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HomeMy WebLinkAboutbocc.con.244.2016 - 'n p % Pitkin County CoinTs Contract Cover Sheet Please complete the Contract Cover Sheet when the contract is completed and signed by Contractor and Pitkin County Project Manager. Return all Contract Cover Sheets and Contracts/Change Orders/Amendments to Procurement rocurement help(u pitkincounb'.com). Any contracts $50,000 and over will be routed for signatures to County Manager and Attorney's Office(if required)by Procurement&Contracts Manager. Contract Information Contract Number 244.2016 Project Name Child Care Fiscal Agreement Contractor Roaring Fork School District Budget Line Item Click here to enter text. Additional Budget Line Item(s) Click here to enter text. and special notes to Finance _ Contract Start Date 11/15/2016 Contract End Date Click here to enter a date. Automatic Renewal Yes ® NoD If Construction: Retainage Click here to enter text. If this is a new contractor,please request they complete and submit to Finance a W-9 Form. Contact Information: Department Health and Human Services Project Manager Ledingham Project Manager 5766 Phone Provide a brief description of the contract: 2016-2017 CCAP Fiscal Agreement Contract Value Summary: Contract Amount S This Change order/Amendment amount(if applicable) New Contract Total Procurement Method: None © Informal❑ Formal ❑ Sole Source ❑ Emergency ❑ Contract Renewal ❑ Contract Type: Services/Maintenance Z Construction ❑ Goods, Equipment, Supplies ❑ Change Order/Amendment❑ Other, please explain ❑ Click here to enter text. NOTE: CLERKS OFFICE WILL KEEP ORIGINAL DOCUMENTS IN COMPLIANCE WITH COLORADO STATE ARCHIVES RETAINAGE SCHEDULE. ALL ATTACHMENTS MUST BE WITH THIS CHECKLIST. etydnutt _ z .za (`' Licensed Child Care Provider Fiscal Agreement Child Care Assistance Program Pitkin County Health and Human Services License/Certificate No: 88835 PO Box 660 Eagle, CO 81631 • Lill a Roaring Fork School District 161 Cottonwood Drive NOV 1 7 2016 bi Basalt,CO 81621 This Agreement Is entered Into and between Pitkin County, herein referred to as"Department"and Roaring Fork School District herein referred to as'provider'who will provide child care at the following address: 151 Cottonwood Drive. Basalt. CO 81821. This Agreement shall be in effect from 11/15/2016 to 09/30/2018. Provider Agrees to: 1. Maintain a valid child care license as required by Colorado Statute and conform to all applicable State and Federal Regulations and local law. 2. Report to the Department If the provider's license has been revoked,suspended,denied,or placed on probation within three(3)calendar days of receiving notification.A recovery will be established for all payments made as of the effective date of closure. 3. Report to the Department any changes in phone number and/or address no less than ten(10) calendar days prior to the change. 4. Allow parents or adult caretakers immediate access to the child(ren)in care. 6. Accept referrals for child care without discrimination with regard to race,color,national origin, age,sex,religion,or physical or mental handicap. 6. Develop an individualized care plan for children with additional child care needs. 7. Provide children with adequate food,shelter, and rest. 8. Maintain as strictly confidential all information concerning children and their families. 9. Protect children from abuse/neglect and report any suspected child abuse and neglect to the Department. 10. Hold the County Department of Human Services,Colorado Department of Human Services (CDHS),and the State of Colorado,harmless for any loss or actions caused by the performance of this Agreement. 11. Offer free,age-appropriate alternatives to voluntary activities. 12. Provide child care only at the facility address listed above and/or in Exhibit A,and ensure care is provided only by the person or business listed above.Provide care for children under this agreement only if authorized by the Department in advance. 13. Sign the child care Fiscal Agreement and all other county or state required forms. 14. Notify the Department of a child's unexplained,frequent,and/or consistent absences within ten(10)calendar days of an established pattern. 15. Collect the full parental fee each month.Parental fees are due to the provider from the parent or adult caretaker on the first of the month.Providers shall report non-payment of parental fees no later than the end of the month following the month the parental fees are due unless county policy requires it earlier.The unpaid parental fees must be reported in writing by FAX, email,mall,or on a manual claim form. 16. Maintain proof of age-appropriate Immunizations for the children in the provider's care based on licensing requirements. cCAP Licensed Provider Fiscal Agreement(Rev.04/2015) 1 of 5 17. Shall not charge the counties more than the lowest established private pay rates and keep the Department informed of changes In the private pay rates at least ten(10)days prior to the change.Attach a copy of the current policies including rates,transportation,activity, registration fees,payment policies,and all policies distributed to parents or adult caretakers. 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 and/or If providers are paid for care that contradicts provider or county policies. 18. 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,transportation fees, absences,and holidays es set by Department policy).The rate In the Fiscal Agreement Is the maximum allowable rate of reimbursement for the care provided and includes any portion for which the parent or adult caretaker Is responsible. Providers may not receive payments for days in which they were not open or available for use. 19. Attend a county face-to-face training before the provider will receive a Point-Of-Service (POS)device, before the fiscal agreement may begin and before the provider may bill the county for care.The provider may be required to attend additional county face-to-face training at the discretion of the county.The POS device Is how the provider will bill for the care provided, POS usage Is a requirement. 20. Understand this fiscal agreement Is effective on or after the date the county receives the signed fiscal agreement from the provider, all additional required forms and documentation, and the provider attended a live face-to-face POS training. Providers will not be reimbursed for any care provided before this fiscal agreement start date and after this fiscal agreement end date. 21. Maintain a land-based phone service to ensure the POS terminal is able to transmit attendance Information to the Department for payment on a daily basis.The provider shall not hold any parent or adult caretaker responsible for the cost of care if the transactions are not transmitted timely. Store-and-Forward(SAF)transactions must be transmitted timely for payment. 22. Ensure the parent or adult caretaker swipes his/her card at the provider's location to check the chlld(ren)Into and out of care daily for attendance tracking and payment.Missed check-in and check-out swipes may be updated within nine(9)days of the date of service.The Department does not guarantee payment to the Provider if the transaction status on the POS - device Is'pending;-denied,'or"not authorized,"or if the attendance is not accurately recorded through the POS device. The parent or adult caretaker shall be responsible for payment and the Department shall not be held liable if the child care Is not authorized or the parent or adult caretaker does not accurately record attendance through the device.Only approved attendance transactions resulting In a daily matched pair of check-Ins and check- outs will be reimbursed by the Department. 23. Contact the XEROX Provider Helpline directly at 1-877-779-1932 within two business days if the Point of Service(POS)terminal slops working for any reason for troubleshooting or repair. 24. Ensure updates to the POS device are Implemented as required by CONS or the fiscal agreement will be terminated. 25. Follow the instructions included in the POS User Manual.Train all new staff on the proper use and requirements of the POS device. 28. Contact the Xerox Provider Helpline at 1-877-779-1932 to request a self-addressed postage paid return label to assist In returning the POS device N the provider stops caring for children under the Colorado Child Care Assistance Program.If the POS device is not returned within fifteen(15)calendar days and In good condition(allowing for normal wear and tear)to Xerox, the Department will establish a recovery for the POS device,which is$385. 27. Maintain sign in/out sheets for children In their care.These records are to be maintained for three years plus the current year and are to be made available to the Department upon request.The sign-In/out sheets must include no less than:the date of care;the full name of the child(ren);accurate sign-In time;authorized adult caretaker legible signature for sign-in time;accurate sign-out time; authorized adult caretaker legible signature for sign-out time. CCAP Licensed Provider Fiscal Agreement(Rev.04/2015) 2 of 5 Sign-In/out times must be accurate and within five minutes of the time recorded on the POS device. 28. Manually bill the Department for authorized services, based on county payroll policies, not reimbursed automatically based on approved POS transactions.The provider shall provide sign in/out sheets and all other requested Information based on county policy to support requests for manual payment.Counties may impose additional requirements regarding manual claims.Manual bills are only accepted under certain rare circumstances or exceptions.The provider forfeits payment for services If the original manual billing form la receivedby the county more than sixty(60)calendar days following the end of the month of care.The provider forfeits payment for services billed manually If the care could have been paid through the automated payment process. 29. Never keep in their possession(whether at the facility or In any other place)a client's CCAP Card used to swipe for attendance.Violations of this nature will be reported to CDHS licensing staff. 30. Understand 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.Violations of this nature will he reported to CDHS licensing staff. 31. Allow county and/or child care licensing the authority to Inspect the provider's facility for the presence of CCAP cards or any other(fraudulent)or suspicious billing information. Upon discovery of these materials the provider understands either of these entities have the right to seize these materials Including the CCAP cards and/or the(Point of Service)(POS)Device, 32. Return any overpayment.All overpayments 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 care payment and every payment thereafter until the overpayment Is paid in full, unless negotiated otherwise by the county through a signed repayment agreement.The county shall collect the overpayment in accordance with standard collection procedures,which may include State Income Tax intercept if your fiscal agreement Is inactive. Fraudulent billing will be prosecuted. Pull Time Rates Rate Type OM-BM 6M-12M 12M-18M 18M-24M 24M-30M 30M-36M 35M-SA SA Regular $0.00 $0.00 $48.00 $48.00 $48.00 $48.00 $43.00 $43.00 Part Time Rates Rate Type OM-8M 6M-12M 12M-18M 18M-24M 24M-30M 30M-36MM 36M-SA SA Regular $0.00 $0.00 $27.50 $27.50 $27.50 $27.50 $25.50 $25.60 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 3.9W,(E). • 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 shall be held within two weeks of the dale 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 16 days of the conference date. CCAP Licensed Provider Fiscal Agreement(Res.042015) 3 of 5 • DEPARTMENT OF SOCIAUHUMAN SERVICES /*A itccur'h. itovv /2-42-. / lv Authorized Representative(Print Name f J .Date ' 7,16 v Signature r7jk(513.1 PO Box 660 Mailing Address Eagle,CO 81631 970-3288888 City,State,Zip 'Phone *Please NOTE: Fiscal Agreement it NOT complete until the provider has completed FOS training • CCAP Licensed Provider Fiscal Agreement(Rev.04/2015) 6 M 6 • This request should be addressed to the county director of the county Department of Social/ Human services responsible for the action. • The conference shell 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,(0). • The final decision of the county shall be mailed to the provider within 15 days of the conference date. , Department Agreee 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'racking System(CHATS)within five(5) business days of receipt of the completed Fiscal Agreement and all supporting documentation 3. Determine client's 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)business days at the Department's Initial approval or prior to making any changes 7n eligibility for each child such as parental fees,authorized amount of care,added or deleted children,and/or any other changes to child care arrangements.;. 5. Reimburse the provider for authorizedattended,and properly recorded and transmitted child care in accordance with Colorado Child Care Assistance Program rules.Payment to the licensed provider is the total cost of the lesser of authorizedand attended care based on rates set by this Agreement minus the parental fee(if applicable). Either party may terminate this Agreement by giving the other party eleven(11)calendar days'notice. This Agreement may be terminated without advance notice if a child's health or safety is endangered;if the provider is under a negative licensing action;If the Department has concerns involving the provider, an employee,or a resident in the provider's home;or if the Department or.CDHS verifies the provider possesses any CCAP card(s). By signing thisAgreement,the provider acknowledges receipt of information regarding the rules and policies of the Colorado Child Care Assistance Program The effective dateof this contract is no earlier than the date that the provider attends required in person training;and the county receives and signs the Fiscal Agreement The provider shall receive a copy of the signed Fiscal Agreement. CHILD CARE DIRECTOR CHILD CARE OWNER OR DESIGNEE Print Name Dat Print Name Date Skin Kra fi `may ttjrib 6 Signature r� Signature a:llb,► Mailing Address Mailing Address ISt CmtiLDDLOO D city, State Zip39 ,4' OCity State Zip Phone � ati� Cc� u that DEPARTMENT OF SOCIAL/HUMAN SERVICES. EXHIBIT A PROVIDER LOCATION INFORMATION Provider ID Number: Tax ID.No: The following are the Provider locations are authorized by the State of Colorado to care for children under the license numberlisted above.Copy this page if more locationsneed to be listed: Location Primary Location 2 3 4 Number 7 Location Street ISI ni .oc4 Address 7K�de— _ I City extsaii' State and Zip i ElEGa Primary phone a10r9q 6070 Secondary __ _..:..._. phone# Fax number E-mail address fersosoo( NJ1coI Se cr.P1 lel Emergency _.. phone# i Primary 0. _. Point of jJ'i R FerclO Contact Secondary Point of Contact _Check here if additional sheets are attached listing more locations. This Is sheet (#)of (tots)) Please return this form to the county If you provide care at any location in addition to the one indicated on page one (1)of the fiscal agreement Care provided at additional locations must be in accordance with licensing requirements, Colorado Child Care Assistance Program rules and county policies,Any additions or modifications to provider locations must be submitted to the county no less than ten(10)days prior to the change. CCAP Licensed Provider Fiscal Agreement Exhibit A(Rev 0a12013)