1-CSA - New Contractor Application.pdf

DEPARTMENT OF SOCIAL SERVICES

FAUQUIER COUNTY

May 15, 2026

CSA Contractor:

It is time to start working on the FY 2027 service year contracts for our Children’s Services Act.

Fauquier County utilizes a five (5) year contract, renewed annually each year over the course of the five-year period. Each renewal year, you will be requested to provide a few documents that allow us to update your rates, licenses, and certificates of insurance in our systems. Fauquier Procurement will be responsible for tracking all required documents and issuing the final renewal document. Fauquier Community Policy and Management Team (CPMT) is responsible for the approval of any rate increase proposals. Please check one of the boxes listed below to indicate what type of rate increase proposal your agency will be submitting for review and include a letter justifying the increase in rates. Fauquier CSA staff will be available to assist if there are any questions. Questions should be sent through Bonfire. All renewal documents should be uploaded within Bonfire by June 15, 2026, to be processed for FY 2027. The Service period of the annual renewal will continue to be July 1st to June 30th of each CSA fiscal year.

All CSA contractors must register with Bonfire https://fauquiercounty.bonfirehub.com, once registered the documents can be obtained on Fauquier County’s projects listed within Bonfire https://fauquiercounty.bonfirehub.com/projects

If you are a new CSA contractor, please submit your documents for review and processing through the link within the Bonfire application.

RENEWAL CHECKLIST:

Updated cover sheet with current contacts to include- address, phone, fax, and contact person for clinical services AND billing issues

Updated Rate sheet or fee schedule for FY 2027 There are no proposed rate increases for FY 2027 The proposed rate increases for FY 2027 are below a 3% increase The proposed rate increases for FY 2027 are above a 3% increase

Updated School Calendar for education services (including ESY if appropriate)

Updated program/ staff licenses if applicable

No Crimes Against Children Form

Updated COI (Certificate of Insurance)

If you have questions, please submit them through Bonfire application. We look forward to another successful year of serving our children and families in Fauquier County.

Sincerely, Michael Mahoney Administrative Program Manager, Fauquier County Department of Social Services

Michael Mahoney Administrative Program Manager 320 Hospital Drive, Suite 11 Warrenton, VA 20186

(540) 422-8409 Phone

(540) 422-8449 Fax https://fauquiercounty.bonfirehub.com/ https://fauquiercounty.bonfirehub.com/projects

Fauquier County Agreement for Purchase of Services Rev. 03/2024

CSA PROVIDER INFORMATION

Fiscal Year 2027

Please Print

PROVIDER: Agreement #:_____________

Corporate (Legal) Name: _______________________________________________________________

DBA (if applicable): __________________________________________________________________

Address:

Phone: ___________________________ Website:__________________________________

Contract Contact: _________________________ Contract E-mail: ___________________________

Contract Phone: ___________________________ Contract Fax: _____________________________

Admissions Contact:________________________ Admissions E-mail: ________________________

Admissions Phone:_________________________ Admissions Fax: __________________________

Payment Contact: __________________________ Payment Email: ___________________________

Payment Phone: ___________________________ Payment Fax: _____________________________

PROVIER SERVICES UNDER PURCHASE AGREEMENT (check all that apply):

□ Special Education and Related Services □ Treatment Foster Care Services

□ Congregate Care and Residential Services □ Community Based Services

□ Community Based Services for DJJ Court Services Unit

PROVIDER SERVICES THAT ARE MEDICAID ELIGIBLE:

□ Treatment Foster Care: □ Residential Facility

□ Community Based Services: □ Other: __________________________________

□ Group Home – Level B only

CHILDREN’S SERVICES

DEPARTMENT OF SOCIAL SERVICES

FAUQUIER COUNTY, VIRGINIA

Carly Baughn, CSA Coordinator

320 Hospital Drive, Suite 11

Warrenton, VA 20186

(540) 422-8409 Phone

(540) 422-8449 Fax

Fauquier County Agreement for Purchase of Services Rev. 03/2024

FAUQUIER COUNTY CSA INFORMATION

Fiscal Year 2027

CSA Coordinator: Carly Baughn

Coordinator E-mail: carly.b.baughn@dss.virginia.gov

Coordinator Phone: 540-422-8440 Coordinator Fax: 540-422-8449

Coordinator Mailing Address: 320 Hospital Drive, Suite 11, Warrenton, VA 20186

Director of Procurement: Kristen Hylton

CM E-mail: Kristen.Hylton@fauquiercounty.gov

CM Phone: 540-422-8357

CM Mailing Address: 320 Hospital Drive, Suite 23, Warrenton, VA 20186

CSA Administrative Specialist (AS): Lisa Trapani

AS E-mail: lisa.trapani@dss.virginia.gov

AS Phone: (540) 422-8425

AS Mailing Address: 320 Hospital Dr., Suite 11, Warrenton VA 20186

FCPS Supervisor of Special Education (SSE): Angie Gum

SSE E-Mail: agum@fcps1.org

SSE Phone: 540-422-7147 SSE Fax: 540-422-7198

SSE Mailing Address: 430 East Shirley Ave, Bldg. B, Warrenton, VA 20186

Utilization Review Specialist (URS): Mimi DeNicholas

URS E-mail: mimi.denicholas@dss.virginia.gov

URS Phone: (540) 422-8409 URS Fax: 540-422-8458

URS Mailing Address: 320 Hospital Drive, Suite 11, Warrenton, VA 20186 mailto:carly.b.baughn@dss.virginia.gov mailto:lisa.trapani@dss.virginia.gov mailto:agum@fcps1.org mailto:mimi.denicholas@dss.virginia.gov

Agreement#

Fauquier County Agreement for Purchase of Services

Rev. 03/2024

AGREEMENT FOR PURCHASE OF SERVICES

This Agreement is entered into by and between Fauquier County and the Fauquier County School

Board, political subdivisions of the Commonwealth of Virginia, on behalf of the Fauquier County

Community Policy and Management Team (CPMT), hereinafter referred to as the “Buyer” and

, hereinafter referred to as the “Provider”. It is understood that this entire

Agreement for Purchase of Services, hereinafter referred to as the “Agreement,” contains General

Terms and Conditions which are to be adhered to by all parties, as well as, Specific Terms and

Conditions of the Addendum, if any, applicable to the services to be provided by the Provider, and a

Rate Sheet. Where there exists any inconsistency between the General Terms and Conditions of the

Agreement and the terms of the Addendum, if any, the provisions of the Addendum will control.

Whereas the Buyer is responsible for providing services purchased hereunder pursuant to Title 2.2-

5200 - 2.2-5214 of the Code of Virginia; https://law.lis.virginia.gov/vacode/title2.2/chapter52/

Whereas the Provider has established itself as a qualified Provider of the services purchased hereunder and meets all applicable State and Federal laws, regulations and standards relative to those services:

NOW THEREFORE, the parties hereto do mutually agree as follows:

1. ADHERENCE TO LAW: This Contract is subject to the provisions of the Code of Federal

Regulations, the amendments thereto, and relevant state and local laws, ordinances, regulations and pertinent health and behavioral health accreditation agencies/organizations. The Provider shall remain in compliance with all current laws and regulations pertaining to the facilities, staff and services provided. The Buyer may modify this Contract to comply with any requirements mandated by federal, state or local law by giving written notice of said modification to the Provider.

2. CHOICE OF LAW AND FORUM. This Contract shall be governed in all respects, whether as to validity, construction, capacity, performance, or otherwise, by the laws of the Commonwealth of

Virginia and any action, administrative or judicial, brought to enforce any provision of this Contract shall be brought only in the Circuit Court of Fauquier County.

3. SPECIFIC INTERPRETATIONS:

A. Waiver. The failure of the Buyer to enforce at any time any of the provisions of this Contract, or to exercise any option which is herein provided, or to require at any time any performance by the Provider of any of the provisions hereof, shall in no way affect the validity of this

Contract or any part thereof, or the right of the Buyer to thereafter enforce each and every provision.

B. Remedies Cumulative. All remedies afforded in this Contract shall be construed as cumulative, that is in addition to every other remedy provided herein or by law.

C. Severability. If any part, term, or provision of this Contract is held by a court of competent jurisdiction to be in conflict with any state or federal law, the validity of the remaining portions or provisions shall be construed and enforced as if this Contract did not contain the particular part, term or provision held to be invalid.

D. Captions. This Contract includes the captions, headings and titles appearing herein for convenience only, and such captions, headings and titles shall not affect the construal, interpretation or meaning of this Contract.

E. Contract Construal. Neither the form of this Contract, nor any language herein, shall be interpreted or construed in favor of or against either party hereto as the sole drafter thereof.

https://law.lis.virginia.gov/vacode/title2.2/chapter52/ https://law.lis.virginia.gov/vacode/title2.2/chapter52/

Fauquier County Agreement for Purchase of Services

Rev. 03/2024

4. OTHER AGREEMENTS:

A. Any documents expressly referred to in this Agreement but not attached hereto, including among others, the Individual Family Service Plan (IFSP) and the Individualized Education

Program (IEP), are incorporated by reference as part of this Agreement.

B. In the event any provision of the Agreement for Purchase of Services is inconsistent with the placement agreement of the Provider, the provisions of the Agreement for Purchase of

Services will prevail.

C. Service Provision: Providers are knowledgeable of the full range of services and supports in the community. Providers implement their states treatment model (e.g., models that are evidence-based, evidence-informed or practice-based evidence) with fidelity.

D. Accountability: Providers are accountable at the individual child and family, system, and community levels for desired outcomes, safety and cost effectiveness.

5. MEETINGS AND REVIEWS: The Provider shall participate in all meetings scheduled by the

Buyer for the purpose of reviewing services and assessing progress or for the purpose of addressing issues that arise. Attendance at FAPT, Family Partnership Meetings and IEP meetings is required at the Provider’s expense. The Buyer will not pay for mileage, travel time, or other travel costs.

Information to be provided at such meetings may include, but is not limited to, evaluations, assessments, recommended services, the services provided, and the progress resulting from the service interventions. To the extent possible, the Buyer will provide at least forty-eight hours (48 hrs.) notice of such meetings. The Provider shall ensure that a representative with personal knowledge of the progress of the child and authority to bind the Provider, participates in such meeting by telephone or video conferencing or in person.

A. COURT APPEARANCES: It is understood that in the course of the provision of services the

Provider may be called upon by the Buyer’s case manager to appear for court hearings.

Information to be provided at such appearances may include, but is not limited to, evaluations, assessments, recommended services, the services provided, and the progress resulting from the service interventions. The Provider shall receive payment based on the actual number of hours the Provider is required by the court to be present at the court hearings. The hours will include actual testimony and waiting time. The Buyer will not reimburse for mileage, travel time, or other travel costs. Payment will be made in accordance with the established hourly rate for court appearances, as set forth on the attached

Rate Sheet. The Buyer will make every attempt to notify the Provider well in advance of the

Provider's requirement to appear at the hearings. When possible, subpoenas will be provided.

6. QUALITY OF CARE:

A. The Provider shall permit representatives authorized by the Buyer to conduct program, facility, and fiscal reviews/visits in order to assess service quality. Such reviews/visits may include, but are not limited to, site visits, classroom monitoring, meetings with the child(ren) provided for under this Agreement, review and copying any and all records maintained on children covered by this Agreement, review of individual service plans, review of service policy and procedural issuances, review of staffing ratios and job descriptions and meetings with any staff directly or indirectly involved in the provision of services. Such reviews may occur as often as deemed necessary by the Buyer and may be with or without prior notification. The above mentioned fiscal reviews are limited to the invoices associated with specific CPMT placed children.

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Rev. 03/2024

B. The Provider shall ensure that the treatment/service plan (IFSP) is developed in conjunction with the Buyer, is consistent with, and can be expected to meet, the goals recorded in the

IFSP, IEP and supporting documents. The Provider shall assure that the treatment services delivered are consistent with the treatment/service plan for the child and family. The

Provider shall ensure that treatment/service plans (IFSP) for Virginia children are driven by and regularly reassessed based on the functional assessments in the state mandatory uniform assessment, the Child and Adolescent Needs and Strengths (CANS) instrument. The

Provider shall ensure that the child and the family progress toward the goals in the treatment/service plan and/or IEP, and shall notify the Buyer’s case manager if progress is not being made. The Buyer shall review the procedures related to emergencies, client satisfaction and service delivery to assure implementation of all aspects of the treatment/service plan and/or IEP. The Buyer shall share formal assessment of outcomes with the Provider and client perceptions of satisfaction and outcomes.

C. In the event the Provider believes it is in the best interest of the child to relocate the daily living residence of the child, the Provider shall discuss with the Buyer’s case manager the proposed relocation, the circumstances surrounding the proposed relocation, and the impact the move shall have on the child a minimum of ten (10) business days prior to any move being made, unless an emergency regarding child safety and well-being cause an emergency move. In all emergencies, the Provider shall notify the Buyer, immediately. If the Buyer disagrees that it is in the best interest of the child, or is not in accordance with the child’s IFSP, the Buyer may make alternative placement plans for the child.

D. If the Provider is unable to discuss the relocation with the Buyer’s case manager prior to its occurrence, the Provider shall notify the Buyer’s case manager, immediately. The Buyer may make alternative placement plans for the child if the relocation is not in the best interest of the child, or is not in accordance with the child’s IFSP.

E. Discharge planning shall begin at intake and be consistent with IFSP and other supporting documents. Discharge plans shall include time expected time period, goals and steps to reaching these goals.

7. ANNUAL REPORTS: Providers who collect and disseminate data, that include performance measures and/or outcomes, to the public, purchasers of Provider services, regulatory agencies including the Department of Education, accrediting organizations, licensing agencies and/or as required by local, state or federal reporting, shall submit such reports, with all annual contract documents, to the CSA Contracts Manager. Transmittal by email is encouraged.

8. REPORTING: All individual purchases of services require case specific reports to be submitted to the Buyer by the fifteenth (15th) calendar day of each month for the services provided in the previous month, except for the services provided in June, when the Provider shall submit the reports by July 15th this Agreement for Purchase of Services. This assures CSA Service Authorization reviews are completed timely in order to continue funding.

9. TREATMENT PLAN/SERVICE PLAN/EDUCATIONAL PLAN : The Provider shall submit to the

Buyer a proposed written treatment plan, within thirty (30) calendar days of the initiation of services to the child. The treatment plan shall include at least the following information: type(s) and number(s) of disabilities, and/or mental health and intellectual disability diagnoses, and/or delinquent behaviors which the purchased services are intended to address, prognosis, short and long term goals with action steps, expected outcomes, anticipated time of discharge and transition plan, medications administered (if any) and performance timeframes mutually agree to between the Buyer and Provider when the services are purchased.

Fauquier County Agreement for Purchase of Services

Rev. 03/2024

10. REPORTS

1) The Provider shall complete and submit all progress, monthly and quarterly reports to the

Buyer’s case manager and the CSA Administrative Specialist by the fifteenth (15th) day of each month for the services provided in the previous month, except for the services provided in June, when the Provider shall submit the reports by July 10th as applicable. The Provider shall complete and submit Discharge/Termination reports within ten (10) business days of the discharge/end of service.

2) All reports shall incorporate progress or lack of progress of child toward treatment goals and reasons thereof, medications administered (if any), medication changes, and any significant incidents affecting the child including change of therapist. Educational progress reports should include progress made by the child or lack thereof indicated by the educational goals/objectives.

3) Each service type requires specific data elements be included in reports. See service addendum for specific elements.

4) If the Provider fails to provide any written treatment plan, progress report, educational progress report or termination report in a timely manner as specified in this Agreement for

Purchase of Services and all applicable Addenda, the Buyer may withhold payment of the

Provider’s invoices until such plan or report is received.

5) All reports shall include progress on independent living goals where applicable.

6) For children funded under Virginia Medicaid, a copy of the monthly written report submitted to Medicaid must also be submitted to the Buyer’s case manager and CSA

Administrative Specialist within the time frames stipulated by Medicaid.

7) For all Medicaid eligible CSA children, the Provider shall provide the Buyer’s case manager and CSA Coordinator with copies of the Medicaid forms “Continued Stay

Review” and “Care in Progress” that are sent to the Department of Medical Assistance

Services. If the Buyer determines the report inadequate then such determination shall be communicated to the Provider. Payment may be withheld until the report is satisfactory.

Any costs associated with the preparation of the reports are included in the relevant hourly rate and therefore cannot be billed as a separate itemized cost. In the event that the Provider fails to submit any written report within the stipulated time, the Buyer may withhold payment of the Provider invoices until said reports are received and approved by the Buyer.

8) In addition, the Provider, by telephone or office visit, shall apprise the Buyer’s case manager about the child’s and family’s progress and activities, as necessary. Such communications are not billable and shall not replace the required written reports.

9) The Provider shall provide the Buyer’s case manager with a copy of any reports of annual physical and dental examinations and psychological or psychiatric examinations of the child conducted while under the care of the Provider.

10) All IEPs must be submitted on Fauquier County Public Schools’ (FCPS) forms which will be made available by the Buyer.

11) The Provider shall complete and submit a discharge summary report on Provider’s letterhead within ten (10) business days of the discharge/end of service.

11. SERIOUS INCIDENT REPORTING:

A. The following procedures shall be adhered to in reporting a serious incident, actual or alleged, which involves children referred or placed by the Buyer. A serious incident includes, among others, abuse or neglect; criminal behavior; death; emergency treatment; facility related issues, such as fires, flood, destruction of property; food borne diseases; physical assault/other serious acts of aggression; sexual misconduct/assault; substance abuse; serious illnesses, (such as tuberculosis or meningitis), serious injury (accidental or otherwise);

Fauquier County Agreement for Purchase of Services

Rev. 03/2024 suicide attempt; unexplained absences; or other incidents which jeopardize the health, safety, or well-being of the youth.

Immediately, or as soon as possible, but no later than within twenty-four (24) hours of knowledge of a serious incident, the Provider shall report the incident by speaking to or leaving a message for the Buyer’s case manager, CSA Coordinator and legal guardian for each child involved.

B. Within forty-eight (48) hours of the verbal report of the serious incident, the Provider shall submit to the Buyer’s case manager and the CSA Coordinator, via encrypted email or facsimile at (540) 422-8449, a concise account of the incident and include: name of Provider and, if applicable, facility name; name of person completing form; date and time of serious incident; date of the report; child's name, age, gender, ethnicity; placing agency name;

placing agency case manager's name; where the incident occurred; description of incident

(including what happened immediately before, during and after the incident); names of witnesses; action taken in response to incident, including whether physical restraint or seclusion was used; names/agencies notified (family, legal guardian, child protective services, medical facility, police); recommendations for follow-up and/or resolution of incident; signature of person completing report; and facility/Provider director's (or designee) signature and date.

C. Separate reports shall be completed and submitted for each child involved and placed by the

Buyer. The Provider is responsible for ensuring the confidentiality of the parties involved in the incident.

D. The following types of serious incidents, which do not directly involve children placed by the Buyer, but impact the health, safety or wellbeing of children placed by the Buyer, shall also be reported to the Buyer for all programs, sites, and facilities where the Provider currently has a contract with the Fauquier County Community Policy Management Team:

1) the death of any student or resident

2) any serious criminal activity in a facility or on the grounds where the Buyer has placed a child

3) sexual assault of any resident

4) any serious contagious illnesses

5) facility related issues, such as fires, flood, destruction of property, or other incidents which jeopardize the health, safety, or wellbeing of the child(ren)

6) suspension/termination of staff due to non-employment related allegations that involve allegations of abuse and neglect of children.

The report should include: the nature of the incident, date, time, and facility address in accordance with all Federal, State and local laws relating to appropriate standards of conduct by the Provider relating to confidentiality and HIPAA. A verbal report shall be made to the

Buyer’s case manager and CSA Administrative Specialist within seventy-two (72) hours, and a written report that states the nature of the incident shall be submitted within ten (10) business days to the Buyer’s case manager and CSA Coordinator.

E. In the event the Buyer’s case manager determines that a serious incident has occurred, the

Buyer’s case manager will notify the Provider of the allegation. The Provider shall within forty-eight (48) hours of the case manager's notification, complete and submit a written report to both the Buyer’s case manager and CSA Coordinator.

12. RECORDS MAINTENANCE:

A. The Provider and any subcontractor shall maintain an accounting system and supporting records adequate to assure that invoices are in accordance with applicable State and federal requirements. Such supporting records shall reflect all direct and indirect costs of any nature

Fauquier County Agreement for Purchase of Services

Rev. 03/2024 expended in the performance of this Agreement and all income from any source. If required, the Provider shall also collect and maintain fiscal and statistical data on forms designated or approved by the Buyer. The Provider shall maintain such program records as may be required by the Buyer. The Provider covenants to retain all books, records, progress reports, educational records and other documents relative to this Agreement for three (3) years after termination or final payment under this Agreement, except when a longer period of retention is necessary for the purposes of complying with the requirements of an unresolved federal or State audit, State or federal law, or court order. The Buyer, its authorized agents, and/or

State and federal auditors shall have full access to and the right to examine any of said materials specific to children served by this Agreement during said period. In the event of a determination that the Provider received funds improperly or did not provide the authorized services or goods for which funds were received, the Provider shall provide the Buyer full restitution of any such funds.

B. The Buyer, based upon findings, may require that the Provider, within thirty (30) calendar days from the date of the request, submit an independent Certified Public Accountant prepared compilation, review or audit. The requested compilation, review or audit must have been completed within the last two fiscal years.

13. FINANCIAL REVIEWS OF PROVIDERS:

A. The Buyer reserves the right to review Provider’s financial records for the purpose of determining the financial stability of the company in relation to the Buyer’s contracted programs, adequacy of internal controls, and propriety of accounting and or budgetary review of contract funds. These reviews may be conducted either remotely or via onsite visits from the Buyer’s officials, or their designees, assigned to conduct such reviews.

B. For purposes of the routinely scheduled reviews, Providers may be required to provide to the

Buyer, annually, the following records as applicable:

1) Annual Audited Financial Statements and related footnotes and supplemental schedules, to include Provider’s Balance Sheet/Statement of Financial Position, Income Statement/Statement of Activities, and Statement of Cash Flows,

2) Independent Auditor’s Report/Opinion Letter,

3) Independent Auditor’s issuance of any Management Letter Comments (MLC), or a statement that no MLC letter was issued,

4) Management’s Discussion and Analysis (MD&A), if applicable, or a statement that no MD&A was prepared and presented in the financial statements,

5) Independent Auditor’s Report on Compliance and Internal Control over

Compliance Required by the Uniform Guidance, if applicable, or a statement that it is not applicable,

6) Commission on Accreditation of Rehabilitation Facilities (CARF) Survey Report, if applicable, or a statement that it is not applicable,

7) Federal IRS Form-990, 1120, 1065, or other applicable Income Tax return filing as applicable, with all supporting schedules and attachments,

8) Any M-1 adjustment or other reconciling information needed to agree Financial

Statements to the Tax Returns filed, and

9) Any other required notifications of financial difficulties or internal control issues that are found that could impair the continuing operability of Provider’s Buyer funded programs, as they may occur.

C. Should more in depth reviews be deemed necessary, the Buyer will make specific requests for additional records, to include but not limited to: 1) Transactional supporting documents for:

a. Revenues and Accounts Receivable

Fauquier County Agreement for Purchase of Services

Rev. 03/2024

b. Accounts Payable and other Expenses

c. Procurement and Company Credit Cards

d. Banking and Financing

e. Payroll and Timekeeping

f. Tax filings and tax payments

g. Fixed Asset Accounting

h. General Ledger

i. Company Policy documentation

j. Board Meeting Minutes

k. Trial Balances and Adjusting/Closing Journal Entries

l. Accounting Reconciliations

14. CONFIDENTIALITY:

A. Any information obtained by the Provider concerning the child pursuant to this Agreement shall be maintained as confidential. Use and/or disclosure of such information by the

Provider shall be limited to purposes directly connected with the Provider's responsibilities for services under this Agreement. If applicable, it is further agreed by both parties, that this information shall be safeguarded in accordance with the provisions of Title 63.2, Sections 102 and 104 of the Code of Virginia (1950), as amended, and any other applicable provisions of State and federal laws and regulations including but not limited to the

Individuals with Disabilities Education Act, 20 USCS@1400, et seq. (2002) (IDEA), the

Family Education Rights Privacy Act of 1974 (FERPA) and/or Educational Records

Management regulations, the Health Insurance Portability and Accountability Act of 1996

(HIPAA), and 42 CFR Part 2, as amended.

B. The Provider shall comply with the confidentiality provisions of VA. Code Section

2.25210. This includes, among others, not photographing the child placed by the Buyer nor permitting media coverage of the child without the written permission of the parent(s) or the legal guardian, as the case may be. It further precludes audiovisual recording of the child, as well as prohibits the child’s participation in any research projects without the written permission of the parent(s) or the legal guardian, as the case may be.

15. SUBCONTRACTORS: The Provider shall not enter into subcontracts for any of the services to be provided under this Agreement without obtaining prior written approval from the Buyer. The

Rate Sheet shall reflect those services which are approved and subcontracted by the Provider.

Unless otherwise agreed in writing by the Buyer, such subcontractor shall be required to comply with all of the terms and conditions set forth in this Agreement. The Provider is responsible for the performance of its subcontractors. However, prior written approval shall not be required for the purchase by the Provider of articles, supplies and equipment which are incidental but necessary for the performance of the services to be provided under this Agreement. The Provider shall not assign this Agreement without prior written approval of the Buyer, which approval shall be attached to this Agreement and subject to such conditions and provisions as the Buyer may deem necessary. Nothing in this Agreement shall be construed as authority for either party to make commitments which will bind the other party beyond the scope of service contained herein.

16. EMPLOYEES:

A. Neither the Provider, nor its employees, volunteers, assignees or subcontractors shall be deemed employees or agents of the Buyer by virtue of the services to be performed pursuant to this

Agreement or the contractual relationship established hereby. The Provider shall have the sole responsibility for its staff and volunteers, including its work, personal conduct, directions and

Fauquier County Agreement for Purchase of Services

Rev. 03/2024 compensation. The Provider hereby agrees to indemnify and hold harmless the Buyer from any and all employee tax liability (including withholding liability) and any employment-related claims, including any claim of entitlement to employee benefits, imposed or threatened to be imposed solely as a result of the contractual relationship established hereby.

B. Upon request of the Buyer, the Provider shall submit resumes and, if applicable, credential information for certain employees, so long as no Federal or State law is breached as to information protected by confidentiality laws.

17. CRIMINAL BACKGROUND CHECKS: The Provider shall be in compliance with its state’s laws, regulations, and licensure requirements, as applicable, relating to conducting criminal background checks and child protective service registry checks of its employees, subcontractors, and volunteers. All employees, subcontractors, and volunteers providing services to or having direct contact with a child shall be checked through a child protective service registry in the state in which the child is placed, provided such a check is not in conflict with the Provider's state's law. If any of the Provider’s employees, subcontractors, or volunteers moved from another state within one year prior to their employment or volunteering, the child protective service registry in the state from which they moved must also be checked. Provider shall also perform a criminal background check on all employees, subcontractors, and volunteers providing services to or having direct contact with a child.

Provider shall provide documentation to the Buyer, prior to its employees, subcontractors, or volunteers providing services to or having contact with a child, evidencing that a criminal background check and child protective service registry check was completed for all of the

Provider’s employees, subcontractors, and volunteers and that the checks revealed no incident history. If any employee, subcontractor, or volunteer’s criminal background check or child protective service registry check reveals an incident history, Provider shall transmit the information regarding the incident history to the Buyer for its review. Pending the Buyer’s review and approval, the Provider shall not permit that employee, subcontractor or volunteer to have contact with or provide services to the child.

Provider shall institute and enforce a policy which requires employees, subcontractors, and volunteers to notify Provider of any change in their criminal incident history and/or their incident history on any child protective service registry. The policy shall require employees, subcontractors, and volunteers to report any change in their criminal incident history on the day they return to work following their arrest in a criminal case. The policy shall require employees, subcontractors, and volunteers to report any change in their incident history on any child protective service registry on the day they return to work following the issuance of a child protective service complaint against them. The Provider shall provide a copy of Provider’s policy to the Buyer within ten (10) days of Buyer’s request. If the Provider learns that any of its employees, subcontractors, or volunteers have a change in their incident history on a child protective service registry and/or have a change in their criminal incident history, then Provider shall call Buyer and report that information no later than the next business day following receipt of that information. Provider shall report the incident by speaking to or leaving a message for

Buyer. Within forty-eight (48) hours, Provider shall submit a written report regarding the incident which led to the change in the individual’s incident history to Buyer. Pending the Buyer’s review and approval, the Provider shall not permit that employee, subcontractor or volunteer to have contact with or provide services to the child.

18. ANNUAL DEPARTMENT OF MOTOR VEHICLE (DMV) CHECKS: The Provider shall

Fauquier County Agreement for Purchase of Services

Rev. 03/2024 provide written documentation to the Buyer, prior to its employees, subcontractors and volunteers transporting the child and/or family (clients), certifying they have undergone an annual DMV check to verify a valid driver’s license is in place and the record checks have yielded no moving violations or other violations that would question the client’s safety while being transported. All vehicles used to transport clients shall be equipped with a first aid kit and a road safety kit. Seat belts and child safety seats shall be used at all times while clients are being transported. Regularly scheduled maintenance and all repairs shall be performed to ensure the safety of the client while being transported. All vehicles transporting clients shall be insured with automobile liability insurance coverage at limits as stipulated per Section # 22 INSURANCE of this Agreement for

Purchase of Services.

Provider shall institute and enforce a policy which requires employees, subcontractors, and volunteers, who transport clients, to notify Provider of any change in their DMV driving record and status of driver’s license. The policy shall require employees, subcontractors, and volunteers to report any change in their driving record or status of driver’s license on the day they return to work following the change. If the Provider learns that any of its employees, subcontractors, or volunteers have a change in their DMV driving record or driver’s license status, where a client’s safety while being transported would be questioned, then Provider shall not permit that employee, subcontractor or volunteer to transport the client.

19. CONTINUITY OF OPERATIONS: The Provider is required to maintain Continuity of

Operations Plan (COOP Plan), in compliance with any and all federal, state, and local requirements, and to make this available upon request to the Buyer. COOP planning information may be found on the Federal Emergency Management Administration website at http://www.fema.gov/continuity-operations.

20. ANTI-DISCRIMINATION: By submitting their agreement, Providers certify to the Buyer that they shall conform to the provisions of the Federal Civil Rights Act of 1964, as amended, as well as the Virginia Fair Employment Contracting Act of 1975, as amended, where applicable, the

Virginians with Disabilities Act, the Americans with Disabilities Act and Title 2.2-4311 of the

Virginia Public Procurement Act. If the agreement is made to a faith-based organization, the organization shall not discriminate against any recipient of goods, services, or disbursements made pursuant to the contract on the basis of the recipient’s religion, religious belief, refusal to participate in a religious practice, or on the basis of race, age, color, gender or national origin and shall be subject to the same rules as other organizations that contract with public bodies to account for the use of the funds provided; however, if the faith-based organization segregates public funds into separate accounts, only the accounts and programs funded with public funds shall be subject to audit by the public body. (Code of Virginia, Title 2.2-4343.1(E)).

During the performance of this Agreement, the Provider agrees as follows:

A. Provider shall not discriminate against any employee or applicant for employment because of race, religion, color, sex, national origin, age or disability, or any other basis prohibited by state law relating to discrimination in employment, except where there is a bona fide occupational qualification reasonably necessary to the normal operation of the Provider. The

Provider agrees to post in conspicuous places, available to employees or applicants for employment, notices setting forth the provisions of this nondiscrimination clause.

B. The Provider, in all solicitations or advertisements for employees placed by or on behalf of the Provider, shall state that such Provider is an equal opportunity employer.

http://www.fema.gov/continuity-operations http://www.fema.gov/continuity-operations

Fauquier County Agreement for Purchase of Services

Rev. 03/2024

C. Notices, advertisements and solicitations placed in accordance with federal law, rule or regulation shall be deemed sufficient for the purpose of meeting the requirements of this section.

D. The Provider shall include the provisions of the foregoing paragraphs A, B and C in every subcontract or purchase order of over $10,000, so that the provisions shall be binding upon each subcontractor of the Provider.

21. RATES:

A. The rate negotiated between the Buyer and the Provider shall not exceed that stated in the

Service Fee Directory as defined in Title 2.2-5214 of the Code of Virginia.

http://www.csa.virginia.gov/Directory/ServiceFee

B. The Provider states that the rates for the services described in this Agreement are not more than those set forth in the Service Fee Directory. The negotiated rate is set forth on the Rate

Sheet attached hereto and made a part hereof. The Rates remain fixed for the term of this

Agreement.

C. The rates applicable to services provided in accordance with this Agreement appear on the

"Rate Sheet" attached to this Agreement. The Buyer may purchase only those services included on the Rate Sheet attached to this Agreement. In the event the Provider elects to offer services not included on the Rate Sheet attached hereto, the Provider shall submit to the CPMT, via the CSA Coordinator, a request to add the service. Written approval from the

Buyer shall be secured prior to the offering of the service. Failure to obtain such approval will result in non-payment for such services.

D. To the extent that any charges are billed to the Buyer on a per session or per treatment basis, the Buyer shall have no obligation to pay amounts charged for sessions or treatments that a child does not actually receive for any reason, including, without limitation, absence or illness. The Provider agrees that its submission to the Buyer of any invoice on which charges are billed on a per session or per treatment basis constitutes its certification that all services for which payment is requested thereby have been provided to the child identified therein.

E. The Provider agrees that no child or any member of the child's family shall be charged a fee besides the rate agreed to by the Buyer for the same service, except services specifically excluded.

F. The Provider agrees to not bill per child when services are provided concurrently, such as in supervised visitation between a parent and a sibling group or for family therapy for multiple siblings, unless specifically planned for, in writing, by the Buyer’s case manager.

G. Any amounts paid by the Buyer pursuant to this Agreement which are subsequently determined to be inappropriate for any reason, including without limitation, those services not actually provided, shall be refunded by the Provider to the Buyer within fifteen (15) days of notification by the Buyer or within fifteen (15) days after Provider’s internal audits.

H. Rate increases are not automatic and require the Buyer’s written approval. All rate increase requests shall be submitted by the Provider in writing to the CSA Contracts Manager a minimum of forty-five (45) days prior to the end of the fiscal year or a minimum of forty-five (45) days prior to proposed effective date. This allows for proper review and approval.

Rate increases are not retroactive to request date.

I. The Provider shall not charge or accept from the Buyer compensation for services which is more than the Provider charges other public governmental buyers of equivalent services in equivalent volumes.

J. The Provider guarantees that any cost incurred pursuant to this Agreement shall not be included or allocated as a cost of any other federal, state, or locally financed program.

http://www.csa.virginia.gov/Directory/ServiceFee

Fauquier County Agreement for Purchase of Services

Rev. 03/2024

22. INDEMNIFICATION: Provider shall indemnify, keep and save harmless Fauquier County, the

Fauquier County School Board, its agents, officers, employees and volunteers against claims of injuries, death, damage to property, patent claims, suits, liabilities, judgments, cost and expenses which may otherwise accrue against the Buyer in consequence of the granting of a contract or which may otherwise result there from, if it shall be determined that the act was caused through negligence or error, or omission of the Provider or his or her employees, volunteers or that of the subcontractor or his or her employees, if any; and the Provider shall, at his or her own expense, appear, defend and pay all charges of attorneys and all costs and other expenses arising there from or incurred in connection therewith; and if any judgment shall be rendered against the Buyer in any such action, the Provider shall, at his or her own expense, satisfy and discharge the same.

The Provider expressly understands and agrees that any performance bond or insurance protection required by this contract, or otherwise provided by the Provider, shall in no way limit the responsibility to indemnify, keep and save harmless and defend the Buyer as herein provided.

23. INSURANCE:

A. The Provider shall be responsible for its services and every part thereof, and for all personnel, materials, tools, equipment, appliances and property of any and all description used in connection therewith. The Buyer shall in no event be responsible for any direct or indirect damage or injury to the property or persons used or employed by the Provider on or in connection with the services contracted for, or any damage or injury to any person or property, wherever located, resulting from any action, omission, commission or operation under the Agreement.

B. The Provider agrees to maintain (i) statutory Worker's Compensation and (ii) Employers'

Liability insurance in limits of not less than $100,000/$500,000/$100,000 to protect the

Provider from any liability or damages for any injuries (including death and disability) to any and all of its employees, volunteers or subcontractors, including any and all liability or damage which may arise by virtue of any statute or law in force within the Commonwealth of Virginia, or which may be hereinafter enacted.

C. The Provider agrees to maintain Commercial General Liability insurance, including coverage for sexual misconduct, sexual abuse and sexual molestation, in the amount of

$1,000,000 per occurrence/ $3,000,000 aggregate to protect the Provider, its subcontractors, its officers and employees against any and all injuries to third parties, including bodily injury, property damage, and personal injury, resulting from any action or operation under the

Agreement or in connection with the agreed work.

D. If applicable to this contract, the Provider agrees to maintain owned, non-owned and hired

Automobile Liability insurance, in the amount of $1,000,000 per occurrence/aggregate, including property damage, covering all owned, non-owned, borrowed, leased, or rented vehicles used in the performance of any work under this contract.

E. The Provider agrees to maintain during the term of this agreement Professional Liability

Insurance or medical malpractice insurance in the limits of $1,000,000 per occurrence/aggregate. If issued on an “Occurrence” basis the Coverage shall remain in effect for two (2) years following the termination of this Agreement. If the liability insurance purchased by the Provider has been issued on a "claims made" basis, the Provider must comply with the following additional conditions. The limits of liability and the extensions to be included as described previously in these provisions, remain the same. For all coverages, except sexual abuse/molestation, the Provider must either:

1. Agree to provide certificates of insurance evidencing the above coverage for a period of

Fauquier County Agreement for Purchase of Services

Rev. 03/2024 two (2) years after the final payment for the Contract for General Liability policies. This certificate shall evidence a “retroactive date” no later than the beginning of the Provider’s work under this Contract, or

2. Purchase the extended reporting period endorsement for the policy or policies in force during the term of this Contract and evidence the purchase of this extended reporting period endorsement by means of a certificate of insurance or a copy of the endorsement itself.

For sexual abuse/ molestation the Provider must either:

1. Agree to provide certificates of insurance evidencing the above coverage for a period of thirty-eight (38) years after final payment for the Contract for General Liability policies.

This certificate shall evidence a “retroactive date” no later than the beginning of the

Provider’s work under this Contract, or

2. Purchase the extended reporting period endorsement for the policy or policies in force during the term of this Contract and evidence the purchase of this extended reporting period endorsement by means of a certificate of insurance or a copy of the endorsement itself.

F. Liability insurance may be arranged by general liability and automobile liability policies for the full limits required, or for a combination of underlying liability policies for lesser limits with the remaining limits provided by an excess or umbrella liability policy.

G. The Provider agrees to provide insurance issued by companies acceptable to the Buyer and authorized to do business in the Commonwealth of Virginia, and/or with the Best's Key

Rating of at least A:VIII. The only exceptions to this are insurers of the London Syndicate and other recognized British and European insurers, Surplus Lines Market that are not rated by the Best Guide.

H. The Provider shall provide a copy of Certificate of Insurance, evidencing such insurance and such endorsements as prescribed herein, and shall have it filed with the Buyer prior to the signing of this Agreement.

I. The Provider shall provide on demand certified copies of all insurance coverage required by this Agreement within ten (10) days of such demand. These certified copies shall be sent directly to the Buyer’s CSA Contract Manager by the Provider's insurance agent or representative.

J. No change, cancellation or non-renewal shall be made in any insurance coverage without a forty-five (45) day written notice to the Buyer’s CSA Contract Manager.