completed training for testing English Language learning students; Administered and scored tests for grades K-12 at numerous sites in district 1988-1989 Field Director/Camp Director Campfire Boys and Girls, Windsor, CO Responsible for training and supervision of volunteer staff; Directed summer camp, hired, trained and supervised staff of 20; Ensured compliance with the State licensing department 1986-1987 Caseworker Arapaho County Department of Useful Public Service, Aurora, CO Supervised 400 cases annually, arranged service work for alcohol related offenses; Maintained weekly contact with community agencies to determine client compliance; Completed court documentation and testified regularly 1983-1985 Residence Hall Director Elmhurst College, Elmhurst, IL Coordinated all aspects of women's residence hall of 100 students; Trained, monitored and mentored student staff; Responsible for student activities budget of$85,000 BONNIE S. LINDSTROM, M.S., LPC Page 2 1980-1982 Adult Probation Officer DuPage County, IL Managed caseload of 100 adult offenders; Compiled detailed social history reports on repeat offenders and collaborated with States Attorneys and Judges to advise on appropriate adjudication; Extensive knowledge and understanding of the criminal justice system VOLUNTEER EXPERIENCE HIGHLIGHTS: 2008-9 Weld County Summit on Substance Abuse, Greeley, CO Addressing school prevention of substance abuse. 2006 Book Talk Leader, Lesher Jr. High, Fort Collins, CO Guided Junior High youth through content and plot discussions monthly. 2005 Reading tutor, Kruse Elementary, Fort Collins, CO Tutored over 50 hours with first grade students. 2004 Classroom volunteer, Kruse Elementary, Fort Collins, CO Aided teacher in student preparation for Young Scholars program. 2001 Board President, Loveland L.I.G.H.T.S. (Larimer Initiative for Gifted High Ability and Talented Students). Promoted partnerships among parents, teachers, administrators, legislators and businesses to enhance educational opportunities for gifted students. 2000 Board Member, Loveland TDSAC (Talent Development Services Advisory Council) Served for two years, spear headed committee to gather information on educational opportunities for gifted students. 1994-8 President of the Auxiliary, Namaqua Center, Loveland, CO. (residential treatment facility for emotionally disturbed youth). Coordinated numerous fundraising projects. CONTINUING EDUCATION September 29, 2012 Building a caring community—Yampa Valley Wellness Conference 2012. Steamboat Springs, CO May 23, 2012 Doing What Works: The Third Colorado Summit on Children, Youth and Families. Keystone, CO. May 7, 2012 Kempe Center Symposium. Des Runion, MD, DrPH; Jill Korbin, PhD; Richard Barth, PhD; Lucy Berliner, MSW. Denver, CO. BONNIE S. LINDSTROM, M.S., LPC Page 3 September 16-17, 2011 Bridging the Couple Chasm: A New Research Based Approach (Level 1). John Gottman, PhD & Julie Schwartz Gottman, PhD. Colorado Association of Marriage and Family Therapy. Denver, CO. October 28-30, 2010 Ninth Symposium on Child Custody Evaluations. Association of Family and Conciliation Courts. Cambridge/Boston, MA. September 24, 2010 Mental Health Law and Ethics. Leslie Matthews, BSN, JD, and Reo Leslie, LMFT, LPC, CACIII. Colorado School for Family Therapy, Denver, CO. March 26, 2010 Autism Spectrum Disorders: A Closer Look. Sally Ozonoff, PhD. The Rosenberry Conference. Children's Hospital. Denver, CO. March 1, 2010 Turning Down the Heat: Tips to Reduce Stress in our Kids. Terry Bradley, MA. Poudre School District Gifted and Talented Program. November 4, 2009 Visitation Assessment. Sue Eliertsen, LCSW &Marion Garza, LSW. El Paso County Department of Human Services. Greeley, CO. October 9, 2009 Clinical Challenges and Advanced Approaches for Mood Disorders. Fall Symposium University of Colorado Denver School of Medicine Depression Center. Denver, CO. September 25, 2009. Weld County Conference for Post—Adoptive Families. Greeley, CO. June 29, 2009 Expert Testimony in Child Abuse and Neglect Cases. Donald Bross, PhD, JD, & Diane Baird, LCSW. Greeley, CO. January 28, 2009 Permanent Connections for Teens. Denise Leffingwell, MSW, LCSW. The Adoption Exchange. Greeley, CO. November 12, 2008 Drug Testing Essentials: Fundamentals of a Valid Dug Testing Program. Joni Harris, MT (ASCP). Greeley, CO. July 29, 2008 Domestic Violence, Coercive Control and Child Well Being: Putting the Revolution Back on Course Evan Stark PhD, MSW. University of Colorado, Denver. BONNIE S. LINDSTROM, M.S., LPC Page 4 April 26, 2008 Spotlight on Development: Adoption Issues at Different Ages and Stages. Colorado Post Adoption Resource Center. Denver, CO. February 22, 2008 Why Relational Health in Childhood Creates Healthy Communities: Applying Emerging Concepts in Neurobiology to Help Children, Families and Communities. Bruce Perry, MD, PhD. Greeley, CO. June 7, 2007 Brain Functioning and Dynamics involved in Problematic or Abusive Sexual Behavior. Kevin Creedin, MA, LMHC. Colorado Continuum Network. Denver, CO. STATE OF COLORADO Department of Regulatory Agencies Division of Professions and Occupations PRINTED ON SECURE PAPE. Active PSY • PSY.0001303 09/01/2013 08/31/2015 Number Issue Date Expire Date Barry Richard Lindstrom Greeley CO Division Director Sign re STATE OF COLORADO • Department of Regulatory Agencies Division of Professions and Occupations PRINTED ON SECURE PAPE: Active LPC LPC.0005671 09/01/2013 08131/2015 Number Issue Date Expire Date Bonnell K Lindstrom Greeley CO 80634656E • Division Director Signature PY-14-15-CORE-0141 EXHIBIT C SCOPE OF SERVICES 1. Contractor will provide Mental Health Services to individuals and/or families referred by the Department, at 3211 20th Street,Suite D, in Greeley,CO, unless otherwise arranged.Services include the following: a. Mental Health Assessments: Contractor can assess children,adolescents or adults. Service includes two (2)one-hour interviews to obtain relevant psychosocial history and mental status evaluation with each referred family members, conjoint clinical interviews with all family members(when applicable), conjoint clinical interview with child and current caregiver(s) if child is in out-of-home placement at the time of the referral,and psychological screening and testing. Assessments will include a review of the Weld County Social History and Family Services Plan, but minimal collateral information. Contractor will conduct psychological screening but no formal psychological testing. For adults,this may include the Beck Depression Inventory,Beck Anxiety Inventory, Penn Inventory for Post-Traumatic Stress Disorder(PTSD), Stressful Life Events Questionnaire, Rotter Incomplete Sentences, Mood Disorder Questionnaire,Adult Self-Report Scale (for ADHD), and other screening instruments as needed. For children and adolescents,screening may include the Behavioral Assessment System for Children- Second Edition (BASC-2)standardized behavioral assessment for each child,completed by the child (as age appropriate), parents, foster parents and teachers;Stressful Life Events Questionnaire;other non-standardized behavioral assessment and developmental history forms completed by parents, foster parents,and teachers as clinically indicated;Conners Rating scales; Stressful Life Events Questionnaire;other non-standardized behavioral assessment and developmental history forms completed by parents,foster parents,and teachers as clinically indicated. b. Evaluations—Contractor can evaluation individual children,adolescents, adults, or family members together for the purpose of interactional evaluation. Contractor will interview each referred family member for the purpose of obtaining relevant psychological history and mental status. The number of hours required will vary dependent upon the type of evaluation requested and the number of participating clients. Family evaluations require an average of eight(8) hours of direct contact and include the equivalent of an individual Mental Health Assessment of each family member and assessment of interaction between family members. Evaluations will assess risk factors from the Kempe Family Stress Inventory including: Parent Beaten or Deprived as a Child; Parent has a History of a Criminal Record,Mental Illness or Substance Abuse; Parent Suspected of Abuse in the Past; Parent with Isolation, Low Self Esteem or Depression;Multiple Stresses or Crises;Violent Temper Outbursts; Rigid, Unrealistic Expectations of the Child's Behavior; Harsh Punishment of Child;Child Difficult or Provocative or Perceived to be by Parent;and Child Unwanted or at Risk for Poor Bonding/Attachment Difficulties. Family Evaluations can also assess level and intensity of visitation and address issues related to visitation between children and incarcerated parents.The evaluation will include some or all of the following depending on family composition,child's placement and the caseworker's referral questions,and take from one to three months to complete: i. Interviews: a. Individual Clinical Interview(s)with each family member(1 to 3 hours for each member); b. Conjoint clinical interviews with all family members(including marital, parent-child, and sibling subsystems as clinically indicated;3 to 5 hours) 1 PY-14-15-CORE-0141 c. Conjoint clinical interview/consultation with child and current caregivers (foster parent, relative etc) if child is in out of home placement at the time of evaluation. ii. Psychological Testing: a. Adults: Beck Depression Inventory, Beck Anxiety Inventory, Penn Inventory for PTSD, and Stressful Life Events Questionnaire, Rotter Incomplete Sentences; Mood Disorder Questionnaire,Adult Self-Report Scale(for ADHD), and other screening instruments as needed such as the Minnesota Multiphasic Personality Inventory-2-restructured format; Millon Clinical Multiaxial Inventory-Ill (MCMI-III);Wechsler Abbreviated Scale of Intelligence (WASI); Wide Range Achievement Test-Fourth Edition (WRAT-4); Bender Gestalt Visual Motor Test (BGVMT);Thematic Apperception Test(TAT); Projective Drawings; Rorschach Test. b. Children and Adolescents: Behavioral Assessment System for Children-2n° Edition (BASC-2) standardized behavioral assessment for each child,completed by the child (as age appropriate), parents,foster parents,and teachers; Conners Rating scales; Stressful Life Events Questionnaire; other non- standardized behavioral assessment and developmental history forms completed by parents,foster parents, and teachers as clinically indicated; Minnesota Multiphasic Personality Inventory for Adolescents(MMPI-A); Million Adolescent or Pre-Adolescent Clinical Inventory, (MACI, M-PACI);Wechsler Abbreviated Scale of Intelligence (WASI); Wide Range Achievement Test-Fourth Edition (WRAT-4); Bender Gestalt Visual Motor Test(BGVMT);Thematic Apperception Test(TAT)or Children's Apperception Test(CAT); Projective Drawings; Rorschach Test. iii. Evaluation Reports: A written report for all assessments/evaluations will be provided to the referring caseworker within thirty(30)days of the completion of the evaluation.This report will summarize the referral questions; brief case history;evaluation course; methods and procedures (including psychological testing, records reviewed and collateral contacts);findings; conclusions and recommendations. Evaluation reports will address both strengths and protective factors and risk factors or problems related to the child's Safety, Permanency and Well Being. Recommendations will focus on how to maintain the child in his current placement, or how a change in placement would help to move the child closer to his permanency goal. If the child is legally free for adoption, recommendations will include whether the goal of adoption is appropriate at that time and/or how to move toward getting the child into an adoptive home, and what type of home would best meet the child's needs. iv. Client Feedback: Individuals and families will be offered a final diagnostic feedback session as part of the evaluation process to discuss test results and the findings and recommendations of the evaluation. Copies of the evaluation will be distributed to appropriate parties by the caseworker or psychologist in keeping with privacy laws, client consent and legal and professional standards. a. Individual and Family Treatment Services—Services will be problem-focused and will assist in the resolution of the issues that led to the Department's involvement with the family, as well as supporting the treatment goals of 2 PY-14-15-CORE-0141 safety,well being and maintenance of the child's placement.Treatment will include development,cognitive-behavioral and family systems approaches with an emphasis on a continuum of care and evidence-based practices. b. Therapy—Contractor can provide individual and/or family therapy to children,adolescents and adults to address individual obstacles to reunification related to the client's symptoms,diagnosis and history with an emphasis on working through any identified trauma history. Individual therapy will be provided through Problem-focused Individual Therapy,Cognitive Behavioral Therapy(CBT) and Trauma-focused Cognitive Behavioral Therapy(TF-CBT). Family therapy interactions and interventions will be based on the principles of Parent Child interaction Therapy(PCIT),which focused on both Child Driven Interaction and Parent Driven Interaction. c. Consultation—Contractor will provide case-specific consultation to assist in preserving or maintaining placement,to minimize the number of changes or transitions and to assist with meeting permanency goals. 2. Services will be provided by Barry R. Lindstrom, Ph.D., and Bonnie S. Lindstrom, M.S,LPC.All Mental Health Assessments and evaluations will only be conducted by Barry R. Lindstrom,Ph.D. 3. Barry R. Lindstrom, Ph.D.,can conduct evaluations on clients incarcerated in the Greeley area. 4. 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. 5. 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. 6. 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. 7. 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. 8. 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. 9. 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. 3 PY-14-15-CORE-0141 10. 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. Upon receipt of an invitation from the Department,Contractor must contact the Child Welfare Contract and Services Coordinator to request approval to bill for participation if Contractor wishes to be reimbursed. The Department will reimburse for actual participation in the meeting only so long as the meeting is at least one hour in length,the Contractor requests approval to bill in advance of the meeting and participation in the meeting is deemed appropriate and necessary by the Department. Staffings and/or meetings other than those listed above are not considered reimbursable unless otherwise approved by the Child Welfare Contract and Services Coordinator. 4 PY-14-15-CORE-0141 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, 2015. 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 $325.00/Hour(Ph.D. - Mental Health Assessment/Psychological Evaluation/Interactional Evaluation) $150.00/Hour(Ph.D. -Case Consultation) $150.00/Hour(Ph.D. - Family Therapy) $125.00/Hour(Ph.D. - Individual Therapy) $75.00/Hour(M.S.-Family Therapy) $65.00/Hour (M.S.-Individual Therapy) $150.00/Hour(Ph.D.-Court Facilitation/Court Staffing/Family Team Meeting/Team Decision Making Meeting) $125.00/Hour(Ph.D.-Clinical or Educational Staffings) $75.00/Hour(M.S.-Court Facilitation/Court Staffing/Family Team Meeting/Team Decision Making Meeting. Clinical or Educational Staffing.) 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 1 PY-14-15-CORE-0141 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 INSURANCE POLICY DECLARATIONS RENEWAL DECLARATIONS ATTACH THIS RENEWAL DECLARATIONS TO YOUR EXPIRING POLICY Policy Number: PHCP072277 Philadelphia Indemnity Insurance Company Administered by: CPH&Associates • 711 S. Dearborn St, Ste.205 Chicago, IL 60605 Barry R. Lindstrom PhD,LLC Barry Lindstrom 3211 20th St. Suite D Greeley, CO 80634 Affiliation: ACA Professional Occupation: Licensed Psychologist Coverage Term From: 10/04/2013 To: 10/04/2014 at 12:01 a.m. Standard Time at the Insured's Mailing Address shown above. COVERAGE A—PROFESSIONAL LIABILITY LIMITS OF LIABILITY PREMIUM COVERAGE Individual-Each Incident: SN/A $1050 Aggregate: $N/A Association, Partnership or Corporation-Each Incident: $1 million Aggregate: $3 million COVERAGE B—SUPPLEMENTAL LIABILITY COVERAGE Each Incident: $1 million (Included) Aggregate: $3 million COMMERCIAL GENERAL LIABILITY COVERAGE Each Incident: N/A Aggregate: N/A PROPERTY COVERAGE N/A Premium(including taxes): $1150.00 Policy Forms &Endorsements: PI-PHCP-02(07/10) By: Jamie Maguire,Authorized Representative State Endorsement(s) made a part of this policy at the time of issue: refer to www.cphins.com Call the Administrator to Verify Claims History at 1-800-875-1911 P.O. Box 1515 Spokane WA 9921 0-1 51 5 THE TRAVELERS INDEMNITY COMPANY OF CONNECTICUT 09/07/2013 PATHWAYS MANAGEMENT 3211 20TH STREET SUITE D GREELEY CO 80634 Thank you for continuing your business with Travelers. FLOOD & PETERSON INS INC, in conjunction with Travelers, is pleased to forward your renewal coverage contract for the following policy(ies): Coveraae Policy Form Policy Number MASTER PAC 680 390N4113 a O= The Travelers Service Center is positioned to assist you. Please take a few minutes to review the coverages, and call us with any changes or questions that you may have at the following number: or— Phone: (888 ) 661 —3938 Travelers Service Center is open Monday- Friday, 8:00 a.m. -8:00 PM EST - If you experience a loss and/or need to report a claim, please contact the Travelers Claim Line directly at 1-800-238-6225. Claim representatives are available 24 hours a day, 7 days a week. 7= 0 Travelers is providing the peace of mind and stability that over half a million American business owners rely on = every day. We are glad to be providing you with the thorough protection and superior service that your business deserves. - If you have other policies with Travelers, the policy paper may be mailed to you under separate cover. Sincerely, Travelers Service Center )08257 PINNACOL 7501 E Lowry Blvd Denver, CO 80230-7006 ASSURANCE 303-361-4000 / 800-873-7242 www.pinnacol.com May 2, 2013 Policy#: 3217113 ITEM 1. INSURED Pathways Management, LLC 3211 20th St. Ste D Greeley, CO 80634 PR/.00 ITEM 2. POLICY PERIOD: FROM: 05/01/2013 TO 05/01/2014 12:01 A.M. MOUNTAIN STANDARD TIME ITEM 3. A. Workers' Compensation Insurance: Part One of the policy applies to the workers' compensation law of the states listed here: COLORADO B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in Item 3 A. The limits of our liability under part two are: BODILY INJURY BY ACCIDENT $100,000 EACH ACCIDENT BODILY INJURY BY DISEASE $100,000 EACH EMPLOYEE BODILY INJURY BY DISEASE $500,000 POLICY LIMIT C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: NONE (Please contact Pinnacol Assurance for information on coverage outside the state of Colorado) D. This policy includes the attached endorsements and schedules: 511 Other State Endorsement CAT09 Catastrophe (Other than Certified Acts of Terrorism) TER09 Terrorism Risk Insurance Program Reauthorization Act ITEM 4. We will determine the premium for this policy by our manuals of rules, classifications, rates and rating plans. All information required below is subject to verification and change by audit. The statements of • estimated advanced premium are also a part of this policy. • 7501 E Lowry Blvd Denver.CO 80230-7006 Page 2 of 6 P UB408- 05/02/2013 19:05:49 3217113 38657041 P4ALL Coverage Information for 3217113 Location: Pathways Management, LLC 3211 20th St Ste C & D Greeley, CO 80631 Period: 05/01/2013 - 05/01/2014 Class RT Description Emp Payroll Rate Prem Charge 883205 EM PHYSICIANS & CL .00 $167,530 .464000 $777 Total for Pathways Management, LLC $167,530 $777 Description Period Adjustment Amount Ratable Manual Premium 05/01/2013 - 05/01/2014 $777 Designated Provider Discount 05/01/2013 - 05/01/2014 .975 $19- Retention Discount 05/01/2013 - 05/01/2014 .930 $53- Annual Policy Fee 05/01/2013 - 05/01/2014 $195 Terrorism Insurance Coverage 05/01/2013 - 05/01/2014 $17 Catastrophe Insurance Coverage 05/01/2013 - 05/01/2014 $17 Net Estimated Annual Premium 05/01/2013 - 05/01/2014 $934 • Policyholder Disclosure Notice of Terrorism and Catastrophe Insurance Coverage Coverage for acts of terrorism is included in your policy. Under your existing coverage, any losses resulting from certified acts of terrorism would be partially reimbursed by the United States government. The United States government would pay 85% of our insured losses that exceed our insurer deductible. Premium for terrorism is calculated on the basis of total payroll. The total Colorado payroll is divided by$100 and multiplied by the approved terrorism rate, $0.01 per$100 of payroll. The calculation is expressed as (Colorado payroll /$100 X Approved Terrorism Rate= Premium). This premium is not subject to any other modification including, but not limited to, premium discount, experience rating, schedule rating, or retrospective rating. • • Additionally, all workers' compensation carriers are required to charge premium to cover large losses. Premium for Catastrophe (other than Certified Acts of Terrorism) is calculated on the basis of total payroll. The total Colorado payroll is divided by$100 and multiplied by the approved Catastrophe(other than Certified Acts of Terrorism) rate, $0.01 per$100 of payroll. The calculation is expressed as (Colorado payroll/$100 X Catastrophe (other than Certified Acts of Terrorism) Value= Premium). This premium is not subject to any other modifications including, but not limited to, premium discount, experience rating, schedule rating, or retrospective rating. • This Policy Information Page reflects coverage, premium and payroll information as of the date of issuance. 7501 E Lowry Blvd Denver,CO 80230-7006 Page 3 of 6 P UB408- 05/02/2013 19:05:49 3217113 38657041 P4ALL PY-14-15-CORE-0174 CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND POUDRE VALLEY HEALTH CARE, INC. DBA POUDRE HEALTH SYSTEM This Agreement, made and entered into thes.A day of Ouu7 2014 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 Poudre Valley Health Care, Inc.,dba Poudre Valley Health System, hereinafter referred to as the "Contractor". Contractor owns and operates Poudre Valley Hospital, a hospital located at 1024 South Lemay Avenue, Fort Collins,Colorado 80524("PVH"), and operates Mountain Crest Behavioral Health Center("Mountain Crest"), located at 4601 Corbett Drive, Fort Collins, Colorado 80528,as a department of PVH. PVHS, PVH,and Mountain Crest are collectively referred to herein 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 Response to the Request for 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 Cores Services funding to the Department for Home Based Intensive Services, and Crisis Intervention and Stabilization Services. 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, 2014, upon proper execution of this Agreement and shall expire May 31, 2015 unless sooner terminated as provided herein. 2. Scope of Services Services shall be provided by the Contractor to any person(s) eligible for services in compliance with • Exhibit A,Weld County's Request for 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. • 1 Ao4— a3 PY-14-15-CORE-0174 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. 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 Response to the Request for 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. 2 PY-14-15-CORE-0174 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 0MG Circular A-133. 6. Payment Method Unless otherwise provided in Exhibit A,Weld County's Request for Proposal, Exhibit B,Contractor's Response to the Request for Proposal, Exhibit B,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 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 3 PY-14-15-CORE-0174 - 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. 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 4 PY-14-15-CORE-0174 - 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. Contractor certifies that it shall comply with the provision of the Colorado Revised Statutes (C.R.S.)8- 17.5-101,et. seq. Contractor 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 to the Contractor that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this Agreement. Contractor represents, warrants, and agrees that it(a) has verified that it does not employ any illegal aliens,through participation in the Basic Pilot Employment Verification Program administered by the Social Security Administration and Department of Homeland Security, and(b)otherwise will comply with the requirements of C.R.S. 8-17.5-102(2)(b). Contractor shall comply with all reasonable requires made in the course of an investigation under C.R.S.8-17.5-102 by the Colorado Department of Labor and Employment. If Contractors fails to comply with any requirement of this provision or C.R.S. 8-17.5-101, et.seq., the Department may terminate this Agreement for breach and Contractor shall be liable for actual and consequential damages to the Department. Except where exempted by Federal law and except as provided in C.R.S.24-76.5-103(3),if Contractor receives federal or state funds under this Agreement,Contractor 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 this Agreement. If Contractor operates as a sole proprietor, it hereby affirms under penalty of perjury that s/he(a)is a citizen of the United States or is otherwise lawfully present in the United State 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 this Agreement. 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. 5 PY-14-15-CORE-0174 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 the Agreement,or any extension thereof,during any warranty period, and for three(3)years after termination of the Agreement.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: i. 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 6 PY-14-15-CORE-0174 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. iii. 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. g. 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 7 PY-14-15-CORE-0174 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. 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. 8 PY-14-15-CORE-0174 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 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: For Contractor: Heather Walker, Administrator Shari Simmons, Manager 9 PY-14-15-CORE-0174 17. Notice 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: For Contractor: Judy A. Griego, Director Shari Simmons, Manager P.O. Box A Mountain Crest Behavioral Health Center Greeley, CO 80632 4601 Corbett Drive (970) 352-1551 Fort Collins, CO 80528 (970) 207-4867 With Copy to: PVHS Legal Department 2315 East Harmony Road,Suite 200 Fort Collins, CO 80528 18. Litigation 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. 21. Governmental Immunity 10 PY-14-15-CORE-0174 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. 11 PY-14-15-CORE-0174 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. 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 Contractor agrees it is an independent contractor and that its officers and employees do not become employees of Weld County, nor are they entitled to any employee benefits as Weld County employees, as the result of this Agreement. 28. Entire Agreement This Agreement,together with all attachments hereto, constitutes the entire understanding between the 12 PY-14-15-CORE-0174 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. 13 PY-14-15-CORE-0174 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. 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. 14 PY-14-15-CORE-0174 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 d & / C.l ; 1, WELD COUNTY, COLORADO id (.' �c Weld County Clerk to the Board 4.‘s Lz Douglas Ra emacher,Chair OCT 2 2 2014 De4uty Clerk to the Board t>fbt CPI �I APPROVED AS TO FOR • ' `� � APPROVED AS TO FUNDING: • c----oaL016,8 County Attorney Controller WELD COUNTY DEPARTMENT POUDRE VALLEY HEALTH CARE,INC. DBA OF HUMAN SERVICES POUDRE VALLEY HEALTH SYSTEM By: I y A.Grie , Direcqm. I Kevin Unger,Chief Executive Officer of POUdre Valley Hospital and Medical Center of the Rockies 15 D!�- 303 WELD COUNTY'S REQUEST FOR PROPOSAL. Bid No. B1400069 BOARD OF COUNTY COMMISSIONERS OF THE COUNTY OF WELD, STATE OF COLORADO, BY AND THROUGH THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES DATE: 03/05/2014 PAGES 1-4 OF THIS REQUEST FOR PROPOSAL CONTAIN GENERAL INFORMATION. NOT ALL OF THE INFORMATION CONTAINED IN PAGES 1-4 MAY BE APPLICABLE. SPECIFICATIONS UNIQUE TO THIS REQUEST FOR PROPOSAL FOLLOW PAGE 4. 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 SERVICES (AS DESCRIBED ON PAGES 12-14) 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 11`h Avenue, Greeley, CO 80631, through: WEDNESDAY, MARCH 21, 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 12-14). 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, Service Utilization 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. B1400069 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 and the name of the state of the incorporationby th si enature and title of the g 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, Service Utilization 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. B1400069 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. Contractor certifies that it shall comply with the provisions of Colorado Revised Statutes (C.R.S.) 8-17.5-101, et seq. Contractor shall not knowingly employ or contract with an illegal alien to perform work under this Contract or enter into a contract with a subcontractor that fails to certify to Contractor that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this Contract. Contractor represents, warrants, and agrees that it (a) has verified that it does not employ any illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by the Social Security Administration and Department of Homeland Security, and (b) otherwise will comply with the requirements of C.R.S. 8-17.5-102(2)(b). Contractor shall comply with all reasonable requests made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and Employment. If Contractor fails to comply with any requirement of this provision or C.R.S. 8-17.5-101, et seq., Weld County may terminate this Contract for breach and Contractor shall be liable for actual and consequential damages to Contractor. Except where exempted by federal law and except as provided in C.R.S. 24-76.5- 103(3), if Contractor receives federal or state funds under this Contract, Contractor 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 this Contract. Page 3 Bid No. B1400069 If Contractor 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 a Contract. M. All goods shall remain the property of the seller until delivered to and accepted by Weld County, Colorado. N. 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, 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. Page 4 Bid No. B1400069 B. 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. C. 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 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. D. 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. E. 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. F. 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. G. 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 Page 5 Bid No. B1400069 beneficiary only. H. 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. 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, during any warranty period, and for three (3) years after termination of the Agreement. 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. ii. Types of Insurance: Contractor/Contract Professional shall obtain, and maintain n 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. (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: Page 6 Bid No. B1400069 * $1,000,000 each occurrence; * $2,000,000 general aggregate; * $2,000,000 products and completed operations 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 * 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 on Page 7 Bid No. B1400069 www.lns-Cert.com and link the information to 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. 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 8 Bid No. B1400069 Project Overview: The Weld County Department of Human Services (WCDHS) is seeking various services. Service areas include, but are not limited to, Anger Management/Domestic Violence, Day Treatment, Foster Parent Consultation, Foster Parent Training, Functional Family Therapy, Home Studies/Relinquishment Counseling, Life Skills, Mediation, Mental Health, Monitored Sobriety, Multi-Systemic Therapy, Home Based Intensive Services, Sexual Abuse Treatment, and Substance Abuse Treatment Services and Aftercare Services. Refer to pages 12-14 for specific definitions related to the above-mentioned service areas. Qualifications: To be considered, a bidder must meet the following minimum qualifications: 1) A bidder must submit a completed Provider Information Form. 2) 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. 1) 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. 3) 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. 4) A bidder must demonstrate the knowledge, training and expertise to conduct the proposed service(s). 5) A bidder must provide a current resume, as well as proof of licensure, for self and staff members. 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). 6) 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. Page 9 Bid No. 81400069 7) A bidder must demonstrate prior and current capacity to be organized, responsive and to quickly and successfully schedule services as requested. 8) 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 shall commence on June 1, 2014, through May 31, 2015, 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. 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: 2) Completed Provider Information Form with original signature of authorized representative. 3) 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. 4) 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. 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. Page 10 Bid No. B1400069 6) 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. 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. 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 11 Bid No. B1400069 SERVICE AREA DEFINITIONS Program , _ � flnition � , 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. 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. 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. Page 12 Bid No. B1400069 Program Area . # `a` x ,Definition ;_ ;_ ,,' . sue , Homes Studies/Relinquishment Counseling Home studies and home study updates per the standardized SAFE home study tool for the purpose of adoption, foster care, and expedited permanency planning. Relinquishment counseling for parents considering relinquishment of their children. 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. 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. Sex Abuse Treatment Therapeutic intervention designed to address issues and behaviors related to sexual abuse victimization, sexual dysfunction, sexual abuse perpetrations, and to prevent further sexual abuse and victimization. Page 13 Bid No. B1400069 Program.,Area l i . 'Definition ✓+ rte§ . 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 14 Bid No. B1400069 EXHIBIT A CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND«CONTRACTOR1» This Agreement, made and entered into the_day of ,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 Department's Request for Proposal, Exhibit B,Scope of Services,Exhibit C, Contractor's Response to the Request for Proposal, 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«funding»to the Department for «Services»;and NOW THEREFORE, in consideration of the premises,the parties hereto covenant and agree as follows: 1. Term This agreement shall become effective on «TermStart»,upon proper execution of this Agreement and shall expire«TermEnd», unless sooner terminated as provided herein. 2. Scope of Services Services shall be provided by the Contractor to any person(s)eligible for services in compliance with Exhibit A,Weld County's Request for Proposal,and Exhibit B,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 1 Bid No. B1400069 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 7`h of the month, following the month of service,utilizing billing forms required by the Department. 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, Department's Request for Proposal, Exhibit B, Scope of Services,,Exhibit C,Contractor's Response to the Request for Proposal,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. S. 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 2 Bid No. B1400069 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 A, Department's Request for Proposal, Exhibit B, Scope of Services, , Exhibit C, Contractor's Response to the Request for Proposal, 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 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 3 Bid No. B1400069 - 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. 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«funding». 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. 4 Bid No. B1400069 e. Contractor certifies that it shall comply with the provision of the Colorado Revised Statutes (C.R.S.) 8- 17.5-101,et. sea. Contractor 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 to the Contractor that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this Agreement. Contractor represents,warrants, and agrees that it(a) has verified that it does not employ any illegal aliens,through participation in the Basic Pilot Employment Verification Program administered by the Social Security Administration and Department of Homeland Security,and (b) otherwise will comply with the requirements of C.R.S. 8-17.5-102(2)(b). Contractor shall comply with all reasonable requires made in the course of an investigation under C.R.S.8-17.5-102 by the Colorado Department of Labor and Employment. If Contractors fails to comply with any requirement of this provision or C.R.S.8-17.5-101,et.seq.,the Department may terminate this Agreement for breach and Contractor shall be liable for actual and consequential damages to the Department. Except where exempted by Federal law and except as provided in C.R.S. 24-76.5-103(3), if Contractor receives federal or state funds under this Agreement, Contractor 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 this Agreement. If Contractor operates as a sole proprietor,it hereby affirms under penalty of perjury that s/he(a)is a citizen of the United States or is otherwise lawfully present in the United State 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 this Agreement. 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 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 5 Bid No. B1400069 Commissioners of Weld County, its employees,volunteers and agents. Contractor shall provided the liability(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. 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. - Standard Workman's Compensation and Employer's Liability o As required by State statute including occupational disease,covering all employees at the work site. - General Liability(PL and PD) (Minimum) o Combined single limit-$500,000.00 written on an occurrence basis. o Additional insurance required if claims reduce the annual aggregate below$500,000.00. o Weld County,State of Colorado,to be named as additional insured on each comprehensive general liability policy. o Certificate of Insurance to be provided to Weld County. o Insurance shall include provision preventing cancellation without 60 days prior notice by certified mail to Weld County. - Automobile Liability(Minimum)for any Contractor transporting children or any party to whom Department services are being provided. - Additional coverage may be required in specific program areas. For any insurance that are required by this Agreement,a completed Standard Certificate of Insurance shall be provided to the Department by the Contractor prior to the start of any Agreement. 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 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 6 Bid No. B14O0069 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. 7 Bid No. B1400069 - 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. 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: For Contractor: Heather Walker,Administrator «RepFName»eRepLName», «RepTitle» 17. Notice 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: For Contractor: Judy A. Griego, Director «NoticeFName»«NoticeLName», P.O. Box A «Addressl»,«Address2» Greeley.CO 80632 «City», «State» «Zip» (970) 352-1551 «Phone» 18. Litigation 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. 8 Bid No. B1400069 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 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 relationship 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, 9 Bid No. B1400069 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, 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 applicant/recipient of about or obtained from Child Protection. No information any 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 10 Bid No. B1400069 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 Contractor agrees it is an independent contractor and that its officers and employees do not become employees of Weld County, nor are they entitled to any employee benefits as Weld County employees,as the result of this Agreement. 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. Acceotance of Services Not a Waiver. Upon completion of the work, the Contractor shall submit to Department originals of ail 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. 11 Bid No. B1400069 32. Employee Financial Interest/Conflict of Interest. C.R.S. §§24-18-201 et sea. 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. 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. 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. 12 Bid No. B1400069 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,COLORADO Weld County Clerk to the Board Douglas Rademacher,Chair By: Deputy Clerk to the Board APPROVED AS TO FORM: County Attorney WELD COUNTY DEPARTMENT «CONTRACTOR1» OF HUMAN SERVICES By: By: Judy A.Griego, Director «SigFName» «SigLName», «Title» 13 Bid No. B1400069 EXHIBIT A REQUEST FOR PROPOSAL Bid No. B1400069 BOARD OF COUNTY COMMISSIONERS OF THE COUNTY OF WELD, STATE OF COLORADO, BY AND THROUGH THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES DATE: 03/05/2014 PAGES 1-4 OF THIS REQUEST FOR PROPOSAL CONTAIN GENERAL INFORMATION. NOT ALL OF THE INFORMATION CONTAINED IN PAGES 1-4 MAY BE APPLICABLE. SPECIFICATIONS UNIQUE TO THIS REQUEST FOR PROPOSAL FOLLOW PAGE 4. 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 SERVICES (AS DESCRIBED ON PAGES 12-14) 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: WEDNESDAY, MARCH 21, 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 12-14). 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, Service 14 Bid No. B1400069 Utilization 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. 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, Service Utilization 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. 15 Bid No. B1400069 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 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. Contractor certifies that it shall comply with the provisions of Colorado Revised Statutes (C.R.S.) 8-17.5-101, et seq. Contractor shall not knowingly employ or contract with an illegal alien to perform work under this Contract or enter into a contract with a subcontractor that fails to certify to Contractor that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this Contract. Contractor represents, warrants, and agrees that it (a) has verified that it does not employ any illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by the Social Security Administration and Department of Homeland Security, and (b) otherwise will comply with the requirements of C.R.S. 8-17.5-102(2)(6). Contractor shall comply with all reasonable requests made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and Employment. If Contractor fails to comply with any requirement of this provision or C.R.S. 8-17.5-101, et seq., Weld County may terminate this Contract for breach and Contractor shall be liable for actual and consequential damages to Contractor. 16 Bid No. B1400069 Except where exempted by federal law and except as provided in C.R.S. 24-76.5- 103(3), if Contractor receives federal or state funds under this Contract, Contractor 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 this Contract. If Contractor 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 a Contract. M. All goods shall remain the property of the seller until delivered to and accepted by Weld County, Colorado. N. 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, 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. 17 Bid No. B1400069 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. 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. C. 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 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. D. 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. E. 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. F. 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. G. 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 18 Bid No. B1400069 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. H. 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. 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, during any warranty period, and for three (3) years after termination of the Agreement. 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. 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. 19 Bid No. B1400069 (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; * $2,000,000 products and completed operations 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 * 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. iii. 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 20 Bid No. B1400069 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 on www.lns-Cert.com and link the information to 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. 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. 21 Bid No. B1400069 Project Overview: The Weld County Department of Human Services (WCDHS) is seeking various services. Service areas include, but are not limited to, Anger Management/Domestic Violence, Day Treatment, Foster Parent Consultation, Foster Parent Training, Functional Family Therapy, Home Studies/Relinquishment Counseling, Life Skills, Mediation, Mental Health, Monitored Sobriety, Multi-Systemic Therapy, Home Based Intensive Services, Sexual Abuse Treatment, and Substance Abuse Treatment Services and Aftercare Services. Refer to pages 12-14 for specific definitions related to the above-mentioned service areas. Qualifications: To be considered, a bidder must meet the following minimum qualifications: 1) A bidder must submit a completed Provider Information Form. 2) 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. 1) 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. 3) 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. 4) A bidder must demonstrate the knowledge, training and expertise to conduct the proposed service(s). 5) A bidder must provide a current resume, as well as proof of licensure, for self and staff members. 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). 6) 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. 22 Bid No. B1400069 7) A bidder must demonstrate prior and current capacity to be organized, responsive and to quickly and successfully schedule services as requested. 8) 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 shall commence on June 1, 2014, through May 31, 2015, 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. 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: 2) Completed Provider Information Form with original signature of authorized representative. 3) 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. 4) 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. 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. 23 Bid No. B1400069 6) 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. 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. 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. 24 Bid No. B1400069 SERVICE AREA DEFINITIONS ,Progrartt 1fea - en. ,t 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. 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. 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. 25 Bid No. B1400069 Pro ,. d. ® finiti A ftS � pv. rti .. • s . vx. aRh}r�t r Y u9%..,•.+;y:-.. Homes Studies/Relinquishment Counseling Home studies and home study updates per the standardized SAFE home study tool for the purpose of adoption, foster care, and expedited permanency planning. Relinquishment counseling for parents considering relinquishment of their children. 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. 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. Sex Abuse Treatment Therapeutic intervention designed to address issues and behaviors related to sexual abuse victimization, sexual dysfunction, sexual abuse perpetrations, and to prevent further sexual abuse and victimization. 26 Bid No. B1400069 Program"Area Definition tI" ' 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. 27 Bid No. B1400069 EXHIBIT B SCOPE OF SERVICE 1. 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. 2. 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. Upon receipt of an invitation from the Department,Contractor must contact the Child Welfare Contract and Services Coordinator to request approval to bill for participation if Contractor wishes to be reimbursed. The Department will reimburse for actual participation in the meeting only so long as the meeting is at least one hour in length,the Contractor requests approval to bill in advance of the meeting and participation in the meeting is deemed appropriate and necessary by the Department. Staffings and/or meetings other than those listed above are not considered reimbursable unless otherwise approved by the Child Welfare Contract and Services Coordinator. 3. 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. 28 Bid No. B1400069 EXHIBIT C CONTRACTOR'S RESPONSE TO THE REQUEST FOR PROPOSAL 29 Bid No. B1400069 EXHBIT 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, 2015. 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 «Rate Schedule» 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 7`h 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. 30 Bid No. B1400070 BOARD OF COUNTY COMMISSIONERS OF THE COUNTY OF WELD, STATE OF COLORADO, BY AND THROUGH THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES DATE: 03/05/2014 PAGES 1-4 OF THIS REQUEST FOR PROPOSAL CONTAIN GENERAL INFORMATION. NOT ALL OF THE INFORMATION CONTAINED IN PAGES 1-4 MAY BE APPLICABLE. SPECIFICATIONS UNIQUE TO THIS REQUEST FOR PROPOSAL FOLLOW PAGE 4. 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: CRISIS INTERVENTION AND STABILIZATION SERVICES 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 21, 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 Crisis Intervention and Stabilization Services. 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, Service Utilization 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. B1400070 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, Service Utilization 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. B1400070 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. Contractor certifies that it shall comply with the provisions of Colorado Revised Statutes (C.R.S.) 8-17.5-101, et seq. Contractor shall not knowingly employ or contract with an illegal alien to perform work under this Contract or enter into a contract with a subcontractor that fails to certify to Contractor that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this Contract. Contractor represents, warrants, and agrees that it (a) has verified that it does not employ any illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by the Social Security Administration and Department of Homeland Security, and (b) otherwise will comply with the requirements of C.R.S. 8-17.5-102(2)(b). Contractor shall comply with all reasonable requests made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and Employment. If Contractor fails to comply with any requirement of this provision or C.R.S. 8-17.5-101, et seq., Weld County may terminate this Contract for breach and Contractor shall be liable for actual and consequential damages to Contractor. Except where exempted by federal law and except as provided in C.R.S. 24-76.5- 103(3), if Contractor receives federal or state funds under this Contract, Contractor 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 this Contract. Page 3 Bid No. B1400070 If Contractor 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 a Contract. M. All goods shall remain the property of the seller until delivered to and accepted by Weld County, Colorado. N. 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, 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. Page 4 Bid No. B1400070 B. 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. C. 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 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. D. 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. E. 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. F. 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. G. 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 Page 5 Bid No. B1400070 beneficiary only. H. 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. 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, during any warranty period, and for three (3) years after termination of the Agreement. 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. 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. (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: Page 6 Bid No. B1400070 * $1,000,000 each occurrence; * $2,000,000 general aggregate; * $2,000,000 products and completed operations 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 * 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 on Page 7 Bid No. B1400070 www.lns-Cert.com and link the information to 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. 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 8 Bid No. B1400070 Project Overview: The Weld County Department of Human Services (WCDHS) is seeking Crisis Intervention and Stabilization Services. Crisis Intervention and Stabilization Services are defined as 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. The primary goal of services is to prevent out-of-home placement of youth and/or child(ren) and provide families with the services they need to maintain their youth and/or child(ren) in their home. Services may also be utilized for crises occurring during reunification. At a minimum, a bidder must include the following in a proposed service package: • Crisis Response, inclusive of in-person/in-home crisis intervention and stabilization, and safety planning (24 hours a day, 7 days a week) • Solution-focused, strength-based short term interventions to assist the family in mitigating or eliminating the crisis (45-60 days maximum) • Case management • Referral to additional services • Access to community resources to ensure sustainability of progress post-crisis • Collaboration with WCDHS and other agencies, including courts and school Qualifications: To be considered, a bidder must meet the following minimum qualifications: 1) A bidder must submit a completed Provider Information Form. 2) 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. 3) 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 Page 9 Bid No. B1400070 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) A bidder must demonstrate the knowledge, training and expertise to conduct Crisis Intervention and Stabilization Services. 6) Bidder acknowledges that all Crisis Intervention and Stabilization workers must retain a Bachelor's degree or higher. A bidder must provide a 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. 7) 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. 8) A bidder must demonstrate prior and current capacity to be organized, responsive and to quickly and successfully schedule services as requested. 9) A bidder must agree to enter into a contract, attached as Exhibit A, with Weld County Department of Human Services and comply with all requirements of the contract. Contract Period and Pricing: 1) The initial contract period shall commence on June 1, 2014, through May 31, 2015, 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. 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. Page 10 Bid No. B1400070 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) Completed Provider Information Form with original signature of authorized representative. 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. 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) 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. 7) 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. 8) 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. Page 11 Bid No. B1400070 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 12 CONTRACTOR'S RESPONSE TO THE REQUEST FOR PROPOSAL. Weld County Department of Human Services Core and Services Contract Coordinator PO Box A Greeley, CO 80632 March 17, 2014 To Whom It May Concern: Mountain Crest is excited to be responding to the 2014-2015 RFP for Core and Contract Services for Weld County youth. Over the last fourteen years, Mountain Crest Residential and Outpatient Wraparound Programs have experienced success in working with youth who have significant mental health issues and are in need of residential or outpatient services. Our emphasis on the Wraparound philosophy (See Attachment A), an evidence-based approach has allowed us to work with some of the most challenging youth with success. Mountain Crest is equipped to accommodate the requirements, terms and conditions as specified in the RFP B1400069 for PY2014-2015. In the documents that follow, the selection committee will be presented with the following: Letter of Intent Provider Information Form Proposed Services, Scope and Rates Certificate of Insurance and W-9 Resumes, Licensure for Staff Summary of Wraparound, Trauma Informed Care Training Mountain Crest has demonstrated itself as a cutting-edge program with positive outcome measures. 2013 data is as follows: 90% of youth were successful, 3 months post-discharge from Residential 80% of youth were successful, 3 months post-discharge from Outpatient Wraparound Mountain Crest has found that providing youth with a variety of flexible and accessible treatment programming based on cultural, environmental, physical and emotional needs; allows families a sense of empowerment and investment in treatment. Areas evaluated in post discharge success, as well as focus areas on each individual Treatment Plan include: Safety- Children are protected and maintained in the lowest level of care whenever possible. Permanency-- Children have consistency, permanency and stability in their familial relationships. We offer a continuum of care designed to prevent out of home placements. Well Being— Services are provided to enhance children's educational, physical, emotional and mental health needs. Mountain Crest is one of the health care entities under the umbrella of University of Colorado Health. As a 2012 Malcolm Baldridge Award winner, University of Colorado Health works to ensure that all of the hospitals under its ownership employ staff who can carry out its vision: To provide world-class health care. Mountain Crest employees are evaluated annually on their ability to successfully carry out the mission of the hospital: To he an independent, non-profit, organization,providing innovative, comprehensive care of the highest quality and exceeding customer expectations. In addition, staff receive annual training on Trauma Informed Care. (See Attachment B) In Avatar (the patient satisfaction survey utilized by Mountain Crest), the RTC unit, staff, programming and treatment are evaluated by youth and their families on a monthly basis. Data from this program evaluation is computed and benchmarked across the system, requiring action plans for areas needing improvement. The RTC credits its program excellence to these patient surveys and constantly revises services based on client needs. With an overall 96% residential success rate on Avatar surveys in 2013, youth on the Residential unit were the greatest testimony to the benefits of treatment. It is with confidence that we stand behind our treatment at Mountain Crest in the Residential and Outpatient Adolescent programs and will provide a continuum care that promotes family voice/choice, individualized treatment, healthy development, and preservation of dignity. Respectfully Submitted, Shari Simmons, LCSW Manager of Residential Services Community Based Menu of Services for Weld County 2014-2015 Service Areas: Home Based Intervention, Mental Health Services, Mediation/Intensive Family Services In-Home Wraparound: This evidence-based process emphasizes family "voice and choice" in treatment. With a team of both professional and natural supports, families are supported in their communities through services that each youth's team agrees upon. The Wraparound process allows for goals the family embraces, bringing about change that is sustaining and promotes self-sufficiency and permanency within the home. This service is available to youth, ages 5-18, who currently reside in the community or are transitioning out of placement. Duration of this service is typically 3-9 months. Services included - • Therapist/Wraparound Facilitator to meet with youth and family as agreed upon by the team • Intensive weekly Individual and Family Therapy in the home • Parent education and support • Strength Needs and Cultural Discovery • Risk Assessment • Crisis/Relapse Prevention Planning • Natural support team development • Youth is connected with community resources as agreed upon by the team • Monthly Team Meetings and Care Plan Updates • Court reports and appearances as necessary • Assistance with Community Service requirements • Life skill/Independent living skill development Rates— $1800.00 per month (or $60.00 per day for partial monthly services) Service Areas: Home Based Intervention, Mental Health Services, Mediation/Intensive Family Services In-Home Wraparound (Therapist Only): Youth, ages 5-18 or families that need an in-home therapist only. Services to include - • Intensive weekly Individual and Family Therapy in the home • Crisis Stabilization • Monthly Team Meetings and Care Plan Updates • Court reports and appearances as necessary • Parent education and support Rates— $1000.00 per month (or$33.00 per day for partial monthly services) Service Areas: Home Based Intervention, Life Skills In-Home Wraparound (Facilitator Only): Youth, ages 5-18 or families that need an in-home Wraparound Facilitator to lead team meetings, provide education on parenting skills, assist youth/family on accessing resources in the community and providing case management services. Services included - • Wraparound Facilitator to meet with youth and family as agreed upon by the team • Case management Services • Crisis/Relapse Prevention Planning based on Strength Needs and Functional Assessment • Natural support team development • Youth is connected with community resources as agreed upon by the team • Monthly Team Meetings and Care Plan Updates • Court reports and appearances as necessary • Parent education and support • Community Service assistance • Life skill/Independent living skill development Rates— $800.00 per month (or $26.00 per day for partial monthly services) Service Area: Crisis Intervention and Stabilization, Home Based Intervention, Mental Health Services Short-term Crisis Stabilization: (for youth at immediate risk of out-of-home placement who need adjunct services to stabilize). This service is offered to youth who may or may not already be receiving Intensive In-home services but are experiencing higher acuity needs and require additional support. This service will be used as a prevention or intervention tool. A trained counselor will meet with the youth/family and begin creating a detailed Crisis Plan for longer term stabilization. The counselor will meet with the clients in-home for intensive, ongoing support for up to a maximum of 4 weeks. Services Included — • Develop a detailed written plan to prevent future escalations • Concrete behavior management strategies for parents to help with issues such as parenting, communication, anger management, mood management, child development • Identify and utilize resources within their communities and within their extended support networks • Develop on-call emergency support plan • Identify child welfare concerns and make appropriate reports • Assess and make recommendations for ongoing mental health services Response time: Counselor will contact youth and/or family within the next business day. Referrals made to the Wraparound Program at Mountain Crest at 970-576-5014. Rates— $100.00 per hour for face to face contact, phone, travel, documentation and on-call support. Service Area: Other Mentoring: This service will focus on youth, ages 10-19 who need a positive role model in their lives. Trained counselors will engage youth in pro-social activities such as volunteering, recreational activities and developing hobbies/interests. Mentors will also support youth in school,job hunting and creating/maintain positive peer relationships. Rates— $50.00 per hour Service Area: Other After School Groups: Gender-specific programming for youth, ages 12-18 including transportation for youth from school to meeting location. Topics will cover healthy relationships, boundaries, self-esteem, goal setting, coping skills, problem solving, and identity development. Counselors will pick youth up from schools at 3:15pm and parents or guardians will be expected to pick youth up by 5:30pm. Snacks will be provided. Rates — 4 groups per month, with transportation and snack - $50.00 per group/per youth. 10 week program. Need a minimum of 3 youth per group. SHARI LYNETTE SIMMONS 851 Scarborough Dr. Loveland,CO 80538 (970)402-6536 QUALIFICATIONS SUMMARY Sixteen years experience managing/supervising and providing training to clinical and school personnel (both in private practice and in residential facilities). Seventeen years experience providing therapy to children, adolescents and families from diverse populations. Extensive background in program development, assessment and intervention, treatment planning and systemic problem solving. Proven ability to interact successfully with a broad range of community agencies, social services and law enforcement entities. Awareness of trends in mental health and ability to strategically plan according to changing community needs. EDUCATION LCSW Licensed in the state of Colorado— 1997 Masters Degree in Social Work Denver University— 1995 Bachelor Degree in Social Work Colorado State University— 1993 PROFESSIONAL HISTORY Clinical Director- Poudre Valley Hospital (Mountain Crest Adolescent Residential/Outpatient Programming and The Corbett House): 2005-2010 *Manage a 14 bed residential facility for adolescents and 8 bed transitional living unit *Manage an adolescent outpatient program that specializes in the Wraparound Philosophy *Developed and implemented Wraparound programming in 2007 in the Residential milieu *Developed and currently supervise Wraparound facilitators in the Mountain Crest aftercare(in-home) program *Supervise and evaluate team of 30 professionals consisting of therapists, psychiatrist, school personnel and mental health technicians *Provide training for employees and for professionals in the community on the (- Generation, Working with gang-involved youth, Secondary PTSD and Group Therapy *Manage budget/financials *Write policies/protocols in compliance with State Regulations and JCAHO standards *Actively involved in fundraising, providing presentations to law enforcement and schools, PR within the community *Secure funding and solidify contracts with providers *On-call administrator for all adolescent units, adult inpatient and Crisis Assessment Center in the ER *Grievance Representative on the residential unit *Obtain and configure data from patient satisfaction scores and Balanced Score Card Clinical Supervisor- Wingshadow, Inc.: 2003-2005 *Developed and managed an 18 bed RTC program for adolescents *Supervised 20 clinicians *Interfaced regularly with the Board of Directors *Created and implemented policies and procedures for the residential program and a short term, crisis/assessment and stabilization unit *Provided 27/10 psychiatric assessment *Facilitated treatment conferences *Trained employees on Ethics, Brief-Solution Focused therapy, Crisis Milieu *Management and DSM Diagnosis *Managed and operated a non-profit budget *Provided 24 hour on-call consultation for the residential unit and the school *Developed RFP proposals *Assisted with grant writing and fundraising Clinical Supervisor- Stillwater Services, LLC: Founded company in 2001-2004 *Employed and supervised team of therapists and mentors who provided in-home individual/family therapy and after school therapy groups *Developed the following programs for the Weld County: El Mundo de Esperanza (a non-profit that provided after school counseling) and Smart Start (a internship partnership with local businesses and adolescents) *Provided educational classes and support groups for youth and families sentenced by the courts—(Anger Management, Conflict Resolution, Girls Empowerment) *Submitted court reports and testified as an expert witness on Child Protection cases Weld County Juvenile Detention Supervisor: 2002-2003 *Supervised employees who screened Weld County youth once they were apprehended by law enforcement *Made decisions regarding the detainment or future placement of youth based on screening criteria and local policy *Evaluated incarcerated youth for future services Clinical Supervisor/Contract Therapist—EAGLE Homes: 1998-2002 *Supervised case managers and therapists providing care to foster children and teen mothers *Facilitated clinical meetings to establish treatment plans *Provided training for the Foster Parents Consortium - classes on cutting behaviors, PTSD, communication, Ritualistic/satanic abuse *Provided individual, foster family and biological family therapy Therapist—Alternative Homes for Youth: 1995-2001 *Developed treatment plans for youth—diagnosis and goals *Facilitated treatment staffings *Provided individual, family and group therapy *Provided "play therapy" for younger clients *Supervised MSW interns *Educated line staff during weekly staff meeting about diagnosis and intervention Case manager— Family Extension: 1993-1995 *Provided case management to youth and families in foster care *Provided pre-service and on-going training to foster parents *Performed assessments and wrote home studies on prospective foster parents Darortd R. Dotson, Ph.D., U[Vi°FT 512 E. Monroe Dr. D412 Ft. Collins, CO 80525 970:231.0856 dotsondamond@yahoo.com Education Ph.D. 1995. Child and Family Development. Specialization: Marriage and Family Therapy. The University of Georgia, Athens, Georgia. M.S. 1991, Human Development and Family Studies. • Specialization: Marriage and Family Therapy. Colorado State University, Fort Collins, Colorado. B.S. 1989. Psychology. Minor: Management. Texas A&M University, College Station, Texas. Professional Licenses Licensed Marriage and Family Therapist, State of Colorado, #576. Professional Experience Investigative Assistant. Kroll Government Services, Loveland, CO. Gathered sensitive information from state and local legal and law enforcement agencies, employers, landlords, and personal references to assist with final adjudication for employment with the California Department of Corrections. Utilized MS Office tools (Word, Excel, and Outlook) to conduct detailed documentation and management and follow-up for background inquiry requests for multiple applicants. 2008-present. Instructor. Front Range Community College, Fort Collins, CO. Developed and presented course content using Power Point presentations. Incorporated online tools to post lecture notes, administer quizzes, and receive submissions of student work. Grading responsibilities included training students in the technical aspects of scientific writing and documentation of research sources. Email and online communication tools were used to communicate with students. Courses taught: human growth and development over the lifespan, introductory psychology courses, and the psychology of gender. 2003-present. Instructor. Colorado Christian University, Loveland, CO. Masters of Counseling program. Developed and presented course content using Power Point presentations. Incorporated online tools to post lecture notes, conduct online discussions of course readings, receive submissions of student work, and post grades. Courses taught: research and evaluation, human growth and development. 2007-present. Licensed Marriage and Family Therapist. Private practice & Light of the Rockies Christian Counseling Center, Fort Collins, Colorado. Provided counseling to individuals, couples, and families with a range of presenting problems including anxiety, depression, alcoholism and substance abuse, addictions, stress management, anger problems, marital difficulties, adolescent developmental concerns, parenting, divorce and remarriage, domestic violence, and grief and loss issues. Created and maintained a database of marketing contacts. Created a marketing package including the development of brochures, staff biographies, and description of services. Created and tracked annual budgets using Excel spreadsheets. As President of the Board, facilitate discussions and decisions on matters such as increasing the utilization of counseling services, financial and budgetary issues, and the management of staff. 1998-2008. Youth and Family Coordinator. Meadowlark Church of Christ, Fort Collins, Colorado. Led. a program for adolescents ages 12-19 for a 300-member church. Created and maintained Access database of church membership/student participants. Used Word, Publisher, and Power Point to create printed information and advertising for classes and events. Managed multiple ongoing projects requiring coordination and communication with volunteers. Coordinated international travel for teams of 10-12 including creating itineraries and collaborating with the leaders of foreign human relief programs. Other responsibilities included creating and teaching classes and workshops for teens and adults, planning and leading international and local service projects, and developing and leading weekend retreats. 1995-2003. Adjunct Supervisor. Department of Human Development and Family Studies, Colorado State University. Supervised Master's level students' practicum in marriage and family therapy assisting couples, families, and individuals with a wide range of family and relationship difficulties. 2001-2005. Clinic Coordinator. University of Georgia, McPhaul Marriage and Family Therapy Clinic, Monitored daily operations of the clinic: created and maintained client database, conducted intake interviews, tracked therapists' training hours. Trained and supervised interns in conducting intake interviews and following clinic procedures. Assisted in the preparation of materials for AAMFT accreditation review. 1991-1993. Clinic Coordinator. Colorado State University, Marriage and Family Therapy Clinic. Monitored daily operations of the clinic: conducted intake interviews, maintained active and archived files. Assisted in the preparation of materials for AAMFT accreditation review. 1989-1990. Scholarships and Honors Master Teacher Award Nomination, Front Range Community College, Ft. Collins, Colorado, 2006. The Hazel and Gene Franklin Scholarship, University of Georgia, 1993. Kilgore Scholarship Recipient, University of Georgia, 1991, 1992. University-Wide Assistantship Recipient, University of Georgia, 1991. Membership Psi Chi National Honor Society, 1988. Amy M. Martin, LPC 2903 Brumbaugh Dr. Fort Collins, CO 80526 970.227.3022 'ucation .inter of Arts, Community Counseling, University of Northern Colorado, 2003. Bachelor of Fine Arts, University of Nebraska-Lincoln, 1999. Professional Experience Clinical Care Coordinator, Mountain Crest, Poudre Valley Hospital, October 2008-present. • Conduct individual and family therapy sessions with residents on a weekly basis. • Coordinate a weekly art therapy group for all residents. e Attend monthly treatment review meetings with parents/guardians, county caseworkers and other community professionals involved in cases. • Provide after care services for residents and their families and/or coordinate discharge service planning. Private Practice Therapist, August 2007 present. • Provide weekly in-home therapy and case management for Larimer County families. • Coordinate parent support and therapy groups. • Complete court-ordered and requested mental health evaluation reports for clients. Intensive Care Coordinator, Lorimer Center for Mental Health, September 2007-October 2008 (half-time position). • Provided case management and treatment planning for clients in a psychiatric setting. < Coordinated discharge planning and client aftercare with psychiatric hospital doctors and staff. • Facilitated collaboration with all parties involved in client care to improve integrated service delivery. MST Supervisor, Lorimer'Center for Mental Health, July 2006-September 2007. • Managed team of 8 MST therapists, providing individual and group supervision, attending sessions to provide live supervision, and monitoring therapist adherence to the MST model. • Served as a Larimer Center representative and mental health consultant on the Level 1 Drug Court Team, worked with adolescents and families participating in Drug Court to access MST treatment as well as get connected with other local family services, • Maintained positive working relationships with professionals from DHS, Probation, Judicial Court and DYC and assisted in coordinating referrals from those agencies. MST Therapist, Larimer Center for Mental Health, October 2005-July 2006. • Provided intensive home-based treatment and case management for a caseload of 5-6 families. • Provided crisis intervention and 24-7 on-call services to MST families, < Assisted families in safety and supervision planning to prevent and address high-risk behaviors of youth. • Maintained high adherence to MST model while providing services. Core/HUB Therapist, Larimer Center for Mental Health, November 2004-October 2005. • Provided crisis assessment and intervention, as well as brief therapeutic interventions for the DHS HUB. • Completed mental health evaluations for youth involved in the judicial system as well as adults involved in DHS cases. e Provided individual and family therapy treatment to children and adults involved with DHS through Core Services. e Served as a mental health consultant for DHS caseworkers to help identify and coordinate appropriate community services for clients of DHS. • Therapist, Peak Wellness Center, Cheyenne, WY February 2004-October 2004 • Provided individual and family therapy to youth and families at the Center as well as on-site at the Department of Family Sen'ices, • Assisted in coordinating the adolescent substance abuse program and completed SA evaluations, led groups and provided individual treatment to youth and their families. Other Work Experience Program Assistant'0utreach Coordinator, City of Fort Collins SmartTrips Program, February 200)-February 3007. AmeriCorps'' VISTA Volunteer, Safe Nights Coordinator, Lincoln; NE, August 1999-August 2000. Jennifer Hall Fort Collins, CO - (970)310-0509, halljennyann@gmail.com a t r • Summary of qualifications: • Colorado State Licensed Professional Counselor#5917 • Two+years field experience providing individual, group,and family therapy post-degree • Master's in Counseling Psychology for University of Denver-May 2007 • Seven years work experience including one year servicing a college population • Excellent skills in treatment planning,verbal/written communication,and documentation Work Experience: Poudre Valley Health—A Malcom Baldrige Hospital • Mountain Crest Therapist March 2009-present • Collaborate with family and professionals to develop care plan • Meeting with families in-home and onsite to guide individual and family therapy • Staffing clients with county Social Services, and Youth Probation to meet treatment goals • Assessment of patient to guide treatment intervention Mental Health Counselor/Shy Coordinator July 2009-present • Organization of staff and shift responsibilities • • Individual case management to promote behavioral health of individual residents a . Running groups for psycho-education and therapeutic processing • Managed therapeutic milieu to maintain safety,professionalism,customer service • Mentoring of employees to promote their professional development Crisis Assessment Clinician December 2010-present • Triage of mental health patients in PVH emergency department • Coordination with police and medical personnel to determine disposition • Matching mental health needs of client to the appropriate level of care Highlands Behavioral Health Intake Clinician June 2008-June 2010 • Make provisional psychiatric diagnoses based on DSM-IV criteria • Assessment of mental health patients to determine appropriate level of care • Coordinated care with psychiatrists, therapists, and primary care physicians Colorado Christian University Counseling Center Clincian August 2006-May 2007 • Provided individual psychotherapy for students with relational, familial,and identity concerns • Counseled couples through premarital curriculum • Presented actual case studies to two clinical teams University of Denver Mental Health Clinic Counselor January 2006-May 2006 • Supplied adult community members with individual therapy services • Assessed client needs and objectives via intake interviews • Received and provided live colleague feedback on a weekly basis (4/12/2011) Nathan Hartman - Nathan Hartman resume 2-11.doc Page 1 I NATHAN HARTMAN , MA , LPC 816 Snowberry Street Longmont, CO 80503 nathan@bouldervalleycounseling.com 303-817-5341 EXPERIENCE Mountain Crest Behavioral Health Center, Fort Collins, CO Clinical Care Coordinator, Residential Treatment Center(RTC) (May 2010—present) • Providing individual, family, and group psychotherapy for adolescents and their families. • Participation in Wraparound team approach for inpatient and outpatient clients in Weld, Arapahoe, and Boulder Counties. Equinox Counseling and Wellness Center, Denver, CO Clinical Director(September 2009— May 2010) • Directing clinical programming at a community-based counseling center • Clinical supervision of interns and therapists • Providing individual, group, and family counseling for youth, adults, and families • Guiding multidisciplinary treatment working with Social Services, Colorado Department of Youth Corrections, school interventionists, medical doctors, and psychiatrists • Member of leadership team, trainer/educator for clinical and technical staff • Design and facilitation of wilderness and adventure experiences to adjunctively supplement ongoing therapy and counseling Boulder Valley Counseling (Private Counseling Practice), Boulder, CO Psychotherapist (January 2005- Present) • Individual, group, and family psychotherapy and counseling for adolescents, adults, and families • Multidisciplinary treatment working with schools, medical doctors, and psychiatrists • Transpersonal approach integrating cognitive behavioral, developmental, experiential, and humanistic modalities • Facilitate wilderness and adventure experiences to adjunctively supplement ongoing therapy and counseling Outer Edge Performance, Denver, CO Clinical Team Member, Ropes Course Facilitator and Rock Climbing Instructor(April 2008 - Present) • Facilitation of high and low ropes course initiatives for adolescents and young adults • Guiding of adolescent groups to outdoor rock climbing areas, oversight of safety protocols, risk management and facilitation of briefing and debriefing • Clinical therapist facilitating clinically-based adventure and wilderness therapy programming Naropa University, Boulder, CO Co-Director, Undergraduate Academic Advising Center(June 2004— June 2007) • Supervision of advising staff and coordination with administrative and academic departments • Development of systems, procedures, and policies relevant to advising 450+ students • Academic advising of 90+ undergraduate students • Brief counseling and subsequent referral of high risk/need students Mountain Crest Behavioral Health Center, Fort Collins, CO Treatment Team Leader, Residential Treatment Center(RTC) (October 2002-July 2004) (4/12/2011) Nathan Hartman - Nathan Hartman resume 2-11.doc Page 2 • Unit oversight/supervision, program development/coordination, and milieu therapy for adolescents • Clinical team member involved in case management, treatment planning, and extensive contact with community agencies and schools • Group and individual therapy with an adolescent population diagnosed with ADHD, Bipolar, Depression, PTSD, RAD, substance abuse/dependence, Schizoaffective Disorder, Bulimia/Anorexia, ODD, and GAD Mental Health Center of Boulder County - Child, Adolescent, and Family Services Team, Longmont, CO Graduate Intern (September 2001 -July 2002) • 700+ hours of clinical work conducting individual, group, and family psychotherapy • Coordination of multidisciplinary treatment with psychiatrists, case managers, and family/youth advocates • Responsible for case management and client advocacy in Longmont schools and area resources Attention Homes, Boulder, CO Residential Counselor(June 1998-August 1999) University of Wyoming — Laramie, WY Graduate Teaching Assistant (August 1997 - June 1998) Shodair Children's Hospital, Helena, MT Residential Child Care Worker(June 1996-August 1997) EDUCATION Naropa University, Boulder, CO M.A., Transpersonal Counseling Psychology, 2002 University of Wyoming, Laramie, WY Ph.D. Candidate, Clinical Psychology, 1997-1998 Colorado State University, Fort Collins, CO B.S., Psychology, Human Development/Family Studies Minor, 1996 LICENSURE & ADDITIONAL TRAINING Licensed Professional Counselor, State of Colorado Current from January 2005, LPC#3967 Wilderness First Responder Wilderness Medicine institute—NOLS (current through December 2011) Bottom Managed Climbing Instructor Certification American Climbing Institute, Boulder, Colorado (April 2009) Bottom Managed Climbing Instructor Course (4/12/2011) Nathan Hartman - Nathan Hartman resume 2-11.doc Page 3 American Climbing Institute, Boulder, Colorado (May 2008) Ropes Course Facilitator Training Leahy, Inc. Golden, Colorado (April & May 2003) Basic Facilitator Course — 40 hours Critical Skills for Safety — 30 hours 338 Amber Drive (970)776.6351 Mndsor,CO 8055D Thadeus Jessen • Qualifications • Strong working relationships with many agencies and resources in Larimer County in order to provide the best treatment and services for clients and their families. High level of independence, initiative, energy and integrity. Personable and innovative team player, resourceful, flexible and reliable. Experience 8/2007— present Poudre Valley Health System Fort Collins, CO Clinical Care Coordinator • Individual Psychotherapy sessions on a weekly basis. • Family therapy sessions on a weekly basis, unless contraindicated. • Group therapy sessions. • Monthly treatment review meetings with wrap treatment team meetings. • Discharge planning. • Utilization Management. • Working closely with the wrap facilitators and treatment teams. • Working closely with the addictions therapist and group. 2/2007 - 8/2007 Larimer Center for Mental Health Fort Collins, CO MST (Multi-Systemic Therapist) • Population 12-17 years old and their caregiver(s), in the legal system. • All clients are at risk of being placed out of their home. • Family therapy, on call, crisis interventions, and intensive case management. • Service planning with multiple agencies. 6/2006-2/2007 Larimer Center for Mental Health Denver, CO Core Services Therapist • In home and out patient therapy for children and adults. • Helping adults whom have lost custody of their child or children complete their service plans and regain custody. • Transitioning clients from residential treatment facilities and hospitalization. • Worked closely with Department of Human Services caseworkers. 10/2005-6/2006 Larimer Center for Mental Health Fort Collins, CO Family Preservation Therapist • Individual, couple and family therapy provided in the home. • Goal setting and crisis management provided to families at risk of having their children removed from the home. • Mental health representative on the Multi Disciplinary Action Team (MDAT). 10/2004-10/2005 Larimer Center for Mental Health Fort Collins, CO Platte Valley Youth Services Counselor • Provided counseling and stabilization for youth at the youth correction facility in Greeley, Colorado. • Managed youth on suicide watch. • Coordinated with psychologists, security staff and management team. 5/01-10/2004 Larimer Center for Mental Health Fort Collins, CO Family Preservation Therapist • See above Additional Licensed Professional Counselor (3535, expires'8/2009) Levet 1 EMOR Trained. Qualifications Co-Occurring Champion Group Member(Substance Abuse and Mental Health Services). Training Committee for Larimer Center for Mental Health. Intern coordinator and clinical supervisor Larimer Center for Mental Health Education May 2001 University of Northern Colorado Greeley, CO • Masters of Art in Agency Counseling. May 1999 University of Northern Colorado Greeley, CO • Bachelors of Arts, Psychology Mr. Darcy L. Speer 3930 Boulder Dr. Loveland, CO 80538 970-988-6340 .. Objective: I would like to use the skills I have gained in 11 years of working with youth and 12 years of building relationships in the banking industry to work on Wraparound team at Mountain Crest Hospital. Executive Summary: • 11 years working with youth in probation, youth corrections, and church youth group settings. • 12 years working with people and families in the banking industry listening to needs and providing solutions. • 9 years teaching, coaching, and counseling at different levels and in different settings in my church, including public speaking experience. • 2 years training new employees in my position. December 13th 2010-Current Poudre Valley Health Systems/Mountain Crest Hospital-Wraparound Facilitator • Interview families to determine strengths, needs, and culture to help treatment team with treatment plan based on these things. • Facilitate treatment process by helping the family form a team of natural supports as well as the professionals involved in their lives. • Coordinate team meetings and document treatment plans. • Collaborate with other professionals such as caseworkers and probation officers with team oriented treatment for families. April 3`d, 2006-November S°, 2010 Compass Bank-Senior Financial Sales Consultant • Meet branch goals in new accounts, home equity loans, business accounts, mortgage loans and investments. • Develop new business and cross-sell current business for all branch goals by making both inside and outside consumer and business calls. • Trainer for new hire employees in my position. February 1999—Present Lost and Found and the River Foursquare Churches-Various Teaching Capacities • Nine years teaching, coaching and counseling in small group and Sunday school setting. • Associate pastor for men's ministry. • Church Council for 6 years. • 4 years of public speaking. • 4 Missions trips, one youth related. • 5 years working with youth groups. September 2001-March 2006 Western States Bank/Western Insurance Services-Loan Officer/Insurauce Agent • Solicit new installment loan business by making in person business calls, • and cold and warm•phone calls. • Underwrite, and process new installment loan applications, both home equity and consumer loans. Collect title and deed of trust info, file appropriate liens, and release appropriate liens. • Helped commercial lenders file the appropriate liens on both vehicles and commercial real estate. • Collect on loan payments that became past due. • Commercial and consumer insurance sales making both inside and outside calls January 2001-September 2001 Smith Barney-Registered Sales Assistant • Conduct client investment performance reviews, research and complete client reports. • Purchase investments as instructed by broker. • Customer service contact for the broker. • Assist with customer presentations and seminars. September 1997-January 2001 Commercial Federal Bank-Personal Banker • Meet branch goals in home equity and consumer loans. • Solicit and process all loan applications. • Work with title companies to order title work. • Collect and file deed of trust info for home loans and titles for auto loans. • Refer current customers to investment broker for appointment opportunities. • 6 months in the mortgage closing department. Preparing loan documents for 6 mortgage bankers. Prepared full sets of documents to include deeds of trust, HUD settlement statements, and truth in lending statements. Obtained title work from various title companies. November 1991-September 1997 State of Nebraska- Youth Counselor and Juvenile Probation Officer • Plan and implement treatment in a youth corrections setting. • Observe and interact with youth in group and one to one settings. • Perform pre-sentence investigations with youth and their families, compile' information into pre-sentence reports, form and make recommendations for court, find out of home placements, and supervise case load of approximately 60 youth. Degrees University of Nebraska-Lincoln Bachelor of Science in Criminal Justice-1991 Licenses Held Series 6, Series 63,Life, Health, Property, and Casualty. Print Lookup Details Page I of I w t iY 1\1 sY'4 Barbara J.K0111:y 1 r� t � � 3 l�s• rr Executive Director • t ?pap 1 Dep,Artmv.nt of Rcgu'atrry Ag!ncles Lookup Detail View Licensee Information This serves as primary source verification*of the license. *Primary source verification:License information provided by the Colorado Division of Professions and Occupations, established by 24.34-102 C.R.S. Name Public Address Shari Lynette Simmons Loveland, CO 80538 Credential Information License License License Original Issue Effective Expiration Number Method License Type Status Date Date Date CSW.00991864 Examination Licensed Clinical Active 07/31/1997 09/01/2013 08/31/2015 Social Worker Board/Progam Actions Discipline There is no Discipline or Board Actions on file for this credential. Generated on: 3/18/2014 3:27:22 PM paps://wwtia-.coloraclo.gov clora/licensing/Lookup/PrintL.icenseDetails.aspx'?creel=88075>&... 3/18/2014 Print Lookup Details Page 1 of ] oarbara J.Kelley �ti1 i • r _ h,, ,,,, Executive Director Ocpartmentof Reg u'alcryAgencicc ` Lookup Detail View Licensee Information This serves as primary source verification*of the license. *Primary source verification:License information provided by the Colorado Division of Professions and Occupations,established by 24.34-102 C.R.S. Name Public Address Damond R Dotson Fort Collins, CO 80525-2038 Credential Information License License License Type License Original Issue Effective Expiration Number Method Status Date Date Date MFT.0000576 Examination Marriage and Family Active 04/13/2001 09/01/2013 08/31/2015 Therapist Board/Progam Actions Discipline There is no Discipline or Board Actions on file for this credential. Generated on: 3/18/2014 3:26:17 PM https://w\v\v.coloraclo.gov/dOrailicensi ng/I.00kup/PrintLicenseDetails.aspx'?cred=3744 51&... 348/2014 Print Lookup Details Page 1 of 1 thieH kPP a;; Barbara J.Kelley t,1�1r s \ »w Executive Director ' �;,.tj" h nerarlmant ofaegu'atary Agencies a4- Lookup Detail View Licensee Information This serves as primary source verification*of the license. *Primary source verification:License information provided by the Colorado Division of Professions and Occupations,established by 24-34.102 C.R.S. Name Public Address Amy Michele Martin Fort Collins, CO 80526-6230 Credential Information License License License Original Issue Effective Expiration Number Method License Type Status Date Date Date LPC.0004310 Examination Licensed Professional Active 05/05/2006 09/01/2013 08/31/2015 Counselor Board/Proqam Actions Discipline There is no Discipline or Board Actions on file for this credential. Generated on: 3/18/2014 3:26:57 PM lutps:/hv w.colorado.gov/dora/licensing/Lookup/PrintLicenseDetails.aspx?erect=867034&.,. 3/18/2014 Print Lookup Details Page 1 of 1 � 1 c a : Barbara J.Kelley /PC! ! 1 ,� - Executive Director . •.t8 lb Department of 4094184,y Agencies • ._ Lookup Detail View Licensee Information This serves as primary source verification*of the license. "Primary source verification:License information provided by the Colorado Division of Professions and Occupations,established by 29-34-102 C.R.S. Name Public Address Jennifer A Brandsma 4601 Corbett Drive Fort Collins, CO 80528 Credential Information License License License Original Issue Effective Expiration Number Method License Type Status Date Date Date LPC.0005917 Examination Licensed Professional Active 11/26/2010 09/01/2013 08/31/2015 Counselor Board/Progam Actions Discipline There is no Discipline or Board Actions on file for this credential. Generated on: 3/18/2014 3:24:27 PM baps:/1w ww.colorado.gov/flora/licensing/Lookup/Print I.icenseDetails.asps'?cred=861034&... 3/18/2014 Print Lookup Details Page 1 of I ': Barbara J.Kelley /%f1]'' 1 >�1\ ;1,Yoti E7.171 ''- Executive Director { .' ia Oeariment of Begestory Aeroflot ��= � Lookup Detail View Licensee Information This serves as primary source verification* of the license. *Primary source verification:License information provided by the Colorado Division of Professions and Occupations,established by 2434-102 C.R.S. Name Public Address Nathan C. Hartman Longmont, CO 80503 Credential Information License License License Original Issue Effective Expiration Number Method License Type Status Date Date Date LPC.0003967 Examination Licensed Professional Active 01/26/2005 09/01/2013 08/31/2015 Counselor Board/Progam Actions Discipline There is no Discipline or Board Actions on file for this credential. Generated on: 3/18/2014 3:25:58 PM hops:1/wwtc.colorado.goy/dora/licensing/Lookup/PrinlLieenseDetai ls.aspz°creel=866527&... 3/13/2014 Print Lookup Details Page 1 of 1 J. ra 11411 l pil`r1• \'‘:• ; ; r Barbara J.Kelley Executive Director `- •'.iatfi..=/ Qeprtment of iequ'atery Agrnde% }a Lookup Detail View Licensee Information This serves as primary source verification*of the license. *Primary source verification:License information provided by the Colorado Division of Professions and Occupations,established by 24-34-102 C.R.S. Name Public Address Thadeus C lessen Fort Collins, CO 80528-9579 Credential Information License License License Original Issue Effective Expiration Number Method License Type Status Date Date Date LPC.0003535 Examination Licensed Professional Active 08/21/2003 09/01/2013 08/31/2015 Counselor Board/Progam Actions Discipline There is no Discipline or Board Actions on file for this credential. Generated on: 3/18/2014 3:25'33 PM ttps://ww‘v.co klora/licensing/Lookup/Printl.icenseDetails.asps?cre(1=405780&... 3/18/2014 _{ " Co-Sponsored by Colorado Members and NCISN The ci,ad the university of Southern California y t '� s `Traumatic Stress Network "n " AdotescentTrauma Training Centerr Integrative Treatment of Complex Trauma for Adolescents This training will provide information on ITCT-A, a treatment approach developed to assist clinicians with evaluation and treatment of adolescents who have experienced multiple forms of psychological trauma, often in the context of socioeconomic deprivation. When : February 18th and 19th from 9:00 am - 4:30 pm Where: The Colorado Department of Human Services at the Colorado Mental Health Institute at Fort Logan 3520 W. Oxford Ave • Denver, CO 80236 Presenters: Dr. John Briere and Dr. Cheryl Lanktree The core components of ITCT-A include: Assessment-driven treatment; attention to complex trauma issues; use of multiple treatment modalities; relational processing of early attachment schema and current interpersonal expectations, cultural and developmental adaptations for clients needs; skills development; therapeutic exposure and exploration of trauma; and advocacy and interventions at the system level. **This training is FREE and offers CE credits through the NCTSN for APA and NASW** Please join us for this amazing training opportunity by clicking on the link: https://duke.qualtrics.com/SE/?SID=SV__432bvgBMUJzcHOJ For questions contact: www.NCTSN.org.org Kimberly Blackshear at 919-613-9854 . . ,,; or kimberly.blackshear@duke.edu PY-14-15-CORE-0174 EXHIBIT C SCOPE OF SERVICES 1. Contractor will provide Home Based Intensive Services, in the form of Outpatient Wraparound,and Crisis Intervention and Stabilization Services,to individuals and families,as referred by the Department. 2. Home Based Intensive Services(Outpatient Wraparound): Contractor will provide Outpatient Wraparound services, an evidence-based process,to those families referred by the Department. • Services are available as follows: • In-Home Wraparound(Therapist and Facilitator) • In-Home Wraparound(Therapist Only)—Utilized when youth or family require in-home therapy only. • In-Home Wraparound(Facilitator Only)—Utilized when youth or family require facilitation of team meetings, education on parenting skills, assistance in accessing community resources, and case management services. • Services include: • Therapist and/or Wraparound Facilitator interaction with youth and family in the home • Intensive individual and family therapy in the home • Parent education and support • Assessment of strengths, needs and cultural discovery • Risk assessment • Natural support through team development • Crisis/relapse prevention planning • Youth is connected with community resources as appropriate • Monthly team meetings and Care Plan updates • Court reports and appearances as necessary • Assistance with Community Service requirements • Life skills/independent living skill development • Services are available as follows: • In-Home Wraparound(Therapist and Facilitator) • In-Home Wraparound(Therapist Only)—Utilized when youth or family require in-home therapy only. • In-Home Wraparound(Facilitator Only)—Utilized when youth or family require facilitation of team meetings,education on parenting skills,assistance in accessing community resources, and case management services. • The goal of the Wraparound Aftercare Services Program is to bring the residential program to the youth's home and community by providing needed support and services that the Wraparound team has agreed upon. The intent of the services is to solidify the work begun in residential placement and empower families to implement what is needed for their own unique circumstances,ultimately allowing for self-sufficiency. 3. Crisis Intervention and Stabilization Services: Contractor will provide Crisis Intervention and Stabilization Services for youth at immediate risk of out-of-home placement who are experiencing higher acuity needs and require additional support to stabilize. Services are intended to serve as a prevention and/or intervention tool,and are short term(maximum of four weeks). Services include: • Development of a detailed written plan to prevent future escalations • Concrete behavior management strategies for parents to help with issues such as parenting, 1 PY-14-15-CORE-0174 communication,anger management,mood management,and child development • Identification and utilization of resources within the youth's community and within their extended support networks • Development of an on-call emergency support plan • Identification and reporting of child welfare concerns • Assessment of ongoing mental health concerns and recommendations to address those concerns 4. 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. S. 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. 6. 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. 7. 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. 8. 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. 9. 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. 10. 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 PY-14-15-CORE-0174 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, 2015. 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 Crisis Intervention and Stabilization Services: $100.00/Hour(Inclusive of face-to-face contact, phone,travel,documentation and on-call support) Home Based Intensive Services (Outpatient Wraparound): $1,800.00/Month (Therapist and Facilitator) $1,000.00/Month (Therapist Only) $800.00/Month (Facilitator Only) $60.00/Day (Partial Monthly Services—Therapist and Facilitator) $33.00/Day(Partial Monthly Services—Therapist Only) $26.00/Day(Partial Monthly Services—Facilitator Only) 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. 1 PY-14-15-CORE-0174 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 -----1 ® MM1DD/YVYY) 4/MM)DDh ACOO DATE( R CERTIFICATE OF LIABILITY INSURANCE 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). CONTACT PRODUCER Beecher Carlson Insurance Services, LLC NAME 321 North Clark Street, 5th Floor PHONE • FAX Chicago, IL 60654 E-MAIL Est):_ (AIC.No): E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAICA INSURER COpic Companies I 11860 • INSURED INSURER B: Poudre Valley Health Care Inc. INSURER C: Steadfast Insurance Company 26387 dba Poudre Valley Health System 2135 E. Harmony Rd Suite 200 INSURER 0: _ Fort Collins CO 80528 INSURER E _ INSURER F: COVERAGES CERTIFICATE NUMBER: 19779688 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. A COMMERCIALOFI NEURAL LIABILITY -- ADDL 5UBRI- - -- -- - - --��- POLICY EFF POLICY E%P INSR POLICY NUMBER POLICY IMM/DDIYYYY) LIMITS ✓ LTR INSD wvD,H000008522 4/1/2014 4/1/2015 EACH OCCURRENCE _ 5 1,000,000 DAMAGE TO �/ CLAIMS M1IADE ✓ PREMISES(Ea o occur OCCUR RENTED 5 500.000 MED EXP(Any one person) 5 5,000 PERSONAL BADV INJURY 5 1,000,000 I GENE AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE- _ 5 3,000,000 I PRO- r 1 PRODUCTS COMP/OP AGO $ 1,000,000 ' I POLICY JEDT L_i LOc I 5 - - I OTHER COMBINED SINGLE LIMIT $ AUTOMOBILE LIABILITY '. (Ea accitlentl _. • BODILY INJURY(Per person) 5 A • LL AUTO ALL _ OWNED SCHEDULED BODILY INJURY(Per accident) 5 AUTOS _ AUTOS --- NON-OWNED PROPERTY CAMAGE 5 HIRED AUTOS AUTOS l (Per accident) 5 --' C ✓ UMBRELLA LIAR 1_e OCCUR 'HPC 9155525-00 4/1/2014 4/1/2015 EACH OCCURRENCE $ 15,000,000 EXCESS LIAB I CLAIMS-MADE AGGREGATE 5 15,000,000 DED RETENTION 5 5 WORKERS COMPENSATION PER ' OTH- • ANY PRDPRIMOR/PARTNER:E+ STATUTE ER__ AND EMPLOYERS'LIABILITY Y I N OFFCER'MEMBER/EXCR LUDED%ECUTIVE EL EACH ACCIDENT 5 N IA (Mandatory in NH) EL.DISEASE-EA EMPLOYEE 5 If yes.describe under E L DISEASE-POLICY LIMIT 5 DESCRIPTION OF OPERATIONS below A 'Health Care Professional Lability j :HCO0008522 4/1/2014 4/1/2015 Per Claim: $1,000,000 Aggregate:$3,000,000 I • iI DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached it more space is required) Mountain Crest Behavior Health Services Inc. is additional named insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Weld County Department of Human Services THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 3156 N 11th Avenue ACCORDANCE WITH THE POLICY PROVISIONS. Greeley CO 80632 AUTHORIZED REPRESENTATIVE // n iikovvvI (CHI)Frank C. Dodero ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD CERT NO.-- _65/ 'CHI: peeve Lsai 4.e/]2:; 12-50.23 rN :do_ . c_ 1 October 17, 2014 Beth Rasmussen 229 East 215` Street Road Greeley, CO 80631 RE: Decision Dear Ms. Rasmussen: A pre-dismissal hearing was held with you on Thursday, October 16, 2014, per Weld County Code, Section 3-4-20. During this hearing, you presented information verbally regarding the contents of your pre-dismissal letter, dated October 15, 2014. You did not wish to add an written statements. 1. You stated that, for the most part, the performance issues outlined in the pre-dismissal letter were accurate and you did not refute them. You stated that you appreciated the efforts of the Ft. Lupton Management Team and Ms. Yolanda Morales-Leon, South County Program Resource Specialist, who assisted you in training and management support. 2. You identified two areas of the letter that you had disagreement or it was an area of concern to you. One area was the entering of incorrect multipliers for client's reported earned income. You felt that you were originally told to use the wrong set of multipliers when you began employment and that affected your scores; however, you became aware recently that you were not entering the multiplier formula correctly. The second concern was the statement that you lacked "concern for your job and for the well-being of the clients we serve". You stated that statement was not accurate. You cared for your job and for the well-being of clients. 3. You identified a time, during your early employment in Ft. Lupton (approximately 2009- 2011), when your cubicle were surrounded by Spanish-speaking technicians. You felt that the possibility to learn from these technicians was hampered because of the language barrier and that you were further were concerned by their conduct in making unprofessional remarks in Spanish. You reported the unprofessional remarks to the former Ft. Lupton Manager, Jamie Ulrich. 4. You made a request to me to be transferred to another position that would better meet your skills and interests; however, you stated that you realized that option may be remote because you were not meeting expectations in your present position. The Eligibility Technician position is a vital position for the smooth operation of the Department of Human Services. It is essential that the position be filled on a full-time basis with someone capable of fully performing the essential functions and assigned duties of the position. After review of your personnel file and your verbal statements at your pre-dismissal hearing, I have decided to terminate you from your position as an Eligibility Technician effective October 17, 2014, for failure to meet performance standards in the areas of 1) Accuracy in determining eligibility; 2) Quality/Consistency of case processing; customer service; and production standards. You are not able to perform all the essential functions of your job. You have the right to grieve your dismissal per Weld County Code, Section 3-4-60. If you have questions concerning the grievance process or any benefits to which you may be entitled, please contact County Human Resources. A copy of the Grievance sections is enclosed with this letter. Sincerely, Judy A. Griego, Director Weld County Department of Human Services cc: Luis Garcia, John Kruse, Assistance Payments Division Head Patti Russell, Director, Weld County Human Resources Hello