HomeMy WebLinkAboutbocc.con.094.2014 RESERVED
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Licensed Provider Fiscal Agreement RECEIVED
PRkin County Health and Human Services PROVIDER#: 462�-8
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Eagle, CO 81631 � NFACT H�h�MAN SERVICES
Mt Sopris Montessori School
879 Euclid Ave
Carbondale, CO 81623
This Agreement is entered into and between Pitkin County, herein referred to as"DepartmenY'and Mt
Sopris Montessori School, herein referred to as"provide�'who will provide child care at the following
address: 879 Euclid Ave. Carbondale. CO 81623. This Agreement shail be in effect from 2/17/2014 to
2/28l2017.
Provider Agrees to:
1. Maintain a valid child care license as required by Colorado Statute and conform to all applicable
State, Federal Regulations and local law.
2. Report to the county if the provider's license has been revoked, suspended, or denied within
three(3)calendar days of receiving notification, a recovery will be established of all payments
made as of the effective date of ciosure.
3. Allow parents immediate access to the child(ren)in care.
4. Accept referrals for child care without discrimination with regard to race, color, national origin,
age, sex, religion, or physical or mental handicap.
5. Provide children with adequate food, shelter and rest.
6. Maintain as strictly confidential all infortnation conceming children and their families.
7. Protect children from abuse/neglect and report any suspected child abuse and neglect to the
Department.
8. Hold the Colorado Department of Human Services and the State of Colorado hartnless for any
loss or actions caused by the performarice of this Agreement.
9. Provider shall offer free, age-appropriate aitematives to voluntary activities.
10. Provide child care at the facility address listed above and ensure that care is provided only by the
person or business listed above. Provide care for children under this agreement only'rf authorized
by the Department in advance.
11. Sign the child care Fiscal Agreement and all other county or state required forms. Develop an
individualized care plan for children with addRional child rare needs.
12. Notify the Department of unexplained, frequent and/or consistent absences within ten (10)
calendar days of an established pattem:
13. Providers are required to collect the fuli parental fee each month:Parental fees are due to the
provider from the parent or adult caretaker at the beginning of the month. Report non-payment of
parental fees no later than the last day of the month for which they have not been received.
14. Maintain proof of age-appropriate immunizations for the children in the provider's care, if required
by county policy. Immunization records shall be obtained from parents or adult caretakers either
at the time of admission or within thirty(30)calendar days of the date of admission and shall be
updated annually. For children whose parents or adult caretakers object to immunizations on
religious grounds or for children whose medical condition contraindicates immunization, providers
shall maintain a statement in the child's file signed by the parent or adult caretaker stating the
reason for not immunizing.
15. Shall not charge the counties more than the established private pay rates and keep the
Departrnent informed of changes in the private pay rates within ten (10)days of the change. ,
Attach a copy of the current charge policies on rates, transportation, activiry, registra6on fees and
payment policies. Allowable rates and other associated charges shall be in accordance with State
Rules for Colorado Child Care Assistance Program. The provider is subject to recovery if the
reported private pay rates are lower than the agreed upon county reimbursement rates
established in this Fiscal Agreement.
16. Shall not charge parents or adult caretakers rates in excess of those agreed upon in the Fiscal
Agreement(this includes the agreed upon registration, activity and transportation fees'rf ihe
Cf.AP Lirer�¢ed ProviAr.r Ficral Aarnemenf lRw. 09@0111 7 M 3 �
county pays these fees).The rate in the Fiscal Agreement is the maximum allowabfe rate of
reimbursement for the care provided and includes any portion for which the parent or adutt
caretaker is responsible.
17. The provider understands that they must attend a county face-to-face training before the provider
will receive a Point-Of-Service(POS)device. The provider is required to use the POS device to
record attendance and bill for care provided.
18. Maintain a land-based phone service to ensure that the POS terminal is abie to submit
attendance information to the Department for payment on a weekly basis.
19. Provider is responsible to ensure the parent or adult caretaker swipes his/her card to check the
. child(ren) into and out of care daily for attendance tracking and payment Missed check-in and
checkout swipes may be updated within nine (9)days of the date of service. The Depar6ment
does not guarantee payment to the Provider if the authorization status on the POS device is
"pending,""denied,"or"not authorized." If the child care is not authorized, the parent or adult
caretaker shall be responsible for payment and the Departrnent shall not be held liable.
20. Provider is responsible to contact A�liated Computer Service, Inc(ACS)at 1-877-779-1932 if the
Point of Service(POS)terminal stops working for any reason for troubleshooting or repair.
21. If the provider stops caring for children under the Colorado Child Care Assistance Program they
shall contact ACS to request a self-address postage paid retum label to assist in retuming the
POS device. If the POS device is not retumed within thirty(30)days and in good shape(allowing
for normal wear and tear)to ACS a recovery will be established for the cost of replacement for
the POS device which is$365.
22. The provider is required to maintain sign in/out sheets for children in their care. These records
shall be maintained for three years plus the current year and are to be made available to the
Department upon request
23. The provider may manually bill the Departrnent for services authorized, based on county payroil
policies, that were not reimbursed automatically based on the POS transactions. The provider
shall provide sign in/out sheets to suppoR requests for manual payment. The provider forteits
payment for services.if the original manual billing fortn is submitted more than sixty(60)calendar
days following the end of the month the service period ended.
24. Never keep in their possession(whether at the facility or in any other place)a clienYs CCAP
Card. Possession of any CCAP Card(s)will tertninate this Fiscal Agreement and prevent the
provider from providing child care assistance services in the future with any county in Colorado.
25. The provider understands that if the provider commits fraud or an intentional program violation
the provider will be subject to disqualification from the Colorado Child Care Assistance Program
(CCCAP) as a provider for 12 months for the first offense; 24 months for the second offense and
permanently for the third offense.
26. The Department and/or child care licensing shall have the authority to inspect the provider's
facility for the presence of CCAP Cards or any other suspicious billing information. Upon
discovery of these materials the provider understands either of these enti6es have the right to
seize these materials inGuding the CCAP Cards andlor POS Device.
27. I understand that any overpayment will be recovered including, but not limited to, inaccurate or
fraudulent billing. If at the time any overpayment is established while your fiscal agreement is
active, the amount of the overpayment will be deducted beginning with the next child rare
payment and every payment thereafter until the overpayment is paid in fuil. If your fiscal
agreement is inactive, the county shall collect the overpayment in accordance with standard
collection procedures which may include State Income Tax intercept. Fraudulent billing will be
prosecuted.
28. The provider will be paid the rates agreed upon in this fiscal agreement listed below.
CCAP Licensed Provider Fiscal Aareemenl(Rev.09I20171 2 of 3
Full Time Rates
Rate T e OM-6M 6M-12M 12M-18M 18M-24M 24M-30M 30M36M 36MSA SA
R utar $0.00 $0.00 $0.00 $49.55 $49.55 $49.55 $46.60 $46.60
Part Time Rates
Rate T OM-6M 6M-12M 12M-18M 18M-24M 24M-30M 30M-36M 36M-SA SA
R ular $0.00 $0.00 $0.00 $38.50 $38.50 $38.50 $34.80 $34.80
Provider Rights:
1. When a provider contends that the county has not made adequate payment based on program rules
for care provided,the provider has the right to an informal conference with county staff pursuant to 9
CCR 2503-1 at Section 3.910, (D).
• Providers may request a conference in writing within 15 days of the date of the action.
• This request should be addressed to the county director of the county Department of
Social/Human services responsible for the action.
• Provider may request that State CCCAP staff participate in the conference. That participation
may be by telephone conference.
• The conference shali be held within two weeks of the date the request for a conference is
received by the county.
• The purpose of the conference is limited to discussion about the payments in dispute and the
relevant rules regarding payment.
• The final decision of the county shall be mailed to the provider within 15 days of the
conference date.
2. A provider may request an informal conference if s/he disputes the termination of a Fiscal Agreement.
• Providers may request a conference in writing within 15 days of the date of the action.
• This request should be addressed to the county director of the county Department of
Social/Human services responsible for the action.
• The conference shall be held within two weeks of the date the request for a conference is
received by the county.
• The purpose of the conference is limited to discussion about the termination of the fiscal
agreement pursuant to 9 CCR 2503-1 at Section 3.906, (D).
• The final decision of the county shall be mailed to the provider within 15 days of the
conference date.
Department Agrees to:
1. Provide face-to-face training to the provider on how to use the Point of Service(POS)device prior to
entering into a Fiscal Agreement with the provider.
2. Enter the Fiscal Agreement into the Childcare Automated Tracking System(CHATS)within frve(5)
business days of receipt of the completed Fiscal Agreement and all supporting documentation.
3. Determine clienYs eligibility for child care services within fifteen (15) days of receiving the complete
application packet including verification.
4. Send Child Care Authorization Notices to the provider within seven (7)working days of the
DepartmenYs initial approvai or prior to making any changes in eligibility for each child such as
parental fees, author¢ed amount of care, added or deleted children, and/or any other changes to
child care arrangements. `
5. Reimburse the provider for aufhorized chiid care in accordance with Colorado Child Care Assistance
Program rules. Payment to the licensed provider is the total cost of authorized pre based on rates
set by this Agreement minus the parental fee.
This Agreement may be terminated by either party by giving the other party fifteen(15)days notice. This
,�yreement may be terminated without advance notice if a child's health or safety is endangered, if the
provider is under a negative licensin9 action, or if the Department verified the provider possesses any
CCAP card(s).
CCAP Licensed Provider Fiscal Aareement(Rev.09/201 tl 3 of 3
By signing this Agreement, the provider acknowledges receipt of infortnation regarding the rules and
policies of the Colorado Child Care Assistance Program. The effective date of this contract is the date
that the county receives and signs the Fiscal Agreement. The provider shall receive a copy of the signed
Fiscai Agreement
� '� CHILD CARE DIRECTOR or OWNER
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Authorized Representative D te
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Mailing Address
C�b�.l�., Co 81��3 R7o- 963-350 6
City, State, Zip Phone Number � �
DEPARTMENT OF SOCIAUHUMAN SERVICES
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uthonzed Repr sentative _ l . Date �
PO 8ox 680
Address
Eaale CO 81631 � � 970.328-8888
City,State, Zip Phone Number
CCAP Licensed Provider Fscal Agreement(Rev.09/2011) � 4 of 3