HomeMy WebLinkAbout20021355.tiff RESOLUTION
RE: APPROVE NOTIFICATION OF FINANCIAL ASSISTANCE AWARD FOR SEX ABUSE
TREATMENT AND AUTHORIZE CHAIR TO SIGN -ADOLESCENT AND INDIVIDUAL
THERAPY
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 Sex Abuse Treatment 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 Adolescent and Individual Therapy, 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 Adolescent and Individual Therapy, 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 29th day of May, A.D., 2002.
BOARD OF COUNTY COMMISSIONERS
,n WELD COUNTY, OLO DO
o �,� ^ k 1/
ATTEST: it
ale Vaad, Chair
Weld County Clerk to the = W. �J A
/I ,� O �, avid E. ng, Pr em
BY: iriet of (�l , e
Deputy Clerk to the Board
M. J. Geile
APPR D AS TO F : alms
illiam H. Jerke
my Attorndy 2
1 ^ '
Robert D. asden
Date of signature: 1ST
2002-1355
C C'. , 5S SS0029
ate
DEPARTMENT OF SOCIAL SERVICES
PO BOX A
GREELEY,CO 80632
1 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: Jud - 011Aker
Count Director
p n
Weld County Department of Social Services lets
RE: PY 2002-2003 Notification of Financial Assi nce Awards (NOFAA) under Core
Services Funds-Adolescent & Individual Development
Enclosed for Board approval is the PY 2002-2003 Notifications of Financial Assistance
Award(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 the following bid.
Adolescent & Individual Development
Sex Abuse Treatment: This program serves sexually abusive adolescents from the age of
12 through 18 who have been adjudicated, have admitted to sexual abuse, or are sexually
reactive. The program provides for a maximum of five clients, with one-hour weekly
group sessions, and one group session with mandated attendance of parent-guardian.
Currently, Bilingual services are not available. South County services are provided if an
adequate number of clients are referred. Family reunification services upon request. Rate
is $50.58 per hour.
If you have any questions, please telephone me at extension 6510.
of
2002-1355
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-0027
Revision (RFP-FYC-02005)
Contract Award Period Name and Address of Contractor
Adolescent&Individual Therapy
Beginning 06/01/2002 and Sex Abuse Treatment
Ending 05/31/2003 P. O. Box 321
Fort Lupton, CO 80620
Computation of Awards Description
Unit of Service The issuance of the Notification of Financial
Assistance Award is based upon your Request for
This program serves sexually abusive Proposal(RFP). The RFP specifies the scope of
adolescents from the ages of 12 though 18 who services and conditions of award. Except where it is
have been adjudicated, have admitted to sexual in conflict with this NOFAA in which case the
abuse, or are sexually reactive. The program NOFAA governs, the RFP upon which this award is
provides for a maximum of clients, 1 hour based is an integral part of the action.
weekly group sessions, 1 group session with
mandated attendance of parent-guardian. Special conditions
Currently Bilingual services are not available. 1) Reimbursement for the Unit of Services will be based
South County services are provided if an on an hourly rate per child or per family.
adequate number of clients are referred. Family 2) The hourly rate will be paid for only direct face to
reunification services upon request. face contact with the child and/or family, as
evidenced by client-signed verification form, and as
Cost Per Unit of Service specified in the unit of cost computation.
3) Unit of service costs cannot exceed the hourly and
Hourly Rate Per $ 50.58 yearly cost per child and/or family.
Unit of Service Based on Approved Plan 4) Payment will only be remitted on cases open with,
Enclosures: and referrals made by the Weld County Department
X Signed RFP:Exhibit A of Social Services.
X Supplemental Narrative to RFP: Exhibit B 5) Requests for payment must be an original submitted
X Recommendation(s) to the Weld County Department of Social Services by
_Conditions of Approval 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 Department of Social Services.
Approvals:o>, Progra Official•
By--l!� LLE� By
Glenn Vaad, Chair Judy . Gn ,Direct
Board of Weld County Commissioners Wel o ty Department of Social Services
Date: O5/a9f,ODa Date: 5 to /0Z
aa- /R55
EXHIEIT A
SIGNED RFP
RFP-FYC-02007 Attached A
SEXUAL ABUSE TREATMENT$ROGRAM BID PROPOSAL AND
REQUEST FOR CONTINUATION 9F AWARD UNDER FPP CORE SERVICES FUNAING
FAMILY PRESERVATION PROGRAM ��
2002-2003 BID PROPOSAL APPLICATION
PROGRAM FUNDS YEAR 2002-2003
BID#RFP-FYC-02007
NAME OF AGENCY: A d d J e5C e nit _noon)5 ID Red -De t H Jn p ro p ,t> f
ADDRESS: 7- O. Sox ? I FT Lu p-km, Uo $n6 ;1 (Intaglios)
PHONE: (3Oa) 8'S7- 4 7/9 Chm) q70- 673i - 9719$i - 9719 (64-(s,Ness)
CONTACT PERSON:7-Ae be r r c.. ( LU c)-L TITLE: Lx o ,ci e Dies C Ite/0 w N e e
DESCRIPTION OF FAMILY PRESERVATION PROGRAM CATEGORY: The Sexual Abuse Treatment Program must
wide for therapeutic intervention through one or more modaliHe to or v n Furth s ,at ah,ce pe eTM
✓ictimization
12-Month approximate Project Dates: _ I2-month contract with actual time lines of:
Start June 1.2002 Start 6- /-O
End May 31.2003 n End 5- 31 -0 3
TITLE OF PROJECT: .JL4,t,�p.,-0 l .t.et tLA0 y tegj,' t givt P.
.MOUNT REQUESTED: $ a S `7
(Ca. It C 411 LK - /1- O .
Jame and Signature of Person Preparing Doc Date
2o�PC« J QutL Q —3
etc teC 3 - 1V - Oa.
dame and Signature Chief Administrative Officer Applicant Agency Date
MANDATORY PROPOSAL,REQUIREMENTS
'or both new bids and renewal bids,please initial to indicate that the following required sections are included in this
roposal for Bid.For renewal bids,please indicate which of the required sections have not changed from Program Fund
'ear 2001-2002 to Program Fund year 2002-2003.
Indicate No Change from FY 2001-2002 to 2002-2003
Project Description
_ Target/Eligibility Populations
_ Types of services Provided
_ Measurable Outcomes
_ Service Objectives
_ Workload Standards
_ Staff Qualifications
_ Unit of Service Rate Computation
Program Capacity per Month
i
Certificate of Insurance
Page 25 of 31
RFP-FYC-02007
Sexual Abuse Treatment Program
Adolescent & Individual Development
I Project Description:
Adolescent & Individual Development (A. I . D. ) Serves sexually
abusive adolescents from the age of 12 through 18 . The mission
of AID is designed to protect the safety of the community. This
includes protecting the safety of the victim or potential
victim(s) at all costs. This is an outpatient Offense Specific
Program which offers group therapy along with individual and
family services .
AID recognizes the importance of the family when working
with the adolescent . The agency will provide family
reunification under strict guidelines to help prevent any future
victimization. The program is designed to work in a team effort
in order that the adolescent may receive the skills and concepts
necessary to help him/her to refrain from using sexually abusive
behaviors . The team consists of the Probation Officer if one is
appointed, Social Services Caseworker, counselor, and the
parent (s) or guardian (s) of the client, plus anyone else who is
considered supportive to the adolescent and who wants to be
involved.
AID will comply with upcoming standards and regulations of
the sexually abusive adolescent and will be flexible in the
program materials to ensure each adolescent is receiving the best
services possible. AID will work with each adolescent as an
individual and will address the individual' s specific issues.
AID has been recognized by the Colorado Sex Offender
Management Board (SOMB) as an agency at full operating status in
working with adult sex offenders . This agency will additionally
apply as a provider for the adolescent sexually abusive youth
when the standards are implemented in July, 2002 . AID will
remain flexible to adjust to the new rules and regulations and
will review program materials as new studies indicate necessary
change.
II Target/Eligibility Populations:
AID serves those adolescents referred by Weld County
Department of Social Services who are 12 to 18 years of age and
have been adjudicated, have admitted to sexual abuse, or are
sexually reactive. Eligibility for the AID program will be
addressed through recommendations provided within the Offense
Specific Evaluation which includes police reports, victim
statements, interview with the client and his/her parent (s) or
•
guardian (s) . The total number of clients expected from Weld
County Department of Social Services will be five. The program
will provide weekly group sessions which meet once a week for 60
minutes and one group a month in which the parent (s) or
guardian (s) will be mandated to attend. There will be group
sessions for male and female. There will be no mixture of males
and females in a group. The client can expect the program to
last a minimum of 12 months.
AID does not provide services for bilingual individuals at
this time. However, it does provide services for all races and
creeds without discrimination. Services for South County will
not be specifically provided for unless there is an adequate
number of clients referred. At that time, services will be again
reviewed.
Family reunification will be provided for those family' s
requesting the service. At that time, it will be necessary for
the victim, the victim' s counselor, the parent (s) , the
perpetrator, and the perpetrator' s counselor to all agree that
reunification is in the best interest of the victim. If anyone
of the required participants of the reunification do not believe
the reunification is in the victim' s best interest, the subject
will be dismissed until all parties agree. The reunification may
be expected to last a minimum of six months with weekly meetings
of 60 minutes . Victim counseling will be provided for
individuals whose perpetrator is not participating in Offense
Specific Treatment with AID.
III Type of Services To Be Provided:
The services which will be provided are Offense Specific
Evaluations, Treatment, Reunification, Family sessions, and
Individual sessions .
A. Upon referral, each client must have been adjudicated
for or admitted to a sexual offense. The adolescent will be
required to participate in an Offense Specific Evaluation which
will contain the following components :
Clinical Interview
Millon Adolescent clinical Inventory
Jesness Inventory - Adolescent
Multiphasic Sexual Inventory (MSI)
State-Trait Anger Expression Inventory
Shipley Institute of Living Scale
SASSI - Alcohol & Drug
Beck Depression Inventory
Wilson Sex Fantasy Questionnaire
Adolescent Sex History
Adolescent Parent (s) statements
Review of Collateral Information
Police Reports
Victim' s Statements
It is important to note not all the above psychological
tests are for all age groups . Therefore, only the age
appropriate exams will be given to the adolescent . Additionally,
it will be necessary for the adolescent to have a sixth grade
reading level . The above battery of psychological exams will
comply with upcoming standards and guidelines for adolescents the
SOME is recommending.
The adolescent' s evaluation will give recommendations for
the type of treatment in which he/she will be involved. The
client will be required to participate in polygraphs to determine
his/her treatment progress. The polygraphs will be a disclosure,
offense specific, and/or a maintenance. The polygraphs have been
found to be very useful in the breakdown of secrets . Adolescents
may be polygraphed at the age of 12 as long as the client knows
right from wrong.
The adolescent will have a treatment team which may include
the Probation Officer if one is assigned, a caseworker from Weld
County Department of Social Services, the family/legal guardian,
and the counselor from AID plus any other interested party who is
considered to be supportive to the client. The purpose of this
staffing will be for ongoing treatment planning including, but
not limited to, assessment of the client' s progress in treatment
as well as his/her daily living.
B. The client may require services AID can not provide and
he/she will be referred to an appropriate provider. This
includes, but is not limited to, medication intervention,
psychiatric evaluations, and polygraphs . The client' s family may
require additional services such as parenting skills, domestic
violence treatment, or drug and alcohol intervention. These also
will be referred to the appropriate source.
C. The adolescent' s treatment plan will include
individual, family, and group sessions. It is necessary the
family be involved if they are involved the client' s life in
order for them to understand sexually abusive behavior and to
support his/her son/daughter. This will be especially relevant
to those requesting reunification. The adolescent is more than
just an individual who is sexually abusive. Therefore it is
important to deal with the whole person and not simply the sexual
behavior
AID will provide counseling for anger management, teenage
domestic violence, as well as general psychological issues.
These services will only be provided if other agencies do not
have these type of counseling services . If the client has
Medicaid, he/she will be referred to the mental health facility
which has this contract .
D. The type of therapy which has proven most effective
with the adolescent offender has been a cognitive based therapy
in a group format . Issues which will be addressed in the group
are thoughts, feelings, and behaviors, thinking errors, basic
sexual education, the sexual offense cycle, stress management,
empathy, and relapse prevention. The adolescent will be required
to do daily journals and homework assigned by the group
counselor. There will be projects assigned to determine what the
client has learned and is applying to his/her life so as not to
sexually re-offend. If it is discovered a client has been
victimized, he/she will be recommended to participate in victim' s
counseling after participating in the Offense Specific Treatment
Program for not less than a period of six months . The reason for
the delay is to make sure the adolescent does not blame his/her
perpetration on the victimization.
E. Investigation for families with sexual abuse
allegations will be reported and referred to those individuals
who have the expertise in this field.
IV. Measurable Outcomes :
A. Adolescent & Individual Development' s program for
Offense Specific Treatment has a time line of not less than 12
months . During this time frame recidivism may be reduced through
the program materials . The adolescent will learn how his
thoughts, feelings, and behaviors are 100% the individual' s
responsibility. He/she will be presented with anger management
skills, empathy, and how his/her behavior impacted the victim,
family and the community. The client will learn coping skills,
stress management, the sexual offense cycle, victim
clarification, and the entire program will be based on Relapse
Prevention.
B. The client will demonstrate a decrease in re-
victimization by the use of the polygraph. Each client will be
required to participate in and pass a disclosure polygraph. The
purpose for this polygraph is to make sure the adolescent is
taking responsibility for all his sexually abusive behaviors .
He/she will be expected to take a maintenance polygraph near the
end of the program. This polygraph will help determine if the
adolescent is using the skills and concepts provided and to note
if he/she is able to follow the rules and regulations which may
•
keep him/her from re-victimization. Additionally, each client
will be required to demonstrate the skills and concepts they have
been given through written assignments . The skills and concepts
will not only indicate what the adolescent has put to use in
his/her life but, will also demonstrate the level of empathy
he/she has gained. These skills and concepts will be displayed
before termination from the program by the requirements to write
out his/her sexual offense cycle, an apology letter, and a
Relapse Prevention Plan.
C. Victim perpetration may be prevented because the client
will learn through their own counseling how to deal with the
emotional turmoil and pain appropriately without becoming
sexually abusive to others .
D. The child abuse incest victim will remain in the home
unless it is determined there is a safety issue. The perpetrator
will be removed immediately to a place where he/she will not have
access to other potential victim(s) .
E. The parent (s) will be educated during the course of the
adolescents treatment. This will be done through family sessions
and mandated parent groups . Additionally, probation has an
educational program which the client who is on probation is
mandated to attend. The parent will be involved in the treatment
process including the evaluation, polygraphs, and other relevant
areas . The parent will demonstrate competency by their
understanding of the material and allowing the adolescent to take
the responsibility of the sexual assault without trying to
rescuing him/her. If there is question of the parent (s)
competency, an outside agency may be recommended to go into the
home to work with the parent (s) . This has been found to be
useful in the past .
F. Reunification will depend solely on the progress of the
offender in treatment. It will be necessary the adolescent take
full responsibility for the sexual assault without blaming the
victim. Reunification can be expected to take a minimum of six
months with weekly sessions . The family will be mandated to
participate in every step of reunification. The family will be
mandated to learn and demonstrate how to determine the at risk
behavior the sexually abusive adolescent. What steps will be
taken to either lower the risk or immediately report the
behaviors to the appropriate source to protect the victim or
potential victim(s) . Reunification will take place only when the
victim, his/her counselor, the parent (s) of the victim and the
parent (s) of the adolescent offender, and the treatment provider
of the adolescent offender all agree on all parties want the
reunification. Reunification is necessary because the adolescent
may return home at some point. However, it will be important for
the victim to feel safe at all costs and know how to report any
inappropriate behavior immediately to remain safe. Again, it is
necessary the victim never feel re-victimized by any part of the
process.
V. Service Objectives:
A. Parental competency will be explored by observation of
how they maintain sound relationships as well as appropriate
physical and emotional boundaries with each of their children.
This will be done through family sessions, individuals, and the
parent group. If additional services are required, the
recommendation will be made to have in home services by
counselors who are experienced in this field as well as
recommendations of parenting classes.
B. Family conflict will be addressed through individual and
family sessions . If there are issues which require more
specialized treatment, recommendations will be made to the
referral source.
C. Adolescent & Individual Development' s program addresses
self-esteem, victim awareness, awareness and management of one' s
own personal history of victimization, sex education, peer
relationships enhancement, establishing appropriate physical and
emotional boundaries, assertive versus aggressive behaviors, and
assuming full responsibility for one' s own behavior. The entire
program addresses these items within the group, individual, and
family sessions.
D. Resources are given whenever it is necessary to the
parent and/or client . These resources are given immediately when
issues arise which are determined are best handled outside of
Adolescent & Individual Development' s scope of expertise.
VI Workload Standards:
A. The client will be expected to participate in group
treatment every week for one hour at the minimum. Individual
sessions will be 50 minutes on an as needed basis. Family
sessions will be 60 to 90 minutes on an as needed basis.
B. The number of counselors providing services will be at
minimum two counselors.
C. Maximum caseload per counselor will be eight clients in
group treatment . This caseload will be adjusted to meet the
guidelines and standards of the SOMB when they are given.
D. The modality of treatment will be groups, individuals,
and family sessions.
E. The number of hours for group will be at the minimum of
one per week during throughout the treatment process . Individual
and family hours will be on an as needed basis .
F. There will be a minimum of two counselors providing the
services . As the program expands, more counselors will be made
available.
A copy of the insurance Adolescent & Individual Development
requires is attached.
VII . Staff Qualifications:
AID staff members will possess at minimum a Master' s level
education in a counseling related field including but not limited
to psychology, rehabilitation, or sociology. They will be
licensed with the State of Colorado or be eligible to become
licensed. The agency will apply to the SOMB for full operating
status to work with Offense Specific adolescents. This will
include evaluations and treatment at the minimum. At this time,
I have full operating status with the SOMB to work with adults .
The Sex Offender Management Board is currently in the process of
finalizing the guidelines and standards for an agency and/or
individual to have the expertise of working with the adolescent.
Application will be made as soon as the SOMB determines how the
applications will be completed. I have worked with sexually
abusive youth for approximately six years . I have and will
continue to attend workshops, conferences, and other types of
training to be able to provide the most up to date treatment for
the adolescent . This will include not only Offense Specific
treatment, but other relevant issues of the adolescent as well.
B. The total number of staff which AID will contract for
will be limited to the guidelines and standards of the SOMB' s
Adolescent procedures. The staff will be supervised by myself
until the individual counselor is given full operating status
from the SOMB in treating and evaluating the adolescent .
C. Adolescent & Individual Development is an approved
agency for adult sex offenders at this time. The standards and
guidelines for the adolescent will be completed by July, 2002
according to the SOMB. Application will be made when the SOMB
has completed the appropriate forms and sent them to AID. All
program materials and group, family, and individual treatment are
currently following what the SOMB has indicated in the draft copy
of the adolescent standards and guidelines.
'" gqv gao
is ' t ct
.. k
/() $ ✓O •
''.c' i;a. seAt tr .* 71.S�
► s .3 x4IJ - i'314
. .
. .
.,..,
As
.. C7dam'S manic.
hotels n aeswrts
alkiatSo0.0� „ - a S VAS.
gig 500 X S = asOU,no
s‘salaisiksox s = a sa.oo
d?u,AX 50 F 4 X S = J SOO.0:3
5 30 X = 7ROO 00
Pattie q aas x 5 = HSoo.Oo
5 , hivcn 5xso x S = la50.00
14 Zoo.a7
S soo., Co Soo a500---"--
I s0 Jro...ML so 2W
40 .SO (o 1 :1 '5 30Q 150 O - '
4 S0 !a FAnv\ 396 )5OO
sa S a 156° 7800
12 LI polue 9o0 9500
if 5 illIALLID 5O _ 1(9 60
al 3840 x 19800.00
‘\:‘
aids
a adoa, 9a
50 '.-8'
For reservations at any Adam's Mark call 800-414 ADAM (2326)
Buffalo,NY•Charlotte,NC•Clearwater Beach,FL•Colorado Springs,CO•Columbia,SC
Columbus,OH•Dallas,TX•Daytona Bach,FL•Denver,CO•Grand Junction,CO•Houston,TX
Indianapolis,IN•Kansas City,MO•Memphis,TN•Mobile,AL•Orlando,FL•Philadelphia,PA
St.Louis,MO•San Antonio,TX•Wm,OK•Winston-Salem,NC
RFP-FYC-02007 Attached A
VIII. COMPUTATION OF DIRECT SERVICE RATE •
This form is to be used to provide detailed explanation of the hourly rate your
organization will charge the Core Services Program for the services offered in •
this Request for Proposal. This rate may only be used to bill the Weld County
Department of Social Services for direct, face-to-face services provided to
clients referred for these services by the Department. Requests for payment based
on units of service such as telephone calls, no shows, travel time, mileage
reimbursement, preparation, documentation, and other costs not involving direct
face-to-face services will not be honored. Likewise, billings must be for hours
of direct service to the client, regardless of the number of staff involved in
providing those services. Therefore, it is imperative that this rate be
sufficient to cover all costs associated with this client, regardless of the
number of staff involved in providing these services.
(Explanations for these Lines are Provided on the Following Page)
Total Hours of Direct Service per Client 8'7 Hours [A)
Total Clients to be Served - S Clients [B]
Total Hours of Direct Service for Year T J Hours [C]
(Line [A] Multiplied by Line [B) (�
Cost per Hour of Direct Services $ '1 4 31 Per Hour [D]
Total Direct Service Costs $ / I 3 co. OS [E]
(Line [C] Multiplied by Line [D] )Administration Costs Allocable to Program $ INtioa • 9 (F)
Overhead Costs Allocable to Program $ / OO C) 00 [G]
Total Cost, Direct and Allocated, of Program$ a Q 0 0 8.g7, [H]
Line [E] Plus Line (F] Plus Line [G] )
Anticipated Profits Contributed by this Program $ [I]
Total Costs and Profits to be Covered �1
by this Program(Line [H] Plus Line (I) ) $ a, a 00 3 , a7 [J]
I /
Total Hours of Direct Service for Year I/35 (K]
(Must Equal Line [C] )
Rate per Hour of Direct, Face-to-Face Service
to be Charged to Weld County Department of f""Q SQ' [L]Social Services $ J 8
Day Treatment Programs Only:
Direct Service House Per Client Per Month [M]
Monthly Direct Service Rate $ [N]
Page 30 of 31
RFP-FYC-02007 Attached A
[II. COI7UTATION OF DIRECT SERVICE RATE •
This form is to be used to provide detailed explanation of the hourly rate your
organization will charge the Core Services Program for the services offered in
this. Request for Proposal. This rate may only be used to bill the Weld County
Department of Social Services for direct, face-to-face services provided to
clients referred for these services by the Department. Requests for payment based
on units of service such as telephone calls, no shows, travel time, mileage
reimbursement, preparation, documentation, and other costs not involving direct
face-to-face services will not be honored. Likewise, billings must be for hours
of direct service to the client, regardless of the number of staff involved in
providing those services. Therefore, it is imperative that this rate be
sufficient to cover all costs associated with this client, regardless of the
number of staff involved in providing these services.
(Explanations for these Lines are Provided on the Following Page)
Total Hours of Direct Service per Client 9 7 Hours [A]
Total Clients to be Served 5 Clients [B]
•
Total Hours of Direct Service for Year ,7 a s Hours [C]
(Line [A] Multiplied by Line [B] ! 1
Cost per Hour of Direct Services $ (1.3 7 Per Hour [D]
Total Direct Service Costs $ rig ' '7CQ. G [E]
(Line [C] Multiplied by Line [D] )
Administration Costs Allocable to Program $ 170Q. 95 [F]
Overhead Costs Allocable to Program $ ) 0 0O , 00 [G]
Total Cost, Direct and Allocated, of Program$ .1Q 003. S7 [H]
Line [E] Plus Line [F] Plus Line [G1 )
Anticipated Profits Contributed by this Program $
[1]
Total Costs and Profits to be Covered
by this Program(Line [H] Plus Line [I] ) $ a a no 3. a7 [J7
Total Hours of Direct Service for Year 1-435
(Must Equal Line [C] ) [K]
Rate per Hour of Direct, Face-to-Face Service
to be charged to Weld County Department of
Social Services $ 5O. 5
----------------------- -
IL]
_________________________________________________
Day Treatment Programs Only:
Direct Service House Per Client Per Month
[M]
Monthly Direct Service Rate
$ [NI
Page 30 of 31
BRANCH B/A PRODUCER NUMBER DATE OF ISSUE RENEWAL OR REPLACEMENT NO.
32 A 0001614 • 200 4/4/01 80M-1193737
PROFESSIONAL LIABILITY OCCURRENCE
INSURANCE POLICY FOR Client* 293607
PROFESSIONAL COUNSELORS
AND
HUMAN DEVELOPMENT PRACTITIONERS
PURCHASING GROUP POLICY NUMBER: 44-2010129
Item DECLARATIONS CERTIFICATE NUMBER 80M- 1193737
Named Insured ADOLESCENT & INDIVIDUAL DEV .
2• MAILING ADDRESS PD UUX 3E1
FT . LUPTON, CO 80621-0321
3. Policy Period 12:01 A.M. Standard Time At From: 04/03/2001 To: 04/03/2002
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 C X3 $ 301 . 00
B. General Liability C 3
C. Endorsements C 3
TOTAL PREMIUM: $ 301 .00
5. LIMITS OF LIABILITY
$1 , 000, 000 each Incident *3, 000, 000 in the Aggregate
or Occurrence
6. The Named Insured is: Sole Proprietor (including Individual) Partnership Corporation
Other.
Affiliation: MENTAL HEALTH INSURANCE PROGRAM
7. Business or Occupation of the Named Insured: COUNSELOR
a. 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 form(s) or endorsement(s):
PLE-2081 PLJ-2016 PON-2003 PLE-2189(6/96)
CHICAGO INSURANCE COMPANY
55 E. MONROE STREET, CHICAGO, ILLINOIS 60603
REPRESENTATIVE:
SEABURY d SMITH - CHICAGO
332 S. MICHIGAN AVENUE
CHICAGO, IL 60604
1-800-621-3008
PLP-2016(Rev. 10/94) (elec)
PLP-2031(10/94)
RFP-FYC-02007 Attached A
at.
Date of Meeting(s)with Social Services Division Supervisor: 3//'79.)--
omments by SSD SuQervisor: %btu /'4 ..).u-r:e.L )
Kint-4 td4-1 ce_s ci..r Gb[ uori-t-
/(. - 1-41—$44L17 t 1P.7 w7n ct ,00* I • aid
3/p/o
\lame and Signature of SSD Supervisor Date
Page 26 of 31
EXHIBIT B
SUPPLEMENTAL NARRATIVE TO RFP
RECOMMENDATIONS
Adolescent & Individual Development
Mailing: PO Box 321 Fort Lupton, CO 80621
Pager 970-681-9719 Fax 303-857-9720
April 14, 2002
Attn: Gloria Romansik, Social Services Administrator
Weld County Department of Social Services
P.O. Box A
Greeley, Colorado 80632
RE: Adolescent & Individual Development
Results of RFP Bid Process for PY 2002-2003
Dear Ms. Romansik:
I am accepting the recommendation as written by the FYC
Commission. I will provide to the Weld County Department of
Social Services and/or Caseworker outcomes of each client when
necessary and will provide monthly progress notes of each client .
These progress notes and outcomes will be specific to the Offense
Specific Treatment the client is receiving. Additionally, when
necessary, a staffing will be arranged whenever the Casework
and/or counselor deem it necessary. This recommendation will be
added under Measurable Outcomes.
ebe ca .A. CRC
Licensed professional Counselor
Full Operating Level Offense Specific
Evaluator and Treatment Provider
14111.
DEPARTMENT OF SOCIAL SERVICES
PO BOX A
GREELEY.CO 90632
' WEBSITE:vAvw.co.weld.co.us
Administration and Public Assistance(970)352-1551
Child Support(970)352.6933
COLORADO
April 5, 2002
Rebecca Quick,MA, CRC, LPC
Adolescent& Individual Development
Post Office Box 321
Fort Lupton, CO 80621
Re: RFP 02007 Sex Abuse Treatment
Dear Ms. Quick:
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 RPF Bid Process for PY 2002-2003
Through the 2002-2003 Core Services bid evaluation process, the Families, Youth and
Children(FYC) Commission approved the RFP listed above for inclusion on our vendor
list. The FYC Commission attached the following recommendation regarding your RFP
bid.
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.
RFP 02007 Sex Abuse Treatment:
Approved with the above recommendation.
B. Required Response by FYC Bidders Concerning FYC Commission
Recommendations and Conditions.
The Weld County Department of Social Services is requesting your written response to
the FYC Commission's recommendation. 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:
Page 2
Adolescent & Individual Development
Results of RFP Bid Process for PY 2002-2003
FYC Commission Recommendations:
You are requested to review the FYC Commission recommendations and to:
a. accept the recommendation as written by the FYC Commission; or
b. request alternatives to the FYC Commission recommendations; or
c. not accept the recommendation of the FYC Commission.
Please provide in writing how you will incorporate the recommendation 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
7 y A 'ego, ' ect
Id C unty Department artment of Social Services
of
cc: Dick Palmisano, Chair,FYC Commission
Gloria Romansik, Social Services Administrator
Hello