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Home My WebLink Aboutbocc.con.095.2014 c��-,�� -� � _ �� s - z� � y /: � � . � dSs - ��c� - ��SI � Licensed Proyider FisGal Agreement Pitkin County Health antl Human Services PI tOVIDER#: 1548990 � PO Box 660 � Eagle, CO 81631 � BasaltCampus Kids (2f-CrjVE� 51 School St Basalt, co aisz� �EB 6 2014 !!Fr1LTH F i 1�l:;.q�. 4-RVICS 7his Agreement is entered into and tween Pitkin Counry, herein referred o as"Deparim8ht'�anb Basalt Camous Kids, herein referred to as"provider who will provide child�are at the tolbwing address: � � 51 School St&�salt. CO 81921. This Agreemerit shall 6e in effed from 2l'L 1�4 to 2 2 Y 7. - � Provider Agrees to: �1. Maintain a valitl child care license as required by Colorado Statute and wnfirm to all applicable � � State, Federal Regulations anil local law. 2. RepoA to the county if the providers license has been revaked,su;pended, or denied within three{3}calendar deys of receiving notification,a recovery will be E sfablished of all payments made as af the ef�ective date of closure. 3. Allow parents immediate access to the child(ren) in care. � . 4. Accept referrals for child care without tliscrimination with regard to ace,color, naGonal origin, age,sex, religion, or phyaical or mental handicap. 5. Provide children with adequate food, shetter and rest. 6. Maintain as strictly confidentlal all informaUon conceming children:md their families. 7. Protect children from abuselneglect and report eny suspected chilc aBuse antl naglect to the . Department. g. Hold the Calorado Department of Muman Services and the State a Colorado harmless for any � . loss or actions causad by the performance of this Agrcement. ' 9. . Provider shall offer hee,age-appropriate al[ematives to voluntary z ctivities. 70. Provide child care al the facility address Iisted above and ensuie U at care is proviEed onty by the . person or business listed above. Provitle care for children under th s agreement onty if authorized by the Department in ativence: 11. Sign the chiltl cara Fiscal Agreement and all other county or state i equired forms, Develop an individualized care plan for children with addiNonal chiltl care need �. � 12. Notify the Department of unefcplained,hequeot andlor consistent a�sences within ten(10) � ' celendar days af an established pattem. � 13. Provitlers are required In collect the full parental fee each rtronth. F areMal fees are due to the � provider from the parent or adult pretaker at the beginning of the i nonth. Report non-payment of parental(ees no later than the last day of the month far which they have not hcen received. 14. Maintain prooi of age-appropriate immunizations for the children in the prwiders care,if required by county policy. Immunization records shall be obteinetl hom parE nts or aCUlt ceretakers e'rther at the Hme of admissian or wRhin thidy (30)calendar days of the d�ite of admission arxi shall be updated annually. For children wbose parents or aduH caretake�s c�bjact to immunizations on religious grounds or for children whosa medical wndition conVainc icates immunizatian, providers � 'shall maintain a statement in tha child's file signed by Ihe parent oi adult ca2talcer stating the . reason for not immunizing. � � 15. Shall not charge tha counties more than the established private pa� rates and keep the Department informed of changes in the pri�ale pay retes within ter (10)days of the change. At�ch a copy of the eurrent charge policies on retes,transportatio i,activity;registration fees . and payment policies.Allowable rates and other assuciated charg�:s shall he in accordance wfth Stete Rules for Colotedo Child Ca2 Assistanee Program. The pro�ider is subject to recovery if the reported phvate pay rates are lower than the agreetl upon cc unry reimbursement rates establisFied in this Fiscel Agreement 18. 6hall nat charge parents or edult caretakers rates in excess of tha se agreed upon in the Fiseal Agreement(this includes the agreed upon registration, activiry anc twansporfation fees if tfie G0/L0 39tid �OOHOS 3�QQIW l�tlSVH S06S48E0L6 8L�9T 4SBL(90/L0. , ��. , ( counry pays these fees).The rate in the Fiscal Agreement is the rrr.ximum allowable rate af reimbursement for the caie provided a�d includea any partion for w iich the�parent or adWt , caretaker is responsible. 17. The provider understands mat they must attend a county face-to-fa��training before the pmvider will receive a PoinlAf-Service(POS)device.The provider is requin;d to use the POS device to recortl ettentlance antl bip forcare provided '18. Maintain a land-based phone service to ensure that the POS termir al is able to submit ettendance information to the Deparonent for payment on a weekly basis. 18. Proviaer is responsible to ensure the parent or adult carataker swlp:s his/her cerd to check the child(ren) into and out Of care daily for altendance tracking and pay nent Missed check-in antl . check-out swipes may be updated within nine(9)days of the tlate c f service. The Department does not guarentee payment ro the Provider if the authorizetion sta us on the POS device is "pending,""denled,"or"not authorized"If the ehild care is not autlu�rized, the parent or atlu It pretaker shall be responsible for payment and the Departmant sha II not be held liable. � 20. Provider is responsible to confact�liated Computer Service, Inc(�CS)at 1-877-779•1932 if the • � Point of Service(POS)terminal staps working for any reason for�trc ubteshooting or repair. • . 21. If the provider stops earing for children under the Colorado Child C:ue Assistance Program they shal)oontact AGS ta request a selfadAress postage paid retum lab sl W assist in retuming the � POS device. If the POS device Is not reNrned within thirty(30)day:;and In gootl shape(allowing for normal wear and tear)to ACS a recovery will be established for the cvst of replacement for the POS de�lce which is 3365. � � . � 22. The provider fs required to maintain sign inlout sheets for children i �their care.7hese records . shall be maintained for three years plus the wrrent year and are to be made available to the Departrnent upon request. � 23. The provider may manu3ly bill the Department for services authorc:ed, based on wurrty payrWl policies, that were rrot reimbursed autpmaticaly based on the POS transaetions.The provider shall provide sign in/out sheets to support requests for manual payi nent.Tfie provider forfeits payment for senices If the original manual billing form is submitted more than sixty(60)calandar days following the end of the monM the service pedutl entletl. � - 24. Never keep in their possession (whether at the facility or in any oth ar place)a client's CCAP � . Card. Possession oi any CCAP Carcl(s)will terminate this Fisoal Ac,ireement antl prevent the pravider from providing child care assisten6e se�vices in the fUture Nith any county in Coforedo. 25. 7he provider underahands that if the provider commits fraud or an i��tendonal program viulation the provider will be subjed to disqualification from the ColoraCO Ch Id Care Assistance Program (CCCAP)as a provider fnr 12 months for the flrst offense;24 mond is for the second offense and � permanently for�the third offen5@. � . 26. The Department andlor ehiltl care Ilcensing shall have the authorit� to inspect the providers facility for the presence of CCAP Cartls or any other suspieious 6ili ng informadon. Upon � � discovery of these ma4erials the provider understands either of the:;e enti6es have the right to seize these materials including the CCAP Cards andlor PO$Devic e. 27. I understand thet eny overpayment will be recadered including, but not IimRed to, inaccurate w frauGUlent bitling. If at the time any overpayment is established v�hile your fiscal agreement is adive,lhe amount of the overpayment will be deducted beginnir a with Ihe neM child care payment end every payment thereaRer undl the overpayment is pa d in full. If your fiscal agreement is inactive,tha eounty Shall callect the overpeyment in�.ocordance wifh sfantlafd collecdon procedures which may inGude State Income Tex tnterce�t Fraudulent bilGng wiil be prosecuted. � 28. 'The pravider will be paid the rates agreed upon in this fiscal agreei nent listed below. b0/Z0 3JVd 100Fp5 3�QQIW l�VSdH - 5065D8£0L6 Bd�Si 7T0Z/90/L0 , f _ �_ Full Time Rates Rate e OM.bM 6M.12M 12M.78M 79M-24M 2dM30M 301136M 36MSA SA � Re ular $0.00 $0.00 $37.85 $37.85 $37.85 $3i.85 $37.85 � $0.�0—� PaR Ticne Rates ItaM T a OM�M 6M-72M 1ZM-16M 18M-24M 24MJOM 3011J6M SBM-SA SA Re ular $0.00 $0.00 $21.30 $21.30 $27.30 $2'.30 $21.30 50.00 � Provlder Rights: t. When a provider contends that the county has not made adequate payr ient based on program rules for care providetl,the provider has the right to an infortnal conferenca H ith wunty staff pursuant W 9 CCR 2503-1 at Section 3.91 D, (D). • Providers may request a conference in wnting within 15 days o� the dete of the actlon. • This request should ba addressed to the county direc0or of the� ountq Department of Social/ Human services responsible for tM1e action. � ' � � � - Provider may request that State CCCAP steff participate in the :onference. That participation may be by talephons confarence. • The conference shall be heltl within hvo weeks of the date the r:quest tor a conference is received by the county. • The purpose of the conference is limited to discussion about th ;payments in dispute antl fhe relevant rules regartling payment. • The final decision of tl�e County shall be maled ta the provider�vithin 15 days of the conference date. 2. A provider may request an in�rmal conference I}s/he disputes the.tern ination of a Fiscal Agreement. - • Providera may request a wnference in writing within 15 days o'the date of the action. • Thie request shauld be adtl2ssed to the counry Girecror of tl�e :ounty Department af SociaU Humen aervices responsible for 7ie action. � The conference shall be held within lwo weeKS of the date tha i equest tor a conPe2nce is received by the county. • The purpose of the conference is iimited to discussion about th:termi�tion of Ne fiscal -agreement pursuant to 9 CCR 25031 at Sedion 3.906,(D). � � - - � The flnat decision of the courrty shall be mailed to the provider r+ithin 15 days of the � corrference date. . � Departrnent Agrees to: 1. Provide face-tatace training to the provider on how to use the Point of 3ervice (POS)device prior ta entering into e Fiscal Agreement wNh the pmvider. 2. Enter the Fiscal Agreament into the Childpre Automated Tracking Sys tem(CHATS)within five(5) business days of receipiof ihe completed Fiscal Agreement and all su��porting documentation. � 3. Determine dfenYs eligibility for child cere ssrvices within fiReen (15)da is of receiving the oompleta � apDlication packet including veriBcaGon. 4. Sand Child Care Authwization Notices to the provitler withln seven(7) ++orking days of the DepartmenYS inidal approval or prior to making any changes in eligibilit/tor each child such as - pa2ntal fees, authorQed amaunt of care, added or tleleted child�en, ai dlor any other changes to child care artangements. 5. Reimbursa the provider for authorized child care in accordance with C��lorado Child Care Assistance . Program rules. Payment to the Ifcensed provider is the tota�cost of aul wrized care based on rates set hy this Agreement minus the parentel fee. 7his Agreement may be terminated by either party by giv(ng fhe othar part!'fifteen(15)days notice.This Agreement may be terminated without advance notice if a cfiild's healtl�or safety is endangered, if the provider is uncier a negative Iicensing acdon, or"rf the DeparMient verified t�e provitler possesses any CCAP card(s). 4B(E0 39Vd �OOHDS 3�QQIW 1'lVStifl � 506SV8E0L6 81�9I 4T0L(90/l0 � ( 8y signing;his Agreement, the provider acknowletlges receipt of InfofmaGo�. regarding the rules and policies of Uie Colorado Child Care Assislance Program.The effective date �f this conVact is the date that the counly receives and siyns the Fisc�l Agreement.7he provider shall receive a mpy of the signed - Fiscal!{qreement. . CHILD CARE DIRECTOR orOWNER . - ,� �/ 1 � Authoriza Representauue oate �I CGl�wdl S� Meinng Aeeress �asliz-4 ('o n��.r� � �I�o 3o�1- ssl� Cib,State, Zip PhOne Nurt�ber _ DEPAR7MENT OF SOCIALIHUMAN SERVIC ES '� �� j vt�ps, ,/L _Z I �t 1 � Aut�e eprese la4ve . � . PO 6ax 660 � � - . . Adtlresa � . � . � . Fenla �oa�es� - � � a�aazaaaa�,,, � CkY,Stete, 21p . . Phone Number D9/40 39Cd - �OOFqS 3�QUIW l�tlSdH 5065b8E0L6 8L�5i 4L0L/90/L0