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Home My WebLink About20080596.tiff RESOLUTION RE: APPROVE VICTIM'S ASSISTANCE AND LAW ENFORCEMENT (VALE) GRANT APPLICATION FOR LONG TERM CARE OMBUDSMAN ADVOCATE/FRIENDLY VISITOR PROGRAM AND AUTHORIZE CHAIR TO SIGN WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with a Victim's Assistance and Law Enforcement (VALE) Grant Application for the Long Term Care Ombudsman Advocate/Friendly Visitor Program between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Human Services, Area Agency on Aging, and the Victim's Assistance and Law Enforcement Board, commencing July 1, 2008, and ending June 30, 2009, with further terms and conditions being as stated in said application, and WHEREAS, after review, the Board deems it advisable to approve said application, a copy of which is attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the VALE Grant Application for the Long Term Care Ombudsman Advocate/Friendly Visitor Program between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Human Services,Area Agency on Aging,and the Victim's Assistance and Law Enforcement Board, be,and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said application. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 13th day of February, A.D., 2008. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO ATTEST: F' ! /1 A /I / ,,,,4, `' �: H. Jerke, Chair Weld County Clerk to the Board 2(6‘. 186;i '\EX D , , e Madero-Tem Deputy C k to the Board . k; '' a Garcia APP ) c44 l• cj„,4 David E. Long u ttorne / � � Y �_0? Oe Douglas9 Rademacher Date of signature: 2008-0596 HR0079 C CIO: /AS Cie -,-(5-) x'34 G�/C� MEMORANDUM TO: William H. Jerke, Chair, Weld County Board of Commissioners Walter Speckman, Executive Director, (�� C FROM: Department of Human Services COLORADO DATE: Wednesday, February 13`h, 2008 SUBJECT: Weld County Area Agency on Aging's Long Term Care Ombudsman Advocate/Friendly Visitor Program VALE grant approval Enclosed for Board approval and signature is the grant application for VALE (Victims Assistance and Law Enforcement)assistance. The Ombudsman Program has received this grant for the past 10 years. The amount being requested for the July 2008-June 2009 funding cycle is$10,000. This grant will allow the Ombudsman program to provide elder abuse prevention programs to long term care staff; continue the long term care friendly visitor program, and maintain and strengthen the Volunteer Ombudsman program. If you have additional questions, please contact Eva Jewell at 353-3800, extension 3331. 2008-0596 2008-2009 VALE ASSISTANCE FUNDS 19th Judicial District,Weld County Application page 1 VALE USE ONLY SECTION A-AGENCY INFORMATION Grant it. Amount Requested: 1. APPLICANT AGENCY: Amount Funded Program Name: Weld County Area Agency on Aging Division of Human Services Street Address: 1551 North 17th Avenue Greeley, Colorado 80632 Mailing Address: Post Office Box 1805 Greeley, Colorado 80632 Phone: (970) 353-3800 extension 3324 Fax: (970) 304-6442 E-Mail: rmaldonado(aco.weld.co.us 2. CONTACT PERSON: Eva Jewell Title: Weld Area Agency on Aging Director Phone: (970) 353-3800 extension 3331 Fax: (970) 304-6442 E-Mail: ejewell@co.weld.co.us 3. AGENCY STATUS: Governmental Tax ID Number: 14-02101 4. PROJECT TITLE: Weld County Long Term Care Ombudsman/ Friendly Visitor Program 5. PROBLEM STATEMENT: The VALE funds will allow the Ombudsman Program to have a consistent presence in Weld County long term care settings, allowing for early intervention and advocacy. The funding will enable the LTC Ombudsmen to maintain an elder abuse prevention and awareness program. In addition, the Assistant Ombudsman will be able to continue recruitment and training for the Ombudsman Volunteer Program. 6. FUNDS REQUESTED: $10,000 1 SECTION B - NARRATIVE SUMMARY: 7. AGENCY DESCRIPTION: The Weld County Long Term Care Ombudsman Program is housed under the umbrella of the Weld County Area Agency on Aging. The Long Term Care Ombudsman Program has been a consumer voice for the elderly residing in nursing homes and assisted living facilities for more than twenty(20) years. The authority of the local Ombudsman Program comes from the Older American's Act, Colorado Revised Statutes 25-11.5 and the Nursing Home Reform Law of 1987. The Weld County Ombudsman acts as a consumer voice for the concerns of the elderly living in institutions, who may have no one else to speak for them. The Ombudsman also receives and resolves questions, issues, problems and complaints made by, for, or on behalf of residents of long term care facilities. The purpose of the Weld County Long Term Care Ombudsman Program is to assist and empower consumers of long term care services by providing information about those services and furnish support in complaint resolution. These issues or complaints may include,but are not limited to access to long term care services, redress of neglectful or abusive care, and information and assistance with civil and human rights. The Long Term Care Ombudsman program is a resident/patient/consumer-centered advocacy program. Long Term Care Ombudsmen have statutory status under the Older Americans Act of 1965 as amended and are required by federal and state law to visit every nursing home monthly and every assisted living facility quarterly. They also receive, investigate and resolve complaints, identify needs of long term care residents and help establish programs to meet those needs. The Ombudsmen also document and report problems of long term care and help to stimulate and promote improvement of the system. 8. BRIEF PROJECT DESCRIPTION: The V.A.L.E. grant has allowed the Ombudsman Program to increase staff time to keep up with the increasing demand for advocacy on behalf of this very vulnerable population. The funds have also enabled the program to maintain an abuse prevention and awareness program aimed at educating Certified Nurse Assistants (C.N.A.'s) and other long term care staff. This has allowed the Assistant Ombudsman to educate residents and staff about the Ombudsman Program, abuse issues and resident rights, as well as investigation of complaints of abuse and neglect. The Ombudsman's role through observation and a frequent presence in the facilities; is to insure that resident rights are being respected, that quality care is administered, and that abuses do not occur. Continued funding of the Assistant Ombudsman will make it possible for the Weld County Area Agency on Aging Ombudsman Program to serve the increasing number of vulnerable long term care residents and their families. We believe that our request for a continuation of funding relates to the mandate of early crisis intervention and to provide assistance and support to victims and their families. 9. MANAGEMENT PROJECT: The Director of the Weld County Area Agency on Aging, Eva Jewell, will supervise the Lead Long Term Care Ombudsman during the duration of this project. The Lead Long Term Care Ombudsman, Raegan Maldonado, will be responsible for providing reports to the V.A.L.E. Board. The Director and the Lead Ombudsman will be responsible for the day-to-day management of this project. The Lead and Assistant Ombudsmen, Kathleen Alvarado, will carry out the duties outlined in this project. The Fiscal Accountant, Crystal Hedberg, will be responsible for the accounting functions. 10. Who will provide the proposed services? Will volunteers be utilized? The Assistant Ombudsman will recruit and train Volunteers for the Friendly Visitor Program. The Lead and the Assistant Ombudsmen will facilitate the Abuse Free Prevention Training, C.N.A. Training and Sexual Assault Training. The Assistant Ombudsman will have a consistent presence in Weld County long term care settings. 2 SECTION C - GOALS AND OBJECTIVES: (Goal 1, objectives 1 and 2, are mandatory for all applicants). 11. GOAL 1 (standard): This project will provide direct services that assist crime victims with emotional and physical needs to stabilize their lives, provide a measure of safety and security, and/or enhance victims' experience with the criminal justice system. • OBJECTIVE 1 (standard): To provide services to the following estimated unduplicated number of crime victims during the 12-month grant period. (Note: Count each victim only once based upon predominant crime type). EST. NO. EST. NO. VICTIMS TYPE OF CRIME VICTIMS TYPE OF CRIME Child Physical Abuse Assault Child Sexual Abuse Adults Molested as Children Domestic Violence 60 Elder Abuse (including economic exploitation and fraud crimes) 10 Adult Sexual Assault Robbery Victims of vehicular assault, homicide, Other violent crimes such as hate and DUI/DWI crashes or careless driving bias crime, gang violence (specify). resulting in death. Survivors of Homicide Victims TOTAL UNDUPLICATED VICTIMS ESTIMATED TO BE SERVED DURING THE 12-MONTH PERIOD 70 3 • OBJECTIVE 2 (standard): To provide the following types of services to the following estimated number of victims during the 12-month grant period. EST. NO. EST. NO. VICTIMS SERVICES VICTIMS SERVICES Crisis Counseling Emergency Financial Assistance 70 Follow-up Emergency Legal Advocacy Therapy 70 Victim Compensation Assistance (required) Group Treatment/Support 60 Personal Advocacy Shelter/Safehouse 70 Telephone Contact(information/referral) 50 Information/ Referral (in person) Crisis Hotline Counseling Criminal Justice Support/Advocacy Other(specify): TOTAL EST. NO. VICTIMS: 320 4 • 12. PROJECT-SPECIFIC GOALS AND OBJECTIVES: GOAL 2: Ongoing supervision and training of the Volunteer Ombudsman for the Friendly Visitor Program. Objective 1: Sustain the current 3 Volunteer Ombudsmen and continue supervision and education. Objective 2: Maintain the current number of volunteers by December 2008 and fill any volunteer vacancies by June 2009. Objective 3: Train 1 Volunteer Ombudsman to assist with Abuse Free Training and the Sexual Assault Training by July 2008. GOAL 3: Provide Abuse Free Prevention Training to Direct Caregivers who work in Long Term Care settings. Objective 1: Educate new Administrators, Manager and Nurse Supervisors on the importance of an Abuse Free Environment by September 30th, 2008. Objective 2: Continue efforts with Alzheimer's Assoc to provide education on behaviors and schedule two training dates to take place during funding cycle; September 2008 and April 2009. Objective 3: Organize and facilitate 2 Abuse Free Environment Trainings for Certified Nursing Assistants during funding cycle; November 2007 and February 2008. GOAL 4: Educate students enrolled in the Certified Nursing Assistant Program about the importance of Elder Abuse Prevention and the Ombudsman Program. Objective 1: Schedule monthly training with the coordinator of the C.N.A. Program at AIMS, 1-2 times monthly during funding cycle. Objective 2: Educate 30 students on Ombudsman Program and Abuse Prevention by December 2008 and 30 students by June 2009. Objective 3: Calculate evaluation results for trainings during June-December 2008 by January 31 2009. Calculate evaluation results for trainings during January-June 2009 by July 31 s, 2009. GOAL 5: Sexual Assault Training for all staff who work in long term care settings. Objective 1: Research for potential educators on the topic by September 30th, 2008. Objective 2: Complete curriculum that Ombudsman Program can provide to staff by October 31S1 2008. Objective 3: Begin efforts to coordinate a conference for all long term care staff in Weld by October 315, 2008. 5 Cont— PROJECT- SPECIFIC GOALS AND OBJECTIVES: 13. What problems do you anticipate in implementing your program's goals and objectives, if any? Currently, the program has two active volunteers. Due to the complex nature of the Ombudsman Program, there is an ongoing challenge of recruiting appropriate and reliable volunteers. Volunteer Ombudsmen cannot have any current connection to a Weld County long term care facility, as this would be considered a conflict of interest for the Ombudsman Program. The Assistant Ombudsman will continue to recruit and screen potential volunteers for appropriateness when existing volunteer positions are vacant. Staffing issues continue to be a major crisis in long term care facilities. For this reason, the Assistant Ombudsman continues to be flexible and open to suggestions from long term care facilities regarding training programs. If necessary, the developed programs can be modified to meet the needs and schedules of those working in long term care facilities. We do not anticipate any problems of reaching the new goals and objectives for July 2008-June 2009. The Assistant Ombudsman will be able to fulfill the original goals and objectives while enhancing the Volunteer, C.N.A. training, Sexual Assault training and CARIE programs. 14.How does the project address the victims and witnesses services need outlined in the V.A.L.E. statute? Refer to C.R.S. 24-4.2-105 (4) (a - m). This program continuation request most relates to 24-4.2-105, Section 2, part a and part b. Part a addresses provision of service for early crisis intervention. There is evidence that when there is consistent community presence in long term care facilities the potential to improve the quality of life and prevent abuse and exploitation is reduced for the residents. We intend to continue advocate contacts with long term care residents as a preventative action. We know that there may be many barriers to the elderly, particularly those in long term care facilities, to express their individual needs without assistance from others. Some of these barriers are physical due to loss of sight, speech, or hearing. Some barriers are psychological due to a sense of isolation, fear of retaliation, or disorientation. Barriers to self-advocacy can also be related to the lack of information about rights, alternatives, and legal remedies. Part b addresses assistance programs for victims and their families. A key role of the long term care Ombudsman is complaint investigation and complaint resolution. Long term care residents must be assured that the Ombudsman will be able to follow up on their complaints in a timely and professional manner. With the continued increase in long term care beds, the ability of the present Ombudsman to respond appropriately to complaints will be jeopardized. The extension of the friendly visitor/advocate under this proposal will continue our Ombudsman hours, insuring that the Lead Ombudsman and the Assistant Ombudsman will be able to respond to residents and their families in a timely and appropriate manner. 6 SECTION D - SERVICE INFORMATION: 15. What is the population and geographic area targeted for service through this project? Populations targeted are 60 plus elderly residing in nursing homes, assisted living facilities and personal care boarding homes located in Weld County. There are proposed plans to build a 50+bed Assisted Living facility in the Greeley area, as well as two Assisted Living facilities in Windsor. In addition, plans have been made to add an additional Nursing Home in the Windsor area. This Nursing Home will likely have a secure area for those with memory impairments and who exhibit wandering behaviors. a) How many people are in need of these services? Currently there are approximately 1,400 Weld County residents live in long term care facilities. All of these residents receive services through the Ombudsman program, either directly with visitations and complaint resolution or indirectly through training and technical assistance provided to staff to improve the quality of care. By extension, the program also may represent the concerns of relatives and/or friends of long term care residents as long as the concern reflects the concerns of the resident. Continuation of support will make it possible for the Area Agency on Aging Ombudsman Program to continue to serve all of the long term care residents and their families with the same type and degree of services that we currently are providing. b) How many people are presently being served? All of the 1,400 Weld County residents who live in long term care facilities receive services through the Ombudsman program, either directly or indirectly, as stated above. 16. Are there other community agencies currently providing like services to the targeted population? If yes, explain how this project is not a duplication of services. There are no other programs which provide services equivalent to the Ombudsman Program. 7 17. Document community support, coordination and networking by providing the following information: a) List the agencies with whom your agency has an active memorandum of understanding or an agreement regarding the coordination and provision of services. See SECTION I. ATTACHMENTS We have formal agreements with agencies that we fund directly to provide a variety of services to seniors such as: Eldergarden Adult Day Program; Senior Peer Counseling through North Range Behavioral Health and in-home personal care through RVNA. We also work in collaboration with Adult Protective Services, the Alzheimer's Association, local skilled nursing facilities and local assisted living facilities. We have established a Coordinating Committee for Victims of Crime coordination agreement with the following agencies: The 19th Judicial District Attorney's Office; the Probation Department; C.A.R.E.; Colorado Legal Services; Weld County Law Enforcement; SASI; the Greeley Police Department; A Woman's Place; Partners; UNC's Assault Survivors Advocacy Program and A Kid's Place. b) Is your agency an active participant in Weld County's Coordinating Committee for Victims of Crime (CCVC)? If"yes," provide the name and position(s) of the CCVC participant(s) and their level of involvement in that group and attach the most current Coordinating Agreement. See SECTION I. ATTACHMENTS The Weld County Area Agency on Aging is an active participant in Weld County's Coordinating Committee for Victims of Crime (CCVC), and also a participant in the CCVC Coordination Agreement. Currently, the active members are Raegan Maldonado, Lead Long Term Care Ombudsman and Kathleen Alvarado, Assistant Long Term Care Ombudsman. The Lead Long Term Care Ombudsman anticipates further involvement with future subcommittees, as assigned and needed in the CCVC meetings. The Assistant Ombudsman is available to share information from our"Ensuring an Abuse Free Environment" training with the members of CCVC. In addition, the Lead Ombudsman routinely presents information to the CCVC committee about other networking groups available in the community that focus on aging and adult services. c) Briefly describe any other agency actions that demonstrate its high priority for developing community support, coordination, networking, and cooperation. Weld County Senior Service Network,Northern Colorado Culture Change Coalition, Bioethics Committee, and Adult Protection Network. d) List the agency name(s) and person(s) who provided letter(s) of support (no more than three) applicable to this specific grant funding request. See SECTION I. ATTACHMENTS Agency Names AIMS Community College Shirley Cassidy Rocky Mountain Alzheimer's Association Bonnie Wacker 8 SECTION E -VICTIM COMPENSATION : Provide the following information concerning your agency's involvement with the Crime Victim Compensation Program: 18. a) Does your agency regularly inform victims about Victim Compensation and help them to apply when appropriate? Yes How? The Weld County Area Agency on Aging regularly informs victims about Victim Compensation. For example, during a sexual assault case involving an at-risk adult, the Ombudsman's office assisted the victim's family in applying for services. The victim's family and the Ombudsman used resources available through Victim Compensation during the time of the trial. Such resources include the Victim Assistance area set up for victims and families at the Weld County courthouse. b) Explain any major issues that hinder your agency in helping crime victims to understand Victim Compensation eligibility requirements and to apply for benefits. The Weld County Area Agency on Aging and the Ombudsman program do not foresee any issues that would prevent informing crime victims of the Victim Compensation eligibility requirements and information regarding victims' rights. We would also be able to provide assistance to those individuals who are unable to apply for assistance independently. c) Does your agency regularly conduct/receive Victim Compensation training for direct services staff and volunteers? Yes, we require that our Volunteer Ombudsmen attend this training as a fulfillment for their continuing education. If"yes," what was the date of the last training and who provided it? Our agency receives Victim Compensation training for direct services staff and volunteers on a regular basis. The last training was provided by Karol Patch from the District Attorney's office on July 12th, 2007. Future training sessions will be provided by Karol Patch. In addition, The Ombudsman Program participated in the Victim Awareness Luncheon on April 20th, 2007 and plans to attend the luncheon in 2008. VALE USE ONLY Reviewed Victim Compensation Coordinator Comments: 9 • • SECTION F - VICTIM RIGHTS ACT: 19. Has your agency taken steps to assure that all staff and volunteers have read and understand the GUIDELINES FOR ASSURING THE RIGHTS OF VICTIMS OF AND WITNESSES TO CRIMES: Rights afforded to crime victims — C.R.S. 24-4.1-302.5 CRS; Procedures for assuring rights of victims of crimes - C.R.S. 24-4.1-303; and Child victim or witness - rights and services - C.R.S. 24-4.1-304? Yes If"yes", a) Does your agency have a statutory mandate to notify victims about their rights under VRA? No b) Briefly describe how your agency assures that all staff and volunteers are trained on VRA. The Weld County Ombudsman Program requires that each volunteer attend the training provided by the Karol Patch and the Victim Witness Program. If a volunteer is activated when a training opportunity is not available, the Assistant Ombudsman educates the volunteer(s) using information from the training that we have attended. c) Provide the date of your last VRA training and who provided that training. July 12th, 2007. d) How does your agency notify victims of their rights under VRA? When appropriate, the Area Agency on Aging notifies victims of their rights under VRA by referring individuals to the District Attorney's Office Victim Assistance Program. As mentioned above, the Area Agency on Aging referred the victim of the sexual assault case and her family to the District Attorney's Office. The Ombudsman Program also educates residents, families, and facility staff on residents' rights and provides them with resources. e) Does your agency have a brochure describing VRA? If"yes", list the languages in which your brochure is available. See SECTION I. ATTACHMENTS Yes We distribute Ombudsman brochures that include information about Residents' Rights. The brochures are provided in both English and Spanish. f) If your agency does not have a brochure describing VRA, please indicate if your agency utilizes brochures from other agencies. See SECTION I ATTACHMENTS When appropriate, we distribute brochures provided by the District Attorney's Office. VALE USE ONLY 10 • SECTION G - EVALUATION: How will you evaluate the effectiveness of this project? To evaluate the effectiveness of the CARIE program, the Assistant Ombudsman will continue to collect data from evaluations that are distributed at the end of each training session. This data continues to be utilized to determine if the goals and objectives of the program are being met. This information will also be used to enhance and modify the program as needed. The success of the Ombudsman Volunteer Program will be measured by monitoring the number of additional visits, educational sessions and volunteer satisfaction surveys will be evaluated. In addition to previous years, the results of this year's evaluations highlight how valuable the CARIE training is for staff working in long term care facilities. The Ombudsman Program maintains files that generate monthly, quarterly, and annual reports. Data is kept on numbers of visits, complaints, referrals and technical assistance contacts. Data is broken down further to reflect types of interventions,types of complaints,types of facilities,and actions taken.This data is analyzed by the state Ombudsman office to assist in determining the efficiency of the program. In addition, the Ombudsman Program has developed and utilizes a client satisfaction survey. It is anticipated that these questions will assist with measuring the quality of Ombudsman services provided to residents, families and community individuals. Overall, the 2006-07 survey response was positive. At the conclusion of the current grant period, the Ombudsman Program will have provided CARIE training for CNA staff representing all nursing homes and the majority of Assisted Living Residences in Weld County. 20. If this is an application for continuing funding, how successful has this project been in the past in accomplishing its proposed goals and objectives? We have been very successful in accomplishing past goals. 21. What is the projected cost per client served (cost/benefit ratio)? Cost Savings: When an advocate visits a long term care facility and discovers issues that affect the direct health of a resident, the advocate can facilitate and coordinate care with the facility to enhance the resident's plan of care to help reduce the problem from escalating. There are considerable medical savings to the taxpayer(most nursing home residents are on Medicaid) when extreme medical procedures can be avoided. When long term care patients are restrained, not only is it a violation of individual rights, but an opportunity is missed to administer therapies, which can help the patient become more independent. The ombudsman, again, can identify these situations and work with the staff to develop alternate interventions which will respect individual rights and give the patient care that may increase his/her potential to be independent. Dependence costs society. Elder abuse education is invaluable to reduce incidences that occur. When a resident is exposed to an abusive situation the experience can cause not only physical, but also emotional,psychological, and social damage. The resources used to investigate and monitor these incidences are costly and limited, the Ombudsmen become a valuable resource to assist and prevent abuse in long term care facilities. Repercussions from abuse result in expensive and time consuming therapies and utilize valuable resources allocated for the community. The abuse education provided by the funds from this grant help to raise awareness and allow intervention before abuse situations occur. Cost/ benefit ratio: Due to the complexity and uniqueness of the program, the current cost benefit ratio is difficult to determine as we provide a combination of training, technical assistance and direct service to an unlimited number of residents and family members. However, we do know that early intervention by the Ombudsman can prevent costly medical costs that may have resulted due to poor quality of care. SECTION H - BUDGETARY INFORMATION: 22. All Budget pages MUST be completed. 11 VALE Grant Application Signature Page Applicant Agency: WELD COUNTY AREA AGENCY ON AGING Street Address: 1551 North 17th Avenue Mailing Address(if different): Post Office Box 1805 Phone: (970) 353-3800 ext 3324 Fax: (970) 304-6442 Email: rmaldonado(dco.weid.co.us Project Title: Weld County Long Term Care Ombudsman Advocate/Friendly Visitor Grant Period: July 1, 2008 to June 30, 2009 The following signatories,understand and agree that any grant received as a result of this application shall incorporate and be subject to the statements made within the above described VALE Grant Application(The Application). Furthermore,the signatories certify that they have each read The Application and are fully cognizant of their duties and responsibilities for this project. (Original signatures of each party to this application(i.e.,Project Director,Financial Officer and Authorized Official) are required. Please use BLUE INK to distinguish the original documents from copies). Project Director: Name: Eva Jewell Position/Title: Weld County Area Agency on Aging Director Agency(including Division or Unit): Weld County Area Agency on Aging, Division of Human Services Mailing Address: 1551 North 17th Avenue, Post Office Box 1805 Greeley, CO 80632 Phone: (970) 353- -3800 ext 3.331 Fax: (970) 304-6442 E-Mail: ejewell(i6co.weld.co.us Signatuyt lc t )(`1,-) ukl-eg, Date: 2 g v.;f Financial Officer: Name: Dennis Bogott Position/Title: Financial Officer Agency(including Division or Unit): Division of Human Services Mailing Address: 1551 North 17th Avenue,Post Office Box 1805 Greeley, CO 80632 Phone: (970) 353-3800 ext 3350 Fax: (970)304-6442 E-Mail: dbogott(dgco.weld.co.us nn i Signature: ,2., t4 1/ •:i° Date: fl/i Authorized Official Name: William H. Jerke Position/Title: Chair Agency(including Division or Unit): Weld County Board of Commissioners Mailing Address: 915 10th Street, Greeley, CO 80631 Post Office Box 758, Greeley, CO 80632 Phone: (970) 356-4000 ext 4208 Fax: (970) 352-0242 E-Mail: bjerke(aco.weld.co.us Signature: 72,—[ / A ‘,„--Li Date: FEB 1 3 2008 In accordance with the Colorado Revised Statutes 24-72-202.6,information supplied in this application is considered a public record. Hello