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Home My WebLink About20061610.tiff Weld County Department of Social Services Notification of Financial Assistance Award for Families,Youth and Children Commission(Core)Funds Type of Action Contract Award No. X Initial Award FY 06 06-CORE-0037 Revision (PY 06-07 RFP-FYC-006-00A; 06FPC09) Contract Award Period Name and Address of Contractor Beginning 06/01/2006 and Transitions Psychology Group, LLC Ending 05/31/2007 Foster Parent Consultation 810 11 Avenue Greeley, CO 80631 Computation of Awards Description Unit of Service The issuance of the Notification of Financial Program incorporates the elements of Assistance Award is based upon your Request for assessment, solution-focused consultation and Proposal (RFP). The RFP specifies the scope of group education and support. Foster parent are services and conditions of award. Except where it is directly served through support groups, in conflict with this NOFAA in which case the individual foster parent consultation, and NOFAA governs, the RFP upon which this award is mandated training under corrective action plans. based is an integral part of the action. Services to Weld County foster parents. Foster parent consultations will be provided through Special conditions groups,monthly capacity per group is 10 members or a total of 50 participants monthly. 1) Reimbursement for the Unit of Services will be based Group participation is limited to one group on a per participant rate. session per foster parent per month. Individual 2) Payment will only be remitted on currently certified consultation services will only be provided when WCDSS foster parents, and referrals made by the approved by the Resource Services Manager or Weld County Department of Social Services. Child Welfare Administrator of Social Services. 3) Requests for payment must be an original submitted to Bilingual and South County services are the Weld County Department of Social Services by available. the end of the 25th calendar day following the end of Cost Per Unit of Service the month of service. The provider must submit Per individual foster parent responses for payment on forms approved by Weld Participant per episode County Department of Social Services. Treatment Package $58.33 4) Requests for payment must include original foster Other Services Per Hourly Rate $90.00 parent verification signatures (blue or red ink Enclosures: preferred) and dates and hours of service. X Signed RFP: Exhibit A 5) The Contractor will notify the Department of any _Supplemental Narrative to RFP: Exhibit B change in staff at the time of the change. _Recommendation(s) Conditions of ApprovalEL Approvals: � ` !� Program Official: a (By 1/,� , _ By M.J. Geil:, Chair v Judy . Grie ,Directo� Board of Weld County Commi•-tofiers • Weld/County Depaitunent of Social Services Date: JUN 14 2006 2006-1610 0 F PC' C\I INVITATION TO BID OFF SYSTEM BID 001-06(06005-06011 and 006-00,A, B,&C) DATE: March 1, 2006 BID NO: 006-00A RETURN BID TO: Pat Persichino, Director of General Services 915 10th Street, P.O. Box 758, Greeley, CO 80632 SUMMARY Request for Proposal (006-00A) for: Colorado Family Preservation Act—Foster Parent Consultation, Emergency Assistance Program Deadline: March 31, 2006, Friday, 10:00 a.m. The Families, Youth and Children Commission, an advisory commission to Weld County Social Services, announces that applications will be accepted for approved providers pursuant to the Board of Weld County Commissioners' authority under the Colorado Family Preservation Act(C.R.S. 26-5.5-101) and Emergency Assistance for Families with Children at Imminent Risk of Out-of-Home Placement Act (C.R.S. 26-5.3-101). The Families, Youth and Children Commission wishes to approve services targeted to run from June 1, 2006, through May 31, 2007, at specific rates for different types of service, the county will authorize approved providers and rates for services only. The Foster Parent Consultation Program must provide services that focus on providing psychological consultations and parenting support to foster parents which are designed to improve foster parent competency, family conflict management, and effectively access community resources. This program announcement consists of five parts, as follows: PART A...Administrative Information PART D...Bidder Response Format PART B...Background, Overview and Goals PART E...Bid Evaluation Process PART C...Statement of Work Delivery Date (After receipt of order) BID MUST BE SIGNED IN INK Savhi Moe -ft(Vfvna v� TYPED OR PRINTED SIGNATURE PROVIDER Trahsi17oh€ Psychology Grourt(Az (Name) Handwritten Signature By Authorized Officer or Agent of Provider ADDRESS 8IN [Irbpsve• TITLE "2- d1 lreLtVY One lei !-0 eob"; I DATE 03- 3a- D(o PHONE # (°(1'0) 33(p -112-3 The above bid is subject to Terms and Conditions as attached hereto and incorporated. ORIGINAL Page 1 of 39 } Bid Number 001-06(RFP-FYC COMMISSION 006-00A) Attached A FOSTER PARENT CONSULTATION PROGRAM BID PROPOSAL AND REQUEST FOR CONTINUATION OF AWARD UNDER FPP CORE SERVICES FUNDING COLORADO FAMILY PRESERVATION ACT 2006-2007 BID PROPOSAL APPLICATION PROGRAM FUNDS YEAR 2006-2007 BID 001-06 (006-00A) NAME OF AGENCY: TalS flOVl6 Ps+lrHnto amp, 1-1-6B ADDRESS: OA(' 1In' kve., &ree'le y1 log %D10 I PHONE: (%Tha ) 310' l l23 CONTACT PERSON: Talml Noe-l-tzlrtvyah i MA - TITLE: ao-director DESCRIPTION OF FAMILY PRESERVATION PROGRAM CATEGORY: The Foster Parent Consultation Program Category must provide services that focus on teaching life skills designed to facilitate implementation of the case plan by improving household management competency, parental competency, family conflict management and effectively accessing community resources. 12-Month approximate Project Dates: _ 12-month contract with actual time lines of: Start June 1, 2006 Start End Mav 31, 2007 End TITLE OF PROJECT: poc{er Pavevt-E Covcait tioVl JQmi Mae-NZIVtrnan, "A 71 War 63-3i-a(o Name and Signature of Person Preparing Document Date SaV1ti Moe-1-110- Avtl MA Name and Signature Chief Administrative O ficer Applicant Agency Date MANDATORY PROPOSAL REQUIREMENTS For both new bids and renewal bids, please initial to indicate that the following required sections are included in this Proposal for Bid. Project Description Target/Eligibility Populations Types of services Provided Measurable Outcomes Service Objectives Workload Standards Staff Qualifications Unit of Service Rate Computation illing Process rogram Capacity per Month Certificate of Insurance Assurance Statement Page 29 of 39 Poster Parent Consultation 2006-7 Transitions 1 Bid Number 001-06 (RFP-FYC 006-00A) •�� ♦ FOSTER PARENT CONSULTATION • 4,.:• ♦ . Individual and Group Consultation • •*• • • • Transitions Psychology Group, LLC •i.• ♦ � I �• .••�� , •• Transitions PSYCHOLOGY GROUP,LLC I. PROJECT DESCRIPTION Transitions Psychology Group, LLC (Transitions) is a private counseling agency consisting of a multidisciplinary team of human service professionals providing superior counseling, assessment services, and supportive services to children and families in Northern Colorado. The mission of the Foster Parent Consultation Program is to enhance the overall quality and safety of foster care for children in Weld County by supporting foster families. The purpose of the Foster Parent Consultation Program is to provide psychological consultations and parenting support in order to promote foster family retention, increase foster parent competencies, improve family conflict management, and improve access to appropriate community resources. The design of the Foster Parent Consultation program incorporates elements of assessment, solution-focused consultation and group education and support. The components are intended to encourage foster family retention through the experience of successful foster parenting. Transitions will promote the program to all foster families in Weld County. Transitions Foster Parent Consultation is based on the belief that foster families possess inherent strengths and that these strengths can be shared in foster parent networks in order to bolster parenting effectiveness and satisfaction in fostering children. Access to information and resources is a vital part of promoting behavioral change and increased effectiveness in parenting. Transitions Foster Parent Consultation strives to empower foster parents through reduction of isolation, viewing the foster parents as experts, mutual sharing of information on educational and community resources, encouraging positive parent-child interactions, and promoting continual self- motivated development of parenting competencies. Programs that provide social support have direct and indirect influences on the family from the personal health and sense of well-being of the foster parents, to family functioning to parent-child interaction, to child behavior and development. Transitions Foster Parent Consulting is geared towards creating a ripple effect of positive change within and among families. ORIGINAL Foster Parent Consultation 2006-7 Transitions 2 Bid Number 001-06 (RFP-FYC 006-00A) II. TARGET/ELIGIBILITY POPULATIONS Transitions Foster Parent Consultation serves foster families in Weld County. Foster parents are directly served through foster parent support groups, individual foster parent consultation, and mandated training for foster parents under corrective action plans. Finally the foster children are served indirectly through improved foster parent-child interaction, and subsequently improved behavior and personal development, and maintained placements. Transitions does not discriminate based on race, color, religion, national origin or sex, in accordance with State and Federal lawn, rules, and regulations. Transitions Foster Parent Consultation is equipped to handle up to five groups per month. Groups are open. The monthly capacity per group is 10 members per group or a total of 50 participants monthly. Transitions can accept up to five new referrals a month for individual foster parent consultation or mandated training, with a monthly maximum case load of ten referrals. Accounting for participants from the groups, individual consulting and mandated training, the program could have up to 110 participants. Of course, many of these participants could attend more than one group or consultation. We would expect to serve 150 individuals and approximately 50 families. Transitions provides services in South Weld County and would expect to serve approximately 20 individuals in South County. Transitions currently operates foster parent consultation groups in Windsor and Platteville in order to make services more accessible to foster families. Transitions provides culturally sensitive services and takes pride in offering bilingual services. Individual foster parent consultation and consultation groups are available in Spanish. Approximately 20 participants could receive bilingual services. III. TYPE OF SERVICES TO BE PROVIDED A. Consultation and Foster Parent Group Support Transitions will form up to five ongoing consultation groups for foster parents. Groups meet for two hours at Transitions' offices, in foster parent's homes or other community sites. Members will be encouraged to attend the same group monthly but will be allowed to attend more than one group per month, based on need and Department approval or recommendation. Members will also be allowed to attend other groups with advanced notice to Transitions, when they have scheduling conflicts. Transitions creates cohesiveness in each group, and at the same time, maintains enough flexibility to accommodate foster families' needs and busy schedules. `Foster Parent Consultation 2006-7 Transitions 3 Bid Number 001-06 (RFP-FYC 006-00A) The support group offers a unique opportunity for foster families to create a supportive network and to share useful information on community resources and parenting successes. Transitions uses Rebuilding Children's Lives foster parent training curriculum developed and researched by Girls Boys Town as applicable in groups. The curriculum includes themes such as creating a safe environment, foster parents as teachers, encouraging positive behaviors, responding to problem behaviors, communication, and motivational systems in the homes. The groups are solution-focused, intended to remain proactive and preventative in nature, and counselors will structure groups so as not to become complaint sessions or social hours. Transitions counselors are trained to be facilitate the group process, to consult, and to respect and encourage the participation and contribution of each member. Transitions will solicit ideas for group themes from the participants based on their specific needs so the group will remain relevant and helpful. B. Individual Foster Parent Consultation Transitions will accept referrals for foster parent consultation from the Weld County Social Services foster care caseworkers. Alternately, Transitions may identify foster parents in need if individual consultation when a situation of critical and urgent nature arises that cannot effectively be dealt with in the support group format. The criteria for the request to social services for individual consultation would include the risk of imminent removal or danger to a foster child. Transitions utilizes solution- focused models of parent consultation, the Rebuilding Children's Lives foster parent training curriculum developed by Girls and Boys Town and other applicable educational information and community resources. Goals or areas for change will be developed from the initial referral concern and the foster parent's concern together with the consultant's input. Progress towards goals will be tracked and measured utilizing solution-focused self- anchored scales. Transitions consultants maintain clear boundaries for the intervention so as not to confuse the consultation with therapy. Appropriate referrals for counseling or other necessary services will be made depending on professional assessment at the time of the intervention. The initial referral will consist of up to three hours of consultation, renewable for an additional three hours, with caseworker's and supervisor's approval. Consultations will be limited to six direct contact hours. C. Mandated Training for Foster Parents Transitions will receive referrals of mandated training of foster parents under corrective action plans and follow-up services. The goals on the `Foster Parent Consultation 2006-7 Transitions 4 Bid Number 001-06 (RFP-FYC 006-00A) action plan will be central to the intervention and will be incorporated on the Foster Parenting Assessment. Intervention in the mandated training for foster parents also follows a solution-focused model of parent consultation and incorporates Rebuilding Children's Lives foster parent training curriculum developed by Girls andBoys Town. Progress towards goals will be tracked and measured in this manner pre and post utilizing solution-focused self-anchored scaling to measure the parent's progress. Goals will incorporate both the families perspective of the issue and the initial referral concern. D. Assurances Transitions assures that foster parent group consultation will not be provided by a professional staff member who is providing therapeutic services to foster children in the same home. Transitions works in collaboration with case workers and other service providers serving the children involved. All assessments, clinical recommendations, and opinions derived in consultation will be directly shared with the case worker. Transitions strives to have all components of the system working in together and will attend any necessary case consultations with case workers, foster parents, and supervisors involved in the case. In accordance with 19-1-120 C.R.S., reports of child abuse and identifying information is held in strict confidentiality. IV. MEASURABLE OUTCOMES Transitions will use client self-anchored scales and single case designs for conducting out come evaluations for individual foster parent consultation and the mandated foster parent training. Progress towards stated goals will be tracked starting from the time of referral. Client goals will address the specific referral concern as indicated by the Department of Social Services. Solution- focused goals are stated in the client's own language and view of the problem. The solution-focused self-anchored scales allow the consultant to formulate solutions in collaboration with the participant, from the participant's view of the problem and tapping into the participant's resources. People are more accepting of help and have a greater sense of empowerment in this approach. This approach also fosters self-efficacy and less dependence on the "system" for solutions. The The self-anchored scales are essentially a single-case AB research design. In this design, foster parents will be asked to rate the issue on a 1-10 self-anchored scale at the time of referral. They will rate progress towards the solution at each subsequent consultation meeting. The results will be charted on a graph along with anecdotal data. Transitions will also conduct a 3-month follow-up to monitor maintenance of progress. The effectiveness of this method for conducting outcome evaluations for solution- `Foster Parent Consultation 2006-7 Transitions 5 Bid Number 001-06 (RFP-FYC 006-00A) focused interventions has been documented in the research [Franklin, C., et al. (1997) Using client self-anchored scales to measure outcome in solution- focused therapy. Journal of Systemic Therapies, v 16(3), pp. 246-265.] Retention of foster families as an important resource for Weld County will serve as a measurable outcome for the foster parent support groups. V. SERVICE OBJECTIVES The Transitions Foster Parent Consultation program uses a solution-focused approach to consultation. Consultation services will address the specific referral questions as indicated the Department of Social Services in the referral and in other communications with the referring caseworker. The brief, solution-focused assessment in individual consultation begins to shape participants' expectations for the program because content areas are directly covered. In foster parent support groups, if foster parents' concerns fall outside of the content areas or go beyond the content areas in severity, the foster parents would be screened from the consultation group and the appropriate referrals would be made. Program service objectives will address household management competencies and parental competencies. Each group will be unique, based on participants' stated goals and needs, but the group facilitator has the obligation to ensure to the best of his/her assessment that basic competencies, such as providing a safe environment, care, nutrition, hygiene, discipline, protection and supervision are met. Consultants and other group members will assist foster parents to access resources in the community and within local, state, and federal governments. The Transitions Foster Parenting Consulting program service objectives are geared towards improved outcomes in foster care as indicated in the Performance Improvement Plan. The intervention the program provides to foster families through assessment, support groups, and consultation contributes to retention of foster parents and more stable placements for children in foster care as well as improved quality of care provided by foster families. VI. WORKLOAD STANDARDS Transitions will have up to five groups per month. Transitions can accept up to five new consultation referrals per month with a total of ten open cases at any given time. There will be four professionals providing services on the program with a maximum caseload of facilitating four groups a month and having five open consultation cases. The program uses the following modalities of treatment: psycho-educational and support group, individual and Foster Parent Consultation 2006-7 Transitions 6 Bid Number 001-06 (RFP-FYC 006-00A) family psychological consultation. Transitions' professionals also perform case management, case consultation and staff meetings associated with the program. Total number of work hours per week would be up to 15. Transitions has four professionals available to provide services. Each individual carries professional liability insurance with coverage of at least $1,000,000 per occurrence and $3,000,000 aggregate. VII. STAFF QUALIFICATIONS All staff involved in the Foster Parent Consulting program have a minimum of a master's degree in a counseling related field; the primary service providers in this program area are PhD level. For case consultation on more complex cases, a supervisor who is a Licensed Psychologist is utilized. Currently we have three Licensed Professional Counselors, one Licensed School Psychologist and one Licensed Psychologist available for the program. One full-time Transitions counselor has received mandated new caseworker training. Other counselors will not receive this training. All Transitions counselors have experience in risk assessment. Many of the providers are licensed and thus able to determine whether or not a person is a danger to himself or others and in need of hospitalization. One Transitions counselor is trained in Family Risk Assessment for caseworkers. VIII. UNIT OF SERVICE RATE COMPUTATION Please see the attached budget form. Services are billed at an hourly unit rate cost for individual foster parent consultation and mandated training for foster parents. The established hourly unit rate is $90/hour. Fees for foster parent support groups are billed per person, per group unit rate. The unit rate for group participants is $58.33/participant. Transitions only bills for direct face- to-face services. Transitions does not request reimbursement of other services such as telephone calls, no-shows, travel time, mileage reimbursement, preparation, documentation, childcare and other incidental expenses that are incurred. IX. BILLING PROCESS A. Billing Process Transitions follows a structured billing process in order to maintain prompt billing for services. Transtions staff are required to submit all signed and dated verification forms for foster parent groups and for individual foster parent consultation by the 1st workday of the month. All documentation including original, signed written monthly reports for foster parent groups • 'Foster Parent Consultation 2006-7 Transitions 7 Bid Number 001-06 (RFP-FYC 006-00A) and for individual foster parent consultation are due by the 5th workday of the month. The administrative assistant completes all invoices, Authorization Forms, and Core Service Forms by the 5th workday of the month. The forms are audited by a co-director for accuracy and signed. The billing, which includes all signed documentation (i.e., Transitions' invoices, Authorization Forms, Core Services Forms, and monthly reports), is then hand delivered to the Department of Social Services. B. Fictional Monthly Billing Demonstration Please see attached billing forms. X. PROGRAM CAPACITY PER MONTH Transitions Foster Parent Consulting is equipped to handle a maximum of five groups per month. The monthly capacity per group is 10 members per group or a total of 50 participants monthly. Transitions needs a minimum of two groups with at least six members per group in order to support the program. Transitions can accept up to five new referrals a month for individual foster parent consultation or mandated training, with a monthly maximum case load of ten referrals. Transitions needs a minimum of one new referral per month to support the program. XI. UNIT OF SERVICE RATE COMPUTATION Please see the attached budget. 03/13/2006 FRI 15:30 FAX i )003/009 cerCoo� Aid 001-06(RFP-FYC 07600:I' Attached A Date of Meeting(s)with Social Services Division Supervisor: Comments by SSD Supervisor: ait, _gaga as, • _ gyp Name and Signature of SSD r Date ,is�AIM AMAIAL WELD COUNTY AUTHORIZATION FOR CONTRACTUAL SERVICES Date: _02/28/06 Provider: Transitions Psychology Group, LLC Billing Contact: Karel Longan Phone #: 970-336-1123 Address: 804 11`h Avenue Greeley, CO 80631 Description of Services: Foster Parent Consultation Service Month / Year 02/06 Charges:$471.65 I CERTIFY THE SERVICE AUTHORIZED WAS PROVIDED ON THE DATE INDICATED AND THE CHARGES ARE MADE PURSUANT TO A BONA FIDE CONTRACT BETWEEN ME AND THE WELD COUNTY DEPARTMENT OF SOCIAL SERVICES. I v--6 s ( d '_ �� I / -5 A-(6 c Printed Name of Signer rovid Signature Date AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA FOR COUNTY USE ONLY: Approvals: / / Core Caseworker Date Director Date AMOUNT PAYABLE: $ ANY CHANGES LISTED BELOW: Client/ID/HH# Billed Amt Denied Paid Reason CPi/G/NAL • Transitions Psychology Group, LLC Invoice 80411th Avenue Date Invoice# Greeley, CO 80631 2/28/2006 444 Bill To WCDSS-Foster Parent Consultation PO Box A Greeley,CO 80632 Due Date 3/31/2006 Client Name Provider# Qty Item Rate Amount Ark,Joan 554266 2 Foster Parent C... 90.00 180.00 Foster Parent group 2/25/06 Locust, Paul 5 Foster Parent Su... 58.33 291.65 Locust,Rachel Mars,Lisa Mars Juan Nelson,Lyle Total $471.65 : . � Attendance Confidentiality Statement ••�"r• . . • "•• . •• •• S . Its Transitions PSYCHOLOGY GROUP,Li C I acknowledge that by my attendance at the foster parent consultation group, I will obtain confidential information. 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L0 - U U o Z .C n v, U. 0L an Vi [i Y �, Z O.rn 03/28/2006 12 : 47 FAX 970 346 7690 GREELEY/WELD HSG AUTH al 002/002 4 illirMi CiREELEY/WLLD HOUSING AUTHORITIES Nom 315 N. 11th Avenue, 81dg. B 16 1'.O. 13ox 13O oreeley, Colorado 80632-0130 (970) 346-7660 (970) 346-7690 Pax March 28, 2006 (800) 659-2656 TTY Relay Gregory S. Creed, MA, LPC Transitions Psychology Group, LLC 804 11th Avenue Greeley, CO 80631 Dear Mr. Creed: As a Housing Authority we would be glad to accept any appropriate referrals for clients needing our services from Transitions. If you are awarded a contract to work with Weld County clients we will be agreeable to enter into a Memorandum of Understanding concerning the services provided by each agency. If you have any questions please contact me at (970) 353-7437 ext 103 Sincerely, Thomas Teixeira Executive Director ORIGINAL , d DEPARTMENT OF HUMAN SERVICES itelEMPLOYMENT SERVICES OF WELD COUNTY 1551 NORTH 17TH AVENUE PO BOX 1805 GREELEY, CO 80632 (970)353-3800 111kFAX (970) 356-3975 COLORADO March 21, 2006 Transitions Psychology Group, LLC Employment Services of Weld County is providing you this letter outlining the areas of collaboration when a client you serve under CORE service funds is identified as having an employment need. The collaborative areas were developed from your responses concerning the parameters you felt were practical, based upon the services you intend to provide. Transitions Psychology Group, LLC currently collaborates extensively with Employment Services of Weld County(ESWC) in serving Temporary Assistance for Needy Families (TANF) participants. The Transitions Psychology Group, LLC is proposing a variety of services which include Mental Health services to provide both Psychological and Mental Health evaluations, and Life Skills services which include Therapeutic Visitation and Life Skills Coaching to work with parents to increase the parents' ability to provide appropriate care to their children. It is unknown if these services will have a direct relationship to employment, however, the following outlines the plan for referrals when, or if, they arise: Case management: The Transitions Psychology Group, LLC agrees to provide case management for families that may require the parent to seek employment. For these individuals, the Transitions Psychology Group, LLC agrees to make a referral to Employment Services of Weld County. Referral process: For individuals identified as having employment needs, the Transitions Psychology Group, LLC will refer the client to Employment Services of Weld County and will send an email to Employment Services, under the attention of Linda Perez, stating that the client was referred. The Transitions Psychology Group, LLC agrees to forward the email within five business days of making the referral. Follow up: The Transitions Psychology Group, LLC will email a follow-up concerning the referral made to Employment Services of Weld County 10 business days after sending the initial email. Employment Services of Weld County will email the Transitions Psychology Group, LLC if the client does not contact us, and the Transitions Psychology Group, LLC agrees to discuss the matter with the es s 4 1 client at their next visit. The Transitions Psychology Group, LLC will provide a written email of that discussion to the attention of Linda Perez within five business days. Cross training: As new staff come to the Transitions Psychology Group, LLC they will be made aware of this collaborative arrangement and will be provided training concerning the employment and training services offered by Employment Services of Weld County. Other collaborative areas: At this time there are no additional collaborative efforts with Employment Services. As additional areas of collaboration arise, the 7+jbile Qen+e `e- mica Transitions Psychology Group, LLC agrees to include them in the Memorandum of Understanding discussions to be completed by February 1, 2007. Employment Services will meet with representatives of the Transitions Psychology Group, LLC in July 2006 to initiate the collaborative Memorandum of Understanding process once bids for CORE services are completed and accepted. Sincerely, j l T 77 ,,,('k \ ✓E%'...L;( "Linda L. Perez > Director Employment Services of Weld County ORIGINAL r. • North Range Behavioral Health March 29, 2006 Jami Moe-Hartman Transitions Psychology Group 804 11th Avenue Greeley, CO 80631 Re: Letter to Accompany Proposal to Weld County Department of Social Services To Whom it May Concern: This letter is written to support the application of Transitions Psychology Group to provide CORE Services through the Weld County Department of Social Services. North Range Behavioral Health is pleased to commit to a collaborative relationship with Transitions Psychology Group to develop a system of care for children and families served to ensure that duplications in services are minimized, that gaps in needed services are eliminated and that services are billed to the appropriate payer source. For services involving Medicaid eligible clients North Range Behavioral Health will work with Transitions Psychology Group to determine which services are benefits of the Medicaid Mental Health program and to facilitate a process through which Transitions Psychology Group can be compensated with Medicaid funds when services provided are a benefit of Medicaid. Sincerely, Wayne A. Maxwell, Ph.D. Executive Director Mission: North Range Behavioral Health provides professional, ORIGINAL culturally competent mental health services for Weld County. 130811th Avenue/Greeley,CO 80631 /(970)347-2120/Fax(970)353-3906 Healthcare Providers Service 416`J44 Organization? Purchasing� Group ®HPSO CNA Plaza, CCerttf LCI#,C o f ;:linsurance MuhMu1P.uvd1rns.,v�V Clricago,IL 60685 OCCURRENCE POLICY FORM r Producer Branch Prefix Policy Number Policy Period from: 12:01 AM Standard Time on: 07/04/05 018098 970 HPG 270170686-8 to: 12:01 AM Standard Time on: 07/04/06_ Named Insured and Address Program Administrator Healthcare Providers Service Organization GREGORY S CREED 159 East County Line Road 804 11TH AVE Hatboro, PA 19040-1218 GREELEY CO 80631-3246 Insurance Provided Medical Specialty: Code: by . CliuicalCounselor/LPCC 72990 American Casualty Co. of Reading, PA CNA Plaza 26S Chicago, IL 60685 COVERAGE PARTS LIMITS OF LIABILITY A. PROFESSIONAL LIABILITY" Professional Liability , 0.,000,000.00 each claim $6,000,000.00 aggregate Good Samaritan Liability Included above Personal Injury Liability Included above Malplacement Liability Included above B. Coverage Extensions License Protection $10,000.00 per proceeding $25,000.00 aggregate Defendant Expense Benefit $10,000.00 aggregate Deposition Representation $2,500.00 per deposition $5,000.00 aggregate Assault $10,000.00 per incident $25,000.00 aggregate Medical Payments $2,000.00 per person $100,000.00 aggregate First Aid $2,500.00 aggregate Damage to Property of Others - $500.00 per incident $10,000.00 aggregate C. WORKPLACE LIABILITY Coverage part C. does not apply if Coverage part D. is made part of this policy. Workplace Liability Included in A. Professional Liability Limit shown above Fire and Water Legal Liability Included above subject to $150,000 sub-limit Personal Liability 1 $1,000,000.00 aggregate D. GENERAL LIABILITY Coverage part D. does not apply it Coverage part C. is made part of this policy. Workplace Liability None None Hired Auto & Non Owned Auto None Fire & Water Legal Liability None None Personal Liability 1 None Total Premium $330.00 Policy forms and endorsements attached at inception QUESTIONS? CALL: 1-800-982-9491 G-121500C G-121501C G-121503C G-145184-A G-147292-A G-144872-A G-123846C-05 Healthcare Providers Service Orgmization is a division of Affinity Insurance Services,Inc;in NY and NH,AIS Affinity Insurance Agency.an MN and OK.AIS Affinity Insurance Agency.Inc.;and in CA.AIS Affrniry Insurance Agency,Inc.dba Acn Direct Insurance Administrators License?0795465. Master Policy: 188711433 I A vi‘j+.. ' Keep this document in a safe place. This and your cancelled check act as proof of coverage. I Chairman of the Boar Secretary 604 XX 0000098—R 050321 RENHCP 1/05 R1C3HN 05080 Healthcare Providers Service 1, Organization Purchasing Group C'VA Plaza, (Certificate of 4i n uranrL Chicago.II.60685 OCCURRENCE POLICY FORM Producer Branch Prefix Policy Number Policy Period from: 12:01 AM standard Time on: 07/04/05 018098 970 HPG 270170798-8 to: 12:01 AM Standard Time on: 07/04/06 Named Insured and Address Program Administrator _ Healthcare Providers Service Organization JAMI MOE HARTMAN 159 East County Line Road 804 11TH AVE Hatboro, PA 19040-1218 GREELEY CO 80631-3246 Medical Specialty: Code: Insurance Provided by Clinical Counselor/LPCC 72990 American Casualty Co. of Reading, PA CNA Plaza 26S Chicago, IL 60685 COVERAGE PARTS LIMITS OF LIABILITY A. PROFESSIONAL LIABILITY Professional Liability $1,000,000.00 each claim $6,000,000.00 aggregate Good Samaritan Liability Included above Personal Injury Liability Included above Malplacement Liability Included above IB. Coverage Extensions License Protection $10,000.00 per proceeding $25,000.00 aggregate Defendant Expense Benefit $10,000.00 aggregate Deposition Representation $2,500.00 per deposition $5,000.00 aggregate Assault $10,000.00 per incident $25,000.00 aggregate Medical Payments $2,000.00 per person $100,000.00 aggregate First Aid $2,500.00 aggregate Damage to Property of Others $500.00 per incident P $10,000.00 aggregate C. WORKPLACE LIABILITY Coverage part C. does not apply if Coverage part D. is made part of this policy. Workplace Liability Included in A. Professional Liability Limit shown above Fire and Water Legal Liability Included above subject to $150,000 sub-limit Personal Liability 1 000 000.00 a re ate D. GENERAL LIABILITY Coverage parr D. does nor apply if Coverage par: C. is made pact of this policy. Workplace Liability l None None Hired Auto & Non Owned Auto None Fire & Water Legal Liability None None Personal Liability None I Total Premium $330.00 Policy forms and endorsements attached at inception QUESTIONS? CALL: 1-800-982-9491 G-121500C G-121501C G-121503C G-145184-A G-147292-A G-144872-A G-123846C-05 Healthcare Piovidets Seivice organization is a division of Affinity Insurance Services,Inc;in NY and MI,AIS Affinity Insurance Agency;in MN and OK.AIS Affinity Insurance Agency,Inc..and in CA.AIS Affinity Insurance Agency,Inc.dba Ann Direct Insurance Administrators License ftu795$65. Master Policy: 188711433 —'11i keep this document in a safe place. 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'/...cc., .�s 0 0 0 a 0 o o - , '* e • 80411th Avenue FAX • • O • Greeley,CO 80631 s • + . Phone(970)336-1123 « 4. '1°0 y . FAX(970351-0182 TransltiOnS •ITcnoLOGT GROUP.LLC TO: Gloria Romansik FAX# 346-7698 FROM: Jami Moe-Hartman, MA, LPC DATE: 05/19/06 RE: Bids PAGES: 3 COMMENTS: CONFIDENTIAL The information contained in this facsimile message is privileged and confidential information intended for the use of the individual or entity named above. If the reader of this message is not the Intended recipient or the employee or agent responsible to delver it to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this fax in error, please immediately notify us by telephone and return the original message to us at the above address via the U.S. Postal Service. Thank you. TO 39Cd ZBT0T9E IT :4T 900Z/6T/90 e el 804 11h Avenue r r r 6 f, Greeley,CO 80631 • f Tel.(970)336-1123 •i•4, * . FAX (970)351-0182 rest . •Transitions MUEROGY CWI!us May 18, 2006 Gloria Romansik, Social Services Administrator Weld County Department of Social Services PO Box A Greeley, CO 80632 RE: Bid # 06LS15 (RFP 05005) Lifeskills Bid # 06FPC09 (RFP 006-00A) Foster Parent Consultation Bid # 06HS07 (000-00B) Home Study, Relinquishment Counseling Bid #06MH07 (RFP 006-00) Mental Health Services Dear Ms. Romansik, I am writing in response to Judy Griego's letter concerning the Bid process for PY 2006-2007. Thank you for sending the results of the process; it was helpful to see our bid scores this year. A. Bid # 06MH0T (RFP 006-00) Mental Health Services Transitions agrees to work with the Weld County DSS Business Office to set the rate per episode for completed evaluations. Psychological Evaluation and Assessment Services for Children, Adolescents and Adults: These services will be provided by a licensed eligible psychologist with a PhD who is supervised by a licensed psychologist, or by a licensed psychologist. The billing rate is $282.38/face-to-face client hour. A typical psychological evaluation ranges form 4-6 hours of direct service time. Clients sign a verification form for this time and Transitions bills it at the hourly rate; test materials, scoring, analysis, collateral contacts, case management and report writing time are not billed. The average rate for a completed evaluation will be $1270.71 Mental Health Evaluations: These services require a minimum of masters degree in the human services field, a minimum of five years' Z0 39tld Z8TOT5E TT 5T 900Z/6T/50 experience, and a mental health license (e.g. Licensed Professional Counselor, Licensed Clini al Social Worker, etc). The Mental Health evaluations are billed at a�flat rate of$212.50 per evaluation. This is based on an hourly rate of$106.25 for face-to-face client contact. B. Transitions Psychology Group, LLC accept the recommendations as written by the FYC Commission. The Terms and Conditions on the Bid and NOFAA act as a cover sheet to Transitions' written bids. Transitions adheres to all }he Terms and Conditions. Transitions accepts all of the conditi ns and recommendations set forth in the Department of Social Services letteridated May 15, 2006. Transitions will include this letter and the letter received from the Department as addendiims to our bids. Transitions confirms that it will provi a the services delineated in Bid #06LS15, Bid #obl-PC09, Bid #06HS07, and id #06MH07. If you have any questions about our esponses to the condition and recommendations on the bid, please let us know. We would be more than happy to discuss them with you. Thank you for your consideration. Sincerely, Se-----rti,p7-------, Jami Moe-Hartman, MA, LPC Co-Director Transitions Psychology Group, LLC E0 39Vd Z8T0T9E TT:ST 900Z/6T/c0 dDEPARTMENT OF SOCIAL SERVICES 61:It P.O.BOX A GREELEY, CO. 80632 Website:www.co.wdd.co.us 1 Administration and Public Assistance(970)352-1551 Child Support(970)352-6933 e COLORADO May 15,2006 Jami Moe-Hartman, Co-owner Transitions Psychology Group,LLC 804 11 Avenue Greeley, CO 80631 Re: Bid#06LS 15 (RFP 05005)Lifeskills Bid#06FPC09(RFP 006-00A)Foster Parent Consultation Bid#061-1S07(006-00B)Home Study,Relinquishment Counseling Bid#06MH07(RFP 006-00)Mental Health Services Dear Ms. Moe-Hartman: The purpose of this letter is to outline the results of the Bid process for PY 2006-2007 and to request written confirmation from you by Monday,May 22,2006. A. Results of the Bid Process for PY 2006-2007 • The Families, Youth and Children(FYC)Commission recommended approval of your Bid#06LS 14(RFP#06005), Lifeskills, for inclusion on our vendor list. Your bid scored a total of 98 points out of 100. • The Families,Youth and Children(FYC)Commission recommended approval of your Bid#06FPC09 (RPF 006-00A), Foster Parent Consultation, for inclusion on our vendor list. Your bid scored a total of 100 points. • The Families,Youth and Children(FYC)Commission recommended approval of Bid #06HS07, (RFP 006-00B),Home Studies and Relinquishment Counseling, for inclusion on our vendor list. Your bid scored 87 points. • The Families, Youth and Children(FYC) Commission recommended approval Bid #06MH07(RFP 006-00)Mental Health Services for inclusion on our vendor list. Your bid scored 98 points. The FYC Commission attached the following conditions and recommendations to your bid. Condition: The bidder will work with the Weld County DSS Business Office to set a rate per episode for completed evaluations. Recommendation: You must clarify the level of expertise or credentials of the staff person who is providing each service. • Page 2 Transitions Psychology Group/Results of RFP Process for 2006-2007 B. Required Response by FYC Bidders Concerning FYC Commission Conditions and Recommendations: Conditions: All conditions will be incorporated as part of your Bid and Notification of Financial Assistance Award(NOFAA).If you do not accept the condition(s),you will not be authorized as a vendor unless the FYC Commission and the Weld County Department of Social Services accept your mitigating circumstances. If you do not accept the condition,you must provide in writing reasons why.A meeting will be arranged to discuss your response. Your response to the above conditions will be incorporated in the Bid and Notification of Financial Assistance Award. Recommendations: You are requested to review the FYC Commission recommendations and to: 1. accept the recommendation(s)as written by the FYC Commission; or 2. request alternatives to the FYC Commission's recommendation(s); or 3. not accept the recommendation(s)of the FYC Commission. Please provide in writing how you will incorporate the recommendation(s)into your bid. If you do not accept the recommendation,please provide written reasons why.All approved recommendations under the NOFAA will be monitored and evaluated by the FYC Commission. The Weld County Department of Social Services is requesting your written response to the FYC Commission's conditions and recommendations. Please respond in writing to Gloria Romansik, Weld County Department of Social Services,P.O.Box A, Greeley,CO, 80632,by Monday,May 22, 2006, close of business. If you have questions concerning the above,please call Gloria Romansik at 352.1551, extension 6230. Sincerely, y A. -ego, for I cc: Juan Lopez, Chair,FYC Commission Gloria Romansik, Social Services Administrator • w•o 4 vs 80411'"Avenue FAX •� * Greeley,CO 80681 a • + . Phone (970)330-1129 • e a * ,• FAX(970351-0182 s• Transitions PacwowCT GROUP.tIC TO: Gloria Romansik FAX# 346-7698 FROM: Jami Moe-Hartman, MA, LPC DATE: 05/19/06 RE: Bids PAGES: 3 COMMENTS: CONFIDENTIAL The information contained in this facsimile message is privileged and confidential information intended for the use of the individual or entity named above. If the reader of this message is not the intended recipient or the employee or agent responsible to delver it to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this fax in error, please immediately notify us by telephone and return the original message to us at the above address via the U.S. Postal Service. Thank you. TO 39Vd Z8T0I9E TT:ST 900Z/6T/9A experience, and a mental health license (e.g. Licensed Professional Counselor, Licensed Clini al Social Worker, etc). The Mental Health evaluations are billed at alflat rate of$212.50 per evaluation. This is based on an hourly rate of$106.25 for face-to-face client contact B. Transitions Psychology Group, LLC accept the recommendations as written by the FYC Commission. The Terms and Conditions on the Bid and NOFAA act as a cover sheet to Transitions' written bids. Transitions adheres to all khe Terrns and Conditions. Transitions accepts all of the conditi I ns and recommendations set forth in the Department of Social Services letter dated May 15, 2006. Transitions will include this letter and the letter received from the Department as addendums to our bids. . Transitions confirms that it will provi e the services delineated in Bid #06LS15, Bid #U6I-PC09, Bid #06HS07, and d #06MH07. If you have any questions about our esponses to the condition and recommendations on the bid, please let us know. We would be more than happy to discuss them with you. Thank yo for your consideration. Sincerely, Jami Moe-Hartman, MA, LPC Co-Director Transitions Psychology Group, LW • CO 39Vd ZBTOtSE TT:ST 900Z/61/S0 d DEPARTMENT OF SOCIAL SERVICES P.O. A BOX GREELEY, CO. 80632A Website:www.co.wetd.co.us wilge. Administration and Public Assistance(970)352-1551 Child Support(970)352-6933 COLORADO May 15, 2006 Jami Moe-Hartman, Co-owner Transitions Psychology Group,LLC 804 11 Avenue Greeley, CO 80631 Re: Bid#06LS15 (RFP 05005)Lifeskills Bid#06FPC09 (RFP 006-00A)Foster Parent Consultation Bid#06HS07 (006-GOB)Home Study,Relinquishment Counseling Bid#06M1-I07 (RFP 006-00)Mental Health Services Dear Ms.Moe-Hartman: The purpose of this letter is to outline the results of the Bid process for PY 2006-2007 and to request written confirmation from you by Monday, May 22, 2006. A. Results of the Bid Process for PY 2006-2007 • The Families, Youth and Children(FYC)Commission recommended approval of your Bid#06LS 14 (RFP#06005), Lifeskills, for inclusion on our vendor list.Your bid scored a total of 98 points out of 100. • The Families,Youth and Children(FYC) Commission recommended approval of your Bid#06FPC09(RPF 006-00A), Foster Parent Consultation, for inclusion on our vendor list. Your bid scored a total of 100 points. • The Families,Youth and Children(FYC)Commission recommended approval of Bid #0611S07, (RFP 006-GOB),Home Studies and Relinquishment Counseling, for inclusion on our vendor list. Your bid scored 87 points. • The Families, Youth and Children(FYC) Commission recommended approval Bid #06MH07 (RFP 006-00)Mental Health Services for inclusion on our vendor list.Your bid scored 98 points.The FYC Commission attached the following conditions and recommendations to your bid. Condition: The bidder will work with the Weld County DSS Business Office to set a rate per episode for completed evaluations. Recommendation: You must clarify the level of expertise or credentials of the staff person who is providing each service. Page 2 Transitions Psychology Group/Results of RFP Process for 2006-2007 B. Required Response by FYC Bidders Concerning FYC Commission Conditions and Recommendations: Conditions: All conditions will be incorporated as part of your Bid and Notification of Financial Assistance Award(NOFAA). If you do not accept the condition(s),you will not be authorized as a vendor unless the FYC Commission and the Weld County Department of Social Services accept your mitigating circumstances. If you do not accept the condition,you must provide in writing reasons why. A meeting will be arranged to discuss your response. Your response to the above conditions will be incorporated in the Bid and Notification of Financial Assistance Award. Recommendations: You are requested to review the FYC Commission recommendations and to: 1. accept the recommendation(s) as written by the FYC Commission; or 2. request alternatives to the FYC Commission's recommendation(s); or 3. not accept the recommendation(s) of the FYC Commission. Please provide in writing how you will incorporate the recommendation(s)into your bid. If you do not accept the recommendation,please provide written reasons why.All approved recommendations under the NOFAA will be monitored and evaluated by the FYC Commission. The Weld County Department of Social Services is requesting your written response to the FYC Commission's conditions and recommendations. Please respond in writing to Gloria Romansik,Weld County Department of Social Services,P.O. Box A, Greeley, CO, 80632,by Monday,May 22, 2006, close of business. If you have questions concerning the above,please call Gloria Romansik at 352.1551,extension 6230. Sincerely, et y A ff riego,Cfr-tor cc: Juan Lopez, Chair, FYC Commission Gloria Romansik, Social Services Administrator Weld County Department of Social Services Notification of Financial Assistance Award for Families,Youth and Children Commission (Core) Funds Type of Action Contract Award No. X Initial Award FY06-CORE-0007 Revision (PY 06-07 RFP-FYC-006-00A; 06FPC04) Contract Award Period Name and Address of Contractor Beginning 06/01/2006 and Jubilee Retreat Center-Lori Kochevar, LLC Ending 05/31/2007 Foster Parent Consultation 810 12 Street Greeley, CO 80631 Computation of Awards Description Unit of Service The issuance of the Notification of Financial This program provides foster parent consultative Assistance Award is based upon your Request for services in the areas of(1)consultation and foster Proposal (RFP). The RFP specifies the scope of parent support, (2) mandated corrective action services and conditions of award. Except where it consultation, and(3)mandated critical care is in conflict with this NOFAA in which case the consultation. Foster parent consultations will be NOFAA governs, the RFP upon which this award is provided through group consultation services. based is an integral part of the action. Capacity is 10 groups per month, an average of eight participants per group. Group participation is limited Special conditions to one group session per foster parent per month. Individual consultation services will only be provided 1) Reimbursement for the Unit of Services will be when approved by the Resource Services Manager or based on a per group rate. Child Welfare Administrator of Social Services. 2) Rates will only be remitted on cases open with, and Bilingual-Bicultural services are available to all referrals made by the Weld County Department of families. South County services are available. Social Services. 3) Requests for payment must be an original and Cost Per Unit of Service submitted to the Weld County Department of Social Services by the end of the 25th calendar day Per individual foster parent following the end of the month of service. The participant per episode provider must submit requests for payment on Treatment Package $58.33 forms approved by Weld County Depaitrnent of Other Services Per Hourly Rate $90.00 Social Services. Enclosures: 4) Requests for payment must include original client X Signed RFP: Exhibit A verification signatures (blue or red ink preferred) Supplemental Narrative to RFP: Exhibit B and dates and hours of service. Recommendation(s) 5) The Contractor will notify the Department of any change in staff at the time of the change. Conditions of Approval Approvals: lle /. *` Program Official: By M f t By M. J. G-ile, Chair % _• Ju . i o,Dir or Board of Weld County .s 7 .� 7 We co Department of Social Services Date: JUN 14 ZI 1i;�` s •_. Date: 5931 J0 cv y � Bid Number 001-06(RFP-FYC COMMISSION 006-00A) Attached A FOSTER PARENT CONSULTATION PROGRAM BID PROPOSAL AND REQUEST FOR CONTINUATION OF AWARD UNDER FPP CORE SERVICES FUNDING COLORADO FAMILY PRESERVATION ACT 2006-2007 BID PROPOSAL APPLICATION PROGRAM FUNDS YEAR 2006-2007 BID 001-06 (006-00_4), NAME OF AGENCY: 14.1,24141c Ca/ t /�T t-tru _f2 o ADDRESS: it�acl 4-k SF-vrc PHONE: (RIM CONTACT PERSON: ? rpckial t J TITLE: DESCRIPTION OF FAMILY PRESERVATION PROGRAM CATEGORY: The Foster Parent Consultation Program Category must provide services that focus on teaching life skills designed to facilitate implementation of the case plan by improving household management competency,parental competency, family conflict management and effectively accessing community resources. 12-Month approximate Project Dates: _ 12-month contract with actual time lines of: Start June 1, 2006 Start End May 31, 2007 n /1 End TITLE OF PROJECT: T PcL t ( y'vcuc �ht/LLL� f cam' ,O6 j 10 hl /6(o N --e and gnature of Pe n Preparing Document Date Nante and Signature Chief Administrative Officer Applicant Agency Date MANDATORY PROPOSAL REQUIREMENTS For both new bids and renewal bids,please initial to indicate that the following required sections are included in this Proposal for Bid. A<-Project Description 4`Target/Eligibility Populations 1K.Types of services Provided 134-Measurable Outcomes 'he-Service Objectives �t✓Workload Standards /it Staff Qualifications Unit of Service Rate Computation likc Billing Process Program Capacity per Month {K Certificate of Insurance )4.'Assurance Statement Page 29 of 39 INVITATION TO BID OFF SYSTEM BID 001-06(06005-06011 and 006-00,A,B,&C) DATE: March 1, 2006 BID NO: 006-00A RETURN BID TO: Pat Persichino,Director of General Services 915 10th Street,P.O. Box 758, Greeley, CO 80632 SUMMARY Request for Proposal (006-00A) for: Colorado Family Preservation Act—Foster Parent Consultation,Emergency Assistance Program Deadline: March 31, 2006, Friday, 10:00 a.m. The Families, Youth and Children Commission, an advisory commission to Weld County Social Services, announces that applications will be accepted for approved providers pursuant to the Board of Weld County Commissioners' authority under the Colorado Family Preservation Act (C.R.S. 26-5.5-101) and Emergency Assistance for Families with Children at Imminent Risk of Out-of-Home Placement Act(C.R.S. 26-5.3-101). The Families, Youth and Children Commission wishes to approve services targeted to run from June 1, 2006, through May 31, 2007, at specific rates for different types of service,the county will authorize approved providers and rates for services only. The Foster Parent Consultation Program must provide services that focus on providing psychological consultations and parenting support to foster parents which are designed to improve foster parent competency, family conflict management, and effectively access community resources. This program announcement consists of five parts, as follows: PART A...Administrative Information PART D...Bidder Response Format PART B...Background, Overview and Goals PART E...Bid Evaluation Process PART C...Statement of Work Delivery Date (After receipt of order) BID MUST BEtin SIGNED / IN INK ic7C-11 cuc1O2; jjTYPED OR NTED SIGNATURE G , PROVIDER T -L 4' AS LLC �) fr-i C.1e) Hand tten Sign ture By Authorize Officer or Agent of Provider ADDRESS 1O l 1 l Shie of TITLE ‘4,21-e/112.--4--- e.P(Pt ('rr ) 2O& 31 DATE (O31/nc,-: PHONE# (cf 70� - W 7 The above bid is subject to Terms and Conditions as attached hereto and incorporated. Page 1 of 39 03/17/2006 FRI 15:17 FAX ®002/003 Bid Number 00I-06(RFP-PYC COMMISSION tM66IA) Attached A Date of Meeting(s)with Social Services Division Supervisor: Comments by SSD Supervisor: led- aid fralelei C441-C, .. e � , re-e-A-JA ern t 404 Aotre rameg-se V1‘ 100 Name and Signature of SSD u.- ' or Date I Page 30 of 39 Foster Parent Consultation Program Purpose: The purpose of the Foster Parent Consultation Program is to provide on- going support and consultation to foster parents so that they are better able to provide positive healing relationships for the children they serve. Design: This program is designed on a strength based family preservation model of service. This model is proactive as well as promptly responsive to the foster parents in order to decrease placement disruption for foster children. This program provides a variety of support group tailored to meet the individual needs of the foster parent. In addition, when requested by the department, prompt individual consultation by phone or appointment will be available to work with foster parents in accordance to their needs. In our experience, during a crisis the need for intense consultation decreases after the initial solution orientated planning sessions. This program can provide training opportunities to help foster parents meet the state requirements for on-going professional development. The information discussed during consultation services is always confidential for voluntary participants. Why Services are Important- Foster Parents have the difficult role of providing a loving relationship and a structured home environment to children whom have most often been severely abused and or neglected. These children often have a distorted sense of self. Children in the Foster Care system often act out their feelings of unworthiness by displaying behavior that is destructive to self and others. Foster parents need to be able to access consultation services quickly to assist them in better understanding what the child/children are going through and how to respond to their behavior. As caretakers they also need awareness and skills to address their own issues in order to not repeat maladaptive interactions behavior with the foster children. Consultation - Consultation will consist of short-term, solution orientated planning that facilitate empowerment of the foster parents. Services will be able to be accessed through a call to the specific provider and will be provided in an expedient manner. It is common for caregivers to feel anxious, overwhelmed, depressed and or resentment when working with children that are experiencing all of these same feelings. Receiving a response from an objective consultant in a timely manner can help the foster parents to regain their composure and confidence to act instead of react to the challenging behavior exhibited by many foster children. 1 Target / Eligibility Population A. Total number of clients to be served in the twelve month program has been calculated as follows. We would be able to provide up to ten support groups a month. We estimate that there would be an average of eight participants at each support group. Henceforth, at ten support group a month, x twenty hours, x eight participants, x 11 months this part of the program would provide 1600 hours of service a year. We anticipate that on the individual component of this program that we would spend two hours a week providing services for foster parents. Henceforth, 2 hours a week x 52 weeks provides 108 client hours a year. We anticipate that the average foster parent using our services would attend 11 hours of support group a year, which would mean that we would serve 80 individual foster parents a year. We anticipate that individual crisis consultation would be available to 40 families for 6 hours of individual service a week. Total number of client hours provides over one year would be 1912 hours. B. Families Served. We anticipate serving 40 foster families, 80 foster parents. C. Sub total who will receive bicultural / bilingual services. All services provided will be in a manner which is sensitive to the culture of origin of the family. All of the therapist have extensive training in cultural competency issues. In addition, Lori Kochevar was the chair of the multicultural task force that successfully implemented multicultural training throughout the San Luis Valley. Due to our experience in bicultural settings, all individuals in our program will receive bicultural services. Lorenza Perezerdia, a bilingual provider, would be available for any Spanish speaking families and written program materials will also be available in Spanish. D. Consultation services will be available in South Weld County. Currently We are running two support groups in South Weld County. Services will be available where the foster parents live. E. The monthly program capacity per group would be 10 foster parents per group. Currently we are running 8 groups that would be able to served 80 foster families. If needed, we could expand the number of hours we are available to do 10 groups a month. 2 F. The monthly average capacity per group would be 8 foster parents per group. G. Average stay in the program - The average stay in this program would be 12 months. H. Average groups per week in the program would be 2 per week, spread throughout the month. Services Provided A. Consultation and Foster Parent Support will be provided around these and other key issues that will assist foster parents: initial placement adjustment, transition, separation and loss, effective discipline for children raised with inconsistent parenting, behavioral management, child development, the effects of visitation, legal risk and commitment issues, importance of documentation , work with foster parents and caseworkers around interpretation and implementation of treatment plans, solution oriented planning, and balancing your own /couples/ biological children's /birth families/ systems/foster children's needs. Both consumer elicited and mandated consultation for critical care foster parents and corrective action plans will be provided. B. Individual Foster Parent Consultation- on a time limited basis will be provided with a sighned referral from social services. C. Mandated training's for foster parents under corrective action plans will be provided as directed by the Department of Social Services D. Training's - Training needs will be identified through an evaluation of foster parents needs as well as in response to needs identified by the department. The mandated critical care consultation group will receive one training credit per month. Before training's are offered they will be approved and or requested by the department. The budget for training will be determined on a per event basis. All foster parents in Weld County will be invited to participate in each event. Evaluations of training's provided will be conducted. E. Therapeutic services for foster children will not be provided in a home where consultation services are in place. 3 F. Team building staffing - At the foster parents request and if the caseworker is willing, a team building meeting with the foster parent and the caseworker will be held to address ongoing concerns and to develop a solution oriented plan. This will be coordinated with the administration at DSS. This will help develop a unified plan and address any miscommunication or differences in opinion before court. This will increase the probability that the systems involved are able to work together for the best interest of the foster children in their collective care. All assessments and recommendations will be shared directly with the children's caseworker. G. Agree to comply with 19-1-120 CRS., which requires that reports of child abuse and any identifying information in those reports are strictly confidential. All federal laws will be followed including the confidential reporting of suspected child abuse. In this program consultation funds will not be used to fund therapy or drug and alcohol services for foster parents. If deemed appropriate a referral to a mental health provider, or ADAD professional will be made. Program Components: A. Consultation - Both foster parent elicited and mandated consultation for critical care foster parents and corrective action plans will be provided. Short term, problem solving services will facilitate personal empowerment of the consumer. It is imperative that foster parents have access to a variety of resources to support their own psychological well being and to prevent burnout. B. Support groups - We will organize and facilitate in depth exploration of issues that effect certain sub-groups of foster parents i.e.., critical care, foster adopt, etc... Foster parents will be encouraged to support each other. This creates a natural ongoing support system. Underlying focus will include collaborative team work with all parties working toward serving the best interest of the child in placement, i.e. DSS, GAL, Therapist, etc. C. Resource and Referrals - This program will facilitate the development of internal and external resources to enhance the foster parents ability to meet the demanding requirements of their role. Foster parents will be able to access written information on specific diagnostic, behavioral, and developmental issues specific to the foster children's special needs. See appendix A for a 4 ' partial listing of topics available. In addition, it is important to link foster parents to appropriate community resources and with each other. We will facilitate knowledge of and encourage use of available community resources , and make appropriate referrals. See Appendix A for listing of current community resources available to foster parents. D. Team building staffing - When requested by the foster parent and agreed upon by the caseworker the consultant will facilitate a group meeting with the foster parent and the case worker. This staffing will be coordinated with the administration at DSS. The focus of the team building will always be on the foster child's needs. We will address ongoing concerns and develop a solution oriented plan. This will increase the probability that we are able to work together for the best interest of the foster children in the systems care. Measurable Outcomes When clients are self-referred to this program they will choose training's, goals, and objectives according to their perceived needs. In the case where the foster parent is sent for disciplinary action or critical care, the consultant and the foster care coordinators will help design specific outcome measures appropriate to the situation. It is important to understand that as in any consultation process that these skills, concepts, and techniques need to be understood and practiced before foster parents will be able to consistently apply them with the children they serve. A. After involvement in this program component foster parents will be able to identify an improvement in their ability to deal competently with household management issues, as measured by a pre and post assessment inventory - Volume 7 Compliance Checklist. • Increase knowledge of and understanding of Volume 7 requirements for foster parents. • Increase understanding of importance of documentation and timelines concerning medical, dental and, medication monitoring • Increase awareness of state and federal requirements in Volume 7 regarding higher standards of care required by foster homes. • Increase awareness of and adherence to household cleaning, safety, and maintenance requirements outlined in Volume 7. • Increase awareness of resources available to assist with budgeting and purchasing resources for foster children. 5 B. After involvement in this program component foster parents will be able to identify an improvement in their parental competency as measured by a pre and post assessment of skills needed to implement non-power based parenting effectively. • Increase adherence to and understanding of state and federal requirements regarding discipline policies. • Increase understanding of characteristics of children raised with inconsistent parenting. • Increase ability to use and identify alternative discipline strategies. • Increase ability to acknowledge and listen to the child's concerns with empathy. • Increase recognition of communication barriers. • Increase ability to set effective limits using choices and enforceable statements. • Increase ability to use empathy and consequences effectively. • Increase ability to facilitate problem solving skills in foster children. • Increase understanding of the importance of positive relationship message when delivering negative content message. • Increase ability to redirect mis-behavior. • Increase understanding of foster children's need to learn about cause and effect thinking in an emotionally neutral non blaming environment. C. Foster parents will increase their ability to access community, state local and federal government resources independently so that they are able to improve their ability to meet the specialized needs of each individual foster child they serve. This will be measured by self report on evaluations completed by foster parents after consultation and tracking the number of referrals made by this program. • This program will facilitate empowerment for foster parents by providing clear user friendly information about the resources available in the community and within the local, state, and federal government. D. Foster parents will obtain higher skills and competency levels in fulfilling their role in providing a healing relationship for children in out of home placement. This will be measured and monitored through the development of individualized consultation service objectives which will be evaluated at the exit interview by the foster parent and the consultant. • Increase ability to accept the child as s/he is • Increase ability to deal with child's behavior in the context of a healing relationship. • Increase ability to support what the foster child is going through. 6 • ' • Increase understanding of dynamics of child abuse and neglect. • Increase understanding of developmentally appropriate expectations and the effects of trauma on development. • Increase understanding of the factors influencing the child's reaction to parent separation and loss. • Increase understanding of cultural competency issues that effect foster parenting. • Increase understanding of roles and dynamics of children that grow up in homes where parents have substance abuse issues. • Increase ability to anticipate special emotional needs. • Increase attunement to attachment and bonding issues. • Increase understanding of the need for foster children to have empowering corrective experiences. • Increase understanding of regressive behavior and the need for reparative bonding within the relationship. • Increase understanding of the need for consistency and structure to establish trust. • Increase understanding of the effects severe boundary violations have on children and how to facilitate the development of health boundaries in children. E. Foster parents will positively meet their own and the needs of their biological children's in adjusting to and dealing with the presence of foster children in the home. This will be measured and monitored through the development of individualized consultation service objectives which will be evaluated at the exit interview by the foster parent and the consultant. • Increase ability to set and maintain outside interests and relationships. • Increase ability to communicate effectively with the multiple systems involved in foster children lives. • Increase ability to set and teach children how to set effective physical and emotional boundaries. • Increase awareness of symptoms of burnout. • Increase understanding of the importance of knowing when to access support. • Increase awareness of grief and loss issues for foster families when foster child reunifies with family of origin. • Increase awareness of inappropriate coping strategies (i.e , substance use, denial, eating, fault-finding, passivity, revenge, withdrawal or excessive worry, etc...). • Increase ability to use appropriate coping strategies (i.e , diversions, balance, conflict resolution, flexibility, networking, affirmations, 7 • assertiveness, contact, enforceable limits, linking, organization, problem solving, re-labeling, providing choices, time management, relaxation, self- care, exercise, commitment, prayer, worship, surrender, etc...). Service Objectives We have the following service objectives: A. Improvement of household management competencies. It is imperative that foster parents are aware of and uphold regulations outlined in Volume 7 regarding the need to maintain a safe household environment, that is adequately cleaned and maintained. In addition, foster parents need to be able to budget their resources so that they are able to provide for the children they serve. Specific aspects on this service objective may include the following; consultation and referrals. This component will be measured through the foster parents ability to reach specific individualized consultation goals, a pre and post assessment tool and program evaluations. B. Improved parental competencies. Foster parents need to have the capacity to maintain a solid relationship with each other, with their own biological children and with the foster children they serve. In addition, foster parents need to provide developmentally appropriate care, nutrition, hygiene, discipline, protection, guidance and supervision. This service objective will be met through support groups and consultation. This component will be measured through the foster parents ability to reach specific individualized consultation goals, a pre and post assessment tool and program evaluations. C. Improve ability to access resources. Foster parents shall be empowered to access resources in the community, as well as resources available thorough the local, state and federal government. This program will encourage networking with other foster parents. This service objective will be provided through support groups, linking, consultation, and referrals. This component will be measured through foster parent evaluations, ability to reach specific individualized consultation goals, and record of number of referrals made. D. Address specific issues outlined in referral- all services shall be solution focused and address the specific issues specifed by the Department of Social Services on the referral form. This component will be measured through foster parent evaluations. 8 ' K Our bid will directly address the following outcomes in the Performance Improvement Plan- • Children who experience abuse in out of home care will decrease to 0.57% (Baseline 0.73%) o Will attend statewide training on Confirming Safe Environments (assessing safety of the foster home prior to and during placement) o Foster parent training curriculum (Core and Advanced) will provide information and suggestions to ensure that needs and behaviors of special needs children are addressed to prevent inappropriate or abusive treatment. • Adoptive families will be informed on the process for negotiation of subsidies (Child Welfare/Colorado Coalition for Adoptive Families). o Handouts and website links regarding the negotiation of subsidies will be provided to adoptive families. • For 76% of children who experience change of placement, the change will be directly related to helping the child achieve his/her goals in the case plan. (Baseline from July/Aug data was 72%) o Recruitment and retention of foster parents will be community-based to better meet the needs of children in their neighborhood home environment. • Inform foster parents of process for requesting a mentor. • We will teach practices learned from Adolescent Connections Project for establishing life-long connections for youth in care that will be shared statewide. The components from the PIP will be measured through documenting that each of the above topics is discussed in each of the foster parent support groups. Workload Standards A. The program has the capacity to serve 80 foster parents. Consultants would spend up to forty four hours a month providing services. With an average of eight foster parents per group, total number of client hours provides over one year would be 1912 hours. B. Number of anticipated reguests for individual consultation services per month is between 3-8 depending on the occurance of specialized issues in the foster homes. 9 C. Staff- There are five Family Preservation Specialists. Lori Kochevar M.S., L.C.., LLC will serve as a provider and the program supervisor for Sharon Benson, M.A., Bill George M.A., Barb Jetley, M.A. and Lorenza Perezerdia B. S.. Lorenza is available specifically for Spanish speaking foster parents. All providers have extensive experience in Family Services as documented in the attached resumes. D. The caseload will be between 2-10 families per therapist. The caseload of each therapist will depend on matching the specific needs of the referred family with the therapist area of specialty. E. The modality of treatment is support groups and individual crisis consultation. Referral and linking services will be provided. F. Hours - Total number of clinical time devoted to this program equals two hours a day, eleven hours a week, and forty four hours a month. G. Staff- The providers are supported by part time bookkeeping and clerical services. H. Supervisor- This contract would be supervised part time by Lori Kochevar M.S. L.P.C. who would monitor the project for program compliance and clinical excellence. I. Insurance - - Lori Kochevar M.S., L.P.C., LLC carries one million three million liability on the company and each one of the independent contractors connected to this bid. In addition, Lori Kochevar M.S., L.P.C., LLC carries a general liability policy related to accident or injury on the premises. The State of Colorado is named as an additional insured on this policy. Each individual provider also carries a one million three million liability insurance. Both general and group liability coverage's are attached. All therapist providing services are self employed and choose to be exempt from workman's compensation and Employer's liability insurance. Staff Qualifications A. All the providers meet the minimum qualifications needed for both education and experience. All providers have their Master's Degree or Bachorlate Degree's in Counseling. In addition, the therapists have between 10 6-12 years a piece providing services for families. See Resumes in Appendix C. B. Staff available for this project consists of four experienced consultants that have a similar core value of clinical excellence. We believe in providing strength-based, family-focused services that empower the families we serve. Another strength of our staff is our diverse areas of specialties. • Lori Kochevar a licensed professional counselor has extensive experience and training in providing services and supervision using the family preservation model. She has specialized training in substance abuse, trauma, grief, and domestic violence. In the last ten years Lori has developed and facilitated multiple training's that emphasize experiential learning opportunities. Many of these training's were developed specifically for Foster Parents, while others were created for families, school personnel, and service providers across the state. • Sharon K. Benson has been in Greeley since 1979. After graduating in 1985 with her masters in Professional Psychology with an emphasis in trauma, she began a private psychotherapy practice and provided consultation to a number of local non-profit agencies. She has worked with support service organizations for over twenty years in the areas of Domestic Violence, adolescent offenders, disabilities and family preservation. For the past 10 years Sharon has taught classes in the Psychology, Business and Emergency Service departments at Aims Community College. The most recent turn in her career has led into the Early Childhood field where she has received specialized training in assessment, behavior management, positive parenting and services to children with disability or mental health issues. • Lorenza Perezverdia, is a Certified Addictions bi-lingual and bi-cultural Counselor. She has extensive knowledge of how to provide state of the art services for clients addicted to substances. She is trained in Motivational Interviewing that helps clients address the core issues that keep them from progressing. Lorenza got her bachelor's degree in Psychology in Mexico in 2000. She has done relapse prevention, individual and group therapy, substance abuse evaluations, anger management groups, groups for victims of sexual abuse and also worked with children with special needs. She has recently developed a program to help DUI offenders understand and abide by the United State Laws and Culture as they progress into their adaptation process. 11 • Bill George has a master's degree in counseling from the University of Northern Colorado. He has over twenty years of experience in the field and is certified in many areas of practice. He has specialized training in individual and group services as a member of a psychiatric crisis team, drug and alcohol counselor, medical social worker, and vocational rehabilitation specialist. He is a Certified Alcohol and Drug Counselor in the State of Colorado, level III and an Expert Witness. Most recently he became certified as a Disability Management Specialist and has provided evaluations, vocational testing and assessments for the Department of Veteran Affairs. He is currently taking additional training on therapeutic attachment and bonding issues. • Barb Jetley is a licensed professional counselor. She received her Master's degree from the Adams State University. Barb has been in the field for the last sixteen years and has extensive experience working with many different clinical populations. Most recently, she serves as the clinical coordinator for children under six and their families for Project BLOOM. She has worked as a family preservation specialist, domestic violence counselor and an outpatient clinician. Along with being skilled consultants, due to our extensive background as therapists we are knowledgeable of the systems (i.e.. biological families, social services, mental health services, legal services, etc..) that foster parents need to interface with as advocates for the children that are placed with them. C. New Caseworker Training- Lori Kochevar, M.S. L.P.C. the supervisor for this bid has attended the Core training for Supervisors through the State of Colorado, she will oversee the work of all other staff to make sure it is in compliance with requirements. In addition, Jenna Reed who is working on bids submitted from this agency has successfully completed new caseworker training. D. Risk assessment knowledge is taught during the foster parent core training; in addition all staff are versed in multiple levels of risk assessment and are able to address risk issues as they occur during interventions. 12 Billing Process A. Description of process is as follows: • All records for the month (i.e. contact notes, client verification form with signature, and billing to DSS) are kept in the same file. These are organized as follows: Left pocket has contact notes, client verification form with signature in the order that they are billed. All group and training session signatures are at the back. Right pocket has monthly billing submitted and receipt of payment. • Time with the client is only billed for face-to-face contact. On face-to-face contact the client signs the verification sheet provided by DSS which indicates the date and amount of time seen. • Subcontractors are responsible for sending an original copy of contact notes and client verification form with signature by the 5th of the month. This information is kept in an individual consultant file for the year. Subcontractors are paid by LLC when the payment for services is received from DSS. This is tracked in with the consultant's file. • The bill for the county is prepared monthly using the following guidelines from the RFP (page 20 of 30 a, b-1, 2 & 3): We report expenditures and case disbursement at agreed upon times. o Submit monthly FYC completed billing forms to Ms. Andrea Shay, Core/PRT Caseworker, on or about the 10th day of the month after the month following the month the services were provided. o The provider furnishes the following deliverables required to verify services provided during the service month. The completed deliverables must be received by Social Services no later than the 25t day of the month following the dates of service. Required Deliverables: Authorization for Contractual Services will include: • Provider name, address, phone number, • Provider billing contact, phone number, • Program area, • Dollars ($) billed, 13 • Original signature, • Month of service. Request for Reimbursement will include: • Client information (TRAILS or Case ID number when available) • Rate, • Units billed, • Date(s) of service. Client Verification Form will include: • Client name, • Date, • Time of Service, • Hours per service, • Original client signatures signed at the time of service. B. Fictional billing process- see Appendix . 14 Foster Parent Consultation Program Appendix Outline Appendix A • Consultation plan Appendix B • Resumes Appendix C • Sample Billing • Insurance Appendix A Individualized Consultation Plan for 1. Foster parents will be able to identify an improvement in their parental competency as measured by a pre and post assessment of skills needed to implement non-power based parenting effectively. • Increase adherence to and understanding of state and federal requirements regarding discipline policies. • Increase understanding of characteristics of children raised with inconsistent parenting. • Increase ability to use and identify alternative discipline strategies. • Increase ability to acknowledge and listen to the child's concerns with empathy. • Increase recognition of communication barriers. • Increase ability to set effective limits using choices and enforceable statements • Increase ability to use empathy and consequences effectively. • Increase ability to facilitate problem solving skills in foster children. • Increase understanding of the importance of positive relationship message when delivering negative content message. • Increase ability to redirect miss-behavior. • Increased understanding of foster children's need to learn about cause and effect thinking in an emotionally neutral non blaming environment. 2. Foster parents will increase their ability to access resources independently so that they are able to improve their ability to meet the specialized needs of each individual foster child they serve. • Increase understanding of the importance of knowing when to access support. • Increase awareness of resources available. • Increase ability to access resources available in the community and within the local, state, and federal government. 3. Foster parents will obtain higher skills and competency levels in fulfilling their role in providing a healing relationship for children in out of home placement. • Increase ability to accept the child as s/he is. • Increase ability to deal with child's behavior in the context of a healing relationship. • Increase ability to support what the foster child is going through. • Increase understanding of dynamics of child abuse and neglect. 15 • Increase understanding of developmentally appropriate expectations and the effects of trauma on development. • Increase understanding of the factors influencing the child's reaction to parent separation and loss. • Increase understanding of cultural competency issues that effect foster parenting. • Increase understanding of roles and dynamics of children that grow up in homes were parents have substance abuse issues. • Increase ability to anticipate special emotional needs • Increase attunement to attachment and bonding issues • Increase understanding of the need for foster children to have empowering corrective experiences. • Increase understanding of regressive behavior and the need for reparative bonding within the relationship. • Increase understanding of the need for consistency and structure to establish trust. • Increase understanding of the effects severe boundary violations have on children and how to facilitate the development of health boundaries in children. 4. Foster parents will positively meet their own and the needs of their biological children's in adjusting to and dealing with the presence of foster children in the home. • Increase ability to set and maintain outside interests and relationships. • Increase ability to communicate effectively with the multiple systems involved in foster children lives. • Increase ability to set and teach children how to set effective physical and emotional boundaries. • Increase awareness of symptoms of burnout. • Increase understanding of the importance of knowing when to access support • Increase awareness of inappropriate coping strategies (i.e. ...., substance use, denial, eating, fault-finding, passivity, revenge, withdrawal, or excessive worry.) • Increase ability to use appropriate coping strategies (i.e. ...., diversions, balance, conflict resolution, flexibility, networking, affirmations, assertiveness, contact, enforceable limits, linking, organization, problem solving, re-labeling, providing choices, time management, relaxation, self- care, exercise, commitment, prayer, worship, surrender, etc...) 16 ' 5. The areas checked above would assist me in serving the needs of foster children and the areas circled are where improvement has occurred. Household Management Issues 1. Foster parents will identify an improvement in their ability to deal competently with household management issues. • Increase knowledge of and understanding of Volume VII requirements for foster parents. • Increase understanding of importance of documentation and timelines concerning medical, dental and, medication monitoring. • Increase awareness of state and federal requirements in Volume VII regarding higher standards of care required by foster homes. • Increase awareness of and adherence to household cleaning, safety, and maintenance requirements outlined in Volume VII. • Increase awareness of resources available to assist with budgeting and purchasing resources for foster children. 17 Appendix B Lori J. Kochevar M.S. L.P.C. 1024 8th street Greeley, CO 80631 (970)352-8873 lorik@aspacetogrow.com Clinical Facilitation Skills: • Ability to provide an energetically clear environment for conflict resolution. • Facilitate a creative process that allows knowledge to be integrated on multiple levels of awareness. • Clear understanding of when family members are physiologically able to negotiate differences. • Ability to assist family in synthesizing large amounts of sensitive information to reach a consensus. • Skill in facilitating resolution of issues in a manner that is respectful and sensitive to individual differences in culture, agendas, and desired outcomes. • Unique ability to teach physiological self-regulation through use of mirror-neurons. • Extensive training and experience in group/family dynamics, spirituality,trauma, child welfare, and body-centered psychotherapy. • Ability to assess and mitigate physiological effects of trauma on current functioning. • Proven skills in identifying multi-faceted family dynamics, psychological, and social issues for families involved in the child welfare system. Training&Curriculum Development Skills: • Trained colleagues in multiple agencies on strength-based,family-focused models: Family Preservation Services and Family Group Decision Making. • Have provided training across the state for schools, agencies, and the general public. • Use of experiential strategies to access multi-dimensional learning of information which increases participant's ability to recall and implement strategies across time and in non-ideal circumstances. Training Approach: o Present comprehensive coverage of all essential information, in the moment as dictated by the group dynamics and specific training needs. o Build cohesive curricula which employ progressive skill sets with multiple review of core material in different areas to increase retention and ability. o Facilitate a transformative process that motivates participants to take action in order to improve their life situation. o Encourage self-exploration and understanding of how a participant's thoughts,words,feelings and actions affect their own and other's well being. o Empower participants by seeing how they can transfer applicable existing skills into their new role, while building additional role-specific skills. o Use transfer-of-learning strategies to increase participant's ability to utilize the skills taught. Program Development&Community Organizational Strengths: • Developed and direct the following bid programs with Social Services: Family Preservation Services, Family Group Decision Making, Foster Parent Core Training, Foster Parent Consultation, and Home-Studies. • Currently serve as program administrator and grant writer for the Bonding Program. • In a director level position, guided 18 agencies in collaborative efforts in fundraising, program expansion,and community development. • Spearheaded community efforts to fundraise for and build a Boys and Girls Club in the San Luis Valley,which currently has three sites and are serving over 1,500 youth. • Organized Philanthropy Days: brought in philanthropists,foundation directors, and trustees to visit and enjoy the Valley's multiple cultures, learn of its services and strategize in partnership with the Valley for short and long term financial successes. • Successfully completed the Colorado Leadership Program to learn all phases of fund raising, management, and board development. • Develop and maintain solid working relationships within the community. • Participated in the El Pomar Community Leadership Program to increased awareness of personal leadership style, strengths, and developmental edge. Supervision&Consultation Skills: • Program Supervisor of Independent Contractors for grant compliance, agency/client satisfaction, and clinical excellence. • Provide program and clinical consultation to Program Directors at the Child Advocacy Resource Education (CARE)agency, and independent therapists. • Participated in Mastering the Art of Child Welfare Supervision training to achieve high standards of supervisory practices in order to assure the effective and efficient delivery of child welfare services. Work History: 1995—Present Private Therapist Contracted with Departments of Social Services in the San Luis Valley and Weld County, Hospice,Ackerman and Associates, Child Advocacy Resource Center, Prevention Project, and Mountain Trails Youth Ranch. 1995—1996 Director-Grant writer San Luis Valley Community Fund 1992— 1995 Family Preservation San Luis Valley Mental Health Center Specialist 1992—1995 Wilderness Therapist San Luis Valley Mental Health Center 1989—1991 Disabilities Consultant University Affiliated Program, USM 1989 Teaching Assistant University of Northern Colorado 1986—1989 Supervisor Boys and Girls Club, Greeley, CO Education: University of Southern Mississippi, M.S. Counseling Psychology GPA: 3.8 University of Northern Colorado, B.A. Professional Psychology GPA: 3.5 Involvement: Member,Weld County Child Welfare Committee Founding Board Member, Boys and Girls Club of Alamosa Member, San Luis Valley Coalition for Youth Services Chairperson, San Luis Valley Multicultural Task Force. TRAININGS FACILITATED: CHILD WELFARE 02/07/03 How Trauma and Neglect Effect Children's Development 2000-2005 Investigations: Rules,Roles and Resources 1998 Family Group Decision Making 1998 Creating Health/Balance in Relationships 1997—2005 Foster Parent Support Groups 1997 Family Preservation Services 05/30/97 Team Building for Families—Healthy Families 05/30/97 Finding Balance: Multicultural Dynamics with Clients and Foster Families FOSTER PARENTING 2000-Present Core Training—Foster Parents 2001 State Foster Parent Annual Conference—Trauma in the Body 03/10/00 Healthy Transitions for Foster Children 02/26/00 What Does a Foster Child Hear? Messages Underlying Discipline 03/02 Working with Trauma in the body;Empowering Children 1999 Enhancing Communication Skills 07/10/99 ADHD—How to Create Peaceful Moments 1999 Effective Parenting for Foster Parents 03/27/99 Helping Foster Parents Deal with Attachment Issues 01/12/99 Multicultural Diversity—A Celebration of Differences 1998 Love and Logic Parenting for Foster Parents 08/08/98 Understanding Differences 04/04/98 Stress Management 101 04/04/97 Interpersonal Effectiveness for Foster Parents INTERPERSONAL EFFECTIVENESS 05/15/97 Goal Setting 101 02/07/97 Effective Communication for Mental Health Workers 1997 Young Women's Group:A therapeutic self discovery group 06/21/96 Stress Management for Health Care Professionals 04/13/96 Interpersonal Effectiveness and Team Building 01/23-25/96 Interpersonal Effectiveness for School Personnel 07/13/94 Multicultural Diversity Training of Facilitators(TOF) 03/1-7/92 Career Exploration DRUG AND ALCOHOL PREVENTION 03/11/00 There's an Elephant in the Living Room 03/27-28/95 Family Preservation Services: Motivational Interviewing 1994 Teen Baseline: Drug Prevention 05/13-14/94 Impact of Sexual Addiction on Families: Family Sculpting 1993 Baseline: Drug Prevention COMMUNITY DEVELOPMENT 09/23/05 Conscious Parenting—Resolving Conflict from Within 10/19/04 State Farm Lunch and Leam;Consciousness from Within 09/15/03 Spiritual Parenting 11/10/04 Diet and Emotions 12/11/04 Relationship and Hormones 1/15/04 Holistic Health Planning 09/06/97 Day of Caring—United Way Service Day 04/22/97 Golden Rule—United Way Awards for Excellence 04/19-20/96 Non-Profit Board Development 04/19/95 Building a Strong Non-Profit Board 07/13-15/95 Philanthropy Days—Organizer 03/01/92 International Women's Week Organizer CONFERENCES ATTENDED: TRAINING/GROUP FACILITATION 4/23-30/02 Survival Skills for Healthy Families,Facilitators Training 10/30/99 Matrix Leadership 10/21-22/96 Working as Partners with Managed Care 04/02-05/96 El Pomer Community Leadership Program 1995 Community Resource Center,Leadership Program 02/09-13/95 Challenge by Choice: Ropes Course 05/20-22/94 Organizational Conflict Management: CSAP 02/01-04/94 Multicultural Conference 04/14/94 Empowering Resistive Client II 05/03-14/94 Teen Baseline,Training Of Facilitator 06/09/93 Empowering Resistive Clients 10/05-09/93 Baseline,Training Of Facilitator 11/30/93 Exploring Multiculturalism,Facilitator Training 10/13/93 Conflict Mediation Training 08/11-14/92 Multicultural Training:CSAP 05/12-26/89 Women as Leaders FAMILY/ORGANIZATIONAL SYSTEMS 08/07-08/05 Preserving Connection,Effective Visitation 2004-2005 Mastering the Art of Child Welfare Supervision 11/03-05/02 Marriage and Family—2000 National Conference 06/04-06/99 Passionate Marriage 10/15-19/98 Marriage and Family Conference 05/16-17/98 Relationship Enhancement 12/08-09/97 Family Group Decision Making 10/06/97 Family Group Decision Making 05/02-03/97 Marriage and Family Conference Fall 1995 Leading Edge/Strategic Planning 03/29/95 Fund-saving Workshop 09/15-16/94 Family Preservation—Supervision 07/20/94 Jim Fay Parenting 07/13/94 Family Sculpting 04/26-27/93 Family Sculpting Spring 1993 Redirecting Children's Behavior 02/06/93 Meaningful Family Communication 07/07-08/92 Active Parenting 03/16-19/92 Family Preservation Training 09/20-21/90 Parents and Professionals United BODY-PSYCHOTHERAPY;TRAUMA AND GRIEF 08/04/05 Ron Kurtz-Hakomi 08/5-7/05 Hakomi-Body-Psychotherapy Conference 03/03-06/04 Developmental Need Meeting Strategy 06/20-23/03 EMDR International Conference 3/7-9/03 EMDR 10/26-27/01 Nero-science and Somatic Treatment of PTSD 1/14/01 Allan Schore—Neurobiology of Trauma 2/16/01 Bessel Van der Kolf—The Limits of Talk Therapy in Trauma 03/28/01 Bruce Perry—Brain Development 1999-2000 Hakomi, Sensorimotor Integrative Somatics-Certificate 12/03/99 Jurisprudence Workshop 06/25/99 Molecule of Emotions 04/09/99 Depression and Anxiety 05/19/97 Cultural Grief 09/14-16/95 Annual Hospice Conference CHILD WELFARE 12/13/04 Therapeutic Foster Parenting 06/04/05 Primal Wound,Parenting the Acting out Children 01/07-08/00 Foster Parent Core Training 01/23/02 Attachment Disorders&Adoptive Parents,Terry Levy 2001 Bonding and Attachment-Infant Massage 2001 Pulled From Rushes—Power of Narrative in Adoption 2001 A Day of Play Fred Donaldson 2000—2005 Child Welfare Conference 2000 State Foster Parent Conference-Trauma in the Body 1999 Reaching Children—Play Therapy Byron Norton 09/10/99 Testifying in Child Abuse Cases 07/12/99 Fire starting—Prevention and Intervention 01/29/99 Play Therapy 12/11/98 Attachment Disorders 10/18/97 Art Therapy for Children 04/04/97 Attachment Disorders 10/11-13/96 International Play Therapy Conference 07/08-09/94 Play Therapy 09/26/93 Traumatic Stress Reactions in Children 03/11-14/93 Child Adolescent Conference Spring 1993 Play Therapy for Adolescence 02/16-17/91 Strategic Therapy for Adolescence 10/11-13/90 C.H.A.D.D. Conference on ADHD 05/30-6/1/90 Early Intervention 12/05/89 Play Assessment SUBSTANCE ABUSE AND DOMESTIC VIOLENCE 07/19/05 Challenges of Methamphetamine—Community 10/14/98 Working with Aggression in Group Therapy 09/23/97 Domestic Violence 09/17/97 Substance Abuse 05/16-17/94 FPS—Motivational Interviewing—Jill Kenney 09/17-19/92 Annual Mental Health Conference 04/23-24/92 Domestic Violence Conference SHARON K. BENSON, M.A. 2201 2nd Street**Greeley, CO 80631 970-351-8246 FORMAL EDUCATION Graduated University of Northern Colorado,Greeley,Colorado 1985 Master of Arts degree in Professional Psychology Graduated California State University at Northridge,California 1978 Bachelor of Arts degree in Psychology Graduated Moorpark Community College,Moorpark,California 1975 Associate of Arts degree Studied University of Northern Colorado,Greeley,Colorado 1982-1984 Special Education,Secondary Graduate program WORK EXPERIENCE 11/04 to Present—Disability and Mental Health Specialist,FENWC Head Start,Greeley,CO 1/97 to Present—Adjunct Instructor,Aims Community College,Greeley,CO Courses taught in the Psychology,Business and Emergency Medical Academy departments. 3/98 to Present—Financial Advisor,Waddell&Reed,Greeley,CO Professional financial advisor,planner,and educator. Series 6 and Life insurance licensed. 1/93 to 6/98 -Consultant,self-employed,Greeley,CO Contractual work with court ordered families,private and public companies. Specialization: Critical Incident Stress and Trauma 1/85 to 12/96 - Licensed Psychotherapist,self-employed,Greeley,CO Psychotherapy counseling in a private practice with families and individuals. Specialization: Trauma. 1/86 to 12/89 -Executive Director,Greeley Resources for Independent People,Greeley,CO Not for profit center for people with disabilities providing independent daily living skill training and equipment. LICENSE,CERTIFICATIONS,MEMBERSHIPS&AWARDS 1998 Licensed *National Association of Security Dealers Series 6—Securities License 1998 Licensed *Insurance—Life 1992-1997 Licensed *Licensed Professional Counselor 1995-present Certified *Hypnotherapist 1993-present Certified *Critical Incident Stress Management—Advanced Training 1997-2002 Credential *Colorado State Board for Community Colleges&Occupational Education-Vocational Credential in Business&Health Occupations 1985-present Certified *Mediation/Conflict Resolution 1992-present Member/ *Centennial Critical Incident Stress Management(CISM)Team Director *Clinical Director CISM Team from 1997 through 2000 2000 Award *Aims Community College Award for Excellence in Adjunct Teaching William(Bill) E.George 4909 30th St. Greeley, CO 80634 Home Ph. (970) 339-3427 Cell Ph. (970)371-2220 E-mail bgeorgel6©comcast.net Objective To work as a health care professional where I can utilize my skills in counseling, mediation, case management and consulting. Relevant Skills Clinical Knowledge& Practice: • Unique ability to communicate with people in stressful situations, establish trust, and facilitate positive change. • Have counseled adults in both outpatient and inpatient settings. Over six years of experience in group and individual therapy. Experience in mental health and substance abuse assessments with adults and adolescents. Identification of appropriate diagnoses using ICD-9 and DSM IV-TR. • Over ten years of case management experience coordinating patient focused outcomes. Excellent problem resolution skills through face to face intervention, groups or telephone. • The ability to gather and synthesize sensitive information from people with varied backgrounds. • Three years of providing assessments and testing for veterans to determine vocational aptitudes and interests for the Dept. of Veteran Affairs. • Experience in home visits to clients for vocational/medial disability evaluations. • Expertise in medical and psychiatric utilization review. A unique blend of clinical background including mental health, substance abuse, vocational rehabilitation counseling or consultation and disability management. • Training in child bonding and attachment. Facilitation& Mediation Skills: • Facilitation of a foster/adopt parent support group to provide family support for children with attachment and bonding issues. • The ability to multi-task and coordinate sensitive medical information between the physician, client and various providers to facilitate positive treatment planning and case direction. • Ability to analyze family dynamics and multi-faceted psychological/social issues with clients who have disabilities or work injuries. • Communication with a gentle and family focused style that assists clients to examine difficult decisions and to facilitate positive life choices regarding life situations. • Accomplished negotiator: Coordinated treatment with various providers, insurance companies. Arranged costs and pricing with a range of service providers, including home health care, skilled nursing facilities, rehabilitation centers, and hospitals. Administrative&Organizational Strengths: • In a director-level position, made policy decisions, delegated work, handled problems, oversaw budget, and represented interests for a non-profit organization. • Proven skills in classifying and organizing information, allowing for quick access to needed facts and resources. • Implemented new treatment curriculum for a non-profit agency. • Possess broad computer background in database administration, Microsoft Word and Internet. Skills in Management&Supervision: • Supervised seven highly-skilled case management professionals, providing guidance, monitoring work quality and deadlines, and overseeing reporting and administrative activities. • Supervised three counselors and provided clinical supervision of two hundred clients for an outpatient alcohol/drug treatment program. • Have consistently received positive feedback for managerial and administrative work performed. Comment from previous supervisor: "He is not afraid to face a challenge, and works as a team player. He had a good grasp on the business end, and follows up every step of the way." • Excellent oral/written communication abilities, especially for status reports, business correspondence, etc. Comments from a provider:"He was kind, direct, thorough and respectful." Benefits Knowledge: • Knowledge of COBRA, HIPAA, Workers' Compensation, labor acts, and discrimination policies. • Extensive background in benefits claims handling, including serving as a liaison between the plan participant, the insurance provider, and other related parties. • Highly accomplished at managing enormous amounts of data: Was responsible for knowing the details for more than 30 different benefit insurance plans, as well as monitoring eligibility status for thousands of plan participants. Work History: 2005-Present Facilitator with Lori Kochevar-Jubilee Retreat Center-Greeley, CO 2003- Present Vocational/Medical Genex-Denver, CO Case Manager 2001 -2002 Medical Case Manager Sedgwick CMS-Denver, CO 2000 -2001 Clinical Director Mile High Council on Alcoholism and Drug Abuse- 1994-2001 On-call Therapist Longmont United Hospital-Longmont, CO 1994 -2000 Health Management Zenith Administrators-Westminster, CO Coordinator 1987- 1993 Supervisor Intracorp-Denver, CO (Also held positions as Psychiatric Case Coordinator and Rehabilitation Specialist at Intracorp) 1983- 1987 Therapist Island Grove Regional Treatment Center- Greeley, CO 1980 - 1983 Psychiatric Team Assistant North Colorado Medical Center-Greeley, CO Education: University of Northern Colorado, M.A., Psychology, Counseling &Guidance with emphasis in Agency Counseling, 1984 University of Northem Colorado, B.A., Psychology, 1980 Certifications: Certified Case Manager Alcohol and Drug Counselor,Level III-State of Colorado Barbara Jetley Master of Arts Licensed Professional Counselor P.O. Box 40996 970-314-2608 Grand Junction, CO 81504 pogojet©hotmail.com 6/05 — Present Project BLOOM Clinical Coordinator, Colorado West Mental Health Center, Grand Junction, CO. I provide consultative services and collaboration with Early Childhood Partners and other service providers in Mesa County. Social Marketing of a wrap around approach for intervention and participation in a National Evaluation is a major component of this Federal Grant. I provide mental health assessment case management and therapy services to children under six, and their families. This non-traditional model includes services in variety of settings including childcare settings and home. 7/04- 5/05 ADMINISTRATIVE WORK, Kelly Services, Everett, WA I provided temporary administrative work in insurance, publishing and intellectual property settings. 8/96— 3/04 PRIVATE PRACTICE, Pagosa Springs, CO. I provided general counseling services to a variety of clients, both privately and under contract with the Archuleta County Department of Social Services. I provided Family Preservation/Home Based Family Therapy entailing intensive home based services to families with children at risk for out of home placement, individual and family therapy, case management and crisis intervention. Also, with the same contractor, I employed, administered, and was clinical supervisor to a paraprofessional, providing mentoring services to boys with behavior problems. I provided standardized treatment as a Certified Provider for court ordered Domestic Violence Offenders. I provided clinical supervision to two Domestic Violence Counselors in the Twelfth Judicial District. I received frequent referrals from Victim's Compensation and Probation. I was elected President of the volunteer Board of the Archuleta County Victim Assistance Program, and served for two years. 1/93 - 8/96 FAMILY DEVELOPMENT SPECIALIST, Southwest Colorado Mental Health Center, Pagosa Springs, CO. I provided the above Family Preservation Services through this agency. Duties included a children's summer program, outreach to homebound seniors, and service on the Quality Assurance Committee. Community development included the Community Support Team, Adult Protection Team, Long Term Care Committee, and the Child Protection Team. 7/92 - 1/93 CLINICIAN, Creative Resource Center, Monte Vista, CO. As Certified Domestic Violence Treatment Provider, I was recruited by this agency to take over their Domestic Violence Offender Program. I provided outpatient clinical services to a general population. 2/90 - 6/92 CLINICIAN, San Luis Valley Comprehensive Community Mental Health Center, Alamosa, CO. I provided counseling services to groups and individuals with major and chronic mental illness, including adults, children, couples and families. My duties included 24 hour crisis intervention, mental status evaluations, assessment, diagnosis, treatment planning, charting and peer review. 9/88 - 12/89 MASTER OF ARTS, Adams State College, Alamosa, CO. GPA: 4.0. 1/86 - 12/88 BACHELOR OF ARTS, Adams State College, Alamosa, CO. GPA: 3.97. Summa Cum Laude, Psychology Major CERTIFICATIONS AND LICENSING Colorado Licensed Professional Counselor#1056 Certified Equine Assisted Psychotherapist Certified Family Development Specialist Certified Teacher of English as a Foreign Language MEMBERSHIPS (former and current) American Counseling Association Colorado Counseling Association Archuleta County Victim Assistance Program Board President President's Honor Society, ASC Dean's Honor Organization, ASC Barbara Jetley Continuing Education DC 0-3R Diagnostic Assessment for Early Childhood—Grand Junction, CO—Aug. 30-31, 2005. NCAST Conference and Mental Health in Pregnant Women—Seattle, WA—Aug. 5-8, 2005. Nurse's Child Assessment Satellite Training—Grand Junction, CO—9 days, Jul. Aug. Sept. 2005 High Fidelity Wraparound Multi-system Case Management—Grand Junction—July 6-8, 2005. HIV/AIDS Education and Prevention Class—Everett, WA—April 2, 2005. Teaching English as a Foreign Language—Net based-Jan to April, 2004. Grant Writing- Pagosa Springs-March 27-28, 2003. Art and Play Therapy with Child Victims of Trauma- Denver-2002. Family Group Decision Making- Pagosa Springs-June 25-26, 2001. Play Therapy Workshop, A Play Odyssey- Denver- Mar 8-9, 2001. Colorado Organization for Victim Assistants- Keystone-Nov 13-15, 2000. Tactics of Men who Batter—Duluth, MN -Oct 26-28, 2000. Equine Assisted Psychotherapy Certification- LaVeta -July 12-14, 2000. Colorado Child Welfare Conference-Vail -June 7-9, 2000. Mental Health and Infants- Ignacio-Apr 14, 2000. Ongoing Foster and Adoption Training - Durango- December 8-9, 1999. ACVAP Voluntary Board Training-Pagosa Springs-Sept 19, 1999. Issues of Post Legal Adoption - Douglas Califono- Durango -May 19-21, 1999. Jurisprudence-Larry James-Durango-April 23, 1999. Anti Social Personality Disorders-Stanton Saminow- Denver- Nov 18-20, 1998. Assessment of Lethality-Gary Gibbons-Alamosa-Sept 11, 1998. Child Welfare Conference-Vail -June 10-12, 1998. Colorado Organization for Victim's Assistants Conference-Steamboat Springs-Oct 22-24, 1997. Training in Assessment and Treatment of Domestic Violence- Durango-Oct 15-16, 1997. Custody Evaluations-Breckenridge-Sept 11-13, 1997. Grant Writing - Durango- Feb 21, 1997. Ending Violence Against Women- Pagosa Springs-Aug 19-20, 1996 Child Therapy, Foster Cline- Pagosa Springs-June 14, 1996. Making Sense of Marital Conflict-Denver University-June 10-12, 1996. Secret Crimes- Ft. Lewis College-May 16-17, 1996. Family Reunification - Denver-April 22-24, 1996. Colorado Mental Health Conference- Breckenridge -Sept 17-19, 1995. Four Corners Indian Country Conference-Stopping the Cycle of Violence-Durango-Aug 23, 1995. Lorenza P. Perezverdia B.S. CAC II Bilingual counselor (English-Spanish) Eaton, Co. 8061 5 (970) 405 4491 lorenzach@hotmailcom Bi-cultural counseling skills • Ability to identify individual's struggle to adapt into the American Culture due to cultural differences • Ability to assist and ease individuals and family's adaptation process. • Extensive knowledge of local public resources • Ability to recognize the kind of public resources and provide information about them to the individual according to their unique needs. • Ability to visualize potential problems/obstacles that the clients might encounter to succeed in their environment. • Ability to recognize common behaviors in the Hispanic culture that represent a major risk for the client or people in the community. • Ability to assist client to recognize such behaviors as potential problems and assist them to find better choices to achieve desired results. Drug and alcohol counseling skills • Knowledge in the use of tools to assess individual's Probability of having Substance Abuse or Substance Dependence Disorder. • Ability to provide knowledge regarding drug and alcohol short and long time effects and consequences in different areas in a person's life. • Great ability to empathize with client's current situation • Ability to provide knowledge in a manner that could be integrated in the individual's daily, practical life. • Habituated in using a extensive variety of tools to provide knowledge (visual, hearing, hands-on, experiential) • Knowledge in Motivational Interviewing and ability to encourage client's major changes in a life style. • Ability to work in team with different State Departments to better assess client's needs and to assist clients to succeed. Training All classes required to be a Certified Addiction Counselor II Sub-cultures Trained in Cognitive-Behavioral based Programs. I sub-developed a Therapy program for DUI Hispanic offenders in Larimer Co Work history 2000 Internship Educational Psychology in a Special School that worked with children with special needs such as learning, development, motor disabilities. Industrial Psychology in a Human Resources/Job placement place. Clinical Psychology in a Victim's Advocacy place. I worked with Sexual Assault Victims. 2000- Present CATS I started as a volunteer and was hired as Contract counselor former Teen Counseling in 2002. I've Worked with adult Hispanics,teenagers and Center I've held Anger Mgmt.Groups. Most of the clients are DUI offenders.The main goal of the program is to prevent Relapse and Recidivism. 2000- 2002 Part-time job as Interpreter,working especially in the medical/ Rehabilitation field. 2002-Present Creative Counseling Hired a full-time Counselor in 2003. My job includes but is not Services/Institute for limited to working with DUI offenders,doing intakes,discharges Alcohol Awareness Case Management,Substance Abuse Evaluations, Individual and Group Therapy sessions, Relapse Prevention, Monitoring sobriety,etc. Education Universidad de Guadalajara UNIVER AIMS Community College Odyssey Training Center Appendix C WELD COUNTY AUTHORIZATION FOR CONTRACTUAL SERVICES Date: J ui1 a. 5, 26175 Provider: Lori Kochevar MS, LPC. LLC Billing Contact: Loci I(A Tilt or 1024 8th Street Phone #: qqo- 352 -gg'7 3 Greeley, c0 80631 (970) 352-8873 Address: Description of Services: F05-tu.r Palt-n-{' C01150ltnt is i Service Month / Year M QJS Charges: $_�j5fo• Q U I CERTIFY THE SERVICE AUTHORIZED WAS PROVIDED ON THE DATE INDICATED AND THE CHARGES ARE MADE PURSUANT TO A BONA FIDE CONTRACT BETWEEN ME AND THE WELD COUNTY DEPARTMENT OF SOCIAL SERVICES. LOd'i Kcrykeuu r O92} Kcal-Iwo/lire-G-405 Printed Name of Signer P vider Signature Date AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA FOR COUNTY USE ONLY: Approvals: / / Core Caseworker Date Director Date AMOUNT PAYABLE: $ ANY CHANGES LISTED BELOW: Client/ID/HH# Billed Amt Denied Paid _ Reason iii x o3 0 E/ / § CO ) k » t N en ea. f \ o o u, \ � E [ ) g / \ \ o � 7 . ) 2 z « oAk \} e ; § ) 0 < 0 , § y ^ ) \ 0 \ 1 \ \ / 0. § .2 0 ; z ) � � » ! @2 • o = \/% ) ; § ( © < J j g § = o < EF2 % * . $ u as x v � N - dam . \ \ 76 � iAarz4 — _ _ ' \ 3 a at / 7( \\ a 37 ON � / { Ie Ho z )� ® ® o . 0 , - 0Q to \ § ] \) . j ) ` § � X \ � § C — } co co ( � 1 2 § ) 2 / / o © • \ k \) ( z . 0 O ) ) \ © / H 9 ) ®0 () 0 ` a O { ) > \ = o 03 0 t 4-5 ± ! ; ) \ ® cm § \\ ) / ) ) } 4, z ± ) \ a ] \ O � \ (\ \ ± § k \\ \ § k } 9 Ea [ v ) k 2 \ z • - / % i / \• \ / ; a Q to \ ( ( \ — \ . / k ( ) � q j tu * N § \ > \ en o ell \ § CO 0 rn 0 } \ \ ( • ° 00 \ 0 t § -4t 0 ; 2 >-' ) ) \ \ 013,'C ) § \ » 2 %00 2 § ( ® } 2 ) � / w k % } $ ) ) }f \ ) ) % 4 U ) . 72 ` _ (\ . ` Q -0 ± ) ) f2 \ / ) }/ d \ Vin § = ; I ? , o o \ \ / 0.- ( j / } ) � k ® a 0 ! )7 \ - bb ( \ ] f \ � \ \ / } § ) j ) a \ \ k ) t.-. \ ( \ } / ] ( Z z w w = 5- aaOS Pub 6Z,e io ";;27 p Tim (2u(+on Tuvt /Uu . 2 . 3 (04 Pitt- Piet-- 3 A n) d na John, A rti ' l JtomfL ( Anc-turf sLru tc Aai (?tst U, 1-Yip �s pooh (dith eA4 Ryan At wood - ktiocuct f-4 ischo 13aiton E'1UJGkl. 60.4z-v•- g. 12a6ku.l Gi son 0 _ MRR-2e-289G 13:44 14-riNilr iro srnv.LO CL., . I., •1.,,.... I .�. HEALTHCARE PROVIDERS CAM SOME Date: 03/28/06 SERIRCE OItiGARIZATION �GROUP . CERTIFICATEOF INSURANCE OCCURRENCE POLICY FORM a 1 mT• 970 0273177648 12 I rtne ,r r ' t . 12 '1 AM 'Cr... :..:_-_ ` ... g- -. Lori Koahevar MS LPC LLC Healthcare Providers Service Organization 1024 8th Street 159 East County Line Road Greeley, CO 80631 Hatboro,PA 19040-1218 MScewa LA ed i ionat Counselor Am 72 American Casualty Co of =r ading,PA CNA Plaza 285 Chicago,IL 80685 • A. PROFESSIONAL LIABILITY Professional Liability(PL h cl) $ 1,000.000 each claim S 6,000,000 aggregate Good Samaritan_Lla6aR— included above ^; 9 s - eersonalTMury Liability included above _ __— _ _ y M„s3 _'Mai 1acement Liability included above _ — w 1 'k' :� B. COVERAGE EXTENSIONS: —Pecliion $ f:000 er 5 25 00— aeg __ Defendant Expense genefn r : $ 10,000 aggregate _Deposition Representation % _ ;s +. r 16,000 .4ur,esiate— Assauk $ 10,000 per Incident S 25,000 aggregate Msmcal Falr„muts -- S 2 000 f t0Q�__ aggregate_. AW a1 c +'"l�'.'f. = s 2.500 aggregate .. Damage to Property of Others $ 2,500 per incident $ 10,000 aggregate C. WORKPLACE LIABILITY anew pen C.~On Liability tares aa ageing ctr,awe.+D.General usea*►mad.Pert or . Workplace Lia n -Fire&Water LegaTiiabifdy none _ — _isitrsoneltiebdiy lianteitittntnaginUE none D. GENERAL LIABR]TY 'v pert D.Generr Waller me netep$r Icr.rac3 pad C.VMS*Le**is made wm WM.Doan. General Liability(GL) $1.000,000 each occurrence 1, , aggregate —Ri D " " 'Ai none 000000 • .Pa J Fire&Water Legal WWI included in Gt.Whit above subject to 5250,000 sub-limit^ it— _Personal Liability xraas ilaeilr= n�f .-' nw Total Premium:$ 650.00 QUESTIONS?CALL: 1-888-288-3534 G-121500-C G-121501-C G-145184-A G-147292-A G-144872-A G-123846-COS G-121504-C G-123827-B G-123828-B G-141234-A tte.p On der,.ebeb•.r&Plana. Kann prader Mewl IIb enema,of Master Policy ft X08711433 (/ �/\�\� �r0[�1./e�1�S1�1�./1A1�e.//f/.OWI.K. � /A V A 4kér (( Secretary x.141241-A (07/20011 Coveraae Chance Date_ 03/24/06 Endorsement Chanoe Date: 03'/24/06 MAR-28-2006 13:25 HFFINIIY INS Stilt-NI-LS ta.' r,.i 4aro r.urw • ® HEALTHCARE PROVIDERS GENERAL LIABILITY COVERAGE PART ENDORSEMENT Additional Insured General Liability In consideration of the premium paid.and subject to the General liability land of liability shown on the certificate of insurance, it is agreed that the GENERAL LIABIUTY COVERAGE PART is amended as follows: The person or entity named below(the"additional insured')is an insured under this Coverage Part but only as respects its liability arising out of named insured's operations,or premises owned by or rented by the named Insured and solely to the extent that: 1. a general liability claim is made against the named insured and the additional insured;and 2. in any ensuing litigation arising out of such claim,the named insured and the additional insured remain as co-defendants. In no event is them any coverage provided under this policy for an occurrence that is the drect liability of the additional insured. Additional Insured: State of Colorado Weld County/Social Services PO Box A Greeley, CO 80834 This endorsement is a part of your policy and takes effect on the effective date of your policy, unless another effective date is shown below. All other provisions of the policy remain uncharged. Must Be Completed Complete Only When This Endorsement Is Not Prepared with the Policy Os Is Not to be Effective with the Policy. ENOT. NO. POLICY NO. ISSUED TO ENDORSEMENT EFFECTIVE DATE • 01 i 0273177648 Lori Kochevar MS LPC LLC 3/24/2006 TOTAL P.03 ( w - ,. 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S. L. P. C. 97O-284-O232 p. 2 • S The Bonding Program The Jubilee Center for Families 1024 8"'Street Greeley,CO 80631 970-:57-RR7; Weld County DSS PO Box A Greeley Co 80631 Re: RFP 06005; Lifeskills Re: RFP 006-00a: Foster Parent Consultation Re: RFP 006-00c: Foster Parent Training Dear Ms. Griego, This letter serves as written confirmation that I received the results of the Bid process for the 2006-2007. I am in agreement with the Commission's conditions. The following is the response requested by the conditions for the RFP 06005, Lifeskills. Recommendation, identify staff and there qualification. Staff qualification are attatched to this letter. Resumes can be found in Appendix B of the original bid proposal. Compliance Items are found in my original grant submission for Lifeskills in Appendix E. Letters of collaboration from Weld county Housing authority, employment training partners,and A Women's place,as well as a letter from NRBH defining the process we will utilize to facilitate Medicade eligible clients receiving services at NRBH. Thank you for this opportunity to again serve the families of Weld County. Please let me know if you are in need of any further clarification. Sincerely, Q 'icaLori kochevar M.S. LPC May 19 06 09: 57a Lori Kochevar M. S. L. P. C. 970-284-0232 P- 3 STAFF QUALIFICATIONS A. All the providers exceed the minimum qualifications needed for both education and experience. All providers have their Master's and or a Bachelors Degree in Counseling or Registered Nursing Degree. In addition, the therapists have between 5-20 years a piece providing services for families. See Resumes in Appendix B. B. Staff available for this project consists of five experienced bonding specialists that have a similar core value of clinical excellence. We believe in providing strength-based, services that empower the families we serve. Another strength of our staff is our diverse areas of specialties. • Lori Kochevar a licensed professional counselor has extensive experience and training in providing services and supervision using the family preservation model. She has been working in the field for over twenty years. She has specialized training in substance abuse, attachment and bonding, trauma, grief, and domestic violence. In the last fifteen years Lori has developed and facilitated multiple training's that emphasize experiential learning opportunities. Many of these training's were developed specifically for foster parents, while others were created for families, school personnel, and service providers across the state. • Lorenza Perezverdia, is a Certified Addictions bi-lingual and bi- cultural Counselor. She has extensive knowledge of how to provide state of the art services for clients addicted to substances. She is trained in Motivational Interviewing that helps clients address the core issues that keep them from progressing. Lorenza got her bachelor's degree in Psychology in Mexico in 2000. She has done relapse prevention, individual and group therapy, substance abuse evaluations, anger management groups, groups for victims of sexual abuse and also worked with children with special needs. She has recently developed a program to help DUI offenders understand and abide by the United State Laws and Culture as they progress into their adaptation process. 18 May 19 06 09: 57a Lori Kochevar M. S. L. P. C. 970-284-0232 p. 4 • Jenna Reed has a bachelor of Social Work and seven years experience in child welfare as a caseworker with ten total years of experience in the Social Work field. She has completed all of the CORE trainings and has performed multiple duties as a caseworker over the years including but not limited to crisis intervention, intake, ongoing, and resource utilization. In addition to her current duties as an emergency child protection worker in Boulder County she is currently teaching a Parenting through Nurturing class focusing on safe and effective parenting of infants and toddlers. • Becky McMahan has had extensive experience in the area of child health care. She received her RN. from the Mennonite Hospital School of Nursing - Bloomington, Illinois. She worked as pediatric nurse for fourteen years. The past 7 1/2 yrs she was a public health nurse where she was in chime of the bonding program and other pediatric related programs. • Barb Jetley is a licensed professional counselor. She received her Master's degree from the Adams State University. Barb has been in the field for the last sixteen years and has extensive experience working with many different clinical populations. Most recently, she serves as the clinical coordinator for children under six and their families for Project BLOOM. She has worked as a family preservation specialist, domestic violence counselor and an outpatient clinician. C. New Caseworker Training- Lori Kochevar, M.S. L.P.C. the supervisor for this bid has attended the Core training for Supervisors through the State of Colorado, she will oversee the work of all other staff to make sure it is in compliance with requirements. In addition, Jenna Reed who is working on bids submitted from this agency has successfully completed new caseworker training. D. Risk assessment knowledge is taught during the orientation training; in addition all staff is versed in multiple levels of risk assessment and are able to address risk issues as they occur during interventions. 19 • , #(1‘17: 11 y DEPARTMENT OF SOCIAL SERVICES P.O. A BOX GREELEY, CO. 80632A Website:www.co.weld.co.us ' Administration and Public Assistance(970)352-1551 Child Support(970)352-6933 WI C. COLORADO May 15,2006 Lori Kochevar MS LPC The Jubilee Center for Families 810 12th Street Greeley, CO 80631 Re: Bid 06LS09(RFP 06005), Lifeskills Bid 06FPC04(RFP 006-00A),Foster Parent Consultation Bid 06FPT03 (RFP 006-00C),Foster Parent Training Dear Ms. Kochevar: The purpose of this letter is to outline the results of the Core Bid process for PY 2006-2007 and to request written confirmation from you by Monday, May 22,2006. A. Results of the Bid Process for PY 2006-2007 • The Families, Youth and Children(FYC)Commission recommended approval of your Bid 06LS09 (RFP 06005), Lifeskills, for inclusion on our vendor list, attaching the following recommendation. This bid scored a total of 94 points. Recommendation: You must identify your staff and their qualifications. • The Families, Youth and Children (FYC)Commission recommended approval of your Bid 06FPC04 (RFP 006-00A), Foster Parent Consultation for inclusion on our vendor list.This bid scored a total of 96 points. • The Families, Youth and Children(FYC)Commission recommended approval of your Bid 06FPT03 (RFP 006-00C), Foster Parent Training for inclusion on our vendor list. This bid scored a total of 93 points. Compliance Item: For bids numbered 06FPC04 and 06FPT03,you must provide the required letters under the Collaboration Section from Weld County/Greeley Housing Authority, employment/training partners, and other partners as identified in the bidder's assessment of needs. You must identify the process you will utilize to facilitate Medicaid eligible clients receiving mental health services at North Range Behavioral Health. Page 2 Lori Kochevar,LLC, Results of Bid Process 2006/2007 B. Required Response by FYC Bidders Concerning FYC Commission Recommendations: Recommendations: You are requested to review the FYC Commission recommendations and to: 1. accept the recommendation(s)as written by the FYC Commission; or 2. request alternatives to the FYC Commission's recommendation(s); or 3. not accept the recommendation(s)of the FYC Commission. Please provide in writing how you will incorporate the recommendation(s)into your bid. If you do not accept the recommendation,please provide written reasons why. All approved recommendations under the NOFAA will be monitored and evaluated by the FYC Commission. The Weld County Department of Social Services is requesting your written response to the FYC Commission's recommendations and compliance item. Please respond in writing to Gloria Romansik, Weld County Department of Social Services, P.O. Box A, Greeley, CO, 80632, by May 22, 2006, close of business. You may fax your response to us at 970.346.7698. If you have questions concerning the above,please call Gloria Romansik at 352.1551, extension 6230. Sincerely, u A. Grie o, Direct cc: Juan Lopez,Chair,FYC Commission Gloria Romansik, Social Services Administrator Hello