Documents › Board of Education, 2026-08-27

agreement 13 pages Scanned/OCR — text may contain errors

Also attached to this agenda item: Agreement for Services The Karafin School 2026-2027 (291 KB) MAG Business Operations Contract 2026-27 (461 KB) MAG STAC Contract 2026-2027 (496 KB) Special Education Agreement for Services

Green Chimneys Children’s Services 400 Doansburg Road Brewster, New York 10509 Telephone: (845) 279-2995 SCHOOL INSTRUCTIONAL AGREEMENT THIS AGREEMENT, made this 14" day of August 2026 by and between Green Chimneys Children’s Services (hereinafter referred to as the “SERVICE PROVIDER”), as the party of the first part, having its principal place of business for purposes of this Agreement at 400 Doansburg Road-Caller Box 719, Brewster, NY 10509, and Croton Harmon Union Free School District (hereinafter referred to as the "SCHOOL DISTRICT"), as the party of the second part, having its principal place of business located 10 Gerstien Street, Croton on the Hudson, NY 10541. WITNESSETH: WHEREAS, pursuant to Education Law, the School District is authorized by law to contract with institutions within the State of New York for the instruction of children with disabilities in those situations where the SCHOOL DISTRICT is unable to provide for the education of children with disabilities in special classes in the public schools; and WHEREAS, the SERVICE PROVIDER is a registered non-public school chartered by the Board of Regents of the University of the State of New York as a non-profit education corporation authorized to establish, conduct, operate and maintain an educational program for children with disabilities; and WHEREAS, the SCHOOL DISTRICT desires that the SERVICE PROVIDER provide instruction to the students enrolled in the program operated by the SERVICE PROVIDER; and WHEREAS, the SERVICE PROVIDER warrants that it has reviewed the individualized education program (“IEP”) of each pupil to be enrolled in its program, and represents that it will provide the level of services identified in the IEP to meet the needs of such children; and WHEREAS, the SERVICE PROVIDER is capable of and willing to provide the within services to the SCHOOL DISTRICT. NOW, THEREFORE, in consideration of the mutual promises and covenants contained in this Agreement, the parties hereto mutually agree as follows: 1. TERM OF AGREEMENT: This Agreement shall be in effect for the period July 1, 2026 to June 30, 2027 unless terminated earlier, as set forth herein. 2. SCOPE OF SERVICES: The SERVICE PROVIDER shall provide adequate instruction, related services and/or a facility to students enrolled at the SERVICE PROVIDER'S facility during the school year. The education provided by the SERVICE PROVIDER shall be appropriate to the mental ability and physical condition of the children. The SERVICE PROVIDER agrees to provide services in accordance with parameters acceptable to the New York State Education Department. All services shall be provided in compliance with the student's IEP. The SERVICE PROVIDER further agrees that all disciplinary measures for disabled students will be conducted in accordance with applicable Federal, State and local laws, rules and regulations. The SERVICE PROVIDER shall provide the following services, consisting of, but not limited to, the following: i. Services based on individual student IEPs; ii. The implementation of goals and objectives for the educational services 1 provided as per each individual student's IEP; iii. The completion of progress reports regarding student achievement of objectives as per report card schedules; iv. Provide the Committee on Special Education (CSE) with annual progress reports for each individual student receiving service to be reviewed at each student's CSE meeting; v. Attend all such CSE meetings; vi. Complete evaluations as per the request of the Director of Special Education on an as needed basis; and vii. Comply with any testing requirements upon notification of such review dates. 3. PAYMENT SCHEDULE: a. _In full consideration for the educational services to be rendered by the SERVICE PROVIDER to the SCHOOL DISTRICT for the period of this Agreement, the SCHOOL DISTRICT will pay to the SERVICE PROVIDER, for each child, the applicable tuition rate set by the State Education Department, based on the child's program. b. If the tuition rates for this school year are not available at the beginning of the school year, the SCHOOL DISTRICT shall pay the rates applicable to the previous school year until new rates are set, at which time the parties shall adjust future tuition payments so that the SERVICE PROVIDER will be paid in accordance with the rates applicable to that current school year. Any overpayments will be reimbursed by the SERVICE PROVIDER to the SCHOOL DISTRICT. c. The SCHOOL DISTRICT shall be responsible for payment of the tuition as provided for in this Agreement as long as the child is enrolled in the SERVICE PROVIDER's program. The SCHOOL DISTRICT reserves the right to add or delete a child covered by this Agreement at any time during the school term upon seven (7) days written notice to the SERVICE PROVIDER. 4. INVOICE DUE ON MONTHLY BASIS: The SERVICE PROVIDER will submit an invoice for services rendered on amonthly basis, and payment to the SERVICE PROVIDER shall be made within thirty (30) days from receipt of invoice from the SERVICE PROVIDER. Billing for partial months will be rendered only during the Admission and Discharge of a student. The invoice shall include type(s) of services rendered, the names of the students who received services and fees payable. The SCHOOL DISTRICT shall give the SERVICE PROVIDER notice of any invoice dispute within twenty (20) days of its receipt and reserves the right to withhold payment pending the resolution of this dispute. Failure to dispute any invoice shall not be deemed as an acceptance and does notact as a waiver of the SCHOOL DISTRICT’s rights or prevent the SCHOOL DISTRICT from availing itself of any remedy or course of action it has at law or in equity at a later date. 5. INDEPENDENT CONTRACTOR: All employees of the SERVICE PROVIDER shall be deemed employees of the SERVICE PROVIDER for all purposes and the SERVICE PROVIDER alone shall be responsible for their work, personal conduct, direction, and compensation. The SERVICE PROVIDER acknowledges that it will not hold itself, its officers, employees and/ or agents out as employees of the SCHOOL DISTRICT. The SERVICE PROVIDER is retained by the SCHOOL DISTRICT only for the purposes and to the extent set forth in this Agreement, and its relationship to the SCHOOL DISTRICT shall, during the periods of its services hereunder, be that of an independent contractor. The SERVICE PROVIDER shall not be considered as having employee status and shall not be entitled to participate in any of the SCHOOL DISTRICT's workers’ compensation, retirement, fringe benefits, unemployment insurance, _ liability insurance, disability insurance, or other similar employee benefit programs. Similarly, the SERVICE PROVIDER, its officers, its employees and/ or agents shall not be considered as having employee status for the purposes of any other rights, privileges or benefits derived from employment by the SCHOOL DISTRICT. The SERVICE PROVIDER agrees that this Agreement does not confer benefits of any 2 nature whatsoever upon it other than payment for services provided herein. The SERVICE PROVIDER shall not assert any claim for additional benefits of any nature, including, but not limited to, unemployment compensation benefits, by reason of the services to be performed pursuant to this Agreement. The SERVICE PROVIDER shall not be entitled to assert any claim to entitlements pursuant to any collective bargaining agreement now or hereafter in effect between the SCHOOL DISTRICT and its employees. 6. EXPENSES OF SERVICE PROVIDER: The SERVICE PROVIDER shall be responsible for all costs and expenses incurred by the SERVICE PROVIDER that are incident to the performance of services for the SCHOOL DISTRICT, including, but not limited to, all tools, vehicles, or other equipment to be provided by the SERVICE PROVIDER, all fees, fines, licenses, bonds or taxes required of or imposed against the SERVICE PROVIDER and all other of SERVICE PROVIDER's costs of doing business. The SCHOOL DISTRICT shall not be responsible for any expenses incurred by the SERVICE PROVIDER in performing services for the SCHOOL DISTRICT. 7. INCOME TAX DESIGNATION AND INDEMNIFICATION: The SCHOOL DISTRICT shall not withhold from sums payable to the SERVICE PROVIDER under this Agreement any amounts for Federal, State, or local taxes including Federal or State income taxes, employment taxes (including Social Security and Medicare taxes), and unemployment taxes. The SERVICE PROVIDER agrees that any tax obligation of the SERVICE PROVIDER arising from the payments made under this Agreement will be the SERVICE PROVIDER's sole responsibility. The SERVICE PROVIDER will indemnify the SCHOOL DISTRICT for any tax liability, interest, and/ or penalties imposed upon the SCHOOL DISTRICT by any taxing authority based upon the SCHOOL DISTRICT's failure to withhold any amount from the payments for tax purposes. 8. RESPONSIBILITY FOR PAYMENT OF SERVICES: No parent or guardian or any other person shall be required to make any payment for services on behalf of any child covered by this Agreement. The SERVICE PROVIDER and its employees shall not share or accept any fee or gratuity from the student or student's family for services provided pursuant to this Agreement. 9. SCHOOL DISTRICT'S RIGHT TO EXAMINE ACCOUNTING RECORDS: The SCHOOL DISTRICT shall have the right to examine any and all accounting records of the SERVICE PROVIDER as they pertain to tuition and related service costs. For purposes of this Agreement, the definition and calculation of enrollment and attendance shall be determined by the SCHOOL DISTRICT, in accordance with section 175.6 of the Regulations of the Commissioner of Education. 10. AUTHORIZATION: The SERVICE PROVIDER warrants that it is authorized to perform the services as described herein. Where applicable, for Medicaid reimbursement purposes, the SERVICE PROVIDER agrees to submit to the SCHOOL DISTRICT proof of certification and/ or professional licensing of all individuals providing Medicaid reimbursable services to Medicaid eligible school aged students, 5-21 years old, classified with a disability or suspected of having a disability. The SERVICE PROVIDER further agrees to complete and submit, upon the request of the SCHOOL DISTRICT, all forms to document the evaluation and services provided to Medicaid eligible school aged students, 5-21 years old, classified with a disability or suspected of having a disability for Medicaid reimbursement purposes. The individuals who are furnishing services hereunder shall be subject to the approval of the SCHOOL DISTRICT. The SCHOOL DISTRICT reserves the right to reject the placement of any individual. 11. SAVE LEGISLATION: The SERVICE PROVIDER understands and agrees that it is responsible for complying with all applicable Federal, State, local statutes, rules, and ordinances including the New York State Safe Schools Against Violence In Education (SAVE) legislation. The SERVICE PROVIDER shall adhere to all requirements and protocols as established by the SCHOOL DISTRICT 3 and the State Education Department of New York: to wit, but not limited to, fingerprinting. The SERVICE PROVIDER further agrees and understands that all individuals providing services under this Agreement must be cleared by the New York State Education Department in accordance with the provisions contained in the SAVE Legislation Prior to providing services to the SCHOOL DISTRICT. In the event that the SERVICE PROVIDER utilizes a provider who has not obtained fingerprinting clearance with the State Education Department, the SCHOOL DISTRICT shall have the right to immediately terminate the within contract. 12. ATTENDANCE RECORDS: The SERVICE PROVIDER shall maintain attendance records which shall be submitted to the SCHOOL DISTRICT at the end of each month. If a child has been absent for a period of five (5) or more consecutive days, the attendance record shall indicate the reason for that absence. 13. REPORTS OF STUDENTS: The SERVICE PROVIDER will obtain whatever releases or other legal documents that are necessary in order that the SERVICE PROVIDER may render full and complete reports concerning the education and progress of the students covered by the terms of this Agreement. The full responsibility for obtaining such clearances rests on the SERVICE PROVIDER. Any failure to carry out such responsibility shall permit the Commissioner of Education to withdraw approval for the placement of such child in such program, in which event this Agreement shall be canceled forthwith in regard to such child for whom such releases are not submitted. 14. REPORTS TO STATE: The SERVICE PROVIDER hereby agrees to furnish to the State all reports, audits, etc. required to make determinations as to eligibility under the provisions of the Regulations of the Commissioner of Education. Such materials shall be furnished at such times as are required by the State. Failure to submit required materials within ten (10) days of demand or as required by regulations shall constitute grounds for the SCHOOL DISTRICT to terminate thisAgreement. The SERVICE PROVIDER agrees to provide the State access to all relevant records which the State requires to determine either the SERVICE PROVIDER's or the SCHOOL DISTRICT's compliance with applicable Federal or State statutes or regulations with the effect of law, which regulate either the execution of the Agreement or the performance of obligations under the Agreement. The SERVICE PROVIDER agrees to retain all materials and records relevant to the execution or performance of the Agreement in accordance with the provision of section 74.21 of volume 34 of the Code of Federal Regulations, but in no event less than six (6) years from the date of this Agreement. 15. REPORTS TO SCHOOL DISTRICT: The SERVICE PROVIDER hereby agrees to furnish written reports of each pupil's educational progress to the SCHOOL DISTRICT. The SERVICE PROVIDER will render such reports to the SCHOOL DISTRICT at any time that such reports are made to the parents of the students covered by the terms of this Agreement, and will render such additional reports as may be required by the SCHOOL DISTRICT. Ata minimum, all reports shall be furnished at the end of each semester, i.e., January 31st and June 30th. Any and all reports shall be furnished upon termination of the Agreement. The SERVICE PROVIDER shall provide such additional information concerning the student's progress as may be required by the SCHOOL DISTRICT. 16. COMMISIONER VISITS: The SERVICE PROVIDER shall be subject to the visitation of the Commissioner of Education or his/her designated representative(s). 17. AUTHORIZATION OF SCHOOL DISTRICT: The SERVICE PROVIDER shall coordinate all instruction through the Pupil Personnel Services Office or any other authorized office of the SCHOOL DISTRICT. 4 18. STUDENT PRESCRIPTIONS: Where applicable, the SCHOOL DISTRICT shall obtain all medical prescriptions from the parent/ guardian of students referred to the SERVICE PROVIDER. The SCHOOL DISTRICT shall forward copies of these prescriptions to the SERVICE PROVIDER upon its written request. 19. TERMINATION NOTICE: a. This Agreement may be terminated by the SCHOOL DISTRICT upon seven (7) days’ written notice to the SERVICE PROVIDER. In the event of such termination, the parties will adjust the accounts due and payable to the SERVICE PROVIDER for services rendered. The SERVICE PROVIDER will not incur any additional expenses upon receipt of the SCHOOL DISTRICT’s notification that the SERVICE PROVIDER’s services have been terminated. Upon any such termination, the parties shall endeavor in an orderly manner to wind down activities hereunder. In the event of termination, all reports and services due to the SCHOOL DISTRICT must be completed by the SERVICE PROVIDER within thirty (30) days of the termination date. b. This Agreement may be terminated by the SCHOOL DISTRICT in the event of a material breach by the SERVICE PROVIDER, upon seven (7) days written notice from the SCHOOL DISTRICT to the SERVICE PROVIDER. 20. CONFIDENTIALITY: The SERVICE PROVIDER, its employees, and/ or agents agree that all information obtained in connection with the services provided for in this Agreement is deemed confidential information. The SERVICE PROVIDER, its employees, and/or agents shall not use, publish, discuss, disclose or communicate the contents of such information, directly or indirectly with third parties, except as provided for in this Agreement. The SERVICE PROVIDER further agrees that any information received by the SERVICE PROVIDER, its employees, and/ or agents during the course of the services provided pursuant to this Agreement which concerns the personal, financial, or other affairs of the SCHOOL DISTRICT, its employees, agents, clients, and/ or students will be treated by the SERVICE PROVIDER, its employees, and/ or agents in full confidence and willnot be revealed to any other persons, firms, or organizations. The parties further agree that the terms and conditions set forth herein shall survive the expiration and/ or termination of this Agreement. 21. HIPAA/FERPA: Both parties to this Agreement understand that they may receive and/or come into contact with protected health information as defined by the Health Insurance Portability and , Accountability Act of 1996 (HIPAA) and/or the Family Education Rights and Privacy Act (FERPA). The Parties hereby acknowledge their respective responsibilities pursuant to HIPAA and FERPA. 22. INDEMNIFICATION and HOLD HARMLESS PROVISION: The SERVICE PROVIDER further agrees that it shall defend, indemnify and hold harmless the SCHOOL DISTRICT, its officers, directors, agents and employees for all loss, costs, damages and expenses, including attorneys’ fees, judgments, fines and amounts paid in settlement in connection with a terminated, pending or completed action, suit or proceeding arising from any act, error or omission, misstatement, misleading statement, neglect or breach of duties by the SERVICE PROVIDER or any of its officers, directors, agents or employees taken or made with respect to this Agreement. The SERVICE PROVIDER is not indemnifying the SCHOOL DISTRICT for any claims arising out of the SCHOOL DISTRICT'S negligence or willful misconduct during the term of this Agreement. 23. INSURANCE PROVISION: The SERVICE PROVIDER shall purchase from and maintain in a company or companies lawfully licensed to do business in the State of New York such insurance as will protect the SERVICE PROVIDER and the SCHOOL DISTRICT from claims set forth below for which the SERVICE PROVIDER may be legally liable, whether such operations be by the SERVICE PROVIDER or 5 by anyone directly or indirectly employed by any of them, or by anyone for whose acts any of them may be liable. Notwithstanding any terms, conditions or provisions, in any other writing between the parties, the SERVICE PROVIDER hereby agrees to effectuate the naming of the SCHOOL DISTRICT as an additional insured on the SERVICE PROVIDER's insurance policies, with the exception of workers’ compensation, N.Y. State disability and professional liability. If the policy is written on a claims-made basis, the retroactive date must precede the date of the contract. The policy naming the SCHOOL DISTRICT as an additional insured shall: a. Purchase an insurance policy from an A.M. Best rated "secured" insurer, licensed in New York State. b. State that the organization's coverage shall be primary and non-contributory coverage for the SCHOOL DISTRICT, its Board, employees and volunteers. c. The SCHOOL DISTRICT shall be listed as an additional insured by using endorsement CG 2026 or equivalent. A completed copy of the endorsement must be attached to the certificate of insurance. d. The certificate of insurance must describe the specific services provided by the SERVICE PROVIDER (e.g. physical therapy, psychological services) that are covered by the commercial general liability policy and the umbrella policy. e. At the SCHOOL DISTRICT’s request, the SERVICE PROVIDER shall provide a copy of the declaration page of the liability and umbrella policies with a list of endorsements and forms. If so requested, the SERVICE PROVIDER will provide a copy of the policy endorsements and forms. f. The SERVICE PROVIDER agrees to indemnify the SCHOOL DISTRICT for any applicable deductibles and self-insured retentions. g. Required Insurance: i. Commercial General Liability Insurance: $1,000,000 per occurrence/$3,000,000 aggregate. ii. | Workers’ Compensation and N.Y.S. Disability: Statutory Workers’ Compensation, Employers’ Liability and N.Y.S. Disability Benefits Insurance for allemployees. Proof of coverage must be on the approved specific form, as required by the New York State Workers’ Compensation Board. ACORD certificates are not acceptable. A self-employed person and certain partners and corporate officers are excluded from the definition of "employee" pursuant to Workers' Compensation Law Section 2(4). As such, individuals in such capacity are excluded from Workers’ Compensation Law coverage requirements. A person seeking an exemption must file a CE-200 form with the state. The form may be completed and submitted online: http//www.web.ny.gov/content/ebiz/wc_db_exemptions/requestExe mptlonOverview.|sp iii. Professional Errors and Omissions tnsurance: $1,000,000 per occurrence/$3,000,000 aggregate for the professional acts of the SERVICE PROVIDER performed under the contract for the SCHOOL DISTRICT. If written on a "claims-made" basis, the retroactive date must pre-date the inception of the contract or agreement. iv. Excess Insurance: $1,000,000 each occurrence and aggregate. Excess coverage shall be on a follow-form basis. h. The SERVICE PROVIDER acknowledges that failure to obtain such insurance on behalf of the SCHOOL DISTRICT constitutes a material breach of contract. The SERVICE PROVIDER is to provide the SCHOOL DISTRICT with a certificate of insurance, evidencing the above requirements have been met, prior to the commencement of work or use of facilities. The failure of the SCHOOL DISTRICT 6 to object to the contents of the certificate or the absence of same shall not be deemed a waiver of any and all rights held by the SCHOOL DISTRICT. i. The SERVICE PROVIDER is amember/ owner of the NY Schools Insurance Reciprocal (NYSIR). The SERVICE PROVIDER further acknowledges that the procurement of such insurance as required herein is intended to benefit not only the SCHOOL DISTRICT but also the NYSIR, as the SCHOOL DISTRICT’s insurer. j. In the event that any of the insurance coverage to be provided by the SERVICE PROVIDER contains a deductible, the SERVICE PROVIDER shall indemnify and hold the SCHOOL DISTRICT harmless from the payment of such deductible, which deductible shall in all circumstances remain the sole obligation and expense of the SERVICE PROVIDER. k. The SERVICE PROVIDER shall provide the SCHOOL DISTRICT with evidence of the above insurance requirements upon execution of the within Agreement. The SERVICE PROVIDER further acknowledges that its failure to obtain or keep current . the insurance coverage required by this Agreement shall constitute a material breach of contract and subjects the SERVICE PROVIDER to liability for damages including, but not limited to, direct, indirect, consequential, special and any other damages the SCHOOL DISTRICT sustains as a result of this breach. In addition, the SERVICE PROVIDER shall be responsible for the indemnification to the SCHOOL DISTRICT of any and all costs associated with such lapse in coverage including, but not limited to, reasonable attorneys’ fees. l. Prior to commencement of its services, the SERVICE PROVIDER shall obtain and pay for insurance as may be required to comply with the indemnification and hold harmless provisions outlined under this Agreement. 24, NOTICES: Any notices to be given under this Agreement by either party to the other may be effected by personal delivery in writing or by mail, registered or certified, postage prepaid with return receipt requested. Each party may change the address by written notice in accordance with this paragraph. Notices delivered personally will be deemed communicated as of actual receipt; mailed notices will be deemed communicated as of five (5) days after mailing. Notice shall be delivered or mailed, addressed as follows: To the SERVICE PROVIDER: Green Chimneys Children’s Services 400 Doansburg Road-Call Box 719, Brewster, NY 10509 To the SCHOOL DISTRICT: Croton Harmon Union Free School District 10 Gerstein Street, Croton on the Hudson, NY 10541 25. ASSIGNMENT OF CONTRACT: The SERVICE PROVIDER shall not assign, transfer or convey any of its respective rights or obligations under this Agreement without the prior written consent of SCHOOL DISTRICT. 26. DISCRIMINATION: Services provided pursuant to this Agreement shall be provided without regard to age, race, creed, color, religion, national origin, sexual orientation, military status, sex, gender, disability, predisposing genetic characteristics, marital status or other applicable discriminatory classification under federal and state law. 27. NEW YORK STATE LAWS: This Agreement shall be governed by the laws of the State of New York. 28. SEVERABILITY: If any term, provision, covenant or condition of this Agreement, or the application thereof to any person, place or circumstance, shall be held by a court of competent jurisdiction to be invalid, unenforceable or void, the remainder of this Agreement and such term, provision, covenant or condition as applied to other persons, places and circumstances shall remain in full 7 force and effect. 29. NO PRIOR AGREEMENTS: This Agreement constitutes the full and complete Agreement between the SCHOOL DISTRICT and the SERVICE PROVIDER, and supersedes all prior written and oral agreements, commitments or understandings with respect thereto. This Agreement may not be altered, changed, added to, deleted from or modified except through the mutual written consent of the parties. 30. AGREEMENT CONSTRUCTION: This Agreement has been arrived at mutually and is not to be construed against any party hereto as being the drafter hereof or causing the same to be drafted. 31. REPRESENTATIONS AND WARRANTIES: The SERVICE PROVIDER represents and warrants: 1) that the SERVICE PROVIDER has no obligations, legal or otherwise, inconsistent with the terms of this Agreement; 2) that the performance of the services to be provided in this Agreement does not and will not violate any applicable law, rule or regulation or any proprietary or other right of any third party; and 3) that the SERVICE PROVIDER has not entered into or will not enter into any Agreement (whether oral or written) in conflict with this Agreement. 32. AMENDMENT: This Agreement may be amended only in writing and signed by the parties. 33. NON-WAIVER: No action or failure to act by the SERVICE PROVIDER or the SCHOOL DISTRICT shall constitute a waiver of aright or duty afforded them under the Agreement, nor shall such action or failure to act constitute approval of or acquiescence in a breach thereunder, except as may be specifically agreed in writing. 34. CHARTER: The SERVICE PROVIDER shall maintain its charter as an approved educational program from the Regents of the University of the State of New York. It is understood and agreed by the parties that failure to do so shall render this Agreement void, in which case the SERVICE PROVIDER shail be entitled to no compensation for the portion of the school year in which the charter ceases to be maintained and shall reimburse the SCHOOL DISTRICT any amounts already received for that portion of the school year. The SERVICE PROVIDER shall be responsible for appropriate staff orientation and training for all its educational and supporting personnel, including, but not limited to, in-service training related to provision of educational services to disabled children. 35. AUTHORITY TO ENTER AGREEMENT: The undersigned representative of the SERVICE PROVIDER hereby represents and warrants that the undersigned is an officer, director, or agent of the SERVICE PROVIDER with full legal rights, power and authority to enter into this Agreement on behalf of the SERVICE PROVIDER and bind the SERVICE PROVIDER with respect to the obligations enforceable against the SERVICE PROVIDER in accordance with its terms. 8 IN WITNESS WHEREOF, the parties hereto have executed this agreement the day and year first above written. Croton Harmon Union Free School District Green Chimneys Children’s Services Chonda Or ohatclcon, District Representative Rhonda Richardson, CFO 08/14/2026 Date Date ADDENDUM “A” School represents and warrants, as a material term of this contract, that neither it nor any of its employees will perform services under this contract if it or any of its employees are (1) currently excluded from participation in federal or state health care programs; (2) the subject of any pending exclusion proceeding, or (3) the subject of an adjudication or determination that they have committed any action that could subject Contractor to exclusion from government programs (collectively, “Exclusion Activity”). Additionally, Contractor agrees that, as a continuing obligation of this contract, contractor will (1) maintain documentation evidencing annual exclusion checks with the Office of the Inspector General, General Services Administration and New York State, and will produce such documentation to Green Chimneys upon Green Chimneys’ request; (2) report in writing to Green Chimneys any Exclusion Activity involving Contractor as soon as practicable after contractor learns of such Exclusion Activity. The contract may be terminated by Green Chimneys immediately upon notice that Contractor has been the subject of any Exclusion Activity, as define above, or if representations and warranties made above are false or the subject of breach. 9 Operating Procedure Section I, Sub-Section C, Procedure #2 Page | GREEN CHIMNEYS OPERATING PROCEDURE SECTION I TITLE Administration SUB-SECTION Cc TITLE Human Resource Management PROCEDURE 2 TITLE Credentialing/Privileging EFFECTIVE DATE 2/24 ]|SUPERSEDES: 4/96, 12/98, 3/99, 5/06, 07/13, 3/16 I. POLICY: Green Chimneys employs a mechanism to review the credentials of new staff prior to hire and regularly thereafter. The Credentialing/Privileging process is the quality assurance mechanism for ensuring that treatment and education services are performed by fully qualified staff and involves a confidential review of the staff's licenses, formal and informal education. experience and demonstrated ability in a particular field. Staff competency must be evaluated upon hire and throughout staffs’ employment at Green Chimneys. Standards for performance are set and it is cach department Director’s responsibility to monitor staff performance in meeting standards. Human Resources is responsible for developing and implementing a system that reviews and verifies professional staff credentials upon hire Department Directors are responsible to ensure the level of supervision required to obtain or maintain certification or licensure. Privileged staff at Green Chimneys includes licensed independent healthcare providers, social workers, mental health counselors, psychologists, psychiatrists, speech and language therapists, occupational therapists, clinicians, nurses, nurse practitioners, teachers, teachers’ assistants, recreational therapists and art therapists whose competencies must be assessed through granting of educational or clinical privileges. Green Chimneys employs interns, externs, and students in their field who are license or certification eligible. I. PROCEDURE: Steps to be followed in processing credentials file and awarding Privileges include the following: Operating Procedure Scction 1, Sub-Section C, Procedure #2 Page 2 A. A Recruitment File is prepared by Human Resources Recruiter, which includes a Personnel Requisition Form, Job Posting and Job Description. It is the expectation of the agency that Directors prioritize certified candidates. B. Human Resources verifies licensure, references, and education and conducts criminal background check. C. Upon receipt of all completed paperwork, the Human Resources Recruiter enters all information into a paper file and electronic database. Uncertified staff are told upon hire that certification is a requirement of their job, and if they do not obtain certification within the ; expected time frame, their ability to maintain their position can be reconsidered. Human Resources provides uncertified staff with information on how to become certified through the NYSED website, and a Human Resources representative will assist as needed. D. On a quarterly basis or more frequently if necessary, the VP of Human Resources, or Human Resources designee, reviews the credentials of all applicable employees. Uncertified staff are required to show proof of the program they are attending, and provide an estimated date of graduation and/or certification. E. If credentials are near expiration; or are expired, Human Resources notifies the employee in writing that their privileges will be suspended until correct and/or updated credentials are provided. PROVIDER AGREEMENT BETWEEN THE NEW YORK STATE DEPARTMENT OF HEALTH AND ° THE SERVICE PROVIDERS UNDER CONTRACT WITH THE SCHOOL DISTRICT WHICH IS ENROLLED IN THE NEW YORK STATE MEDICAID SCHOOL SUPPORTIVE HEALTH SERVICES PROGRAM (SSHSP) Based upon a request by the school district to participate in the New York State Medicaid SSHSP Program under Title XIX of the Social Security Act, GREEN CHIMNEYS 2026-2027 , (Organization/Contracted Provider's Name) will hereinafter be called the (outside contracted) Provider, agrees as follows to: A) 1) Keep any record necessary to disclose the extent of services the Provider furnishes to recipients receiving assistance under the New York State Plan for Medicaid Assistance. 2) On request, furnish the New York State Department of Health, or its designee and the Secretary of the United States Department of Health and Human Services, and the New York State Medicald Fraud Control Unit any information maintained under paragraph (A)(1), and any information regarding any Medicaid claims reassigned by the Provider. 3) Comply with the disclosure requirements specified in 42 CFR Part 455, Subpart B. B) Comply with Title VI of the Civil Rights Act of 1864, Section 504 of the Federal Rehabilitation Act of 1973, and all other State and Federal statutory and constitutional non-discrimination provisions which prohibit discrimination on the basis of race, color, national origin, handicap, age, sex, religion and/or marital status. C) Abide by all applicable Federal and State laws and regulations, including the Social Security Act, the New York State Social Services Law, Part 42 of the Code of Federal Regulations and Title 18 of the Codes, Rules and Regulations of the State of New York. (Outside Contract) Provider's Authorized Signature: ~Chreda Giehasdsorn Address; 400 Doansburg Road - Caller Box 719 city, Brewster state: NY Zip, 10509 Telephone: 845-279-2995 Date Signed: 0814202060 Please list the School District(s) under contract with on the back of this form. Croton Harmon UFSD STATEMENT OF REASSIGNMENT GREEN CHIMNEYS 2026-2027 Name of the Outside Contracted Provider By this reassignment the above-named outside contracted provider of services agrees: 1. to reassign all Medicaid reimbursements to the school district that you contracted with for providing medical services billed under the School Supportive Health Services Program (SSHSP). 2. to accept as payment in full the contracted reimbursement rates for covered services. 3. to comply with all the rules and policies as described in your contract with the school district. 4, to agree not to bill Medicaid directly for any services that the schoo! district will bill for under the SSHSP program. NOTE: Nothing in this "Agreement of Reassignment" would prohibit a Medicaid practitioner from claiming reimbursement for Medicaid eligible services rendered outside of the scope of the Schoo! Supportive Health Services Program (SSHSP) 08/14/2026 Chosde Crobarebsor (Date) (Outside Contract Service Provider's Signature) Rhonda Richardson (Printed Name) Croton Harmon UFSD School District (under contract with): List additional ones on back of this form.)