HomeMy WebLinkAbout20021316 RESOLUTION
RE: APPROVE NOTIFICATION OF FINANCIAL ASSISTANCE AWARD FOR FOSTER
PARENT CONSULTATION AND AUTHORIZE CHAIR TO SIGN - LORI KOCHEVAR
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board has been presented with a Notification of Financial Assistance
Award for Foster Parent Consultation between the County of Weld, State of Colorado, by and
through the Board of County Commissioners of Weld County, on behalf of the Department of
Social Services, and Lori Kochevar, commencing June 1, 2002, and ending May 31, 2003, with
further terms and conditions being as stated in said award, and
WHEREAS, after review, the Board deems it advisable to approve said award, a copy of
which is attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of
Weld County, Colorado, ex-officio Board of Social Services, that the Notification of Financial
Assistance Award for the above listed program between the County of Weld, State of Colorado,
by and through the Board of County Commissioners of Weld County, on behalf of the
Department of Social Services, and Lori Kochevar, be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said award.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 22nd day of May, A.D., 2002.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, CO ORADOs
ATTEST: LS ��t IE t
t Gle���nnn���(((aa7d, C itF4
Weld County Clerk to the ar ��a
avid E. Lo , Pro-Tem 7)
BY: _ti/ ,. o . „
Deputy Clerk to the Boa .i.,;UN""'
I� J.4eile
APPRO AS T 41 -t-e
iam H. Jerk e\(t
ounty or"ne4 ~— �
Robert D. Masden
Date of signature: $/3°
2002-1316
SS0029
1.111 •
DEPARTMENT OF SOCIAL SERVICES
PO BOX A
GREELEY,CO 80632
' WEBSITE:www,co.weld.co.us
Administration and Public Assistance(970)352-1551
Child Support(970)352-6933•
COLORADO
MEMORANDUM
TO: Glenn Vaad, Chair Date: May 22, 2002
Board of County Commissioners
FR: Judy Griego, Director a
Weld County Departme f So 'al Se •ces
RE: PY 2002-2003 Notification of Financial Assistance Awards (NOFAA) under Core
Services Funds-Lori Kochevar, MS, LPC, LLC
Enclosed for Board approval are the PY 2002-2003 Notifications of Financial Assistance
Awards (NOFAA) for Families, Youth, and Children Commission (FYC) Core Services
Funds,which are for the period of June 1, 2002, through May 31, 2003.
The Families, Youth and Children Commission (FYC) reviewed proposals under a
Request for Proposal process and are recommending approval of these bids.
Lori Kochevar, MS, LPC, LLC
A. Foster Parent Consultation: Program capacity provides for services for 50
individual foster parents per year. Four hours of services per week, 8 hours of
support group and 4 hours of consultation per year per foster parent,for a total
of 600 client hours per year. Monthly average capacity is 16 hours of consultation
services and 6 support group hours. The average stay in the program is 7 weeks.
Bilingual-Bicultural services available to all families. South County services
available. $80/hour individual rate; $45/hour group rate.
If you have any questions, please telephone me at extension 6510.
of
2002-1316
Page 1 of 1
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 FY02-CORE-0007
Revision (PY 02-03 RFP-FYC-06-000)
Contract Award Period Name and Address of Contractor
Beginning 06/01/2002 and Lori Kochevar.
Ending 05/31/2003 Foster Parent Consultation
810 12 Street
Greeley, CO 80631
Computation of Awards Description
Unit of Service The issuance of the Notification of Financial
Assistance Award is based upon your Request for
Program capacity provides for services for 50 Proposal (RFP). The RFP specifies the scope of
individual foster parents per year, 4 hours of services and conditions of award. Except where it is
service per week, 8 hours of support group, and 4 in conflict with this NOFAA in which case the
hours of consultation per year per foster parent, NOFAA governs, the RFP upon which this award is
for a total of 600 client hours per year. Monthly based is an integral part of the action.
average capacity is 16 hours of consultation
services and 6 support group hours. Average stay Special conditions
in the program is 7 weeks. Bilingual-bicultural
services available to all families. South County 1) Reimbursement for the Unit of Services will be based
services available. on an hourly rate per child or per family.
2) The hourly rate will be paid for only direct face-to-face
Cost Per Unit of Service contact with the child and/or family as evidenced by
Hourly Rate Per $80.00 client-signed verification form, and as specified in the
Hour Rate per Group $45.00 unit of cost computation.
Unit of Service Based on Approved Plan 3) Unit of service costs cannot exceed the hourly and
yearly cost per child and/or family.
Enclosures: 4) Rates will only be remitted on cases open with, and
X Signed RFP:Exhibit A referrals made by the Weld County Department of
X Supplemental Narrative to RFP: Exhibit B Social Services.
X Recommendation(s) 5) Requests for payment must be an original and
Conditions of Approval submitted to the Weld County Department of Social
Services by the end of the 25th calendar day following
the end of the month of service. The provider must
submit requests for payment on forms approved by
Weld County Depattment of Social Services.
Approvals: Program Official:
By aS By lit (
Glenn Vaad, Chair Judy riego, 'rector�
Board of Weld County Commissioners Weld unty Department of Social Services
Date: O57.2a/aOO,:), Date: 51
!(lot-
„zoo.-/3/fo
EXHI.BTT A
SIGNED RFP
,
INVITATION TO BID
PY 02-03 006-00
` --- `.
DATE:February 27, 2002 BID NO: PY02-03 006-00
r a
RETURN BID TO: Pat Persichino, Director of General Serviees
915 10th Street, P.O. Box 758, Greeley, CO 80632
SUMMARY
Request for Proposal (006-00) for: Family Preservation Program Foster Parent
Consultation
Family Issue's Cash Fund or Family Preservation
Program Funds
Deadline: March 22, 2002, Friday, 10:00 a.m.
The Families, Youth and Children Commission, an advisory commission to the Weld County Department of
Social Services, announces that applications will be accepted for approved vendors pursuant to the Board of
Weld County Commissioners' authority under the Statewide Family Preservation Program (C.R.S. 26-5.5-
101) and Emergency Assistance for Families with Children at Imminent Risk of Out-of-Home Placement
(C.R.S. 26-5.3-101). The Families, Youth and Children Commission wishes to approve services targeted to
run from June 1, 2002, through May 31, 2003, at specific rates for different types of service, the county will
authorize approved vendors 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
accessing 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 MST Jris !ft LLG
(After receipt of order) ID ST BE SIGNED IN INK
Lori KpJie Vat KS) L, pc lie.
TYPED OR PRINTED SIGNATURE
9;e0 Parna2/1
VENDOR ' I (� % LZ (Lc by b/Y`) f(n wcoi /YES t—
(Name) Handwritten Signature By Authorized
Officer or Agent of Vender
ADDRESS Jo I aZh Shtt± TITLE Seto C Lal
Grreleci CO tb3( DATE 3J!! Q2
PHONE # (no) a --f73
The above bid is subject to Terms and Conditions as attached hereto and incorporated.
Page 1 of 29
006-00 Attached A
FOSTER PARENT CONSULTATION PROGRAM BID PROPOSAL AND
REQUEST FOR CdONTINUATION OF AWARD UNDER FPP COR€SERVICES FUNDING
FAMILY PRESERVATION PROQRAM
• 2002-2003 BID PROPOSAL APPLICATION
PROGRAM FUNDS YEAR2002-2003
BID #006-00
NAME OF AGENCY: Lcrl
ADDRESS: gip f, 5 ' OIi.Eky CeD 6 3 /
PHONE: (617) 1 3Sd 2873
CONTACT PERSON: /..Zito )CYh�t& TITLE: OW//C G�
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 accessi g community resources.
12-Month approximate Project Dates: _ 12-month contract with actual time lines of:
Start June 1. 2002 Start
End May 31. 200? End
TITLE OF PROJECT:
AMOUNT REQUESTED:
[ Z �
b ` ')ry ,L Lis 3Jdf/OZ.
Name and Signature of Person Preparing Document Date
Name and Signature Chief Administrative Officer Applicant Agency Date
MANDATORY PROPOSAL REOUIREMENTS
For both new bids and renewal bids, please initial to indicate that the following required sections are included in
this Proposal for Bid. For renewal bids,please indicate which of the required sections have not changed from
Program Fund Year 2001-2002 to Program Fund year 2002-2003.
Indicate No Change from FY 2001-2002 to 2002-2003
Project Description
t� Target/Eligibility Populations
Types of services Provided S.nnan Gre s{!
f— Measurable Outcomes•
Service Objectives- 7 12/011 '16,
ott- Workload Standards 11214-LLEM
Staff Qualifications 4100.tY fiad
"et Unit of Service Rate Computation ,J
'el Program Capacity per Month
Certificate of Insurance
Page 23 of 29
006-00 /6 Attached A
Date of$eeting(s)with Social Services Division Supervisor: a• 3/ /O
Comments by SSD Supervisor: _ e
%h (5 rea vi cf,z. A 61-.s sere(1.4f) /A.:2.—j . - _
e` s _,u-y over —
�`L` tZ4PSr1 'itnareesr71 c ,fit
, o gve, a
c..02-oiLLe _.,_.: 4-2, ...t
0.4, ,
3161, ,
Name and Signature o SD pervisor Date
Page 24 of 29
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
prompt phone consultation initially and then work with foster parents in accordance
to their needs. In our experience, 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 interactional 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 paging system 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.
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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 four support groups a month.
We estimate that there would be an average of five participants at each two hour
support group. Henceforth, at four support group a month , x eight hours , x five
participants, x 10 months this part of the program would provide 400 hours a year.
We anticipate that on the other components of this program that we would spend
four hours a week providing services for foster parents. Henceforth, 4 hours a week
x 50 weeks provides 200 client hours a year. We anticipate that the average foster
parent using our services would attend 8 hours of support group and 4 hours of
consultation a year, which would mean that we would serve 50 individual foster
parents a year. Total number of client hours provides over one year would be 600
hours.
B. Distribution of clients. On average most foster parents provide services for
approximately four foster children a year. Each foster child is in placement an
average of 6 months. By providing support and consultation services for 27 foster
families these services improve that quality of care for approximately 216 children
in the placement system.
C. Families Served. We anticipate serving 27 foster families, 50 foster parents.
D. 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. Carmen Jimenez, a bilingual bicultural provider, would
be available for any Spanish speaking families and written program materials will
also be available in Spanish.
E. Consultation services will be available in South Weld County. Currently 11 out
of 70 foster families reside in South Weld County. Given this ratio, we anticipate
that four of the families we serve will reside in South Weld County. Services will
be available where the foster parents live.
F. The monthly maximum program capacity - If needed, we could expand the
number of hours we are available for consultation to 6 hours a week, which would
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'make available 24 hours of individual consultation and 8 hours of support groups a
month.
G. The monthly average capacity - The monthly average capacity of this program
is 16 hours of consultation services and 6 support group hours.
H. Average stay in the program - The average stay in this program would be 7
weeks.
I. Average hours per week in the program would be one hour a week. From
experience, most foster families choose to use more hours when they are initially
dealing with an issue and then cut back after the first few solution orientated
planning sessions have occurred.
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. Mandated training's for foster parents under corrective action plans will be
provided as directed by the Department of Social Services
C. 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. 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.
D. Therapeutic services for foster children will not be provided in a home where
consultation services are in place.
3
J
' E. 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.
F. 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:
1. 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 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.
2. 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.
3. 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 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
4
'of available community resources , and make appropriate referrals. See Appendix
A for listing of current community resources available to Foster parents.
4. 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.
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.
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' • 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 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.
• 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.
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'• 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-fording, passivity, revenge, withdrawal or excessive worry,
etc...).
• 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...).
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.
Workload Standards
A. The program has the capacity to serve 50 foster parents. Consultants would
spend four hours a week providing individualized services for foster parents.
Henceforth, 4 hours a week x 50 weeks provides 200 client hours a year.
B. Staff- There are three Family Preservation Specialists. Lori Kochevar M.S..
L.P.C., LLC will serve as a provider and the program supervisor for Mary
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• Mumby-Grahm L.C.S.W. and Carmen Jimenez L.C.S.W. All providers have
extensive experience in Family Services as documented in the attached resumes.
C. 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.
D. The modality of treatment is consultation and support groups Referral and
linking services will be provided.
E. Hours - Total number of clinical time devoted to this program equals one hour a
day, five hours a week, and twenty hours a month.
F. Staff- The providers are supported by part time bookkeeping and clerical
personnel.
G. 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.
H. 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 exceed the minimum qualifications needed for both
education and experience. All providers have their Master's Degree in Counseling.
In addition, the therapists have between 5-15 years a piece providing services for
families. See Resumes in Appendix C.
B. Staff available for this project consists of three experienced consultants that
have a similar core value of clinical excellence. We believe in providing
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' strength-based, family-focused services that empower the families we serve.
Mother 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 familles, school personnel, and service providers across the state.
• Mary Mumby-Grahm is a licensed clinical social worker with clinical expertise
in educational psychology and learning differences. She has extensive
experience in identifying and accessing resources as a teacher and a social
worker for families with specific developmental needs.
• Carmen Jimenez is a bilingual bicultural licensed clinical social worker with
clinical expertise in medical social work. She is trained as a family preservation
specialist and has extensive experience in providing bilingual services.
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.
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Appendix A
Lori Kochevar M.S. L.P.C. LLC
♦♦♦
Stretching our Strengths 1 810 12th Street t Greeley CO 80631
Phone(970) 352-8873 1 Fax(970)352-8879
Additional Resource
• Consultation Program - Call Dee or Barb for Info 352-1551 Ex 6293 or 9292
• Clothing Allowance - $200 per child per calendar year, see forms
• Foster Parent Library - Extensive collection of books and Videos, located at DSS
• Weld-Foster Parent Association- See brochure. Call Linda King 506-9754
• Food Bank- Medicaid side & Weld Foster Parent Association, 100 pounds a month.
• Round Table Lunches- Monthly at DSS with Dee and Barb
• State Foster Parent Association - Call Beverly Holtz at (303) 463-7989
• Training's- Look in Newsletters
• Rocky Mountain Children 's Law Center- (303) 871-6410
• Court Appointed Special Advocates- Contact Marsha at 353-3400
• Guardian ad Litem (GAL)- Appointed for your child by the court
• Monthly Newsletter- Sent by Barb and Dee
• Child Find- See brochure and contact Brenda at 330-3842
• Children 's Hospital Evaluation - (303) 861-6410
• North Range Behavioral Health - 346-1166
• Medicaid 1800 511- 5010 (Access) 1-800221-3943 (Regular services)
• Sunrise Clinic - 353-9403
• North Colorado Family Medicine - Scheduling 346-2818 356-2424
• Monforts Clinic- 352-8898
• Dentistry for the Handicapped Orthodontics and other dentistry 1-800-466-8129
• Smile High Dentistry (303)825-2295
• HCP- orthodontics (303) 678-6064
• Statewide list Drs. & GDS - take Medicaid(303) 866-4562
• Donated Dental Services 298-1910
• Child Car Safety check- Greeley Fire Department- Mike Medhearst 350-9500
• Recreation Center- 350-9400 Voucher in summer&scholarships.
• Larimer- Foster Parent Association- (970) 669-3047
• Probation Department- 356-4000 ext 3870
• Boys and Girls Club- 353-5109
National Youth Sports Program- Summer camp ages 10-16 351-1996
w4
Lori Kochevar M.S. L.P.C. LW
Stretching our (9x'970 Strengths -8873.F�j Greeley 80631
Phone Additional Information Available
Specific Issues
• Fetal Alcohol Syndrome
• Eating Disorders
• Sexuality
• Guidelines for Substance Abused Infants
• Medication for Children with Behavior and Emotional Problems
Attachment - Healthy and Disorders
• Infant Stimulation Activities
• Professional Burnout
• Discipline
• Communication difficulties with multiple systems
• Attention Deficit disorder
• Trauma
z, sath Behaviors
16.4,rtittne.
• ame - Calling
.' Verbal Aggression
•,,. Anger Management
• Delinquency
• Lyipg
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Please feel
nee to Patb352-8873 #
for additional resources.
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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 mis-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.
• 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.
11
i _
' • 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...)
5.
The areas checked above would assist me in serving the needs of foster children
and the areas circled are were improvement has occurred.
12
Household Management Issues
I. Foster parents will identify an improvement in their ability to deal competently
with household management issues.
• 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.
13
Appendix B
LORI KOCHEVAR, M.S., L.P.C.
2118 19th Avenue
Greeley, CO 80631
(970) 353-6568
EDUCATION:
University of Southern Mississippi, M.S.
Counseling Psychology,
Cumulative GPA 3.8
University of Northern Colorado, B.A.
Pre-Professional Psychology,
Cumulative GPA 3.5
PROFESSIONAL
EXPERIENCE:
5/95 - PRIVATE PRACTICE THERAPIST, STRETCHING
OUR STRENGTHS
Serve others through a creative process that stretches participants
strengths and provides an environment for authentic healing. Facilitate
opportunity for individuals, families, and groups to participate in body
centered spiritually based psychotherapy. Interpersonal dynamic
facilitation for community development, team building, stress
reduction, anger management, parenting, and personal effectiveness
are available.
5/95 - 9/96 DIRECTOR, VALLEY COMMUNITY FUND
Serve and manage Board of Directors to strengthen the internal
structure of the agency to increase fundraising capabilities.
Responsibilities include: access state, government, and businesses
to participate in payroll deduction, grant writing, marketing, coordination
of special events and community trainings, and disbursement of funds.
5/92 - 5/95 FAMILY PRESERVATION SPECIALIST, SAN LUIS VALLEY
MENTAL HEALTH CENTER
Provide intensive home-based treatment for families that are at risk of
having youth removed from the home. Intervention emphasizing
strength-based approaches, including psychotherapy, skill building
(parenting, communication, anger control, problem-solving, etc. ,
educational support, and assistance in obtaining support for concrete
needs. Management duties: public relations, supervise students,
hire staff, and provide training for staff and community.
3/92 - 5/95 WILDERNESS THERAPIST, SAN LUIS VALLEY MENTAL
HEALTH CENTER
Provide intensive tent-based treatment for youth ages 8-17. Facilitate
opportunities for young people to learn skills in leadership, team work,
decision making, dealing with stress, facing fears, and building
responsibility. Use outdoor challenge course experience such as
rafting, backpacking, mountaineering, and rock climbing to provide skills
based learning opportunities.
5/89 - 5/91 CONSULTANT, GRADUATE ASSISTANT, UNIVERSITY
AFFLILIATED PROGRAM, UNIVERISTY OF SOUTHERN
MISSISSIPPI
Participating in an interdisciplinary team that provides assistance for
community-based child care centers who serve children with
disabilities and their families. Responsibilities include: Grant writing,
development and presentation of awareness training, assessment of
learning environment and handicapping conditions. Provide
consultation for teachers and parents using a coaching model, skills-
based training, and evaluation of improvement.
1/89 - 5/89 TEACHING ASSISTANT, UNIVERSITY OF NORTHERN
COLORADO
Teach skills for report writing and use of computer programs, PC Write
and Labstat. Teach weekly labs and grade lab reports.
4/86 - 9/89 RECREATION SUPERVISION, BOYS AND GIRLS
CLUB OF GREELEY
Providing guidance and support for at-risk youth, fundraising, program
planning, facilitate teenage drug and pregnancy prevention program,
family and community involvement, organization and supervision of
field trips, and participation in local and national staff development
training.
INVOLVEMENT:
FOUNDER, BOARD MEMBER, BOYS AND GIRLS CLUB OF
ALAMOSA
Spearhead community organization to obtain Boys and Girls Club.
Organize fundraising, board development, marketing, and regional and
national networking.
MEMBER, SAN LUIS VALLEY COALITION FOR YOUTH
SERVICES .
Member of steering committee and chairperson of the multicultural task
force.
CONFERENCES:
SPIRITUAL
2000 Hakomi Training
11/05/99 Mariane Williamson - Enchanted Love
10/22-24/99 Shapeshifting: Shamanic Tranformation
1999 Women Who Run With the Wolves - Jungian
10/5-17/99 Phoenix Rising: Yoga Therapy Levels 1 and 2
09/24-26/99 Energy Medicine - Donna Eden
08/19/99 James Redfield -The Celestine Prophecy
08/14/99 Ruth and Naomi - Women's Partnerships
04/24/99 Substanability and Spirituality
04/23/99 Time, Money and the Meaning of Life
03/19/99 Gandhi's Search for Meaning
10/23/98 Spirituality and Religion
06/06/98 Tying it all Together - Biblical Overview
03/28/99 Transformation - Job of the Old Testament
03/06/98 Matthew Fox - Spirituality of Compassion
11/6-9/97 Common Boundaries: Joy of Creation
07/10-13/97 Body and Soul Conference
04/26/97 Day of Prayer
04/19/97 Contemplative Living
1997 Catholic Biblical School
11/6-10/96 Common Boundaries: Intentional Living
1993-1995 Creative Process
COMMUNITY DEVELOPMENT
1/7-8/00 Foster Parent Core Training
10/30/99 Matrix Leadership
10/21-22/96 Working as Partners with Managed Care
04/02-05/95 Leadership for Executive Directors
03/29/95 Fundsaving Workshop
Fall 1995 Leading Edge/Business
02/09-13/95 Challenge by Choice: Ropes Course
05/20-22/94 Organizational Conflict Management: CSAP
05/06/94 CPR and First Aid Certification
02/01-/4/94 Multicultural Conference
11/30/93 Exploring Multiculturalism Within
10/13/93 Conflict Mediation Training
08/11-14/92 Multicultural Training: CSAP
05/12-26/89 Women as Leaders
FAMILIES
06/4-6/99 Passionate Marriage
10/15-19/98 Marriage and Family Conference
05/16-17/98 Relationship Enhancement
12/08-9/97 Family Group Decision Making
10/06/97 Family Group Decision Making
05/2-3/97 Marriage and Family
9/15-16/94 Family Preservation - Supervision
07/20/94 Jim Fay Parenting
07/13/94 Family Sculpting
4/26-27/93 Family Sculpting
Spring 1993 Redirecting Chidren's Behavior
02/06/93 Meaningful Family Comunication
07/070-8/92 Active Parenting
03/16-19/92 Family Preservation Training
09/20-21/90 Parents and Professionals United
CHILDREN AND ADOLESCENTS
09/10/99 Testifying in Child Abuse Caes
07/12/99 Firestarting - Prevention and Intervention
01/29/99 Play Therapy
12/11/98 Attachment Disorders
10/18/97 Art Therapy for Children
04/04/97 Attachment Disorder
10/11-13/96 International Play Therapy Conference
07/8-9/94 Play Therapy
09/26/93 Traumatic Stress Reactins in Children
03/11-14/93 Child Adolescent Conference
Spring 1993 Play Therapy Class
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
TRAUMA AND GRIEF REACTIONS
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
04/14/94 Empowering Resistive Client II
06/09/93 Empowering Resistive Clients
09/17-19/92 Annual Mental Health Conference
SUBSTANCE ABUSE AND DOMESTIC VIOLENCE
10/14/98 Working with Aggression in group Therapy
09/23/97 Domestuc Violence
09/17/97 Substsance Abuse
05/16-17/94 FPS - Motivational Interviewing - Jill Kenney
05/3-14/94 Teen Baseline TOF - Drug Prevention
10/5-9/93 Baseline TOF - Drug Prevention
04/23-24/92 Domestic Violence Conference
San Luis Valley
0 Comprehensive Community
Mental Health Center
yy CLINIC OFFICE
+� ADMIN AND CLINIC OFFICE 1015 FOURTH STREET CLINIC OFFICE
522 ALAMOSA AVENUE ALAMOSA,CO 81101 402 FOURTH STREET
ALAMOSA,CO 81101 TDD 719-589-3671 MONTE VISTA,CO 81 144
719-589-3673 719-589-3671 719-852-5186
a
FAX 719-589-1521 FAX 719-589-9136 FAX 719-852-3043
August 6, 1996
26041 Woodland Ave.
Esparto, CA 95627
Dear Colleagues:
I have worked very closely with Lori in the Family Preservation program. Lori has
been a wonderful asset to this program and to all her colleagues at Mental Health.
More importantly, her dedicated and skillful service to our clients has greatly benefitted
many SLV families.
Lori's skills are numerous. She is well organized and very conscientious. She has
excellent speaking and writing skills. Her forte is her ability to work with all kinds of
people, and work through difficult interpersonal situations. Lori has consistently
impressed me with her resilience and problem solving skills in dealing with some of the
most chaotic and resistive families. In working with these families, Lori has also come to
know the needs of SLV families and has become an expert in resources that are
available throughout the Valley. She has worked in every county in the Valley.
Despite carrying a full caseload of challenging cases, Lori took "time off for herself
by making solid contributions to other programs. I was amazed to see Lori doing good
work for such things as the Mental Health Center's Wilderness Program, the Boys and
Girls Club of Alamosa, the Multicultural Awareness Committee and the Drug and
Alcohol Baseline program. She attended trainings in all of these programs and then
consistently returned to share her expertise and take responsible roles in each, and
handling the mix of responsibilities effectively.
Lori has a strong philosophical commitment to the empowerment of the oppressed.
Lori will direct people toward healthy, fun relationships. Lori will earn the confidence of
the people with whom she works: staff, clients, and community leaders. I highly
recommend her.
Sincerely, AA
Offering Comprehensive Mental Health Care For The Entire San Luis Volley
TRAININGS
FACILITATED:
FAMILIES/COUPLES
1997 - Family Preservation Services
1998 - Creating Health/Balance in Reltionships
1997 - Parenting Group
05/30/97 Team Building For Families
FOSTER PARENTING
03/10/00 Healthy Transitions for Foster Children
02/26/00 What Does a Foster Child Hear? Messages Underlying Discipline
1999 - Enhancing Communication Skills
07/10/99 ADHD - How to Create Peaceful Moments
1999 - Advanced 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
08/8/98 Understanding Differences
04/4/98 Stress Management 101
04/4/97 Interpersonal Effectiveness for Foster Parents
INTERPERSONAL EFFECTIVENESS
05/15/97 Goal Setting 101
02/7/97 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
3/27-28/95 Family Preservation Services: Motivational Interviewing
1994 - Teen Baseline : Drug Prevention
5/13-14/94 Impact of Sexual Addiction on Families: Family Sculpting
1993 - Baseline : Drug Prevention
COMMUNITY DEVELOPMENT
09/6/97 Day of Caring - United Way Service Day
04/22/97 Golden Rule - Unted 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
03/1/92 International Women's Week Organizer
MAN.-Ili-01 I R1 21 :29 P. 03
P.
•
MARY ML'MBY-GRAHAM
LICENSED CLINICAL SOCIAL, WORKER
LICENSE #991347
38280 WCR 19
Fort Collins, CO 80524
970-686-9015
OBJECTIVE.
To provide for the highest good and well being of all my clients using my teaching and counseling
experience, through ongoing skills in counseling, crisis intervention, written and verbal
communications, and systems networking and coordination with a multidisciplinary, holistic
approach-
EMPLOYMENT BISTORY:
1998-Present - Clinical Social Worker/Partner, InnerHealth(Fort Collins) and
Linden Street House(Greeley)
Established a practice specializing in the mental health counseling and treatmem of children,
adolescents, families and women, Created two practices in Fort Collins and Greeiey, Colorado to
provide more and diverse patient care
1990 — 1991 - Clinical Social Worker, Pathways
Provided a practice focused on psychotherapy, spiritual awareness and a healing journey for all
patients. Specialties included treatment with children, adolescents, families and women.
1987— 1994 - School Community Facilitator/Social Worker, Weld County School#6
Provided family intervention and assessment counseling. Directed teacher support and consultation_
Handled abuse and dealt with department of Social Services, referrals, follow-up, in-services and
SPED staffngs.
1986 - Medical Social Worker, Mercy Medical Center
Performed high-risk screening, identified specific psvchosociai, medical and financial needs.
Created a system for crisis intervention counseling/networking with human service agencies which
included family meetings, follow-up, case load supervision, illness adiustment. Oversaw staff and
medical team member interactions. Conducted support groups for nurses and facilitated weekly
discharge planning meetings.
1985 — 1986 - School Social Worker, Internship, District RE-8 Ft Lupton Middle School
Attended stafEngs and child study meetings, assessed children's specific needs, provided guidance
between administrators, counselors and teachers. Set up and attend home visits and telephone
conferences with middle school students and/or parent. Worked with Weld County Mental Health,
Social Services and Probation personnel Attended court hearings; prepared and updated records
and reports on all clients; classroom observation,group work crisis intervention and created and
oversaw the self-concept classes for the gifted and talented program.
MAR-16-01 FRI 21 :29 n 04
1984 1986 - Aerobic Instructor/Desk Manager, Ft. Collins Athletic Club
Choreographed and lead aerobic classes
NNautilus equipment. Trained patrons how to effectively use free weights and
aluded bookkeeping,t. Counseled patrons regarding exercise and health. Managed
P cashier, sales and marketing, scheduling, or front desk, which
198?, — g organizing and public relations.
7 984 - Teacher, Third Grade, Cache La Poudre Elementary
Prepared and administered classroom studies and tests. Balanced personal, school and district
teaching objectives. Supervised playground activity. Provided counseling support for both students
and parents.
EDUCATION:
• State Licensed and Board Certified Licensed Clinical Social Worker, 1994
• Masters Degree in Social Work (MSW), Colorado State University,May 1986
• BA Elementary Education, Arizona State University, 1981.
• High School, College Prep, Grand Junction High School, 1977,
CLINICAL SPECIALIZATIONS:
• Counseling Adolescents, Children, Families and Women
• Child Development and Special Needs/Exceptional Children
• Languaeetcommunication Styles
• Educational Psychology,Learning Differences, ADD, ADHD
• Alcohol and Drug Abuse
• Depression and Anxiety Disorders
• Healing Abuse; Sexual,Emotional, Physical
• Supervised Visitation/Consultation
RECOGNITION:
• Rituals Officer in Delta Gamma Sorority
• Life Saving Certificate Life Guard/Swimming Instructor,'CPR Certificate
• Deans List Arizona State University
• Certified Aerobics Instructor
• Preschool Board Member, Faithsteps, Windsor
• Parent Volunteer, Windsor School District
• Coach for Windsor Parks and Recreation
• Member ofP.E.O Women's Organization
• Member Weld County Pro Bono Committee, Board Member
• Golden Rule Award for Pro Bono services, Weld County
• Member National Association of Social Work
• Member Colorado Association of Play Therapy
PROFESSIONAL REFERENCES:
• Available upon request
• PERSONAL REFERENCES.
• Available upor. request
1
CARMEN M. JIMENEZ
MSW, LCSW
3304 26" St. Greeley, CO 80634 Hm # (970) 339-8345
Fax # (970) 346-8776
Objective: Psychotherapist/Medical Social Worker
SUMMARY OF QUALIFICATIONS
O Eight years experience in mental health
O Five years experience in medical social work
O State of Colorado License in Clinical Social Work
O Master's Degree in Social Work with an emphasis in Generalist Social Work
O Medicare provider
O Bi-lingual and bi-cultural in Spanish
O Specializing in work with victims of abuse and trauma
O Trained in mediation, issues in the workplace, and substance abuse
O Skilled in hospice work and life transition issues
WORK EXPERIENCE/ACCOMPLISHMENTS
08/98 - COMPASION COUNSELING, Greeley, Cob.
Pres. Carmen Jimenez, MSW, LCSW - Sole Proprietor
Individual and group psychotherapy services to families, children, and
adolescents. Contractual work with managed care and insurance com-
panies. Provider on the Crime Victim Compensation Board of the 19th
Judicial District of Weld County. Consultation and mental health counseling
to residents in nursing facilities. Consultation with the Weld County Juvenile
Diversion Program. Medicare and Colorado Access provider.
06/00-ASSOCIATED PROFESSIONAL HOME HEALTH CARE, INC.
Pres. Medical Social Work (Part-time)
Social work services to patients who are home-bound which include community
resource planning, brief therapy, counseling for long-range planning, advocacy.
10/98 -LHS HOME AND COMMUNITY CARE, Greeley, Cob.
10/99 Medical Social Work
Social work services to home-bound patients which included community resource
planning, counseling for long-range planning and decision-making, financial
resource management, short-term therapy.
•
Page 2
02/98 - MONFORT'S CHILDRENS CLINIC, Greeley, Colo.
03/99 Medical Social Worker(Part-time)
Intensive family outreach program advocating for the needs of under-privileged
families served by the Clinic.
• Supervision of interns from Colorado universities
• Development of psychosocial needs assessment
• Psychosocial needs assessments& Family education of medical issues
• Individual counseling of children and families, with emphasis on play
therapy and systems models
• Extensive interagency networking
07/96 -PREFERRED HOME HEALTH
11/98 Social Services Director
Social work services to home-bound patients which included community resource
planning, counseling for long-range planning and decision-making, financial
resource management, short term therapy.
• Instituted the Social Work Department; developed the Policies and
Procedures Manual; systematized Medicare guidelines
• Participation in Quality Improvement Standards
• Extensive interagency networking
02/96 -ACKERMAN & ASSOCIATES, P.C., Greeley, Colo.
08/98 Contractual Position in Private Practice
Individual psychotherapy services to families, children, adolescents. Mediation
services for Dept. of Social Services. Interpretation services in Spanish for
psychological evaluations and Social Security eligibility. Intensive home-based
psychotherapy services to families referred to the Family Preservation Program.
11/95 - NORTH RANGE BEHAVIORAL HEALTH, Greeley, Colo.
07/96 Mental Health Therapist
Individual psychotherapy services to children referred to the Children's Division.
Many of these children were from under-privileged families, and had severe
experiences of trauma and abuse. Facilitated groups for adolescent females of
sexual abuse.
05/93 — CENTENNIAL MENTAL HEALTH, Fort Morgan, Colo.
11/95 Mental Health Therapist
Individual psychotherapy services to families, children, and adolescents.
Psychotherapist for the Obra Program in geriatric settings. Therapist for the
Community Support Program, working with persons with chronic mental illness.
• Assisted with the development of the Logan County and Morgan
County Adult Protection Teams
• Emergency psychological evaluations and initiation of 72 hour holds
• Psychosocial group work and teaching of self-management skills to
persons with chronic mental illness
• Extensive out-patient psychotherapy and case management services
with spanish-speaking clients
Page 3
09/91 - COLORADO STATE UNIVERSITY
05/93 GRADUATE PROGRAM,Ft. Collins, Colo.
06/81 - CITY OF FORT COLLINS, Fort Collins, Colo.
08/91 Community Development Block Grant Program
Administrative Assistant
Work with non-profit agencies under the U.S. Housing and Urban Development
Program for community development and housing rehabilitation projects.
Extensive work with low-income families and persons with disabilities.
EDUCATION
Master's Degree in Social Work, Summer 1993
Colorado State University, Fort Collins, Colorado
Graduate School Research Positions:
• Colorado Division of Mental Health, Rural Crisis Grant, Fort Logan,
Denver, Colo.
• Centennial Mental Health, Sterling, Colo.
• Fostering Families Project, Fort Collins, Colo.
Bachelor of Arts Degree, Social Work,Fall 1987
Colorado State University, Fort Collins, Colo.
REFERENCES
Jalein Arnold, RN, BSN
1955 23n°Ave.
Greeley, CO 80631 #(970) 356-6023
Leonor Willis,LPC
3417 W. 17th St.
Greeley, CO 80631 #(970) 352-8045
Carmen Haynes, MSW
Juvenile Diversion Program
District Attorney's Office
915 Tenth St.
Greeley, CO 80632 #(970) 356-4010
Pat Orleans, LCSW
North Range Behavioral Health
1306 11th Ave.
Greeley, CO 80631 #(970) 353-3686
Appendix C
3-19-2002 11 :23AM FROM DONNA J RUNDELL AGCY 970 3531014 P 1
• '
ievr�es
4.04%:, FARMER 5-
FARMERS INSURANCE CROUP OF COMPANIES
AUTO QUOTATION PROPOSAL
DUCTS 0: 575990
PROPOSAL DATE : 03/19/2002
PREPARED FOR : PREPARED FT:
LORI KOCHEVAR-SULLIVAN Donna Rundell Lute'
23830 WCR 48 929 38TH AVENUE CT
LASALLE< C0' 8064S CD 80645 GREELEY CC 80634
( 370 ) 284 - 5645 ( 970 ) 363 - 8900
VEH 001 VEM 002
DRIVER NAME LORI LORI
RATE EFFECTIVE 03/19/200: 03/19/2002
YEAR/MODEL 96 TERCEL D 96 RANGER X
CAR SYMB/TERR W 007 R 007
COMPANY FARMERS INS EXCHANGE FARMERS INS EXCHANGE
POLICY TYPE 30/60 PKG 30/60 PKG
RATE CLASS IA 7A
DISCOUNT/SURC
PR- PASSIVE RESTRAINT FR- PASSIVE RESTRAINT
MA-MULTI CAR DISCOUN MA-MULTI CAR DISCOUN
TS- 6 YR TOWING SURCH TS- 6 YR TOWING SURCH
TOTAL COSTS
SUBTOTAL 6 MTHS- > 399 . 30 6 MTHS• > 338. 40
POLICY FEE
TOTAL PREMIUM 6399 . 30 4338 . 40
COVERAGES
BIRD 100/300/100 126 . 00 100/300/100 117 . 70
UM ;00/300 1$ . 70 100/300 15 , 70
RIPIP 50K MD 0/0 85 . 90 0/0 85 . 90
?PO
COMPREHENSIVE 1000 57 . 40 1000 43. 60
COLLISION 1000 91 . 60 1000 65 . 10
TOWING 6 . 00 6.00
GIGS DED BYBA 6 . 70 4. 40
PAGE 1 OF 1
THIS IS MERELY A PROPOSAL AND IS NOT A POLICY OF INSURANCE OR OFFER 70 INSURE.
RATES QUOTED REFLECT THE RATES IN EFFECT AS OF THE DATE OF THIS PROPOSAL AND
APE SJ➢JEC1 TO PEVISIOIJ. THE COMPANY RESERVES THE RIGHT TO ACCEPT , REJECT , OR
••
Issue Date: 09/07/01
< i&ii?anh1)140CTh Recal :PROFESSIONAL LIABILITY OCCURRENCE
ce INSURANCE POLICY FOR
Risk Retention Group PROFESSIONAL COUNSELORS AND HUMAN
DEVELOPMENT PRACTITIONERS
ACA Insurance Trust,Inc.
5999 Stevenson Avenue ACA usuLtn¢
Policy Number: CL12509801 Administered by: Alexandria,VA223043300 TRUST
Toll Free:1.800347.6647 x284
ITEM DECLARATIONS INDIVIDUAL POLICY
1. NAMED INSURED: Lori Kochevar M. S . , L. P . C. LLC
2. ADDRESS:
810 12th Street
Greeley, CO 80631
3. POLICY PERIOD: From: 09/17/01 To: 09/17/02
12:01 A.M. Standard Time at Location of Designated Premises
4. The insurance afforded is only with respect to such of the following types of insurance as indicated by specific premium charge or charges:
COVERAGE PREMIUM
A. PROFESSIONAL LIABILITY S 550 . 00
B. GENERAL LIABILITY S 117 . 00
TOTAL PREMIUM: S 667 . 00
5. LIMITS OF LIABILITY: $1, 000 , 000 each Incident or each Occurrence $3 , 000, 000 in the Aggregate
6. THE NAMED INSURED IS: Sole Proprietor(incl.Individual) Partnership
Corporation X Other(refer to Item 7 below)
7. BUSINESS OF THE NAMED INSURED: Part-Time c 20 hours Self-Employed
(Rating Category) Bodywork Counselor
8. This policy is made and accepted subject to the printed conditions of this policy together with the provisions,stipulations and
agreements contained in the following formis)or endorsement(s): CPL-0004.0199 CPL-0005-0199 CPL0006-0199
CPL-0007-0199- 0
NOTICE
THIS POLICY IS ISSUED BY YOUR RISK RETENTION GROUP. YOUR RISK RETENTION GROUP MAY NOT BE SUBJECT TO ALL OF THE
INSURANCE LAWS AND REGULATIONS OF YOUR STATE. STATE INSURANCE INSOLVENCY GUARANTY FUNDS ARE NOT AVAILABLE
FOR YOUR RISK RETENTION GROUP.
CPL-0005-0199-00
•
AMENDMENT -
ADDITIONAL INSUREDS ENDORSEMENT
THE RECIPROCAL ALLIANCE (RISK RETENTION GROUP)
This endorsement modifies insurance provided under the Professional Liability Occurrence Policy for
Professional Counselors and Human Development Practitioners.
The following spaces preceded by an asterisk(1need not be completed if this endorsement and the policy have the same inception date.
ATTACHED TO AND FORMING 'EFFECTIVE DATE *ISSUED TO:
PART OF POLICY NO. OF ENDORSEMENT
CL12509800 04/01/01 Lori J. Kochevar
The premium for this endorsement is included in the premium shown on the declarations unless a specific amount
is shown below:
Additional Premium $ 4 5 . 0 0
Return Premium
It is agreed that the"Designated Personlsl"or"Designated Entityliesl"shown below shall be included as additional
insured(s)but only as respects claims arising out of the sole negligence of the individual or entity specified in the
Persons Insured section of the policy.
Additional Definition:
"Designated Personlsl"or"Designated Entityliesl"as used in this endorsement shall mean:
1 State Of Colorado
c/o Weld County Social Servics
P.O. Box A
Greeley, CO 80634
Nothing herein contained shall be held to vary,alter,waive,or extend any of the terms, conditions, provisions.
agreements,or limitations of the above mentioned policy, other than as above stated.
Y/ 2. 7 03/16/01
Authorized Representative Date
CPL.0007.0199. 2
Appendix D
, r .
FOSTER PARENT CONSULTATION BUDJET
TOTAL GROUP INDIVIDUAL
A. TOTAL HOURS OF DIRECT SERVICE PER CLIEN' 12 8 4
B. TOTAL CLIENTS TO BE SERVED 50 50 50
C.TOTAL HRS DIRECT SERVICE YEAR 600 400 200
D. COST PER HOUR OF DIRECT SERVICE 27 _ 50
E. TOTAL DIRECT SERVICE COST 22680 10800 10000
F. ADMIN COSTS ALLOCATED TO PROG 2860 1800 1600
G. OVERHEAD COST ALLOCABLE TO PROG 5402 4792 3928
H. TOTAL COST, DIRECT AND ALLOCATED 32920 17392 15528
I. ANTICIPATED PROFITS 1080 608 472
J. TOTAL COST& PROFITS 34000 18000 16000
K. TOTAL HOURS DIRECT SERVICE YEAR 600 400 200
-L. RATE PER HR DIRECT FACE TO FACE 45 80
3/19/02
EXHIBIT B
SUPPLEMENTAL NARRATIVE TO RFP
RECOMMENDATIONS
Lori Kochevar M.S. L.P.C. LLC
♦♦♦
Stretching our Strengths•810 12th Street$Greeley CO 80631
Phase(970) 352-8873•Fax(970) 352-8879
Iiw r n
Gloria Romansik
Weld County Social Services
P.O. Box A
Greeley Co, 80632
Dear Ms. Romansik,
This letter is to inform you that I accept the recommendation as written by
the FYC Commission regarding the bid for Foster Parent Consultation (RFP PY
02-03-06-000).
I will provide report outcomes specific to the Foster Parent Consultation
Program on a yearly basis beginning in 2003 regarding the outcome of services
rendered. This report will cover the overall general response of foster parents
perception to change as well as documented change on the individualized
consultation service objectives.
Thank you for the opportunity to continue serving the foster parents in Weld
County.
Sincerely,
1 2 2t
Lori Kochevar M.S., L.P.C., LLC
Licensed Professional Counselor
DEPARTMENT OF SOCIAL SERVICES
PO BOX A
GREELEY,CO 80632
1 WEBSITE:www.co.weld.co.us
Administration and Public Assistance(970)352-1551
CChild Support(970)352-6933
COLORADO
April 8, 2002
Lori Kochevar,Private Practice
810 12 Street
Greeley , CO 80631
Re: RFP 02005 Lifeskills
RFP PY 02-03 06-000,Foster Parent Consultation
Dear Ms. Kochevar:.
The purpose of this letter is to outline the results of the RFP Bid process for PY 2002-
2003 and to request written information or confirmation from you by Wednesday, April
17, 2002.
A. Results of the RFP Bid Process for PY 2002-2003
Through the 2002-2003 Core Services bid evaluation process,the Families, Youth
and Children(FYC) Commission approved or did not approve the RFP(s) listed
above for inclusion on our vendor list. The FYC Commission attached the
following recommendation regarding your RFP bid(s).
The FYC Commission approved the following recommendation for all programs
on the vendor list for 2002-2003. The recommendation reads as follows:
Recommendation:Providers will report outcomes specific to their programs.
1. RFP PY 02005,Lifeskills
The FYC Commission did not recommend approval of this RFP for PY
2002-2003.
2. RFP PY 02-03 06-000,Foster Parent Consultation
Approved with the above recommendation.
Page 2
Lori Kochevar,MS,LPC
Results of RFP Bid Process for PY 2002-2003
B. Required Response by FYC Bidden Concerning FYC Commission
Recommendations and Conditions
The Weld County Department of Social Services is requesting your written
response to the FYC Commission's recommendations. Please respond in writing
to
Gloria Romansik,Weld County Department of Social Services,P.O. Box A,
Greeley, CO, 80632, by Wednesday,April 17,2002, close of business, as
follows:
FYC Commission Recommendations:
You are requested to review the FYC Commission recommendations and
to:
a. accept the recommendations) as written by the FYC Commission;
or
b. request alternatives to the FYC Commission's recommendation(s);
or
c. 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.
If you wish to arrange a meeting to discuss the above conditions and/or
recommendations, please do so through Elaine Furister, 352.1551, extension 6295, and
one will be arranged prior to April 17, 2002.
Sincerely,
Judy A. Griego, Director
cc: Dick Palmisano, Chair,FYC Commission
Gloria Romansik, Social Services Administrator
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