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COOPERATIVE REIMBURSEMENT PROGRAM AGREEMENT
Eagle County
015
This agreement is executed as of
Whittier
Department of Social Services
March 24,
. 19 81
by and between Beth A.
(hereinafter "County Attorney") and the Eagle County
Department of Social Services (hereinafter "Department";
WITNESSETH THAT
WHEREAS, the Department, under the Social Security Act, as amended by Section 101 of PL 93-647,
45 CFR Parts 232, 301, 302, 303, 304, and 26-2-104 and 26-2-105 CRS 1973, has been delegated
responsibility for the development and implementation of a program to secure support and establis
paternity for children receiving AFDC benefits and those otherwise eligible but nZreceiving
a• asistance payment grant, and
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WHEREAS, the Department desires to enter into an agreement with the County Attorney to:
1) assist the Department in providing the services necessary to establish paternity and
secure support for children receiving AFDC and those otherwise eligible but not receiving
an assistance payment within the meaning of Federal regulations pertaining thereto, and 2)
assist in other matters of common concern to the Department and the County Attorney, and
WHEREAS, the County Attorney is desirous of entering into such an agreement with the Department-
Nr THEREFORE: The Department and County Attorney, in consideration of the promises and
ai 'al covenent is hereinafter contained, do hereby agree as follows:
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1. Scope of Services
Services will be provided to AFDC grant recipients and any individuals not otherwise eligible
for such service by the County Attorney in compliance with the Program Narrative which Part II
of the Program Application, a copy of which is attached hereto and made a part hereof by referee
2. Duration of Program
This agreement shall be in effect from the date first shown above until December 31,
19 81 but not to exceed twelve months.
3. Pavment-Schedule and Amount
A. Amount. Payment will be made on the basis of the Program Budget which is Part III of the
F ;ram Application, a copy of which is attached hereto and made a part hereof by reference
pto ided, that no more than $ 2250.00 shall be paid from combined State and Federal Funds
during the duration of this agreement.
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B. Schedule. Payment will be made monthly upon receipt of itemized billing for actual
expenditures incurred pursuant to this agreement. All payment will be used only for the conduct
oche program as encompassed by this agreement.
4. Cancellation, Termination and Amendment
This agreement may be terminated, cancelled, revoked and annulled by either party upon written
notice of a least thirty(30) days. This agreement may be amended in whole or in part by
mutual consent, provided that said amendment be reduced in writing, properly executed and
made a part of this agreement.
5. Reports, Records and Retention Periods
The County Attorney shall maintain such records as are deemed necessary pursuant to the State
Department's Rules to assure a proper accounting for all costs and funds collected. These
r- irds will be made available for audit purposes to the U. S. Department of HEW, the State
i 3rtment, or any authorized representative of the State of Colorado, and will be retained
for five years after the expiration of this contract unless permission to destroy them is grante
by the State Department of Social Services.
The County Attorney shall make financial, program progress and other reports as requested by
the County or State Department of Social Services.
6. Equipment Purchased with Federal, State and County Money
An inventory shall be maintained of all equipment purchased by the County Attorney pursuant
to this agreement. The County Attorney shall take the necessary action to assure that title
to all aforesaid equipment shall be vested in the County Department of Social Services upon
f [.ration of this agreement.
Confidentiality
Information provided by the County Department of Social Services in furtherance of the aims
and purposes of this agreement will be used only for the purposes intended and in accordance
with Federal and State laws and regulations.
8. Political Activities
None of the funds, materials, property, personnel or services contributed by the United States,
the State Department of Social Services or the County udner this agreement shall be used
for any partisan political activity, or to further the election of defeat of any candidate for
public office in a manner which would constitute a violation of 5 U.S.C. Sections 1501 et seq.
9 Religious Activity
'11�e shall be no religious worship, instruction or proselytization as part of or in connection
with the performance of this agreement.
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10. Non -Discrimination
I'wonnection with the performance of services under this agreement the County Attorney
agrees to comply with the provisions of the laws of Colorado, the Civil Rights Act of 1964,
as amended, the Regulations of the Department of Health, Education and Welfare issued pursuant
to that Act, the provisions of Executive Order 11246, Equal Employment Opportunity, dated
September 24, 1865, as amended.
11. Studies and Investigations
All official reports of ca-aes, recoveries, investigations, studies, etc., made as a result
of this agreement shall acknowledge the support provided by the Department.
12. Federal and State Laws and Regulations
T' agreement shall be performed in compliance with the Social Security Act, as amended,
Federal regulations and amendements thereto which implement the Social Security Act, and
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the rules and regulations of the State Department of Social Services, as amended.
IN WITNESS WHEREOF
Department and County Attorney have caused this agreement to be executed by their respective
officers duly authorized so to do.
This agreement is expressly made subject to the approval of the Executive Director, Colorado
Department of Social Services, or his designee; however, the State of Colorado, the Colorado
Department of Social Services, the Executive Director, or her designee, are not parties of
'agreement.
County Dir or
IA=&&Z
County Attorney for Social Services Matters
APPROVED: STATE OF COLORADO
RICHARD D. LArLki, GOVERNOR
P in A. Date
End utive Director
Colorado Department of Social Services
Member County Board of Social Services
Member County Board of Social Services
Member County Board of Social Services
*If the Hoard of Social Services resolves to empower the Chairman of the Board of Social Service
to enter into and sign this agreement for the County Counissioners then a copy of the Board's
resolution to do so must be attached.
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COOPERATIVE REIMBURSEMENT PROGRAM APPLICATION
STATE OF COLORADO
DEPARTMENT OF SOCIAL SERVICES
PART I
Application is hereby made to the Colorado Department.of Social Services for
approval of a program designed to provide services to persons receiving an assistance an
assistance payment grant under the AFDC program, and any individual not otherwise eligible
for such services, in accordance with the H.E.W. approved State Plan.
Location of Program (City, County)
Program Director (Name, County Attorney, Deputy
District Attorney, etc.
t
Si nature of Chairman, Board of Social Services
Signature of County Attorney for Social
Date
Services matters
Signature of Director, County Department
of Socia Se ices
Date
y
Type of apielcation
Application for xe-runaing
an existing Program
ED New application
13 District Attorney
1KCounty Attorney for
Social Services matters
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PART II — PROGRAM NARRATIVE
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PART III PROGRAM BUDGET FOR ---------
YEAR OPERATION
FI-Personnel
(List all positions by
Percentage
County State
Total
tle and
annual salary; use
I of Time on
Funds Funds
Estimated
continuation sheets, if necessary.)
Job
Costs
(1) (2)
45 /hour,
which includes all
$ 2250
personnel
and overhead cost.
50 hours
Fringe Benefits
subtotal I 1 I I $ 2250
2. Travel (Itemize by Purpose)
3. Supplies (Itemize)
subtotal
.01
subtotal
4. Training Cost (Itemize)
subtotal
5. Other Expenditures (Itemize)
subtotal
6. Rent (Total Area and Cost per sq.
ft.)
subtotal
TOTAL COSTS
$ 2250
0
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PrLRT II - PROGR.91 NARFt aTI4 E (CON T' D . )
C) Program Function (Describe Nature and Extent of the expansion of pres-
ent services and the nature and extent of services created pursuant to
the program. Include how these services will be provided, where they
will be provided and other pertinent facets of the prograa, use con-
tinuation sheets if necessary. ,
1. Handle reciprocal support actions.
2. Handle paternity, to include: development of evidence
through polygraph and blood tests, pre-trial discovery,
and court action to establish paternity.
3. Establish and enforce support actions, collection methods,
contempt citations, issuance of warrants, attachment of
wages and other proceedings.
114� 1 4
?age 3 of 3
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Reviewed by:
Reviewed by:
PART IV STATE DEPARTMENT OF SOCIAL SERVCIES
Executive Of f icer
Office of Administration
Comments:
Signature
Support Unit
Comments:
Approved Disapproved
Date
Approved Disapproved
Signature Date