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HomeMy WebLinkAboutC12-070 Stacey Horn Agreement AGREEMENT BETWEEN EAGLE COUNTY AND STACEY HORN, LCSW, CHT T. HORN ENTERPRISES, INC. dba FAMILY ROOM CO., INC This Agreement ( "Agreement ") dated as of this 14 day of February, 2012 is between the County of Eagle, State of Colorado, a body corporate and politic, by and through its Board of County Commissioners ( "County "), and, Stacey Horn, LCSW, CHT, T. Horn Enterprises, Inc. dba Family Room CO., Inc. with a mailing address of PO Box 6042, Eagle, CO 81631 -6042 ( "Contractor "). WHEREAS, the County, through its Department of Health and Human Services ( "HHS "), works to promote the health, safety and welfare of County residents of all ages; and WHEREAS, County provides various services to Eagle County residents in order to promote health, safety and welfare; and WHEREAS, the use of outside providers enhances the ability of County to promote such health, safety and welfare; and WHEREAS, County wishes to hire Contractor to perform the services outlined in Section 1.1 hereunder; and WHEREAS, County and Contractor intend by this Agreement to set forth the scope of the responsibilities of the Contractor in connection with the services and related terms and conditions to govern the relationship between Contractor and County in connection with the services. AGREEMENT NOW THEREFORE, based upon the representations by Contractor set forth in the foregoing recitals, for good and valuable consideration, including the promises set forth herein, the parties agree to the following: 1. Scope of Services: 1.1 The Contractor will provide the services more particularly set forth in the attached Exhibit "A" labeled Scope of Services (hereinafter called "Contractor's Services ") incorporated herein by reference. The Contractor's Services are generally described as providing individual and family counseling for Child Welfare clients to prevent unnecessary placement of children and youth in out -of -home care, support family preservation, and assist in family reunification. 1.2 Any revision, amendment or modification of this Agreement shall be valid only if in writing and signed by all parties. Except as may be expressly altered by the amendment, all terms and conditions of this Agreement shall control. To the extent the terms and conditions of this Agreement may conflict with Exhibit "A" or any future exhibits or amendments, the terms and conditions of this Agreement shall control. )-011) 1.3 The Contractor agrees that Contractor will not knowingly enter into any arrangement with third parties that will conflict in any manner with this Agreement. 1.4 Contractor has given the County a proposal for performing the Services and represented that it has the expertise and personnel necessary to properly and timely perform the Services. 2. Term of Agreement: 2.1 This Agreement shall commence on the agreement date first above written and, subject to the provisions of Section 2.2 hereof, shall continue in full force and effect until December 31, 2012. 2.2 This Agreement may be terminated by either party for any reason with 15 days written notice, with or without cause, and without penalty. In the event the Contractor files for bankruptcy or is declared bankrupt or dissolves, County may declare in writing that this Agreement is terminated, and all rights of Contractor and obligations of County, except payment of accrued but unpaid fees set forth in Section 2.3 hereof, shall terminate immediately. 2.3 In the event of any termination of this Agreement, Contractor shall be compensated for all hours of work then satisfactorily completed. 3. Independent Contractor: 3.1 With respect to the provision of the Contractor's Services hereunder, Contractor acknowledges that Contractor is an independent contractor providing Contractor's services to the County. Nothing in this Agreement shall be deemed to make Contractor an agent, employee, partner or representative of County. 3.2 The Contractor shall not have the authority to, and will not make any commitments or enter into any agreement with any party on behalf of County without the written consent of the Board of County Commissioners. 3.3 The Contractor and its employees are not entitled to workers' compensation benefits through the County. The Contractor is solely responsible for necessary and adequate workers' compensation insurance and shall be responsible for withholding and paying all federal and state taxes. The Contractor and its employees are not entitled to unemployment insurance benefits unless unemployment compensation coverage is provided by an entity other than the County. The Contractor hereby acknowledges full and complete liability for and timely payment of all local, state and federal taxes imposed including, without limitation, tax on self - employment income, unemployment taxes and income taxes. 4. Compensation: 4.1 For the Contractor's Services provided hereunder, County shall pay to the Contractor a fee as set forth in the attached Exhibit "A." Contractor will not be entitled to bill at overtime and/or double time rates for work done outside normal business hours unless 2 specifically authorized to do so by County. In no event shall fees or compensation under this Agreement exceed $5,000. Fees for any additional services will be as set forth in an executed addendum between the parties. 4.2 For reimbursement Contractor must submit invoices by the fifth business day of each month. Invoices shall include a description of services performed. If County is not satisfied with the completeness of a submitted invoice, County may request Contractor to either revise the invoice or provide additional information to explain the insufficiency of the invoice. Fees will be paid within thirty (30) days of receipt of a proper and accurate invoice from Contractor for Contractor's Services. All invoices must be mailed or delivered in- person to the following address to ensure proper payment. Invoices sent by fax or email will not be accepted. Eagle County Health & Human Services Business Office 550 Broadway P.O. Box 660 Eagle, CO 81631 4.3 If, prior to payment of compensation or reimbursement for services but after submission to County of a request therefore by Contractor, County reasonably determines that payment as requested would be improper because the services were not performed as prescribed by the provisions of this Agreement, the County shall have no obligation to make such payment. If, at any time after or during the Term or after termination of this Agreement as hereinafter provided or expiration of this Agreement, County reasonably determines that any payment theretofore paid by County to Contractor was improper because the services for which payment was made were not performed as prescribed by the provisions of this Agreement, then upon written notice of such determination and request for reimbursement from County, Contractor shall forthwith return such payment to County. Upon termination of this Agreement as hereinafter provided or expiration of the Term, any unexpended funds advanced by County to Contractor shall forthwith be returned to County. 4.4 Notwithstanding anything to the contrary contained in this Agreement, no charges shall be made to the County nor shall any payment be made to the Contractor in excess of the amount for any work done in respect of any period after December 31st of the calendar year of the Term of this Agreement, without the written approval in accordance with a budget adopted by the Board of County Commissioners in compliance with the provisions of Article 25, Title 30 of the Colorado Revised Statutes, the Local Government Budget Law (C.R.S. § 29 -1 -101 et seq.) and the TABOR Amendment (Colorado Constitution, Article X, Sec. 20). 3 5. Indemnification: Within the limits allowed by law, Contractor shall indemnify County for, and hold and defend the County and its officials, boards, officers, principals and employees harmless from all costs, claims and expenses, including reasonable attorney's fees, arising from claims of any nature whatsoever made by any person in connection with the negligent acts or omissions of, or presentations by, the Contractor in violation of the terms and conditions of this Agreement. This indemnification shall not apply to claims by third parties against the County to the extent that the County is liable to such third party for such claim without regard to the involvement of the Contractor. 6. Contractor's Professional Level of Care and Additional Duties: 6.1 In rendering its services hereunder, Contractor shall comply with the highest standards of customer service to the public. Contractor shall provide appropriate supervision of its employees to ensure the maintenance of these high standards of customer service and professionalism, the performance of such obligation to be determined at the sole discretion of County. In the event that County finds these standards of customer service are not being met by Contractor, County may terminate this Agreement, in whole or in part, upon ten (10) days notice to the Contractor. 6.2 All funds received by Contractor under this Agreement shall be or have been expended solely for the purpose for which granted, and any funds not so expended, including funds lost or diverted for other purposes, shall be returned to County. Contractor shall provide the County with progress reports upon County's request; or Contractor shall furnish progress reports as more specifically set forth in the attached Exhibit "A ". 6.3 Contractor shall maintain, for a minimum of 3 years, adequate financial and programmatic records for reporting to County on performance of its responsibilities hereunder. Contractor shall be subject to financial audit by federal, state or county auditors or their designees. Contractor authorizes County to perform audits or to make inspections during normal business hours, upon 48 hours notice to Contractor, for the purpose of evaluating performance under this Agreement. Contractor shall cooperate fully with authorized HHS representatives in the observation and evaluation of the program and records. Contractor shall have the right to dispute any claims of misuse of funds and seek an amicable resolution with County. 6.4 Contractor shall comply with all applicable federal, state and local rules, regulations and laws governing services of the kind provided by Contractor under this Agreement. Contractor shall be solely responsible for ensuring proper licensing and credentialing of those providing services under this Agreement. 6.5 Contractor shall comply with the requirements of the Civil Rights Act of 1964 and Section 504, Rehabilitation Act of 1973, concerning discrimination on the basis of race, color, sex, age, religion, political beliefs, national origin, or handicap. 7. Notice: 4 Any notice required under this Agreement shall be given in writing by registered or certified mail; return receipt requested which shall be addressed as follows: COUNTY: CONTRACTOR: Eagle County Health & Human Services Stacey Horn, LCSW, CHT Sherri Almond T Horn Enterprises, Inc. dba Family Room CO P.O. Box 660 P.O. Box 6042 Eagle, CO 81631 Eagle CO 81631 -6042 970 - 328 -8852 970- 926 -4357 8. Insurance: 8.1 At all times during the term of this Agreement Contractor shall maintain in full force and effect the following insurance: Insurance Type Coverage Minimums • Workers' Compensation Statutory • Employers Liability, including $500,000 Occupational Disease • Comprehensive General Liability, including $600,000 per occurrence or as specified in Broad Form Property Damage the Colorado Governmental Immunity Act, whichever is greater • Professional Liability Insurance $500,000 per occurrence 8.2 Contractor shall purchase and maintain such insurance as required above and shall provide certificates of insurance in a form acceptable to County upon execution of this Agreement. 9. Non - Assignment and Subcontractors: Contractor shall not assign this Agreement or employ any subcontractor without the prior written approval of the County Representative, who is designated in Section 7 of this Agreement. The Contractor shall be responsible for the acts and omissions of its agents, employees and sub- contractors. The Contractor shall bind each subcontractor to the terms of this Agreement. The County may terminate this Agreement, if the Contractor assigns or subcontracts this Agreement without the prior written consent from the County, and any such assignment or subcontracting shall be a material breach of this Agreement. 10. Jurisdiction and Confidentiality: 10.1 This Agreement shall be interpreted in accordance with the laws of the State of Colorado and the parties hereby agree to submit to the jurisdiction of the courts thereof. Venue shall be in the Fifth Judicial District for the State of Colorado. 10.2 The Contractor and County acknowledge that, during the term of this Agreement and in the course of the Contractor rendering the Contractor's Services, the Contractor and County may 5 acquire knowledge of the business operations of the other party not generally known deemed confidential. The parties shall not disclose, use, publish or otherwise reveal, either directly or through another, to any person, firm or corporation, any such confidential knowledge or information and shall retain all knowledge and information which he has acquired as the result of this Agreement in trust in a fiduciary capacity for the sole benefit of the other party during the term of this Agreement, and for a period of five (5) years following termination of this Agreement. Any such information must be marked as confidential. The parties recognize that the County is subject to the Colorado Open Records Act and nothing herein shall preclude a release of information that is subject to the same. 11. Miscellaneous: 11.1 This Agreement constitutes the entire Agreement between the parties related to its subject matter. It supersedes all prior proposals, agreements and understandings, either verbal or written. 11.2 This Agreement does not and shall not be deemed to confer upon or grant to any third party any right enforceable at law or equity arising out of any term, covenant, or condition herein or the breach hereof. 11.3 Invalidity or unenforceability of any provision of this Agreement shall not affect the other provisions hereof, and this Agreement shall be construed as if such invalid or unenforceable provision was omitted. 12. Prohibitions on Public Contract for Services: If Contractor has any employees or subcontractors, Contractor shall comply with C.R.S. § 8- 17.5 -101, et seq., regarding Illegal Aliens — Public Contracts for Services, and this Contract. By execution of this Contract, Contractor certifies that it does not knowingly employ or contract with an illegal alien who will perform under this Contract and that Contractor will participate in the E -verify Program or other Department of Labor and Employment program ( "Department Program ") in order to confirm the eligibility of all employees who are newly hired for employment to perform work under this Contract. (a) Contractor shall not: (i) Knowingly employ or contract with an illegal alien to perform work under this contract for services; or (ii) 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 the public contract for services. (b) Contractor has confirmed the employment eligibility of all employees who are newly hired for employment to perform work under this Contract through participation in the E -verify Program or Department Program, as administered by the United States Department of Homeland Security. Information on applying for the E -verify program can be found at: http:// www .dhs.gov /xprevprot/programs /gc 1185221678150.shtm 6 (c) The Contractor shall not use either the E- verify program or other Department Program procedures to undertake pre - employment screening of job applicants while the public contract for services is being perfcgmed. (d) If the Contractor obtains actual knowledge that a subcontractor performing work under the public contract for services knowingly employs or contracts with an illegal alien, the Contractor shall be required to: (i) Notify the subcontractor and the County within three (3) days that the Contractor has actual knowledge that the subcontractor is employing or contracting with an illegal alien; and (ii) Terminate the subcontract with the subcontractor if within three (3) days of receiving the notice required pursuant to subparagraph (i) of paragraph (d) the subcontractor does not stop employing or contracting with the illegal alien; except that the Contractor shall not terminate the contract with the subcontractor if during such three days the subcontractor provides information to establish that the subcontractor has not knowingly employed or contracted with an illegal alien. (e) The Contractor shall comply with any reasonable request by the Department of Labor and Employment made in the course of an investigation that the department is undertaking pursuant to its authority established in C.R.S. § 8- 17.5- 102(5). (f) If a Contractor violates these prohibitions, the County may terminate the contract for a breach of the contract. If the contract is so terminated specifically for a breach of this provision of this Contract, the Contractor shall be liable for actual and consequential damages to the County as required by law. (g) The County will notify the office of the Colorado Secretary of State if Contractor violates this provision of this Contract and the County terminates the Contract for such breach. 1/ SIGNATURE PAGE TO FOLLOW // 7 IN WITNESS WHEREOF, the parties hereto have executed this Agreement the day and year first above written. COUNTY OF EAGLE, STATE OF COLORADO By and through its County Manager By: /; � Ke ' Montag, County Manager CONTRACTOR • Stacey Horn, LCS ■ , CHT STATE OF C oo • ) ) SS. COUNTY OF � The foregoing instrument was acknowledged before me by Stacey Horn, this GI day of \ ID•coo.rys- r pi , 2012. My commission expires: 3— M ESGAR ACOSTA 1 N Public NOTARY PUBLIC STATE OF COLORADO Co nmhla amine 5312212515 8 EXHIBIT A SCOPE OF SERVICES, PAYMENT & FEE SCHEDULE Description of Services: Provide individual and family counseling for Child Welfare clients to prevent unnecessary placement of children and youth in out -of -home care, support family preservation, and assist in family reunification. Additional Provisions: 1. Assessments and Planning. Contractor shall provide the County with an assessment and plan within thirty (30) days of enrollment or participation in services by a family or child. This plan shall include the treatment plan for the child's family, including specific objectives and target dates for accomplishment. Such plan shall be subject to review and approval by County. Thereafter, at monthly intervals, Contractor shall submit reports that include progress and barriers in achieving the goals and provisions of the treatment plan. Reimbursement for services relating to the plan is subject to the timely receipt of written assessment, plan, and reports. 2. Eligibility. County is responsible for determining the eligibility of each individual family for services under this agreement. County shall advise Contractor in writing of the authorized service plan within three (3) working days of receipt of the certification and service plan (Exhibit B). There shall be no payment for services provided without prior authorization for such services by the County. Such authorization shall include the level of services to be provided, the nature and type of services provided and the time frames in which these services are to be provided. 3. Mandatory Reporting. Contractor shall notify HHS immediately of all reports of suspected child abuse or neglect involving Contractor, including, but not limited to, employees, volunteers and clients. HHS contractors are considered to be mandatory reporters for suspected child abuse and neglect and are to make those reports directly to HHS Youth and Family Services Division - (970) 328 -8840. Payment and Fee Schedule: County will compensate Contractor for performance of services as follows: (1) Face to face contact with the client family or HHS representatives - $75 per hour; (2) Case management services -$35 per hour including travel to and from a client family home to perform services or participating in case conferences. The maximum contract amount is not to exceed $5,000. 9 Exhibit B Eagle County Health & Human Services Authorization for Services Household #: 19- Case Name: Service Provider: Telephone #: Family's Mailing Address: Dates of Service: / Family's Physical Address: Start End Family Information Father Mother Child Child Child Child Child Family Members Date of Birth Household Suffix 01 02 03 04 05 06 07 State ID # Social Security # Types of Services Reauested Please Check [i] Which Family Members Will Receive Services Indicated Suffix 01 02 03 04 05 06 07 Family Communication Individual Parenting Skills Intensive Family/ Individual Therapy Group Services Substance Abuse Evaluation Substance Abuse Treatment (Specified) Sexual Abuse Treatment Day Treatment Psychological Evaluation Psychiatric Evaluation Parent -Child Interact Tonal Other (Specified) Comments Total Number of Units Approved (1 unit = 1 hour): Payment Method EHS Core TANF Child Welfare CWMH Core: Human Service Other Progress Reports Required Monthly Not Required Case Manager: Telephone #: Date Manager: Telephone #: Date Bills must be submitted by the 5 of the month. Mail to HHS, P.O. Box 660, Eagle, CO 81631 HHS Business Office Total Obligation: Date Entered: Service Dates Service Amounts Date Paid Obligation Balance 10 HEALTHCARE PROVIDERS SERVICE ORGANIZATION PURCHASING GROUP ®1 11 >,.JO C NA Certificate of 3in urance .r...�. OCCURRENCE POLICY FORM PRODUCER I BRANCH I PREFIX I POLICY NUMBER Policy Period: 0180 . 970 .HPG 0418937100 -8 From 07/29/11 to 07/29/12 at 12:01 AM Standard Time Named Insured Program Administered by: Healthcare Providers Service Organization Stacey L. Horn 159 East County Line Road PO Box 6042 Hatboro, PA 19040 -1218 Eagle, CO 81631 -6042 1- 800 -982 -9491 • www.hpso.com Medical Specialty Code Insurance is provided by: -Social Viol kcr, CI ical - ------- 80fi23 — — �cmencamCa rng; Pennsylvania 333 South Wabash Avenue Chicago, Illinois 60604 Professional Liability $1,000,000 each claim $5,000,000 aggregate Your professional liability limits shown above include the following: • Good Samaritan Liability • Malplacement Liability • Personal Injury Liability • Sexual Misconduct included in the PL Limit shown above subject to $25,000 aggregate sublimit Coverage Extensions License Protection $25,000 per proceeding $25,000 aggregate Defendant Expense Benefd $1,000 per day limit $25,000 aggregate Deposition Representation $10,000 per deposition $10,000 aggregate Assault $25,000 per incident $25,000 aggregate Includes Workplace Violence Counseling Medical Payments $25,000 per person $100,000 aggregate First Aid $10,000 per incident $10,000 aggregate Damage of Property of Others $10,000 per incident $10,000 aggregate Information Privacy (HIPAA) Fines & Penalties $25,000 per incident - $25,000 aggregate Workplace Liability Workplace Liability Included in Professional Liability Limit shown above Fire and Water Legal Liability included in the PL limit above subject to $150,000 aggregate sub limit Personal Liability_ $1,000,000 aggregate Total: $147.00 Premium reflects self- employed, part-time rate. Policy Forms & Endorsements (Please see attached fist for a general description of the policy forms/ endorsements that rney or may not apptir to this ply) G- 121500 -D G- 121501 -C G- 121503 -C G- 145184 -A G- 147292 -A GSL3886 GSL3908 GSL13424 GSL15563 GSL15564 GSL15565 GSL17101 G- 123846 -0O5 Chairman of the Board Secretary Keep this Certificate of Insurance in a safe place. This Certificate of Insurance and proof of payment are your proof of coverage. There is no coverage in force unless the premium is paid in full. In order to activate your coverage, please remit premium in full by the effective date of this Certificate of Insurance. G- 141241 -B (3/2010) Master Policy: 188711433 510 XX 0001683 -R 110421 H10910 R1M7HM 11111 • HEALTHCARE PROVIDERS SERVICE Print fie: 1113!2012 CNA ORGANIZATION PURCHASING GROUP IIIHNO Certlfltate of lingurante Y aa4n re r mt�r sa. Service Ch,.mw,r OCCURENCE POLICY FORM Producer Branch Prefix Policy Number Policy Period 018098 970 HPG 0285507145 from 01/13/12 to 01/13/13 at 12:01 AM Standard Time Named Insured and Address: Program Administered by Catherine J Zeeb Healthcare Providers Service Organization Po Box 4708 154 E. County Line Road Edward, CO 81832 -4708 Hatboro, PA 19040 -1218 1-800-982-9491 www.hpso.com Medical Specialty: Code: Insurance is provided by: Pastoral Counselor 80723 American Casualty Company of Reading. Pennsylvania 333 5. Wabash Avenue, Chicago, IL 60604 Professional Liability 91,000.000 each claim S 3,000,000 aggregate Your professional liability limits shown above include the following: Good Samaritan Liability • Malplac ment Liability • Personal Injury Liability Sexual MtsconduCt Included in the PL limit shown above subject to $ 25.000 aggregate subitmit Coverage Extensions l_icerree Protection $ 25,000 per proceeding S 25,000 aggregate Defendant Expense Benefit $ 1.000 per day limit 5 25,000 aggregate Deposition Representation 510,000 per deposition $ 10,000 aggregate Assault $ 25,000 per incident $ 25,000 aggregate Incudes Wcr'c7Iace Violence Counseling Medical Payments $ 25,000 per person $ 100,000 aggrega:e Fist Aid $ 10,000 per incident $ 10,000 aggregate Damage to Property of Others $ 10.000 per Incident $ 10,000 aggregate Information Privacy (HIPAA) Fines and Penalties 5 25,000 per incident 5 25,000 aggregate Workplace Liability Workplace Liability Included in Professional Liability Limit shown above Fire & Water Legal Liability Included in the PL timit shown above subject to $150,000 aggregate subiimit Personal Liability 81 ,000,000 aggregate Total: 158.00 Base Premium $158.00 Premium reflects Self Employed . Part Time Policy ;Forms & Endorsements(Please see attached list for a general description of many common policy forms and endorsements.) G- 1215040 G - 121503 - G - 121501 - G 145184 - A G 147292 - A GSL15563 G6115584 GSL15585 GSL17101 GSL13424 G- 123848 -0O5 GSL3886 GSL3908 Keep t h i s document in a safe piece. r V:41M4Plit ..,. and proof of payment are your proof of coverage. There is no coversgs in form T. MJ U&2k 1 ' 4 \ unifies the premium is paid in MO in order Secretes to activate your coverage, please remit Chairman of the Board Secretary premium in M by the effective date or this Certificate of !nst,rance Master Policy *188711433 G - 14 - (03/2010) Coverage Change Date: Endorsement Change Date: • EXHIBIT C PROOF OF INSURANCE (Certificate of insurance to be inserted as Exhibit C) 11