FINANCIAL AGREEMENT – TOUCHSTONE PROGRAM

This agreement is for a third-party payer for the Touchstone Program of Arch to Freedom in Boynton Beach, Florida.

I, __________________ (“payer”) certify that I am paying the program fees for __________________ (“resident”) to pay for their rent and services at Arch to Freedom. I understand and agree to the terms as follows:

I. The Security Deposit is $800 dollars and is due prior to resident living in the home and receiving services. $400 is a non-refundable administrative fee. Upon receiving this fee, Arch to Freedom will hold a bed for the resident for up to two weeks for no additional charge prior to the move in date. In order to hold the bed beyond 2 weeks, we may begin charging our standard monthly fees minus case management cost. The other $400 of the deposit is refundable provided the resident stays a minimum of 4 months, provides a 2 weeks notice before leaving, fully cleans the room including sheets, etc. and leaves all Arch to Freedom supplies supplied to the resident (laundry basket, sheets, towels, chargers, hangers, etc.) If a resident leaves Arch to Freedom before meeting these conditions, then the entire deposit is non-refundable.

II. Touchstone Program includes all services at our CORE Program housing, in addition to case management services, a therapy group once a week, and biweekly outings/ community building. Case management is a part of the program for a minimal 90 days and every resident begins with 3 hours of case management services per week for at least the first month.

The program fees are as follows:

Keystone House:

2900/mo. (3 hours of Case Management per week)

2450/mo. (1.5 hours of Case Management per week)

2000/mo. (No Case Management)

Private room is an additional $500/mo.

Lakehouse

3000/mo. (3 hrs of Case Management per week)

2550/mo. (1.5 hours of Case Management per week)

2100/mo. (No Case Management)

Private room is an additional $600/mo.

 Freedom House:                              3500/mo. (3 hrs of case management per week)

                                                                    3050/mo. (1.5 hrs of case management per week)

                                                                    2600/mo. (No Case management)


Additional Case Management fees are $100/session

III. Program fees (“fees”) are due on the 1st of the month and are considered late on the 5th. It is important in order that we provide the best service that we can that all rent payments are paid on time. Arch to Freedom reserves the right to charge a $75 late fee for all payments that come in after the 5th. All payments paid by credit card online or over the phone incur a 2% convenience fee.

IV. Arch to Freedom will reserve a spot for someone prior to initial intake for up to 2 weeks without any additional cost. If we must hold the space for longer than the two week period before the resident’s initial intake, we reserve the right to charge the no case management price for that house beyond the 2-week period until the resident has his intake.

When a current resident has to take a leave of absence for any reason for 2 weeks or more, we will reduce our fees to the no case management price until the resident returns. This is to continue to save the spot for the resident until the resident returns. This leave of absence includes but is not limited to: extended vacations, medical or psychiatric reasons, or for going to a higher level of care like a residential treatment center.

We do not give discounts or reductions of fees if a resident takes a leave of absence for any reason, under the two weeks. They are still considered to be under our care and our staff and case managers will still be in communication with the resident, the family of the resident, and/or anyone involved in the clinical care of that resident.

V. Arch to Freedom reserves the right to charge a reduced case management fee ($75/hr) for additional time spent with the resident in unscheduled, extraordinary circumstances. This would typically be in urgent situations that require an immediate response from the case manager. Other additional sessions that are scheduled would be at full price ($100/session) and communication and scheduling would occur prior to the charge. Any crisis management done by Arch to Freedom staff other than the case manager would be at no additional charge.

VI. Arch to Freedom Refund Policy dictates that all fee payments are non-refundable, unless you have prepaid for a month before that month begins. This means that the security deposit, and program fees are non-refundable if any services are rendered during the month the fees were paid for or the resident resided at an Arch to Freedom property at any point during the month that the fees were paid for. Arch to Freedom owners may decide to issue a partial refund as a courtesy, but this is not guaranteed. By signing this agreement, the payer understands and agrees to this refund policy.

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