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HomeMy WebLinkAboutbocc.con.302.2016 7/2015 kjm prKIN Pitkin County COUNTS 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 (procurement_help@,pitkincounty.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 302.2016 Project Name Child Care Fiscal Agreement Contractor Faith Lutheran Church and Child Care Center 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 10/1/2016 Contract End Date 9/30/2017 Automatic Renewal Yes ❑ No❑ 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 $ This Change order/Amendment amount(if applicable) $ New Contract Total $ Procurement Method: None InformalD Formal ❑ Sole Source ❑ Emergency 0 Contract Renewal 0 Contract Type: Services/Maintenance ® 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. bocc • cor\ . 3° • -o to Licensed Child Care Provider Fiscal Agreement Child Care Assistance Program Pilkin County Health and Human Services License/Certificate No; 1537130 PO Box 660 Eagle, CO 81631 Faith Lutheran Chum,h and Child Cara Canter SC--? 2 8 1340 Highway 133 Carkindalta,CO 81623 B`l This Agreement Is entered Into and between Pitkin County,heroin referred toes°Department"and Faith Lutheran Church and Child Care Center,herein referred to Rs provider"wife will provide child care at the following address:1340 Highway'133,Carbondale,CO 81623.This Agreement shall be 1n effect from 1011t2016 to C19/30/2018. Provider.Agrer s to: 1. Maintain a valid child care license as required by Colorado Statute and conform to oil applicable State and Federal Regulations and local law. 2, Repent to the Department If the provider's license has been revoked,suspended,dented,or placed on probation within three(3)calendar days of receiving notification,A recovery will he established for ell payments made as of the effective date ofclo.iure. 3. Report to the Department any changes In phonenumber and/or address no fess than ten(10) Calender days prior to the change. 4. Allow parent$or adult caretakers immediate access to the ahild(ren)in core. 5. Accept referrals for child care without discrimination with regard to rade,color,national origin, age,sex,religion,or phyefcal or mental hpndicep 6. Develop an individualized care plan for children-with additional child care needs. 7. Pfovkfe children with adequate rood,shelter,end rest 8, Maintain as strictly conf1CfenUal all information Concerning children and their families. 0. Protect children from abuse/neglect end 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 Co)orodo,har,rttoss or any foss or actions caused by the performance of-this Agreement. 11. Offer free,age-appropriate alternatives to voluntary artrvities. 12. Provide child care only nt the facility address listed above and/or in Exhibit A,and ensure care Is erovided only by the person or business Hated above,Provide cafe 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 requfrtd forms. 14, Notify the Department,of a child's unexplained;frequent,and/or consistent-absences within ten(10)calendar days of an estsbllshod pattern. 15. Collect the full parental fee each month.Parental fes are due to(tie provider from the parent or adult caretaker on-the first of the month.Providers shall report nonpayment ofparental -fees no later then the end of the month following the month the parental fees-are due unless county policy requires it earlier.The unpaid par-entaflees must bereportad In writing by FAX, email mail,or on a manual claim form, 16. Maintain proof Wage-appropriate immuntzatfons for the Children In the provider's rare based -on licensing requirements. CLAP Licensed Provider Frew!Agreement(Rev.04/2015) 1 of 5 17, Shall not charge the counties more than the lowest established private pay rtes 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 Fncleding rates,transportation, activity, registration fees.payment policies,and all policies distributed to parents or adult caretakers. Allowable rates and other associated charges shell be in accordance with Stale liulet for Colorado Child Cam Assistance Program,The provkler is subject to receVery If the reported private pay rates aro lower than the agreed upon county reimbursement rates established In this Fiscal Agreementapd/or if providers are paid fot caro that contradicts provider or county policies, 18. Shall not thieve.parents or adult caretakers rates In excess of those agreed upon In the Fiscal Agreerfent(this includes the agreed upon registration,activity,transportation fees, absences,and h6Cdays as set by Department policy),The rate in the Fiscal Agreement is the mexirrwm allowable rate of relmbursernent fpr the care provided and includes any portion for which the parent oradult caretaker is rasp:melba?.Providers may not receive payments for days in whist 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 regio and before the provider may bill the eotlnly far 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 Of after the date the county receives the signed fiscal agreement from the provider,all additional required-farms and documentation, and the provider attended a live face-to-face PUS training, Providers will not be reimbursed for any care provided beforethisfiscal agreement start data and ager this fiscal agreement and date. 21. Maintain a land-based phone service to ensure the PUS terminal is able to transmit attendance Information to trie Departmentfor payment eq a daily basis.The provider shall not hold any parent or edult caretaker responsible tor the cost of tare lithe transactions are not transmitted timely.Store-and-Forward(SAF)transactions must be transmitted timely for payment. 22. Ensure the parent or adult caretaker ewlpes his/her card at the provider's location to check the child(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 dale of service.The Department does not guarantee payment lb the Provider if the transaction status on the PDS 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 lithe child care is not authorized or are parent or adult caretaker does not accurately record attendance through the device.Only approved attendance transactions resulting In a daily matched pair of deck-ins and check- outs will imp reimbursed by The Department 23. Centsct the XEROX Provider Helpline directly at 1-877-779-1232 within two business days if the Point of Service(POS)terminal stops working forany reason for troubleshooting or repair. 24. Ensure updates to the POS device are Implemented-as required by CORS or the fiscal agreement will be terminated. 25, Follow the instnict ens Included In the PUS User Manual.Train all new staff on the proper use and requirements of the POS device. 26. Contact the Xerox Provider Helpline at 1-877-779-1932 to request a self-addressed postage paid return Label to assist to returning the POS device if the provider stops raring for children under the Colorado Child Care Assistance Program.li the POS device is not returned within fifteen(15)calendar days and In good condition(allowing for normal wearand 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 plug the current year and ere to be made available to the Department upon request.The sign-tn/out sheets must include no less that the date of care:1114 full name of the child(ren);accurate signan borne;authorized adult caretaker legible signature for sign-In time;accurate sign-dut time; authorized adult caretaker teglble-signature for sign-put time. CLAP LbanEa4 remota'ream Aerearnere(Rev.O420145) 2 of 6 Sign-41tool times must be accurate and within five minutes of the time recorded on the POS device. 28. Manually bill the Departritent for authorized services,based on county payroll policies,not reimbur36d automatically based on approved POS transactions.The provider shall provide sign In/out sheets and all other requested Information based on courtly policy to support requests for manual-ayntent..Counties may impose additional requirements regerdtrtg manual data's.Manuel bills are only accepted under certain rare cht entstances or exceptions.The provider forfeits payment-for services if the original mantel billing form is received by the county more than sixty(60)calendar days following the end of-the month of care.The provider furfetts payment for services billed manually ifthe care:mulct have been paid through the automated payment process. 29. Never keep In their possession(whether et the facility or in any other place)a dlenrs 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 Assist nce Program(CCCAP) as a provider for 12 months for the that offense;24 months for the second offense and permanently-for the third offense.Violations of this nature will be reported to CDHS licensing staff. 31. Avow county and/or child cera 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 understandseither bf these engirds have the right to sate these materials Including the CCAP cards and/or the(Point of Servfc )(PDS)Device, 32, Return any overpayment.All overpayments wllj be recovered including,but not limited to, Inaccurate orirauduient belling,it at the time any overpayment is established while your fiscal agreement is active,the at>i.Mtof the ovetpayrhehtwilt be deducted begirtnine-With the next child care payment and Ovary payment theru4nr until the ovorpaynlent is paid In full,unless negelitted otherwise by the county through a geed repayment agreement The county shall collect the ovepaymestt In accordance with standard Collection procedures whit may include State Income Tax intercept If yourfiscal agreement IS Inactive.Freudulent billing will be prosecuted. Eull Time Rates Rate Type OM-6M 6M-12M 12M- 18M- 24M- 30M- 36M-SA SA 1BM 24M 30M 38M Regular $65.00 $65.00 $65.00 _ $57.38 $57.38 $57.38 $53.38 _ $53.38 Part'Time-Rates Rate.Typa OM-BM BM-12M 12M 111M- 24M- 30M• 36M-SA SA 1BM 24M 30M 36M Regular $35.76 835.76 $35.75 $35.75 $35,75 $35.75 _$35.75 $35.75 Provide'Rights: 1. When a plovider contends that the county has riot made adequate payment based on prografn rules for cafe provided,the provider hes the right to an informal conference with county staff pursuant to 9 CCR 2503-1 at Section 3.910,(E), • Providers may request a conference in writing within 15 days of the date of the schen. • This request should be addressed to the county director of the county Department of Sociat/I-luvin services responsible for the action. • Provider May request that State CCCAP staff participate In the confere;ce, That partiolp,stion may be by telephone conference. • 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 payments in dispute and the relevant rules regarding payment. CLAP Llaerssed Provider Fiscar Afire r nt(Rev.0412016) 3 of 6 • The final decision of the county shall be mailed to the provider within 15 days of the conference date, 2. A provider may regtiest an Informal-conference if s/he disputes the tenninetton of a Fiscal Agreement pursuant to 9 CCR 2503.11 at Section 3.912.4. . • Providers may retltlest a conference in Writing within 15 days.of the date of the action. a This request should be addressed to the county director of the eountyDepartment of Socfal/Huirmn serviice -responsit le for the action. • The conference shall be heki 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 al Section 3,906,(D), • The final decision of the coUnTy shell be malted to(he provider within 15 days of the conference date. • Department Agrees to; 1. Pride face-to-face training to the provider on how to use the Point of Service(PQS)device prior to entering intoa Fiscal Agreement with the provider. - 2. Filter the Fiscal Agreement Into the Childcare Automated Tracking System(CHATS)within live(5) business days of r6ceipt of the cern-plated Fiscal Agreement and-all supporting documentation. 3. Determine client's eligibility for child care services within fifteen(15)daye of receiving the complete application packet indudingVerificatien. 4. Sand Child Care Authorization Notices to the provider-within seven(7)business days of the Department`s Initiat approval or prior to making any changes in eligibility for each child-such as parentai 1e-es,authorized amount of care,added or deleted children,end/orany otter Changes to Chad care arrangements, 5. Reimburse the provider for evthorized,attended,and properly recorded and transmitted child care In accordance wt h Coforsdo Child Care Assistants Program rules.Payment to the licensed provider Is the tote)cwt of the user of authorized and attended care based on rates set by this Agreement mlrtue the parental faa{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 arsafety is endangered; If the provider is under a negative licensing action;if the Department has concerns Involving the provider, en employee,ora resident in the provider's home;or if the Department or CDHS verifies the provider possesses arty CCAP curd(s). By signing this Agreement,the provider acknowledges receipt of I formallorrregarding the rules and policies of the Colorado Child Care Assistance Program,The effective dale-of ibIs 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 C. p_it 1 i JD CARE DIRECTOR CHiLD CARE OWNER OR DESIGNEE Print Name Date 08y/to, Print Name TR Thjegioseate nature- Slge.ture /,%/() High WO /35 MO O H1, htAlra1 13' Mailing Address Mailing Addr s CCAP licensed Provider Stoll AOroeni et(Rev.0412015) 4 or 5 Calitr Th(Ia 10- • 8'14) ) 976 • BYO ( d4 yk co f/o.)1 City,State Zip Phone city State Zip Phone DEPARTMENT OF-SOCIAL/HUMAN SERVICES Authorized RepresehtatIve(print Name) Date Signature PO Box 660 Mailing Address Eagle,CO 81631 970-32 -8888 City,State,Zip Phone *Please NOTE: Piseul Agreement h NOT complete until the provider huW completed FOS training CLAP licensed Provide!Fiscal Agreement(Rev.041201$) 5 of 5 EXHIBIT A PROVIDER LOCATION INFORMATION Provider ID Number: i>l j i Tax ID. No: L'/-7—.26,()17/9r- The following ate the Provider locations are authorized by the State of Colorado to care for children Under the license number listed above. Copy this page if more locations need to be listed. Location Number Primary Location 23 4 Location Street 15t-}a !-A int �.t 133 Address- L City CCt,`ta Stats and Zip Cotntdo '� Primary phone# q7 - Secondary phone# C170" a _ culla Fax number E-mail address �ui�v�C�rLxtidC . Emergency phone Primary 364/41,11.1-t`�'dofi - Dircei Point of Contact i- PPoSecondary int f Cryontact cart` lir i(tir- ?car( Check here if additional sheets aro attached listing more locations. This is sheet -, (#)of I (total) Please return this form to the county if you provide care at any location to addition to the one indicated on page one(1)of the fiscal agrreerneht, Care provided at additional locations must be In accordance with licensing requirements,Colorado Child Care Assistance Program rules,and county policies.Ahy additions or modifications to provider locations must be submitted to the county no less than ten(111)days prior to the change. CLAP Licensed pre ider Frscai Agreement Exhfbll A{Rev,03f24)13}