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Home My WebLink About20082650.tiff RESOLUTION RE: APPROVE GRANT APPLICATION FOR HB08-1391 PILOT PROGRAM 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 Grant Application for the HB08-1391 Pilot Program from 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, to the Colorado Department of Human Services,with 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 Grant Application for HB08-1391 Pilot Program from 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, to the Colorado Department of Human Services be, and hereby is, approved. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 1st day of October, A.D., 2008. BOARD OF COUNTY COMMISSIONERS ' T WELD COUNTY, COLORADO ATTEST: f lD 1861 lliam H. Jerke, Chair Wel ounty Clerk to the rex � XCUSED HeA 1 14 Robert /M s Pro-Tem BY:� �4 �7 ( De uthe Board �' Willia Garcia O DAS • David E. Long ount orney 6 4/— Douglas ademacher Date of signature: IC 2008-2650 HR0079 CO 145 I0-/0 -65 a ;its.:, DEPARTMENT OF SOCIAL SERVICES P.O. BOX A GREELEY, CO. 80632 Website:www.co.weld.co.us Administration and Public Assistance(970)352-1551 ill III li Fax Number(970)353-5215 C COLORADO MEMORANDUM TO: William H. Jerke, Chair Date: October 1, 2008 Board of County Commissioners FR: Judy A. Griego, Director, Human Services ,_., RE: Grant Application under HB08-1391 Pilot Program Enclosed for Board approval is a grant application under HB08-1391 Pilot Program. HB08-1391 creates a pilot program to provide mental health services for children who have been involved in a substantiated case of child abuse or neglect. It also funds mental health services to siblings of the abused or neglected child. The grant application is a request by the three partners, which includes the Department, North Range Behavioral Health, and Child Advocacy and Education(c.a.r.e.),to participate as one of the three statewide projects permitted under HB08-1391. In addition to increasing the mental health services capacity of North Range Behavioral Health and other providers,the focus of Weld County's grant application will be on the development of a common assessment tool to include additional mental assessments for siblings and family decision making processes to positively impact outcomes of families. If selected, the Department will be the fiscal agent for the project for a period SFY2009 through 2012. The overall project budget for four years (SFY09 through SFY2012) is: $3,853,220. The funding source for this project is State General Fund. 2008-2650 State of Colorado — Department of Human Services Request for Application HB-08-1391 COr Y County/Region Name(s): - Weld County County/Region Classification: - Urban County/Region Pilot Site Lead Contact Information: Weld County Department of Human Services 315 N. 11th Avenue Greeley, Colorado, 80631 Executive Director: Judy Griego North Range Behavioral Health 1300 N. 17th Avenue Greeley, Colorado, 80631 Executive Director: Wayne Maxwell Child Advocacy and Education 3700 Golden Street Evans,Colorado 80620 Acting Interim Director: Marianne Dinges Table of Contents Cover Page Pilot Abstract 1 Checklist 2 Pilot Site Narrative(Exhibit A) 3 • Description of Pilot Site Classification and Demographics 3 • Description of Pilot Site eligible populations 3 • Description of County/Region demographics 5 • Description of family advocacy provided in DHS and community 5 • Description of Pilot Site Community (Stakeholders) Advisory Council 9 • Description of Advisory Council provision for documented input for shaping public policy, programming, and practices 10 • Description of Advisory Council networking of services for families in the community 10 Pilot Site Parent, Caregiver, and Youth Involvements 10 • Description of parents/caregivers/youth involvement in developing service plans 10 • Description of parents/caregivers/youth involvement in becoming their own best advocate 11 • Description of parents/caregivers/youth parents opportunities to be a full partner 12 • Description of parents/caregivers/youth participation in designing programs and policies 12 Description of Pilot Site Family Advocacy Involvements 12 • Description of Family Advocacy involvement as a full partners 12 • Description of Family Advocacy involvement in the lives of families being served 13 • Description of Family Advocacy participation in shaping public policy, programming, and practices 13 Description of Pilot Site Cultural Diversity and Competencies 13 • Description of cultural diversity challenges, including language barriers 13 • Description of project plans to respond to those challenges 14 • Description of project plan to reduce/ disparities associated with race/ethnicity gender, or age in the outcomes of Safety, Permanency, and Child and Family Well-Being 14 Attachments— Exhibit B—Strength Assessment Exhibit C—Needs Assessment Exhibit D—Resources Commitments Assessment Exhibit E - Pilot Site Community Advisory Council Exhibit F Pilot Site Budget Narrative and Projections; 2008-2009 Exhibit G Pilot Site Budget Projections; 2009-2010 Exhibit H Pilot Site Budget Projections; 2010-2011 Exhibit I Pilot Site Budget Projections; 2011-2012 Appendices Appendix A- Pilot Site Baseline Data-Eligible Service Populations (Open Cases of Substantiated Abuse or Neglect; ages 4-10 years, and siblings); Current and projected eligible children,youth, siblings, parents, and caregivers per year of the Pilot Program Appendix B - Pilot Site Baseline Data-Child Welfare Outcomes; Current safety, permanency, and well-being outcomes Appendix C -Pilot Site Baseline Data-Mental Health Outcomes; current information outcomes Appendix D -Commitment Letters Judy Griego (DHS) Wayne Maxwell (NRBH Marianne Dinges (c.a.r.e.) Pilot Abstract Weld County is a geographically and culturally diverse region with a primary agricultural character. Weld has significant rates of poverty and undocumented individuals and records reflect rising incidents of child abuse and neglect, particularly among Hispanics. Weld County child and family service agencies have a history of excellent collaboration resulting in innovative programs and recognized strategies. As a result of these collaborations and recent agency mergers, Weld is poised to consolidate service delivery practices and assessment protocol for substantiated cases of child abuse and neglect under the auspices of HB-08-1391. To more effectively serve our families The Weld County Department of Human Services, North Range Behavioral Health and Child Advocacy Resource and Education have strengthened our collaborative relationship and committed ourselves to enhancing family voice and choice. Our pilot project will: • Utilize the Child and Adolescent Needs and Strengths (CANS) for cross system assessment, service planning, tracking and outcome evaluation. • Expand the use of Family Team Decision Making as the venue for collaborative service planning. • Hire and train Family Facilitators to coordinate and guide the service planning process with families and involved service providers for greater consistency, quality of care and cost effectiveness. • Rearticulate and significantly enhance the role and voice of Family Advocacy in our system. • Train Family Facilitators, Family Advocates, Case Workers, Mental Health Therapists and others in the pilot model utilizing the CANS assessment and single family service plan within the context of FTDM meetings. • Leverage resources from all three agencies to improve and streamline our services through the identification and importation of evidence based and best practice intervention strategies. • Participate as a full partner in this program with the Colorado Department of Human Services as well as the winning HB-08-1391 RFP bidder(s). Weld County is enthusiastically requesting pilot funding from HB-08-1391 to institute these strategies and, in consultation with our CDHS and RFP partners, transform our current child welfare system into a more coordinated, family directed, effective, cost effective system of care. Page 1 of 15 X Completed Pilot Site Narrative(Exhibit A) X Completed Pilot Site Strengths Assessment(Exhibit B) X Completed Pilot Site Need Assessment(Exhibit C) X Completed Pilot'Site Resources Commitment Assessment(Exhibit D) X Completed Community Advisory Council (or equivalent) Roster(Exhibit E) X Completed Pilot Site Budget Projections; 2008-2009 (Exhibit F) X Completed Pilot Site Budget Projections; 2009-2010 (Exhibit G) X Completed Pilot Site Budget Projections; 2010-2011 (Exhibit H) X Completed Pilot Site Budget Projections; 2011-2012 (Exhibit I) X One (1) original RFA Application (marked "ORIGINAL") X Seven (7) copies of the original RFA Application (marked "COPIES") X Pilot Site Baseline Data- Relevant General and Pilot Site-Specific; Include data sources/citations whenever citing data or relevant information (Included in Narrative) o Pilot Site Baseline Data-Eligible Service Populations (Open Cases of Substantiated Abuse or Neglect; ages 4-10 years, and siblings); Current and projected eligible children, youth, siblings, parents, and caregivers per year of the Pilot Program (Appendix A) o Pilot Site Baseline Data-Child Welfare Outcomes; Current safety, permanency, and well-being outcomes (Appendix B) o Pilot Site Baseline Data-Mental Health Outcomes; current information outcomes (Appendix C) ❑ Pilot Site Baseline Data-Education; Local Schools/School Districts (Included in Narrative) Page 2 of 15 Exhibit A Pilot Site Narrative • Describe Pilot Site Classification and Demographics Weld County with a population of 236,857 is a geographically and culturally diverse region that stretches from the Wyoming border to metropolitan Denver and includes communities that reflect both (2006 Census est.). Weld's population grew by 31%between 2000 and 2006. Greeley, with a population of 89,046 (2006 Census est.) is the county seat and the only area within Weld County that is classified as urban. Agriculture was responsible for early growth in Weld County and even as Denver's suburban population has spilled into southern Weld County and its western Larimer County borders have grown increasingly suburbanized, the county maintains an overarching agrarian character. This is driven by the vision of pioneers who believed that well engineered irrigation and water practices would feed agriculture well into the future and local feedlot/meatpacking industries, which employ many Weld County residents. In fact, Weld County ranks No.1 among the nation's counties in the production of cattle. (1997 Census of Agriculture) Partners in the submission of this grant proposal, Weld County Department of Human Services (DHS), North Range Behavioral Health (NRBH) and Child Advocacy Resource and Education (c.a.r.e.), all serve Weld County through central offices in Greeley and satellite offices in Ft. Lupton and Del Camino. Weld DHS, NRBH and c.a.r.e., a core service provider for DHS, are full partners in this application. Each agency will participate in their identified capacities to provide resources and staffing that will ensure the success of this venture. In addition the Weld partnership will seek a formal consultative relationship with the Colorado Federation for Families for Children's Mental Health to ensure that best practices in family advocacy are followed. It is significant to note that this collaboration is strengthened by recent mergers that solidified the service base in Weld County. The Weld County Department of Social Services (DSS) and Weld County Division of Human Services merged programs and resources on June 1, 2008, as the Weld County Department of Human Services. The merge integrated Social Services, Employment Services, Area Agency on Aging, and Regional/Migrant Head Start programs toward family centered services. The merger continued the efforts of the County to increase access, decentralized services throughout Weld County, and build stronger alliances with the communities, faith based partners, the courts and other interrelated county systems. NRBH and Island Grove Regional Treatment Center, (IGRTC) also merged programs and resources July 1, 2008, the first such programs in the state to implement integrated programming for co-occurring diagnoses. Both mergers ensure better quality program management, reduction in the amount of paperwork that follows or fails to follow clients throughout the system, and better access for families who are often involved in multiple service sectors. • Describe Pilot Site projected eligible populations to be served based on the County's data (i.e. historical, Trails, etc.) and projected population and potential service growth trends. Include information about race, ethnicity, and other cultural factors, including information about language(s) other than English that are spoken. The populations to be served through this funding request are children 4 to 10 years of age and their families, who have open cases of substantiated child abuse or neglect. The inclusion of Page 3 of 15 families in the service description multiplies the number of children and includes caregivers who will also benefit from the implementation of best practices. The possibilities that this proposal presents will have far reaching effects on intake, treatment, case management, information exchange, advocacy and evaluation for DHS clientele in Weld County. Weld County's population is 27.5% Hispanic as compared to 19.5% for the state, with Greeley counting higher at 29.5%. In addition, the population of children 5+ years of age in Weld County who live in a home where a language other than English is spoken is 20.3% compared to the state average of 15.1%. The population of Hispanic students enrolled in Greeley/Evans schools rose to 51% in 2006 and continues to increase. Weld County families living below the poverty level minor state averages (between 9 and 10%) but in the county seat of Greeley (where the Hispanic population is also higher), significantly more families are living below the poverty level; 16.9% compared to the state level of 10.2% (1999 Census). Both DHS and NRBH saw increases in requests for all services over the last four years. Following are highlights of the trends related to cases of child abuse and neglect that will be impacted by the requested funding: • There was an increase of 23% in the number of founded cases of child abuse/neglect of children aged 4-10, between 2005 and 2008 (Weld DHS, 2008) • 2008 data indicate that 56 % of these children were of Hispanic descent. (Weld DHS, 2008) • Hispanic children of all ages represent 53% of the current open cases of child abuse in Weld County. (Weld DHS, 2008) • A disproportionate number of Hispanic children, compared to the County demographics (27.5%Hispanic)were victims of child abuse or neglect. (Weld DHS, 2008) • Between January 2005 and June, 2007, NRBH saw a 13.2% increase in the number of children up to the age of 11 years who presented for treatment. (NRBH, 2008) • Significantly, children in the targeted 4-10 year old range who presented for treatment increased by 27%. (NRBH, 2008) • 36% of all children served by NRBH between 2006 and 2007 were of Hispanic descent. This represented a 5% increase in the number of Hispanic children who presented for treatment from January, 2006 to June 2007. During the same period, the number of all other children who presented for treatment (including those who did not identify by ethnicity) increased by 18%. Significantly, child abuse and neglect appears to be increasing among Hispanic children, while treatment is not keeping pace. (NRBH, 2008) County growth, changing demographics, poverty and language issues all contribute to a social context and economic base that is fertile ground for family problems that can manifest as child abuse and neglect. Projections based on current trends suggest that founded cases of child abuse and neglect will continue to increase by approximately 6%per year and that more than half of those cases will involve children of Hispanic descent. Finally, the disproportionate increase in the number of Hispanic children, 4-10 years of age, with substantiated cases of child abuse indicates a Page 4 of 15 strong need for culturally relevant assessment tools, culturally sensitive treatment approaches and family advocacy that incorporates both. • Describe County/Region demographics • The population of Weld County is 236,857 (2006 Census est.) • Weld County's population grew by 31%between 2000 and 2006. • Greeley, with a population of 89,046 (2006 Census est.) is the county seat • Weld County families living below the poverty level minor state levels (between 9 and 10%) • In the county seat of Greeley significantly more families are living below the poverty level - 16.9% to the state level of 10.2% (1999 Census). • Weld County's population includes 27.5% Hispanic compared to 19.5% for the state, with Greeley counting higher at 29.5%. • The population of children 5+ years of age in Weld County who live in a home where a language other than English is spoken is 20.3% compared to the state average of 15.1% (Census est., 2006). • The population of Hispanic school children attending Greeley/Evans schools grew to 51% in 2006 and continues to increase. • The population of Hispanic high school students in Weld County overall is 30%. A similar demographic was not found for elementary age students but it is presumed that the number is even greater given growth trends in Weld among Hispanics. (Census est. 2006) Greeley and Weld County have high rates of undocumented individuals that are difficult to count and include in demographic data descriptions. However, it is understood in the community that recent immigration raids at the Swift and Company Meatpacking Plant left many Hispanic families in Weld County struggling financially. The impact on local poverty levels will not likely be known until the current US Census is complete if ever, however local agencies report feeling the brunt in their budgets. A final situation that has also impacted the local culture is the recent academic watch status of the Greeley/Evans school district, the largest of 12 in Weld County. While the school district worked hard to make changes that have resulted in removal from academic watch this past spring 2008, that status while in effect, seems to have eroded consumer confidence, community relations and in the final analysis the local economy, none of which have fully recovered. • Describe how family advocacy is being provided in the County Department of Human/Social Services in conjunction with the local community mental health centers, or other organizations. Several Weld County programs currently provide family support and advocacy and many will be fortified through this proposal. In addition, significant events have occurred in Weld County over the past several years that portend readiness to move toward a more comprehensive family advocacy model. They are detailed as follows: • A Home-based Services model is one of the cornerstones of the c.a.r.e. program. Families are referred to c.a.r.e. through the courts or DHS. Parent Educators (family advocates) Page 5of15 provide in home advocacy, parenting skills and support throughout the family's involvement in the system. • DHS has provided in-home Parent Advocacy in cases of Dependency and Neglect for the past nine years. Three of the eight Parent Advocates provide therapeutic services for cases identified as requiring more intensive supervision. • The Multi-Disciplinary Youth Assessment Team (MYAT) was established by DHS in 2002. MYAT is a collaborative project that brings together professionals from mental health, substance abuse, faith-based organizations, school districts,juvenile justice and employment services to increase youth protective factors, reduce risk factors, and promote a safe community through treatment planning and short term interventions utilizing family strengths and existing resources. • The Interagency Oversight Group was formed in 2005. The IOG is comprised of the "Chiefs of Staff' of all of the major youth and family service agencies in Weld County. This group provides a collaborative approach to program management in order to avoid duplication of services, identify and evaluate best practices and provide the most appropriate level of care to Weld County children and families within existing consolidated resources. • In an effort to provide a more seamless system of care for children and families, Weld DHS and NRBH have been pursuing a goal of using a common assessment tool for children and families entering the system since late 2005. Extensive literature reviews and communication with professionals around the country led to The Child and Adolescent Needs and Strengths (CANS) instrument. Weld County hosted a training session in August of 2007 with Dr. John Lyons, the author of the system. Working with Dr. Lyons, a Weld County specific CANS was developed and the instrument has been used to evaluate children in residential placement. Dr. Lyons returned to Weld County in August, 2008 to help move the county forward integrating the use of the CANS throughout our system of care. • In 2006 the Weld County District Attorney's office, in collaboration with community partners, opened the Juvenile Assessment Center (JAC) to provide a single point of system entry for youth exhibiting signs of delinquency. At the same time the Weld County Juvenile Diversion program was reinstated to serve first time youth offenders charged with non-violent crimes. • The Weld County community and Faith Based organizations provide a variety of mentoring opportunities to families, parents and youth through volunteerism, small grants or direct funding. Examples include: • MYAT- Adult mentorship for youth is one intervention option that is offered through MYAT. • Mentor Moms—Two "Mentor Moms" are provided to the Model Family Court by DHS to support parents through treatment and the legal process. • Be A Man (BAM)—A partnership that was established in 2007 between the Weld DHS and Summit View Church which provides fathers/expectant fathers who are voluntarily referred with group support, activities, parenting and mentoring. • Windows to Weld—Room at the Inn and Faith Community Service Fund have established an adult to adult mentorship program that utilizes faith based volunteers to help adults who struggle with daily responsibilities to function more effectively. Page 6 of 15 • The Weld County Faith Based Initiative, initiated by DHS in 2007, is a community outreach effort among faith based and community networking organizations which provides education and links to resources for all members of the community. • Several School-Based Health Clinics were developed and initiated in collaboration with the Northern Colorado Health Alliance and other agencies in 2005. These clinics allow for the provision of basic medical and mental health treatment to low income students and their families at two schools in the Greeley/Evans school district. • NRBH provides school based behavioral health services to students in 12 schools throughout Weld County. • Weld County DHS received a five million dollar, five year grant from the U.S. Department of Health and Human Services in September, 2006 to develop the Building Healthy Marriages Program. DHS developed the project with its Partners- Weld County United Way and Family Mediation (Faith Based Organization). The University of Northern Colorado is evaluating this project. This comprehensive project provides marriage communication classes, coaching, mentoring, financial management, conflict resolution and marriage enrichment seminars to low income couples. The project relies on agencies such as NRBH, pastors, counselors and therapists throughout Weld County to provide for the enhancement and stability of services. The goal is to keep couples together which will lead to better outcomes for children and families. • The Truancy Diversion Program under the supervision of the 19`h Judicial District Attorney's Office was established in January 2007, to provide access to services, case management and support for court ordered and truant youth. • Two high intensity family treatment and support programs were added to the NRBH menu of services in 2006: • Multi-Systemic Therapy(MST) -Intensive home-based services for juveniles demonstrating multiple determinants of antisocial behavior related to delinquency • Functional Family Therapy (FFT)—Addresses family relational dysfunction in the treatment of conduct disorder, violent acting-out and substance abuse in adolescents • Weld County DHS, in 2007, initiated a therapeutic preschool in conjunction with Eaton Early Learning Center and Family Connects for children under the age of five years of age who were being expelled from child care centers/homes and foster care homes because of disruptive behaviors. The therapeutic preschool provides for an assessment, therapeutic services for children and onsite training options for foster care, parents, and foster care providers. • NRBH was awarded an Early Childhood Mental Health Grant in January, 2006. "The Incredible Years", an evidence based prevention curriculum that provides parent education in both English and Spanish was implemented through the grant. Referrals come from local health clinics, daycare centers, NRBH, DHS etc. Utilizing a portion of this funding, Family Connects, a program of the North Colorado Medical Center Foundation, supports the Therapeutic Pre-School Program. • The Today Offers Positive Skills (TOPS) Day Reporting program opened in spring 2008 to provide intensive supervision, monitoring, education and life skills for juvenile offenders and their families. "TOPS" is a partnership between NRBH, Juvenile Services Page 7 of 15 Planning Commission, DHS, Aims Community College, Youth Alternative Mentors and Friends, Weld County Health Department, c.a.r.e. and the JAC. • Weld Social Services and Weld DHS (Area Agency on Aging, Employment Services, and Regional/Migrant Head Start) merged on June 1, 2008, allowing for family centered services and greater collaboration among Weld County DHS, legal, faith based community, community organizations/agencies, and schools. • NRBH (mental health) and IGRTC (substance abuse treatment services) merged on July 1, 2008, allowing for more coordinated treatment of co-occurring substance abuse and mental health disorders. Concurrently, a new facility was opened that includes state of the art observation rooms which will be used for Family Team Decision Making (FTDM) meetings and therapeutic intervention training which will be strengthened through this pilot. • The Northeast Child Welfare Project (a collaboration of Weld and Larimer County)was awarded a 2.4 million dollar grant in October, 2007. The focus of the grant is to assist drug impacted(specifically methamphetamine exposed) children and increase their safety, permanency and well being. The specific intent of these funds is to help expedite the reunification of families impacted by substance abuse. • The 19th Judicial District was designated a Model Court site in December 2007 due to the work of the Weld County Child Welfare Collaborative. Under the auspices of the Model Court, new programs and practices were established including the establishment of the Division 7 Family Court with DHS funding. The aforementioned $2.4 million grant continues funding for the Family Treatment Court which expanded services to also include Division 9. • Lutheran Family Services, in conjunction with DHS is currently developing an assistance model for unaccompanied refugee minors (from Burma)who are expected to relocate to this area in the near future. • Greeley/Evans School District 6, the largest of 12 districts in Weld County was placed on Academic Watch by the Colorado Department of Education in 2006 for low CSAP scores, high expulsion rates and needed reforms for Exceptional Student Services (ESS). In the process of restoring accreditation (spring 2008), the school district reduced the level of mental health services provided within the district in lieu of state required academic measures. The expanded behavioral support inherent in this pilot may help to compensate for some reductions in behavior support especially in the context of Positive Behavior Support (PBS). Weld County School District 6 and other school districts throughout Weld County have adopted PBS, a school wide behavior support system that addresses levels of behavior with three tiered prevention/intervention. Within this system, third tier(red zone) interventions are essential for students on Individualized Education Plans (IEP) and others with more intensive behavioral support needs, (often system involved). The expansion of the CANS and the FTDM offer new coordination and collaboration opportunities that will be mutually beneficial. Weld County is poised to become a pilot site for mental health research, evaluation and service. This is strongly supported by the scope and variety of collaboration in cutting edge strategy which is already occurring. Family Advocacy will be enhanced and coordinated through this proposal. Extending the use of the CANS as a common assessment in lieu of other required assessment instruments will lead to common language, a single service plan utilized by both Page 8 of 15 agencies, improve case processing, reduce the amount of paperwork that follows a case through the system and transform the way cases of child abuse and neglect are treated in Weld County. Family Team Decision Making (FTDM) meetings, incorporating the full participation of the families, their advocates and the treating professionals, will provide the venue for plan development based on the CANS. Family Facilitators will guide the process and Family Advocates will support families. In the process Child Welfare objectives of safety, permanency and well being will be achieved in a more collaborative, cohesive, efficient manner. "The overarching goal of this funding request is to improve intervention for victims of child abuse and neglect and their families through the facilitated development of a single service plan using a common assessment(the CANS) in the context of FTDM meetings." • Describe Pilot Site Community (Stakeholders) Advisory Council (or equivalent) Involvement. Describe the structure of and processes used by your council or equivalent. The Interagency Oversight Group (IOG)will be the Advisory Group for this project. This group will provide broad oversight and direction to the administrative leadership of this pilot project. The IOG was formed in 2005 after the Colorado General Assembly concluded that it is in the best interests of the state to establish collaborative management of multi-agency services provided to children and families. The Weld County Department of Human Services and local organizations have been quick to embrace this approach. The local IOG is comprised of the executive directors or their designees from every major point of system entry for children and families in Weld County. The members of the IOG are the "decision makers" and as such can problem solve, bring resources to the table, develop models and change policy to meet the needs of the community, develop funding streams and incorporate state of the art strategy to provide quality care. • Describe how it provides documented input for shaping public policy, programming, and practices. Each organization that is part of the IOG entered into a memorandum of understanding (MOU). The MOU outlines monetary and in-kind contributions, provisions for data-sharing, membership responsibilities etc. Each representative to the IOG has voting member status. The IOG has a paid Director and an operating budget of$266,000 (combined fiscal and in-kind contributions of members). Meetings occur monthly or more often if necessary. Meeting minutes are collected and posted. There is an elected Chair, Vice-Chair, Treasurer and Secretary that comprise an Executive Committee. The Executive Committee develops meeting agendas with input from members. Each representative is responsible for bringing the needs and input from their representation arena to the table to guide decision making. The existence of the IOG ensures every effort is made to articulate best practices in the delivery of services to youth and families. While the IOG will function in an advisory capacity to this pilot, direct administrative leadership will be provided by the Social Services Administrator and the Social Services Manager III from DHS, the Director of Child and Family Services from NRBH and the director of c.a.r.e. The IOG functions in a similar capacity with other regional grants such as the Colorado Prevention Partnership (CPP). Page 9of15 • Describe how your council creates or enhances the network of services for families in your community. The IOG has identified a 1451 Collaborative Management Process to reduce duplication and fragmentation of services, increase the quality, appropriateness and effectiveness of services and encourage cost-sharing among service providers. In addition, the JOG created a procedure to allow any realized savings from the implementation and continuation of the 1451 Collaborative Management Process to be reinvested back into the 1451 program and to use such savings to build on the principals of the 1451 process. Individualized agency savings can be kept and used by agencies to reinvest in support staff participation and in-kind contributions. The reinvestment of any earned incentive dollars are used first for the development and continuation of integrated staffing, and secondly to promote program development for meeting gaps in service as identified through needs assessment and planning. Earned incentive monies are housed at DHS and budgeted with priority for: • One time expenses • Consultation and training • Start-up expenses for programs which demonstrate solid ongoing operational funding • Programs, services or infrastructure that impacts one or more of 1451 target populations • Involve collaborative ventures • Lead to a reduction in dependency on services • Increase process or cross system efficiencies • Lead to a reduction in costs of providing service, especially those outside of Weld County for comparable services • Priority given to programs that meet the criteria of being Evidenced-based, Best Practices, or Promoting Practice programs • Final decision on the reinvestment of monies saved, incentive monies, or any new grants/funding is made by member consensus 3. Describe Pilot Site Parent, Caregiver, and Youth Involvements • Describe how parents/caregivers/youth are involved in developing their own service plans. Currently every effort is made, as reported and monitored by the CFSR, for DHS Caseworkers to develop case plans in conjunction with all involved parties including parents or caregivers, children as age appropriate and agencies involved in the treatment or supervision of involved parties. This effort is advocated and viewed as a necessary part of a successful treatment practice. Similarly, families are fully involved in individual and family treatment planning at NRBH and under the auspices of the specialized programs described in a previous section of this proposal (MST and FFT). Use of the FTDM, a nationally identified best practice, will be strengthened with this funding. Also, training in the use of the common assessment (CANS) will facilitate shared professional communication, the development of one service plan per family for multiple agencies and greater family/youth involvement. Weld County DHS may purchase ancillary services from other community providers to support this project. Page 10 of 15 • Four Masters Level Family Facilitators will be hired with this funding to facilitate the FTDM process and coordinate treatment planning, monitoring and evaluation. • Paraprofessional Family Advocates from c.a.r.e, will participate in FTDM meetings to articulate the needs of the family and identify areas where support can be given. Funding will be used to shore up existing FTE for this purpose and provide supervision and training which will improve Advocate functioning and participation. • Funding will be used to provide training in the use of the CANS and the structure of the FTDM process for all Case Workers, Mental Health Therapists, Family Facilitators, Family Advocates and other related professionals,paraprofessionals and volunteer advocates involved in cases of child abuse and neglect. Previously, the assessments used by the DHS, NRBH, probation, the courts and other agencies have involved client self report, observation and informational interviews, resulting in more subjective interpretations of data. This process has the inherent potential for case plans to contain oppositional elements which confuses families, frustrates professional colleagues and complicates the process. Implementation of the CANS, which possess reliability and validity scores that are highly rated by the California Clearinghouse for Evidence-Based Practices, has proven relevance to families in the Child Welfare System. The CANS will streamline the assessment and treatment planning process and, most importantly, improve quality of care. Review of current literature indicates that an essential ingredient in the matrix of factors required to achieve best practices is a sound, evidenced-based decision support system that ensures fair and replicable assignment of children to the appropriate level of care. This is achieved only if there is a method to consistently guide decisions that match clients' needs with the level of care to be recommended. (Community Mental Health Journal, American Journal of Psychiatry, Harvard Review of Psychiatry and the Journal of Mental Health Administration). The CANS contains scales that measure functioning in a variety of domains including: social, recreational, developmental, medical, school behavior, child and caregiver strengths, risks and acculturation. The CANS assessment is easy to use, well liked by parents and yields information that leads to coordinated case plans and outcomes with clear evaluation protocol. Finally the CANS is proven to reduce treatment costs by pinpointing treatment focus accurately. In Illinois, the use of a simple decision model for residential treatment resulted in savings of approximately $80 million per year in residential treatment in the late 1990's. h Philadelphia, the use of the decision model for Treatment Foster Care reduced lengths of stay dramatically and saved the city$11 million in the first year of use. This highly researched and vetted assessment and treatment planning instrument is currently used in over 25 states in the U.S. and provides a valuable tool for families and case workers to view the larger picture as opposed to communicating from separate silos. • Describe how parents/caregivers/youth are involved in becoming their own best advocate. NRBH affords opportunities for clients to participate in Consumer Forums to express their concerns and opinions. In addition a Parent/Family Advocate was recently hired by NRBH to respond to and track grievances, educate Medicaid consumers, and provide outreach and technical assistance to human service agencies and rural areas. Page 11 of 15 • DHS provides clients with the opportunity to participate on a Utilization Review Team. The Utilization Review Team is comprised of program and community members such as NRBH, Weld County Juvenile Probation, the Weld County District Attorney's Office and Juvenile Diversion, school district personnel as well as former clients, who review placement cases to provide oversight and quality control. The mission of c.a.r.e. is to "strengthen and preserve families while protecting children from abuse or neglect". In this capacity, c.a.r.e. teaches parents skills to advocate for themselves and their children and the opportunity to learn better parenting skills. This organization serves over 16,500 clients a year, including parents, teens and young children. While families served at all three agencies are currently involved in treatment planning to the extent that they provide information, opinions and cooperation during their intake and follow up meetings, the adoption of the CANS and formal implementation of FTDM will provide families a greater opportunity to have a direct voice in their treatment plans. Family Facilitators and Family Advocates will model and teach a strength based approach to help families navigate the system, increase their advocacy skills and form appropriate social, emotional and professional relationships. The collaboration of families and professionals in the FTDM meeting facilitates more creative problem solving which will lead to increased family ownership and investment. The intended outcome of the FTDM is for parents to become better advocates by virtue of the modeling and teaching that is inherent in the design which fosters discussion and negotiation. • Describe how parents/caregivers/youth parents are provided opportunities to be a full partner. Everyone who participates in the FTDM process is a full and equal partner with the same information (the results of the CANS) to inform decision making. Family Advocates, by definition, reduce resistance by building relationships with the family that foster comfortable expression of needs and goals. The role of the Family Advocate includes ensuring the families participate as full and equal partners, providing support and intervening if equal participation of all parties is not occurring. • Describe how parents/caregivers/youth participate in designing programs and policies. This proposal outlines a new vision for the assessment and treatment of child abuse and neglect through the CANS and the FTDM. The inclusion of all involved parties in the assessment and treatment planning process provides a venue for the development of a cutting edge approach which shapes how new programs and policies will evolve with the full participation of impacted families. Describe Pilot Site Family Advocacy Involvements • Describe how Family Advocacy is involved as a full partner. It is envisioned that, in the context of this plan, family advocacy will be facilitated and enhanced on several levels. Paraprofessional Family Advocates, as currently defined by c.a.r.e., will continue to be important role models, support systems and liaisons between families and the systems they navigate. Grass roots models such as "Mentor Moms" that were piloted in the award Page 12 of 15 winning Weld Model Family Court will be expanded to from a corps of individuals to a support network. Our community plans utilize these grant dollars to expand our ongoing efforts to recruit, train and develop a cadre of former service recipients to mentor and advocate for those currently receiving services in our system. • Describe how Family Advocacy is involved in the lives of families being served. Family Advocacy that is evolved to the level described in the previous section can be a call in the middle of the night to a peer mentor from an active addicted person who is trying to regain custody of her children, but is tempted to use. Family Advocacy as defined by this pilot is the paraprofessional who helps a paroled father to hone his job interview skills and acquire appropriate clothing for an upcoming interview. Family Advocacy is also the skill of a Family Facilitator who unpacks the information in the CANS and facilitates a plan that is agreed to be all involved parties, based on best practices and fully inclusive of all participants. • Describe how Family Advocacy is involved in shaping public policy, programming, and practices. Family Advocacy as it is articulated within this proposal has the potential to be a springboard that shapes public policy, future programs and best practices. As one of three pilots chosen to implement new and innovative assessments and protocol, Weld County partners are committed to participation in a statewide best practice laboratory for the processing of child abuse and neglect cases. Weld County is, and will continue to be, inclusive and efficient, and pledges to provide all relevant data from the project. Weld County partnership representatives will attend trainings and forums that detail successes and challenges and remain open to guidance from the RFP contractors. Additionally, it is our plan to develop a formal consulting relationship with the Colorado Federation for Families for Children's Mental Health to improve our capacity in this area. 5. Describe Pilot Site Cultural Diversity and Competencies • Describe the cultural diversity challenges, including language barriers, for your project. Weld currently faces a variety of barriers and challenges with respect to cultural diversity issues within the region. • The lack of bilingual case managers and treatment providers in Weld County for DHS and NRBH clients is ongoing. • Poverty(the lack of the ability for families to prioritize and pay for needed services) is a pervasive problem for many of the families served in the partner programs. Weld County families living below the poverty level minor state levels (between 9 and 10%). In the county seat of Greeley significantly more families are living below the poverty level - 16.9% to the state level of 10.2% (1999 Census). • Weld County's population grew by 31% between 2000 and 2006. • Weld County's population includes 27.5% Hispanic compared to 19.5% for the state, with Greeley counting higher at 29.5%. Page 13 of 15 • The population of children 5+ years of age in Weld County who live in a home where a language other than English is spoken is 20.3% compared to the state average of 15.1% (Census est., 2006). • The population of Hispanic school children attending Greeley/Evans schools grew to 51% in 2006 and continues to increase. The population of Hispanic high school students in Weld County overall is 30%. A similar demographic was not found for elementary age students but it is presumed that the number is even greater given growth trends in Weld among Hispanics. (Census est. 2006) • Describe how your project plans to respond to those challenges. • One of NRBH goals over the past three years has been the integration of Spanish speaking mental health therapists throughout the organization. Currently NRBH employs 27 professional level bilingual staff. • NRBH developed a Latino Professional Development project in conjunction with the University of Northern Colorado in Greeley and Colorado State University in Ft. Collins. BA recipients are eligible for tuition stipends to complete graduate counseling work if they commit to the provision of two years therapeutic service to NRBH following completion of their MA degree. Professionals from among these ranks will be recruited for Family Facilitator roles. • NRBH has initiated comprehensive cultural competency training that is required of all new hires. • DHS currently employs 6 bilingual caseworkers and employs numerous bilingual staff members who provide accurate translation. • DHS incorporates monthly cultural competency training into required professional development for all staff. Cultural competency is considered to be core training required for all staff. • DHS actively recruits and trains bilingual/bicultural families for foster care. • Both DHS and NRBH adhere to the standards of Indian Child Welfare Act (ICWA) with respect to their work with Native American children. • Describe how the project will reduce any disparities associated with race/ethnicity gender, or age in the outcomes of Safety, Permanency, and Child and Family Well- Being. This will be achieved primarily through the use of the CANS and the FTDM meeting structure. The CANS is an exceptional multi-purpose tool developed for children's services to support decision making, including level of care and service planning, to facilitate quality improvement initiatives, and to allow for the monitoring of outcomes of services. As previously stated, the CANS is widely used and has demonstrated cultural competency. The CANS was developed from a communication perspective to facilitate the linkage between the assessment process and the development of individualized service plans which include the application of evidence-based practices. Each CANS item suggests different pathways for service planning. Within the context of a facilitated FTDM meeting, all participants have equal access to the information in the CANS format and can use the information to express cultural needs or Page 14 of 15 preferences. The CANS assessment and the unified family service plan developed in the FTDM strive to increase the safety, permanency and child and family well being by including all participants' perspectives. The CANS demonstrated reliability and validity and widespread use within the Child Welfare System speaks to its success in addressing these topics. The CANS is auditable and audit reliabilities demonstrate that it is reliable at the item level. Validity is demonstrated with the CANS relationship to successful level of care decisions and other similar measures of symptoms, risk behaviors, and functioning. The CANS is an open domain tool that is free for anyone to use. There is a community of people who use the various versions of the CANS and share experiences and additional items and supplementary tools adding to its value in a pilot program where monitoring and adjustment of best practice is ongoing. Training in the use of the CANS and FTDM meeting structure will be provided in conjunction with Cultural Competency Training for all participants in the Weld Child Welfare and Behavioral Health Systems as a primary objective of the pilot program. Note: Each county or region partner SHALL sign the application to ensure concurrence with the application content, accuracy,and resources commitments. N_ItA Cill ,Thc (71pi/ Signature of Desigted Fiscal Agent Representative Date ‘.1 U tip 97 g Signature of Community Advisory Cot cc Chair(or Equibal t) Date V/ llk orr3 7:5,0„ Signatur8/o Director,County Depp,tment of iocial/Human Services Date VV t-e /- '71 9/o/o r Signature of Director,Community Mental Health Center Date Q//OF. 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O F C y Q J < j 0 3 a • O .E * C co (0 �- C U "O a to a+ a 'a L 'o .- .aOll m f a) * , m Da O 4, E * .E < < u i APPENDIX D DEPARTMENT OF HUMAN SERVICES P.O. BOX A GREELEY, CO. 80632 Website: www.co.weld.co.us Administration and Public Assistance(970)352-1551 ip O Child Support(970)352-6933 • COLORADO September 30, 2008 House Bill 1391 RFA Review Committee: The Weld County Department of Human Services is participating as a full partner in this request for funds to implement a HB 08-1391 pilot. As a full partner, the Weld County Department of Human Services is committed to complementing, wherever possible and as appropriate, its core services funding with pilot site funding to improve, expand and enhance our continuum of services to articulate an improved approach to services for abused and neglected children in Weld County. In addition, the Weld County Department of Human Services will donate the necessary in-kind resources such as staffing, pilot facilitation, meeting space, transportation costs, copying, equipment use and other items that will enable the project to be successful and as designed in the Weld County application. The Weld County Department of Human Services will act as the fiscal agent for the requested funding with the full decision making collaboration of each of the three partner agencies. The Weld County Interagency Oversight Group will act as an advisory group and provide broad direction, support and collaboration at the county level. Executive leadership from the Weld County Department of Human Services,North Range Behavioral Health, and c.a.r.e. will meet at least monthly to direct activities and articulate pilot development. Expenditure of pilot funds will be a shared decision making function of the executive leadership and will be based on the budget designed in the Weld County application. The executive leadership partners will also give full cooperation to the state and Pilot Program Contractor partnership in the collection of data and best practices research. The Weld County Department of Human Services enthusiastically supports this RFA and looks forward to pilot site designation and the resultant improvement in local service delivery. Sincerely, Jtrd A. Gigo, Di�_r��}}LL"tor V W, d Count ty,Department of Human Services North Range Behavioral Health September 30, 2008 To: House Bill 1391 Review Committee, North Range Behavioral Health is excited to participate as a full partner in this application to implement the HB 08-139lpilot program in Weld County. We are committed to full partnership with the Weld County Department of Human Services in this important effort to provide effective assessment and intervention for abused and neglected children. North Range Behavioral Health provides high quality evidence based services to improve the safety, permanency and well-being of the most vulnerable citizens of Weld County, abused and neglected children. To support this effort we will provide significant funding and in kind resources. Examples include staffing, meeting space, transportation costs, copying, equipment use and other items which are identified in our proposal. As North Range Behavioral Health and the Weld County Department of Human Services reviewed this exciting opportunity and discussed the potential community changes program would support we arrived at the following vision for resource commitments: • North Range Behavioral Health is committed to accessing Medicaid and CHP + funding, when applicable, to provide behavioral health services to these children and their families. Additionally, we will allocate federal block grant and state general funds dollars to support this pilot program. This detail is reflected in the RFA narrative as well as Exhibits B and D. • Weld County Department of Human Service is committed to integrating core services funding with pilot site funding to improve, expand and enhance our continuum of services to articulate an improved approach to services for abused and neglected children in Weld County. • Child Advocacy Resource and Education (c.a.r.e.) is committed to expanding agency funded Parent Advocate roles to more fully embrace the vision of advocacy articulated in this proposal. This will lead to better outcomes for the children and families of Weld County. Isms S. 17th '„..„IC /(„„),_(1)80631 /(!rn)347'_IPO/REv(97U)34(t.U8Uu FIB 1391 Review Committee September 30, 2008 Page 2 The partners have decided that Weld County Department of Human Services will act as fiscal agent for this pilot program. Additionally, the Weld County Interagency Oversight Group will act as an Advisory group and provide broad direction, support and collaboration at the county level. Executive leadership from the Department of human Services, North Range Behavioral health and c.a.r.e. will meet at least monthly to direct activities and articulate pilot development. Expenditure of pilot funds will be a shared decision making function of the executive leadership. We also pledge full cooperation to the state and Pilot Program Evaluation Contractor in the collection of data and best practices research. I enthusiastically support this application and look forward to participating in this important pilot project which will lead to more integrated and effective services for the people of Weld County. Respectfully submitted, Wayne A. Maxwell, Ph.D. Executive Director . c • a • r • eo 0 0 0 )1(' (Child advocacy resource and education, Inc. c.a . r.e. September 30, 2008 3700 Golden Street Evans, CO 80620 House Bill 1391 RFA Review Committee: (970)356-6751 FAX(970)506-2726 Child Advocacy Resource and Education, Inc. (c.a.r.e.) is participating as contact@careweld.org a full partner in this request for funds to implement a HB 08-1391 pilot. wwwcareweld.org C.a.r.e. is committed to expanding agency funded Parent Advocate roles to more fully embrace the vision of advocacy articulated in this proposal Programs: in order to improve the approach to serving abused and neglected children Parent Education in Weld County. Children's Programs SafeTouch In addition c.a.r.e. will donate in kind resources such as bilingual administrative staffing, pilot facilitation, meeting space, office space, Supervised Visitation and Safe Exchanges copying, telephones, equipment use and other as identified. for Children The Weld County Department of Human Services will act as fiscal agent Home-Based Parent for the requested funding with the full decision making collaboration of Education each of the three managing agencies. The Weld County Interagency CommunityAwareness Oversight Group will act as an Advisory group and provide broad direction, support and collaboration at the county level. Executive leadership from DHS, NRBS, and c.a.r.e. will meet at least monthly to direct activities and articulate pilot development. Expenditure of pilot 7ffida%tx, funds will be a shared decision making function of the executive '7a adzeiiytlrea leadership. The executive leadership partners will also give full and cooperation to the state and Pilot Program Contractor partnership in the statue hotted collection of data and best practices research. a¢noteeel#9 Child Advocacy Resource and Education, Inc. enthusiastically supports e![Pdnea6wxa7uae this RFA and looks forward to pilot site designation and the resultant and Me9lect. improvement in local service delivery. Sincerely, • tS� Anonymous® Marianne Dinges, M.A. Interim Executive Director United y Way I qt. 'united Way of Weld County Hello