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HomeMy WebLinkAboutC22-023 Eagle Valley Hope CenterDocuSign Envelope ID: D714489B-A1AE-4D74-8C41-1FDC1857F48E
AGREEMENT FOR PROFESSIONAL SERVICES
BETWEEN EAGLE COUNTY, COLORADO
AND
EAGLE VALLEY HOPE CENTER
THIS AGREEMENT ("Agreement") is effective as of January 1, 2022 by and between Eagle Valley
Hope Center (hereinafter "Consultant" or "Contractor") and Eagle County, Colorado, a body corporate
and politic (hereinafter "County").
RECITALS
WHEREAS, the County, through its Department of Public Health and Environment ("ECPHE") works to
promote the health, safety and welfare of County residents of all ages; and
WHEREAS, the County uses outside providers and professionals to enhance the ability of County to
promote such health, safety and welfare; and
WHEREAS, County desires to hire the Consultant to perform the Services defined below in paragraph 1;
and
WHEREAS, Consultant is authorized to do business in the State of Colorado and has the time, skill,
expertise, and experience necessary to provide the Services; and
WHEREAS, this Agreement shall govern the relationship between Consultant and County in connection
with the Services.
rx"RINTSUMEN
NOW, THEREFORE, in consideration of the foregoing and the following promises Consultant and
County agree as follows:
1. Services. Consultant agrees to diligently provide all services, labor, personnel and materials
necessary to perform and complete the services described in Exhibit A ("Services") which is attached
hereto and incorporated herein by reference. The Services shall be performed in accordance with the
provisions and conditions of this Agreement.
a. Consultant agrees to furnish the Services no later than one year from the execution of
this contract and in accordance with the schedule established in Exhibit A. If no completion date is
specified in Exhibit A, then Consultant agrees to furnish the Services in a timely and expeditious manner
consistent with the applicable standard of care. By signing below Consultant represents that it has the
expertise and personnel necessary to properly and timely perform the Services.
DocuSign Envelope ID: D714489B-A1AE-4D74-8C41-lFDC1857F48E
b. In the event of any conflict or inconsistency between the terms and conditions set forth in
Exhibit A and the terms and conditions set forth in this Agreement, the terms and conditions set forth in
this Agreement shall prevail.
C. Consultant agrees that it will not enter into any consulting or other arrangements with
third parties that will conflict in any manner with the Services.
2. County's Representative. The Public Health and Environment Department's designee shall be
the Consultant's contact with respect to this Agreement and performance of the Services.
3. Term of the Agreement. This Agreement shall commence upon the date first written above, and
subject to the provisions of paragraph 11 hereof, shall continue in full force and effect through December
31, 2022.
4. Extension or Modification. This Agreement may not be amended or supplemented, nor may any
obligations hereunder be waived, except by agreement signed by both parties. No additional services or
work performed by Consultant shall be the basis for additional compensation unless and until Consultant
has obtained written authorization and acknowledgement by County for such additional services in
accordance with County's internal policies. Accordingly, no course of conduct or dealings between the
parties, nor verbal change orders, express or implied acceptance of alterations or additions to the Services,
and no claim that County has been unjustly enriched by any additional services, whether or not there is in
fact any such unjust enrichment, shall be the basis of any increase in the compensation payable hereunder.
In the event that written authorization and acknowledgment by County for such additional services is not
timely executed and issued in strict accordance with this Agreement, Consultant's rights with respect to
such additional services shall be deemed waived and such failure shall result in non-payment for such
additional services or work performed.
5. Compensation. County shall compensate Consultant for the performance of the Services in a sum
computed and payable as set forth in Exhibit A. The performance of the Services under this Agreement
shall not exceed $240,000.00. Contractor shall not be entitled to bill at overtime and/or double time rates
for work done outside of normal business hours unless specifically authorized in writing by County.
a. For reimbursement Contractor must submit invoices monthly. 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.
Payment will be made for Services satisfactorily performed within thirty (30) days of receipt of a proper
and accurate invoice. All invoices shall include detail regarding the hours spent, tasks performed, who
performed each task and such other detail as County may request.
The County will disburse funds to the Contractor within thirty (30) days of receipt of a proper and
accurate invoice. All invoices must be emailed to phinvoices(abeaglecounty.us to ensure proper payment.
b. Any out-of-pocket expenses to be incurred by Consultant and reimbursed by County shall
be identified on Exhibit A. Out-of-pocket expenses will be reimbursed without any additional mark-up
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thereon and are included in the not to exceed contract amount set forth above. Out-of-pocket expenses
shall not include any payment of salaries, bonuses or other compensation to personnel of Consultant.
Consultant shall not be reimbursed for expenses that are not set forth on Exhibit A unless specifically
approved in writing by County.
C. 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 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 set forth in this Agreement, then upon written notice of such determination
and request for reimbursement from County, Consultant shall forthwith return such payment(s) to County.
Upon termination or expiration of this Agreement, unexpended funds advanced by County, if any, shall
forthwith be returned to County.
d. 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.
e. County will not withhold any taxes from monies paid to the Consultant hereunder and
Consultant agrees to be solely responsible for the accurate reporting and payment of any taxes related to
payments made pursuant to the terms of this Agreement.
f. Notwithstanding anything to the contrary contained in this Agreement, County shall have
no obligations under this Agreement after, nor shall any payments be made to Consultant in respect of any
period after December 31 of any year, without an appropriation therefor by County in accordance with a
budget adopted by the Board of County Commissioners in compliance with 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).
g. Contractor acknowledges that this contract is funded by a local sales and excise tax.
Taxes may be variable and the tax generated may be less than what was budgeted. Should this occur,
Eagle County may be required to revise the scope of Services described in Exhibit A. The County will
provide you with 60 days notice under these circumstances.
6. Sub -consultants. Consultant acknowledges that County has entered into this Agreement in
reliance upon the particular reputation and expertise of Consultant. Consultant shall not enter into any
sub -consultant agreements for the performance of any of the Services or additional services without
County's prior written consent, which may be withheld in County's sole discretion. County shall have
the right in its reasonable discretion to approve all personnel assigned to the subject project during the
performance of this Agreement and no personnel to whom County has an objection, in its reasonable
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discretion, shall be assigned to the project. Consultant shall require each sub -consultant, as approved by
County and to the extent of the Services to be performed by the sub -consultant, to be bound to Consultant
by the terms of this Agreement, and to assume toward Consultant all the obligations and responsibilities
which Consultant, by this Agreement, assumes toward County. County shall have the right (but not the
obligation) to enforce the provisions of this Agreement against any sub -consultant hired by Consultant
and Consultant shall cooperate in such process. The Contractor shall be responsible for the acts and
omissions of its agents, employees and sub -consultants or sub -contractors.
7. Insurance. Consultant agrees to provide and maintain at Consultant's sole cost and expense, the
following insurance coverage with limits of liability not less than those stated below:
a. Types of Insurance.
Workers' Compensation insurance as required by law.
ii. Auto coverage with limits of liability not less than $1,000,000 each accident
combined bodily injury and property damage liability insurance, including coverage for owned, hired, and
non -owned vehicles.
iii. Commercial General Liability coverage to include premises and operations,
personal/advertising injury, products/completed operations, broad form property damage with limits of
liability not less than $1,000,000 per occurrence and $2,000,000 aggregate limits. This policy shall be
endorsed to include coverage for physical/sexual abuse and molestation.
iv. Professional liability insurance with prior acts coverage for all Services required
hereunder, in a form and with an insurer or insurers satisfactory to County, with limits of liability of not
less than $1,000,000 per claim and $2,000,000 in the aggregate. In the event the professional liability
insurance is on a claims -made basis, Consultant warrants that any retroactive date under the policy shall
precede the effective date of this Agreement. Continuous coverage will be maintained during any
applicable statute of limitations for the Services.
b. Other Requirements.
i. The automobile and commercial general liability coverage and such other
coverage as indicated above shall be endorsed to include Eagle County, its associated or affiliated entities,
its successors and assigns, elected officials, employees, agents and volunteers as additional insureds.
ii. Consultant's certificates of insurance shall include sub -consultants as additional
insureds under its policies or Consultant shall furnish to County separate certificates and endorsements for
each sub -consultant. All coverage(s) for sub -consultants shall be subject to the same minimum
requirements identified above. Consultant and sub -consultants, if any, shall maintain the foregoing
coverage in effect until the Services are completed. In addition, all such policies shall be kept in force by
Consultant and its sub -consultants until the applicable statute of limitations for the Services has expired.
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ill. Insurance shall be placed with insurers duly licensed or authorized to do business
in the State of Colorado and with an "A.M. Best" rating of not less than ANII.
iv. Consultant's insurance coverage shall be primary and non-contributory with
respect to all other available sources. Consultant's policy shall contain a waiver of subrogation against
Eagle County.
V. All policies must contain an endorsement affording an unqualified thirty (30)
days notice of cancellation to County in the event of cancellation of coverage.
vi. All insurers must be licensed or approved to do business within the State of
Colorado and all policies must be written on a per occurrence basis unless otherwise provided herein.
vii. Consultant's certificate of insurance evidencing all required coverage(s) is
attached hereto as Exhibit B. Upon request, Consultant shall provide a copy of the actual insurance
policy and/or required endorsements required under this Agreement within five (5) business days of a
written request from County, and hereby authorizes Consultant's broker, without further notice and
authorization by Consultant, to immediately comply with any written request of County for a complete
copy of the policy.
viii. Consultant shall advise County in the event the general aggregate or other
aggregate limits are reduced below the required per occurrence limit. Consultant, at its own expense, will
reinstate the aggregate limits to comply with the minimum limits and shall furnish County a new
certificate of insurance showing such coverage.
ix. If Consultant fails to secure and maintain the insurance required by this
Agreement and provide satisfactory evidence thereof to County, County shall be entitled to immediately
terminate this Agreement.
X. The insurance provisions of this Agreement shall survive expiration or
termination hereof.
xi. The parties hereto understand and agree that the County is relying on, and does
not waive or intend to waive by any provision of this Agreement, the monetary limitations or rights,
immunities and protections provided by the Colorado Governmental Immunity Act, as from time to time
amended, or otherwise available to County, its affiliated entities, successors or assigns, its elected
officials, employees, agents and volunteers.
xii. Consultant is not entitled to workers' compensation benefits except as
provided by the Consultant, nor to unemployment insurance benefits unless unemployment compensation
coverage is provided by Consultant or some other entity. The Consultant is obligated to pay all federal
and state income tax on any moneys paid pursuant to this Agreement.
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8. Indemnification. The Consultant shall indemnify and hold harmless County, and any of its
officers, agents and employees against any losses, claims, damages or liabilities for which County may
become subject to insofar as any such losses, claims, damages or liabilities arise out of, directly or
indirectly, this Agreement, or are based upon any performance or nonperformance by Consultant or any
of its sub -consultants hereunder including claims for bodily injury or personal injury including death, or
loss or damage to tangible or intangible property; and Consultant shall reimburse County for reasonable
attorney fees and costs, legal and other expenses incurred by County in connection with investigating or
defending any such loss, claim, damage, liability or action. This indemnification shall not apply to claims
by third parties against the County to the extent that County is liable to such third party for such claims
without regard to the involvement of the Consultant. This paragraph shall survive expiration or
termination hereof.
9. Ownership of Documents. All documents prepared by Consultant in connection with the Services
shall become property of County. Consultant shall execute written assignments to County of all rights
(including common law, statutory, and other rights, including copyrights) to the same as County shall
from time to time request. For purposes of this paragraph, the term "documents" shall mean and include
all reports, plans, studies, tape or other electronic recordings, drawings, sketches, estimates, data sheets,
maps and work sheets produced, or prepared by or for Consultant (including any employee or
subcontractor in connection with the performance of the Services and additional services under this
Agreement).
10. Notice. Any notice required by this Agreement shall be deemed properly delivered when (i)
personally delivered, or (ii) when mailed in the United States mail, first class postage prepaid, or (iii)
when delivered by FedEx or other comparable courier service, charges prepaid, to the parties at their
respective addresses listed below, or (iv) when transmitted via e-mail with confirmation of receipt. Either
party may change its address for purposes of this paragraph by giving five (5) days prior written notice of
such change to the other party.
COUNTY:
Eagle County Public Health & Environment
Attention: Heath Harmon
551 Broadway
P.O. Box 660
Eagle, CO. 81631
Phone: (970) 328-8819
E-Mail: heath. harmon@eaglecounty.us
With a copy to:
Eagle County Attorney
500 Broadway
Post Office Box 850
Eagle, Co 81631
Telephone: 970-328-8685
Facsimile: 970-328-8699
E-Mail: atty@eaglecounty.us
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CONSULTANT:
Eagle Valley Hope Center
Attn: Carrie Benway
Executive Director
P.O. Box 2127
Eagle, CO 81631
Phone: (970) 306-4673
email: carrie@ourhopecenter.org
11. Termination. County may terminate this Agreement, in whole or in part, at any time and for any
reason, with or without cause, and without penalty therefor with seven (7) calendar days' prior written
notice to the Consultant. Upon termination of this Agreement, Consultant shall immediately provide
County with all documents as defined in paragraph 9 hereof, in such format as County shall direct and
shall return all County owned materials and documents. County shall pay Consultant for Services
satisfactorily performed to the date of termination.
12. Venue, Jurisdiction and Applicable Law. Any and all claims, disputes or controversies related to
this Agreement, or breach thereof, shall be litigated in the District Court for Eagle County, Colorado,
which shall be the sole and exclusive forum for such litigation. This Agreement shall be construed and
interpreted under and shall be governed by the laws of the State of Colorado.
13. Execution by Counterparts; Electronic Signatures. This Agreement may be executed in two or
more counterparts, each of which shall be deemed an original, but all of which shall constitute one and the
same instrument. The parties approve the use of electronic signatures for execution of this Agreement.
Only the following two forms of electronic signatures shall be permitted to bind the parties to this
Agreement: (i) Electronic or facsimile delivery of a fully executed copy of the signature page; (ii) the
image of the signature of an authorized signer inserted onto PDF format documents. All documents must
be properly notarized, if applicable. All use of electronic signatures shall be governed by the Uniform
Electronic Transactions Act, C.R.S. 24-71.3-101 to 121.
14. Other Contract Requirements.
a. In rendering the 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 are maintained.
The performance of such obligation shall be determined at the sole discretion of County. In the event
County finds these standards of customer service are not being met by Contractor, County may terminate
this Agreement, in whole or in part, upon seven (7) days' notice to Contractor.
b. Consultant shall be responsible for the completeness and accuracy of the Services,
including all supporting data or other documents prepared or compiled in performance of the Services,
and shall correct, at its sole expense, all significant errors and omissions therein. The fact that the County
has accepted or approved the Services shall not relieve Consultant of any of its responsibilities.
Consultant shall perform the Services in a skillful, professional and competent manner and in accordance
Eagle County HHS Prof Sery Final 5/14
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with the standard of care, skill and diligence applicable to Consultants performing similar services. This
paragraph shall survive termination of this Agreement.
C. Consultant represents and warrants that it has the expertise and personnel necessary to
properly perform the Services and covenants that its professional personnel are duly licensed to perform
the Services within Colorado.
d. Consultant agrees to work in an expeditious manner, within the sound exercise of its
judgment and professional standards, in the performance of this Agreement. Time is of the essence with
respect to this Agreement.
e. This Agreement constitutes an agreement for performance of the Services by Consultant
as an independent contractor and not as an employee of County. Nothing contained in this Agreement
shall be deemed to create a relationship of employer -employee, master -servant, partnership, joint venture
or any other relationship between County and Consultant except that of independent contractor.
Consultant shall have no authority to bind County.
£ Consultant represents and warrants that at all times in the performance of the Services,
Consultant shall comply with any and all applicable federal and state laws, codes, rules and regulations.
g. Contractor shall comply with 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.
h. This Agreement contains the entire agreement between the parties with respect to the
subject matter hereof and supersedes all other agreements or understanding between the parties with
respect thereto.
i. Consultant shall not assign any portion of this Agreement without the prior written
consent of the County. Any attempt to assign this Agreement without such consent shall be void.
j. This Agreement shall be binding upon and shall inure to the benefit of the parties hereto
and their respective permitted assigns and successors in interest. Enforcement of this Agreement and all
rights and obligations hereunder are reserved solely for the parties, and not to any third parry.
k. No failure or delay by either party in the exercise of any right hereunder shall constitute a
waiver thereof. No waiver of any breach shall be deemed a waiver of any preceding or succeeding
breach.
1. The invalidity, illegality or unenforceability of any provision of this Agreement shall not
affect the validity or enforceability of any other provision hereof.
M. Consultant shall maintain for a minimum of three years, adequate financial and other
records for reporting to County. Consultant shall be subject to financial audit by federal, state or county
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auditors or their designees. Consultant authorizes such audits and inspections of records during normal
business hours, upon 48 hours' notice to Consultant. Consultant shall fully cooperate during such audit or
inspections.
n. The signatories to this Agreement aver to their knowledge, no employee of the County
has any personal or beneficial interest whatsoever in the Services or Property described in this
Agreement. The Consultant has no beneficial interest, direct or indirect, that would conflict in any manner
or degree with the performance of the Services and Consultant shall not employ any person having such
known interests.
o. The Consultant, if a natural person eighteen (18) years of age or older, hereby swears and
affirms under penalty of perjury that he or she (i) is a citizen or otherwise lawfully present in the United
States pursuant to federal law, (ii) to the extent applicable shall comply with C.R.S. 24-76.5-103 prior to
the effective date of this Agreement.
15. Prohibitions on Government Contracts.
As used in this Section 15, the term undocumented individual will refer to those individuals from foreign
countries not legally within the United States as set forth in C.R.S. 8-17.5-101, et. seq. If Consultant has
any employees or subcontractors, Consultant shall comply with C.R.S. 8-17.5-101, et. seq., and this
Agreement. By execution of this Agreement, Consultant certifies that it does not knowingly employ or
contract with an undocumented individual who will perform under this Agreement and that Consultant
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 Services under this Agreement.
a. Consultant shall not:
Knowingly employ or contract with an undocumented individual to perform
Services under this Agreement; or
ii. Enter into a subcontract that fails to certify to Consultant that the subcontractor
shall not knowingly employ or contract with an undocumented individual to perform work under the
public contract for services.
b. Consultant has confirmed the employment eligibility of all employees who are newly
hired for employment to perform Services under this Agreement 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:
https://www.uscis.gov/e-verify
C. Consultant 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 performed.
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d. If Consultant obtains actual knowledge that a subcontractor performing work under the
public contract for services knowingly employs or contracts with an undocumented individual, Consultant
shall be required to:
i. Notify the subcontractor and County within three (3) days that Consultant has
actual knowledge that the subcontractor is employing or contracting with an undocumented individual;
and
ii. Terminate the subcontract with the subcontractor if within three days of receiving
the notice required pursuant to subparagraph (i) of the paragraph (d) the subcontractor does not stop
employing or contracting with the undocumented individual; except that Consultant shall not terminate
the contract with the subcontractor if during such three (3) days the subcontractor provides information to
establish that the subcontractor has not knowingly employed or contracted with an undocumented
individual.
e. Consultant 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 Consultant violates these prohibitions, County may terminate the Agreement for breach
of contract. If the Agreement is so terminated specifically for breach of this provision of this Agreement,
Consultant shall be liable for actual and consequential damages to County as required by law.
g. County will notify the Colorado Secretary of State if Consultant violates this provision
of this Agreement and County terminates the Agreement for such breach.
[REST OF PAGE INTENTIONALL Y LEFT BLANK]
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IN WITNESS WHEREOF, the parties hereto have executed this Agreement the day and year first set
forth above.
Attest:
DocuSigned by:
By: &U,
Regina O'BrienD6 Je4` io the Board
COUNTY OF EAGLE, STATE OF COLORADO, By
and Through Its BOARD OF COUNTY
COMMISSIONERS DocuSigned by:
By:
Matt Scherr, $kE7�2[)Z18Eo473...
CONSULTANT:
DocuSigned by:
F
By: t, fXV04u,
74BBD31281`074AB...
Print Name: Carrie Benway
Title: Executive Director
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EXHIBIT A
Terms of Funding, Deliverables and Deadlines
Goal: Increase access to clinical mental health and substance abuse services for all students in the Eagle
County School District through the provision of full-time school -based mental health counselors.
Objective: The Eagle Valley Hope Center will provide a minimum of three (3) full-time mental health
counselors to provide clinical mental health and substance abuse services to all students attending public
or private schools within Eagle County School District in accordance with the terms, deliverables and
deadlines set forth in this Agreement.
Deliverables
Deadlines
1. Mental Health Counselors supported by this Agreement
The Eagle Valley Hope Center will
are to provide services to all public and private school
ensure that the requirements and
students, teachers and administrators in the district,
responsibilities for mental health
including:
counselors working within the schools
are consistent with the deliverables in
• Eagle County School District
this scope of work.
• St. Clare of Assisi
• Stone Creek Charter School
• Vail Christian Academy
• Vail Christian High School
Eagle Valley Hope Center will share
• Vail Mountain School
with ECPHE a copy of any
contracts/agreements between Eagle
2. The Hope Center will ensure that the school -based
Valley Hope Center and the District or
mental health counselors are responsible for:
other public and private schools.
a. Assessing or triaging each student who is self -
identified or identified by parents,
administration, teachers, counselors, or coaches
as "at risk".
b. Determining one of three levels of care post
assessment:
i. One-time assessment and diffusing of
crisis at hand
ii. Moderate crisis, but short-term, one or
two follow ups
iii. High crisis and longer term therapy
needed
c. Providing regular, solution focused therapy on
the school campus if long term therapy is
needed and/or referring the student to an
outside provider for ongoing treatment. This
includes diagnostic evaluation, individual, and
family therapy and peer support services to
children and families in need.
d. Providing coordination and follow up of
services for continuity and closing gaps in the
mental health system.
e. Providing therapeutic support services
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approximately 90% of the time with the
remaining 10% of time spent at offsite
meetings or performing other obligations.
f. Proactively coordinate medical care to link
patients to other providers in the mental health
system as needed. This includes coding formal
services for diagnosis and therapy in the
student's electronic medical record.
g. Meeting with students, teachers and
administration to provide services and facilitate
staff development as needed throughout the
contract period, including the provision of
services over the summer months with
teachers, administration and the district's youth
populations (5-18 years of age) as needed.
3. The provision of therapeutic support services, care
ECPHE will coordinate with the Eagle
coordination, and staff development will be evaluated
Valley Hope Center for data collection
through the collection of data coordinated between the
and evaluation throughout the year.
Eagle Valley Hope Center and ECPHE. All private and
public schools in the district are to participate in
evaluation of the quality of mental health services
provided. This includes an assessment of school
personnel and administration regarding the status of
their workload related to behavioral health intervention
and improved school culture as well as student
knowledge of school -based mental health services, how
to access services, and student readiness to access.
4. The Eagle Valley Hope Center is to provide ECHPE
The Eagle Valley Hope Center will
with data four times during the year to include the
provide progress reports during the
following:
months of April 2022, July 2022,
• The number of contact hours for each
October 2022, and January 2023.
counselor provided at each school in the district
per month
• The number of students seen by mental health
counselors at each school per month
• Wait times for each visit (time from referral
from individual student, parent or school
personnel to the time that the student is first
seen by the counselor)
• Demographics for each visit including:
o Age
o Grade
o Gender
o New or repeat visit
o If repeat visit, number of visits to date
o Level of risk
o Diagnosis, if applicable
o Treatment recommended
o Referral, if applicable
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o Outcome
• HIPAA compliant stories to outline successes
and lives impacted
5. The Eagle Valley Hope Center, in collaboration with
The School District is to provide a
the Eagle County School District, is to develop a
written update to ECPHE and the
sustainability plan to independently fund mental health
Mental Health Advisory Committee of
counselors as proposed county supported funding
actions taken to secure long-term
decreases over the next three years.
funding for mental health counselors
by the end of the contract period.
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Eagle County HHS Prof Sery Final 5/14
DocuSign Envelope ID: D714489B-A1AE-4D74-8C41-lFDC1857F48E
Eagle Valley Hope Center Budget for Eagle River Valley
Salaries and Wages for Eagle Valley Hope Center School Based Clinicians (average
Taxes and Benefits I
Personnel Expenses (1) x 3 clinicians
15,600
$226,800
$13
Net Billable Expenses 1 1 $2.
(1) Salaries and Benefits for Eagle Valley Hope Center crisis clinicians who serve the Eagle Valley.
(2) General Operating Expenses are estimated at 6% of Personnel Expenses and include
client expenses, operating supplies, medical records system inclusion for data and outcome
athering, and other general operating expenses.
15
Eagle County HHS Prof Sery Final 5/14
DocuSign Envelope ID: D714489B-AlAE-4D74-8C41-1FDC1857F48E
EXHIBIT B
Insurance Certificate
16
Eagle County HHS Prof Sery Final 5/14
DocuSign Envelope ID: D714489B-AlAE-4D74-8C41-1FDC1857F48E
BEHAHEA-01
IENNYC
ACORDF
CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDDIYYYY)
1/4/2021
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
CONTACT Sonia Becerra
NAME:
PHONE 970 945-9111 FAX 945-2350
(A/C, No, Ext): ( ) (A/C, No): (970 )
Mountain West Insurance - Glenwood
201 Centennial St 4th Floor
Glenwood Springs, CO 81601
AD RESS: soniab@mtnwst.com
INSURERS AFFORDING COVERAGE
NAIC #
INSURER A:Philadelphia Insurance Company
18058
INSURED
INSURER B : Plnnacol Assurance
41190
Behavioral Health Crisis Services Inc dba HOPE Center of
Eagle River Valley
INSURER C :
PO Box 2127
INSURER D :
INSURER E :
Eagle, CO 81631
INSURER F :
COVERAGES CERTIFICATE NUMBER: 1 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OF INSURANCE
ADDL
INSD
SUBR
WVD
POLICY NUMBER
POLICY EFF
MMIDD/YYYY
POLICY EXP
MM/DD/YYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS-MADEOCCUR
PHPK2219018
1/1/2021
1/1/2022
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENTED
PREMISES Ea occurrence
1000000
$
MED EXP (Any oneperson)
$ 20,000
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L
X
AGGREGATE LIMIT APPLIES PER:
POLICYEl PRO- LOC
OTHER:
GENERAL AGGREGATE
$ 3,000,000
PRODUCTS - COMP/OP AGG
$ 3,000,000
$
A
AUTOMOBILE
LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED X NON -OWNED
AUTOS ONLY AUTOS ONLY
PHPK2219018
1/1/2021
1/1/2022
COMBINED SINGLE LIMIT
Ea accident
1,000,000
$
BODILY INJURY Perperson)
$
BODILY INJURY Per accident
$
X
PROPERTY DAMAGE
Per accident
$
A
X
UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
PHUB750512
1/1/2021
1/1/2022
EACH OCCURRENCE
$ 1,000,000
AGGREGATE
$ 1,000,000
DED X RETENTION $ 10,000
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE ❑
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N I A
4227725
1/1/2021
1/1/2022
X PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
500,000
$
E.L. DISEASE - EA EMPLOYEE
$ 500,000
E.L. DISEASE - POLICY LIMIT
500,000
$
A
A
Professional Liabili
Directors & Officers
PHPK2219018
PHSD1596535
1/1/2021
1/1/2021
1/1/2022
1/1/2022
Professional Liab
Directors & Officers
1,000,000
1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Eagle Count Government
g y
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
PO Box 850
Eagle, CO 81631
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD