HomeMy WebLinkAboutContracts & Agreements_252-2005_CCv0001.pdf INDEPENDENT CONTRACTOR AGREEMENT
This Agreement is made and entered into this 20th day of December., 2005 by and
between the City of Redlands, a municipal corporation (hereinafter "City") and Christian
Counseling Services, (hereinafter"Contractor").
RECITALS
WHEREAS, Contractor has expressed an interest in providing a counseling service
program for low-and moderate-income residents of Redlands and surrounding areas;
WHEREAS, Contractor has represented to City that it has the requisite experience,
special knowledge and expertise similar to others in the industry conducting these services;
NOW,THEREFORE,in consideration of the mutual promises contained herein,the
City and Contractor hereby agree as follows:
AGREEMENT
Section 1. Services.
A. City hereby authorizes Contractor to provide a counseling service program
for low- and moderate-income residents of Redlands and surrounding areas
B. Contractor shall determine the method,details and means of performing the
above-described services and shall advise City of the same prior to
commencing any activities under this Agreement. Contractor further agrees
to perform such services to the best of its ability and in an efficient, safe and
competent manner.
C. As compensation for conducting these services, City shall reimburse the
contractor for services necessary to implement this program. Federal, State,
County and City rules and regulations will apply. Compensation shall not
exceed $5,000.00.
D. Contractor shall submit to City a complete record of the services performed
including, but not limited to: copies of invoices, agreements, payroll
expenses, administrative records, advertisements, and backup materials. A
detailed account of the services performed,person(s)performing services and
cost breakdown shall also be provided to the City. Administration and
personnel records shall be available for examination by the City.
E. Contractor shall submit to City with each request for reimbursement
documentation in compliance with the requirements listed in 24 CFR 570.503
including: Agreements with Subrecipients; Statement of Work,Records and
Reports; Program Income; Uniform Administrative Requirements; Other
Program Requirements,Conditions for Religious Organizations;Suspension
and Termination; Reversion of Assets.
F. This program is available to predominantly low- and moderate-income
persons and requires documentation that at least 51% of the persons
benefiting from the counseling program are low-and moderate-income. In
order to document that 51%of the beneficiaries of the program are income-
qualifying, a Beneficiary Qualification Statement (Exhibit 1 of 3) must be
completed for each person attending a counseling session. This form is
available in both English and Spanish. The Beneficiary Qualification
Statement will be used to complete and submit the -Monthly Program
Progress/Direct Benefit Report(Exhibit 2 of 3)to the County Department of
Community Development and Housing. The Monthly Program
Progress/Direct Benefit Reports must be submitted to the County for each
month that CDBG reimbursement is requested. The units of service must be
reported on Part I: Monthly Program Progress Report, (Exhibit 2 of 3)). A
unit of service is defined as person participating in one counseling session.
Christian Counseling Services will provide a measurable outcome with
quantifiable results for the duration of this contract. The measurable outcome
will be recorded on Part II: Monthli,Direct Benefit Report(Exhibit 2 of 3)
and will consist of the number of unduplicated first-time clients who
participate in the program. Copies of all submitted forms must be retained in
Contractor's records for a minimum period of three(3)years from December
7, 2005.
G. Contractor will submit all final claims for reimbursement to City no later than
June 30, 2006.
H. The City of Redlands will submit a final Request for Reimbursement for the
program year no later than July 21, 2006. After July 31, 2006 any balance
remaining in this account will be reprogrammed.
Section 2. Independent Contractor.
It is the express intention of the parties hereto that Contractor is an independent
contractor and not an employee or agent of City. Nothing in this Agreement shall be
interpreted or construed as creating or establishing a relationship of employer and
employee between Contractor and City. Both parties acknowledge that Contractor is
not an employee for State tax, Federal tax or any other purpose.
Section 3. Contractor's Employees.
A listing of all Contractor's employees and agents who may participate in the
performance of Contractor's obligations hereunder is attached hereto as Exhibit "3
of 3)" and incorporated herein by this reference. No other employees or agents of
Contractor shall participate in the performance of services hereunder without the
prior written consent of City.
Section 4. Termination.
City shall have the right to terminate this Agreement,with or without cause,
upon twenty(20)day's prior written notice to Contractor. City shall have no liability for any
claims or damages resulting to Contractor as a result of any exercise by City of its right to
terminate this Agreement.
Section 5. Insurance and Indemnification
5.1 Contractor's Insurance to be Primary
All insurance required by this Agreement is to be maintained by Contractor for the
duration of this Project and shall be primary with respect to City and non-contributing to any
insurance or self-insurance maintained by the City. Contractor shall not perform any
Services pursuant to this Agreement unless and until all required insurance listed below is
obtained by Contractor. Contractor shall provide City with Certificates of Insurance and
endorsements evidencing such insurance prior to commencement of work. All insurance
policies shall include a provision prohibiting cancellation of the policy except upon thirty
(30) days prior written notice to City.
5.2 Workers' CoMpensation and Employer's Liability
A. Contractor shall secure and maintain Workers' Compensation and
Employer's Liability insurance throughout the duration of this Agreement in
amounts which meet statutory requirements with an insurance carrier
acceptable to City.
B. Contractor expressly waives all rights to subrogation against City,its officers,
employees and volunteers for losses arising from work performed by
Contractor for City by expressly waiving Contractor's immunity for injuries
to Contractor's employees and agrees that the obligation to indemnify,defend
and hold harmless provided for in this Agreement extends to any claim
brought by or on behalf of any employee of Contractor. This waiver is
mutually negotiated by the parties. This shall not apply to any damage
resulting from the sole negligence of City, its agents and employees. To the
extent any of the damages referenced herein were caused by or resulted from
the concurrent negligence of City, its agents or employees, the obligations
provided herein to indemnify, defend and hold harmless is valid and
enforceable only to the extent of the negligence of Contractor, its officers,
agents and employees.
5.3 Comprehensive General Liability Insurance. Contractor shall secure and
maintain in force throughout the duration of this Agreement comprehensive general liability
insurance with carriers acceptable to City. Minimum coverage of one million dollars
($1,000,000) per occurrence and two million dollars ($2,000,000) aggregate for public
liability, property damage and personal injury is required. Contractor shall obtain an
endorsement that City shall be named as an additional insured.
5.4 Professional Liability Insurance. Contractor shall secure and maintain
professional liability insurance throughout the duration of this Agreement in the amount of
one million dollars ($1,000,000) per occurrence.
5.5 Business Auto Liability Insurance. Contractor shall have business auto
liability coverage,with minimum limits of 1 million($1,000,000)per occurrence,combined
single limit for bodily injury liability and property damage liability. This coverage shall
include all consultant owned vehicles used on the project,hired and non-owned vehicles,and
employee non-ownership vehicles. Contractor shall obtain an endorsement that City shall be
named as an additional insured.
5.6 Assignment and Insurance Requirements. Contractor is expressly prohibited
from subletting or assigning any of the services covered by this Agreement without the
express written consent of City. In the event of mutual agreement between parties to sublet a
portion of the Services,the Contractor will add the subcontractor as an additional insured and
provide City with the insurance endorsements prior to any work being performed by the
subcontractor. Assignment does not include printing or other customary reimbursable
expenses that may be provided in this Agreement.
5.7 Hold Harmless and Indemnification. Contractor shall defend,indemnify and
hold harmless City,its elected officials,officers,employees and agents,from and against any
and all actions, claims, demands, lawsuits, losses and liability for damages to persons or
property, including costs and attorney fees, that may be asserted or claimed by any person,
firm, entity, corporation, political subdivision or other organization arising out of or in
connection with Contractor's negligent and/or intentionally wrongOU I acts or omissions under
this Agreement; but excluding such actions, claims, demands, lawsuits and liability for
damages to persons or property arising from the sole negligence or intentionally wrongful
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acts of City, its officers, employees or agents.
Section 6. Health Insurance Portability and Accountability Act of 1996
Pursuant to the Health Insurance Portability and Accountability Act of 1996
(HIPAA), regulations have been promulgated governing the privacy of individually
identifiable health information. The HIPAA Privacy Regulations specify requirements with
respect to contracts between an entity covered under the HIPAA Privacy Regulations and its
Business Associates. A Business Associate is defined as a party that performs certain
services on behalf of, or provides certain services for, a Covered Entity and,in conjunction
therewith, gains access to individually identifiable health information. Therefore, in
accordance with the HIPAA Privacy Regulations,Contractor shall comply with the terms and
conditions as set forth in the attached Business Associate Agreement, Exhibit "D" hereby
incorporated by this reference.
Section 7. Entire Ag,
,reement/Modification. This Agreement represents the entire
Agreement of the parties hereto as to the matters contained herein.Any modification of this
Agreement will be effective only if it is in writing and signed by the parties hereto.
Section 8. Assignment. This Agreement shall not be assigned without the prior
written consent of City. Any assignment, or attempted assignment, without such prior
written consent, shall be null and void and, at the option of City, result in the immediate
termination of this Agreement.
Section 9. Attorney's Fees. In the event any action is commenced to enforce or
interpret the terms or conditions of this Agreement,the prevailing party shall,in addition to
any costs or other relief, be entitled to recover its reasonable attorneys' fees.
Executed this 20th day of December 2005.
City of Redlands
Date: December 20, 2005
Jon Haff on, Mayor
Attest:
Lorrie'fovyzer, City. 1 k
City of Redlands
Christian Counseling Services
Date:
i:ca\1em\agreements\RCMA 5
COUNTY OF SAN BERNARDINO DEPARTMENT OF COMMUNITY DEVELOPMENT AND HOUSING
Project Activity Title: Case Number:
Third District: Parent Child Interaction Therapy
Name/Address of Contractor Agency: Date of Issue:
Christian Counseling Service Original: Beginning
51 W. Olive Avenue Amendment#
Redlands,CA 92373
PROJECT/ACTIVITY DESCRIPTION
SERVICES:
This target population for this project is low to moderate income families with young children causing significant stress in the family.
The Parent Child Interaction Therapy program is designed to help children 2—7 years of age with behavior problems. Parents work
directly with their child as the therapist coaches them. The parent(s)are in the playroom with the child;the therapist is in an
observation room speaking to the parent through an earpiece. The program includes initial testing and assessment and approximately
20 weeks of therapy on a once a week basis. Assessments give direction to the therapy as well as providing the basis on which to
measure improvement. Siblings of the child being treated are taken care of as needed by a childcare provider..
Assessment: From January 1,2006 to July 1,2006. Christian Counseling Service will provide assessment materials and do
therapeutic assessments for 3 families. Each assessment takes 2 hours.Therefore we will do 6 assessments.
Therapy:From January 1,2006 to July 1,2006,we will see 2 families for a fall 20 week course of treatment. At two adults and I
child per family we will do 40 hours of treatment or 240 units of service.
Childcare: CCS will provide childcare for 2 siblings of the children treated at an hour each week for 22 weeks for a total of 44 hours
of Childcare.
OPERATIONS:
Christian Counseling Service offices are located in the First Baptist Church of Redlands at 51 W.Olive Avenue,Redlands.The office
hours are 9:00 AM to 9:00 PM Monday through Friday.
UNITS OF SERVICE:Program activities will be reported in the Monthly Program Progress Report(Exhibit 2 of 3). Performance will
be measured using the following units of service:
(1)The number of assessment hours provided per family member(I hour per person= I unit of service)
(2)The number of therapy hour provided per family member(1 hour per person= I unit of service)
(3)The number of childcare hours provided(I hour per person= I unit of service)
PROGRAM PARTICIPANT PERFORMANCE STANDARDS
A sample of measurable performance standards are as follows:
PCIT Families
Family Changes Measurable Outcomes
Pre-test Score Post-test Score
Child Behavior Checklist
Eyberg Child Behavior Inventory
Parent Stress Inventory
EXHIBIT I of - 3
COUNTY OF SAN BERNARDINO DEPARTMENT OF COMMUNITY DEVELOPMENT AND HOUSING
Proiect/Activity Title: Case Number:
Third District: Parent Child Interaction Therapy
Christian Counseling Service
Name/Address of Contractor Agency: Date of Issue:
Christian Counseling Service
51 W. Olive Avenue Original: Beginning
Redlands, CA 92373 —Amendment#
BENEFICIARY QUALIFICATION STATEMENT
This form has the purpose of providing information needed to qualify the use of federal Community
Development Block Grant (CDBG) funds for the project/activity described above. This statement must be
completed and signed by the person(or legal guardian of the person) requesting to receive benefits from the
described project/activity. Only one statement per person, per year is required.
Please answer each of the following questions.
1. This question helps you determine the size of your household. For this question a household is a group
of related or unrelated persons occupying the same house with at least one member being the head of the
household. Renters, roomers, or borders cannot be included as household members. How many
persons are in your household?
2. This question asks if you are from a low- and moderate-income household. For this question a list of the
2005 LOW-INCOME and LOW- AND MODERATE-INCOME categories* are presented below.
Please add up the combined gross annual income of all persons in your household from all sources of
income. In the blank provided,write yes or no, that your combined gross annual income is equal
to or less than the LOW-INCOME amount for the number of persons in your household.
In the blank provided,write,yes or no, if your combined gross annual income is equal to or less
than the LOW-AND MODERATE-INCOME amount for the number of persons in your
household.
Number of Persons in Your Household
1 2 3 4
LOW-INCOME $19,500 $22,250 $25,050 $27,850
LOW- AND MODERATE- $31,200 $35,650 $40,100 $44,550
INCOME (COMBINED)
Number of Persons in Your Household
5 6 7 8
LOW-INCOME $30,050 $32,300 $34,500 $36,750
LOW- AND MODERATE- $48,100 $-5)11,7/OuOu 555,250 S-5)80,800
EXHIBIT I(a) of 3
COUNTY OF SAN BERtNARDINO DEPARTMENT OF CONUM UNITY DEVELOPMENT AND HOUSING
3. Please indicate how you identify yourself by checking only one (1) of the following choices:
Non-
Hispanic Hispanic
White
Black/Afhcan American ❑ F7
Asian 7 7
American Indian/Alaskan Native ❑ ❑
Native Hawaiian/Other Pacific Islander F�
American Indian/Alaskan Native & White 7 F�
Asian&White F�
Black/African American & White E] ❑
American Indian/Alaskan Native &Black/African American El
Balance/Other 0 ❑
4. Please check whether you belong to a Female Headed Household: D Yes ❑ No
5. Please describe the condition that would qualify you as being considered in one of the following
presumed low- and moderate-income categories: abused child, battered spouse, elderly person, homeless
Z�'
person, disabled adult, illiterate person, or migrant farm worker:
(description)
ACKNOWLEDGMENT AND DISCLAIMER
I CERTIFY UNDER PENALTY OF PERJURY THAT INCOME AND HOUSEHOLD
STATEMENTS MADE ON THIS FORM ARE TRUE.
NATME: DATE:
ADDRESS: CITY: ZIP:
SIGNATURE: PHONE:
The information you provide on this form is for Community Development Block Grant(CDBG) program
purposes only and will be kept confidential.
*Taken from 2005 Section 8 Low-Income and Very Low-Income Limits.
EXHIBIT fib) of 3
COUNTY OF SAN BERNARDINO DEPARTMENT OF COMMUNITY DEVELOPMENT AND HOUSING
Project/Activity Title: Case Number:
Third District: Parent Child Interaction Therapy
Christian Counseling Service
Name/Address of Contractor Agency: Date of Issue:
Christian Counseling Service
51 W. Olive Avenue Original: Beginning
C>
Redlands, CA 92373 Amendment#
DECLARACION DE LA CALIFICACION DEL BENEFICIAR10
Esta forma tiene el prop6sito de proporcionar la informaci6n necesaria para calificar el use de los fondos
federales del bloque del desarrollo de la comunidad (CDBG)para el proyecto/actividad descrito arriba. Esta
declaraci6n se debe Ilenar y firmar por la persona(o la tutela legal de la persona) que solicita para recibir
beneficios del proyecto/actividad descrito. Solamente una declaracio'n por persona, por ano se requiere.
Conteste por favor a cada una de las preg-untas siguientes.
1. Esta pregunta le ayuda a determinar el tamaAo de su casa. En esta pregunta un hogar es un grupo de
personas relacionadas o sin relaci6n que ocupan la misma casa por to menos con un miembro que es la
cabeza de la casa. Los inquilinos no se pueden incluir coma imembros de la casa. �Cudntas personas
viven en su casa?
2. Esta pregunta explica si usted es de un hogar de ingresos bajos y moderados. Para esta pregunta la lista
de 2005 de categorias de BAJOS-INGRESOS y del PL'-N, 'TO BAJO Y de INGRESOS-MODERADOS
*se presenta abajo. Sume por favor para arriba los ingresos brutos anuales combinados de todas las
personas en su hogar y de todas las fuentes de los ingresos. En el espacio en blanco, escriba si o no, si
su ingreso anual grueso combinado es igual o menos que la cantidad de INGRESO-BAJO para el
nAmero de personas en su casa.
En el espacio en blanco, escriba, si o no, si sus ingresos brutos anuales combinados son igual o menus
que la cantidad de INTGRESOS BAJOS Y MODERADOS para el ndmero de personas en su casa.
Numero de Personas en su Hogar
2 3 4
INGRESOS-BAJOS $19,500 $22,250 $25,050 $27,850
INGRESOS-BAJOS Y $31,200 $35,650 $40,100 $44,550
, MODERADOS (COMBUNTADOS)
Numero de Personas en su Hogar
5 6 7 8
ITNGRESOS-BAJOS $30,050 $32,300 $34,500 $36,750
INTGRESOS-BAJOS Y $48,100 $51,700 $55,250 $58,800
' MODERADOS (COMBINTADOS)
EXHIBIT l{b) of
COUNTY OF SAN BERNARDINO DEPARTMENT OF COMMUNITY DEVELOPMENT AND HOUSING
3. Indique por favor c6mo se identifica usted, marcando solamente una(1) de las opciones siguientes:
No-
Hispano Hispano
Blanco
Negro/Afro Americano
Asidtico
Indio Americano/Nativo de Alaska
Nativo Hawaiano/Otra Isla del Pacifico
Indio Americano/Nativo de Alaska &Blanco ❑ ❑
Asiatico & Blanco ❑ ❑
Negro/Afro Americano &Blanco ❑ ❑
Indio Americano/Nativo de Alaska&Negro/Afro Amer. ❑ ❑
Balance/Otro ❑ ❑
4. Marque par favor si usted pertenece a un hogar encabezado femenino: ❑ Si ❑ No
4. Describa par favor la condici6n que le calificaria como siendo considerado en una de las categorias de
presumidos ingresos bajos y moderados siguientes: nifio abusado, esposo estropeado,persona mayor,
persona sin hogar, adulto incapacitado, persona analfabeta, o trabajador migratorio de granja:
(descripci6n)
RECONOCEMIENTO Y NEGACION
CERTIFICO BAJO PENA DE PERJURIO QUE LAS DECLARACIONES HECHAS EN ESTA
FORTMA, ACERCA DE LOS INGRESOS Y DE LAS CUENTAS DE LA CASA SON VERDADERAS.
NOMBRE: FECHA:
DOMICILIO: CIUDAD: CODIGO:
FIRMA: TELtFONO:
La informaci6n que usted proporciona en esta forma es para los prop6sitos del programa de foudos del
Moque del desarrollo de la comunidad (CDBG) solamente y seri mantenida confidencial
*Tomado de 2005 Secci6n 8 Ingresos bajos.
EXHIBIT 2 of 3
COUNTY OF SAN BERNARDINO DEPARTMENT OF COMMUNITY DEVELOPMENT AND HOUSING
Project/Activity Title: Case Number:
Third District: Parent Child Interaction Therapy-
Christian Counseling Service
Name/Address of Contractor Agencv: Date of Issue:
Christian Counseling Service
51 W. Olive Avenue Original: Beginning
Redlands,CA 92373 Amendment#
MONTHLY PROGRAM PROGRESS REPORT AND DIRECT BENEFIT REPORT For the Month of AUGUST,2005
PART 1: MONTHLY PROGRAM PROGRESS REPORT
A. Units of Service Provided and Description
Under each type of service listed below,provide a NARRATIVE DESCRIPTION of your program's accomplishments during this month.
Include location,number of persons served,services/benefits provided,and a description of the clients served.Also report the number of
Units of Service provided,as defined in the Project/Activity Description(Exhibit I of 7).
Type of Service: Anticipated Units of Service:
1. Therapeutic Assessment: Goal/6mos: 10 units
(I person assessed for I hour= I unit of senlice)
2.Parent Child Interaction Therapy: Goal/mo:40 units
(I hour of therapy for I person= I unit of service)
3.Childcare
Goal/mo: 8 units
B. Monthly Beneficiary Count(may include individual persons or households previously counted during this grant/program
year)
Total number of beneficiaries(clients/participants)served this month(choose one category only):
#of Persons OR #of Households
PART 11: DIRECT BENEFIT REPORT
Direct Benefit Statistics(Unduplicated first-time client counts since start of contract;taken from Beneficiary Qualification Statement forms)
Enter the number of first-time program beneficiaries directly assisted this month.
Count only as: [ Individual Persons or ❑Households(check one box)
Low-Income(only):_ Low-and Moderate-Income(combined):— All Beneficiaries:
Racial Identity Categories
Non- Non-
Hispanic Hispanic Hispanic Hispanic
(b) (a) (c) (c)
White American Indian/Alaskan Native&White
Black/Affican American Asian&White
Asian Black/African American&White
American Indian,"Alaskan Native Amer.Indian/Alaskan Native&African Amer.
Native Hawaiian/Other Pacific Islander Balance/Other
Grand Total of Racial Identity Categories.Sum of columns a.b,c,and d should equal the"All Beneficiaries"total above: 6
Female Headed Households:—2
Signed Title Date
Printed Name Telephone No./Ext,
4
s
d
EXHIBIT 3 of 3
Employees who may participate in the performance of this contract.
Title Last First Lic.#
Staff Therapist Beswick-Smith Michelle MFT Trainee
Staff Therapist Decker Russell MFT Trainee
Staff Therapist Hirsch Audra IMF45859
Staff Therapist Konkel-White Sue MFC32272
Staff Therapist Mellor Sharon LCS 22891
Childcare Staff
Therapist Asst. Rivas Eva
Therapist Asst. Cote Hilary