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Home My WebLink About20051644.tiff RESOLUTION RE: APPROVE TEN NOTIFICATION OF FINANCIAL ASSISTANCE AWARDS FOR LIFE SKILLS PROGRAMS WITH VARIOUS PROVIDERS AND AUTHORIZE CHAIR TO SIGN WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with ten Notification of Financial Assistance Awards for Life Skills Programs 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 various providers, listed below, commencing June 1, 2005, and ending May 31, 2006, with further terms and conditions being as stated in said awards: 1. Child Advocacy Resource and Education (Family Advocate Program) 2. Child Advocacy Resource and Education (House-Visitation) 3. Victor H. Cordero 4. Alpine Christian Services, Inc. 5. Turning Point Center for Youth and Family Development, Inc. 6. Lutheran Family Services 7. Youth Emancipation and Services, Inc. 8. Ackerman and Associates, P.C. 9. Transitions Psychology Group, LLC 10. The Jubilee Retreat Center- Lori Kochevar, LLC WHEREAS, after review, the Board deems it advisable to approve said awards, copies of which are 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 ten Notification of Financial Assistance Awards for Life Skills Programs 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 various providers listed above, be, and hereby are, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said awards. 2005-1644 SS0032 (10 SS D� c7/ DS' TEN NOTIFICATION OF FINANCIAL ASSISTANCE AWARDS FOR LIFE SKILLS PROGRAMS PAGE 2 The above and foregoing Resolution was,on motion duly made and seconded,adopted by the following vote on the 6th day of June, A.D., 2005, nunc pro tunc, June 1, 2005. BOARD OF COUNTY COMMISSIONERS r IEII A n WELD COUNTY, COLORADO mil_ . / /,,( / /` ` / i 1� iWilliam H. Jer , Chair j. " Clerk to the Board Via. .., Neu Net) / M. J. ile, Pr -Tem -1•••arpoirfia AAi 7d. ..,--tit , Deputy Clerk to he Board D ' . Long AP D F • Robe D. asden unty Attor ey AWL( a Glenn Vaad Date of signature: 4 a©Q .. 2005-1644 SS0032 a s DEPARTMENT OF SOCIAL SERVICES P.O. BOX A GREELEY, CO. 80632 Website: www.co.weld.co.us Administration and Public Assistance(970)352-1551 Child Support(970)352-6933 MEMORANDUM TO: William H. Jerke, Chair Date: June 2, 2005 • Board of County Commissioners COLORADO FR: Judy A. Griego, Director, Social Services :;f4 Cl l,i L2Ler RE: Notification of Financial Assistance Awards for Life �I Skills Programs with Various Providers Enclosed for Board approval are Notification of Financial Assistance Awards (NOFAAs) for Intensive Family Therapy between the Weld County Department of Social Services and various providers. The NOFAAs are based upon the provider's Request for Proposal, which has been reviewed and approved by the Families, Youth and Children(FYC) Commission. The NOFAAs were reviewed at the Board's Work Session of May 31, 2005. The major provisions of the NOFAA are as follows: 1. The term period is from June 1, 2005 through May 31,2006. 2. The Department agrees to reimburse providers under Core Services funding according to the NOFAA and their respective bid proposal for Life Skills Programs. These services are for children, youth, and families receiving child welfare services. 3. Providers will be reimbursed according to various rates and services as provided below: No. Core Services Description of Program/Special Award Amount Contractor Conditions A. Child Advocacy Family Advocate Program is an intensive $69.49 per hour Resource &Education home-based intervention program serving $50 per hour court (c.a.r.e) approximately 8 families per month, 2 testimony hours per week. The average stay in the program is 11 weeks or 20 hours. B. Child Advocacy Supervised Visitation Services provides $41.08 per hour Resource &Education each family up to 2 hours per week of supervised visits (c.a.r.e) supervised visitation, or 3 to 8 hours per $71.58 per hour intensive week interactional visitation,and/or $33.61 per hour transport transportation. $50 per hour court testimony C. Victor Cordero Supervised Visitation Services are $85 per hour for visitation culturally and linguistically provided for $100 per hour court visitation,therapeutic visitation, and testimony parenting instruction. Capacity is 25 families per month with an average stay of 3 to 6 months,up to 4 hours per week. D. Alpine Christian Supervised Visitation Services includes $35 per hour therapeutic 2005-1644 Services both therapeutic and supervised for up to staffing (Lakewood) 16 clients per week. $35 per hour visitation $70 per hour therapeutic visitation E. Turning Point Center Transitional Program for youth and $25 per hour for Youth and Family caregivers as the youth leaves out of home $80 per hour court Development, Inc. placement through developing and testimony practicing lifeskills and access to therapy and education groups. 15 families may be served throughout the year. Additional home studies will be billed at$250 per person. F. Lutheran Family Supervised Visitation Services are $132.42 per hour -high Services provided through five levels of service: treatment package monitored visitation, therapeutic visitation, $101.34 per hour— in-home transition services,case treatment consultation, and transportation. Capacity $64.85 per hour transport is 65 families for the year with an average $60 per hour court of 22 families per month. The average stay testimony in the program is 6 months for 2 to 3 hours per week. G. Youth Emancipation& Family Therapy, mentoring,group $69.86 per hour of therapy Services, Inc. therapy, support groups, lifeskills $65 per hour court instruction,parenting education, testimony employment and crisis intervention services for youth 16 '/2 to 18 years of age and their families. Capacity is 8 families with an average capacity of 6. Average stay is 12 weeks at 2 to 6 hours per week. 24-hour crisis intervention is available. H. Ackerman&Associates Home-Based Visitation and Mentoring $100 per hour for a maximum of 20 families per month. $35 per hour interpreter Up to 5 hours of assessment, goal setting, $100 per hour court and compiling treatment goals, 15 hours of testimony mentoring, and 10 hours of visitation observations and directed teaching. Transitions Psychology Lifeskills Coaching and Parent-Child $92.34 per hour Group Interaction Therapy(PCIT) is available $150 per hour court for a yearly capacity of 180 families, which testimony includes 120 children and youth. Average stay in the program is 12 weeks,3 hours per week. Follow-up is at 3 months and 6 months. J. Jubilee Retreat Center— Supervised Visitation while the family is $86 per hour Lori Kochevar working with the bonding specialist for $86 per hour court children ages 0— 12 years. Yearly services testimony to 60 families with 8-10 families provided serve at any given time. 24 hours of one- on-one supervised visitation with bonding specialist per family. If you have any questions,please contact me at extension 6510. 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 FY05-PAC-6000 Revision (RFP-FYC-05005) Contract Award Period Name and Address of Contractor Beginning 06/01/2005 and Child Advocacy Ending 05/31/2006 Resource&Education (C.A.R.E.)Family Advocate Program 3700 Golden Street Evans, CO 80620 Computation of Awards Description The issuance of the Notification of Financial Unit of Service Assistance Award is based upon your Request for Proposal(RFP). The RFP specifies the scope of The program is a very intensive home-based services and conditions of award. Except where it is intervention program. Each family has an in conflict with this NOFAA in which case the individual service plan depending on the needs NOFAA governs,the RFP upon which this award is of the family and recommendations of the based is an integral part of the action. caseworker. Approximately 25 family units anticipated to be served; average capacity is 8 Special conditions families per month, 2 hours per week. The 1) Reimbursement for the Unit of Services will be based average stay in the program is 11 weeks or 20 on an hourly rate per child or per family. hours. Bicultural-bilingual services and South 2) The hourly rate will be paid for only direct face to County services are available. face contact with the child and/or family or as specified in the unit of cost computation. Cost Per Unit of Service 3) Unit of service costs cannot exceed the hourly and yearly cost per child and/or family. Hourly Rate Per 4) Payment will only be remitted on cases open with, Treatment Package $ 69.49 and referrals made by the County Department of Court Testimony $ 50.00 Social Services. 5) Requests for payment must be an original form and 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 Enclosures: X Signed RFP: Exhibit A submit requests for payment on forms approved by X Supplemental Narrative to RFP: Exhibit B Weld County Department of Social Services. Recommendation(s) 6) The Contractor will notify the Department of any changes in staff at the time of the change. X Conditions of Approval Approvals: / Program Official: By y 117 4.„/ By William H. Jerke, Chair Judy . 'eg , irector Board of Weld County Commissioners Weld a9unty Department of Social Services Date: JUN 0 B 2005 Date: l�_�2�OS SIGNED RFP: EXHIBIT A INVITATION TO BID BID 002-05 (05005 -05011 and 006-00) DATE: February 16, 2005 BID NO: RFP-FYC-05005 RETURN BID TO: Pat Persichino, Director of General Services 915 10th Street, P.O. Box 758, Greeley, CO 80632 SUMMARY Request for Proposal (RFP-FYC-04005) for:Colorado Family Preservation Act--Life Skills Program Emergency Assistance Program Deadline: March 11, 2005, 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 Colorado Family Preservation Program Act(C.R.S. 26-5.5- 101) and Emergency Assistance for Families with Children at Imminent Risk of Out-of-Home Placement Act (C.R.S. 26-5.3-101). The Families, Youth and Children Commission wishes to approve services targeted to run from June 1, 2005, through May 31, 2006, at specific rates for different types of service, the county will authorize approved vendors and rates for services only. The Life Skills Program must provide services that focus on teaching life skills, which are designed to improve household management competency,parental 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 `fl • (After receipt of order) B ST BE SIGNED IN INK Gwen Schooley TYPED OR PRINTED SIGNATURE Child Advocacy Resource VENDOR and Education, Inc. (Name) � l /,l,l�J e, HwrittSignature By Authorized Officer or Agent of Vender ADDRESS 3700 Golden Street Evans, Co 80620 TITLE Co-Chair, Board of Directors March 8, 2005 DATE PHONE # 970-356-6751 The above bid is subject to Terms and Conditions as attached hereto and incorporated. Page 1 of 33 Bid 002-05 (RFP-FYC-05005) • Attached A LIFE SKILLS PROGRAM BID PROPOSAL AND REQUEST FOR CONTINUATION OF AWARD UNDER CORE SERVICES FUNDING EMERGENCY ASSISTANCE PROGRAM 2005/2006 BID PROPOSAL APPLICATION PROGRAM FUNDS YEAR 2005-2006 BID 002-05 (05005) Child Advocacy Resource and Education, Inc. NAME OF AGENCY: ADDRESS: 3700 Golden Street Evans, CO 80620 PHONE: 970-356-6751 CONTACT PERSON: Rose Francella TITLE: Assistant Director DESCRIPTION OF FAMILY PRESERVATION PROGRAM CATEGORY: The Life Skills 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, effectively accessing community resources,and encouraging goal setting and pro-social values. 12-Month approximate Project Dates: _ 12-month contract with actual time lines of: Start June 1. 2005 Start June 1, 2005 End May 31, 2006 End May 31 , 2006 Home Based Parent Education TITLE OF PROJECT: AMOUNT REQUESTED: $69.49 per hr. Gwen Schooley g_it - to- Name and Signature of P son Preparing Document Date Judy A. Griego,Director Name and Signature Chief Administrative Officer Applicant Agency Date MANDATORY PROPOSAL REQUIREMENTS For both new bids and renewal bids,please initial to indicate that the following required sections are included in this Proposal for Bid.For renewal bids,please indicate which of the required sections have not changed from Program Fund Year 2004- 2005 to Program Fund year 2005-2006. Indicate No Change from FY 2004-2005 Project Description Target/Eligibility Populations Types of services Provided �! Measurable Outcomes Service Objectives d Workload Standards Staff Qualifications v Unit of Service Rate Computation Pt Program Capacity per Month t/ Certificate ofInsurance Assurance Statement Page 26 of 33 Bid 002-05 (RFP-FYC-05005) Attached A Date of Meeting(s)with Social Services Division Supervisor: 5 - 2 ` 5-- Comments by SSD Supervisor: n � )a M e _ � ktip- f �.-rci u�<<ir-v4 dlift o Name and Signature of SSD Supervisor Date Page 27 of 33 Bid 002-05 (RFP-FYC-05005) Attached A Program Category Life Skills Program Bid Category Project Title Home Based Parent Education (parent Advocate Program) Vendor Child Advocacy Resource and Education, Inc. PROJECT DESCRIPTION Provide a brief one-page description of the project. II. TARGET/ELIGIBILITY POPULATIONS Provide a brief one-page description of the proposed target/eligibility populations. At a minimum your description must address: A. Total number of clients served. B. Total individual clients and the children's ages. C. Total family units. D. Sub-total of individuals who will receive bicultural/bilingual services. E. Sub-total of individuals who will receive services in South Weld County. F. The monthly maximum program capacity. G. The monthly average capacity. H. Average stay in the program (weeks). I. Average hours per week in the program. III. TYPE OF SERVICES TO BE PROVIDED Provide a two-page description of the types of services to be provided. Address if your project will provide the service minimums as follows: A. Mentoring: Address, at a minimum, the following ways the project will: 1. Teach,model, and coach adaptive strategies; 2. Model and influence parenting practices; 3. Teach relational skills; 4. Teach household management, including prioritizing, finances, cleaning, and leisure activities; 5. Actively help to establish community connections and resources; 6. Encourage goal setting and pro-social values. B. Visitation: Address, at a minimum, the following ways the project will: 1. Monitor parent/child interactions for physical and emotional safety; 2. Document clinical observations; 3. Strategize for teaching and modeling parenting skills; 4. Teach relational skills; 5. Encourage goal setting and pro-social values; 6. Plan structured activities in visitation to help achieve the objectives of the treatment plan. Page 28 of 33 • Child Advocacy Resource and Education, Inc. 3700 Golden Street Evans,CO 80620 Home Based Parent Education (Parent Advocate Proeram) I. PROJECT DESCRIPTION Home-Based Parent Education was developed with the primary purpose of strengthening and preserving families while protecting children from (re) abuse or neglect; thereby,preventing out-of-home placement or expediting the return to the home from children living in foster care. Home-Based services are an integral part of an intervention plan for families struggling with issues of abuse or neglect. Families who mistreat their children, although in dire need of services, have trouble remaining in treatment because of their own difficulties in establishing relationships. By providing services in the home, families can be more comfortable which increases their ability to make necessary behavioral changes. When parents are able to learn skills and practice them in the environment they live in, they increase their ability to maintain new skills through the coaching of the parent educator. Home-based services help to decrease the isolation prevalent in child maltreatment. Developing a relationship with the parent educator can increase the family member's ability to transfer that comfort level to other entities such as schools, neighbors, medical personnel and friends. Finally, because of the parent educator's frequent visits to the home, they are in a position to become aware of any increased instances of further abuse or neglect. Each family that meets the Family Preservation criteria that is referred into the program would be provided an average of 20 hours of Parenting and Life Skills Training which would enhance and strengthen the parents' ability to create and maintain stable and nurturing home environments. Services are designed to promote healthy child development, assist children and families to resolve crisis, connect with appropriate and necessary services, and remain safely together in their homes, avoiding unnecessary out-of-home placement of children and helping children already in out-of-home care to be returned to and maintained with their families. Home-Based Parent Education is also offered to families that are in need of supervised visitation. The purpose of the supervised visit is twofold: 1) to allow children to preserve relationships with people who are important to them, and 2)parent skills training as part of a treatment plan. During visits, the parent educator will teach childcare and demonstrate ways of setting and enforcing limits. During the supervised visit, parents have an opportunity to Page 2 of 10 test and improve the skills they may be learning either with the parent educator or in other settings such as parenting classes or counseling sessions. The visits can occur either at the family home or at another agreed upon location. c.a.r.e. is prepared to make appropriate arrangements as needed to provide supervised visits at other locations in Weld County, particularly the South Weld County area. (The Home- Based supervised visits are not the same as the supervised visits at our c.a.r.e.House facility in Evans.) This Home-Based Parent Education Program, formally known as the "Parent Advocate Program"has been successfully working with Weld County families for the past 17 years. We bring a wealth of professional and community experience to the families. Many families stay connected with the c.a.r.e. agency, accessing other services to help strengthen their family, such as parenting classes, children's groups and support groups. II. Target/Eligibility Population A. Total number of clients to be served: This depends on the amount of referrals into the program; however, as stated below, the program has the capacity to serve approximately 25 families per year. B. Total individual clients and the children's ages: As stated above, there is a total capacity of 25 families; this includes parents,plus children aged birth through teens. Families eligible for this program can vary in age from pregnant/parenting teens through grandparents or other specific caregivers. C. Total family units: 25 total family units per year D. Sub-total of individuals who will receive bicultural/bilingual services: 8 families per year. This is based on the total of 6 families we served in 2004. We are able to provide this program for bicultural/bilingual families. D. Sub-total of individuals who will receive services in South Weld County: 5 families per year. In 2003, we worked with 2 families in South County. We are able to provide this program for other families in South County. The amount of families is driven strictly through referrals received. F. The monthly maximum capacity: 10 families Page 3 of 10 G. The monthly average capacity: 8 families H. Average stay in the program: 11 weeks I. Average hours per week in the program: 2 hours per week. The figures above are approximate. Each family in the program has an individual service plan depending on the needs of the family and recommendations of the caseworker. Therefore, not every family utilizes the program for a uniform amount of hours. The program has the capacity to expand as needed. III. Type of Services To Be Provided Each of the following services could be provided to any family enrolled in the program; however all families do not need all services. Services provided would be determined by the c.a.r.e. Program Coordinator, c.a.r.e. Parent educator and DSS caseworker. A. Mentoring 1. Teach, model and coach adaptive strategies Home-Based parenting and life skills education by a trained parent educator including role modeling, teaching and coaching of appropriate interactions with the family. The parent educator staff will utilize a variety of teaching modalities to achieve the goal of a healthier functioning family. Topics include stress and anger management, behavior management for children and other pertinent topics taught through written materials, videos and homework; role modeling and practicing of new skills in the family environment. Program Goals • Increase ability of parents to be in charge of their family's well being. • Increase ability to provide structure which can be modified as needs arise. • Increase ability to deal with stress in an appropriate manner with less maladaptive coping skills • Increase ability to recognize maladaptive coping skills of other family members and how to assist to regain balance 2. Model and influence parenting practices Provide home-based parent education utilizing ongoing education, support and encouragement. This is accomplished while directly intervening with the family to change maladaptive parenting styles and replace them with a more appropriate interaction. Page 4 of 10 3. Teach relational skills The parent educator will model and teach a nurturing parent role with a focus on parent/child self esteem. The goal is to increase positive family relationships. Relationship skills as they pertain to community are also worked on as families access needed resources. 4. Teach Household Management including prioritizing, finances, cleaning, and leisure activities. Intensive home-based training in household management, especially as it pertains to safe and nurturing child rearing. When it is identified that the family needs to increase their skills in this area, the parent educator will problem solve and coach the family in keeping a home environment adequate to the safety of family members. The parent educator will also work with the family on prioritizing other elements of family life especially as they pertain to leisure and family budgeting. 5. Actively help to establish community connections and resources Provide information, training and role modeling in accessing community resources, as well as follow through in using resources. The parent educator would accompany the family on appointments to community resources, schools, medical offices and other locations when necessary and appropriate. 6. Encourage goal-setting and pro-social values The parent educator will educate the family about setting short and long term goals and a plan to attain them. They will work toward goals that would be within a socially acceptable value system and examine barriers to achieving healthy goals. The supervised visitation service provided through this program includes all of the above activities when appropriate to the goals for the family. The parent educator will meet with the family separately from the supervised visit time to debrief, address concerns and work on issues that will aid them during future visit times. This will include parental support and guidance, help with the use of community resources and ongoing communication and feedback about parenting progress and goals. Page 5 of 10 Quantitative Measures Each service can be offered to each family enrolled in the program, depending on need. Therefore, there is a potential for up to 25 families per year. These figures are estimates, based on the previous year. The program can be expanded when needed, depending on the number of referrals. The program employs hourly personnel to work with families and the staff can be expanded when the need arises. The home-based parent education program is the only home-based program of its' kind in Weld County, working with this population of families that are at risk of children's placement. We do not provide mental health services, substance abuse treatment or other professional services that are funded by another source. N. Measurable Outcomes All families in the program will be evaluated using the following measures. In some instances, availability and ability of the clients might affect the program's success in obtaining outcomes. The average number of families available for measurement of outcomes is 25. A. Improvement of household management competency as measured by pre and posttest instruments. 90% of families will increase their ability to provide a safe home environment. This will be measured by staff report and observation. B. Improvement of Parental Competency as measured by pre and post assessment instruments. This will be measured by parent educator report and observation, and pre and posttest scores on the Ongoing Planning and Assessment Form for Home-based Programs. 90% of families will increase their parental competency scores as reflected in the following: - Increase their ability to understand and implement non-physical methods of child discipline. - Increase their ability to understand the stages of development of their children and appropriate ways to manage their children's behavior at each stage. - Increase their empathic awareness of their child's needs Page 6 of 10 - Decrease parent/child role reversal - Increase their stress management and anger management skills - Increase their ability to implement a"problem solving"model - Increase the communication and conflict resolution among family members C. Parents can independently work with other sources in the community and within the local, state, and federal governments. This will be measured by parent educator report and observation of the family's progress, and pre and post test scores on the Ongoing Planning and Assessment Form for Home-based Programs. 90% of families will increase their ability to access resources in the community when needed D. Families receiving Life Skills services will remain intact six months after discharge of the services. 85% of parents will remain intact six months after discharge of the services. Parents will sign a consent to allow c.a.r.e. to do a follow-up contact with WCDSS six months after completion of the program. E. Families /Participants who complete the Life Skills Services will have improved competency level or reduced risk on standardized assessment, such as the Risk Assessment Tool. Utilizing the Ongoing Planning and Assessment Form for Home-based Programs. pre and post test, there will be documentation of improved competency and/or reduced risk. This will also be measured ongoing by parent educator report and observation. V. Service Objectives Mentoring A. Improve Household Management Competency: Intensive home-based household management techniques taught by parent educators to improve the capacity of parents to provide a safe, nurturing environment. This will include but not be limited to cleaning, budgeting, purchasing, safety, and maintenance. Page 7 of 10 This will be measured partly through the Ongoing Planning and Assessment Form for Home-based Programs as well as parent educator report and observation. B. Improve Parental Competency: The program will provide home-based parent education including coaching, instructing, problem-solving, role modeling, and supervision that will help improve the parent's ability to provide sound relationships within the family. This will include but not be limited to nutrition, hygiene, discipline and protection. This will be measured by advocate record and observation; as well as pre and post scores on the Nurturing Quiz which tests knowledge of parenting, and the Ongoing Planning and Assessment Form for Home-based Programs which documents changes for families. C. Improve Ability to Access Community Connections Parent educator will provide information, training, and follow-through to families to enable them to effectively learn to access appropriate community resources, including those on the local, state, and federal level. Outcomes will be measured by advocate record and observation as well as improved scores on the Ongoing Planning and Assessment Form for Home-based Programs. D. Improve goal-setting and pro-social values The parent educator will set monthly goals with the family. These goals will fall within our socially acceptable value system. VI. Workload Standards A. Number of hours per day,week, or month. Up to 20 hours for each family unit for length of stay in the program. This number changes depending upon DSS request, contracted hours with the family and any periodic changes due to the progress and needs of the family. B. Number of individuals providing services: • 10 (ten)part-time hourly Parent Educators • 1 (one) 25 hr. per week Program Coordinator • 1(one)2 hr. per week Support Staff • I (one)2 hr. per week Administrative Support Page 8 of 10 C. Maximum caseload per worker: Each part-time Parent Educator could work with from 1-4 families, depending upon skill level, amount of contracted hours per family, and personal work preference. Due to our use of hourly workers, they do not carry a specific caseload. D. Modality of treatment: Home-based instruction and/or supervision, coaching, role modeling, practicing, and support. E. Total number of hours per day/week/month: From 1-25 hours per month, depending upon needs of the family. On the average, each family works directly with a parent educator for up to 8 hours per month in the program. F. Total number of individuals providing this service: • 10 (ten)part-time hourly Parent Educators • 1 (one) 25 hr. per week Program Coordinator • 1(one)2 hr. per week Support Staff • I (one)2 hr. per week Administrative Support G. The maximum caseload per supervisor: 10 families per month. H. Insurance: Child Advocacy Resource and Education, Inc. carries a commercial general liability policy with Alliance for Non-Profits for Insurance: Risk Retention Group. VII. Staff Qualifications A. Yes, the staff that is providing direct services will have the minimum qualifications in education and experience. The majority of the staff has bachelor's degrees in related areas. The 10 Parent Educators have the following educational backgrounds: two staff member have master's degrees, eight have bachelor's degrees and two have high school degrees. They all meet the minimum qualifications of a Case Services Aide II, which includes graduation from High School or GED Page 9 of 10 equivalent and six months full-time public contact experience. In addition, each advocate has had experience with parenting and/or working with children and families in environments such as a day care or preschool. The Coordinator of the Home Based Parent Education Program holds a Bachelor's Degree in General Studies with an emphasis in Early Childhood Education. She has 28 years of experience in the human services field as both a teacher and supervisor. The part-time Support Staff person has a Bachelor's degree and appropriate experience. The Executive Director has a Master's in Agency Counseling with an emphasis in Marriage and Family Therapy. She has seven years experience as a Home-Based Parent Educator and four years experience as a Program Coordinator. B. Total number of staff available for the project: 14-16. Page 10 of 10 • Alliance°t ALLIANCE OF NONPROFITS FOR INSURANCE J Nonprofits RISK RETENTION GROUP p P.O. Box 8546, Santa Cruz, CA 95061 t°Insurance P: (800) 359-6422 Risk RetnrrHnn Gros F: (831) 459-0853 COMMERCIAL LINES COMMON POLICY DECLARATIONS PRODUCER: POLICY NUMBER: 2004-11741 CANPO ASI 455 Sherman Street Ste 207 RENEWAL OF NUMBER: 2003-11741 Denver, CO 80203 NAME OF INSURED AND MAILING ADDRESS: Child Advocacy Resource And Education 3700 Golden Street Evans, CO 80620 POLICY PERIOD: FROM 07/23/2004 TO 07/23/2005 AT 12:01 A.M.STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE BUSINESS DESCRIPTION: Child Advocacy Services IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE COVERAGE AS STATED IN THIS POLICY. THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH A PREMIUM IS INDICATED.THESE PREMIUMS MAY BE SUBJECT TO ADJUSTMENT. PREMIUM COMMERCIAL GENERAL LIABILITY COVERAGE PART- OCCURRENCE $4,671 COMMERCIAL AUTO LIABILITY COVERAGE PART $500 IMPROPER SEXUAL CONDUCT COVERAGE PART $1,398 COMMERCIAL LIQUOR LIABILITY COVERAGE PART INCLUDED TERRORISM COVERAGE (Certified Acts) $49 TOTAL: $6,618 FORM(S)AND ENDORSEMENT(S)MADE A PART OF THIS POLICY AT TIME OF ISSUE:* ANI-RRG-GL, ANI-RRG-LL, ANI-RRG-SC. ANI-RRG-AL, SCHEDULE G, SCHEDULE L, SCHEDULE BA, CG0001/11-88, ANI-RRG-X1/08 02, ANI-RRG-E3/1-99, ANI-RRG-E5/3-91, ANI-RRG-E7/06 03, ANI-RRG-E11/7-92, ANI-RRG-E12/5-92, ANI-RRG-E15/3-94, ANI-RRG-E22/8-95, ANI-RRG-E28(1-99, ANI-RRG-E29/1-99, ANI-RRG-E30/4-00, ANI-RRG-E32/9-01, ANI-RRG-E33/1-02, C00033/11-88, CG2011-NPO/11-85, CG2012/11-85, CG2018/11-85, CG2020/11-85, CG2026/11-85, CG2034/3-97, CG2101/11-85, CG 2171/1202, CG2240/11-85, CG2407/11-85, CG2504/11-85, C07794/04 93, IL0017/11-85. IL0228/9-00, IL 09 85/01 03, `Omits applicable forms and endorsement if shown in specific coverage part/coverage form declarations. These declarations and the common policy declarations,if applicable,together with the common policy conditions,coverage form(s)and forms and endorsements,if any,issued to form a part thereof,complete the above numbered policy. "NOTICE This policy is issued by your risk retention group. Your risk y,�/hQ'Q retention group may not be subject to all of the insurance laws BY 0 and regulations of your State. State insurance insolvency (AUTHORIZED REPRESENTATIVE) guaranty funds are not available for your risk retention group." 07/16/2004 AM- RRG -CO (02258-DB) • Alliance„i ALLIANCE OF NONPROFITS FOR INSURANCE Nonprofits RISK RETENTION GROUP • "'Insurance P.O. Box 8546, Santa Cruz, CA 95061 �_•.. -. . -,, P: (800) 359-6422 F: (831) 459-0853 COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS PRODUCER: POLICY NUMBER: 2004-11741 CANPO ASI 455 Sherman Street Ste 207 RENEWAL OF NUMBER: 2003-11741 Denver, CO 80203 NAME OF INSURED AND MAILING ADDRESS: Child Advocacy Resource And Education 3700 Golden Street Evans, CO 80620 POLICY PERIOD: FROM 07/23/2004 TO 07/23/2005 AT 12:01 A.M.STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE BUSINESS DESCRIPTION: Child Advocacy Services IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE COVERAGE AS STATED IN THIS POLICY. LIMITS OF COVERAGE: GENERAL AGGREGATE LIMIT(OTHER THAN PRODUCTS-COMPLETED OPERATIONS) $3,000,000 PRODUCTS - COMPLETED OPERATIONS AGGREGATE LIMIT $3,000,000 PERSONAL AND ADVERTISING INJURY LIMIT $1,000,000 EACH OCCURRENCE LIMIT $1,000,000 FIRE DAMAGE LIMIT $100,000 any one fire MEDICAL EXPENSE LIMIT 10,000 any one person ADDITIONAL COVERAGES: SOCIAL SERVICE PROFESSIONAL LIABILITY AGGREGATE LIMIT $3,000,000 EACH OCCURRENCE LIMIT $1,000,000 CLASSIFICATION(S) SEE ATTACHED SUPPLEMENTAL DECLARATIONS SCHEDULE G PREMIUM $4,671 FORMS AND ENDORSEMENTS APPLICABLE TO THIS POLICY ARE INCLUDED IN COMMERCIAL LINES COMMMON POLICY DECLARATIONS 07/16/2004 BY (AUTHORIZED REPRESENTATIVE) THESE DECLARATIONS AND THE COMMON POLICY DECLARATIONS,IF APPLICABLE,TOGETHER WITH THE COMMON POLICY CONDITIONS,COVERAGE FORM(S) AND FORMS AND ENDORSEMENTS,IF ANY,ISSUED TO FORM A PART THEREOF,COMPLETE THE ABOVE NUMBERED POLICY. "NOTICE : This Policy is issued by your risk retention group.Your risk retention group may not be subject to all the insurance laws and regulations of your State. State insurance insolvency guaranty funds are not available for your risk retention group." ANI - RRG - GL (02258) • re , , . ) 1 , , ; , , ° - 0$ 20 \ , , ) ! ! ; ! _ ; ° | §\ ' ] " \ } § } } ° } ° ; y / el , �/ ° 2 ` ° - ` - : / 34 |2 w ° ( ca !h / — • ) • gt a• Lij 115/ \ } � / jE \ \ \ } ( \ } \ � ��, : ?`2 6 E- 2 } , ; ) • fa [ zw . Lug / ( / ) { \ /�! \ \ \ \ \ \ \ \ - -, au .ui O- ma 88 !,§ .., 6666....,, , 6666., , . f{f ! Lig f{f ! / )!\ ;|;;;;;;;;;;! 8 ;;]\;; 8 } f|| I . § sm. - § )!/ 222 2 ;;;;;;l; 8 ;l;;;; 2 | .f(� �` "} ; $ /222222 ) \ 2228 . - U. ! CH ! ` ` !. . \E ! ® ` /] 82Gg2g2 ( \&2 ( \ \§ f „ - \ : \ a |§ __________9222 222222 il @ 1-31 /2&282@ / ! § !E n f= }!E - iii !r ,6! -- ! ! 0 ! 4. 0 0 ! , | » . 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'i./{ - 5 ( ( ( \A! 222 SUPPLEMENTAL NARRATIVE TO RFP: EXHIBIT B CONDITIONS c • a • r • e 0)74, (clued advocacy resource and education, Inc. Weld County Dept. of S Services c.a.r.e. Clerical Unit 3700 Golden Street April 27,2005 APR 2 7 2005 Evans,Co 80620 Mrs.Gloria Romansik ). y (970)356-6751` Weld County Department of Social Services FAX;(910)506-2726 ` ` P.O.Box A ' car`eweld!gwest.net, Greeley,CO 80632 WirYp.Garewetd.org Dear Mrs.Romansik, Programs: Parentl Education Child Advocacy Resource and Education,Inc.(c.a.r.e.)is accepts the results of the RFP Bid Process for 2005-2006 with further information about Children and Youth specified areas. Saf@Touch 1.RFP 05005 Lifeskills,Parent Advocate Supervised Visits and Exchanges Condition#1: Home-Based Parent c.a.r.e.has the capacity to do after-hours visitation in this program Education evenings and Saturdays. ommunity,Awareness Condition#2: c.a.r.e.will raise the standards of education and experience of staff particularly to testify in court per instruction and guidance from Heather Walker and WCUSS staff. =� +�edlbw: '..,W40geoptiegt Y 2.RFP 05005 Lifeskills,Visitation x ' 3tit be/- x.' Condition#1: c.a.r.e.has the capacity to do after-hours visitation in this program on a . Monday,Wednesday and Friday evenings until 8 pm, Saturdays 9-3 and xj ` 4tedneydret. E Sundays 12-5. Condition#2: c.a.r.e.will raise the standards of education and experience of staff particularly to testify in court per instruction and guidance from Heather Walker and WCDSS staff. A oufl AY•Cons Odom&& i Condition#3 a c.a.r.e.will videotape visits and use feedback sheets per instruction and guidance from WCUt in order to increase the quality of visitation•uiwaw es services. An Abated agency of Untied way of Weld Canty c.a.r.e.accepts the recommendations outlined by the FYC Commission. As per a phone conversation with Heather Walker on 4-27-05,we will be in touch with you in the next month to schedule a meeting between c.a.r.e. program coordinators Tammy Davis,Rose Francella and Gwen Schooley with Heather and other pertinent DSS staff to clarify and outline specifics. Thank you for your consideration and approval of these two programs for inclusion on your vendor list.We look forward to meeting the needs of children and families in Weld County during the 2005-2006 year. Sincerely, Gwe hooley Ad-int\ Executive Director DEPARTMENT OF SOCIAL SERVICES f P.O. BOX A 14 IGREELEY, CO. 80632 Website:www.co.weld.co.us Administration and Public Assistance(970)352-1551 Child Support(970)352-6933 O • COLORADO April 18, 2005 Gwen Schooley, Director C.A.R.E. 3700 Golden Evans, CO 80620 Re: RFP 05005: Lifeskills,Parent Advocate RFP 05005: Lifeskills,Visitation Dear Ms. Schooley: The purpose of this letter is to outline the results of the bid process for PY 2005-2006 and to request written information and confirmation from you by Wednesday, April 27, 2005. A. Results of the Bid Process for PY 2005-2006 • The Families, Youth and Children(FYC) Commission recommended approval of Bid#05005 Lifeskills,Parent Advocate, for inclusion on our vendor list, attaching the following conditions. Condition#1 is applicable to all Lifeskills providers,while Condition#2 is specific to your program. Condition#1: All providers must define their capacity to do after-hours visitation. Condition#2: The provider will raise the standards for the education and experience of staff. In reviewing bids from other agencies,we have found their staff to be more reputable in testifying in court. Please discuss this condition with Heather Walker, extension 6250,if you have questions. • The Families,Youth and Children (FYC) Commission recommended approval of Bid#05005 Lifeskills, Visitation, for inclusion on our vendor list, attaching the following conditions. Condition#1 is applicable to all Lifeskills providers,while Conditions#2 and#3 are specific to your program. Condition #1: All providers must define their capacity to do after-hours visitation. Condition#2: The provider will raise the standards for the education and experience of staff. In reviewing bids from other agencies,we have found their staff to be more reputable in testifying in court. Please discuss this condition with Heather Walker, extension 6250, if you have questions. Page 2 c.a.r.e./Results of 2005-2006 Bid Process Condition #3: The provider will video tape visits and use feedback sheets in order to increase quality of visitation services. B. Required Response by FYC Bidders Concerning FYC Commission Conditions: All conditions will be incorporated as part of your Bid and Notification of Financial Assistance Award(NOFAA). If you do not accept the condition(s), you will not be authorized as a vendor unless the FYC Commission and the Weld County Department of Social Services accept your mitigating circumstances. If you do not accept the condition, you must provide in writing reasons why. A meeting will be ranged to discuss your response. Your response to the above conditions will be incorporated in the Bid and Notification of Financial Assistance Award. The Weld County Department of Social Services is requesting your written response to the FYC Commission's conditions. Please respond in writing to Gloria Romansik, Weld County Department of Social Services, P.O. Box A, Greeley, CO, 80632,by Wednesday, April 27, 2005, close of business. If you have questions concerning the above, please call Gloria Romansik, 970.352.1551 extension 6230. Sincerely, dy ego, ector cc: Juan Lopez, Chair, FYC Commission Gloria Romansik, Administrator Weld County Department of Social Services Notification of Financial Assistance Award for Families,Youth and Children Commission (Core)Funds Type of Action Contract Award No. X Initial Award FY05-PAC-006 Revision (RFP-FYC-05005) Contract Award Period Name and Address of Contractor Beginning 06/01/2005 and Child Advocacy Resource&Education Ending 05/31/2006 C.A.R.E. House-Visitation 3700 Golden Street Evans, CO 80620 Computation of Awards Description The issuance of the Notification of Financial Unit of Service Assistance Award is based upon your Request for The program offers supervised visits or Proposal (RFP). The RFP specifies the scope of exchanges, interactional supervised visits, and services and conditions of award. Except where it is mentoring, as noted on the caseworker referral. in conflict with this NOFAA in which case the Each family would be provided 2 hours per NOFAA governs, the RFP upon which this award is week supervised visitation, 3-8 hours per week based is an integral part of the action. interactional visitation, and transportation, subject to caseworker request. Each of the above Special conditions program areas has the ability to expand as 1) Reimbursement for the Unit of Services will be based referrals fluctuate.Bicultural-bilingual services on an hourly rate per child or per family. and access to South County clients through 2) The hourly rate will be paid for only direct face to transportation to careHouse facility or referral to face contact with the child and/or family or as HBPE program. specified in the unit of cost computation. 3) Unit of service costs cannot exceed the hourly and Cost Per Unit of Service yearly cost per child and/or family. 4) Payment will only be remitted on cases open with, Hourly Rate Per and referrals made by the County Department of Visitation $41.08 Social Services. Treatment Package-Intensive $71.58 5) Requests for payment must be an original form and Transportation $33.61 submitted to the Weld County Department of Social Court Testimony $50.00 Services by the end of the 25th calendar day following Enclosures: the end of the month of service. The provider must X Signed RFP: Exhibit A submit requests for payment on forms approved by X Supplemental Narrative to RFP: Exhibit B Weld County Department of Social Services. Recommendation(s) 6) The Contractor will notify the Department of any changes in staff at the time of the change. X Conditions of Approval Approvals: // Program Official: By rl� -� By William H. Jerke, Chair Judy A 'ego, irector Board of Weld County Commissioners Weld ty Department of Social Services Date: JUN 0 6 2005 Date0 S DOS — /(awe/ SIGNED REP: EXHIBIT A INVITATION TO BID BID 002-05 (05005 -05011 and 006-00) DATE: February 16, 2005 BID NO: RFP-FYC-05005 RETURN BID TO: Pat Persichino,Director of General Services 915 10th Street, P.O. Box 758, Greeley, CO 80632 SUMMARY Request for Proposal (RFP-FYC-04005) for:Colorado Family Preservation Act--Life Skills Program Emergency Assistance Program Deadline: March 11, 2005, 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 Colorado Family Preservation Program Act(C.R.S. 26-5.5- 101) and Emergency Assistance for Families with Children at Imminent Risk of Out-of-Home Placement Act (C.R.S. 26-5.3-101). The Families, Youth and Children Commission wishes to approve services targeted to run from June 1, 2005, through May 31, 2006, at specific rates for different types of service, the county will authorize approved vendors and rates for services only. The Life Skills Program must provide services that focus on teaching life skills, which are designed to improve household management competency,parental 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 N • (After receipt of order) BID MIT BE SIGNED/IN INK Gwen M. Schooley TYPED OR PRINTED SIGNATURE Child Advocacy Resource VENDOR and Education, Inc. TIOA-f/ a uctetto (Name) HandWiitteoignature By Authorized Officer or Agent of Vender 3700 Golden St. Evans, CO 80620 ADDRESS TITLE Co-Chair, Board of Directors DATE March 8, 2005 PHONE# 970-356-6751 Ext. 17 The above bid is subject to Terms and Conditions as attached hereto and incorporated. Page 1 of33 Bid 002-05 (RFP-FYC-05005) Attached A • LIFE SKILLS PROGRAM BID PROPOSAL AND REQUEST FOR CONTINUATION OF AWARD UNDER CORE SERVICES FUNDING EMERGENCY ASSISTANCE PROGRAM 2005/2006 BID PROPOSAL APPLICATION PROGRAM FUNDS YEAR 2005-2006 BID 002-05 (05005) NAME OF AGENCY: Child Advocacy Resource and Education, Inc. ADDRESS: 3700 Golden Street Evans, CO 80620 PHONE: 970-356-6751 CONTACT PERSON: Tammy Davis TITLE: Coordinator DESCRIPTION OF FAMILY PRESERVATION PROGRAM CATEGORY: The Life Skills 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, effectively accessing community resources, and encouraging goal setting and pro-social values. 12-Month approximate Project Dates: _ 12-month contract with actual time lines of: Start June 1.2005 Start June 1 . 2005 End May 31,2006 End May 31 , 2006 TITLE OF PROJECT: Supervised Visitation Program AMOUNT REQUESTED: Low Intensity Supervised Visitation- $41.08 hr. InrecauLiulal Visitation- $71 .58 hr. Transportation- $33.61 hr. , Exchanges = 1/2 of Low intensity fee or � �• Gunn Schoe/iry $20.54 per half hour N. e and Signature of Pers Preparing Document / Date 6 -/o -o S Judy A. Griego,Director Name and Signature Chief Administrative Officer Applicant Agency Date MANDATORY PROPOSAL REQUIREMENTS For both new bids and renewal bids,please initial to indicate that the following required sections are included in this Proposal for Bid. For renewal bids,please indicate which of the required sections have not changed from Program Fund Year 2004- 2005 to Program Fund year 2005-2006. Indicate No Change from FY 2004-2005 Project Description ✓ Target/Eligibility Populations Types of services Provided ✓ Measurable Outcomes Service Objectives Workload Standards Staff Qualifications ✓ Unit of Service Rate Computation JL Program Capacity per Month Certificate of Insurance Assurance Statement Page 26 of 33 Bid 002-05 (RFP-FYC-05005) Attached A Date of Meeting(s)with Social Services Division Supervisor: -2 Comments by SSD Supervisor: 14 q?Zje,-y- L�J / CA ,� 5c m {C2 r eta, J (-(1 -k (J4. I l< 11-d>(,4/ Name and Signature of SSD Supervisor Date Page 27 of 33 Bid 002-05 (RFP-FYC-05005) Attached A Program Category Life Skills Program Bid Category Project Title Supervised Visitation Program Vendor Child Advocacy Resource and Education, Inc. PROJECT DESCRIPTION Provide a brief one-page description of the project. II. TARGET/ELIGIBILITY POPULATIONS Provide a brief one-page description of the proposed target/eligibility populations. At a minimum your description must address: A. Total number of clients served. B. Total individual clients and the children's ages. C. Total family units. D. Sub-total of individuals who will receive bicultural/bilingual services. E. Sub-total of individuals who will receive services in South Weld County. F. The monthly maximum program capacity. G. The monthly average capacity. H. Average stay in the program (weeks). I. Average hours per week in the program. 111. TYPE OF SERVICES TO BE PROVIDED Provide a two-page description of the types of services to be provided. Address if your project will provide the service minimums as follows: A. Mentoring: Address, at a minimum, the following ways the project will: 1. Teach,model, and coach adaptive strategies; 2. Model and influence parenting practices; 3. Teach relational skills; 4. Teach household management, including prioritizing, finances, cleaning, and leisure activities; 5. Actively help to establish community connections and resources; 6. Encourage goal setting and pro-social values. B. Visitation: Address, at a minimum, the following ways the project will: 1. Monitor parent/child interactions for physical and emotional safety; 2. Document clinical observations; 3. Strategize for teaching and modeling parenting skills; 4. Teach relational skills; 5. Encourage goal setting and pro-social values; 6. Plan structured activities in visitation to help achieve the objectives of the treatment plan. Page 28 of 33 Child Advocacy Resource and Education, Inc. 3700 Golden Street Evans, CO 80620 Supervised Visitation Programs I. PROGRAM DESCRIPTION The Supervised Visitation and Exchange Program through c.a.r.e. was developed with the primary purpose of protecting children from (re) abuse and neglect while allowing children to preserve relationships with people who are important to them. Supervised visits reassure children that they have not been abandoned by a parent who for many reasons might not be able to have unsupervised contact with their child(ren). The visit occurs on-site at the careHouse facility. Services are designed to assist children and families in maintaining a relationship during this time of crisis. Depending on the needs of the family and the original referral from the caseworker, two levels of visitation are offered. Transportation is available at a separate cost for both programs when needed. Both programs have the ability to increase the services provided as referrals fluctuate. 1. Supervised Visits or exchanges (Low Intensity), under the control of a Visit Supervisor are designed to supervise a visit, both verbally and physically, for appropriate interactions, with only limited intervention as necessary for the safety and supervision of children. Supervised exchanges insure safe transport of a child between parents where there is the propensity for conflict and/or family violence. The supervised time is limited to the actual transfer between parties with the remainder of the parent/child contact occurring unsupervised. In both cases, the visit supervisor will supervise the interactions between family members and provide written documentation. 2. Interactional Supervised Visits involves more concentrated assistance- the development and enhancement of parenting skills, a directive and interactive approach facilitated by a parent educator. The educator provides coaching and skills training to parents with the goal of giving them the opportunity to practice new skills, improving positive relationships between parents and children. The Parent Educator will interact with the family during the actual visit as well as have time with family before and after the visit as deemed necessary to work on the related parenting and life skills issues. Child Advocacy Resource and Education,Inc. 1 Core Services Visitation-03/10/05 II. TARGET/ELIGIBILITY POPULATIONS: A. Total number of clients to be served: Supervised Visit (Low Intensity) : 2 families Interactional Visitation : 27 families B. Total individual clients and the children's ages: Supervised Visits: 10 (parents and children aged birth to 16) Interactional Visitation (High Intensity): 40 (parents and children aged birth to 16) C. Total Family units: Supervised Visits (Low Intensity): 2 Interactional Visitation (High Intensity: 27 D. Sub-total of individuals who will receive bicultural/bilingual services: Supervised Visitation (Low Intensity): 2 Interactional Visitation (High Intensity): 5 E. Sub-total of individuals who will receive services in South Weld County: 0 Children in the South County area can be transported to the careHouse facility in Evans, or families can be referred to the Home Based Parent Education Program for services in South Weld County. F. The monthly maximum program capacity: Supervised Visits (Low Intensity): 2 Interactional Visitation(High Intensity: 8 G. The monthly average capacity: Supervised Visits (Low Intensity): 2 Interactional Visitation (High Intensity: 5 H. Average stay (weeks) in the program: Supervised Visits (Low Intensity): 2 Interactional Visitation (High Intensity: 9 I. Average hours per week in the program: Supervised Visits (Low Intensity): 2 Interactional Visitation (High Intensity: 2 Child Advocacy Resource and Education, Inc. 2 Core Services Visitation-03/10/05 III. TYPE OF SERVICE TO BE PROVIDED Supervised exchanges insure safe transfer of a child between parents where there is the propensity for conflict and/or family violence. Supervising of exchanges between parties is limited to the exchange time, the remainder of the parent/child contact occurs unsupervised. One parent or caregiver will drop the children off at the careHouse facility and leave. The children will then be in the care of a staff person for 15 minutes. During that time, the children may be occupied in various activities with the staff person, all helping to provide the child with a neutral time to prepare for their time with the other parent or caregiver. Supervised Visitation Visiting parents would attend an initial 1-hr. orientation. At this time, program staff will review and help the parent fill out program paperwork, review program guidelines, and address parental concerns. Children will be brought to visit by caregiver who would leave the premises. Visiting parent would then arrive and visit with children. Upon leaving, the caregiver would return to pick up children. The program at this level can provide family with parenting information and resources as it pertains to their visit. Intervention will be limited to addressing safety concerns during the visit. Interactional Visitation (High Intensity) This program provides parent skills training as part of a treatment plan. A. Visiting parents would attend an initial 1-hr. orientation. At this time, program staff will review and help the parent fill out program paperwork, review program guidelines, address parental concerns and share the plan for parent education which will take place in an interactive manner and may occur before, during, and/or after the visit. Parent education is in the form of knowledge of the developmental needs of the children, nurturing discipline during the visit, appropriate visit activities and acceptable conversation. B. Supervised visits would be scheduled and occur. Before, during, and/or after the visit, the parent educator will provide parent skills coaching and instruction and demonstrate ways of setting and enforcing limits in a direct manner. Parents will have an opportunity to test and improve the skills they may be learning either with the parent educator or in other settings such as parenting classes or counseling sessions. C. Support meetings would occur as needed with the parent to address ongoing concerns and provide parent education as it pertains to their interactions during the visit. When appropriate, families would be provided community resource information. As families show increase comfort and success during the visits, meetings may occur less frequently. A. Mentoring: (Pertaining to Interactional Supervised Visits) 1. Teach, model, and coach adaptive strategies; Child Advocacy Resource and Education, Inc. 3 Core Services Visitation-03/10/05 Parent Educator will incorporate role modeling, teaching and coaching of appropriate interactions with the family. The Parent Educator staff will utilize a variety of teaching modalities to achieve the goal of a healthier functioning family. This includes education through written materials, videos, and homework, role modeling and practicing of new skills during future visits. Each family member will: - Increase ability of parents to be in charge of their family's well being. - Increase ability to provide structure which can be modified as needs arise. - Increase ability to deal with stress in an appropriate manner with less maladaptive coping skills - Increase ability to recognize maladaptive coping skills of other family members and how to assist to regain balance 2. Model and influence parenting practices: The Parent Educator will model and teach a nurturing parenting role in a direct manner: -Increase their ability to understand and implement non-physical methods of child discipline. -Increase their ability to understand the stages of development of their children and appropriate ways to manage their children's behavior at each developmental stage. -Increase their empathic awareness of their child's needs. -Decrease parent/child role reversal. 3. Teach relational skills Provide parent education utilizing ongoing education, support, and encouragement. Parents will be educated on ways to: -Increase their stress management and anger management skills. -Increase their ability to implement a"problem solving" model. -Increase the communication and conflict resolution among family members. -Increase their ability to access resources in the community when needed. 4. Teach household management, including prioritizing, finances, cleaning, and leisure activities; If requested by the caseworker, the Parent Educator will educate in this area as adequately as possible under the circumstances. 5. Actively help to establish community connections and resources: Provide information in accessing community resources. 6. Encourage goal setting and pro-social values: Parent Educator alongside of the parents will establish and achieve goals, which will benefit the family. The parents will be educated on interacting and responding appropriately in a socially acceptable manner. Child Advocacy Resource and Education, Inc. 4 Core Services Visitation-03/10/05 B. Visitation: 1. Monitor parent/child interactions for physical and emotional safety: Parent Educator will supervise visitation between parent and child, help parent maintain appropriate and positive interaction and conversation all the while insuring the emotional and physical safety of the child 2. Document clinical observations: careHouse documentation will consist of observational documentation- appearance of child, noticeable bruises/scratches, activities during visit, general tone of parent/child interaction, and any further comments or concerns related to visit. Documentations will also include progress toward client treatment plan and activities employed by the parent educator to address these goals. 3. Strategize for teaching and modeling parenting skills: Parent education in the form of coaching and modeling will occur during the supervised visits. The Parent Educator will utilize a variety of teaching modalities to achieve the goal of a potentially healthier functioning family. This includes education through written materials, videos, and homework, role modeling and practicing of new skills during supervised visits. There is an opportunity for more education before and after the supervised visit which will address progress as well as concerns in a direct manner in order to aid the family during future visit times. This will include parental support and guidance, along with communication and feedback about parenting progress and goals. 4. Teach relational skills: Provide parent education utilizing ongoing education, support, and encouragement. Parents will be educated on ways to: -Increase their ability to understand and implement non-physical methods of child discipline. -Increase their ability to understand the stages of development of their children and appropriate ways to manage their children's behavior at each stage. -Increase their empathic awareness of their child's needs. -Decrease parent/child role reversal. -Increase their stress management and anger management skills. -Increase their ability to implement a"problem solving"model. -Increase the communication and conflict resolution among family members. -Increase their ability to access resources in the community when needed. 5. Encourage goal setting and pro-social values: Parent Educator alongside of the parents will establish and achieve goals for the family. The parents will be educated on handling and responding appropriately to situations which may arise. Child Advocacy Resource and Education, Inc. 5 Core Services Visitation-03/10/05 6. Plan structured activities in visitation to help achieve the objectives of the treatment: The Parent Educator will provide and educate the parent on appropriate age level activities. However, the parents will be encouraged to provide and initiate activities as part of their demonstration of parenting techniques. Quantitative Measures: Services are offered to each family enrolled in the program, depending on need. Therefore, there is a potential for 27 families per year. These figures are based on the previous year. The program can be expanded when needed, depending on the number of referrals. The Supervised Visit and Exchange Program is the only exchange program offered in Weld County. There are limited supervised visitation services offered through the Department of Social Services and Lutheran Family Services. c.a.r.e. services are available off-hours and during weekends. c.a.r.e. does not provide mental health, substance abuse or other professional services that are funded by another source. IV. MEASURABLE OUTCOMES Supervised Visitation Low Intensity Model: 90% of the families enrolled in the Supervised Visitation Program will increase their positive contact with family members. This will be documented by program staff from observational methods. The average number of families available for measurement of outcomes is 3. Interactional Visitation High Intensity Model: 90% of the families enrolled in the Interactional Visitation Program will show a improvement in the following areas. All families will be evaluated using the following measures. In some instances, availability and ability of the clients might affect the program's success in obtaining outcomes. The average number of families available for measurement of outcomes is 27. A. Improvement of household management competency as measured by pre and posttest instruments. If requested by the Caseworker,this area will be addressed with the family by the Parent Educator to the best of our ability under the circumstances and measured by program documentation. B. Improvement of parental competency as measured by pre and post assessment instruments. 90% of the families in the program will show an improvement in scores on the pre and post Ongoing Planning and Assessment Form. Child Advocacy Resource and Education, Inc. 6 Core Services Visitation-03/10/05 C. Parents can independently work with other sources in the community and within the local, state, and federal governments. 90% of the families in the program will exhibit utilization of applicable community resources, measured by program documentation and client self report. D. Families receiving Life Skills services will remain intact six months after discharge of the services. 90% of the families in the program will remain intact six months after discharge of the program. Parents will sign a consent to allow c.a.r.e. to do a follow-up contact with WCDSS six months after completion of the program. E. Families/participants who complete the Life Skills Services will have improved competency level or reduced risk on standardized assessment, such as the Risk Assessment Tool. 90%of the parents in the program will exhibit an improvement of scores on the AAPI post test, measuring parenting and child rearing attitudes. There will also be documentation of improved competency and/or reduced risk through ongoing program documentation. V. SERVICE OBJECTIVES Mentorine: A. Improve Household Management Competency Parents in the program will follow program guidelines for basic cleanliness of program environment when at the careHouse facility. B. Improve Parental Competency The program will provide parent skills training as part of a treatment plan. During visits, the parent educator will interact with the family, demonstrating ways of setting and following through with appropriate behavior management techniques in a directive manner before, during, and/or after the visit. During the supervised visit, parents have an opportunity to test and improve the skills they may be learning either with the parent educator or in other settings such as parenting classes or counseling. C. Improve Ability to Access Resources Parent Educator will provide information to families as needed regarding community resources, including those on the local, state, and federal level. Outcomes will be measured by program documentation as well as improved scores on the Ongoing Planning and Assessment Form. D. Improve goal setting and pro-social values. Parent Educator will set monthly goals according to the parent's needs and work with the parent on achieving this goal and demonstrating it during future visits. Child Advocacy Resource and Education, Inc. 7 Core Services Visitation-03/10/05 The Parent Educator will also demonstrate educate, and encourage the parent in regards to pro-social values. Visitation: A. Improve parenting skills, parent/child interactions and relational skills for physical and emotional safety through structured activities in, and documentation of,visitations to achieve the objectives of the treatment plan; The program will provide parent education including coaching, instructing, problem-solving, role modeling, and supervision that will help improve the parent's ability to provide sound relationships within the family in order to achieve their treatment plan. The Parent Educator will monitor and document visitation between parent/child while maintaining appropriate and positive interaction as well as conversation. Structured activities and debriefing will be discussed between the Parent Educator and the parent prior to the visit to insure the physical and emotional safety of the child. B. Improve goal setting and pro-social values. The Parent Educator will set a monthly goal according to the parent's needs, work with the parent on achieving the goal and demonstrating it during future supervised visits. The Parent Educator will demonstrate, educate and encourage the parent in regards to pro-social values VI. WORKLOAD STANDARDS Each of the three program areas has the ability to expand as referrals fluctuate. A. Number of hours per day,week, or month. Supervised Visits (Low Intensity): 2 hour per week Interactional Visitation(High Intensity: 3 hours per week B. Number of individuals providing services: Low Intensity: One part time Program Coordinator Hourly Visit Supervisors High Intensity: One part time Program Coordinator Hourly Parent Educators There is also program and administrative support working at a limited level in the program. C. Maximum caseload per worker: Supervised Visits (Low Intensity): 2 Interactional Visitation (High Intensity: 4 D. Modality of Treatment: Child Advocacy Resource and Education,Inc. 8 Core Services Visitation-03/10/05 Center-based supervision of family visits and exchanges, either Supervised Visitation at a lower level of intensity or Interactional Visitation at a higher level of intensity, utilizing parent skills training in the form of education, coaching and structured education when needed. E. Total number of hours per day/week/month: Supervised Visits (Low Intensity): 2 hour per week Interactional Visitation(High Intensity): 8 hours per week F. Total number of individuals providing this service: Supervised Visits (Low Intensity): 2 Interactional Visitation (High Intensity: 6 G. The maximum caseload per supervisor: Supervised Visits (Low Intensity): 3 Interactional Visitation(High Intensity: 8 H. Insurance: Child Advocacy Resource and Education, Inc. carries a commercial general liability policy with Alliance for Non-Profits Risk Retention Group, Inc. VII. STAFF QUALIFICATIONS: A. The staff that is providing direct services will have the minimum qualifications in education and experience. The Program Coordinator, Case Managers and Parent Educators will meet the minimum requirements of a Case Services Aide II. In addition, they will have experience working with families and children in environments such as a day care or school. The Program Coordinator holds a Bachelor's degrees in Psychology and Criminology. She has 4 years experience in the human service field. The Executive Director has a Master's Degree in Agency Counseling with an emphasis in Marriage and Family Therapy. She has seven years experience as a Family Advocate and four years experience as a program coordinator. B. Total number of staff available for the project: 10 Child Advocacy Resource and Education, Inc. 9 Core Services Visitation-03/10/05 Allianceof ALLIANCE OF NONPROFITS FOR INSURANCE RISK RETENTION GROUP Nonprofits P.O. Box 8546, Santa Cruz, CA 95061 forInsurance P: (800) 359-6422 Risk rzem,r/,,,,Group F: (831) 459-0853 COMMERCIAL LINES COMMON POLICY DECLARATIONS PRODUCER: POLICY NUMBER: 2004-11741 CANPO ASI 455 Sherman Street Ste 207 RENEWAL OF NUMBER: 2003-11741 Denver, CO 80203 NAME OF INSURED AND MAILING ADDRESS: Child Advocacy Resource And Education 3700 Golden Street Evans, CO 80620 POLICY PERIOD: FROM 07/23/2004 TO 07/23/2005 AT 12:01 A.M.STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE BUSINESS DESCRIPTION: Child Advocacy Services IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE COVERAGE AS STATED IN THIS POLICY. THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH A PREMIUM IS INDICATED.THESE PREMIUMS MAY BE SUBJECT TO ADJUSTMENT. PREMIUM COMMERCIAL GENERAL LIABILITY COVERAGE PART - OCCURRENCE $4,671 COMMERCIAL AUTO LIABILITY COVERAGE PART $500 IMPROPER SEXUAL CONDUCT COVERAGE PART $1,398 COMMERCIAL LIQUOR LIABILITY COVERAGE PART INCLUDED TERRORISM COVERAGE (Certified Acts) $49 TOTAL: $6,618 FORM(S)AND ENDORSEMENT(S)MADE A PART OF THIS POLICY AT TIME OF ISSUE:* ANI-RRG-GL, ANI-RRG-LL, ANI-RRG-SC, ANI-RRG-AL, SCHEDULE G, SCHEDULE L, SCHEDULE BA, C00001/11-88. ANI-RRG-X1/08 02, ANI-RRG-E3/1-99, ANI-RRG-E5/3-91, ANI-RRG-E7/0603, ANI-RRG-E11/7-92, ANI-RRG-E12/5-92, ANI-RRG-E15/3-94. ANI-RRG-E22/8-95, ANI-RRG-E28/1-99, ANI-RRG-E29/1-99, ANI-RRG-E30/4-00. ANI-RRG-E32/9-01, ANI-RRG-E33/1-02, C00033/11-88, CG2011-NPO/11-85, CO2012/11-85, CG2018/11-85, CO2020/11-85, 002026/11-85, CO2034/3-97, CO2101/11-85, CG 2171/1202, CO2240/11-85, CO2407/11-85, CG2504/11-85, C07794/04 93, IL0017/11-85, IL0228/9-00, IL 09 85/01 03, *Omits applicable forms and endorsement if shown in specific coverage part/coverage form declarations. These declarations and the common policy declarations,if applicable,together with the common policy conditions,coverage form(s)and forms and endorsements,if any,issued to form a part thereof,complete the above numbered policy. "NOTICE r� Q�m 4. This policy is issued by your risk retention group.Your risk U z-C retention group may not be subject to all of the insurance laws BY Cl and regulations of your State. State insurance insolvency (AUTHORIZED REPRESENTATIVE) guaranty funds are not available for your risk retention group." 07/1612004 ANI -RRG -CO (02258-DB) Alliance„y ALLIANCE OF NONPROFITS FOR INSURANCE C Nonprofits• RISK RETENTION GROUP Insurance P.O. Box 8546, Santa Cruz, CA 95061 Ri?k AvnvNnn c.,,,,,, P: (800) 359-6422 F: (831) 459-0853 COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS I PRODUCER: POLICY NUMBER: 2004-11741 CANPO ASI 455 Sherman Street Ste 207 RENEWAL OF NUMBER: 2003-11741 Denver, CO 80203 NAME OF INSURED AND MAILING ADDRESS: Child Advocacy Resource And Education 3700 Golden Street Evans, CO 80620 POLICY PERIOD: FROM 07/23/2004 TO 07/23/2005 AT 12:01 A.M. STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE BUSINESS DESCRIPTION: Child Advocacy Services IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE COVERAGE AS STATED IN THIS POLICY. LIMITS OF COVERAGE: GENERAL AGGREGATE LIMIT(OTHER THAN PRODUCTS-COMPLETED OPERATIONS) $3,000,000 PRODUCTS - COMPLETED OPERATIONS AGGREGATE LIMIT $3,000,000 PERSONAL AND ADVERTISING INJURY LIMIT $1,000,000 EACH OCCURRENCE LIMIT $1,000,000 FIRE DAMAGE LIMIT $100,000 any one fire MEDICAL EXPENSE LIMIT 10,000 any one person ADDITIONAL COVERAGES: SOCIAL SERVICE PROFESSIONAL LIABILITY AGGREGATE LIMIT $3,000,000 EACH OCCURRENCE LIMIT $1,000,000 CLASSIFICATION(S) SEE ATTACHED SUPPLEMENTAL DECLARATIONS SCHEDULE G PREMIUM $4,671 FORMS AND ENDORSEMENTS APPLICABLE TO THIS POLICY ARE INCLUDED IN COMMERCIAL LINES COMMMON POLICY DECLARATIONS 07/16/2004 BY K t -c `' 462 • - (AUTHORIZED REPRESENTATIVE) THESE DECLARATIONS AND THE COMMON POLICY DECLARATIONS,IF APPLICABLE,TOGETHER WITH THE COMMON POLICY CONDITIONS,COVERAGE FORM(S) AND FORMS AND ENDORSEMENTS,IF ANY,ISSUED TO FORM A PART THEREOF,COMPLETE THE ABOVE NUMBERED POLICY. "NOTICE : This Policy is issued by your risk retention group.Your risk retention group may not be subject to all the insurance laws and regulations of your State. State insurance insolvency guaranty funds are not available for your risk retention group." ANI - RRG - GL (02258) • • co iI- to ca 0 Iflll I imo m = m ; o s a -9 1 ' I �I - Lf 2 Lf 2 &II aI 2I Ili � n �e cu V9 8 Ir ^I ryl ml oft - N2I SI „I mI SI ? c . N 9 C' F E;t CO E as; E N t, ` »• 1 » .. »f aI al 1 " a atu °W SV O m w�a O ^ 'J _fel Tf4l - - htl 1 I »I :I Io m " ti x a S` 5 0 Lo 0 Ct u s"m - ma T. ' N avy CI O nay. a m'•CD s i ' 3 2 Y9 8 m '` i u ° O g° 4U x O a > a p p w r r C Z m V m 41 T N rI L G O 1.1 rC K a 0 >- - O�J O 5d♦ LL al L O C 1 Ou V 6 U K O 0 si a > V 2 2 N S-1 S O > > w u 6 K x <S 'T- U Q -, q C yMj N OF d Q W C N 5 w V C O N MIL:), LIZ ¢a 8 F N W 9 O V V 5 LL g 0 2 1 O U p K C dq O O O 5 O r w O F LL Q O Q 2 M it, o Vi o U 2 O D m0 Ou O t L w u o 0 w O O > O Q 3 S d O O N F W 0 N O ¢ vwi 6 r m O rc N y w illN OJ O F K Q N 8 F' ' u W a- + W ° IV 0 " °— OJ re G a w x 1� t- E 1 t 0 1 4 St, N W Q U 2 m H Q A o a' r a < z rc a it' a 7 = `f a 'a w 4 0 w W o o `O 0 0 °a o ° L. 4waC O2 N I - c m m 0 0 W u _ Y 0- 4, 4, '. 88 \;) a 3,4 §) aw��w.gg. .88888888888888 8 ��w . . fff ! f,! . . . .. . . . . ) `/ 7M PI 7 . , ! , . a )!j ;;;|;l;;;;;|;; | ;gaga, .8 . \/ f „ ! ] j ,gags.. ,.._. . ,.. _ P |\ 2 ! ! \f \too OO=0 / �. . . \\ { " rg; gil !j 2222 2,222___ 222222 | _::,: @| /evee&2 / ! / .t!§ ,• !}4 a f!! ,! 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'3 §�^ 2222 \ § � R! !! !§ 222222222922222222 ! `ic /\ §8 8 8 § o f 8 § o . , ! ! ! / ; ! ! \ ! | / f { r ! 0 ! \ � � \4 / \ ( I / \ ( \\! 2 SUPPLEMENTAL NARRATIVE TO RFP: EXHIBIT B CONDITIONS c • a • r • eo . o 4),00 , ,,., 0 tk x 0 (Child advocacy resource and education, Inc. Weld County Dept. of Social Services c.a . 1 P.e, Clerical Unit 3700 Golden Street April 27,2005 APR 2 7 2005 Evans, CO 80620 Mrs.Gloria Romansik (970)356-6751 Weld County Department of Social Services FAX(970)506-2726 P.O.Box A careweld@qwest.net Greeley,CO 80632 www.careweld.org Dear Mrs.Romansik, Programs: Parent Education Child Advocacy Resource and Education,Inc. (c.a.r.e.)is accepts the results of the RFP Bid Process for 2005-2006 with further information about Children and Youth specified areas. SafeTouch 1.RFP 05005 Lifeskills,Parent Advocate Supervised Visits and Exchanges Condition#1: Home-Based Parent c.a.r.e.has the capacity to do after-hours visitation in this program Education evenings and Saturdays. Community Awareness Condition#2: c.a.r.e.will raise the standards of education and experience of staff particularly to testify in court per instruction and guidance from Heather Walker and WCDSS staff. %careagtke c ma 2.RFP 05005 Lifeskills,Visitation ?mamma jaagekea e 9 Condition#1: pateete c.a.r.e.has the capacity to do after-hours visitation in this program on date*twat Sam Monday,Wednesday and Friday evenings until 8 pm, Saturdays 9-3 and awe'9 . Sundays 12-5. Condition#2: c.a.r.e.will raise the standards of education and experience of staff particularly to testify in court per instruction and guidance from Heather tiJ Walker and WCDSS staff. Anonymous® a wad County Calends Condition#3 liec.a.r.e.will videotape visits and use feedback sheets per instruction and guidance from WCDSS in order to increase the quality of visitation UnIbadWy1 services. An affiliated agency of united way of Weld County c.a.r.e.accepts the recommendations outlined by the FYC Commission. As per a phone conversation with Heather Walker on 4-27-05,we will be in touch with you in the next month to schedule a meeting between c.a.r.e. program coordinators Tammy Davis,Rose Francella and Gwen Schooley with Heather and other pertinent DSS staff to clarify and outline specifics. Thank you for your consideration and approval of these two programs for inclusion on your vendor list.We look forward to meeting the needs of children and families in Weld County during the 2005-2006 year. Sincerely, Gwe hooley Aci—ntir Executive Director DEPARTMENT OF SOCIAL SERVICES P.O. BOX A GREELEY, CO. 80632 Website:www.co.weld.co.us ' Administration and Public Assistance(970)352-1551 Child Support(970)352.6933 O • COLORADO April 18, 2005 Gwen Schooley, Director C.A.R.E. 3700 Golden Evans, CO 80620 Re: RFP 05005: Lifeskills,Parent Advocate RFP 05005: Lifeskills,Visitation Dear Ms. Schooley: The purpose of this letter is to outline the results of the bid process for PY 2005-2006 and to request written information and confirmation from you by Wednesday, April 27, 2005. A. Results of the Bid Process for PY 2005-2006 • The Families,Youth and Children (FYC) Commission recommended approval of Bid#05005 Lifeskills, Parent Advocate, for inclusion on our vendor list, attaching the following conditions. Condition#1 is applicable to all Lifeskills providers,while Condition#2 is specific to your program. Condition#1: All providers must define their capacity to do after-hours visitation. Condition#2: The provider will raise the standards for the education and experience of staff. In reviewing bids from other agencies,we have found their staff to be more reputable in testifying in court. Please discuss this condition with Heather Walker, extension 6250,if you have questions. • The Families, Youth and Children(FYC) Commission recommended approval of Bid#05005 Lifeskills,Visitation, for inclusion on our vendor list, attaching the following conditions. Condition#1 is applicable to all Lifeskills providers, while Conditions#2 and#3 are specific to your program. Condition#1: All providers must define their capacity to do after-hours visitation. Condition#2: The provider will raise the standards for the education and experience of staff. In reviewing bids from other agencies,we have found their staff to be more reputable in testifying in court. Please discuss this condition with Heather Walker, extension 6250, if you have questions. Page 2 c.a.r.e./Results of 2005-2006 Bid Process Condition#3: The provider will video tape visits and use feedback sheets in order to increase quality of visitation services. B. Required Response by FYC Bidders Concerning FYC Commission Conditions: All conditions will be incorporated as part of your Bid and Notification of Financial Assistance Award(NOFAA). If you do not accept the condition(s), you will not be authorized as a vendor unless the FYC Commission and the Weld County Department of Social Services accept your mitigating circumstances. If you do not accept the condition, you must provide in writing reasons why. A meeting will be arranged to discuss your response. Your response to the above conditions will be incorporated in the Bid and Notification of Financial Assistance Award. The Weld County Department of Social Services is requesting your written response to the FYC Commission's conditions. Please respond in writing to Gloria Romansik, Weld County Department of Social Services, P.O. Box A, Greeley, CO, 80632, by Wednesday,April 27,2005, close of business. If you have questions concerning the above,please call Gloria Romansik, 970.352.1551 extension 6230. Sincerely, dy riego, ector cc: Juan Lopez, Chair, FYC Commission Gloria Romansik, Administrator Weld County Department of Social Services Notification of Financial Assistance Award for Families,Youth and Children Commission(Core)Funds Type of Action Contract Award No. X Initial Award 05-CORE-65 Revision (RFP-FYC-05005) Contract Award Period Name and Address of Contractor Beginning 06/01/2005 and Victor H. Cordero Ending 05/31/2006 Lifeskills 2828 Speer Blvd.Unit 118 Denver, CO 80211 Computation of Awards Description Unit of Service The issuance of the Notification of Financial Program provides culturally and linguistically Assistance Award is based upon your Request for competent visitation,therapeutic visitation, and Proposal (RFP) and the Addendum RFP information. parenting instruction that optimizes parental The RFP specifies the scope of services and strengths, enhancing parent-child bonds, conditions of award. Except where it is in conflict modifying negative parenting behaviors, and with this NOFAA in which case the NOFAA governs, provides interventions suited to families needs. the RFP upon which this award is based is an integral Observational, in-vivo, didactic, and video part of the action. format utilized. Monthly maximum capacity 25 family units, average stay 3-6 months,average Special conditions hours per week 4, infants through adolescents. 1) Reimbursement for the Unit of Services will be based South County services in Firestone,culturally on a designated per family group conference. ethnically specific: Latino,Hispanic, 2) The designated rate will be paid for only direct face to Bilingual/Spanish. face contact with the child and/or family, as evidenced by client-signed verification form, as Cost Per Unit of Service specified in the unit of cost computation. Hourly Rate Per 3) Unit of service costs cannot exceed the designated Treatment Package $85.00 rate and yearly cost per child and/or family. Court Testimony $100.00 4) Payment will only be remitted on cases open with, and referrals made by the Weld County Department Enclosures: of Social Services. 5) Requests for payment must be an original submitted to X Signed RFP: Exhibit A the Weld County Department of Social Services by the X Supplemental Narrative to RFP: Exhibit B end of 25th calendar day following the end of the Recommendation(s) month of service. The provider must submit requests for payment on forms approved by Weld County X Conditions of Approval Department of Social Services. 6) The Contractor will notify the Department of any change in staff at the time of the change. Approvals: Program Official: By f By William H. Jerke, Chair Judy Grieg ,Director Board of Weld County Commissioners Wel ounty Department of Social Services Date: JUN 0 6 2005 Date:_&114 aOO5 - 164y SIGNED RFP: EXHIBIT A - INVITATION TO BID BID 002-05 (05005—05011 and 006-00) DATE: February 16, 2005 BID NO: RFP-FYC-05005 RETURN BID TO: Pat Persichino,Director of General Services 915 10th Street,P.O.Box 758, Greeley, CO 80632 SUMMARY Request for Proposal(RFP-FYC-04005) for:Colorado Family Preservation Act--Life Skills Program Emergency Assistance Program Deadline: March 11, 2005,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 Colorado Family Preservation Program Act(C.R.S.26-5.5- 101) and Emergency Assistance for Families with Children at Imminent Risk of Out-of-Home Placement Act (C.R.S. 26-5.3-101). The Families,Youth and Children Commission wishes to approve services targeted to run from June 1, 2005, through May 31, 2006, at specific rates for different types of service,the county will authorize approved vendors and rates for services only. The Life Skills Program must provide services that focus on teaching life skills,which are designed to improve household management competency,parental 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 31111O (After receipt of order) BID MUST B``E SIGNED IN INK `I 1 CToR COebEtto /' --n TYPED OR PRINTED SIGNATURE o VENDOR NI lL?OR t\ , Co KDeKO vtc QiNksLAss- (Name) Handwritten Signature By Authorized a$a$ SYEER i�Lvd., Ovict 118 Officer or Agent of Vender ADDRESS -DEYvveg 1 CO g'°all TITLE—DSgec-rot DATE 3)1 o ) g00rj PHONE# 3)3- -\5&- 94go The above bid is subject to Terms and Conditions as attached hereto and incorporated. Page 1 of 33 Bid 002-05 (RFP-FYC-05005) Attached A LIFE SKILLS PROGRAM BID PROPOSAL AND REQUEST FOR CONTINUATION OF AWARD UNDER CORE SERVICES FUNDING EMERGENCY ASSISTANCE PROGRAM 2005/2006 BID PROPOSAL APPLICATION PROGRAM FUNDS YEAR 2005-2006 BID 002-05 (05005) 0 NAME OF AGENCY: NI 1C'\OR NA • CacOERo , rPrY,3), ADDRESS: a8 a8 WccR 'Bt,v& . v,ek we PHONE: 303-I-155-� e 9 y CONTACT PERSON: VLC1aR Con De go TITLET-DiRECToR DESCRIPTION OF FAMILY PRESERVATION PROGRAM CATEGORY: The Life Skills 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,effectively accessing community resources,and encouraging goal setting and pro-social values. 12-Month approximate Project Dates: _ 12-month contract with actual time lines of: Start June 1.2005 Start End May 31, 2006 End \ i„ TITLE OF PROJECT: \/ ISI t 14-T le AMOUNT REQUESTED: 4 a , coo Name and Signature of Person Preparing Document Date Judy A. Griego,Director Name and Signature Chief Administrative Officer Applicant Agency Date MANDATORY PROPOSAL REQUIREMENTS For both new bids and renewal bids,please initial to indicate that the following required sections are included in this Proposal for Bid.For renewal bids,please indicate which of the required sections have not changed from Program Fund Year 2004- 2005 to Program Fund year 2005-2006. Indicate No Change from FY 2004-2005 /Project Description _✓Target/Eligibility Populations ✓Types of services Provided ✓ Measurable Outcomes V. Service Objectives V Workload Standards V Staff Qualifications v Unit of Service Rate Computation Program Capacity per Month v Certificate of Insurance Assurance Statement Page 26 of 33 Victor H.Cordero,Psy.D. Life Skills RFP-FYC 05005 Bid 002-05 (RFP-FYC-05005) Category: Life Skills Project Title: Therapeutic Visitations Vendor: Victor H. Cordero,Psy.D. Victor H.Cordero,Psy.D. Life Skills RFP-FYC 05005 I. PROJECT DESCRIPTION This project is designed to provide culturally and linguistically competent visitation, therapeutic visitation,and parenting instruction to parents involved with Weld County Department of Social Services. The project will provide highest levels of competence in the execution of all services and provide parenting time visitations in a context that is congruent with ethical standards. The program is designed with the goals of optimizing parental strengths, enhance parent-child bonds, modifying negative parenting behaviors, and providing interventions that are best suited to each families individual needs. Observational, in-vivo,didactic, and video format will be utilized to optimize appropriate parenting skill integration. 2 Victor H.Cordero,Psy.D. Life Skills RFP-FYC 05005 II.TARGET/ELIGIBILITY POPULATIONS A. Total Number of Clients to be served: 10 minimum B. Total individual clients and the children's ages: 10 clients minimum, infant, elementary school age,and adolescence. C. Total Family Units: 10 minimum D. Sub-total of individuals who will receive bicultural/bilingual services: 60% E. Sub-total of individuals who will receive services in South Weld County:30% F. Subtotal of individuals who will have access to 24-hour service: 100% G. Monthly maximum program capacity: 25 family units H. Monthly average capacity: 5 ongoing family units I. Average stay in the program: 3-6 months J. Average hours per week in the program: 4 hours per client/family unit K. Cultural/ethnically specific services: Latino,Hispanic,Bilingual/Spanish L. Service to South Weld Count Clients: Services available in Firestone, Frederick, Ft.Lupton area. 3 Victor H. Cordero,Psy.D. Life Skills RFP-FYC 05005 III.TYPE OF SERVICES TO BE PROVIDED A.Visitation: Parenting instruction,therapeutic visitation, and parenting assessment 1. All spectrum of parenting related interventions are intended to provide parents the environment,and interventions necessary to reach the general goal of improving parenting related behaviors and preserving the potential for unrestricted parenting or reunification. a. Instruction and parenting supervision will be designed to produce useful parenting related changes which will teach and model adequate or ideal parenting skills,teach relational skills, encourage goal setting and pro-social values,and plan structured activities in visitation to help achieve the objectives of the treatment plan. b. Clinicians will monitor parent/child interactions for physical and emotional safety issues, and document clinical observations. Clinicians will make all reasonable efforts to collaborate and communicate with Social Workers by personal contact, telephone contact,or via written report. c. Reports will clearly state methods utilized, contacts made, concerns, results and recommendations relevant to the reason for referral. d. Feedback will be made regularly available to the parents or other relevant parties in congruence with ethical standards and practice. e. Techniques utilized will be varied and tailored to the parent/families individual needs,to include specific modifications on the length of visits, mode of intervention,mode of feedback/rehearsal, and manner of presenting didactic information to the parent/family. 4 Victor H.Cordero,Psy.D. Life Skills RFP-FYC 05005 IV. MEASURABLE OUTCOMES The program will provide parents with an improved capacity for household management, improved parental competency,and improved parental ability to independently work with other community based resources. Such families will remain intact for a minimum of six months after discharge from the program and demonstrate improved competency and reduced levels of risk. Families will complete pre and post intervention assessments which will be utilized to assess levels of integration and behavioral competency of the desired parenting related behaviors. 5 Victor H.Cordero,Psy.D. Life Skills RFP-FYC 05005 V. SERVICE OBJECTIVES The primary objectives of this program are to provide sound, ethical,practical, effective,bilingual,and culturally competent interventions to improve/enhance parenting skills and family interactions. Improvements in the areas of parent-child dynamics,child management,safety issues, bonding and attachment,emotional growth, and general parent-child/family communication are anticipated. Parents and families will also enhance their capacity to function as an independent goal setting mechanism, espousing prosocial values. Service objectives will be measured and evaluated by: direct behavioral observation, incident report frequency,and pre/post assessments of functioning. 6 Victor H.Cordero,Psy.D. Life Skills RFP-FYC 05005 VI.WORKLOAD STANDARDS The program will provide a minimum of 10 hours per week,to include up to three clinicians providing these services. The maximum caseload per worker will be 4 ongoing clients per week. Modality of treatment interventions will be in-vivo parenting instruction at the clinicians office,visitation center, or The Department, including Greeley,Ft.Lupton, and South Weld County Annex offices on request. Maximum caseload per supervisor will be 5 ongoing and active cases. Insurance: Attached 7 Victor H.Cordero,Psy.D. Life Skills RFP-FYC 05005 VII. STAFF QUALIFICATIONS A. All staff providing direct services will have the minimum qualifications in education and experience. Psychologists will be licensed in the state of Colorado, be eligible for licensure, or evidence competence in the area of service. All non-licensed clinicians will be directly supervised by a licensed clinical psychologist and the psychologist will sign off on all documents provided to Social Services. B. Total staff number available: 3 C. Staff will receive and comply with any training required by Social Services. D. All staff will have knowledge in risk assessment. E. Staff providing bilingual (Spanish)services will demonstrate adequate levels of linguistic and cultural fluency. 8 Bid 002-05 (RFP-FYC-05005) Attached A Date of Meeting(s)with Social Services Division Supervisor: 3/ o1' Comments by SSD Supervisor: - r "4.) L-cj � t-�--( cdaatik 6-11 Name and Signature of SSD Supervisor Date Page 27 of 33 .00 J 4 ^ # ` m a N 0e - m m ! I-- 7 7 k OS a O m d 69 69 69 69 a \ ® ` \ U) \ \ \ ® \ \ 5 , _ a $ \ _ _ o@ § / G. w § j 5 03 \ _ / j _ O - m 5 — § O z w >- co 2 w / } (g ± q - § § % _ M § > > n u M - s § § § a. 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C/O: American Professional Agency, Inc. 95 Broadway, Amityville, NY 11701 This is to certify that the insurance policies specified below have been issued by the company indicated above to the insured named herein and that, subject to their provisions and conditions, such policies afford the coverages indicated insofar as such coverages apply to the occupation or business of the Named insured(s) as stated. THIS CERTIFICATE OF INSURANCE NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS, EXTENDS OR ALTERS THE COVERAGE(S) AFFORDED BY THE POLICY(IES) LISTED ON THIS CERTIFICATE. Name and Address of Insured: Additional Named Insureds : VICTOR H. CORDERO, PSY.D 2828 SPEER SUITE 118 DENVER, CO 80211 Type of Work Covered: PROFESSIONAL PSYCHOLOGIST Location of Operations: N/A (If different than address listed above) Claim History: Policy Effective Expiration Limits of Coverages Number Date Date Liability PROFESSIONAL/ 1,000,000 LIABILITY 008-1764838 10/01/04 10/01/05 3,000,000 NOTICE OF CANCELLATION WILL ONLY BE GIVEN TO THE FIRST NAMED INSURED ON THIS POLICY AND HE OR SHE SHALL ACT ON BEHALF OF ALL INSUREDS WITH RESPECT TO GIVING OR RECEIVING NOTICE OF CANCELLATION. Comments: This Certificate Issued to: Name: VICTOR H. CORDERO, PSY.D _ 2828 SPEER Address: SUITE 118 DENVER, CO 80211 Au orized Representative SUPPLEMENTAL NARRATIVE TO RFP: EXHIBIT B CONDITIONS From the office of: 2828 Speer Blvd.,Unit 118 Victor H. Cordero, Psy.D., P.C. Denver, CU 80211 t irnnsed Clinical Psychologist Office (303) 455-9480 Fax (303) 651-3773 14 EL SCHEDULE DULE Effective June 1, 2005 - June 30, 2006 Nato RE: Mental Health Services RFP 006-00 Sac unty RE: Li eskills RFP 05005 Cie'caE„�ee° of v��t s APR Service Fee G 7 2005 English, Bilingual and Spanish Assessment & Evaluation Services: Psychological Evaluation $800 Intellectual/Cognitive Test in Addition to Above $400 (I.Q./intellectual, cognitive assessment) Parent-Child Interactional Evaluation $1,120 (Comprehensive evaluation of parenting capacity including in-vivo observation, videotaped observation on multiple visits with fill report and recommendations) Offense Specific Evaluation $1,200 Supervised/therapeutic Visitation $85/clinical hour (Therapeutic visits at WCDSS offices, therapist office,or WCDSS satellite offices North and South Weld County. Available for after hours by appointment and weekends by appointment). Individual Therapy $85/clinical hour Family Therapy $100/clinical hour Anger Management Group (Spanish) $50/Group a DEPARTMENT OF SOCIAL SERVICES i P.O. BOX A �1 GREELEY, CO. 80632 Website:www.co.weld.co.us Administration and Public Assistance(970)352-1551 Child Support(970)352-6933 April 18,2005 COLORADO Victor H.Cordero Psy. D. 2828 Speer,Unit 118 Denver, CO 80211 Re: RFP 006-00 Mental Health Services RFP 05005 Lifeskills Dear Dr.Cordero: The purpose of this letter is to outline the results of the Bid process for PY 2005-2006 and to request written confirmation from you by Wednesday,April 27,2005. A. Results of the Bid Process for PY 2005-2006 • The Families,Youth and Children(FYC)Commission recommended approval of Bid 006-00, Mental Health,for inclusion on our vendor list,attaching the following conditions. Condition#1 is applicable for all Mental Health providers,while Condition#2 is specific to your Mental Health program. Condition#1: It is a requirement that provider reports be received no later than 90 days from the beginning date of services.In the event the report is not received within the required time frame, services will not be eligible for payment. Condition#2: Please clarify your rate for services,assuring that the cost of service is for client contact only. • The Families,Youth and Children(FYC)Commission recommended approval of Bid 05005, Lifeskills,for inclusion on our vendor list,attaching the following conditions for all Lifeskills providers. Condition:All providers must define their capacity to do after-hours visitation. Required Response by FYC Bidden Concerning FYC Commission Conditions: All conditions will be incorporated as part of your Bid and Notification of Financial Assistance Award (NOFAA).If you do not accept the condition(s),you will not be authorized as a vendor unless the FYC Commission and the Weld County Department of Social Services accept your mitigating circumstances. If you do not accept the condition,you must provide in writing reasons why.A meeting will be arranged to discuss your response.Your response to the above conditions will be incorporated in the Bid and Notification of Financial Assistance Award. Page 2 Victor H.Cordero/Results of Bid Process 2005-2006 The Weld County Department of Social Services is requesting your written response to the FYC Commission's conditions.Please respond in writing to Gloria Romansik,Weld County Department of Social Services,P.O.Box A,Greeley,CO,80632,by Wednesday,April 27,2005,close of business. If you have questions concerning the above,please call Gloria Romansik at 352.1551,extension 6230. Sincerely, t y `ego, t, ctor i cc: Juan Lopez,Chair,FYC Commission Gloria Romansik, Social Services Administrator Weld County Department of Social Services Notification of Financial Assistance Award for Families,Youth and Children Commission (Core) Funds Type of Action Contract Award No. X Initial Award 05-CORE-64 Revision (RFP-FYC-05005) Contract Award Period Name and Address of Contractor Beginning 06/01/2005 and Alpine Christian Services, Inc. Ending 05/31/2006 Lifeskills 1200 S Wadsworth Blvd, Suite 300 Lakewood, CO 80232 Computation of Awards Description Unit of Service The issuance of the Notification of Financial Supervised visits,both therapeutic and Assistance Award is based upon your Request for supervised, for up to 16 clients per week. Visits Proposal (RFP) and the Addendum RFP information. will take place at 1200 S Wadsworth Blvd., The RFP specifies the scope of services and Suite#300, Lakewood. Additional locations in conditions of award. Except where it is in conflict Aurora, southeast Denver, and Colorado Springs with this NOFAA in which case the NOFAA governs, are available. Bilingual and multi-cultural the RFP upon which this award is based is an integral services. part of the action. Cost Per Unit of Service Special conditions Hourly Rate Per 1) Reimbursement for the Unit of Services will be based Therapeutic Staffing $35.00 on a designated per family group conference. Visitation $35.00 2) The designated rate will be paid for only direct face to Treatment Package-High $70.00 face contact with the child and/or family, as evidenced by client-signed verification form, as specified in the unit of cost computation. Enclosures: 3) Unit of service costs cannot exceed the designated rate and yearly cost per child and/or family. X Signed RFP: Exhibit A 4) Payment will only be remitted on cases open with, X Supplemental Narrative to RFP: Exhibit B and referrals made by the Weld County Department Recommendation(s) of Social Services. 5) Requests for payment must be an original submitted to X Conditions of Approval the Weld County Department of Social Services by the end of 25th calendar day following the end of the month of service. The provider must submit requests for payment on forms approved by Weld County Depot fluent of Social Services. 6) The Contractor will notify the Department of any change in staff at the time of the change. Approvals: Program Official: va By ' "1 �/ f� �/ By William H. Jerke, Chair Judy . Griego Directo Board of Weld County Commissioners Weld unty epartment of Social Services Date: JUN 0 6 7005 Date: SIGNED RFP: EXHIBIT A INVITATION TO BID BID 002-05 (05005 -05011 and 006-00) DATE: February 16, 2005 BID NO: RFP-FYC-05005 RETURN BID TO: Pat Persichino, Director of General Services 915 10th Street, P.O. Box 758, Greeley, CO 80632 SUMMARY — -- - -- -----_ Request for Proposal (RFP-FYC-04005) for:Colorado Family Preservation Act--Life Skills Program t/ s Emergency Assistance Program Deadline: March 11, 2005, Friday, 10:00 a.m. The Families, Youth and Children Commission, an advisory commission to the Weld County Depai hnent of Social Services, announces that applications will be accepted for approved vendors pursuant to the Board of Weld County Commissioners' authority cinder the Color= .. :lily Preservation Program Act(C.R.S. 26-.z..5 101) °.'.'I l me aen' v Assistance sistance for ''tin r' ccs Ld on P. 'iemin ,nt Risk Of t_cc jlnIc. i"-J- ill?-5.3-104 he Families, Youth and i laid Cen Commission wishes to approve Servicesiaro,ttc.i 1O ma from June 11, 2005, through May 31, 2006, at specific rates for different types of service, the county will autho nze roved vendors and rates for services only. The Life Skills Program must pro de services that on ie,ichnio, i, skills, which are designed to imorov- household - management cc-r o i Th c t :P tai Lt mp .. y. 'amity conflict management i and effectively accessing community resources. This prop,a?m announcement nt 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 March 11 , 2005 (After receipt of order) I ID MUST BE SIGNED IN INK Res Fritache TYPED OR PRINTED SIGNATURE VENDOR 4lpinA Christian 4ervices , (Name) Handwritten Signature By Authorized dha Alpine Visiting Center Officer or Agent of Vender ADDRESS 1200 South Wadsworth Blvd . TITLE Executive Director Suite #300 Lakewood , Colorado 80232 DATE Match 7.7 , 2005 PHONE 1( 303/935-3199 The above bid is subject to Terms and Conditions as attached hereto and incorporated. Page 1 of 33 Bid 002-05 (RFP-FYC-05005) Attached A LIFE SKILLS PROGRAM BID PROPOSAL AND REQUEST FOR CONTINUATION OF AWARD UNDER CORE SERVICES FUNDING EMERGENCY ASSISTANCE PROGRAM 2005/2006 BID PROPOSAL APPLICATION PROGRAM FUNDS YEAR 2005-2006 BID 002-05 (05005) NAME OFAGENCY: Alpine Christian Services , Inc . ADDRESS: 1200 South Wadsworth Blvc . , Suite #300 Lakewood , CO 80232 PHONE: 303/935-3199 CONTACT PERSON: Ron Fritsche TITLE: Exectitive Director DESCRIPTION Cl-- FAMILY PRESERVATION PROGRAM CATEGORY: The Life Skills Program ( -as.o:ss must Est urns-, c services it -a focus on teaching life skills designed to facilitate implementation_of the case plan by improsM.2 household Tana Cconiseteness pteaL_ti_comnetencv. family accessin2co u7cou a tg g. ,rie MCI pro-social values_ I2-Month zpn oximate Project Dates: -12-month contract with actual time h,is< oG Start End --- fitLEOFPROJL.CT: Alpine Visiting Center Program MOUNT REQUESTED: $61 , 600 -Zan_—F-rit-seh� 3/210/2S105 Name and Signature of Person Preparing Document Date Jud_A. (oneoo. I)irector Name nZ Si_r ":t' rh.dt. •Wintinl-thitto.r O1; -r At plie r [ A uncv MANDATORY PROPOSAL REQUIREMENTS For both new bids and renewal bids, please initial to indicate that the following required sections are included in this Proposal for Bid.For renewal bids, please indicate which of the required sections have not changed from Program Fund Year 2004- 2005 to Program Fund year 2005-2006. Indicate No Change from FY 2004-20u5 RDE__ Project Description RDF— Target/Eligibility Populations RDF- Types of services Provided RDF Measurable Outcomes RDF Service Objectives — RDF Workload Standards - RDF Stall Quahlications RDF Unit of Service Rate Computation RDF _ Program Capacity per Month RDF- Certificate of Insurance RDF Assurance Statement Page 26 of 33 Bid 002-05 (RFP-FYC-05005) Attached A Late of Meeting(s)with Social Services Division Supervisor: March 2 , 2005 • Comments by SSD Supervisor: Pleas spaenrlos.ure _. N:m :-llgrJE ore of SADSuperv3,.: Date • Page 27 of 33 March 2, 2005 Met with Mr. Fritsche over the phone about his RFP for lifeskills and told him that it would be a valuable option and to submit a bid. I told him that I would not be able to see him face to face because of the distance and time but that I would like to come at a later date to see the facilities that would be utilized for visits. 'y \ 2 \ ALPINE VISITING CENTER » » 2 \ A Division of Alpine CbnstianServices . K © a6 � \ w <\ 4 / \ . March 11, 2005 . } » 2 \ ( \ Pat Persichino IDirector of General Services 915 10th meet P.O. Box 758 Greeley, CO 80732 \ \� RE: Bid 002- ( 5o 005mmA 05011 and 006-00) DearPat an a The Al e VisitingC r does hereby submit the enclosedwdUyr consideration. We are bidding on sup ised par ;time, the rapeutic fa y / ^ 7visits and casemanagement services. . & : k Sincerely, \ jv y y 4 >441'��. Ron Fritsc n MA /. . . I Executive Dir m« \ , \ : ; 6 , 6 ° ; \» 1200 s @ Wadsworth Boulevard, Suite 300.Lakewood, Colorado 802 z• o,9m Fax: mwm . Toll Free. s/223-« . E-mail: ymmervimA ,m k « . ,. :, w. ��.. . . . ALPINE VISITING CENTER A Division of Alpine Christian Services PROJECT DESCRIPTION Alpine Christian Services, Incorporated, doing business as Alpine Visiting Center (AVC), submits this project description for Supervised and Therapeutic Visitation. Included is the overall mission, purpose and design. The Employer Identification Number is 84-1365958 AVC will provide services to Weld County Department of Social Services (WCDSS) during the fiscal year June 1, 2005 to May 31, 2006. AVC will provide supervised visits, both therapeutic and supervised, for up to 16 clients per week. The visits will take place at our Denver area office located at 1200 South Wadsworth Blvd., Suite #300, Lakewood, Colorado (our main office). The telephone is 303.935.3199, the fax is 303.935.3181. Our e-mail address is coloradoservicesEcigwest.net. Additional locations in Aurora, southeast Denver and Colorado Springs are also available. Related services that are available as space allows include Supervised Child Exchange, Individual Therapy, Family/Couples Therapy, and Parenting Classes. The length and duration of each of these will be determined on an individual basis. Therapeutic Visitation Program Process 1. AVC receives referral from Weld County caseworkers. Therapist consults with caseworker and they discuss information about the family and the case status. This includes family history, history of DSS involvement in the case, pennanency plan, safety issues, ease worker concerns regarding care taker overall parenting ability and contact information. Caseworker defines who may participate in the visits and any details regarding court orders. 2. Therapist and parent arrange for an intake session at the AVC office to discuss parent's perception of the problem, willingness of the parent to work with therapist on goals, begin to develop goals and ensure parent understands and agrees to follow AVC procedures. Therapist begins establishing therapeutic relationship with the parent. 3. Therapist coordinates first visit with parents, caseworker is invited. (S) he communicates with other involved professionals as needed and as authorized by the caseworker. 4. During the first few sessions, treatment goals are discussed and agreed upon. Children may participate in goal development if they are interested. Therapist observes and records baseline measures of behavior indicators related to the goals. 5. Continually assess and update goals through the course of the sessions and maintain frequent contact with caseworker. Work to ensure clear and complete communication between all members of the child's team. 6. Therapist sends one copy of each session notes to the caseworker every 30 days. Caseworker is responsible for distributing the reports to other appropriate persons. 7. Near the end, therapist will complete an assessment of progress, including the family members. Discussion will focus on what has changed and/or improved in their relationships and behavior. Sessions will end when goals have been met or when caseworker decides. 1 3/10/05 ALPINE VISITING CENTER A Division of Alpine Christian Services TARGET/ELIGIBILITY/POPULATION Alpine Visiting Center(AVC) will provide services to a total of 40 clients (family units) during the period June 1, 2005 through May 31, 2006. The Visiting Program exists to work in the best interest of children, enabling them to see their parents, usually when there is a court order or other circumstance prohibiting the parents from seeing their children on an unsupervised basis. Since our primary client is thus a child between the ages of 0 and 17, each child or sibling group thus represents one of these total family units. The family as a whole is the "client." Most children will be 0 to 9, as the need for supervised parenting decreases as children age. The average family we have worked with includes two adults and two children. In some cases there is one child, in others we have worked with a total of 6 related siblings, all of whom needed to see their parents. While this number can be even larger, typically we see only one or two children. Thus the average family system (total individual clients) will be 160 (2 adults + 2 children = 4 people X 40 Family units= 160 total individual clients). AVC's staff is well experienced in multicultural issues, with each staff person averaging over fifteen years of experience in child welfare and social services. Each of AVC's staff members has worked with multicultural issues as we have many foster homes that are bilingual and/or multicultural. Typically we find that the vast majority of clients speak English. For those who do not, within the (amity unit there is usually someone who can translate. We have the ability to provide services on a bicultural/bilingual basis. It is anticipated that approximately 25% or 10 family units will have one or more members who are monolingual in a language other than English. We will provide services to these families by using translators whenever needed. There will be a total of 40 individual clients who will receive bicultural/bilingual services. AVC will provide services to those children who are placed out of Weld County Department of Social Services (WCDSS) that are living in the Denver-Boulder metro area. We estimate that 50% of the clients we serve will be living in South Weld County. Many of these may represent the 25% of the clients mentioned in the preceding paragraph. Thus AVC will provide visitations for 20 family units and a sub-total of 80 individual clients. All 160 clients ( 100%) will have access to 24-hour service. Our monthly maximum program capacity is 35 individual clients. Based upon the Agency's experience with foster children and the child's natural family, the average stay in the program will be between 6-8 weeks. We expect that each family unit will average 1 hour per week in actual visitations. This takes into account the high incidence of parents who typically miss scheduled appointments. Of course sometimes we have dealt with court orders stating 3 visits a week are mandatory, but the average still conies out at 1 hour per week per family unit. Services provided that are culturally/ethnically specific are handled on an individual basis. Our staff has a wide exposure to minority cultures and our clients have given positive feedback about the way we provide these services. We are comfortable providing service to South Weld clients and will provide services to this population as described above. 2 i/10/05 • ALPINE VISITING CENTER A Division of Alpine Christian Services TYPE OF SERVICES TO BE PROVIDED Alpine Visiting Center provides space and time for parents or other relatives to meet with their child family members who are in out of home placement. The Visiting Center provides two levels of service to families. 1. Therapeutic Visiting Time (Therapeutic Services) The sessions are coordinated and facilitated by a Master's level therapist who specializes in working with children and families. Early in the course of the sessions, the therapist will assess various components of the family interaction to develop baseline functioning levels. Then the therapist will work with the family members to develop the goals for the sessions. Areas of assessment may include: • Quality of the relationship • Communication styles of family members • The parent's and child's capacity and level of attachment • Parent's ability to recognize and respond to the child's cues regarding their emotional needs • Parent's ability to demonstrate appropriate physical affection • Parent's ability to manage conflict and set limits and boundaries Over the course of the Therapeutic Visiting Time, the therapist will work with the parent and child to enhance their emotional connection and relationship functioning, using filial therapy and family therapy techniques. The therapist will, at the same time as indicated, provide concrete services (described in the following section). Near the end of the course, the therapist will assess the family's progress on their goals. The assessment will include therapist's observations and conclusions and information obtained from both the child and the parent. 2. Monitored Visiting Time (Concrete Services) The sessions are coordinated and supervised by a bachelor's level placement worker. On occasion, a trained volunteer may supervise the visit, under the supervision of agency staff. The supervisor will provide continuous observation of the interactions among the family members to ensure the child's safety. The supervisor will offer suggestions to parents to improve their skills in communicating with their children, providing for their physical needs and basic parenting skills. In addition to the two types of direct services provided, AVC will complete needed case management services associated with each family's case. Case Management Services will include, but not be limited to: • Maintaining clear and frequent communication with the case worker, parents, foster parents, attorneys. GAL and other involved therapists, as needed and as authorized by the caseworker. • Submitting weekly session notes to the case worker within 30 days of service 3 3/1 0/05 ALPINE VISITING CENTER A Division of Alpine Christian Services • Court involvement as requested by Weld County Department of Social Services (as addressed in a separate section of this RFP). Collateral Services The main focus of the services provided by the AVC staff is the children and family in the Visiting Center environment. If the parents indicate a need for assistance in identifying resources in the local community, the staff will provide the information. The staff will consult with the caseworker to ensure the family's needs are being met in this area. Crisis Intervention The staff of the Alpine Visiting Center is available on a 24-hour basis, seven days per week. We do not anticipate that family members will contact our staff for crisis intervention because we understand that their main contact is their caseworker. However, we will respond to crisis calls as needed. We have found that clients occasionally need to reach our staff outside of usual business hours to confirm or reschedule appointments. In either case we are happy to provide the 24-hour services to out clients from Weld County. 4 3/10/05 ALPINE VISITING CENTER A Division of Alpine Christian Services MEASURABLE OUTCOMES 1. At the end, the child who was the focus of the visitation shall have had successful visitations for at least three months or as agreed upon with the caseworker. The parent will express appropriate physical affection, set and implement age appropriate limits, take care of the child's physical needs, maintain emotional and physical safety for the child, demonstrate praise and encouragement and actively engage in play and conversation with the child. 2. Toward the end of the visitations, the therapist will talk to the parents and the children about what they believe they have accomplished. The parents will be able to express or verbalize an increase in their feelings of competence and abilities as parents. The children will be able to express changes they have experienced. For younger children the therapist will assess progress through observation of the child's behavior and affect. 5 3/10/05 ALPINE VISITING CENTER A Division of Alpine Christian Services SERVICE OBJECTIVES 1. Family Conflict Management The therapist will assess family conflict dynamics as part of the overall evaluation of family functioning. The therapist will then work with the family members to identify areas of conflict and communicate them clearly. The therapist will encourage the family to work together to develop more effective problem solving and conflict resolution skills. Finally, the therapist will provide support and guidance as the family members "practice" their newly acquired skills both during the visits and outside of the sessions. 2. Improve Household Management Competency The therapist will work closely with the caseworker to support the WCDSS treatment goals for the family in this area. The therapist will encourage and praise the family members for their efforts. The therapist will, on a case-by-case basis, assist the caseworker with evaluating progress in this area as needed. 3. Improve Ability to Access Resources The staff of AVC will assist the caseworker in identifying local resources necessary to assist the family in meeting the treatment plan objectives. 4. Address Specific Referral Issues Through consultation with the caseworker and discussions with the family, the therapist will identify specific goals to be addressed during the course of the sessions. The staff of AVC accepts responsibility for keeping the sessions on track and focused on achieving the goals. 5. Measurement, Evaluation and Monitoring of Service Objectives At the end, the child who was the focus of the visitation shall have had successful visitations for at least three months or as aureed upon with the caseworker. The parent \\Ili express appropriate physical affection, set and implement age approprf•n; inTut,, take care of the child's physical needs, maintain emotional and physical safetN for the child, demonstrate praise and encouragement and actively engage in play and conversation with the child. 6 3/10/05 • ALPINE VISITING CENTER A Division of Alpine Christian Services WORKLOAD STANDARDS 1. Alpine Visiting Center(AVC) will provide services to each family across differing stages of progress in the therapy process. It is anticipated that in the early stages, the needed contact time for face-to-face and phone interactions will be 2-4 hours per week. This time difference will not apply to each member of the family, but to specific individuals. By the mid-way point in the therapy sessions, (usually 10 sessions or less) the family system and individuals should be experiencing significantly reduced stress and should need only between one and three sessions per week. The variance in needed hours per family will depend on the ages of each family member, the problems (psychiatric, divorce, parents living apart, substance and/or physical abuse)being dealt with, as well as the number of family members. 2. AVC will have four staff members available to provide services throughout each week. The primary staff(Ron, Lynn, and Charlotte) will be available for up to 5 hours each per week. Dave will be available for up to 1 hour per week. Should the need for servicc increase beyond the expected maximum or remain at the maximum for more than a nu uth with no anticipated decrease in needed service, AVC will respond appropriately to make certain that enough staff are available. 3. Two of the staff with AVC will carry up to 8 cases each. A third staff member will he available to take on the overflow of cases. - 4. Face-to-face counseling services will be provided to the family and to individuals within the family system as needed. 5. It is expected that on average, the therapist or monitor will be providing up to 5 hours of service per week. This can vary markedly depending on the case load and intensity of problems that any family system is working to solve. 6. AVC will have three staff and one supervisor engaged in providing services. 7. The supervisor will be providing services to three staff members with each staff person carrying no more than 8 cases each. 8. Insurance. AVC covers the appropriate worker's compensation, general and professional liability and meets all requirements of the Weld County Department of Social Services. WCDSS will be listed as an additional insured as required by the RIP once the grant has been awarded to AVC. 7 3/1 0/05 ALPINE VISITING CENTER • A Division of Alpine Christian Services STAFF QUALIFICATIONS All staff, including the supervisor meet or exceed the minimum qualifications in education and experience to provide therapeutic or monitored supervision for visitations. At present there are no statutes, rules or regulations covering minimum qualifications for providing visitation services. AVC has a total of 4 professional staff. David Felker, LCSW is the supervisor of the program. He has over 20 years of clinical experience. A copy of his license is enclosed. The others are Ron Fritsche, MA, the executive director; Charlotte Allen, MSW, the placement supervisor; and Lynn Davis, BSW, case manager. Dave, Ron and Charlotte provide therapeutic visitations and Lynn provides monitored visitations. A copy of all of the professional staff resumes are enclosed. The staff of AVC is required to obtain ongoing case manager and therapeutic training each year. Since AVC is associated with a private child placement agency, the training each employee receives is thorough and intensive; covering subjects not only mandated for new caseworkers but experienced ones as well. Our case managers and staff average fifteen years each of experience in child welfare and social services. Thus they understand all aspects of what is involved in the field of child welfare. Our staff has knowledge of risk assessment, although this job is done by county caseworkers, not private agency case managers. We work in conjunction with all county departments of social service that refer cases to us in assessing individuals for high risk factors relating to abuse and neglect issues. The staff of AVC will complete any required training, including the State Home Based Intensive Family Services training component if it is required. All of our case management staff have extensive experience providing Home Based Services. Since this invitation to bid relates to visitations, under this contract our Agency will not he providing Home Based Family Services, as the services are provided in our offices. R 310/05 ALPINE VISITING CENTER A Division of Alpine Christian Services UNIT OF SERVICE RATE COMPUTATION The Unit of Service Rate Computation sheets are enclosed. Phis includes Program Budgets, Administrative Costs Non-Direct, Direct Services and Overhead Costs and Profits. Note Row L on the Program Budget. It states that our costs per Hours of Direct Face to Face Service come out to $114.54/hour for therapy. We only charge $70/hour. In a similar fashion, the budget for Monitored Visits is $38.18/hour, and we only charge $35/hour for these visits. Finally our costs for Case Management come to $76.36/hour and we charge $35/hour for these services. Case Management includes time for preparing"Crib Notes", reports prepared on a word processor and sent out on a monthly basis, and telephone calls to handle most aspects of scheduling, re-scheduling, and occasionally canceling appointment with clients. • 9 3/10/05 cooO (() (n6 Lc) 2 0) . r- 00 01 W OD CD N r` to a N (00 tri N N o Lci CO O( COC r 0 c0 O) ra N= o t,-; n CO CO 2 W n 7 co- (O c0 4- d n '- , N O 69 O W E CA E9 69 0 2 N O O LO (0 O L0 CO o n O O O V V O V O (0 O N T O r` CO (9 N CO •- 69 r CO 'm M CO V •- N N 69 5 COON 0 O W Nj N N O 6 r N co 69 69 co O O 2 ae n r o o M M O C0 u O (0 O r` N O N 41- 01 V o V (O 69 (0 W CO N (0 CO CO COON O W (69 co- (0 O Ca e- N69 69 N .?.• CO 7 n U L I- 5 O O O 0401 O if) LO N CO E O K) O N R OR CD CO o r- ' o `& CO 669 N - -- "•cc h o O O CO N O O ,W 2 N N V O 6 e 69COW co O V O m m m U E gO 0 C) U 0 ce 2 Q a 1 _ m Qom. U a) c U -r,-.) 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ALPINE VISITING CENTER A Division of Alpine Christian Services PROGRAM CAPACITY BY MONTH The maximum client capacity per month necessary to support this program is 10 clients (family units), the minimum is 2 client or family units • • 10 3/10/05 • RESUME David E. Felker,LCSW 5665 S. Bannock,#201 Littleton,CO 80120 720.283.7712 Licensure: Licensed Clinical Social Worker since 1989 (CO#989410) Work Experience: Colorado Family Services/Alpine Christian Services, 1200 S. Wadsworth, Suite 300, Lakewood 80232. (303)935-3199. Clinical Supervisor(9/02 to present) volunteer Executive Dir. - Ron Fritsche, MA Clinical Supervisor(11/94 to 5/01)part-time Executive Dir. - Ron Fritsche, MA * Participated in the startup of this agency as the clinical supervisor * Participate in weekly staffing. * Supervise ongoing clinical care of the foster children: * Actively work with CEO in conflict resolutions * Participate in conflict resolutions in foster homes * Interviewed potential foster parents * Developed policies and procedures with CEO. PacifiCare Behavioral Health, 7887 Bellview Ave., Suite 825 Englewood, CO 80111. (303) 714-1000. Case Manager III(11/97 to 5/99) Supervisor-Jennifer Elpers, LCSW * Assessment and direction of care for individuals in various stages of crisis * Worked with the mental health professionals to access services within PBHI for their clients * Conferred with the treating professional(s)to sort out and reinforce the direction of care * Frequently sought by other case managers and customer service personnel to determine: which professionals would best fit the customers needs, what emergent services were needed, and to access psychological testing Merit Behavioral Care, Inc 7400 E Orchard Rd., Suite 2500, Englewood, CO 80110. (303)689-9230. Acute Care Crisis Clinician(8-95 to 11/97) Supervisor- Bob Eckles, LCSW MBHI's contract was not renewed by PacifiCare and I transitioned to PacfiCare Behavioral Health, Inc. * Brief interventions in crises, assessing for level of care and/or inpatient management * Crisis intervention were done in: hospitals, emergency rooms, and doctor's offices * Focused on coordinating services to gain access to best help the client * As needed mental health holds were signed by this professional Mental Health Corporation of Denver, 1733 Vine, Denver, CO 80206. (303) 377-4300. Psychotherapist(2-93 to 8-95) Supervisor- Faye Copenhaver. MS, RN * Conducted initial assessments for intake and assignment of appropriate services * Actively participated in the emergency services(72 hr holds) * Supervised unlicensed professionals as they sought licensing * Participated in problem solving within the intake and emergency department * Interacted with staff and psychiatrists in hospitals The Men's Center, 4293 Kipling, #190, Wheat Ridge, CO 80033. (303) 420-7322 Psychotherapist(2-93 to 3-96)part-time Director- Gil Milbum-Westfall, Psy.D. * Intakes on perpetrators of domestic violence * Facilitated group treatment of domestic violence * Interacted with the county's person managing treatment of domestic violence perpetrators David Felker, LCSW, 709 Clarkson, Denver, CO. Sole Proprietor Psychotherapist(3-92 to 1-93) * Provided individual, family and group psychotherapy * Focused on family issues and domestic violence. * Developed a group that worked through relational issues. Christian Counseling Services, 6909 Holly Cir., #360, Englewood, CO. 80111. (303) 773-9791. Psychotherapist(3-90 to 2-92) Director/Owner-Jim Collins, Ed.D. Dr. Collins began to sell-off the agency, which prompted my seeking new employment * Delivered individual, and family psychotherapy * Dealt with multiple emergency mental health cases * Participated in the hospitalization of those clients who were an immanent danger to themselves or others CarePsychCenter, Humana Hospital, Mountain View&CompCare Inc. 9191 Grant St., Thornton, CO 80229 (303)450-4500. The position ended as CarePsychCenter ceased connection with Humana Hospital, Mountain View. Case Manager(2-89 to 1-90) Program Director- Darrel Misgen, III, MA * Provided case management on an Acute Care psychiatric floor in a Med/Surg hospital. * Social assessments, individual and group therapy, discharge planning and transitional care. * Earned an LCSW during this time * Began doing emergency assessments and care as a licensed clinical social worker. Contemporary Learning, Inc., 11350 W. 72"' Pl., Arvada, CO 80005 (303)422-9283. Instructor(8-25-1989 and 9-29-1989) * Taught two 6.5 hour continuing education courses in these topic areas * Intimate domestic violence * Adolescent behavior: drug abuse and sexuality Brandon Center, Volunteers of America, 1865 Larimer St., Denver, CO 80202 (303)620-9190. This position was taken to both gain income while seeking a clinical position and a great exposure to emergency work was gained that I had not yet seen. Counselor(5-88 to 2-89) Clinical Supervisor - Mark Annas, ACSW * intake of victims of domestic violence * Group psychotherapy * Crisis calls taken during each work period Dallas Christian College, 2700 Christian Parkway, Dallas, Texas 75234. Associate Professor(1-86 to 6-86)part-time * Taught developmental psychology * Developed the semester course Magnolia Psychiatric Center, 1065 W. Magnolia, Fort Worth, TX 76104 (817)926-5747. Left this agency because ex-wife wanted to return to Colorado Director of Social Services(8-85 to 1-88) Centers for Psychiatry and Psychology, 3300 Joyce Dr., Fort Worth, TX 76116 (817) 560-2256. Medical Director- Heman Burgos, MD *Participated in the initial setup of the center for the urgent partial hospitalization care of children and adolescents * Conducted individual, family and group therapy * Produced social histories * Coordinated Medical Records and Utilization Review * Twice participated in the preparation of the facility for JCAHO audit and supervised staff. Clinical Assistant(3-86 to 11-86) Psychiatric Institute of Fort Worth, PO Box 69, Fort Worth, TX 76101 (817)335-4040. Medical Director - Heiman Burgos, MD * Compiled clinical information for psychiatrists to guide treatment * Interacted with the treating psychiatrist to develop aftercare * Wrote reports to insurance companies * Assisted in utilization review. David Felker, LCSW 2 Social Worker(8-85 to 8-86) Medical Director-Hernan Burgos, MD * Case management * Individual, family and group therapy * Social histories * Hospital liaison. New Life Children's Home, Route 3 Box 274, Burleson, TX 76028. Social Worker(1-85 to 8-85) Medical Director- Hernan Burgos, MD * Case management * Intake interviews * Interfacing with local and state social service agencies * Individual counseling and developed treatment plans Vernon Grounds Counseling Center, 8000 E. Girard Ave., N. Tower, Suite 601, Denver, CO 80231(303) 755-2880. Social Worker(8-84 to 12-84) * Individual and family therapy * Crisis intervention * Social histories Family Counseling Service, Youth for Christ, 1400 S. Emerson, Denver, CO 80210. Social Worker(6-82 to 8-84) Program Director-Luis Villarreal. LCSW * Individual and family therapy * Crisis intervention * Social histories * Interfaced with schools and government agencies, public relations * Designed new framework for Family Counseling Service Education: Graduate School of Social Work, University of Texas at Arlington, Box 9088, UTA Station, Arlington, TX 76019. * Twelve hours were earned toward a Ph.D. in clinical/research social work. (1986- 1987) * Focused on research and statistics Graduate School of Social Work, University of Denver,University Park, Denver, CO 80210. * MSW earned(1980 - 1982) * Focused on the clinical track emphasis in family treatment. * Intern Supervisors: Thomas Cnnack, MA, 1980-1981 & Luis Villarreal. MSW 1981-1982. Nebraska Christian College, 1800 Syracuse, Norfolk, NE 68701. * BA in Pastoral Ministries earned(1975 - 1979) * Preached at area churches as needed * Directed 4 plays for the college Hospital Affiliation: University of Colorado Health Sciences Center, Campus Box C290, 4200 E. 9th Ave., Denver, CO, 80262 (303)315-7565 & Fax(303)315-8494 Non-Medical Affiliate Staff(12/96 to present): Individual, Family&Group Therapy In association with Merit Behavioral Care Hospitalized individuals requiring immediate care for suicidal, homicidal, and grave disability Followed and participated in the individuals care during their brief hospitalization Participated in treatment planning sessions on the unit At discharge, aftercare was developed with the patient. David Felker,LCSW 3 • Followed the individual's aftercare for at least a week to make sure the process was working. Porter Care Adventist Hospital, 2525 S. Downing St., Denver, CO 80210-5876 (303) 778-1955 Non-Medical Affiliate Staff(11/95 to 12/97): Individual, Family, &Group Therapy. In association with Merit Behavioral Care Hospitalized individuals requiring immediate care for suicidal,homicidal, and grave disability Followed and participated in the individuals care during their brief hospitalization Participated in treatment planning sessions on the unit At discharge, aftercare was developed with the patient. Followed the individual's aftercare for at least a week to make sure the process was working. Columbia HealthOne, 3398 S. Pearl St., Englewood, CO 80110 (303) 788-8856 Non-Medical Affiliate Staff(10/95 to 12/97): individual, Family, & Group Therapy. in association with Merit Behavioral Care Hospitalized individuals requiring immediate care for suicidal, homicidal, and grave disability Followed and participated in the individuals care during their brief hospitalization Participated in treatment planning sessions on the unit At discharge, aftercare was developed with the patient. Followed the individual's aftercare for at least a week to make sure the process was working West Pines Psychiatric Hospital, 3300 Lutheran Parkway, Arvada, CO 80033 (303) 239-4000. Non-Medical Affiliate Staff(6-89 9/91): Individual, Family & Group Therapy Hospitalized individuals from private practice needing immediate and emergent care Followed and participated in the individuals care during their brief hospitalization Participated in treatment planning sessions on the unit At discharge, this professional reassumed the treatment of the individual Psychiatric Institute of Fort Worth, PO Box 69, Fort Worth,TX 76101 (817) 335-4040 Non-Medical Affiliate Staff(3-86 to 11-86): Individual, Family&Group Therapy In association with Magnolia Psychiatric Center Participated in group psychotherapy sessions Documentation of treatment process was done regularly Participated in treatment planning sessions on the unit David Felker, LCSW 4 • C STATE OF COLORADO Department of Regulatory Agencies Division of Registrations ACTIVE PRINTED ON SECURE PAPER LICENSED CLINICAL SOCIAL WORKER 989410 07/01/2003 06/30/2005 Number Issue Date Expires David Ernest Felker LITTLETON, CO 80120 • I nn d _ ector _. .. . Signature LYNN DAVIS 3636 South Depew Street, #10• Lakewood, CO 80235 Evening 303 986-0754 • Cell 303 229-3964 cyran99@netzero.com OBJECTIVE To obtain a social work position in child welfare so that I could use nv expertise in htunnt relations, business administration or social work. RELATED Colorado Family Services (A Child Placement Agency) EXPERIENCE Lakewood, Colorado, 1996-2004 Position: Program Director Duties • Case managed foster homes • Assisted with certifying foster parents • Designed and maintained web site(www.alpinech istianservice.org) • Composed monthly newsletters and company brochures • Composed and maintained policies and procedures • Taught core training and on-going training to foster parents and hiological parents • Trainer for CPR and First Aid • Wrote home studies • Demonstrates excellent computer skills • Keeps files up to date RELATED Founder and Executive Director for Bibles for Jails Project, Inc.. VOLUNTEER WORK Small group leader at Bear Valley Church_ Approximately 20 people attend the group. I EXPERIENCE organize and lead the planning meetings EDUCATION Bachelor's Degree in Social Work, Emphasis in Child Welfare expected in May 20(15 Metropolitan State College of Denver, Denver Colorado Major Grade Point Average: 4.0/4.0 Overall Grade Point Average: 3.9/4.0 Phi Alpha Social Work Honor Society Associates of Science Degree in Business Administration. Red Rocks Community College, Golden, CO Red Rocks Community College Honor Roll Three Year Diploma in Interior Design International Institute of Interior Design, Washington, D. C Charlotte Allen, MSW P.O. Box 40443 Denver, CO 80204 Home Telephone: 303 388-0769 Cell Phone: 720 371-3269 EDUCATION: Master of Social Work (August 1992) University of South Carolina, College of Social Work Columbia, South Carolina B.A. Sociology/Applied Social Relations (December 1983) Eastern Connecticut State University Willimantic, Connecticut CLINICAL, CASE MANAGEMENT AND SUPERVISORY EXPERIENCE: 4/02 - present Placement Supervisor Colorado Family Services, Denver, Colorado Supervise this Child Placement Agency's Case Managers. Developed and maintained a quality assurance plan to comply with state regulations. Providing therapy to abused and neglected foster children. Work closely with the Executive Director to develop and implement diverse programs to serve children and families. 2J01 -4/02 Placement Supervisor Creative Beginnings, Inc, Denver, Colorado Supervised Case Managers who work with special needs children placed in ae_ncv :( homes Pa icipat i i"\ case staffir, f ngs and Foster Care Reviews. r'rnmpieted new foster p_rent home studies. �orKed ,. ith the Executive Dscc!o.to deve:op 'o ran �'t;iiate quality assurance protocols. Prov, c u Uid.centered therapy and am{1y Met p, for children placed with the agency. 8/99 -7/00 Treatment Director- Charleston Division Specialized Alternatives for Families and Youth, Inc., Charleston. SC Responsible for the overall operation of the Charleston Division office of a national child placement agency. Supervised the clinical and case management services provided by four social workers and two support staff. Responsible for implementation of quality control measures, outcome achievement, treatment planning, staff and foster parent training, crisis resolution and the day-to day management of the division. Developed cooperative working network within the community and participated fully in corporate activities on a regional state and national level. Charlotte Allen, MSW Page 2 1997 - 1999 Private Practice in Clinical Social Work and Adoptive Services Charleston, South Carolina Provided individual non-directive, child-centered play therapy and family education and therapy services. Completed adoption home studies and court reports, including consultation services in securing relinquishments. 6/98 -8/99 Program Coordinator Reid House Adoption Center, Charleston, South Carolina Supervised staff members in the development and implementation of adoptive recruitment initiatives and strategies. Responsible for monitoring compliance protocols and for reporting inter-agency and government grant information. 1996 - 1998 Adoption Specialist South Carolina Department of Social Services, Charleston. SC Case management duties for special needs children in varied foster care programs, with a focus on achieving the permanency plan of adoption. Provided assessment, education and counseling for children and their perspective adoptive families. 1993 - 1996 Social Worker Human Service Associates, Charleston, South Carolina Provided full clinical support and case management services to youth, foster care providers and prospective adoptive parents in therapeutic foster care setting. Trained, supervised and offered counseling support to therapeutic foster parents. 1993 Family Therapist Charter Hospital of Charleston, Charleston, South Carolina Completed psychosocial assessments, developed and implemented family therapy treatment plans for children and adolescent psychiatric patients in an in-patient environment 1986 - 1993 Victim Service Coordinator People Against Rape, Charleston, South Carolina Provided assessment, counseling and advocacy services to victims of sexual assault, adult survivors of childhood sexual abuse and their families. References provided upon request. RON FRITSCHE 7499 South Teller Street • Littleton, Colorado 80128 • 303/972-7035 Education M.A. — University of Colorado, Counseling & Guidance, 1976 B.A. — Rockmont College, Music, 1970 Summary of Experience Executive Director - Colorado Family Services. I have worked in this field since 1992; starting CFS in 1994. The main office is located in Lakewood, with a satellite office in Colorado Springs. The Agency has quality homes and staff and is financially stable. As a private, Christian, non-profit agency we work with people to help them improve their family relationships and dynamics. Two years ago, we started Alpine Visiting Center in Lakewood. This is a place for families that are experiencing tough times to meet with each other. We provide monitored visits, therapeutic visits and child exchanges in addition to other similar services available. Prior to my present work in social services, I worked from1978 to 1994 in private vocational rehabilitation work in Minnesota and Colorado. In the process, I worked with hundreds of clients, and facilitated many as they returned to work. I developed vocational rehabilitation plans, worked with employers to find jobs for injured workers, and provided related services. In addition, I worked as the Director of Admissions for Rockmont College, Lakewood, Colorado; and Sioux Falls College, Sioux, South Dakota from 1972 to 1978. In this capacity I gained extensive experience in administration of non-profit institutions, which was helpful preparation for my present position. Other jobs have included psychological consultant for Head Start and Lecturer in Psychology at three colleges and universities. Assets Energetic... .articulate... .innovative...creative...entrepreneurial. I have the necessary resources to provide services for children, adolescents and adults. , NW LET/turn L, ;nn amnia LOO ISAEULIEKI INS PAGE 01 ACORD CERTIFICATE OF LIABILITY INSURANCE I BATEIMMDGT.YI PRODUCER 3-10-05 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONGaeddert Insurance Agency MOLLDER. THIS CERTY AND IFICAT RIGHTS DO NOT AM D, EXTEND HE T OR 1401 Saulsbury /107 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. - Lakewood, CO 80214 INSURERS AFFORDING COVERAGE ~_ INSURED _ --- IINSURCAA Western World Insurance __—____— Colorado Family Services — Alpine Christian Services BA"FE"°' ._—..-....._ _ 1200 S. Wadsworth Blvd Suite 300 [NS°�"°y Lakewood, C0780232 [INSURER D.I COVERAGES THE POLICES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 7 LIR I TWIT OF INSURANCE POLCY NUMBEII I DATEy EPPECVIVE n DATEPOLICY SIIIIIDM7 Nl I UNITS GENERAL LIASRRY EACH OCCURRENCE 114000 000 A E COT4ERCIAL GENERAL LIABILITY I NPP0835062 10/04/04 110/04/05 FIRE DAMAGE IMyPmmRAI IS 50.000 "� rX� OCCUR 1. __.._ J CUWS MADE I ,,MED EXP(Any ono poison) 4.y 5,OQ((f1 PERSo IAL E ADV INJURYIE 1A000_OQy IGENERAL AGGREGATE S 2,000.000 GER'L AGGREGATE OMIT APPLIES PER. PRODUCTS-COMP/OP AGO-1-S 1 IPGucY7 I'�ILOC —_... 7 inciudnd AUTOMOBILE LIASILITV i GO.,72 SINGLE LIMIT S ANY AUTO I I Eo lFnl) ALL OWNED AUTOS - "' N snow SCHEDULED AUTOS DOGE"'NARY s HIRED AUTOS _. -- BOOBY AWRY ,S _ NON-OWNED AUTOS 1 (Per modern) { FPM wW DAMAGE S GARAOELWLRT AUTO ONLY-EA ACCIDENT ;S ANY AUTO ' OTNER ONO' FA ACCS___ AUTO OT EGG 5 EXCESS LNBLGY EACH OCCURRENCE S 7 OCCUR 7 CLAIMS MADE AOOREOATE S DEDUCTIBLE I I RETENTION $ '— S WORSENS COMPENSATION AND �we OAT,* IOTH- O►LOYERS'STABILITY __EACHORY ACCIDEMITSNT FR E.L. ACCIDENT S EL.DDSEASE•EA EMPLOYE S E L.DISEASE-POLICY LARTj S OTHER I DESCRIPTION OPOFERATONS/LOCATIONSNENICLEHEXCWSIO, ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER ' I ADDITIONAL INSURED,INSURER LETTER. CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE!I THE EXPIRATION PATE Nieman,.THE ISSUING INSURER WILL ENDEAVOR TO MAIUO_ DAYS WRITTEN County Dept. of Social Services 915 10th Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.BUT FAILURE TO DO SO ALL P.O.Box 758 IMPOSE NO ONLW ID NY ATN OR LIABILITY OF A KIND UPON THE INSURER.ITS AGENTS OR Greeley, CO 80632 REPRESENTATIVES. AUTO tO REPRESENTATIVE ACORD 25-S(7/97) a��0'a'(" ©ACORD CORPORATION 1988 ALPINE VISITING CENTER A Division of Alpine Christian Services ASSURANCE STATEMENT This is an assurance that all of the information contained in this bid is to the best of my belief true and contains no purposeful omissions. Ron Fritsche, MA, Executive Dir 11 3/10/05 SUPPLEMENTAL NARRATIVE TO RFP: EXHIBIT B CONDITIONS • t, a COLORADO FAMILY SERVICES, INC. 0, tt/ A division of Alpine Cfimtian Services,Inc F 9s April 26, 2005 Dept. oe WeisColS vices coal f Gloria Romansik Gierice Weld County Department of Social Services 2005 t-D P.O. Box A An 2 Greeley, CO 80632 Dear Ms. Romansik, We received the bid approval letter for RFP 05005: Lifeskills and for RFP 006-00B: Home Studies and Relinquishment Counseling. We are excited at the opportunity to work as a vendor with your agency. In response to the Commission's request that our agency comply with specific conditions, we submit the following: RFP 05055: Lifeskills #1 Our staff will work closely with the visiting parent(s) and the custodial or foster parent(s) to coordinate the supervised/therapeutic visits. If evening or weekend appointments are necessary in order for the visits to take place, our staff will arrange appointments during those times. #2 We will use pre- and post tests to assess risk for measurable outcomes in order to increase the validity of the written reports. We are currently developing the assessment tools and will have them ready to use by June 1, 2005. #3 Any decrease in the level of supervision and/or service will ultimately be decided by the Weld County Case Worker who is managing the family's case. We will use a risk and safety assessment tool (currently under development), to guide our recommendations. #4 The duration of services generally runs from six to twelve months. Services will end sooner only at the direction of the Weld County Case Worker. RFP 006-00B: Home Studies #1 Incomplete home studies will be billed at an hourly rate of$70.00 per hour, not to exceed 3.5 hours. 1200 South Wadsworth Boulevard,Suite#300•Lakewood,Colorado 80232 Phone:303.935.3199•Fax: 303.935.3181 •Toll free:888.223.0786 • For each additional adult residing in the home, other than the mother and father, $250.00 will be billed in addition to the regular home study fee. #2 We understand that completed home studies are due six weeks from the date of referral. Weld County DSS understands that there may be a delay in completion due to delays in the receipt of required paperwork from the family being studied. When this occurs, Colorado Family Services and Weld County DSS will discuss, and come to agreement on, the expected due date for the home study. We look forward to working with your staff and your families. Please contact me if there are further questions. Sincerely, Ron Fritsche, M.A. Executive Director Apt 26 05 12: 58p Lynn Davis 303 935-3181 p. 1 COLORADO FAMILY SERVICES, INC. fax To: Gloria Romansik ri�s�-•—s Company or Agency: Weld Co. DSS Date: April 26, 2005 Fax Number: 970 346-7698 From: Ron Fritsche, M.A. Executive Director Number of Pages: 3 including cover sheet Subject: Response to bid proposal Gloria— An original will follow by mail. Thank you for your assistance. Please call me if you have any further questions. THIS IS CONFIDENTIAL INFORMATION THAT IS FOR THE ABOVE-NAMED PERSON ONLY. IF THIS PERSON IS NOT AVAILABLE, OR IF THERE ARE ANY PROBLEMS WITH PLEASE CONTACT CHAR OTTE ALLEN IMMEDIATELY AT 303/935-31999 THIS TRANSMISSION, 1200 South Wadsworth Boulevard, Suite 300 • Lakewood, Colorado 80232• Phone: 303/935-3199 Fax: 303/935-3181 • Toll free: 888/223-0786 • E-mail:kids@alpinechristianservice.org Rpr .26 05 12: 59p Lynn Davis 303 935-3191 p• e i6 COLORADO FAMILY SERVICES, INC. A division of Alpine Christian Services,Inc. v ti April 26, 2005 Gloria Romansik Weld County Department of Social Services P.O. Box A Greeley, CO 80632 Dear Ms. Romansik, We received the bid approval letter for RFP 05005: Lifeskills and for RFP 006-00B: Home Studies and Relinquishment Counseling. We are excited at the opportunity to work as a vendor with your agency. In response to the Commission's request that our agency comply with specific conditions, we submit the following: RFP 05055: Lifeskills #1 Our staff will work closely with the visiting parent(s) and the custodial or foster parent(s) to coordinate the supervised/therapeutic visits. If evening or weekend appointments are necessary in order for the visits to take place, our staff will arrange appointments during those times. #2 We will use pre-and post tests to assess risk for measurable outcomes in order to increase the validity of the written reports. We are currently developing the assessment tools and will have them ready to use by June 1, 2005. • #3 Any decrease in the level of supervision and/or service will ultimately be decided by the Weld County Case Worker who is managing the family's case. We will use a risk and safety assessment tool (currently under development), to guide our recommendations. #4 The duration of services generally runs from six to twelve months. Services will end sooner only at the direction of the Weld County Case Worker. RFP 006-00B: Home Studies #1 Incomplete home studies will be billed at an hourly rate of$70.00 per hour, not to exceed 3.5 hours. 1200 South Wadsworth Boulevard,Suite#300•Lakewood, Colorado 80232 Phone:303.935.3199•Fax:303.935.3181 •Toll free: 888.223.0786 Apr 26 05 12: 59p Lynn Davis dud yd5-y1a1 p. d For each additional adult residing in the home, other than the mother and father, $250.00 will be billed in addition to the regular home study fee. #2 We understand that completed home studies are due six weeks from the date of referral. Weld County DSS understands that there may be a delay in completion due to delays in the receipt of required paperwork from the family being studied. When this occurs, Colorado Family Services and Weld County DSS will discuss, and come to agreement on, the expected due date for the home study. We look forward to working with your staff and your families. Please contact me if there are further questions. Sincerely, R Ron Fritsche, M.A Executive Director rt,e 4 a DEPARTMENT OF SOCIAL SERVICES 1 pill P.O.BOXA if GREELEY, CO 80632 Website:wwwco.weld.co.us Administration and Public Assistance(970)352-1551 Child Support(970)352-6933. Re. COL ORADO T COLORADO April 18,2005 Ron Fritsche,Executive Director Alpine Christian Services,Inc.,DBA Colorado Family Services 1200 S Wadsworth Blvd.,#300 Lakewood,CO 80232 Re: RFP 05005:Lifeskills RFP 006-00B:Home Studies and Relinquishment Counseling Dear Mr.Fritschet The purpose of this letter is to outline the results of the Bid process for PY 2005-2006 and to request written confirmation from you by Wednesday,April 27,2005. A. Results of the Bid Process for PY 2005-2006- • The Families,Youth and Children(FYC)Commission recommended approval of the bid,REP 05005 Lifeskills for inclusion on our vendor list with the following conditions.Condition#1 is applicable to all Lifeskills providers,while Condition#2,#3,and#4 are specific to your program. Condition#1: MI providers must define their capacity to do after-hours visitation. Condition#2:Throughout the fiscal year,the provider shall utilize pre and post tests to assess risk for measurable outcomes in order to increase the validity of written reports. Condition#3 Please clarify under the"Service Objectives"section of the bid how you will assess safety in order to decrease the level of service for the visit Condition#4: Discuss sentence one under"Measurable Outcomes"the statement"At the end, . . .for at least three months,or as agreed upon with the caseworker."The statement is unclear because the durations for most client services are from six to 12 months. • The Families,Youth and Children(FYC)Commission recommended approval of the bid,005-00B, Home Studies and Relinquishment Counseling for inclusion on our vendor list,attaching the conditions below for all Home Study and Relinquishment providers. Condition#1: The threshold for hours for an incomplete home study will be set at 3.5 hours. Additional home studies will be billed at a maximum of$250 per person. • Page 2 Alpine Christian Services/Results of Bid Process 2005-2006 Condition#2: It has been mutually decided that the turnaround time for receipt of the completed home study by the Deparment is set at six weeks from the date of receipt of the referral. B. Required Response by FYC Bidders Concerning FYC Commission Conditions. 1. FYC Commission Conditions: All conditions will be incorporated as part of your Bid and Notification of Financial Assistance Award(NOFAA).If you do not accept the condition(s),you will not be authorized as a vendor unless the FYC Commission and the Weld County Department of Social Services accept your mitigating circumstances.If you do not accept the condition,you must provide in writing reasons why.A meeting will be arranged to discuss your response.Your response to the above conditions will be incorporated m the Bid and Notification of Financial Assistance Award. The Weld County Department of Social Services is requesting your written response to the FYC Commission's conditions.Please respond in writing to Gloria Romansik,Weld County Department of Social Services,P.O:Box A,Greeley,CO, 80632,by Wednesday,April 27,2005,close of business. If you have questions concerning the above,please call Gloria Romansik at 352.1551,extension 6230. Sincerely, a_ ego, cc: Juan Lopez,Chair,FYC Commission Gloria ltomansik, Social Services Administra 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 05-CORE-65 Revision (RFP-FYC-05005) Contract Award Period Name and Address of Contractor Beginning 06/01/2005 and Turning Point Center for Youth and Family Development, Ending 05/31/2006 Inc. Lifeskills 1644 S. College Avenue Fort Collins, CO 80525 Computation of Awards Description Unit of Service The issuance of the Notification of Financial Service facilitates transitional step after out-of- Assistance Award is based upon your Request for home placement by supporting caregivers with Proposal (RFP) and the Addendum RFP information. youth's return home. Program assists caregivers The RFP specifies the scope of services and in developing and practicing lifeskills. conditions of award. Except where it is in conflict Continued access to therapy and education with this NOFAA in which case the NOFAA governs, groups, as dictated by their service plan and the RFP upon which this award is based is an integral individual needs. Staff available to assist with part of the action. immediate needs, supervision and mentoring. An estimated 15 families will be served during this Special conditions contract period. Bilingual and South County 1) Reimbursement for the Unit of Services will be based services as referred by WCDSS. on a designated per family group conference. 2) The designated rate will be paid for only direct face to Cost Per Unit of Service face contact with the child and/or family, as Hourly Rate Per evidenced by client-signed verification form, as Treatment Package $25.00 specified in the unit of cost computation. Court Testimony $80.00 3) Unit of service costs cannot exceed the designated rate and yearly cost per child and/or family. Enclosures: 4) Payment will only be remitted on cases open with, X Signed RFP: Exhibit A and referrals made by the Weld County Department X Supplemental Narrative to RFP: Exhibit B of Social Services. Recommendation(s) 5) Requests for payment must be an original submitted to X Conditions of Approval the Weld County Department of Social Services by the end of 25 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. 6) The Contractor will notify the Department of any change in staff at the time of the change. Approvals: Program Official: By 'Lk By William H. Jerke, Chair Judy iego, irector Board of Weld County Commissioners Weld my De artment of Social Services Date: JUN 0 R pf15 Date: WfO r X00-5 /(o t/t j SIGNED RFP: EXHIBIT A INVITATION TO BID BID 002-05 (05005 -05011 and 006-00) DATE: February 16, 2005 BID NO: RFP-FYC-05005 RETURN BID TO: Pat Persichino,Director of General Services 915 10th Street,P.O. Box 758, Greeley, CO 80632 SUMMARY Request for Proposal (RFP-FYC-04005) for:Colorado Family Preservation Act--Life Skills Program Emergency Assistance Program Deadline: March 11,2005, 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 Colorado Family Preservation Program Act(C.R.S. 26-5.5- 101) and Emergency Assistance for Families with Children at Imminent Risk of Out-of-Home Placement Act (C.R.S. 26-5.3-101). The Families, Youth and Children Commission wishes to approve services targeted to run from June 1, 2005, through May 31, 2006, at specific rates for different types of service, the county will authorize approved vendors and rates for services only. The Life Skills Program must provide services that focus on teaching life skills,which are designed to improve household management competency,parental 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 March 11, 2005 (After receipt of order) BID MUST BE SIGNED IN INK ra✓n ,s f1- (LJcr-J��, TYPED OR PRINTED SIGNATURE VENDOR Tnrning Point -- 3,. (Name) Han written Signature By Authorized O er or Agent of Vender ADDRESS 1644 South College Avenue TITLE Fxerntive Director DATE PHONE# (970) 221-0999 ext. 36 The above bid is subject to Terms and Conditions as attached hereto and incorporated. Page 1 of 33 • Bid 002-05 (RFP-FYC-05005) Attached A LIFE SKILLS PROGRAM BID PROPOSAL AND REQUEST FOR CONTINUATION OF AWARD UNDER CORE SERVICES FUNDING EMERGENCY ASSISTANCE PROGRAM 2005/2006 BID PROPOSAL APPLICATION PROGRAM FUNDS YEAR 2005-2006 BID 002-05 (05005) NAME OF AGENCY: Turning Point Center for Youth and Family Development, Inc. ADDRESS: 1644 South College Avenue Fort Collins Colorado 80525 PHONE: (970) 721-0999 ext. 36 CONTACT PERSON: TAMPS Rerker, MNM TITLE: Executive Director DESCRIPTION OF FAMILY PRESERVATION PROGRAM CATEGORY: The Life Skills 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, effectively accessing community resources, and encouraging goal setting and pro-social values. 12-Month approximate Project Dates: _ 12-month contract with actual time lines of: Start June 1.2005 Start End May 31,2006 End TITLE OF PROJECT: Family Life Skills AMOUNT REQUESTED: varies - unit cost basis 1-tt'af ems`. gSao - �' /). !1� -� rain k. S,-A- ame and Signature of Person Preparing Document Date Judy A. Griego,Director Name and Signature Chief Administrative Officer Applicant Agency Date MANDATORY PROPOSAL REQUIREMENTS For both new bids and renewal bids,please initial to indicate that the following required sections are included in this Proposal for Bid.For renewal bids,please indicate which of the required sections have not changed from Program Fund Year 2004- 2005 to Program Fund year 2005-2006. Indicate No Change from FY 2004-2005 • j 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 Certificate of Insurance _ Assurance Statement Page 26 of 33 • Life Skills Program Bid Proposal RFP-FYC-05005 submitted by: Turning Point Center for Youth and Family Development, Inc. Project Description: Turning Point Center for Youth and Family Development, Inc. seeks approval from the Weld County Commissioners to be listed as an approved vendor for services offered under Colorado Revised Statutes known as the Colorado Family Preservation Program Act and the Emergency Assistance for Families at Risk of Out-of-Home Placement Act. Turning Point seeks approval as a vendor during the funding year which runs from June 1, 2005 through May 31, 2006. Turning Point is proposing to develop relevant Life Skills services to be delivered to Weld County families with youth who are: • in placement (thereby decreasing the youth's length of stay in out-of-home placement) • recently returned home from placement, but in need of family life skills programming so as to reduce the likelihood of recidivism • at risk of out-of-home placement, but not yet placed. This proposal is unusual in format and nature in that the specific program components and staffing have not yet been identified. The fees for service are estimates at this point, with fees to be negotiated and confirmed with Weld DSS staff prior to contracting. It is our belief that this submission meets the minimum requirements outlined in the RFP. If, at the discretion of the Board of County Commissioners, Turning Point is selected for placement on the provider list, Turning Point will proceed to cooperate with Weld DSS to develop innovative, research-based best practice Life Skills programming to meet the objectives of decreasing out-of-home placement for the target population. County Commissioners and/or Families, Youth and Children Commission members are welcome to tour a facility or arrange for a presentation from Turning Point staff. Programming will begin when appropriate during this contract year (program development complete and clients identified). Services will be billed on a fee for service basis, with no minimum financial commitment required on the part of Weld County. The following pages provide evidence that Turning Point is a qualified provider uniquely positioned to offer relevant services to a specific portion of the population eligible for CORE services. If the request for approved provider status is rejected for this year, Turning Point will reapply next year. However, in such circumstances, Weld County residents will be denied access to these services until next contract year. Page 1 of 4 Target/Eligible Population: Program services will be specifically targeted toward families of youth already involved in Turning Point's residential treatment (RTC) services. This approach is specifically consistent with goal # 2 of C.R.S. 26-5.5-101 as described in Part B of the RFP: "...Reunify children in placement with their families." Further, pursuant to out-of-home placement criteria, targeting these youth and families (including siblings) will also satisfy goal #1 of the Colorado Family Preservation Act, "...Prevent imminent placement of children..." Turning Point estimates that the agency's RTC program will serve at least 30 youth referred from Weld County DSS and their families. Clients have typically been between 14 and 18 years of age, and approximately 50% male and 50% female. This estimate is based upon trend analysis of Turning Point's service to youth over the past two years: • 40 clients referred and 21 clients accepted during FY2003-04. • 22 clients referred and 16 accepted from July 2004 —Feb 2005. Numbers are expected to increase as residential services are opened locally in Weld County in the spring of 2005. Key factors driving the expected increase are: • more beds available resulting in quicker placement. • the capacity to place local youth locally. • the ability to recruit and train a local staff with cultural competence to for Weld County residents. • The ability to coordinate with local DSS staff to provide most effective treatment planning and services. The provision of family-focus life skills services is directly linked to the therapeutic relationship developed between Turning Point's RTC staff and the youth and families served. Since the Greeley RTC program is in the process of licensing approval, staff recruiting and selection is currently under way. Turning Point intends to recruit, screen and hire for the ability to provide bilingual and ethnically/culturally appropriate services to Weld County families. For Turning Point's RTC services located in Ft. Collins, there are currently 3 bilingual (English/Spanish) staff on the payroll, and three contractors identified, screened, and trained to address youth and family needs. The number of individuals/families who will receive bicultural/bilingual services and the number of clients served from southern Weld County will depend upon the profile of open cases at Weld DSS over the coming year. The program does not have a projected minimum or maximum capacity; if 50% of the estimated youth served have families for which this is an appropriate service; an estimated 15 families per year will be served. Page 2 of 4 Types of Services Provided: Turning Point Life Skills Program will be designed to meet the specific needs of Weld County. As a general guideline, a program would be 10 weeks in length and contact with the client and/or family would be 4 hours/week. At a minimum we will provide mentoring that teaches, models, and coaches adaptive strategies; models positive parenting practices; teaches relational skills; teaches household management skills like prioritizing, finances, cleaning, and leisure activities; establish community connections and resources; encourage goal setting and teaching pro-social values. Turning Point will supervise parent client visits and document the interaction. When relevant we will set up structured activities and teach appropriate relational skills. Measurable Outcomes: General outcomes for this service are as follows: • To decrease the length of stay for youth who are currently in out-of-home placement. • To decrease the imminent risk of placement for youth who have returned home. • To increase the strengths and life skill competencies of targeted families. Typically, Turning Point provides every graduating youth and their family with a "transition plan"which addresses areas of: • living situation • education/work for the youth • pro-social connections and activities • ongoing substance abuse prevention and treatment support services, as needed To measure and document outcomes over time, Turning Point makes follow calls each month for 12 months following youth discharge. Additional outcomes for families involved in the Life Skills program would include: • pre- and post-tests to measure parental competency and household management skills • monthly survey questions to track family connection with community resources, family stability, and parents' ability over time to apply life skills learned Outcomes will be measured, evaluated and monitored by: • tracking the length of stay for youth in residential placement, and comparing the averages on a year-to-year basis. • Reviewing youth's residential treatment plans for the opportunity to provide Page 3 of 4 Service Objectives: The program service objectives in the area of mentoring are to improve household management competencies, improve parental competencies, improve the ability to access community connections and improve goal setting and pro-social values. In the area of visitation the goal is to improve the parent child interaction through improved relational skills. The objectives will be tracked through documentation and trained observation. Workload Standards: One staff would be assigned to a case. A staff member might carry a caseload of ten clients depending on the needs of each family. Staff would meet with clients for three face hours a week and an additional hour would be for case management. Staff Qualifications: Unusual nature of this proposal—specific program, staffing, and service not yet defined— Turning Point's credentials indicating worthiness to be an approved provider are defined: 38 years of experience serving children and families, including: • experience in providing CORE services in neighboring community • experience and credentials in working with substance abuse issues • experience in providing day treatment, home-based services, lifeskills services, emancipation services to young adults, • commitment to following research-based best practices • now providing local RTC services • solid working relationship with Weld DSS • currently in good standing and compliant with Vol. VII and Vol. VIII rules • CJC Agency of the Year 2004 & 2005 numerous other awards Pricing is based upon similar services offered in proximity to Turning Point RTC programs in Larimer County. Turning Point would prefer to confer with Weld DSS staff to outline specific program components, estimate client loads give the availability of local RTC services and the opportunity for integrated follow-on services, Given general trends of a 6 month stay for youth in RTC placement, Turning Point would consider the optimal outcome to have a specific program package designed and priced, have staff selected and trained, and be capable of offering CORE services by November, 2005. Program capacity will be flexible based upon the number of clients and families assessed to be most able to benefit from this service. Rate Computation: (see attached budget form) Page 4 of 4 • L Skills ) j j in j / / 5 to 8 8 co I-- ! k § ) § ) a I. a St 0 0 { 0 k a & § .2 f / k A \ \ I- + o ) ® § k / re ! 0 k » e 5 ) w ( B 7 re f § §« co ! co a uj Z ! | 0 Ir ; _ « }- o ; § re re \/ / e I— \ \ 0 \ O k k w k 8 LL 5- ) ) ce a. 2 2 § § 2 [ ( S k § w J | •-, 2 ( § [ \ k } k § ) b e k & - | 7 o K Z ! § ) k 9 § IIJ § , ) # M i o # ) §@ w » § § § d § 2 k R % R § 2e d 03/09/2005 WED 10:57 FAX 9703467662 WELD C0INTY SOCIAL SERV 1002/002 Bid 002-05(RFP-FYC-05007) Attached A Date of Meeting(s)with Social Services Division Supervisor: Continents by SSD Supervisor: J r c t f err ila B 4 a rrif r0-4 id:4 a CI006..A e.l,` n..e.eoleteil 4. G .el/la 994) 14dej Name Signature of SSD Supervisor Date Page 27 of 32 ACORD,, CERTIFICATE OF LIABILITY INSURANCE DATE ) 07/30/2 O4 PRODUCER 303-894-0298 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION CANPO ASI ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 455 SHERMAN STREET HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. SUITE 207 DENVER, CO 80203-4494 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: ALLIANCE OF NONPROFITS INSURANCE TURNING POINT CENTER FOR YOUTH &FAMILY INSURER B: PINNACOL ASSURANCE DEVELOPMENT INSURER C: 1644 SOUTH COLLEGE AVENUE FORT COLLINS, CO 80525 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR IN-RD TYPE OF INSURANCE POLICY NUMBER DATEIMM/OO/YYI SIAMIMM/DDrvYI , LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY 2004-11832 8/01/04 8/01/05 DAMAGE TO REN IED PREMISES(Ea occurence) $ 100,0O CLAIMS MADE X OCCUR MEDEXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE S 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS,COMP/OP AGG $ 3,000,000 POLICY PRO) LOC - AUTOMOBILE LIABILITY X ANY AUTO 2004-11832 8/01/04 8/01/05 (Ea accident)it SINGLE LIMIT 1,000,000 ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Par person) X HIRED AUTOS BODILY INJURY X NON,OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY,EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG 3 EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE S OCCUR CLAIMS MADE AGGREGATE S $ DEDUCTIBLE S RETENTION $ $ f RY WORKERS COMPENSATION AND X I TO IMITS I IOFR B EMPLOYERS'LIABILITY 4044167 10/01/03 10/01/04 E.L.EACH ACCIDENT 5 100,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L.DISEASE,EA EMPLOYEE $ 100,000 K yes,describe under SPECIAL PROVISIONS below E.L.DISEASE'POLICY LIMIT $ 500,000 OTHER SOCIAL SERVICE PROF 2004-11832 8/01/04 8/01/05 $1,000,000-$3,000,000 IMPROPER SEXUAL COND 2004-11832 8/01/04 8/01/05 $1,000,000-$1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS EVIDENCE OF INSURANCE CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN WELD COUNTY DSS NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL PO BOX A IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR GREELEY CO 80632 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE • ACORD 25(2001/08) 'ACORD CORPORATION 1988 SUPPLEMENTAL NARRATIVE TO RFP: EXHIBIT B CONDITIONS , . . . jrt, April 26, 2005 turning point Ms. Gloria Romansik Center for Youth and Family Social Services Administrator Family Development, p lopment, Inc. Weld County Department of Social Services P.O. Box A Dept. of Weld County Greeley, CO 80632 Social lcal units RE: RFP 05006: Day Treatment APR 2 7 2005 RFP 05005: Lifeskills Dear Ms. Romansik, This correspondence is in response to a request made by Ms. Judy Griego in a letter dated April 18, 2005, regarding the bid process for PY 2005-2006. RE: RFP 05006: Day Treatment—Turning Point would be pleased to be included on the vendor list to provide Day Treatment Services. At our next meeting with licensing officials from the Colorado State Department of Human Services, we will discuss the licensing process and take steps to initiate the process. RE: RFP 05005: Lifeskills-- Enclosed please find response and documentation per Ms. Griego's request. If we may provide additional information, I or someone from Turning Point will be available to meet with members of the Families, Youth and Children Commission or staff from your Department. I may best be reached via cell phone at 970-567-0936. B Regard^� z \ es Becker, MNM ecutive Director/CEO Turning Point Center enc 1644 South College Avenue • Fort Collins,Colorado 80525 Phone 970.221.0999 • Fax 970.221.2727 • Website: www.tumingpnt.org RE: RFP 05005: Lifeskills Response to Conditions outlined by FYC Commission From: Turning Point Center for Youth and Family Development, Inc. Date: April 26, 2005 1) Project Description and Target Eligibility Target Eligibility Program services will be specifically targeted toward families of youth already involved in Turning Point's residential treatment(RTC) services. Families must be referred by Weld County DSS workers, and Turning Point reserves the option to accept or deny in- home service to families, depending upon the results of the safety assessment and other factors. In typical implementation, the DSS caseworker, Turning Point staff, youth, family, and other stakeholders will all concur that lifeskills programming is an appropriate service which will improve safety and family functioning, while reducing out- of-home placement pursuant to C.R.S. 26-5.5-101. As per statute, services to be delivered to Weld County families with youth who are: • in placement(thereby decreasing the youth's length of stay in out-of-home placement) • recently returned home from placement, but in need of family life skills programming so as to reduce the likelihood of recidivism • in some cases, younger youth in the family may be at risk of out-of-home placement, but not yet placed. The provision of family-focus life skills services is directly linked to the therapeutic relationship developed between Turning Point's RTC staff and the youth and families served. Since the Greeley RTC program is newly initiated, number of families who will receive bicultural/bilingual services and the number of clients served from southern Weld County will depend upon the profile of open cases at Weld DSS which meet the conditions described in statute. The program does not have a projected minimum or maximum capacity; if 50% of the estimated youth served have families for which this is an appropriate service, an estimated 15 families per year will be served. Services will be billed on a fee for service basis, with no minimum financial commitment required on the part of Weld County. The fees for service are estimates at this point, with fees to be negotiated and confirmed with Weld DSS staff prior to contracting. Proiect Description Program Goal: Families will continue to develop (as initiated in RTC treatment) pro- social behavior, knowledge and skills that will systematically prepare them for success in the community and reunification as a family. I Services: typically begin with a stay in an RTC facility that allows youth to receive therapy and education while in a safe and supportive environment. As the community reintegration process begins, youth may be eligible for less expensive services under the Lifeskills Service.The service is designed to facilitate the next transitional step after out-of-home placement by supporting caregivers with the transition (youth's return home). Further, caregivers are assisted in developing and practicing sustainable lifeskills. Youth and families in this program may continue to access services, therapy and education groups, as dictated by their service plan and individual needs. Staff are also available to assist with immediate needs, supervision and mentoring. A primary focus is to connect families with resources in our community, and to provide decreased levels of support from Turning Point as the family increases utilization of other resources and their own capabilities. The youth and their family are encouraged to utilize the skills they have learned in more restrictive environments, practice them in a safe, monitored home environment and then transition completely on their own as they demonstrate they are prepared. 2) Safety Assessment Turning Point is currently developing an in-home Safety Assessment that integrates elements of our RTC program's safety protocols as well as elements from the Colorado Safety Accecsment and the North Carolina Family AccPccment Scale (NCFAS). Key elements identified that we will assess include the overall environment, parental capabilities, family interaction and the youth's well being. Examples of what are included are: 1. Family's mutual support. 2. Cooperation/motivation to maintain the family. 3. Role between Parents/Caregivers. 4. Parents/Caregivers in home behavior. 5. How the Parents/Caregivers describes or acts toward youth (i.e. is it predominately negative and/or has extremely unrealistic expectations). 6. Past harm caused by Parents/Caregivers to youth or credible threat of harm. 7. Inability of Parents/Caregivers to protect the youth. 8. Parents/Caregivers refuses access to the youth. 9. Parents/Caregivers is unwilling or unable to meet the youth's immediate needs for food, clothing, shelter, medical or mental health needs. 10. Parents/Caregivers is unwilling or unable to provide sufficient supervision to protect the youth from potential significant harm. 11. Disciplinary practices. 12. History of abuse or neglect of youth by Parents/Caregivers. 13. Physical living condition endangers the youth's health. 14. Parents/Caregivers alleged or observed drug or alcohol use that may seriously affect their ability to supervise, protect or care for the youth. 15. Child sexual abuse is suspected and circumstances suggest that the youth's safety is of immediate concern. 16. Domestic violence exists in the home and places the youth in danger of physical and/or emotional harm. 2 3) Staff Qualifications Turning Point has operated successful Residential Services and CORE services including Day Treatment, Home Based Family Services, Intensive Family Therapy, and outpatient Drug &Alcohol Services beginning in 1989. Turning Point currently employs over 120 highly trained, qualified and committed staff. Staff qualifications include extensive training, professional certification, and licensure which far exceeds what is required by licensing agents and governmental entities. The Life Skills Program is overseen by a Clinical Diiec.lur who is a Licensed Clinical Social Worker (LCSW) and Certified Addictions Counselor III (CAC III) and a Program Director who is a Licensed Marriage and Family Therapist(LMFT). The role of the Clinical Director is to guide the programming and services to be researched-based best practices and to ensure all staff are trained in the best approach to serve the client and maintain them in their home. The role of the Program Director is to directly supervise the service and the staff in the program to ensure that the client care is exemplary. Since the Life Skills Program is a new service offered by Turning Point, we will hire for the position assigned to working directly with the youth and families. If the youth transitions from one of our existing RTC programs, we will strive to have them continue treatment with members of their treatment team in order to provide continuity of care. The number of staff identified for this program is limited only by the number of youth in the program and could grow with the needs of the service. Caseloads, as identified in the original response, would depend on the needs of the family and would likely average 1:10. The chart on the following page details position, minimum requirements per licensing, and current Turning Point qualifications. 3 i Title Minimum Experience Qualifications identified in Volume VII Sections 7.303.13 and 7.0006.Q Clinical Director Not identified Minimum Turning Point Requirement: 1. Masters degree in related field. CAC III preferred. 2. Licensed professional as a: physician, psychologist, clinical social worker, marriage and family therapist, professional counselor or registered nurse 3. Minimum of four years of treatment-oriented experience. Prefer minimum three years experience in management. Current Clinical Director is a LCSW, CAC III and has over 15 years experience in the field. Program Director Bachelors Degree Minimum Turning Point Requirement: with a major in a 1. Bachelors degree in mental health discipline. human behavioral 2. Minimum 3 years treatment oriented sciences field and experience, one of which was a supervisory or 3 years administrative position. 3. Certified Addictions Counselor Level III, or experience. actively seeking certification at this level. Current Program Director is a LMFT and has over 7 years of experience in the field. Counselor 2 Bachelors degree Minimum Turning Point Requirement: with a major in a 1. Bachelors degree in mental health discipline. human behavioral 2. Certified Addictions Counselor Level I,or sciences field and actively seeking this certification. 1 year experience. 3. Minimum of 2 years experience working with at- risk youth, prefer this experience having been in a residential setting. Additionally, prefer interest in outdoor education and experiential treatment modalities. If awarded this contract,Turning Point would advertise locally and seek a candidate who met these requirements. We prefer to have someone with experience working with families or utilize staff who meet this qualification that were on the client's treatment team if they are transitioning from one of our RTC programs. 4 Mitigating Circumstances As indicated in Turning Point's initial response to the Request for Proposals, and where appropriate in responses located above, there are two critical mitigating circumstances in Turning Point's offer to provide services: 1) adequate time is required to develop the "related services"to youth and families Turning Point's offer to provide services is expressly contingent upon our ability to provide RTC services locally to Weld County youth -- with corresponding services provided to families (and lifeskills provided to emancipating youth) after discharge from the RTC. Since the RTC portion of the programming only recently began, we have not yet had the opportunity to develop some of the essential features of the lifeskills programming (i.e. build on the therapeutic relationship already existing between staff and families, or to hire local staff with local experience and connections in lifeskill development). Over time, these elements of quality will manifest— it will not take an entire year, which is why Turning Point offered a response to this spring RFP. But the elements are not all in place at this time because the local RTC programming is so new. 2)time to develop well-targeted programming to meet the needs of Weld County DSS and customized to the needs of the clients Best practice literature indicates that customized service plans provide the most effective results for youth, families, and communities. Turning Point has experience providing programming utilizing a variety of principles, including: substance abuse relapse prevention, adolescent emancipation programming, and various family support models (i.e. Functional Family Therapy, Multi-Systemic Therapy, or"Systems"Approach). But, consistent with the"best practice"approach, the exactservices provided and methods used will be customized to each family, based upon service planning which involves the DSS caseworker, family members, Turning Point, and other stakeholders. The purpose of this RFP response is to provide a very basic menu of services and pricing from which a service plan may be developed and funded. The exact course and duration of the intervention will be flexible, but it will always be designed to provide the best possible service and outcome at the least overall cost to Weld County. 5 a DEPARTMENT OF SOCIAL SERVICES Ill I P.O.BOX A GREELEY, CO. 80632 Website:www.caweld.co.us Administration and Public Assistance(970)352-1551 Child Support(970)352-6933 11 Ilk COLORADO April 18, 2005 James K. Becker, Executive Director Turning Point 1644 South College Avenue Fort Collins, CO 80525 Re: RFP 05006: Day Treatment RFP 05005: Lifeskills Dear Mr. Becker: The purpose of this letter is to outline the results of the Bid process for PY 2005-2006 and to request written information or confirmation from you by Wednesday,April 27,2005. A. Results of the Bid Process for PY 2005-2006 • The Families,Youth and Children(FYC)Commission recommended approval of your Bid#05006,Day Treatment for inclusion on our vendor list. • The Families,Youth and Children(FYC) Commission recommended that the conditions itemized below be attached to Bid#05005, Lifeskills. The FYC Commission's final recommendation for approval or non approval of your bid will be forthcoming following their review of your response and submitted documentation to the conditions itemized below. 1. You are requested to resubmit the Project Description and Target Eligibility sections.Please be more specific in supplying detail and clarification of these sections. 2. You are requested to address and discuss safety assessments. 3. You are requested to address and document staff qualifications. B. Required Response by FYC Bidden Concerning FYC Commission Conditions: All conditions will be incorporated as part of your Bid and Notification of Financial Assistance Award(NOFAA). If you do not accept the condition(s), you will not be authorized as a vendor unless the FYC Commission and the Weld county Department of Social Services accept your mitigating circumstances. If you do not accept the condition, you must provide in writing reasons why. A meeting will be arranged to discuss your response. Your response to the above conditions will be incorporated in the Bid and Notification of Financial Assistance Award. Page 2 Turning Point/Results of RFP Process for PY 2005-2006 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 27, 2005, close of business. If you have questions concerning the above,please call Gloria Romansik, 970.352.1551 extension 6230. rAthnSincerely, 'ego, ector cc: Juan Lopez, Chair, FYC Commission Gloria Romansik, Social Services Administrator Weld County Department of Social Services Notification of Financial Assistance Award for Families,Youth and Children Commission (Core)Funds Type of Action Contract Award No. X Initial Award 05-CORE-LS-0007 Revision (RFP-FYC-05005) Contract Award Period Name and Address of Contractor Beginning 06/01/2005 and Lutheran Family Services Ending 05/31/2006 Lifeskills-Visitation 3800 Automation Way, Suite 200 Fort Collins, CO 80525 Computation of Awards Description Unit of Service The goal of this program is to expedite The issuance of the Notification of Financial reunification of a family, if appropriate, or to Assistance Award is based upon your Request for provide the County Department with an Proposal (RFP). The RFP specifies the scope of assessment which will move the child(ren) services and conditions of award. Except where it is toward an alternate permanent plan through five in conflict with this NOFAA in which case the levels of services; (1)monitored visitation, (2) NOFAA governs, the RFP upon which this award is therapeutic visitation, (3)in-home transition based is an integral part of the action. services, (4) case consultation, and(5) Special conditions transportation. Capacity to serve a total of 65 1) Reimbursement for the Unit of Services will be based family units,monthly average capacity is 22, on an hourly rate per child or per family. average stay in the program is 6 months, 2-3 2) The hourly rate will be paid for only direct face-to- hours per week. Bilingual-bicultural and South face contact with the child and/or family, as County services are available. evidenced by client-signed verification form,and as specified in the unit of cost computation. Cost Per Unit of Service 3) Unit of service costs cannot exceed the hourly and Hourly Rate Per yearly cost per child and/or family. 4) Payment will only be remitted on cases open with, Treatment Package-High $132.42 and referrals made by the Weld County Department Therapeutic Staffing $101.34 of Social Services. Transportation $64.85 5) Requests for payment must be an original submitted Court Testimony $60.00 to the Weld County Department of Social Services by Enclosures: the end of the 25th calendar day following the end of X Signed RFP: Exhibit A the month of service. The provider must submit X Supplemental Narrative to RFP: requests for payment on forms approved by Weld Recommendation(s) County Department of Social Services. X Conditions of Approval 6) The Contractor will notify the Department of any changes in staff at the time of the change. Approvals: Program Official: By 1\, i1/4„ve By William H. Jerke, Chair Judy . Grieg ,Directo Board of Weld County Commissioners Weld o ty epartment of Social Services Date: JUN 0 6 2005 Date: (0/ZI0S.- SIGNED RFP: EXHIBIT A INVITATION TO BID BID 002-05 (05005-05011 and 006-00) DATE: February 16, 2005 BID NO: RFP-FYC-05005 RETURN BID TO: Pat Persichino,Director of General Services 915 10th Street, P.O. Box 758, Greeley, CO 80632 SUMMARY Request for Proposal (RFP-FYC-04005) for:Colorado Family Preservation Act--Life Skills Program Emergency Assistance Program Deadline: March 11, 2005,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 Colorado Family Preservation Program Act(C.R.S.26-5.5- 101) and Emergency Assistance for Families with Children at Imminent Risk of Out-of-Home Placement Act (C.R.S. 26-5.3-101). The Families, Youth and Children Commission wishes to approve services targeted to run from June 1, 2005, through May 31,2006, at specific rates for different types of service, the county will authorize approved vendors and rates for services only. The Life Skills Program must provide services that focus on teaching life skills,which are designed to improve household management competency,parental 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 (After receipt of order) BID MUST BE SIGNED IN INK et TYPED OR P SIGNATURE VENDOR Lutheran Family Services of CO / (Name) tten Signa e By Au ed fficer or Agen Vender ADDRESS 3800 Automation Way, Ste. 200 TITLE /____rte __ Ft. Collins, CO 80525 DATE C�/0/e/ ir— PHONE# (970) 266. 1788 The above bid is subject to Terms and Conditions as attached hereto and incorporated. Page 1 of 33 • Bid 002-05 (RFP-FYC-05005) Attached A LIFE SKILLS PROGRAM BID PROPOSAL,AND REQUEST FOR CO_NTLNUATION OF AWARD UNDER CORE SERVICES FUNDING EMERGENCY ASSISTANCE PROGRAM 2005/2006 BID PROPOSAL APPLICATION PROGRAM FUNDS YEAR 2005-2006 RID 002-05 (05005) NAMEOFAGENCY: Lutheran Family Services of Colorado . ADDRESS: 3800 Automation Way, Suite 200 Fort Collins, CO 80525 PHONE: (970) 266-1788 ' CONTACT PERSON: Sherre Demanche TITLE: Program Director • DESCRIPTION OF FAMILY PRESERVATION PROGRAM CATEGORY: The Life Skills Program Category must provide services that focus on teaching life sldlls designed to facilitate implementation of the case plan by improving household management competency,parental competency, family conflict management, effectively accessing community resources, and encouraging goal setting and pro-social values. 12-Month approximate Project Dates: 12-month contract with actual time lines of: Start June I, 2005 Start End May 31, 2006 End TUILEOFPROJECT: Visitation Program AMOUNT REQUESTED: Julie Swanso 5' D• 05 Name and Signature of Person Prep ocument Date hid A. Grie o Director Name and Signature Chief Administrative Officer Applicant Agency Date MANDATORYPROPOSAL RE UII2EMENTS 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 2003- 2004 to Program Fund year 2004-2005. Project Description Indicate No Chan a from FY 2003-2004 to 2004-2005 Target/Eligibility Populations Types of services Provided Measurable Outcomes S Service Objectives Workload Standards Staff Qualifications - Unit of Service Rate Computation Program Capacity per Month Certificate of Insurance Assurance Statement Page 27 of 33 • Core Services Proposal Life Skills FY 05-06 Lutheran Family Services of Colorado Visitation Services PROJECT DESCRIPTION Lutheran Family Services of Colorado(LFS) is a community-based agency with an experienced staff that offers a wide range of services to children,families and adults. It is a nonprofit agency that has provided human services in Colorado since 1948. Although the agency was established as an affiliate of the Lutheran Church, it is an equal opportunity agency that provides services to all individuals without consideration of religious beliefs, race, ethnicity, gender or economic status. The purpose of this project is to serve children in out-of-home care, who are the subjects of dependency and neglect actions, and who have a court order which requires supervision of the"parenting time" between the children and members of their families of origin,or who the county Department of Social Services determines to be in need of supervised visitation. In some cases,this parenting time, whether with birth parents or other extended family members, could be safely provided in the home of the birth parent/extended family or in another community location that would be less formal, and more normalizing than alternatives in the County Department of Social Services or other agency buildings. If visitation in the client home is not advisable, LFS has rented a home in Greeley to be used for visitation. This is a fully functioning home with a kitchen and bath so that more normal family activities can occur during parenting time. In addition, therapeutic visitation services are available to families who have been served by the program while their children were in out-of-home care and reunification in the family home has now occurred. These in-home transition services are an extension of therapeutic visitation and allow for consistency of support to the family that has successfully reunified. The goal for this visitation program is to expedite and/or maintain the reunification of a family, if appropriate, or to provide the DSS with an assessment that will move the child(ren)toward an alternate permanent plan. The visits may occur in the birth family home, in the Lutheran Family Services' Visitation Home or in another community setting. After an initial assessment period of a maximum of three visits, one of two levels of services will be determined appropriate by consultation between the county caseworker and the Visitation Supervisor,with assistance from the Program Director and Clinical Supervisor, as needed. The least restrictive service on the continuum would be monitoring of the visitation for the physical health and welfare of the child(ren). More intensive services would be provided through educational visitation where we evaluate the visits for appropriateness of interactions, assess the parent-child relationship, evaluate parenting capability and actively intervene, role model, support and educate the family members during the visit. This level of supervision could also include time spent separately with adult family members prior to, and/or following the visitation to discuss parent-child interaction during the visit time. Travel to visit and transportation of children to and from the visitation site could be provided in both of the above-described levels and the transportation hourly rate would be used. II. TARGET/ELIGIBILITY POPULATIONS The target population would include any children who are the subject of dependency and neglect actions requiring supervised "parenting time"by the court or the county Department of Social Services. Children who have met any of the conditions of Criterion#1 for out-of-home placement could be appropriate service recipients, including infants or young children with teen parents also in placement. We will serve children from age birth to 18 and their families. •Lutheran Family Services Visitation Program A. Total number of clients served: 65 family units(260 individuals) We have four service levels available within the visitation program. Our monitored visitation program is budgeted to provide services to 5 family units (20 individuals) and our therapeutic visitation program which includes in-home transition services to families, is budgeted to provide services to 60 family units (240 individuals). For clients who received visitation services when their children were in out-of-the home placements, providing in-home transition services after family reunification can positively assist families with the transition to full-time care of their children. Also available at Caseworker request, will be participation by LFS visitation supervisors at consultations designed to further the movement toward reunification or permanency. These case planning consultations could be Court facilitator meetings,family mediations, meetings with therapists of child visitation client(s), etc.; or time spent at court in response to a subpoena from the county. Billing for attendance at these meetings will be at a lower rate than our therapeutic visitation rate. 10 family units(40 individuals)will be served through case planning consultations. The travel and transportation program is budgeted to provide services for 20 family units(80 individuals). Clients receiving in-home transition services, case consultation services and transportation will be receiving services in one of the visitation levels and are not counted for the purposes of this number(65 families/260 individuals). This number assumes four family members in each family. Lutheran Family Services has eight staff members available to provide direct services. Each is budgeted on a part-time basis to work in this program. B. Total individual clients and the children's ages: 260 We estimate that each family will have four family members. The two visitation services are budgeted to provide services to 65 families. Children's ages can be from birth to 18. C. Total family units: 65 This program is budgeted to provide services to 65 families. D. Sub-total of individuals who will receive bicultural/bilingual services: 65 individuals (16.17 families) We have one bilingual master's level clinician on staff. However,we have not experienced a significant increase in referrals of families who are monolingual and speak Spanish. In anticipation of this need within Weld County,we have budgeted approximately one quarter of our clients to receive bicultural/bilingual services. E. Sub-total of individuals who will receive services in South Weld County: 65 individuals (16.17 families) This number is reflective of an estimated one quarter of the referrals being from South Weld County. F. The monthly maximum program capacity: 25 families The maximum number of cases per month served through this program would be 25 families and could include children from birth through 18, with family members of any ages. It is anticipated that the average contact per family will be two to three hours per week. The actual number of client contact hours with the children will depend on the total number of hours of visitation ordered by the court, or requested by the county Caseworker,e.g., one case may require one hour per week of visitation with a child and another may require two hours,two times per week. We can assign as many staff to this program as the referrals warrant, so our maximum capacity can be much larger. G. The monthly average capacity: 22 families This number is based on our budgeted capacity. H. Average stay in the program(weeks): 6 months The average stay in the program, as well as the average hours per week,would be dependent upon the conditions of the court order and/or the request of the county Department of Social Services. Life Skills— Visitation 2 Weld County Off System Bid 02-03 RFP-FYC 03005 •Lutheran Family Services Visitation Program I. Average hours per week in the program: 2.3 III. TYPE OF SERVICES TO BE PROVIDED Level A: Monitored Visitation—In some situations, children in out-of-home care need only transportation to visitations with birth family members, a reasonable and safe visitation location and a supervisor to assure that the family members are providing for the safety of the child(ren)during the visit. In these situations,the visit supervisor would be expected to arrange for and document the location, time and attendance of participants of the visit, and provide a brief written observation of the appropriateness,timeliness and interaction of visit participants. The supervisor would not be expected to stay within hearing distance of the child(ren)and other visit participants in order to monitor the content of conversations. Transportation for the children in care to and from the site may be provided by LFS. Level B: Therapeutic Visitation and In-Home Transition Services—The focus of this visitation level is to actively monitor, assess and assist in the overall adult/child interaction with the intent to improve the quality of the relationship. This visitation level would require that the supervisor monitor not only the physical behavior and activities of the visit, but remain within a distance reasonable to monitor communication with the children during the visit. The purpose of the therapeutic visit would be to assess the level of future intervention needed for continuing visitation, to provide information to the court and the Department regarding the interaction of the children and other visit participants, to provide parent education to the birth family and to provide protection, physically and emotionally, for children in out-of-home placement during birth family visitation. To accomplish this, intervention and role modeling by the visitation supervisor will occur to ensure appropriate communication and/or safe activities for the well-being of the child(ren). Education, role modeling and coaching, if appropriate, will be included at this level of visitation. Tools such as videos of child development and parent/child interaction, books regarding specific parenting or child development tasks, structured activities during visitation and assignments for ongoing visit preparation may be used. Specific parenting educational needs, such as bonding and attachment work or adolescent anger management may be identified and requested by the caseworker. In order to accomplish parenting instruction without lowering the self-esteem of the parent in front of their children, some of the education may occur at a time outside of the scheduled visitation, usually just prior to, or immediately following, a visit. This parent education may either be accomplished face-to-face or by a pre-scheduled telephone conference with the parent. If possible, and with the approval of the caseworker, this level of visitation could occur within the client family home. Whether in the family home, in the Lutheran Family Services' Visitation Home or in the community, arrangements for the visit location will be made by LFS, with the caseworker's approval, and transportation of the child(ren)to and from the site may be provided by LFS. A second component of therapeutic visitation may occur once the child(ren)are returned to the birth parents. After the child is reunified in the parents home, transitional services may be provided to assist in full-time parenting and to maintain consistency of skills and support. This service would both support the parent(s) and provide an assessment to the Caseworker of the transition relating to the children's health and welfare in the home. Level D: Case Consultation—Participation by visitation supervisors in case assessment and planning with other professionals(e.g.,therapists, caseworkers, attorneys, evaluators, Court facilitator) and with birth family members can provide for more expedient reunification or permanency plans. LFS personnel can be available, at Caseworker request and with appropriate notice, to participate in these case-planning meetings. Case consultation also includes time spent at court in response to a subpoena from the county. Level E: Travel and Transportation— A significant number of the visitation cases involve children and birth parents who live in rural communities that are a great distance from the visitation house or other locations where visits occur. Lutheran Family Services will take on the responsibility for traveling to a location and/or transporting children when these cases are referred. At the request of the Caseworker, LFS will attempt to meet the travel and Life Skills— Visitation 3 Weld County Off System Bid 02-03 RFP-FYC 03005 Lutheran Family Services Visitation Program transportation needs necessary to facilitate the visitation. Travel to and from the location and the time involved transporting the child will be billed at the transportation rate. IV. MEASURABLE OUTCOMES 1. Children will be safe, physically and emotionally, during visitation with birth family members. This outcome will be measured by tracking the number of incidents of inappropriate parenting or suspected child abuse that is reported due to behavior at a visit. 2. Visits ordered or requested for children will occur in compliance with the time frame and duration required. This outcome will be measured through review of monthly reports by LFS. 3. Assessment of child/adult interactions at visits will help move the children toward either reunification with birth family or other permanency plans. This outcome will be measured through the use of the Adult- Adolescent Parenting Inventory and supervisor's assessment provided in monthly reports by LFS. 4. Parenting support and education by visitation supervisors will move the children toward visitations in their family homes, with the goal of eventual unsupervised visitation and then reunification. This outcome will be measured through review of monthly reports by LFS. 5. If children cannot be returned home, visitation supervision and efforts to assist parents will result in information for the county Department of Social Services and courts that will allow for alternative permanency plans to be considered. This outcome will be measured through review of monthly reports by LFS. 6. The county Caseworker will receive written documentation pursuant to whichever level of visitation supervision is being required. This outcome will be measured through review of monthly reports by LFS. 7. Department of Social Services monthly verification, reimbursement requests and program project reports will be submitted as required. This outcome will be monitored through tracking of billing by the Weld County internal accounts receivable department. V. SERVICE OBJECTIVES Objective 1. At least 95%of the individual/family households will participate in setting the goals and objectives for their treatment plan that reflect positive personal and family values clarification and enhancement of the family's strengths and lessening of risk areas. Objective 2. At least 95%of individuals/family households will work toward improved parenting skills, parent/child interactions and relational skills for physical and emotional safety as demonstrated by their acceptance of the supervisor's intervention, education and support to improve parent/child relationship. Objective 3. 100%of children will move toward being reunified in the family or achieve an alternate permanency planning goal. VI. WORKLOAD STANDARDS Life Skills— Visitation 4 Weld County Off System Bid 02-03 RFP-FYC 03005 -Lutheran Family Services Visitation Program A. Number of hours per month: 160.200 per month We have budgeted 160-200 hours of direct service per month for this program. B. Number of individuals providing the services: 8 We have eight direct service staff members available to provide services in this program. C. Maximum caseload per worker: 1:7 Ratio In our structure, a full time professional staff person can provide 20 hours per week of direct service so the caseload will be dependent on the number of weekly direct service hours needed for each case. D. Modality of Treatment: The modality of treatment varies, the priority at both levels is provision for the health and well-being of the child(ren) client. In our Therapeutic Visitation program,the focus is on child/adult interaction, bonding, reciprocity in relationship and development of overall parenting skills. We will use assessment, education, modeling and assistance with application of the skills learned. E. Total number of hours per month: 200 F. Total number of individuals providing these services: 8 We have eight direct service staff members available to provide services in this program. G. The maximum caseload per supervisor: 1:7 Ratio H. Insurance: Our proof of insurance, naming Weld County Department of Social Services as additionally insured, is attached. VII. STAFF QUALIFICATIONS Project Director—This position will be responsible for accepting referrals, assigning the case to the appropriate Visitation Supervisor and assisting the Visitation Supervisor in assessing the referral for the appropriate intervention level after the initial assessment period. Supervision of the ongoing caseloads with the Visitation Supervisors will occur at least every other week, and immediate supervision will be available if needed. In addition,documentation of visits will be monitored through this position and all monthly reimbursement requests, verifications and program project reports will be reviewed or monitored by this position. This position requires a Master's degree or a Bachelor's degree with at least five years of experience in a human services related field. Clinical Supervisor—This position will provide additional supervision for the determination of the appropriate level of services after the initial assessment period and will provide ongoing supervision for any cases in level B, meeting with the visitation supervisor at least every other week, with immediate supervision available as needed. A licensed therapist with experience in human services and child welfare will be required to fill this position. Level A: Monitored Visitation Supervisor—This position will provide transportation for children in out-of-home care to the visit location and monitor the physical safety of the children while they visit with birth family members. Arrangements for ongoing visit locations and any contact with the birth family necessary to make a change in,or cancel due to illness, a visitation will be the supervisor's responsibility. In addition, the Supervisor will provide a Life Skills— Visitation 5 Weld County Off System Bid 02-03 RFP-FYC 03005 •Lutheran Family Services Visitation Program monthly account to the county caseworker with a brief description of visit activities, children's attitudes or comments prior to,during and following the visits and notice of any critical incidents requiring early termination of the visits. This position requires a Bachelor's degree with at least one year of experience in a human services related field. Level B: Therapeutic Visitation and In-Home Supervisor—This position will require a knowledge of families and children and the ability to intervene in, or even terminate, a visit if a child becomes acutely distressed, is at risk either emotionally or physically or if a visitation birth family member acts inappropriately toward a child. In addition to safety of the child(ren),this position will provide role modeling, education, coaching and support to the parent(s)to maintain appropriate parenting skills during the visit. One-on-one time outside the visit with the parent to process the visitation experience, provide education and discuss parenting techniques and skills may be included. This position requires a Master's degree or a Bachelor's degree with at least two years of experience in a human services related field. Case Consultation Supervisor—These positions would be provided by staff meeting the qualifications listed above relevant to the type of visitation services being provided to the children while they are in out-of-home care. Transportation Supervisor—LFS personnel providing transportation for children to visitations will have a valid driver's license and insurance and will provide appropriate safety seats meeting state mandate dependent upon age and size. VIII. COMPUTATION OF DIRECT SERVICE RATE See attached spreadsheet. Life Skills— Visitation 6 Weld County Off System Bid 02-03 RFP-FYC 03005 Bid 002-05 (RFP-FYC-05005) Attached A Date of Meeting(s)with Social Services Division Supervisor: 7- Zcl—E Comments by SSD Supervisor: OAAkl i Q cis A pLiAktcra - it-,Qc_A-- � �z II is-c. 2 z -s Name and Signature of SSD Supervisor Date Page 27 of 33 ACORD CERTIFICATE OF LIABILITY INSURANCE 08/24/2004 PRODUCER - THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Marsh Advantage America ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1G� Spear St. 15th Floor HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR \ p ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. I Francisco, CA. 94105 41-5-983-514 5 INSURERS AFFORDING COVERAGE NAIC# NGDRED Lutheran Family Services of Colorado GUIDEONE SPECIALTY MUTUAL INSURANCE INSURER GUI➢EONE MUTITAT INSURANCE COMPANY INSURER B: 363 South Harlan, Suite 200 INSURER Denver, CO 80226 INSURER Cc 1303-922-3433 z 109 INSURERS COVERAGES THE ROUSES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD NDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM CR CONDMON CE ANY CONTRACT OR OTHER DOCUMENT WRH RESPECT TO WHICH THIS CERRFlCATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BYTE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POUCES.AOGREOATEUMI TSSHOWN MAY HAVE BEEN REDUCED BYPAIDCAIMS. POLICY MECl1VE POGUOYEAPIRATON In woo TYPE OFINSUMM'E POLLCY MUMPER DATEIMMTMYI TEIMMIDM'I LINrtE GENERAL LM.¢R. - EACH OCCURRENCE t 3,000,00C . X cow/RACIAL GENERALWBIUTI „ °E(G;'° F 3,000,00C CWMSAME OCCUR TOED FM(Anyamms) s 1,000,000 A 1213-2363 07/01/04 07/01/05 PER O ALB DVI„,GRY t 1, 000, 000 X COUNSELOR LIAB. GENERAL AGGREGATE 1, 000, 000 GENT AGGREGATE LAND APPLIES PER: PRODUCTS-COMEOP AGO S 5,000 PRO- FOGGY LFCT LOC YrtOMOEEELWtRY X ANTAUTO M IMTNEDGIN EBT 1,000, 000 ALL WINED AUTOS BOOtY INJURY SCHEDULED AUTOS (fours.) B IREDAUTD, 1757-711 07/01/04 7/01/05 BODILYINIURY 1 NON-OWNEDAUTOS IPvcIYG I PROPERTY DAMAGE JJJ lPeracyrU OPRAGE WBEITT AUTOONLY-EA ACCIDENT t ANYALRO OTIMTMH FA ACC t AUTOONLY: AGO 3 P%CP'HR'M'^E'J.^"ABW^ EACH OCCURRENCE t 4,000, 000 Xf DGGDR DLAW8IMDE AGGREGATE 3 4, 000, 000 9618-912 07/01/04 07/01/05 B S DEDucneLE RETENTION WOMERSCCMPENSATNW41O WCSTATU. IOT4 EMPLOYERS'WBRRY TOMISMTS ER Amy r EL EACH ACCIDENT 3 mamas eMitem I�Sr , EL DISEASE-EA EMPLOYEE 3 SPERM.PROVISIONS Yim EL MUSE-POUCY LRAM S DAHER 1213-263 07/01/04 07/01/05 $792,400 A Property DEson.OPOPERATIW -00,71c„sNUYCLESIExCWSCH ADDTO BYEICORSEMENTI SPECVL PROVISIONS - CERTIFICATE HOLDER IS ADDITIONAL INSURED (CG 2026) AS RESPECTS GENERAL LIABILITY ONLY IN CONNECTION WITH CONTRACT SERVICES PROVIDED BY THE INSURED REPLACES CERTIFICATE ISSUED ON 6/23/04 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIED MUCIES BE CANCELLED BEFORE THE ELWATION WELD COUNTY SOCIAL SERVICES DATE THEREOF.THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DYS CRE ATTN: JUDY A. GRE ICO, DIRECTOR NVIICe To THE CERTIFICATE HOLDER NMAEO TO Ills LEFT,BUT FMURE TO SO SO SHAM ' P.O. 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C1 IJi ® O ac. 2 n la y W tl x W W J ap 0 E"4-.-2 J $J• W F W Q U l7, S HUIJIJI O O O a m U 7 _ + Lutheran Family Services RECEIVED MAY 101005 of Colorado Services that heal,strengthen&provide hope May 9, 2005 Gloria Romansik Weld County Department of Social Services P.O. Box A Greeley, CO 80632 Dear Ms. Romansik: As instructed by telephone we are resubmitting the enclosed RFP-FYC-05005, Life SkillsNisitation, for FY 2005-06. We have also included the financial statement for our visitation program for 7/1/04-3/31/05. This statement shows a $46,904 loss for the nine-month time period. This financial statement is for Visitation program expenses only. Currently none of the agency's accounting and other overhead costs is being allocated to this program. Our original 2005-06 bid included rates for a variety of non-face-to-face contact necessary to meet the clinical requirements of this program. We were asked to resubmit, increasing the face- to-face charge to a level that would capture all of the indirect services provided. Accordingly, our new bid is set at a level that will cover costs resulting from the following types of situations that have caused our losses: set-up time with clients; consultation time with parents; travel time for out-lying locations; cancellation of scheduled visits; telephone consultation with caseworkers, other service providers, foster parents and GAL; and travel time to visitation locations when parents are a no-show. If a meeting is needed to discuss this bid in more detail we would be happy to make an appointment with you at your office. If you have any questions please call Sherre DeManche at 970-266.1788 or Julie Swanson at 303.217.5858, as I will be out-of-town during the next week. We look forward to working with you during the upcoming fiscal year. nce - y, President/C En ure 363 S. Harlan Sr., Suite 200 • Denver, CO 80226-3552 • (303) 922-3433 • Fax (303) 922-7335 • www.lfsco.org 1 LSA UnWay- y > y u O It O g Q ≥i e N a c i m ('1 C > n ry Y N _ z _ O C O J 0 m — a n N! - a I mo a T l I TA .m' 0 3 O - - 4 O r P 00 I O. _ N — O e e _ r a _ N V O W V u � co eu N '° N Stir-c a 'I,h .8 "o. ry c - 2 S I e —_- - e^ O N I m a - h rn _ e n L I v N - r - O .> i- ›- .., ?m v e I n .. gg v m' LL - f Mi M1 m N M a` N .m. o o O O N o0 oI N b O 0 I O m ry m 00 N O > _. _ _ 0 2 t L° q c a rnl' I rn _ I N _ _ o I _ Li. a _ _ - li I r a m a a To O O N a r N vi ey r a m ^ 6 N v T L_ _8 o o m N - e - _ _ N N - rn.. a < N —_. I * T. - ___- a -.{- a _. I'_^. __ n a - m M _ _ N t) V m e N ., rce e-.. __—_ o m _ O, m e n '.n a .� a e o ry a o m O' O O Ir _ m u r_ r O ry _ � .� _ e' N O No N 1 N r _ N a CO _N m _ .. a CH, O m -. et, et 111 O d.§ `O N IN n O a) 0 ya - ' e' el r1 - G e E N N r - N r11 I 1 aZ+ Qo m m .. O u xi o - -'. r m - m e E Q O < - - " - - I - C 0 'p ZI I c h N c oo nIM N < ry CO . � _ yy CO Q C. o r a1 w e =I a oo-'�_ ry 8 Ia n. QQ u _ e _ I'1 N r+ a I - d Cc .1 I u2) o 0 __. ._ -_. — __. a ___ --T Oo N ier N " `14 b a -i CU Eo N ≥ c) r a 'z ": E 8 m a e et<I `o .nl� .I I w A -i B '8 .o als a r p z' z C — up n 8 6 Q Z E I h a 8 3 �I I',� c2 E A r 0 .2 ileo- u c M a c4 o JL 'o y y". "I= E t := c7) i 4,F c = g S �''.C vll 2,:a O �o a! O O`. m , ON @ m C � � d1e y ,`, p„, .3 olio: s Li al ee,� y �jy �' o 'ICI mI �''�9g 0: � dw o °) CV al c ca .. _ a C ,t " 6 0 0 E t 8 0 6 0 °i. m 0l ! N V� 0 -c 8 � �� o.� " � 5 aoust a. k- � � oI lw J ' ' a II V 0 Fi_J " " S _ I . y I " F z L M' m n a.,m d ur o. _ _ m r F- I w I 1 I SUPPLEMENTAL NARRATIVE TO RFP: EXHIBIT B CONDITIONS of Welcoc°el S .U^es Cleric"" Lutheran Family Services 2. 1 2005 of Colorado APR Services that heal,strengthen&provide hope April 27, 2005 Gloria Romansik Weld County Department of Social Services P.O. Box A Greeley, CO 80632 Dear Ms. Romansik: We are in receipt of the April 18, 2005 letter concerning the following bids that were submitted by Lutheran Family Services for FY 2005-06. 1. RFP 05010: Option B, Home Base Therapy (A mistake was made when submitted this bid as it was originally identified as RFP 05005. We have corrected it to read RFP 05010) 2. RFP 05005: Option B Lifeskills, Home Base Parent Coach (A mistake was made when submitted this bid as it was originally identified as RFP 05010. We have corrected it to read RFP 05005) 3. RFP 05005: Lifeskills, Visitation Lutheran Family Services hereby accepts the conditions set forth in our bid, which shall be applied to all 2005-06 contacts. In response to the condition that we define our capacity to do after-hours supervision, please be advised that Lutheran Family Services offers all three of the above contract services between the hours of 8:00 am and 8:00 pm, Monday through Friday. We look forward to working with you during the upcoming fiscal year. If you have any questions please c eat 303.217.5831. ce y, a es arclay resident/CE 363 S. Harlan St., Suite 200 • Denver, CO 80226-3552 • (303) 922-3433 • Fax (303) 922-7335 • www.lfsco.org mo I LSA Unt ay a DEPARTMENT OF SOCIAL SERVICES P.O. BOX A If GREELEY, CO. 80632 Website:www.co.weld.co.us Administration and Public Assistance(970)352-1551 Child Supped(970)352-6933 "Mow WI CM-Ott-ADO April 18,2005 James Barclay President/CEO Lutheran Family Services 3800 Automation Way, Suite 200 Fort Collins, CO 80525 Re: RFP 05005: (Corrected to 05010)Option B,Home Based Therapy RFP 05010 Option B,Home Based Parent Coach RFP 05005:Lifeskills,Visitation Dear Mr.Barclay The purpose of this letter is to outline the results of the Bid process for PY 2005-2006 and to request written information or confirmation from you by Wednesday,April 27,2005. A. Results of the Bid Process for PY 2005-2006 • The Families,Youth and Children(FYC)Commission recommended approval of Bids#05010, Option B-Home Based Therapy(Submitted under RFP 05005),and Option B-Home Based Parent Coach for inclusion on our vendor list. • The Families,Youth and Children(FYC) Commission recommended approval of Bid#05005, Lifeskills for inclusion on our vendor list, attaching the following condition for all Lifeskills program providers. Condition: All providers must define their capacity to do after-hours visitation. B. Required Response by FYC Bidden Concerning FYC Commission Conditions: All conditions will be incorporated as part of your Bid and Notification of Financial Assistance Award(NOFAA). If you do not accept the condition(s),you will not be authorized as a vendor unless the FYC Commission and the Weld County Department of Social Services accept your mitigating circumstances.If you do not accept the condition, you must provide in writing reasons why.A meeting will be arranged to discuss your response.Your response to the above condition will be incorporated in the Bid and Notification of Financial Assistance Award. - Page 2 Lutheran Family Services/Results of RFP Process for PY 2005-2006 The Weld County Department of Social Services is requesting your written response to the FYC Commission's condition.Please respond in writing to Gloria Romansik,Weld County Department of Social Services,P.O.Box A, Greeley, CO, 80632,by Wednesday,April 27, 2005,close of business If you have questions concerning the above,please call Gloria Romansik, 970.352.1551 extension 6230. Sincerely, y ego=. ec cc: Juan Lopez, Chair,FYC Commission Gloria Romansik, Social Services Administrator Weld County Department of Social Services Notification of Financial Assistance Award for Families,Youth and Children Commission(Core)Funds Type of Action Contract Award No. X Initial Award FY05-CORE-0022 Revision (FY-FYC-05005) Contract Award Period Name and Address of Contractor Beginning 06/01/2005 and Youth Emancipation&Services,Inc. Ending 05/31/2006 Lifeskills 3400 16 Street,Bldg. 3, Suite R • Greeley, CO 80634 Computation of Awards Description Unit of Service The issuance of the Notification of Financial Family therapy,mentoring, group therapy, support Assistance Award is based upon your Request for groups, lifeskills instruction,parenting education, Proposal(RFP). The RFP specifies the scope of employment, and crisis intervention services.This services and conditions of award. Except where it program is structured to serve youth 16 '/2 to 18 is in conflict with this NOFAA in which case the years of age. Total number of clients to be served NOFAA governs,the RFP upon which this award is 80.This is an estimate of 20 family units. is based is an integral part of the action. Bilingual-bicultural services are expected for 12 Special conditions families. It is estimated that 5-10 families will be 1) Reimbursement for the Unit of Services will be served from South Weld County.Maximum based on a monthly rate per child or per family. capacity is 8 families concurrently,monthly 2) The monthly rate will be paid for only direct face average capacity is 6, average stay is 12 weeks, to face contact with the child and/or family or as average hours per week is 2-6 hours, dependent on specified in the unit of cost computation. phase of service. Service provides 24-hour crisis 3) Unit of service costs cannot exceed the hourly and intervention. yearly cost per child and/or family. 4) Payments will only be remitted on cases open Cost Per Unit of Service with, and referrals made by the Weld County Hourly Rate Per $69.86 Department of Social Services. Therapeutic Staffing 5) Requests for payment must be an original Treatment Package-Intensive submitted to the Weld County Department of Treatment Package-High Social Services by the end of the 25th calendar day Treatment Package-Moderate following the end of the month of service.The Treatment Package-Low provider must submit requests for payment on Court Testimony $65.00 forms approved by Weld County Department of Enclosures: Social Services. X Signed RFP: Exhibit A 6) The Contractor will notify the Department of any X Supplemental Narrative to REP: Exhibit B changes in staff at the time of the change. Recommendation(s) X Conditions of Approval Approvals: Program fficial: n By at-i7/6...._, By , u William H. JerChair Judy 'ego, irecto9'V-it) v Board of Weld County Commissioners Weld un Department of Social Services Date: JUN 0 6 Date: 10 ? J OS ` , COOS ' lelyy SIGNED RFP: EXHIBIT A 4 INVITATION TO BID BID 002-05 (05005 -05011 and 006-00) DATE: February 16, 2005 BID NO: RFP-FYC-05005 RETURN BID TO: Pat Persichino,Director of General Services 915 10th Street,P.O. Box 758, Greeley, CO 80632 SUMMARY Request for Proposal(RFP-FYC-04005) for:Colorado Family Preservation Act- I;if Skills Program Emergency Assistance Program Deadline: March 11, 2005,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 Colorado Family Preservation Program Act(C.R.S.26-5.5- 101) and Emergency Assistance for Families with Children at Imminent Risk of Out-of-Home Placement Act (C.R.S. 26-5.3-101). The Families, Youth and Children Commission wishes to approve services targeted to run from June 1, 2005,through May 31, 2006, at specific rates for different types of service,the county will authorize approved vendors and rates for services only. The Life Skills Program must provide services that focus on teaching life skills, which are designed to improve household management competency,parental 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 JLUJE I� Z�— flC ,641/14,- ,*. /�G (After receipt of order) B ST BE SIGNED IN INK JP & D/, AAE4i TYPED OR PRINTED SIGNATURE VENDOR H jhit ail �iF,RY/GES v2C,�E �/�/ mancipation&Services, Inc. Hand en Signature By Authorized 0016th St., Bldg.3,Suite R Greeley,CO 80634 Officer or Agent of Vender ADDRESS TITLE XLCLG>/ke.- ;It 'e& e y DATE to—/o— ar PHONE# Quo- ` 3-5377 The above bid is subject to Turns and Conditions as attached hereto and incorporated. Page 1 of 33 • • Bid 002-05 (RFP-FYC-05005) Attached A LIFE SKILLS PROGRAM BID PROPOSAL AND REQUEST FOR CONTINUATION OF AWARD UNDER CORE SERVICES FUNDING EMERGENCY ASSISTANCE PROGRAM 2005/2006 BID PROPOSAL APPLICATION PROGRAM FUNDS YEAR 2005-2006 BID 002-05 (05005) NAME OF AGENCY: rr Q /� ADDRESS: �//11/Tff & /Mr /Dnd, Sn1//Gf-S r . / 4/v �6 t&_d t PHONE: no X5"."3--‘575-77, p �.a'� y/ 8D6. CONTACT PERSON: J'• /Vu.�ii TITLE: CxEcun✓& 0/tee-oz. DESCRIPTION OF FAMILY PRESERVATION PROGRAM CATEGORY: The Life Skills 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,effectively accessing community resources, and encouraging goal setting and pro-social values. 12-Month approximate Project Dates: 12-month contract with actual time lines of: Start June 1. 2005 Start End May 31, 2006 / End �/ y� TITLE OF PROJECT: /doe Sari/Gnxe/p47zA/ &64 y/-/'// Ars- AMOUNT REQUESTED: -4,004,(P. 44 5, MA,Lt -/1)-0,5 Name and Signature of Person Preparing Documen Date Judy A. Griego,Director Name and Signature Chief Administrative Officer Applicant Agency Date MANDATORY PROPOSAL REQUIREMENTS For both new bids and renewal bids,please initial to indicate that the following required sections are included in this Proposal for Bid.For renewal bids,please indicate which of the required sections have not changed from Program Fund Year 2004- 2005 to Program Fund year 2005-2006. Indicate No Change from FY 2004-2005 Project Description Target/Eligibility Populations Types of services Provided Measurable Outcomes Service Objectives Workload Standards Qualifications j1'Staff Unit of Service Rate Computation Program Capacity per Month Certificate of Insurance Assurance Statement Page 26 of 33 Bid 002-05(RFP-FYC-0500' Attached A Date of Meeting(s)with Social Services Division Supervisor: .9-3 —5 Comments by SSD Supervisor: L i / 0 1 w-I , 1/J 1141' ( -'/3/C Name and Signature of SSD Supervisor Date Page 28 of 33 Youth Emancipation & Services, Inc. 3400 16th Street, Suite 3-R Greeley,CO 80634 Bid 002-05 (05005) Life Skills Program Bid Proposal Funding Year 2005-2006 Proposal (Attachment A) Project Title: Life Skills/Emancipation Program—March 2005 Vendor: Youth Emancipation & Services,Inc. (YES) Contact Person: James P. Nelson MA,LPC Executive Director 0 I. Project Description What is YES,Inc.? Youth Emancipation& Services,Inc., (YES), is a private not-for-profit Colorado corporation. It is a cooperative venture of several youth service professionals who live and work in Weld County. This group of concerned professionals has come together to provide Weld County families with needed services, such as assessment, life skills education, individual, group and family therapy,emancipation preparation, family and community mediation services,and monitored apartment living. Our Mission The mission of YES is to be of service to families in Weld County who are at risk of broader involvement with the legal and social services systems.We seek to assist youth who have had a difficult adolescence to transition to adulthood in a responsible and sustainable manner.To accomplish our mission we will: L Network effectively with area professionals in the youth service field to identify needs which are under-served, and likely to respond favorably to a timely preventive intervention. 2. Develop quality programming designed to meet these targeted needs. 3. Partner with human service agencies,foundations and benefactors to generate community resources to provide services in the most effective way possible. 4. Provide top-quality stewardship of, and accountability for,community resources. 5. Provide ongoing evaluation of the effectiveness of services we provide in order to make improvements in what we do. 6. Provide timely reports to our referral sources to keep informed of our effectiveness. 7. Remain responsive to the needs of the community,open to new ideas and opportunities to be of service,while consolidating gains and expanding family resources. The Founders of YES are Masters level therapists who have had many years of experience in family therapy, social science research,community needs assessment, individual therapy,group therapy, mediation,and supervision.We have worked extensively with at risk teens and their families, in both a residential treatment and non-residential settings. Life Skills/Emancipation Preparation Program This program is structured to provide youth,aged 16 1/2 to 18 years,with life skills training and assistance in building a community support network which will ease the emancipation process and promote success in a shorter time frame than is traditionally allowed. At the same time,the kinship family itself is in need of support throughout this process, and this project is designed to provide this support as well. Emancipation and family support will be carried out using a full range of services explained later in this proposal.(See Section III. "Types of Services Provided".) Each family will be assigned a Masters level licensed therapist(LPC, LSW, LCSW, or LMFT)who will act as Intervention Coordinator. This person will deliver therapy, case management, and coordinate mentoring,collateral services,and c1q sroom instruction. Family contact will take place primarily during late afternoons,early evenings,and weekend hours when families are not at school or work. Crisis Intervention services will be available 24 hours a day, seven days a week,by phone or through our answering service. All areas of Weld County will be served, including the fast-growing South County area. 1 II. Target/Eligible Populations A. Total number of clients served: 80 persons By serving 20 family units,half of which are composed of 2 parents and half of which are composed of 1 parent,and avenging 2.5 children per household(one of whom will be the individual emancipating),the total of clients impacted will be 80. B. Total individual clients and their ages:20 youth These will be adolescents between the ages of 16%to 18 years of age. The youth will ideally be living with a kinship family, foster family or group home. Youth may also be currently living in an RTC setting,and be scheduled for discharge.* C. Total family units:20 families The program accommodates families with youth who do not currently meet the eligibility criteria for other life skills and/or emancipation programming, such as CHAFFE, due to not being a foster child, but who are struggling in their present home environment and are at risk of being removed. D. Bicultural/bilingual services: 12 families. Youth of any cultural and/or ethnic origin will be served. YES staff are culturally aware and are an ethnically and culturally diverse group. Consideration of and respect for established cultural patterns is an ingrained value in this organization. ** E. Clients receiving services in South Weld County: 5 families. This constitutes 25%of the total case load.This figure was arrived at by comparing population totals from north-central Weld with totals for the South Weld cities. F. Access to 24 hour service:20 families All client families will have access to 24 hour crisis intervention services through a 24 hour answering service. Each family's Intervention Coordinator,or designated on-call therapist,will respond to calls within one(1)hour. G. Maximum Program Capacity: 8 families concurrently. Maximum caseload for an intervention team will be 8 families. We will have two teams in place if awarded a contract.This insures that appointments can be kept without double-booking, support groups and classes will be of optimal size.However, if the Department would like to expand the program,we would be open to discussions on this topic. H. Monthly Average Capacity: 8 families I. Average stay in the program: 12 weeks J. Average hours per week in the program: Hours are flexible and can be arranged to meet existing contingencies. Following is a sample program. Phase 1. (1 month): 6 hours per week. Phase 2.(1 month): 4 hours per week Phase 3. (1 month): 2 hours per week (Total of 48 service hours) *Only youth with an I.Q. of 80 or higher will be served. While we realize that there is often a lack of services available for developmentally delayed individuals,this population is outside our area of expertise. **Weld County is a culturally diverse population center in Northern Colorado.Therefore, services will be delivered in a culturally sensitive manner.YES currently employs staff members who are aware of the issues of acculturation,enculturation and assimilation which are relevant in the present social milieu. Every effort will be made to provide a staff/client match with these issues in mind.YES currently employs Spanish speaking,culturally competent staff to deliver program services. 2 III. Types of Services Provided A.Therapeutic Services Case Planning and Case Management Services: The YES staff will meet with the Dept of Social Services caseworker to design an individual program to meet youth's needs and will report to the caseworker on a timely basis to keep caseworker informed of progress(at least monthly). The YES staff member will coordinate with the youth and family to access other needed community resources as well. Family Therapy: The Intervention Coordinator will be experienced in Family Therapy and will establish appropriate treatment goals and assist the family in working toward the accomplishment of those goals. Extended family and important others will be included in the process as is appropriate. Mentoring: The impact of a knowledgeable and diligent mentor with sophisticated counseling skills,working with families in their home environment cannot be underestimated. The ability to identify the opportunities to stimulate change,work with the key members of the system,and see that right action is taken at the right time, is very powerful in bringing about positive change. Our Intervention Coordinators have expressed frustration with the limitations of working with families in an office or institutional setting.They much prefer the opportunity to"see how it really happens"in the family environment and be able to initiate timely change through friendly,person-to- person interaction and support. Group Therapy/Support Groups: It will be invaluable for those youth who are in the process of emancipating and/or actually living on their own to have a sounding board in which to discuss and process issues related to the difficult challenges of adult living. Groups will be facilitated by a licensed master's level therapist who has experience in group therapy with this challenging yet rewarding population. B. Concrete Services Life Skills Instruction: YES staff will deliver self-paced instruction in Life Skills. Curriculum includes: • Nutrition,menu planning,food shopping, and preparation, • Home Safety,Maintenance,cleaning and repair, • Employability assessment,job-specific prospecting, application and interviewing skills, follow-up techniques, • Home budgeting,money management,banking, • Transportation,needs and affordability, • Finding and leasing an apartment,purchasing a home, • Clothing, shopping,maintenance and repair, • Time management and goal setting, • Personal values, social skills,refusal skills, and sound decision-making, • Community values, living with neighbors,coping with others expectations, • Understanding and managing anger • Accessing Community Resources • Alternative dispute resolution,problem solving, 3 Family Conflict Management: When internal conflict reduces the family's ability to work together to achieve common goals and interests,the YES team will teach dispute resolution skills to reduce stress and foster an atmosphere of cooperation rather than contention.The degree of conflict within the family will be measured using an assessment devise at the initiation of services,and at the termination of services. Parenting Skills: YES Team will teach child rearing and parenting skills, such as: • Effective boundary and limit setting, • Affection,nurturing,and positive reinforcement, • Importance of consistency and dependability, • Effective and safe discipline methods, • Monitoring and maintaining health, • Accessing behavioral assistance when needed. Apartment Location and Leasing: Finding appropriate housing can contribute a great deal toward success in the emancipation process. YES Team staff will teach housing acquisition skills and will assist the youth in practicing them in order to obtain safe affordable housing. Staff will also work with the youth and kinship family to furnish and decorate the new home. C. Collateral Services Accessing Community Support System: YES team will assess the family's connections with agencies in their community which they can access when needs arise. The team will then assist them in filling any gaps in the system through establishing personal contacts at agencies which provide health and medical services, legal assistance, etc. Education: Youth must have either completed high school, or be in the process of finishing.Youth must be eligible for enrollment in public school,attending a GED Program,or attending a Day Treatment Program which has an educational component.Youth who are in school or pursuing a GED will be assisted in finding part-time employment so as to save money for emancipation expenses. If the youth has already finished his/her education,the emphasis will be on securing full-time employment. Employment: Youth will be given a career assessment and skills evaluation,vocational interest measure,and get a full interpretation in order to determine what career area is most advantageous.Youth will be helped to write a resume,fill out applications for employment,taught how to interview appropriately, and otherwise assisted in fmding employment with a future. Physical and Mental Health System: Families must find and develop criteria for using local physical and mental healthcare providers.YES Team will assist family and emancipating youth to match providers with resources and location, develop resources for known chronic health concerns,and balancing treatment and prevention to avoid acute episodes. 4 D. Crisis Intervention Services Telephone Response: YES maintains 24 hour answering services with emergency paging. Intervention Coordinators(or a designated on-call therapist)will be available to contact the family or individual in the event of an emergency. Protocol calls for intervention over the phone as the first step. If phone intervention proves to be insufficient,the responding therapist will assess the level of severity of the incident and take appropriate action, including calling police, ambulance, etc., if danger is imminent. Personal Visit: If the situation would not pose a safety problem for the staff member,they may visit the home on an emergency basis. Otherwise,a safe neutral meeting place will be maintained in the event of the need for person-to-person contact outside the home,or the family may choose to come to the office. Intervention Coordinators and on-call personnel are trained in crisis intervention procedures and follow pre-determined written protocols. IV. Measurable Outcomes A. Youth will have transitioned to a home of his/her own,and therefore will not remain at home at the time the case is closed. This will be reflected in our monthly progress reports,and case termination report. B. Improvements in parental competency,reduction in parent/child conflict, and improvements in household management will be reflected in completion of Skills Units and in scores on pre- post referral competency assessments. These scores will be compared in the form of bar graphs which will be attached to the case termination report. This report will be delivered to the department no later than 30 days after the termination of YES involvement in the case. C. Youth who are in the kinship home at the time of referral to our agency will have successfully transitioned to a home of their own and be performing satisfactorily as reflected in monthly step-down service reports.A quarterly contact summary will be prepared on each referral after emancipation for a period of one year.This information will be mailed to the department caseworker or supervisor in written form no later than 30 days after the close of the quarter. D. Youth who are currently in long-term placement, and who are in the process of reunification at the time of referral,will be living their family home,and will not be in residential placement,DYC custody,or under adult judicial proceedings within 12 months of the termination of YES services. A quarterly contact summary will be prepared on each referral after emancipation,for a period of one year,and a report will be mailed to the department caseworker or supervisor. E. Since parental rights will have been terminated,the quality of the relationship with the kinship home family will be more relevant to success than the youth's relationship with his bio-parent(s). The degree and consistency of support provided to the youth after emancipation will be a subject of the quarterly follow-up reports.These follow-up summaries will be shared(see items C. and D. above). F. Qualitative reports will be accumulated into quarterly summaries which will be used for Continuous Quality Improvement purposes.These will also be released to the department if requested. YES staff will prepare an annual report listing the number of referrals given,referrals accepted,and will chart the disposition of each case on a grid, giving a thorough and detailed breakdown of each case,as well as totals by month, and annual totals.YES will have each client sign a contact sheet at the time of each visit and will be prompt and timely in filing billing and case management forms with the Department. 5 V. Service Objectives A. Improve Family Conflict Management • To keep youth from being removed from the home, family conflict management skills will be addressed using the mentoring and in home family therapy treatment modes.If youth has a high rate of truancy from school,running from the home,disregard for family/home rules,or history of abuse,conflict management will be a top priority. This will be reflected in the family treatment plan. • If youth have already been removed,reuniting the family with targeted support and assistance will be a top priority. Getting buy-in to provide concrete assistance with the emancipation of the youth and outlining the concrete tasks and conditions which require family assistance will be the key. These will be written into the family's treatment plan. The degree of family conflict will be measured at the initiation of services and again at the termination of services. B. Improve Parental Competency To assist clients in adopting and passing along to their children, an improved and more effective life style, YES Team will teach child rearing and parenting skills, such as: • Effective boundary and limit setting, • Affection,nurturing,and positive approval, • Importance of consistency and dependability, • Effective and safe discipline methods, • Monitoring and maintaining health, • Accessing behavioral assistance when needed. YES Team members will use the Family Strengths Assessment to determine the degree of parental competency at referral,and will include in the family treatment plan steps to consolidate assets and develop areas of weakness. Post- intervention results will determine what gains have been made. C. Improve Household Management Competency Household management competence will be measured by YES Team observation and completion of Life Skills learning units having to do with the operation of a household. D. Improved Ability to Access Resources: YES team will assess the family's connections with agencies in their community which they can access when needs arise. The team will then assist them in filling any gaps in the system through establishing personal contacts at agencies which provide health and medical services, legal assistance,etc.The family, and the emancipating youth,will have a complete selection of resources and personal contacts at each community resource by the end of the intervention. E. Satisfactory and Timely Performance: YES Team will make every effort to see that the client family completes the treatment plan within the agreed upon time frame. 6 V. Workload Standards Intervention Coordinators(Licensed Masters level staff),will be assigned based on a ratio of 3:2, (direct contact hours to non-direct hours). Mentors are assigned based on a ratio of 4:1. A. Phase 1. (1 month): 6 hours per week. Phase 2.(1 month): 4 hours per week Phase 3.(1 month): 2 hours per week B. Total number of staff providing services will vary with the number of referrals. Under the present circumstances,the maximum number of families which can be accommodated is 8 per month (average of 8). However, if the sustainable caseload is larger than 20 families per year,we are willing and able to expand to accommodate more. Expansion to accommodate a larger caseload has been planned for in our Strategic Plan. We have currently identified 6 employees for this project,(3 Intervention Coordinators and 3 Mentors). We will begin with one team(I Coordinator, 1 Mentor,and 1 Supervisor)and see how the referral base develops. C. Maximum caseload per worker is 8. D. Modality of treatment will vary with the family's needs and the treatment plan. However, generally,we are planning for a combination of Family Systems based In-Home Family Therapy and Mentoring. E. (See Item IV. A.,above) F. Total number of persons who will initially provide services is 3.This figure is expandable. G. Maximum caseload for each Supervisor is 6 Supervised Masters level therapists. H. (See Attached Affidavit of Insurance) VII.Staff Qualifications A. YES personnel have extensive experience in Marriage and Family Therapy,Individual and Group Therapy with adolescents,Emancipation Programming, Social Work, Case Management,Family and Community Mediation. B. Staff are qualified according to Staff Manual Volume VII, Section 7.303.17,and Section 7.0006, Q. of the Colorado Department of Human Services Regulations. C. Total Number of staff available for this project is 6(1 LMFT, 1 Family Mediator, 1 Case Manager/Intervention Coordinator, and 3 Mentors).Licensed staff members are experienced in risk assessment. Mentors are not. D. We will complete this training at the earliest possible opportunity if awarded the opportunity to serve. 7 V. Unit of Service Rate Computation (Please see attachments) 8 IIIII I I I I I I I I 0 0 0 0 0 0 co co CO 0 ID 3 r 5 N 0 LO CO w J N a) t N r v.' c7 r a m (A (A d9 H f9 H S (.) a CO I— act W tu a r o O L r r N pppp N A M m I• ~1. N N CD , ID r a0 N 0 W 0 to ca comco mco {c pp - EA a S S CO S S O le; fA O COQ q W co,: >. (7 au) d 0 cc 5 f. 8 O 0 re O Woca a m m t O 0 I— >- w a0 X Q U wir z W0 w QQ ¢ cc cc w 0 w 2 C7 p 0 a LL 0 g + LL w w 5 (0 LL w W 0 O re 0 + _ O 0 5 w > co a W < + 5 LL w w V O F IX = W I . CI) CO w F U O U W cc 0 0 0: Q U O W m 0 CO O (6) (9 a OLL 2 8 O O 0 5 6 = O O O cc w LL LL O = F- a LL W Y a w w O < 00 w CC m cn w O -, 2 co >O ow 0) !o 0/) W W a ac} F ~S 2 w W Er_ w w w -cc ww 0 m O w w > cc Cr w cc a' F- z J ¢Oa cr LL cc a w a a ce a O 0 z CO K Z co a O W U U O a O U O r W H OJ u U O O UQ K W Q U (O _i Z 0 0! Q UO 0 °° } > O Q 2 LL a } 0y >- <>- OF o a w z F < O z O z z m O a ¢ O � Z 0 CC Z K O U F' 00 0 O H CO O_ DO p a 0 0 w ct 0 W W co D U CO 2 O 2 W 0 c~i) w c8 Q 0 I w O F- . a z a a � 00 F¢- •F- F co F c w Fa— F- r a F 3 D re 0 0 0 0 0 O > 0 Z O O < 0 0 a F- F- F- O F- Q 0 F- < F- F- a F- O Q CO 0 O W LL 0 I _ -1 Y _I Youth Emancipation &Services March 10, 2005 To Whom It May Concern, This is to certify that Youth Emancipation & Services, and Nelson, Wolf& Associates, it's principle employees, property, facilities and vehicles are insured according to the standards of Weld County Government for the purposes it has undertaken on behalf of the County, and that at the present time due to contracts currently in force, Weld County is a named Co-insured on all policies. A current declarations page is currently on file with the Business Office of the Department of Social Services. Sincerely, James P.Nelson Executive Director 3400 16th Street, Bldg 3R•Greeley, CO 80634•tele:970.353.5577•fax: 970.356.7280•www.grifnyes.org•email:gh@griffinyes.org SUPPLEMENTAL NARRATIVE TO RFP: EXHIBIT B CONDITIONS • Youth Emancipation & Services 69 Judy Griego, Director I Weld County Department of Social Services U8 P.O. Box A Greeley, CO 80632 April 27, 2005 Re: RFP 05005: Lifeskills RFP 05010: Option B, Home Based Services RFP 05008: Intensive Mediation under Intensive Family Therapy Dear Ms. Griego, Thank you for opportunity to be of service to the Department again this year. We will be happy to abide by and fulfill the conditions of the contracts under the above named RFP's. As regards Condition#1. ( Mediation);This is acceptable and will be observed as an ordinary ethical constraint. As regards Condition#2. (Workload Standards); As I am the only trained mediator in the office at the present time, and because of my other duties, I can only conduct one case each week. However, my personal assistant can help coordinate schedules and we now have access to an adequate meeting room. Therefore, I feel confident that we can conduct four(4) cases per month in a satisfactory manner. As regards the Condition(Lifeskills); After-hours visitation, my assumption is that most (if not all)these cases will occur after hours. We are therefore able to schedule visits and consultations Monday through Saturday at the convenience of the client up to 8:00 PM. We provide our therapists with cell phones and alternate taking emergency calls on a 24 hour/day, 7 day per week basis. - I will need additional information from John Kruse as to the back-up documentation which you request in your letter of April 18, 2005. I will contact him this week and provide the information as soon as possible. 3400 16th Street, Bldg 3R•Greeley, CO 80634•tele: 970.353.5577 •fax:970.356.7280•www.griffinyes.org•email: gh@griffinyes.org Again, Thank You and the Commission for the opportunity to be of service. We look forward to working with you again this year. Sincerely, im P.Nelson MA, LPC Executive Director 1;-%;st: DEPARTMENT OF SOCIAL SERVICES P.O.BOX A GREELEY,CO. 80632 Website:www.co.weld.co.us Administration and Public Assistance(970)352-1551 111 ID Child Support(970)352-6933 O • COLORADO April 18,2005 Jim Nelson,MA,LPC Youth Emancipation&Services,Inc./ Nelson,Wolf and Associates,P.C. 3400 16 Street,Bldg 7,Suite MM Greeley,CO 80634 Re: RFP 05005: Lifeskills RFP 05010: Option B,Home Based Services RFP 05008:Intensive Mediation under Intensive Family Therapy Dear Mr.Nelson: The purpose of this letter is to outline the results of the Bid process for PY 2005-2006 and to request written confirmation from you by Wednesday,April 27,2005. A. Results of the Bid Process for PY 2005-2006 • The Families,Youth and Children(FYC)Connrussion recommended approval of the bid,RFP 05010 Option B-Intensive Home Based Therapy for inclusion on our vendor list. • The Families,Youth and Children(FYC)Commission recommended approval of the bid,RFP 05008 Mediation under Intensive Family Therapy,for inclusion on our vendor list with the following conditions.Condition#1 is applicable to all Intensive Mediation providers,while Condition#2 is specific to your program. Condition#1: If a consultation has occurred between a party to this action,and any party objects to the proposed mediator because of that consultation,the mediator shall remove himself/herself from performing the mediation. Condition#2:The provider will clarify"Workload Standards"as requested in the RFP. • The Families,Youth and Children(FYC)Commission recommended approval of the bid RFP 05005, Lifeskills for inclusion on our vendor list with the following condition for all Lifeskills providers. Condition: All providers must define their capacity to do after-hours visitation. • Review of Service Rate Computations for All Submitted Bids: Back-up documentation for cost sheets was not provided for all submitted bids. Page 2 Youth Emancipation&Services,Inc./Nelson Wolf&Associates/Results of Bid Process 2005-2006 B. Required Response by FYC Bidders Concerning FYC Commission Conditions. 1. FYC Commission Conditions: All conditions will be incorporated as part of your Bid and Notification of Financial Assistance Award(NOFAA).If you do not accept the condition(s),you will not be authorized as a vendor unless the FYC Commission and the Weld County Department of Social Services accept your mitigating circumstances.If you do not accept the condition,you must provide in writing reasons why.A meeting will be arranged to discuss your response.Your response to the above conditions will be incorporated in the Bid and Notification of Financial Assistance Award. 2. Unit of Service Rate Computations: You are requested to provide back-up documentation to John Kruse,Business Office Manager. You may contact him at extension 6530 if you have questions. The Weld County Department of Social Services is requesting your written response to the FYC Commission's conditions.Please respond in writing to Gloria Romansik,Weld County Department of Social Services,P.O.Box A,Greeley,CO, 80632,by Wednesday,April 27,2005,close of business. If you have questions concerning the above,please call Gloria Romansik at 352.1551,extension 6230. S. cerely, ^ A. ego, tor cc: Juan Lopez,Chair,FYC Commission Gloria Romansik, Social Services Administra or 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 05-CORE-LS-0002 Revision (RFP-FYC-05005) Contract Award Period Name and Address of Contractor Beginning 06/01/2005 and Ackerman and Associates P.C. Ending 05/31/2006 Lifeskills 1750 25th Avenue, Suite 101 Greeley, CO 80631 Computation of Awards Description Unit of Service The issuance of the Notification of Financial Home based visitation and mentoring. Program Assistance Award is based upon your Request for consists of(1) assessment, goal setting, and Proposal (RFP) and the Addendum RFP information. compiling treatment goals; (2) mentoring to The RFP specifies the scope of services and achieve treatment goals through home-based conditions of award. Except where it is in conflict interactions, and(3) visitation observations, with this NOFAA in which case the NOFAA governs, recommendations and directed teaching to the RFP upon which this award is based is an integral implement changes in visitation setting. 24-hour part of the action. crisis intervention. Maximum number of families per month is 10, monthly average is 2, Special conditions average stay is 5 hours for Part 1, 15 hours for 1) Reimbursement for the Unit of Services will be based Part 2, and 10 hours for Part 3. on a designated per family group conference. Bilingual/bicultural services. 2) The designated rate will be paid for only direct face to face contact with the child and/or family, as Cost Per Unit of Service evidenced by client-signed verification form, as Hourly Rate Per $100.00 specified in the unit of cost computation. Therapeutic Staffing 3) Unit of service costs cannot exceed the designated Treatment Package-Low rate and yearly cost per child and/or family. Visitation 4) Payment will only be remitted on cases open with, Treatment Package-Intensive and referrals made by the Weld County Department Interpreter $35.00 of Social Services. Court Testimony $100.00 5) Requests for payment must be an original submitted to the Weld County Department of Social Services by the Enclosures: end of 25`h calendar day following the end of the month of service. The provider must submit requests X Signed RFP: Exhibit A for payment on forms approved by Weld County X Supplemental Narrative to RFP: Exhibit B Department of Social Services. Recommendation(s) 6) The Contractor will notify the Department of any X Conditions of Approval change in staff at the time of the change. Approvals:y '/ Program Official: al By " "1,`I" By- l.t l k William H. Jerke, Chair Judy . Grie o, Director Board of Weld County Commissioners Wel ounty e ailment of Social Services p Date: JUN 0 6 11115 Date: l0 a- u5- SIGNED RFP: EXHIBIT A INVITATION TO BID BID 002-05 (05005 —05011 and 006-00) DATE: February 16,2005 BID NO: RFP-FYC-05005 RETURN BID TO: Pat Persichino, Director of General Services 915 10th Street,P.O. Box 758, Greeley, CO 80632 SUMMARY Request for Proposal (RFP-FYC-04005) for:Colorado Family Preservation Act--Life Skills Program Emergency Assistance Program Deadline: March 11, 2005, 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 Colorado Family Preservation Program Act (C.R.S.26-5.5- 101) and Emergency Assistance for Families with Children at Imminent Risk of Out-of-Home Placement Act (C.R.S. 26-5.3-101). The Families, Youth and Children Commission wishes to approve services targeted to run from June 1, 2005, through May 31, 2006, at specific rates for different types of service, the county will authorize approved vendors and rates for services only. The Life Skills Program must provide services that focus on teaching life skills,which are designed to improve household management competency,parental 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...Statemeent of Work /' Delivery Date O-r // di 9-OO5— (After receipt of order) BID MUST BE SIGNED IN INK Qo c e Mize r,la..t Ed.. ). TYPED OR PRINTED SIGNATURE VENDOR kit {nu" a.,i OC/QTa4_ Pc tat. (Name) H tt Signature By Authorized O or Agent of Vender • ADDRESS l7Sa v2.�-C�, ,4ve. /DI TITLE PsyJoloil s Gre.e I Co loro.d.a Bo63y DATE iacrd (o 2-p Or PHONE# D 3S-2'33 r) The above bid is subject to Terms and Conditions as attached hereto and incorporated. Page 1 of 33 Bid 002-05 (RFP-FYC-05005) Attached A LIFE SKILLS PROGRAM BID PROPOSAL AND REQUEST FOR CONTINUATION OF AWARD UNDER CORE SERVICES FUNDING EMERGENCY ASSISTANCE PROGRAM 2005/2006 BID PROPOSAL APPLICATION PROGRAM FUNDS YEAR 2005-2006 BID 002-05 (05005) NAME OF AGENCY: R c k /4 5 S o C I u2Z....- P. C . ADDRESS: i ')S✓ aR S-rk Ave Sa..cce 1O1 / G re e l,_ Co [06 37 PHONE: 7?o-3S3- 3393 A'. /920 3r3 - 339v CONTACT PERSON: v 0yce Acktr"On EA.f. TITLE: ,SycGalo/-cST DESCRIPTION OF FAMILY PRESERVATION PROGRAM CATEGORY: The Life Skills 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,effectively accessing community resources,and encouraging goal setting and pro-social values. 12-Month approximate Project Dates: _ 12-month contract with actual time lines of: Start June 1.2005 Start End May 31, 2006 2p pp End •TITLE OF PROJECT: c.6ttrn\.,. aro� 4SSOGta Lt e SkIlS A r?raatr. AMOUNT REQUESTED: / /fiber.194.4T ryp Adler "w,,. EeL0.�� Al" 14ciertruly, /ti0 Z . ..�.T ) Ailtrd lo, 9-005 Name and Signature of Person Preparing Docum Date Judy A. Griego,Director 3 — \ �— Name and Signature Chief Administrative Officer Applicant Agency Date MANDATORY PROPOSAL REQUIREMENTS For both new bids and renewal bids,please initial to indicate that the following required sections are included in this Proposal for Bid. For renewal bids,please indicate which of the required sections have not changed from Program Fund Year 2004- 2005 to Program Fund year 2005-2006. Indicate No Change from FY 2004-2005 ✓ Project Description 7 Target/Eligibility Populations ✓ Types of services Provided / Measurable Outcomes —7 Service Objectives I Workload Standards ✓ Staff Qualifications / Unit of Service Rate Computation / Program Capacity per Month —7 Certificate of Insurance _/Assurance Statement Page 26 of 33 • • Bid 002-05 (RFP-FYC-05005) Attached A ----------------------------------------------------------------- Date of Meeting(s)with Social Services Division Supervisor: 2 ≤ S Comments by SSD Supervisor: 176311-- A.373--1 o2 CSO-Cti cte xt LM 27 Name and Signature of SSD Supervisor Date Page 27 of 33 Bid 002-05 (RFP-FYC-05005) Attached A Program Category Life Skills Program Bid Category p Project Title Ririe r m.— v,-4. /tss o ow Zc.- to;At Ski l&& /r�y_ Vendor ite r m _ ora lasso cta Tn. l/ PROJECT DESCRIPTION Provide a brief one-page description of the project. II. TARGET/ELIGIBILITY POPULATIONS Provide a brief one-page description of the proposed target/eligibility populations. At a minimum your description must address: A. Total number of clients served. B. Total individual clients and the children's ages. C. Total family units. D. Sub-total of individuals who will receive bicultural/bilingual services. E. Sub-total of individuals who will receive services in South Weld County. F. The monthly maximum program capacity. G. The monthly average capacity. H. Average stay in the program (weeks). I. Average hours per week in the program. III. TYPE OF SERVICES TO BE PROVIDED Provide a two-page description of the types of services to be provided. Address if your project will provide the service minimums as follows: A. Mentoring: Address, at a minimum,the following ways the project will: 1. Teach,model, and coach adaptive strategies; 2. Model and influence parenting practices; 3. Teach relational skills; 4. Teach household management,including prioritizing, finances, cleaning, and leisure activities; 5. Actively help to establish community connections and resources; 6. Encourage goal setting and pro-social values. B. Visitation: Address, at a minimum, the following ways the project will: 1. Monitor parent/child interactions for physical and emotional safety; 2. Document clinical observations; 3. Strategize for teaching and modeling parenting skills; 4. Teach relational skills; 5. Encourage goal setting and pro-social values; 6. Plan structured activities in visitation to help achieve the objectives of the treatment plan. Page 28 of 33 Bid 002-05 (RFP-FYC-05005) Attached A Provide your quantitative measures as they directly relate to each service. At a minimum, include the number to be served in each service component. Describe your internal process to assure that FYC resources will not supplant existing available services in the community; e.g. mental health capitation services, ADAD and professional services otherwise funded. IV. MEASURABLE OUTCOMES Provide a two-page description of your expected measurable outcomes of the project.Address the following measurable outcomes: A. Improvement of household management competency as measured by pre and post assessment instruments and/or documented observations. B. Improvement of parental competency as measured by pre and post assessment instruments and/or documented observations. C. Parents can independently work with other sources in the community and within the local, state, and federal governments. D. Families receiving Life Skills services will remain intact six months after discharge of the services. E. Families/participants who complete the Life Skills Services will have improved competency level or reduced risk on the standardized assessment, such as the risk assessment tool. Describe your quantitative measures: Also, describe the methods you will use to measure, evaluate, and monitor each quantitative measure. V. SERVICE OBJECTIVES Provide a one-page description of your expected service objectives and quantitative measures. Mentoring: A. Improve Household Management Competency-capacity of parents to provide a safe household environment for their children through competent household cleaning and maintenance, budgeting,purchasing, and leisure activities; B. Improve Parental Competency-capacity of parents to use adaptive strategies, maintain sound relationships with their children and provide care, nutrition,hygiene, discipline,protection, instruction, and supervision; C. Improve Ability to Access Community Connections and Resources-services shall assist parents to work with other sources in the community and the local, state, and federal governments; D. Improve goal setting and pro-social values. Visitation: A. Improve parenting skills, parent/child interactions and relational skills for physical and emotional safety through structured activities in, and documentation of, visitations to achieve the objectives Page 29 of 33 •• Bid 002-05 (RFP-FYC-05005) Attached A of the treatment plan; B. Improve goal setting and pro-social values. Describe the methods you will use to measure, evaluate, and monitor each service objective. VI. WORKLOAD STANDARDS Provide a one-page description of the project's workload standards and quantitative measures. Address, at a minimum, the following areas. A. Number of hours per day,week, or month. B. Number of individuals providing the services. C. Maximum caseload per worker. D. Modality of treatment. E. Total number of hours per day/week/month. F. Total number of individuals providing these services. G. The maximum caseload per supervisor. H. Insurance. VII. STAFF QUALIFICATIONS Provide a one-page description of staff qualifications and address, at a minimum, the following: A. Will your staff, including supervisors,who are providing direct services,have the minimum qualifications in education and experience as defined in Staff Manual Volume VII, Section 7.303.17, and Section 7.0006, Q, Colorado Department of Human Services?Describe. B. Total number of staff, including supervisors, available for the project. VIII. UNIT OF SERVICE RATE COMPUTATION The budget form is to be used to provide detailed explanation of the hourly or daily 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 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,bills must be for hours or days of direct services 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. The rate for court testimony includes preparation of and actual court testimony during the term of this contract. Please list your requested rate for court testimony separate from your direct hourly rate for client services. There are two different ways to fill out the budget form. The budget can either be done manually or Page 30 of 33 Bid 002-05 (RFP-FYC-05005) Attached A Program Budget worksheet. (G) This represents the agency overhead costs, such as rent,utilities, supplies,postage, travel reimbursement,telephone charges, equipment, depreciation, data processing, interest, and taxes which are not incurred in providing direct, face-to-face service to the client,but can be allocated to this program for time spent on the program for activities such as travel,phone conversations, no-shows, discussions with involved parties, meeting preparation, and report completion. On the manual budget, all highlighted areas on the Overhead Costs and Profits worksheet must be completed according to the descriptions. The Total Overhead Costs must be carried over to the Program Budget worksheet. The computerized budget, once all of the highlighted areas are filled,will automatically carry over to the Program Budget worksheet. (H) This represents the total of all direct face-to-face costs, admin direct non face-to-face costs, and overhead costs. On the manual budget, this will have to be manually calculated by adding these three total costs together. The computerized budget does it automatically. (I) This represents the total amount of profit your firms expects to realize as a result of operating this program. Any difference between lines(H) and(J)must be substantiated by an amount indicated on this line. The manual budget, this amount will be entered on the Overhead Costs and Profit worksheet and then have to be carried over to the Program Budget worksheet. The computerized budget, once it is filled in on the Overhead Costs worksheet, it will then automatically be carried over to the Program Budget worksheet. (J) This represents the total costs and profits added together. This is (H) and(I). On the manual budget, it will have to be calculated manually on the Program Budget worksheet. The computerized budget will automatically calculate it on the Program Budget worksheet. (K) This represents the total hours or days of direct service for the year. This is ( C) above. On the manual budget,you will have to carry this number down from( C ). On the computerized budget, it is automatically carried down. (L) This is the actual direct, face-to-face hourly or daily rate at which you will be requesting payment for the services provided under the conditions of this Request for Proposal. This amount cannot be more then what is charged to the general public or collected from insurance providers. On the manual budget, this amount must be calculated by taking the total costs and profits(J) and dividing it by the total hours or days of direct service for the year(C or K). The computerized budget automatically calculates this total. All providers who receive a NOFAA must also submit a certified computation of the organization's actual expenditures for the approved Core Service program by January 31, 2006, for a seven-month period from June 1, 2005 to December 31, 2005. The actual expenditures must be submitted in the same format as the budget was prepared. The certification language must be the same as on the Computerized Actual Expenditures worksheet. The document must be signed by the Chief Executive Officer or the authorized officer of the bidder in order for it to be considered certified. Page 32 of 33 Bid 002-05 (RFP-FYC-05005) Attached A The use of the actual program expenditures is to insure that the direct, face-to-face hours/daily rate is comparable to the budget computation. The actual numbers will be taken into consideration for the 2006-2007 Request for Proposal for that specific program. Page 33 of 33 Project Description, 2005-2006 Life skills mentoring and visitation program Overview: Ackerman and Associates, P.C. proposes to deliver, for a third year, a life skills home based visitation and mentoring program for 2005-2006. We have had a very successful past ten years of operation delivering a variety of programs for core services clients through WCDSS. This proposal incorporates our accumulated experiences since we began working with WCDSS in the early 1990's. Target families are either facing imminent out of home placement or the family has a member who has returned from foster placement. However, it is envisioned that the life skills eligible families may be more amenable, based upon caseworker and supervisor assessment, to a directed learning approach as opposed to other families who are judged as needing more intensive treatment to avoid placement or be reunified with their children. The life skills activities consist of the following scope of work: Part one: Assessment, goal setting and compiling a set of written treatment goals. Total up to five hours Part two: Mentoring to achieve the treatment goals through home based interactions. Up to fifteen additional hours Part three Visitation observations, recommendations for parental change and directed teaching to implement those changes in a visitation setting. Up to ten additional hours These solution focused services are designed to help maintain placement at home or to help reunification succeed and to produce lasting change in parental interactions to avoid future return into the WCDSS services pool. Strategies are included in this proposal to time limit the delivery of services to an initial assessment and feedback of no more than five hours followed by up to twenty five hours of directed learning services. The mentoring portion of the directed learning services are focused on the treatment goals that are derived from the initial assessment and the caseworkers plan for the family as documented in the referral. The visitation portion of the delivered services derives from observations of parent child interactions and the creation of a directed learning program for the parent to modify observed behaviors to improve interaction with the index child. Entry into the second and third part of the program would involve construction of very clearly defined and measurable goals for the family to achieve during the program. Such goal construction would be completed and accepted by the client by the end of the fifth hour of contact. Purpose: We propose to provide life skills services in Weld County usually in the client's home. These services: 1. Produce a detailed treatment plan during the first five hours of contact, 2. Provide mentoring services to parents whose children are at risk of imminent placement or whose behaviors prevent reunification. These mentoring services derive from the assessment and treatment plan created in part one. Activities are to consist of : teaching, modeling and coaching to influence parental and adaptive strategies, teaching relational skills especially age appropriate child parent expectations and activities, interpersonal, listening and child rearing skills, teaching household management including setting goals and achieving them for prioritizing finances, cleaning and leisure activities, actively helping the parent access needed community connections, learning how to gain access to resources and encouraging early goal setting and socially appropriate values. 3. Provide observation and mentoring at visitation services in our offices, a supervised visit location or in parent's home. We are not proposing to offer visitation services on routine basis to assure physical and emotional safety, though we will provide that service when we are the only professionals supervising the visit. Our primary activity in this format, because all providers are licensed mental health professionals, will be in documenting clinical observations, to create a plan for the teaching and modeling of parenting skills based upon observed and reported areas of difficulty, and to proactively plan future activities to help the parent learn appropriate relational and parenting skills specific to their personal needs. In this way, either through our agency or through other agencies WCDSS can use the plans created. Overall, the program will help parents set appropriate and socially proactive goals for themselves and for their interactions with their children. Design: The strength of our staff in this project, in experience, in bilinguaUbicultural service delivery and in the prior delivery of home-based services and goal directed short term therapy services for WCDSS clients to over several hundred 2 client families are considerations we think are important for the reviewers of this proposal. Emily Jaramillo, M.A., is a bilingual licensed professional counselor from the Greeley community with a master's degree in counseling. She also self-identifies as Hispanic. She has worked in the Family Recovery Center and in educational support for minority students at UNC as well in private practice, including work for Home Based clients for several years. Dr. Joyce Ackerman, Licensed Psychologist, is director of Ackerman and Associates and clinical supervisor of the program Each part of the scope of work is designed to stand alone although Part one should precede either Part two or Part three. If WCDSS desired only the visitation component or the mentoring component either of these could be selected providing a number of ways to tailor the cost of the program to the needs of the client and the department. For example, Part one only would be five hours of service, Part one and Part two would be up to twenty hours of service, Part one and Part three would be up to fifteen hours of service and if all parts were required that would total up to thirty hours of service. Target/Eligibility Populations A. Total number of clients to be served. Two families per month times twelve months equal 24 families per year. If we assume a family size of six, two adults and four children, the total client pool to be served is 138 individuals. That number includes at least 24 individuals who face either imminent out of home placement or who need reunification services. B. Distribution of clients. Total number of clients we will serve is approximately 138 as calculated above. Our experience suggests we would expect approximately 48 of these to be adult members of the family and approximately 90 to be minors. The age of distribution of the index case children would tend toward the younger children based on our experience with WCDSS. We estimate that about one third of the index children would be older than ten with an average age of about 14 and about two thirds would be under ten. The older group would most likely be teenagers in conflict with their family. The younger group will consist of children of no particularly predictable age whose parents are in conflict usually in relation to instability in the marriage. Mentoring and visitation needs will be age sensitive. C. Families Served. We would anticipate serving up to 24 family units. D. Sub total who will receive bicultuSlb finnual services. As stated above, Emily Jaramillo Montoya is a master's level counselor (who is also Hispanic of Mexican American heritage)who can provide services in Spanish or English. 3 She will serve up to 20 of the 24 of the projected caseload. Thus, more than 80% of the projected total will be able to be conducted bilingually. All of the services provided (for a maximum of 24 families) would be done in a manner that is sensitive to the culture of origin of the family. E. Accessibility. All providers of Ackerman and Associates are arressible through a 24 hour answering service, cell phone and pager system. On weekends, our 24 hour access reaches the provider on call who is always a licensed Mental Health Provider. These providers are Laurence Kerrigan, Ph.D., Susan Plock Bromley, Psy.D, Emily Jaramillo Montoya, M.A. L.P.C., Joyce Ackerman, Ed.D., and Tom Pappas MSW, LCSW. F. Maximum per month. The program maximum is two families accepted into the program per month. H. The monthly average capacity is two families per month. I. The average stay in the program is defined under the purpose section of this proposal. It is five hours for part one, fifteen hours for part two and ten hours for part three. Types of Services Provided We will provide the following solution focused services to all families in the program. Specific details that further define these services are in the section of this bid called Service Objectives. We are using the following strategies to help families attain desired outcomes: 1. Assessment and evaluative services are provided in the first five hours. The structure of the evaluation is based upon the referral criteria provided by WCDSS. 2. Mentoring services derive from the assessment and provide services similar to those provided by solution focused goal oriented short term interventions. Techniques to achieve parental redirection include teaching, modeling appropriate behaviors, and coaching a parent though a scenario commonly encountered that presents problems for that parent. For example choices that may eventually lead to situations that would endanger a child or create a situation of potential neglect will serve as opportunities to develop more socially appropriate behaviors. 3. Teaching relational skills, especially age appropriate child parent expectations and activities, interpersonal, listening and child rearing skills will be an important component of the mentoring program. 4 4. Teaching household management including setting goals and achieving them for prioritizing finances, cleaning and leisure activities will be an additional area covered under the mentoring program. 5. Access to needed resources is also an area addressed in the life skills program. This requires actively helping the parent access needed community connections and teaching how to gain access to resources. 6. Overall, the process of educational change needs to direct the parent toward a consistent and self desired pattern of setting appropriate goals early on as opposed to responding to crisis situations and in developing behavior patterns which reflect a commitment to social responsibility in the best interest of the child. 7. Visitation which is our primary activity in this format (because all providers are licensed mental health professionals), will be in documenting clinical observations. Our purpose is to create a plan for the teaching and modeling of parenting skills based upon observed and reported areas of difficulty. We can share this plan with other life skills providers or can proceed to implement it if directed to do so by the caseworker. 8. Based on these visitation observations and recommendations, a plan for future activities to help the parent learn appropriate relational and parenting skills specific to their personal needs can be developed by the caseworker. This would be useful if the need for services exceeds the time allotted under this funding source for establishing behavioral changes sufficient to close the active case. 9. Services are provided in the client's home environment as much as possible to increase accurate assessment, therapist credibility with the client, and the probability the client will incorporate the material they learn into daily family activities. 10.The visitation and mentoring portions of the program promote the development of skills-based intervention to empower the client to handle family situations without the help of others. Overall, the program will help parents set appropriate and socially proactive goals for themselves and for their interactions with their children. Specific techniques that will be incorporated in the delivery of life skills include: 1. Stress reduction and anger management skills. 5 2. Communications, problem solving, and negotiation skills to enhance interpersonal effectiveness and develop relational skills... 3. Practice in hands on parenting skills using a coaching model to provide feedback, reinforcement, and clarification as to appropriate child management skills based on reported and observed behaviors... 4. Money management including budgeting and resource acquisition. Only brief services in this area are possible under the current time limitations. Extensive needs in this area will be referred to a life skills program. 5. Other activities of daily living including recreational activities related to enhancing family development, spiritual support, community involvement and maintenance of physical and emotional well being. Types of referral services that may be needed include: • Drug and Alcohol Services Referrals to alcohol and drug treatment programs including Island Grove and Family Recovery Center are available. • Health Care Referrals are also routinely available in our practice. Referrals to Sunrise Health Center, Monfort's Children's Clinic and The Family Residency Program are also available. •Job training referrals are available through the Job Services and through Vocational Rehabilitation. Crisis Intervention: Twenty four hour access is assured for the families to reach the providers. We have secretarial and office staff support 9-5 Monday through Friday at Ackerman and Associates, P.C. We maintain a twenty four hour, 365 day a year access system through our answering service. All providers can be reached through pagers by the answering service. In-home services for crisis intervention are available through this on call system. We have a rotating call system within the providers of Ackerman and Associates. Measurable Outcomes Measurable outcomes are of two varieties. One type is termed formative outcomes and the other type is called summative outcomes. Formative outcomes measure how the program is proceeding while the treatment takes place. Summative outcomes are the results of the treatment. In terms of formative measures we have the following: 6 1. Was the family assessment in part one completed? 2. Is the family making progress with the treatment plan for each component as outlined in the service objectives as requested on the case referral? 3. Has the family followed through with recommendations and referrals during the course of each part of the life skills program? Summative Outcomes: Over the duration of the twenty hour treatment, we determine the following information: Is the child still in the home? How well are the changes from treatment persisting? This measures if family behavior is different compared to their behavior before treatment. Specific summative goals are listed below. A. Improvement in household competency will be measured by clinical assessment This will be measured by recording the status of the household at the outset and the conclusion of services using a checklist and documenting changes in the monthly report. B. Improvement in Parental competency and parent child conflict management will be measured by clinical assessment A narrative in the monthly summary of treatment of the family will be provided. This is based on a review of the treatment on a month to month basis. This narrative will document the therapist's judgment of changes in parental competency. Surrats or failure to make progress will be discussed in monthly reports. C. Parents can work independently with other sources in the community and within local state and federal governments. Documentation of the resource needs of the family and how the family accesses these needed resources will be made by clinical observation and documented in the monthly reports. D. Families receiving life skills treatment will remain intact six months after discharge from the services. This information can be obtained by checking with the referring caseworker at Social Services at the six month time point after conclusion of services. E Families completing the program will have improved competency level reduced risk on a standardized assessment The providers will rate the adult family member(s)at the time of case closure on a standardized parent child inventory that measures parental interaction and satisfaction with parenting and be able to compare this to the same measure taken earlier in the process. Service Objectives We have the following service objectives: 7 Mentoring A. Improvement of parental competency. The program is specifically designed to resolve conflicts and teach management skills for parents. A solution focused treatment approach is used. Specifically, treatment will be focused on behaviors that either 1. Precipitated the likely imminent placement of the child or 2. Which prevent the reunification of the child with the family. The initial goal of services is to assist the family in finding behavioral solutions to the existing conflict and behavioral shortcomings related to child parent interactions... Each provider is skilled in family systems work and solution focused therapy. Other aspects of conflict management include parent child conflict resolution, problem solving skills development and application of negotiation and communication skills. Activities of daily living care, provision of nutrition, hygiene shelter, discipline protection instruction and supervision are the context that constitute parental competency. Life Skills concentrates on the parents developing more age appropriate strategies. In dealing with conflict with their child, especially with teenagers, the areas of discipline, protection, instruction and supervision seem most responsive to improvement. With younger children the therapy gives the parents the opportunity in their own home to practice and to clarify the roles each parent expects of the other and what is expected of the child. This model of home-based care is able to improve parental performance based on the experience that this staff brings to this proposal. Some examples of these service objectives incude delivery of services in the following skill areas (although not all families will need all skills improved or to work on all topics): improvement of parenting skills related to discipline and management of child behavior, emotional skills set development such as anger management, identification of depression or anxiety related behavior, and techniques for dealing with frustration, interpersonal skills development and assertiveness skills. B. Improve household safety and management One aspect of the treatment plan is associated with maintaining a safe household environment. Some families may need help in behaviors related to having a home adequately cleaned, maintained and stocked with food and supplies. C. The program will provide access to needed services as documented in the treatment plan for each family. Specific types of referrals may include the following drug and alcohol treatment, school issues, probation coordination, domestic violence resources, victim's assistance or other referrals. D improved Goal settings and Pro-social values derive as a direct consequence of service objective A-C above. Setting goals to complete the learning needed based on an agreement at the outset of the life skills program is inherently a learning experience in positive goal setting. Visitation 8 A. Improve parenting skills through directed learning based upon direct observations to promote physical and emotional safety. Use of activities specifically structured as is done by us for child custody and special advocacy activities will form a basis of creating a detailed treatment plan which will combine the referred problem set with additional observations made in the visitation process. By the parent accepting the treatment goals of the life skills program, the parent commits to a process of goal setting and moves to shift attitudes to a more socially positive value set. Workload Standards A. The program has a capacity of two families per month with an average of five families per month. The amount of time per family per week will depend on the family need but is anticipated to be two to three hours per week. Life skills treatment should be completed four to ten weeks after referral depending on the level of services required. B. We have two licensed mental health providers for this program who will be life skills specialists. • Emily Jaramillo Montoya, M.A., L.P.C., received her masters in Agency Counseling. Prior to joining Ackerman and Associates, P.C., she had a wide range of work in mental health including treatment for alcoholic patients and support of minority college students. She speaks Spanish. Her undergraduate major was in Criminal Justice and Sociology. She has worked for five years in home based treatment delivery. • Joyce Ackerman Ed. D. Licensed psychologist has directed the WCDSS program activities for Ackerman and Associates since 1994. She received her license to practice Psychology in Colorado in 1982 and is a trained mediator. Her master's degree is in special education for emotionally disturbed and learning disabled children. Each of our staff members are highly regarded by the caseworkers based on feedback we have received from supervisors. Two psychologists and a Social Worker complete the staff of Ackerman and Associates and serve as back up and support for the Life Skills Specialists. The back up group is available on call to assist them as well as to consult on intervention strategies on an anonymous case presentation basis. The psychologists are Laurence Kerrigan, Ph.D., and Susan Bromley, Psy.D. and Tom Pappas, MSW LCSW is the social worker. We reserve the right to add additional providers to the contract as work demands. C. Of the up to 24 families the caseload is projected at 20 families with Montoya and 4 families with Ackerman in twelve month period 9 D. The modality of treatment is home-based solution focused therapy, directed learning, coaching, modeling and teaching. As well, referral and support will be offered as described above. E. Hourslweeks. The total number of therapist hours is 30 maximum per family or a total for the budget calculation of 720 hours per year based on our projected average of 24 families. The hourly fee is requested at$100 as documented in the rate calculation section. F. Staff. There are two individual providers supported by two office professionals in the practice. There are also two psychologists and a social worker who provide on call support and back up services. G. Supervisor. This contact would be supervised and clinically managed by Joyce Shohet Ackerman, Ed.D., who monitors the project for compliance. The maximum caseload for the supervisor is ten families per month. H. insurance. Ackerman and Associates, P.C. carries one million three million liability coverage for professional liability on the corporation and its associates and each associate also carries the same level of coverage individually. In addition, Ackerman and Associates, P.C. carries a general liability policy related to accident or injury on our premises through Farmer's Insurance. Each provider carries individual automobile insurance. Staff Qualification A. All staff members who will be life skills providers exceed the minimum qualifications needed for this project in both education and experience as described above_ B. Staff available for the project consists of the two life skills specialists and two licensed psychologists and one social worker. C... Current Mandated Training: All of the above are trained at the master's degree or higher as mental health professionals. They have professional training in assisting individuals and families to achieve desired and directed behavioral change as reflected in their licensure by the state of Colorado. D. All of the life skills specialists and all the psychologists have knowledge of risk assessment and are skilled in the application of that knowledge especially in relation to the assessment of risk of harm to self or others. Unit of service rate computation 10 We have calculated the unit of service rate based in the instructions. We used 2004 data for our agency modified per requirements for low bid as of this fiscal year review process. Using overall figures for the agency we arrive at a figure of$100 per contact hour. The profit for Ackerman and Associates for all programs was less than 1% of gross revenues in 2004. The proposed cost is $100 per face to face contact hour. This is lower than or equal to our operating fees for face to face therapy hours as allowed in other protocols we have with WCDSS. Reduction in costs in past years reflected a decrease in doctoral level psychologist participation in this program and a reduction in direct fees charged to WCDSS by Ackerman and Associates providers. We are not able to continue to provide services at a reduced fee basis and the proposed fees reflect more accurately the business needs of our agency Budget Justification A trained accountant who works as an independent subcontractor with Ackerman and Associates tracks contract funds. No special issues are present related to project audit to our knowledge. Ackerman and Associates programs were audited in a random audit(conducted by Anderson and Whitney)after its first year of operation with no deficiencies. Audit of this program conducted on a yearly basis over several years, by Anderson and Whitney, has detected no deficiencies. 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A 1 gist' ! ! § E n iv 1 ! § . p I: P I ° 8 0 8 � i� a. . w k § at ! . a. § \ 0 ! b § q k _ i2 sE § .I k § e § K $ ! k ! § 4 § | k $ 03/10/2005 14:24 9703536134 FARMERS PAGE 02 • TRUCX INSURANCE EXCHANGE NOME IC MM WIE.RE FARMERS ,LOS AN GROUP OF CCAALIFO NM COMPANIES 1. POLICY DECLARATIONS RETAIL Named • DR JOYCE SROHETAC ER? .N PC RVICE - PREMIER Insured • Acct. Mailing • 1750 25TH AVE STE 101 EasyPay Address Prod.Count GREELEY CO 80634-4944 0707-0�4-362 045lcyNum -07 the named insured is an individual unless otherwise stated. Agent No. Poky Number 0Partnership O Corporation O Joint Venture ❑Organization (Any other) Type of Business DOCTOR'S OPPICE 2. Policy Period from 07i�,04 (not prior to time applied for)to 07/01/OS 1 If this policy replaces other coverage that ends at noon standard time of the same d ay until the =z_ 2:07 a.m. Standard Time un it thee, we coverage this polis. cy d is polity will continue for successive policy periods rhs policy flows, this policy will not take effect you pay the required renewal premium for each uccessive l If elect to continue this rules and forms then in effect period subject to our premiums, S. Insured location same as mailing address unless otherwise stated: 4. We provide insurance only far those coverages described below and for which a specific limit of insurance is shown. PROPERTY COVERAGES AND LIMITS OF INSURANCE COVERAGES PREN NO. 001 001 BUSINESS PERSONAL PROPERTY PROPERTY DEDUCTIBLE9639,100 500 GLASS LE TENANTS O EXTERIOR GLASS INCLU$100 DED PINE ARTS COVERAGgUES, PLANTS $2,500 $2,000 COVE RAGE ADDITIONAL COVERAGES Arl premises MUNI 7110 • FrAMI ; • tltl1201 PAGE 1 OF I Atta'dh rtiS yourapolioy with the Same,numberrshoWn on•this:endorsement E( :0 2nd Edition lamed Insured• . DR JOYCE SHOUT ACKERMAN'PC Agent Policy Number Address• 1750 25TH AVE SORE 101 07-04-362 04536-38-07 • GREELBY CO 80631 of the Company • designated in the Declarations • Insured Location - (Same as above unless otherwise stated here) Effective Date • 07/31/96 .Limit of Liability.$ 1,000,000 each occurrence $ 1,000,000 Annual Aggregate ADDITIONAL INSURED"ENDORSEMENT (SPECIAL'SENTINEL) • in consideration of the premium we agree with you to the following: • 1. The insurance provided by this policy for bodily injury liability and property damage liability under Coverage D—Business Liability insurance will also apply to the additional insured named below, but only with respect to an occurrence arising out of the ownership, maintenance or use of that part of the Insured location occupied by you. 2. This insurance does not apply to: (a) Any occurrence which takes place after you cease to occupy the Insured location. (b) Any structural alterations, new construction or demolition operations performed by or for any additional insured named below. 3. The additional insured will not be construed or deemed to be a subscriber to the Company issuing this policy.. 4. The additional insured will not be or become liable for any premium payments due upon this policy. 5. If this policy is terminated for any reason we will give 30 (THIRTY) days notice in writing to the additional insured named below. • 'This endorsement is part of your policy. It supersedes and controls anything to the contrary. It is otherwise subject to all other terms of the policy. STATE. OF COLORADO • Additional Insured • O/O WELD COUNTY SOCIAL SERVICES DEPT ---- ATTN: JUDY GRIECO • PO BOX A • GREELEY CO 80632 Countersigned • Authorized Representative ILRM!RL Oland11,CROUP i� - • PERSONAL- DATA SHEET ' Identif ' n Information; Name : Address : Larence "Larry" P. Kerrigan, Ph.D. 1706 19th Avenue DOB : Greeley, CO 80631 9/20/32 Phone : 353-3373 - business De_pees : BSC - Business MS - Busnnmsss Economics , from Creighton University, 1954 . from St . Louis University, St . Louis , MA - M° • > 1963 . Theology, from St. Mary' s University, Regis College Ph . L. _ Campus , Toronto, Ontario , Canada, 1967 . Philosophy, St. Louis University, St . Louis , Mo . 1960 , Ph . D. - (Ecclesial Degree ) , California School of Professional Psychology, Berkeley/Alameda Campus , 1974 , Clinical Psychology , Currently a licensed psychologist in the state of Colorado . Educational Back round: 1950-54 Creighton University, Business economics , 1954-56 Marquette University, Milwaukee , WI , , Classical studies and 'ascetical theology, 1956-57 Springhill College , Grand Coteau LA. Campus , Classical 1957-gp studies , 1957-67 St . Louis University, Philosophy and Economics , 1961-64 St . Mary' s University, Toronto Campus , Theology, California School of Professional Psychology , clinical psychology, Berkeley/Alameda Campus Positions Held : 1969-71 Member of Board of Directors , Campion College , Prairie du Chien, WI . 1968-71 Director , Department of Psychology, Campion College . 1971-74 Director of Student Counseling Center, Long Mountain College. 1975-80 'Director of Short-term Children and Family Team, Weld Mental Health Center, Greeley, CO . 1975-'87 Clinical Psychologist, Child and Family Team , Weld Mental Health Center, Greeley, CO . Ys,.; .i 1975,88 Co-founder of Weld County Child Protection Team, 1987-88 Member of Executive Board, Weld Mental Health Center , Greeley, CO . Honors Received : 1968-69 and Teacher of the 1970_71 year, Campion College . 1972-73 Class Representative to Campus Executive Committee , and California School of Professional Psychology 1973-74 orlc and Ex eriential B_ acl_�und : 1959-60 Counselor at Dismas Halfway House for ex-convicts , St. Louis , Missouri , 1960-63 Teacher-counselor-coach, Marquette Prep High School , Milwaukee , WI . 1964-67 Counselor-therapist at Street Haven and Sancta Maria Halfway Houses for women and at the Don ( metro ) Jail in Toronto , Canada. 1967-68 Teacher and Campus Counselor at Creighton University, Omaha, NB. 1968-71 Teacher at Campion College , Prairie du Chien, WI . , Director of Psychology Department , Department chairman . 1970-71 Director. and Staff member of a total environment for Inter-city boys , late grade school age from Milwaukee , WI . 1971-73 Director of Student Counseling , Lone Mountain College , San Francisco , CA. Teacher at the Lone Mountain College , San Francisco , California. 1973-74 Psychologist Trainee at San Francisco Mental Health Center, Richmond District, Outpatient Care . 1974-75 Private Practice , So. Bay Human Services Center, San Diego , CA. Part-time instructor at,-California School of Professional Psychology, San Diego , CA. ' 1,975-IIO Director , Short-Term Therapy Team, Children and • Family Unit , Weld Mental Health Center, Greeley, CO . • 1980-87 Member of Children and Family Therapy Team, Weld Mental Health Center , Greeley, CO . 1987- present Full time private practice with Joyce Shohet Ackerman , Ed . D. , Licensed Psychologist , Greeley, CO . Part time practice at Weld Mental Health Center, Greeley , CO , PcaLio,f:• Kerrigan , Laurence P. The Relationship Between Therapist and Client ' s Perceptions of One Therapy Session . Published Doctoral Dissertation , University of California School of Professional Psychology. Copyright , 1074 tior_ksho ay and Since 1974 , I have attended an average per year . Most of these workshops have of asent three workshops ented training in the following areas : Neuro-linguistic s training , Autogenic and relaxation training , Visualization-Imagery- Hypnosis , Cognitive-Behavioral Therapy, Ericksonian approaches to hypnotherapy and psychotherapy, Family therapy, Strategic therapy , Sexual abuse , dynamics and applied pPlied treatment , family intention psychotherapy, and other related areas . In the last fifteen years , I have taught classes and conducted workshops in the following subjects : The Psychology of Dreams Emotional and Physical Health through Visualization and Imagery Western Psychotherapies and Eastern Ways of Liberation Cognitive and Behavioral Therapy 1IYPnosis in Pain and Habit Control The Psychology of Consciousness and Meditation EXEC TIVE RISK CIALTY CO. 11/18/04 - A PSYCHOLOGISTS UPROFESSIONAL ELIABILITY POLICY • THIS IS A CLAIMS MADE POLICY-PLEASE READ CAREFULLY NOTICE:A LOWER LIMIT *** RENEWAL *** OF SEXUAL LOWER M T OF LIABILITY APPLIES TO JUDGEMENTS OR SETTLEMENTS WHEN THERE ARE ALLEGATIONS ( THE SPECIAL PROVISION"SEXUAL MISCONDUCT"IN THE POLICY). POLICY NO: 008-1766682 DECLARATIONS ITEM I. (a)NAME AND ADDRESS OF INSURED; ACCOUNT NO: ITEM I. (b)ADDITIONALONAMED INSUREDS: 0099745B 9 9 7 4 5 B LAURENCE P. KERRIGAN, PH.D. 1750 25TH AVE. SUITE #101 GREELEY, CO 80634 TEM 2. ADDITIONAL INSUREDS: TYPE OF ORG: INDIVIDUAL EM 3. POLICY PERIOD: FROM: 12/01/04 TO: 12:01A.M.STANDARD TIME AT THE ADDRESS OF THE INSURED AS S 05 STATED HEREIN: ENT 4. LIMITS OF LIABILITY: (a)$ 1, 000, 000 EACH WRONGFUL ACT OR SERIES OF CONTINUOUS,REPEATED OR INTERRELATED WRONGFUL ACTS OR OCCURRENCE Ns DEFENSE REIMBURSEMENT M5: (c)$ 3000000 AGGREGATE PREMIUM SCHEDULE: CLASSIFICATION NUMBER lanallICENIMMEWN 1ST PSYCHOLOGIST DEFENSE LIMIT 1191 . 00 1, 191 . 00 SURPLUS LINES TAX 00 INSPECTION FEE 35.73 1. 19 6. RETROACTIVE CTIVEDATE: 12/01/91 EXTENDED REPORTING PERIOD TOTAL PREMIUM: MEM ADDITIONAL PREMIUM((£exercised):$ 2, 148 . 60 POLICY FORMS AND ENDORSEMENTS ATTACHED TO THIS POLICY OL O DISCOUNT INCLUDED C 38 (7/95 ED. ) B22137 2(1 NO0/95) '4 BILL. PREMIUM HAS BEEN PAID. AUT RIZED COMPANY REPRE TATIVE EMILY L. JARAMILLO, M.A. 183 50th Avenue Place Greeley,Colorado 80634 Home Phone (970)3534388 EDUCATION 1996,Master of Arts,Agency Counseling University of Northern Colorado,Greeley, Colorado 1993, Graduate Fellowship Study, Criminology Rutgers State University, Newark, New Jersey 1988, Bachelor of Arts, Sociology/Criminal Justice with emphasis in Psychology University of Northern Colorado, Greeley,Colorado PROFESSIONAL EXPERIENCE 1998-Present Psychotherapist,Ackerman &Associates, Greeley, CO Provide intensive home based family therapy to families referred by the Department of Social Services. Provide mediation services to families. Co-facilitate family group decision making conferences for permanent placement of children. Provide short- term, solution-focused therapy. Provide therapy to individuals referred from Employee Assistance Programs. Facilitate foster parent training workshops. Provide foster parent consultation. Practice is supervised by Sherri Malloy, Ph.D., Licensed Clinical Psychologist. 1996-1999 Director,McNair Scholars Program, University of Northern Colorado, Greeley, CO Provided counseling,guidance, and academic advising to students who were low- income,first-generation college students,and of a minority group. Identified critical personal, familial, cultural, academic,and financial issues to aid in the development of individual success plans. Planned, developed, and implemented scholarly activities nationally. Developed and directed academic year research seminars. Coordinated research activities for scholars preparing for doctoral study. Directed all efforts to ensure efficient administration of a federal grant. Monitored project budget, supervised and trained staff members. 1995-1996 Assistant Director,McNair Scholars Program, University of Northern Colorado Provided counseling, guidance, and academic advising to students who were low- income, first-generation,and of a minority group. Identified critical personal, familial, cultural, academic, and financial issues to aid in the development of individual success plans. Coordinated the recruitment and selection of program scholars. 1996 Psychotherapist(Intern), North Colorado PsychCare/Family Recovery Center, Greeley, CO Facilitated psychotherapy counseling groups and individual counseling for patients and families,with focus on chemically dependent and eating disorders. Performed case management from admission to discharge. Presented psychoeducational information to patients, family members, and staff. Worked collaboratively with a counseling team. 1994-1995 Assistant Coordinator, Student Support Services, University of Northern Colorado, Greeley, CO. Provided counseling and academic advisement to at-risk first-generation,low-income, minority students. Identified critical personal, familial,cultural, academic, and financial issues to aid in the development of individual success plans. 1994-1995 Psychotherapist, Weld Mental Health Acute Treatment Unit, Greeley, CO Provided individual and group counseling to chronically mentally ill in-patient clients. Assisted clients in learning self-care and daily hygiene. Coordinated and implemented client life-skills and social-skills activities. CONTINUING EDUCATION/SEMINARS Jurisprudence Workshop for Psychotherapists Family Preservation Basic and Advanced Training Supervised.Practicum in Family Preservation Reaching Children through Play Therapy Play Therapy and Therapeutic Care Fire Starter Training Diverse Learners Academy Counseling At-Risk Students Cultural Diversity Conference Parent/Child Hispanic Youth Leadership Conference PRESENTER/FACILITATOR The Terrific Twos Prenatal Insults and Long Term Effects Social,Emotional&Sexual Development: Infancy through Adulthood Cognitive&Physical Development:Infancy through Adulthood Parenting with Love& Logic Eating Disorders Cultural Sensitivity and Awareness Communicating Across Cultures Conflict Resolution/Communication Skills Setting Limits&Boundaries HONORS/AWARDS Hispanic Leader of the Year, Cesar Chavez Center, University.of Northern Colorado,1999 Keynote Speaker, Latina Youth Leadership Conference, University of Northern Colorado, 1998 Distinguished Alumni, Department of Sociology, University of Northern Colorado Fellowship, Graduate Study, Rutgers State University of New Jersey Scholarship,National Hispanic Scholarship Fund Scholarship, Candelaria Scholarship • B 32 ch B/A Prod c r Nbs,. I e A 0003107 S Rene_ w`�placem�N� • 11/05/2004 RENEWAL PROFESSIONAL LIABILITY OCCURRENCE INSURANCE POLICY FOR PROFESSIONAL COUNSELORS AND HUMAN DEVELOPMENT PRACTITIONERS PURCHASING GROUP POLICY NUMBER: 44-2010129. Item DECLARATIONS CERTIFICATE NUMBER 1. Named Insured 8UM- 4003488 EMILY L MONTOYA MA LPC 2. MAILING ADDRESS 1851 13 AVENUE GREELEY CO 80631 3. Policy Period 12:01 AM Standard Time At Location of Designated Premises 4. The insurance afforded is onl From: 11/01/2004 To: 11/01/2005 by specific premium char e y with respect to such of the following types of insurance as indicated Sr iE_ A. Professional Liability X PMn 1M B. General Liability $ 293.00 5. $ 293.00 LIMITS OF LIABILITY each Incident 1,000,000 or each Occurrence $ 3,000,000 in the Aggregate 6. The Named Insured is: Other: — — Sole Proprietor (including Individual) Partnership Corporation 7. Business or Occupation of the Named Insured: ;• COUNSELING 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 forms(s) or endorsement(s): PL-I-2016 (10/94) PLE-2189 (9/97) PLE-2081 PON-2003 CHICAGO INSURANCE COMPANY 55 E. MONROE STREET, CHICAGO, ILLINOIS 60603 REPRESENTATIVE: Agent or Broker: Kirke Van Orsdel • Office Address: 1776 West Lakes Parkway Town and State: West Des Moines, IA 50398 Toll-free Number: 1-800-557-5092 P-2016 (10/94) (Elec.) TOM PAPPAS, LCSW 2595 Iris Court Montrose, Colorado 970-240-8468 TomPappasLCSW@Montrose.net EDUCATION 6/86 Masters Degree in Clinical Social Work, Simmons College School of Social Work,Boston,Massachusetts. 5/80 Bachelor of Arts Degree in Psychology and Secondary Education University of Lowell,Lowell,Massachusetts. EMPLOYMENT 3/94- Clinical Social Worker. Montrose Memorial Hospital Care Center Inpatient/Outpatient Services,Montrose, Colorado. Individual, family,marital and group therapy; discharge planning services. Co-therapist for geriatric partial-hospitalization program; supervisor for Masters Level student. 3/90-3/94 Senior Clinician. Justice Resource Center/The Butler Center, Westboro,Massachusetts. Individual, family and group therapy specializing in sexual offender treatment to adjudicated adolescent males in secure treatment facility. 11/86-4/89 Clinical Social Worker. New Bedford Area For Human Services, Inc:, Children Services Unit. Individual, family and group therapy in outpatient setting. Co-therapist for latency-age girls' sexual abuse groups. 9/85-6/86 Social Work Intern. Beaverbrook Guidance Center, Waltham, Massachusetts. Individual, family and group therapy with children in outpatient setting. 9/84-5/85 Social Work Intern. Children's Hospital, Boston, Massachusetts. Individual,family and group therapy in pediatric out-patient setting. 12/81-5/84 Mental Health,Counselor. Marlboro Hospital Mental Health Unit, Marlboro,Massachusetts. Individual, family and group therapy with adolescents and adults in inpatient psychiatric setting • 5/80-5/81 Mental Health Counselor. Littleton Girls House,Littleton, Massachusetts. Counseling to adjudicated adolescent females in secure treatment facility. TRAINING 2/01 Certificate in Level II EMDR Training. 5/91 Postgraduate Certificate in Advanced Psychotherapy With Children and Adolescents,Boston University, Boston, Massachusetts. REFERENCES AVA]LBLE UPON REQUEST CNAHealthcare Providers Service I Organization Purchasing Group ®HPSO CNA Plaza, a Chicago,IL 60685 .�, • �. rmcartP ,w ne...4.os+ee Cexttfte- .cate of ;insurance _producer _ Branch J Prefix Policy Number - Policy Period 018098 970 HIPG 269949616-g from: 12:01 AM Standard Time on: 10/01/04 N18098 nstued and Address to: 12:01 AM Standard Time on: 10101/05 Program Administrator TOM PAPPAS Healthcare Providers Service Organization 2595 IRIS CT 159 East County Line Road M0NTR0SE CO 81401-7485 Hatboro, PA 19040-1218 Medical Specialty: Social Worker 72990ttsurgee'Pr4Yicslft} .. American Casualty Co. of Reading, PA CNA Plaza 26S Chicago, IL 60685 CO P+ 'S LIMITS OF LIABILITY A. PROFESSIONAL LIABILITY Professional Liability $1,000,000.00 each claim $6 Q00,000.00_, aggregate Good Samaritan Liability Included above " Personal Injury Liability Included above ` � �� "' �'� R`�; * ' }� Ma p acement Liability ' Inc e a ove .,.+ .k;' '. . ,,' B. Coverage Extensions License Protection 10,000 00 er roceedin _ Defendant Expense Benefit $25,000.00 aggregate Deposition Representation deposition n $10,000.00 aggregate $2,500.00 per depo $5,000.00 aggregate Assault $10,000.00 per incident Medical Payments $25,000.00 aggregate $2,000 00 per person $100 000.00 First Aid— � aggregate Damage to Property of Others ,n �:i;; :2' £ ' $2,500.00 aggregate $500.00 per incident $10,000.00 aggregate C. WORKPLACE LIABILITY Coverage part C. does not apply if Coverage part D. is made part of this policy. Workplace Liability Included in A. Professional Liability Limit shown above Fire and Water Legal Liability Included above subject to t Personal Liability $150,000 aggresub-lgate I $1,000,000.00 aggregate O. GENERAL LIABILITY Coverage part D. does not apply if Covera a part C. is made part of this policy. Workplace Liability Hired Auto & Non Owned Auto None None None ' ',";.:77': Fire & Water Legal Liability None Personal Liability None None Total Premium $250.00 P`. 1 ni r rsemiternts attacfiinception'Th :l-81) -.. G-144872-A G-145184-A G-1215000 G-1215o1C G-1238460-05 G-121503C G-147292-A Healthcare Providers:avCervice�S on is a division of Affinity Insurance Services.Inc.;in NY and NIL MS Affinity Insurance Agency;in MN and OK.MS Affinity Insurance AAgency,Inc.dba Aon Direct Insurance Adsmisttgota License#0795465. Master Policy: 188711433 j fi / -,fin .i 7/ �l A _ Keep this document in a safe place. This and �-w �'/,/6 >J°" , UI !/u m °`� your cancelled check act as proof of coverage. Chairman of the Board Secretary 601 XX 0000041-N 040913 NENNCp 8/01 111331111 04257 VITA NAME: BROMLEY. Susan Plock May 2004 SOCIAL SECURITY NUMBER: 483-50-9243 POSITION: Licensed Psychologist Ackerman& Associates 1750 25th Ave. Ste 101 Greeley, CO 80634 HOME ADDRESS: 1621 13th Avenue Greeley, CO 80631 TELEPHONE: Office: (970) 353-3373 Home: (970)352-8750 EMAIL: sbromley(dearthlink.net EDUCATION: Year(s) Degree Institution Area of Study 1983 Psy.D University of Denver Clinical Psychology School of Professional Psychology Denver. Colorado 1968 MSSA Case Western Reserve University Casework (MSW) School of Applied Social Sciences Cleveland. Ohio 1965 BA Mt. Holyoke College y g Economics/Sociology South Hadley, Massachusetts WORK EXPERIENCE --Professional Academic: Year(s) Institution/Organization Position Responsibilities 1996-03 University of Northern Colorado Assoc. Professor Ps1985-96 University of Northern Colorado Asst Professor Teaching/Research Psychology Teaching/Research 1983-84 University of Northern Colorado Asst. Professor Psychology Teaching Psychology WORK EXPERIENCE --Professional Non-Academic: Year(s) Institution/Organization Position Responsibilities 1996-present Ackerman and Associates Psychologist 1984-85 Kaiser Permanence Clinical Psych Lakewood, Colorado Psychotherapist Clinical 1979-80 Bethesda Mental Health Center Psychology Intern Clinical/ Denver, Colorado Administrative 1968-79 Denver General Hospital P Clinical Social Worker/ Clinical/ Denver, Colorado Supervisor Administrative AREA OF SPECIALIZATION: Behavioral Medicine/Pain Management/Clinical Hypnosis/EMDR RESEARCH AREAS/INTERESTS: Hypnosis/Pain Assessment and Management/Women's Issues/Teaching Methods 1 PROFESSIONAL ACTIVITIES: Colorado Licensure: Psychology License#1086 PUBLICATIONS --Professional,Juried: Musgrave-Marquart, D., Bromley, S.P. &Dailey, M.B. (1997). "Personality. academic attribution, and substance abuse as predictors of academic achievement in college students". Journal of Social Behavior and Personality, 12(2), 501-511. Karlin. N.J. and Bromley, S.P. (1996). Differences in caregivers of demented and lucid chronically ill family members. American Journal of Alzheimer's Disease, 11(5)39-45. Retzlaff. P. and Bromley, S. (1994). Counseling personality disorders. In Ronch,J.L., VanOrmmm. W. &Stillwell, N.C. (Eds)The counseling sourcebook: A practical reference on contemporary issues. New York: Crossroad Publishing group. pp. 466-474. Bromley, S. and Hewitt,P. (1992). Fatal attraction: The sinister side of women's conflict about career and family. Journal of Popular Culture. 26(3). pp. 17-24. Retzlaff.P. and Bromley, S. (1991). "A Multi-Test Alcoholic Taxonomy: Canonical Coefficient Clusters". Journal of Clinical Psychology, 47(2),pp. 299-309. Bromley, S.P. (1985). "Treatment of Pain: Theory and Research"in Zahourek, R. (Ed.). Clinical Hypnosis and Therapeutic Suggestion. New York: Grune and Stratton. Reprinted in Zahourek. R. (Ed.)(1990). New York: Bruner/Mazel, Inc.,pp. 77-98. PROFESSIONAL PRESENTATIONS --furled: Touchton,M.A. &Bromley, S.P. (2000). Complementary/alternative medical use among undergraduates at the University of Northern Colorado. Poster session presented at the Rocky Mountain Psychological Association, Tucson. AZ. (April). Nickisson, J.W. and Bromley, S.P. (1999)"Hypnosis: Attitudes,knowledge and experience among psychology and nursing students". Paper presentation at the American Psychological Association Convention, Boston. (August) Bromley, S. (1998)Hypnosis, psychology and managed care. In S. Bromley (Chair) Complementary, nontraditional and indigenous healing practices. Symposium conducted at the combined meetings of the Western and Rocky Mountain Psychological Associations. Albuquerque. (April) Bromley, S. (1998). Complementary healing methods: A psychological and artistic exploration. In L. Wickerlgren (Chair). Interdisciplinary courses involving psychology: A sampler. Symposium conducted at the combined meetings of the Western and Rocky Mountain Psychological Associations, Albuquerque. (April) Campbell,J. S., Titus, J. and Bromley S. P. (1998). "Neuroanatomy teaching technique for introductory psychology students. Poster presented at the joint WPA/RMPA convention,Albuquerque, NM. (April) Bromley, S. (1997)(Chair) "Linking through honors programs: The cross-discipline course). Paper presentation as part of a symposium titled"Creating links between psychology and other disciplines," American Psychological Association Convention, Chicago. (August) Bromley, S. , Gilliam D., &Johnson,T. (1995). "Assessment of student created tests as an evaluation method". Poster presented at the American Psychological Association Convention,New York City. (August) Bromley, S. (1994). "Student created tests as an evaluation method". Poster presented at 16th Annual National Institute on the Teaching of Psychology, St. Petersburg.Florida. Karlin, N. and Bromley. S. (1992). " Similarities and differences for caregivers of demented and lucid chronically ill". Poster presented at the Rocky Mountain Psychology Association Convention, Boise, Idaho. (April) Montoya. K.J. and Bromley, S. (Chair)(1992). " Changes in undergraduate counseling styles in an introductory counseling theories course". Paper presented at the Rocky Mountain Psychology Association Convention,Boise, Idaho(April) Bromley, S. (1992)."Connected learning methods to facilitate research understanding". Paper presentation as part of panel titled. 'Teaching techniques in the social sciences', Western Social Science Association Convention,Denver, Colorado. (April) Bromley, S., Ramirez. S.,and McCoy, J. (1991). " Impact of a health psychology course on student health beliefs". Poster presented at the Rocky Mountain Psychology Association Convention. Denver. Colorado. (April) Karlin,N. and Bromley, S. (1991). " Support,burden and affect among caregiver of dementia and non-dementia patients". Poster presented at the American Psychology Association, San Francisco, California. (August) Bosley. G. and Bromley, S. (1990). Post death ritual in a Colorado community. Paper presentation at the American Psychology Association, San Francisco, California. (August) Bromley, S. (1990). "Husbands at Childbirth: Who Does It Help?"Paper presentation at Far West Popular Culture Association, Las Vegas, Nevada (January). Hewitt, P. and Bromley S. (1989). "Images of Work and Intimacy in'Turning Point'and'Fatal Attraction"'. Paper presentation National Convention of Popular Culture Association and American Culture Association, St. Louis, Missouri. (Session Chair) Retzlaff, P. and Bromley, S. (1989). "The Basic Personality Inventory: Alcoh Sub-Group Identification". Poster session at the Joint Convention of the Rock Mountain Psychological Association and Western Psychological Association, Reno. Nevada. Bromley, S. (1988). "Our Culture Affects Our Pain."Paper presentation,National Convention of Popular Culture Association and American Culture Association,New Orleans,LA. (March). Bromley, S. (1987). "Husband-Assisted Autohypnosis for Labor and Delivery: A Clinical Model". Paper presented at Rocky Mountain Psychological Association, Albuquerque,New Mexico(April). Bromley, S. and Loy, P. (1987). "Politics of PMS". Paper presentation Association of Women Psychologists, Denver, Colorado(March). PROFESSIONAL PRESENTATIONS--Invited: Bromley. S.P. &Canales,G. (2000). Issues in presenting information on historically underrepresented groups in the classroom. Symposium conducted at the Rocky Mountain Psychological Association, Tucson. (April). Strongin,D. &Bromley, S. (1999). Student and faculty reactions to the introduction of a graduate ethics course. In Miller, R. (Chair)Ethics in college teaching. Symposium conducted at the Rocky Mountain Psychological Association, Ft. Collins, CO(April) Bromley, S. (1999). Issues of religion and spirituality with therapists and clients. In S. Bromley(Chair)Religion and spirituality in research,practice and the classroom. Symposium conducted at the Rocky Mountain Psychological Association, Ft. Collins, Co(April) Handelsman. M.M.,Bromley, S.P. &Davis, S.F. (1995). "Clinical Psychologist, Counseling Psychologist, Clinical Social Worker, or Psychology Professor: Which Degree is Right for Me?"Psi Chi invited panel presentation,Rocky Mountain Psychological Association, Boulder, CO(April). Bromley, S. (Co-Chair), Seibert,P. (Co-Chair), Knuckey,D.,Bohlin,M.,Zaweski, C., Watson,D., Hammon,D., West, K. &Robins, J. (1994). "Training the Teaching Assistant" Invited Panel Presentation. Rocky Mountain Psychological Association, Las Vegas, Nevada(April) 3 Bromley, S. (1993). "Hypnosis in Dentistry."Presentation at Monthly Meeting of Weld County Dentistry Association, Greeley. Colorado (February). Bromley, S. (1993). "Learning about the author as a way to understand research." Presentation at "Teaching Take Out", CTUP Special Event. WPA/RIvIPA Convention, Phoenix, Arizona(April). Allen, M. and Bromley, S. (1993). Co-Chairs Two CTUP Special Event Sessions, "Teaching Take Out: Experiences in Collaborative Learning", Western Psychological Association/Rocky Mountain Psychological Association Convention, Phoenix, Arizona(April). Bromley, S. (1993). Chair, Invited Symposium, "Psychological and Social Perspectives on Male Violence Against Women", Western Psychological Association/Rocky Mountain Psychological Association Convention,Phoenix, Arizona (April). Bromley, S. (1992). "Enhancement of student research and writing skills in any course". CTUP Workshop presented at the Rocky Mountain Psychology Association Convention,Boise, Idaho. (April) Bromley, S.and Karlin, N. (1992). "General and health locus of control of adult caregivers". Poster session at the UNC Research Forum, Greeley, Colorado. Bromley, S. (1992). Panel member in Mental Health Symposia for Victim Compensation Convention as part of the Colorado Organization for Victim Assistance Conference. (Estes Park/October) Bolocofski, Bromley,Foster and Mean(1988). "Hypnosis: Research and Clinical Perspectives," symposium presentation, Colorado Psychological Association, Greeley(March). Bromley, S. (1986). "Pain: A Psychological Event". Presenter-20th Annual Emotional Crisis Workshop,University of Northern Colorado, Greeley, Colorado(July). LECTURES--Invited: Bromley, S. (1998)"Psychological methods of pain control"Invited lecture for the annual meeting of the Weld County Arthritis Society. Bromley, S. (1998). "Hypnosis for pain control of arthritis" Invited lecture for`Brown Bag" lunch series sponsored by the Greeley Medical Clinic. Bromley, S. (1998)"Headache Control -Psychological Methods". Invited lecture as part of a seminar titled"Coping with headache". Sponsored by the Greeley Medical Clinic. Bromley, S. &Ackerman J. (1998)."What to do to handle burnout"A workshop conducted for foster parents working with Weld County Social Services. Bromley, S. (1995). Keynote speaker for Golden Key Honor Society Induction Ceremony, University of Colorado, Boulder, Co. (November) Bromley, S. (1992). Keynote speaker for Sophomore Honor Society Induction Ceremony. Bromley, S. (1991)Featured speaker. UNC Academic Honors Convocation. (April) Bromley, S. (1991). Banquet speaker Emotional Crisis Workshop, Greeley. Colorado. (July) GRANTS: Bromley, S(1994)Honors Grant ($500)to attend research training at the Society for Clinical Hypnosis meeting, San Francisco(October) Bromley, S. (1994). Research and Publications award of$1500.00. "Assessment protocols to measure the efficacy of 4 hypnotic treatment for injured workers. Karlin, N. and Bromley, S. (1990). Research and Publications award of$2.4440.00. "Control, support,burden and affect differences among dementia and non-dementia caregivers". BOOK/GRANT REVIEWS: Grant review for Boise State Department of Education(1995) Review of Santrock,J. (1991). The science of mind and behavior. W.C. Brown and Benchmark. Review of McKee, P. &Thiem, J. (1993). Real life: Ten stories of aging. University of Colorado Press. PROFESSIONAL CONSULTATION/PRACTICE: Year(s) Institution/Organization Role 1996-presnt Ackerman and Associates Clinical Psychologist 1988 Bonnet Good Samaritan Center 1984-85 Pain Management Consultant and Trainer Denver Metropolitan Dental Care Consultant in Pain Management 1984 Iowa Association of Registered Physical Therapists Hypnosis for Pain Management Consultant and Teacher PROFESSIONAL ASSOCIATION PARTICIPATION: Membership 1986-2003 Rocky Mountain Psychological Association 1988-present American Psychological Association(Divisions 2. 30, 35) 1989-96 Greeley Area Mental Health Network 1987-88 Association of Women in Psychology 1980-89 Colorado Psychological Association 1988 CPA Program Committee Member for Spring Meeting--Greeley Coordinator SERVICE: EXTERNAL: NATIONAL SERVICE: 1994-2002 Rocky Mountain Coordinator- American Psychological Association, Division 2 -Teaching of Psychology 1992-94 Co-Chair,Rocky Mountain Region Council of Teachers of Undergraduate Psychology(CTUP). 1991-94 Mountain States Regional Academic Coordinator, Golden Key National Honor Society REGIONAL/STATE SERVICE: 2000-Moderator for G. Stanley Hall Lecturer-Dweck. C. (2000). Motivation and the self Presented at the Rocky Mountain Psychological Association Convention, Tucson. (April) 1999 -Moderator for G. Stanley Hall Lecturer-Viney, W. (1999). A larger canopy for psychology: Unifying themes and pragmatic empiricism. Presented at the Rocky Mountain Psychological Association Convention,Ft. Collins, CO(April) 1989-present Rocky Mountain Psychology Association 1998-present Ex-Officio Board Member As Division 2 Coordinator 1992-1998 Board Member 1995- 1998 Elected Chair, Groups Under-Represented in Psychology Committee 1992-94 Co-Chair,Groups Under Represented in Psychology Committee 1991 Coordinator of Student Volunteers,RMPA Convention.Denver, Colorado. 1995 Psychology Chair-COW Faculty to Faculty Conference(October) COMMUNITY SERVICE: 2003-present Board Member Weld County Area Agency on Aging 1999-present Member Weld Senior Wellness Program Evaluation Committee 1999-2000 Member, Weld County Area Agency on Aging, Grandparenting Committee 1998-present Member, Weld County Medical Society Committee on Alternative and Complementary Healing 1997-1998 UNC Loaned Executive-United Way of Weld County 5 • 1997 Mental Health Pro Bono Workshop, "Communication in the Workforce"1991- 1996 Board Member, 19th Judicial District Victim Compensation Board 1995-96 Chair 1990-93 Board Member, Weld County Area Agency on Aging 1992-93 Chair 1991-92 Vice-Chair 1986-2001 Exam Supervisor-American Institute for Property and Liability Underwriters/Insurance Institute of America 1987-present Clinical Psychologist -pro-bono work with individual clients and community, training INTERNAL DEPARTMENTAL: 1993-2003 Member, Department Executive Committee 2000-2003 Advisor Psi Chi National Honor Society 1995-1999 Co-Advisor Psi Chi National Honor Society 1996-present Guest lecturer for Psi Chi Grad Night on getting into clinical/counseling g grad 1989-91,93, 1995-1998 Department Representative, CCHE Faculty to Faculty Conference 1987-94 Department Representative to 1986-94 P graduation ceremonies Library Representative 1983,86 89, 90-93,97,98 Member, Faculty Search and Screen Committee 1990-92 Member,Psychology Department Undergraduate Committee(Chair 1992) 1987-88 Co-Coordinator Semester Conversion Committee COLLEGE: 1992.93,96,97 Member of faculty invited to teach in the Cluster Program 1990-93 Graduation Marshall, Arts& Sciences 1988-89 Member, Arts and Sciences Teacher Education Committee 1986-89 Chair,Interdisciplinary Committee to develop and revise Human Development Major in the College of Arts and Sciences and Psychology Department UNIVERSITY: 2002 -present Graduate Faculty 2002-present Field Experience Coordinator for students at Ackerman&Associates 1992-94 1996-99 Member-Research and Publications Board 1993-94 Chair-Elect 1988-99 Founding Co-Advisor. Golden Key Honor Society 1992-95 Member-UNC Women's Commission 1992-94 Co-Chair-Assessment Task Force 1989-90 Faculty Representative, Student Fee Allocation Committee 1986-89 Member,Faculty Senate 1988-89 Secretary 1987-88 Vice-Chair 1986-87 At-Large Member,Executive Committee 1986-89 Member, Academic Policies Committee 1986-87 Member,Elections Committee 1988 Representative, Western States Faculty Leadership Conference, Reno 1988 Senate Representative, Statewide Commission Advisory Committee 1988 Advisor, In-Touch Help Line 1985-86 Volunteer Therapist, UNC Counseling Center GRADUATE STUDENT COMMI I 1 EES--Doctoral: 2003-present Committee Member, Stefanie Stecker(School Psychology) 2002-present Committee Member,Karen Bender(Professional Psychology) 6 1998-99 Committee Member, Shu-Shin Lu,Professional Psycholog y. "Using Metaphor in Child Counseling in Taiwan" 1997-00 Committee Member, Christine Rogers,Professional Psychology, "A Qualitative study of the experiences of pastor's wives." 1995-1997 Committee Member, Lisa Ing, Special Education 1994-2003 Committee Member, Marla Gallagher, Educational Psychology 1993 Committee Member,Hsiu-Lan Ma, Science Ed. -Oral Comprehensives 1993 Committee Member. Jerry Buford, School Psychology,"Treatment of depressive symptoms of early adolescents". 1993-1998 Committee Member, Pat Flanagan, CSPA,Orals,"A comparison of attitudes and practices of Teaching faculty regarding student academic dishonesty at a two year and four year institution". 1991 Committee Member, Mike Propriano, School Psychology 1990-94 Committee Member.Paul Jantz, School Psychology, 1989 Committee Member,Mike Peters, Vocational Rehabilitation, "The Effectiveness of Vocational Evaluation for Various Disabling Conditions 1987 Committee Member, Ane Marie Kajenckii.English,"The Concept of Free Association in Virginia Woolf's The Waves" 1986 Committee Member, Fuming Liao.Mechanical Kinesiology, "Development and Validation of a Method for Providing Immediate Feedback Information on Speed and Angle of Release in Shotputting" GRADUATE STUDENT COMMITTEES --Masters: 2001 Jeremy Ehmke, Chair 1999-00 Jennifer Lawrence,Committee Member 1998 -99 Vanessa Ewing, Committee Member 1997 Stephanie Blasi, Committee Member 1997 John Nickisson, Chair 1994 David Watson, Committee Member 1994 Tiernan McIlwaine, Committee Member 1994 Jerrod McCoy, Committee Member 1993 Sheldine Runyan, Committee Member 1993 Sue Cole, Committee Chair, "Influences on Occupational Goals of Selected Male and Female College Students". 1990 Jerry Benner, Committee Member 1990 Kurtis Armstrong, Committee Member. "Attitudinal Consequences of Pre-Employment and Random Employee Drug Testing" 1989 Michelle Hozer, Committee Member 1989 Anne Schnittgrund, Committee Chair, "Age and Electrothermal Biofeedback Training". 1988 Cherri Hockett, Committee Member, "The Effects of Turnover on Those Who Remain in an Organization" 1988 Tony Ambrosio, Committee Member. "The Belief in a Just-World and the AIDS Epidemic: Predictors of Attitudes Towards Individuals with AIDS" 1988 Steve Foster, Committee Chair. "Hypnotic Susceptibility As a Function of Locus of Control and Director Indirect Induct ional Deepening and Suggestion Style" 1988 Lisa Dillon, Committee Chair, "Cognitive-Behavioral Approach to the Treatment of Elderly Rheumatoid Arthritis Patients" 1987 Deanna Holmes, Committee Member 1987 Darlene Nold, Committee Member, "Reading and Writing Assessment Tests as Predictors of Success in the Basic Peace officer Academy at Aims Community College" 1987 Dan May, Committee Member 1986 Jeff Schiels, Committee Member, "The Reformulated Hypothesis: Is Its dominator of Learned Helplessness Literature Justifiable?" 1986 Linda Coulthard-Morris, Committee Member, "Biofeedback of Cortical Slow Wave Potentials, Hand Temperature and Muscle Tension in Normal and Attention Deficit Disorder with Hyperactivity Children" TEACHING: Honors Activities: 7 2000-2002 Thesis Co-coordinator, Stephanie Price, Allison Osag, Anna Grenier. Jennifer Donnelly 2000-2002 Thesis Co-advisor, Shanti Pepper."Hindsight bias and prejudice against homosexuals" 2000-2002 Thesis Advisor, Angela Hanson, "Effects of aromatherapy on attention' 2000 Thesis Coordinator, Cindy Mitchell, Christin Hillyer,Angela Hanson 1999 Thesis Advisor,Melissa Touchton"Complementary/alternative medical use among undergraduates at the University of Northern Colorado". 1999 Thesis Advisor, Sarah Painton. "Early parent loss in terms of maintaining a connection with the deceased. 1999 UNC Research Day, Faculty Panel Coordinator, " Complementary Healing Methods" 1999 Thesis Coordinator-Kristin Pietryzick,Jennifer Kimberling, Cristine Dickey 1997 Thesis Co-Advisor Kelly Kinser. "An evaluation of the city of Greeley community outreach program". 1997 Honors Connection Course development-Alternative Healing Methods 1996-2002 Honors Co-Coordinator, Psychology Department 1989-94 Honors Coordinator. Psychology Department 1994 Thesis Co-Advisor, Diane Musgrave."The Relationships Among Personality Traits, Alcohol. Caffeine, and Nicotine Consumption, and Academic Performance in College Students" 1994 UNC Research Day. Faculty Panel Coordinator,"Hypnosis: Theory and Research" 1993 UNC Research Day,Faculty Panel Coordinator, "Non-traditional Theories of Therapy Serving Women and Minorities". 1993 Thesis Co-Advisor,Linda Norman, "Clozapine and Event Related Brain Potentials in Schizophrenics" 1992 Thesis Advisor, Deborah Knuckey, "The Effect of Touch on Affect Among Strangers Under Mildly Stressful Conditions" 1992 UNC Research Day, Faculty Panel Coordinator 1992 UNC Research Day, Faculty Panel Coordinator(2 student panels)"Sex Roles and Psychology,"The Power of Social Influence 1989 Thesis Advisor, Geri Bosley, "Post Death Ritual in a Small Colorado Community" 1988 Thesis Advisor,Pam Clasen, "The Use of Relaxation and Imagery Techniques in Pain Management" 1989&97 Honors Connection Course Development Courses Taught: (1-4 Scale with 1 as Highest)(*1-5 Scale with 5 as highest) AVG. DATE COURSE TITLE HRS ENR AVG.RATING 1986-1988 PSY 101 Intro Seminar Psychology 1 30 1.16 1983-1997 PSY 120 Principles of Psychology 4 113 2.35 1984 PSY 121 Intro to Psychology I 4 40 ---- 1985-1988 PSY 230 Human Growth &Development 5 68 1.46 1984 PSY 265 Social Psychology 3 25 ---- 1988-2000 PSY 323 Health Psychology 3 43 3.02 1986 PSY 330 Child&Adolescent Psych3 27 1.4 1986-1993 PSY 331 Maturity&Aging 3 36 1.51 1984-2000 PSY 455 Abnormal Psychology 3 32 3.01 1983-1998 PSY 350 Theories of Personality 3 40 2.05 1986-2000 PSY 407 Intro to Counseling Theories 3 23 2.52 1987 PSY 499 Psychology of Sex Roles 3 16 1.18 2000 PSY 508 Health Psychology and Healing 2 17 4.57 1989 PSY 508 Emotional Crisis Workshop 1-2 39 --- "Frontiers of Mental Health And Education" 1988 PSY 508 Emotional Crisis Workshop 2-3 63 "Mind/Body Interactions" 1987 PSY 508 Emotional Crisis Workshop 2-3 106 "Relationships" 1991 PSY 595 Health Psychology 3 15 1990-2000 PSY 620 Assessment&Interviewing 3 12 3.13 1988 PSY 620 Issues in Behavioral Medicine 3 5 2.08 1992-1997 PSY 621 Practicum College Teaching 2 12 3.11 1997 HON 200 Honors Connections Seminar: "Alternative Healing Methods" 2 20 3.67 of 4 1989 HON 200 Honors Connection Seminar II: 2 9 --- 8 "Love" 1986 Elderhostel "Dream On" NC (25) 1987 Elderhostel `MindBody Interactions" NC 19 Courses Developed: 2000 PSY/PPSY 508,Health Psychology and Healing 1997 HON 200. Alternative Healing Methods 1991 PSY 595,Issues in Health Psychology, Summer 1989 23rd Annual Emotional Crisis Workshop. Frontiers of Mental Health and Education, Summer 1988 PSY 620, Assessment in Behavioral Medicine. Fall(Revised Spring 1998) 1988 PSY 423, Health Psychology,Fall 1988 22nd Annual Emotional Crisis Workshop, Mind/Body Interactions, Summer 1987 21st Annual Emotional Crisis Workshop,Relationships, Summer 1987 Mind/Body Interactions-Elderhostel Program. Summer 1987 PSY 499, Psychology of Sex Roles-Summer 1986 Dream On-Elderhostel. Summer Directed Studies: Graduate: 1995 Cynthia Holley, Hypnosis 1994 Tara Johnson, Hypnosis Theory and Practice 1994 Marla Gallagher, Sociometric Processes 1994 Marla Gallagher, Cluster Development in Intro Psychology Classes 1992 Bruce Holoman,Hypnosis Research and Practice 1988 Paul Jantz,Hypnosis for Pain With Children 1988 Lori Kochevar, Women as Leaders 1988 Jerri Israel, Alan Shaw, Issues in Health Psychology 1988 Steve Foster, Michele Hozer,Teaching Apprenticeship • 1987 Tony Ambrosio,Hypnosis Models 1986 Candy Disch, Psychological Testing Undergraduate: 2000_ Lynell Rice-Cross-cultural attitudes towards healing methods 2000_ Andrea Hagedorn-Attitudes towards counseling(in lieu of honors thesis) 2000 Laura Bell-Psychology of childbirth 1999 Lynell Rice-Healing Methods 1999 Stefani Stecker-Student's perceptions of parent-child sex communication(in lieu of honors thesis 1998 Jennifer Altman-Exercise and Psychology 1996 Kindra Sanchez-Biracial Identity 1996 Jenna Weatherbee-Pain Coping Styles 1995 Allison Ellis-Psychological Theories in Business Management • 1995 Holli Elrick, Counseling and the Hearing-Impaired Child 1994 Lewis Garza,Etiology of Schizophrenia 1994 Suzanne Bodetko,Autogenic Training 1994 Rebecca Furstenberg, Impact of Alzheimer's Disease on Families 1994 Bonnie Salton, Hypervigilence in Youth(Hon 351) 1993 Mary Jo Hamilton, Hypnosis Theory 1994 Greg Schooley,Forgiveness as a Therapy Tool 1993 Jason DeBueno, Youth Advocacy 1993 Kelley Ferguson-Women in Psychology 1993 David Rosenberg-Offender Programs 1992 Robin Trostel,Analysis of Learning Styles 1992 Robin Trostel, Health Locus of Control 1992 Roberta Inman,Family Violence and Lesbians(Hon 351) 1991 Mark Kahl, Back Pain 1991 Tracy Moulton, Treatment of Sexual Abuse 9 1991 Alice McPherson, African American Women and Higher Education 1991 Jody Hurner,Hypnosis: Theory and Practice 1990 Jimmie Berg. Women's Learning Styles 1989 Elary Violett, Cognition and Pain Management 1989 Geri Bosley, Chris Snodgrass,Bev Foster, Elary Violett, Issues in Personality 1989 Penny Vaughn, Female Pioneers in Social Work 1989 Lori Peterson,Pain and the Elderly 1988 Peer Training for Hotline Service 1987 Tracy Boh, Issues in Child Abuse 1987 Julie Stoddard, Grief and Divorce 1987 Eric Bouch, Hypnosis Models 1987 Mike Lesser,Assessment in Sport Psychology 1986 Lynne Sheffield, Childhood and Loss 1986 Jennifer March, Adolescence Practia 2000 Rebecca Kuhn-Aromatherapy research 2000 Ackerman and Associates-Berkely Holston 1999 Melissa Touchton-Applied statistics 1998 Andrea Lamb-Hypnosis and golf performance 1998 Rebecca Varoula-Women's Place 1998 Greeley Medical Clinic-Gay Lemons,Renae Smith 1998 Ackerman and Associates-Amy Munnel, Kristin Pietrzyk,Jennifer Kimberling. Greg Pedersen 1997 Greeley Medical Clinic-Lori Darst,Barbara Glode, Ann Marie McCullen, Jeff Titus 1993 Greg Schooley,Bereavement Research 1993 Di Smice, Women's Commission 1992 Mary Jo Hamilton,Hypnosis Research 1992 Carol Sexton,Psychology Testing 1992 Lisa Schlott,Learning Styles PROFESSIONAL DEVELOPMENT ACTIVITIES: Workshops. Clinics, Symposia, Conferences: (Excluding Conferences as a Presenter) 1999 Cognitive Behavioral Therapy Training Program,Institute for Behavioral Healthcare 1999 EMDR training and Level 1 certification 1998 Qualitative research lecture series-UNC 1998 Lewis M. Terman Western Regional Teacher's Conference sponsored by APA Division2 in conjunction with the WPA/RMPA joint convention. 1998 "Spirituality and health in counseling", CAHEC Workshop, Greeley 1998 "Divorce Busting: Solution oriented brief therapy with couples", Colorado Assoc. Marriage and Family 1997 Health Maintenance -Legal and Ethical Issues 1997 Body and Soul: Healing in the 90's 1996 Celebrating our Essence: Women's Health and Spirituality 1995 International Society for Clinical and Experimental Hypnosis-Research Workshop. San Francisco, CA (30 more hours toward certification) 1989 "Minding the Body, Mending the Mind", CAHEC Workshop,Ft. Collins 1988 Demystifying Publishing", CAHEC Workshop, NCMC, Greeley 1985 "Attentional Deficit Disorders in Children",Meichenbaum,Denver 1980 International Society for Clinical and Experimental Hypnosis-30 certification hours,Denver Numerous other workshops on Parent Loss, Child Abuse, Grantsmanship, Short-Term Treatment, Supervision, Pain Management. Medical Terminology, Depression,Personality Disorders Courses Taken Credit: 1994 EPRE 603 - Analysis of Variance Audit: 1993 EPRE 602 -Elements of Statistics 1990 EPRE 700-Advanced Research Methods Continuing Education Credit: 10 - 1976 C.U. Medical School-Medical Ethics 1972 C.U. School of Nursing-Hypnosis(10 weeks) 1969 University of Chicago -Kubler-Ross,Death and Dying HONORS AND AWARDS: 2000 "Wonderful Outstanding Woman" Award 1998 Distinguished Service Award-Rocky Mountain Psychological Association 1998 Arts and Sciences Teacher of the Year Award 1998 "Wonderful Outstanding Woman" Award-Highlighted in October newsletter-Women's Resource Center 1993 Commencement Banner Carrier, Arts and Sciences 2002,1993, 91,89, 88 -Mortar Board Favorite Professor 1992 Student Representative Council University Professor of the Year 1992 Student Representative Council University Advisor of the Year 1989 Arts and Sciences Achievement Award 1988 Honors Advisor of the Year 1984 Psi Chi, University of Northern Colorado Chapter 1982-83 Writing Associateship-Rocky Mountain Women's Institute 11 BRANCH B/A PRODUCER NUMBER DATE OF ISSUE PRIOR CERTIFICATE NUMBER 23 A 0004087 04/08/2004 Renewal PSYCHOLOGISTS PROFESSIONAL LIABILITY CLAIMS-MADE INSURANCE POLICY NOTICE: THIS IS A CLAIMSMADE POLICY, PLEASE READ THE POLICY CAREFULLY PURCHASING GROUP POLICY NUMBER: 45-0002000 Item DECLARATIONS CERTIFICATE NUMBER:455P- 2050203 1. Named Insured Susan Bromley 1621 13th Ave ADDRESS Greeley,CO 80631-5415 Number&Street Town,County,State&Zip No.) 2. Policy Period: 12:01 A.M.Standard Time At From: To: Location of Designated Premises 04/01/2004 3. COVERAGE 04!01/2005 LIMITS OF LIABIL1fY PREMIUM Professional Liabil' $ 1,000,000 each incident $3.000,000 ,,re,. _ 4. BUSINESS OF THE INSURED: $ 1 PSYCHOLOGY 5. The Named Insured is: X Sole Proprietor(including independent contlactlsi _ Partnership Other. _ Corporation 6. This policy shall only apply to incidents which happen on or after a)the policy effective date shown on the Declarations: or b)the effective date of the earliest claims-made policy issued by the Company to which this policy is a renewal;or c)the date specified in any endorsement hereto. 04/05/1996 7. This policy is made and accepted subject to the printed conditions in this policy together with the provisions,stipulations and agreements contained in the following form(s)or endorsement(s). PLP-2012 f06�3 L8mg,8(Rev.10/94),,PLE-8035(09/97),PLE-2167(07/00),POE-8004(05/88)(Ed.*10/93),PLE-2081 Curren P N- (08/02) CHICAGO INSURANCE COMPANY 55 E. MONROE STREET, CHICAGO, ILLINOIS 60603 REPRESENTATIVE: Agent or broker: Trust Risk Management Services, Inc. Office address: 875 N Michigan Ave Chicago,IL 60611-1803 City,State,Zip: Toll-Free Number. 1-877.637-9700 PLP-2012(06/93) APA- JOYCE SHOHET ACKERMAN, Ed.D. 1750 25th Avenue,Suite 101 Greeley, Colorado 80634 RESUME PERSONAL DATA Date of Birth: August 3, 1950 Health: Excellent Married; two children CERTIFICATION - LICENSURE Licensed Clinical Psychologist,State of Colorado since 1984 Listed in National Register of Health Service Providers in Psychology since 1986 Staff Privileges, North Colorado Medical Center, Greeley, Colorado since 1985 PROFESSIONAL MEMBERSHIP American Psychological Association Colorado Psychological Association (elected board member 1986-1989) HONORS President's Award - Colorado Psychological Association, 1989 EDUCATION 1978 - 1981 Ed.D. in Counseling Psychology, University of Northern Colorado, December 1981 graduate 1972- 1974 M.S. in Education (E.D./L.D.) Lesley College, Cambridge, Massachusetts,August graduate 1968 - 1971 B.S. in Special Education and Elementary Education with a minor in psychology Boston University, Boston, MA, December 1971 graduate PROFESSIONAL EXPERIENCE 1981 - present Clinical Director in group practice in Greeley,CO. Among responsibilities are: Diagnosis, therapeutic intervention and referral for adults,families, children and groups. Primary areas are: mediation, alternative conflict resolution,stress reduction. Also developing, organizing and presenting workshops and consultative programs to community,schools,organizations and agencies. 1986- present Consulting psychologist on interdisciplinary team for in-patient rehabilitation program. Progressive Care Rehabilitation Center,Greeley, CO. Medical Director Dr.Judith Vaughan,Neurologist. Adults with traumatic injuries- primary problems are: psychological aspects of physical rehabilitation,grief counseling, and brief group counseling using cognitive-behavioral goal oriented therapy. 1989- 1992 Consulting psychologist for Head Injury Treatment Team North Colorado Medical Center,Greeley CO Team coordinator - Dr.John McVicker, neurosurgeon. 1986- 1989 Consulting psychologist for Family Recovery Center(in-patient substance abuse/chemical dependency program), North Colorado Medical Center,Greeley CO Coordinator Ruth Wick,R.N. 1986 - 1989 Provider and Coordinator for Mental Health Services in Northern Colorado for Peak Health Care(HMO). Peak mental health services utilized a three-session model for initial services followed by referral. Activities included coordination of Psychological and Psychiatric Services for approximately the last two years of the Contract. Peak supervisor- Elaine Taylor 1983 - 1986 Psychologist subcontractor fora Vietnam Veteran's Counseling Program funded by the Veteran's Administration. Principal Contract Dr. Robert Stewart. 1980 - 1987 Part time faculty member with responsibilities for classes, workshops and community programs in parenting skills. Family/Life Education Program, Aims Community College,Greeley CO August 1980- August 1981 -Clinical internship on Children's Team of Community Mental Health Center. Responsibilities included: consultation to schools and community programs; therapy for children and families; and assessment of diverse mental health programs. Assistant program evaluator - developed evaluation tools to determine cross-cultural perceptions of expectations and satisfaction with services. Supervisors - Dr.Joan Gillespie and Dr. Laurence P. Kerrigan. APA National Convention in Toronto,Canada"Psychology and National Health Reform: "National Health Insurance: Policy Considerations. Benefit Designs. and Economic Realities", and"Marketing: Psychology's Key to National Health Reform. 1993 Disaster Relief Training. Alan Keck through Colorado Psychological Association,Denver CO 1992-Fall Short Term Therapy, Bernard Bloom; University of Northern Colorado, Greeley CO 1990- Fall National Cognitive Rehabilitation Conference, Richmond VA 1990 -summer Postgraduate training: 1. Adult Neuropsychological Method based on Lezak Neuropsychological assessment, 1983. 2. Child Neuropsychology, Dr.Hynd. 3. Child Neuropsychological Methods 1988 Cognitive Rehabilitation Training Program, Dr.Sena, Ph.D., Colorado Springs CO 1988-present Psychologist- Head Injury Treatment Team at North Colorado Medical Center,Greeley CO 1987 Halstead Reitan Neuropsychological Assessment Training. Ralph Reitan, Ph.D., Washington DC Summer 1986 Albert Einstein School of Medicine, Workshop on Adolescent Therapy, Cape Cod MA 1985 to present North Colorado Interdisciplinary Team of Child Custody Member and participant Fall 1985 Interdisciplinary Workshop on Child Custody, Keystone CO Summer 1984 Workshop in Clinical Use of Hypnosis, Boston MA Winter 1983 Workshop on In-patient Programs for Service Related Disorders, Cheyenne Veterans Administration Hospital. Fall 1983 Veteran's Administration Workshop on Post Traumatic Stress Syndrome, Denver Veteran's Center. Fall 1981-Winter 1984 Post-Doctoral Supervised Candidate for Licensure(psychology) under Gale R. Giebler, Ph.D. Licensed Psychologist and Susan Spilman, Ph.D, Licensed Psychologist 1980 - 1981 Intern- Weld County Sexual Abuse Team,Greeley CO Weld Mental Health Center,Greeley CO adults,adolescents, families. Primary areas anxiety disorders, mood disorders and adjustment disorders. Typical problems included: trauma, physical abuse substance abuse,job stress. Orientation used - primarily cognitive-behavioral therapy. 1980 Group Facilitator-Regional and National Conferences in cross-cultural community needs. Flagstaff, AZ-Colorado Springs CO August 1975 -July 1978 Chairperson of the Department of Education and Behavioral Science at an accredited,Indian controlled community college on the Navajo Reservation. Administration responsibilities included: Supervision and evaluation of faculty; budget preparation and management;curriculum development and integration of Navajo culture; personnel recruitment and selection;class scheduling and program development. Also faculty member with academic responsibilities for instruction in Psychology, Child Development and Counseling courses, advising and counseling students. Navajo Community College,Tsaile AZ September 1974- August 1975 Education Specialist and counselor at an Indian controlled primary and secondary school on the Navajo Reservation. Coordinated community resource program,which included: counseling,student assessment, prescriptive programming,staff development and curriculum. Also, adjunct faculty for the University of New Mexico and for Navajo Community College at the Rough Rock Demonstration school, Rough Rock, AZ September 1972 -June 1974 Designed and coordinated Learning Center Program for Dedham Public Schools. A program and crisis intervention center for emotionally disturbed children. Responsibilities included: Diagnostic prescriptive programming,counseling,supervision and training of aides, tutors and volunteers, and consultation with regular classrooms teachers. Also organized group and individual meetings with parents. Adjunct faculty for Curry College assisting with in-service instruction for Dedham School System employees. Dedham Public Schools, Dedham MA WORKSHOPS AND SPECIAL TRAINING 1996 Biodyne training workshop adolescent treatment in short term therapy, Tom Kalous, Ph.D. 1995 Biodyne Training Workshops in short term therapy Julian Ang, Ph.D. 1994 Certification in family mediation,CDR Associates, Boulder CO 1993 Disaster Relief Training. Alan Keck, through Colorado Psychological Association, Denver CO 1993 August Hospital Practice for Psychologists •• Summer 1981 Independent Study of Child Sexual Abuse, University of Northern Colorado Spring 1981 Interdisciplinary Workshop on Assessment of Sexual Assault, Boulder Social Services Summer 1979 Biofeedback Training related to labor and delivery. Summer 1974 Participant in Institute on Obstacles to Learning. Joint Symposium between McLean psychiatric hospital, Harvard University and Lesley Graduate School, Cambridge MA Summer 1973 Kennedy Memorial Hospital,Boston MA. Participant,Summer Aphasia Institute. PUBLICATIONS Ackerman A., Ackerman,J.S., Kelley K. Hale K. Family Planning Attitudes of Traditional and Acculturated Navajo Indians, Key Issues in Population and Food Policy. University Press of America, pp. 178-171 (1979) Ackerman,J.S.,Client Expectations and Satisfaction with Community Mental Health Center Services: A Cross-Cultural Analysis Between Hispanics and Anglos. Published Doctor Dissertation, University of North Colorado. Copyright 1981. BRANCH B/A PRODUCER NUMBER 23 A DATE OF ISSUE PRIOR CERTIFICATE NUMBER 0004087 05/04/2004 Renewal PSYCHOLOGISTS PROFESSIONAL LIABILITY CLAIMS-MADE INSURANCE POLICY NOTICE: THIS IS A CLAIMS-MADE POLICY, PLEASE READ THE POLICY CAREFULLY PURCHASING GROUP POLICY NUMBER: 45-0002000 Item DECLARATIONS CERTIFICATE NUMBER: 45P- 2032570 1. Named Insured Ackerman and Associates PC 1750 25th Ave ADDRESS Greeley, CO 80634.4943 Number&Street,Town, County,State&Zip No.) 2. Policy Period: 12:01 A.M. Standard Time At From: To: Location of Designated Premises 05/01/2004 05/01/2005 3. COVERAGE LIMITS OF LIABILITY PREMIUM Professional Liabili $ 1,000,000 each incident $3,000,000 a..re.ate $ 1,529.00 4. BUSINESS OF THE INSURED: PSYCHOLOGY 5. The Named Insured is: _ Sole Proprietor (including independent contractors) Partnership X Corporation _ Other: 6. This policy shall only apply to incidents which happen on or after: a) the policy effective date shown on the Declarations: or b) the effective date of the earliest claims-made policy issued by the Company to which this policy is a renewal; or c) the date specified in any endorsement hereto. 05/01/1992 7. This policy is made and accepted subject to the printed conditions in this policy together with the provisions, stipulations and agreements contained in the following form(s) or endorsement(s). PLP-2012 (06/93), PLJ-2008(Rev. 10/94), , PLE-8035(09/97), PLE-2167(07/00), POE-8004(05/88) (Ed. *10/93), PLE-2081 Current, PON-2003(08/02) CHICAGO INSURANCE COMPANY 55 E. MONROE STREET, CHICAGO, ILLINOIS 60603 REPRESENTATIVE: Agent or broker: Trust Risk Management Services, Inc. 875 N Michigan Ave Office address: Chicago, IL 60611-1803 City, State, Zip: Toll-Free Number: 1-877-637-9700 PLP-2012(06/93) APA- SUPPLEMENTAL NARRATIVE TO RFP: EXHIBIT B CONDITIONS Ackerman and Associates P.C. pePt. of 1h Weld County 1750 25 Avenue, Suite 101 Soc ai.Services Greeley, Colorado. 80634 Cler cel -c121-110: n t 970-353-3373 APR 2 ? 2005 Gloria Romansik Weld County Department of Social Services P.O. Box A Greeley, Colorado 80631 April 27, 2005 Dear Ms. Romansik: Thank you for your queries concerning the PY 2005-2006 bids containing the comments of the FYC commission. We understand that RFP 05007 Sex Abuse Treatment and 05010 Option B Intensive Home Based Therapy are recommended for inclusion on the vendor list. As to our Life Skills Program, 05005 : The following defines our capacity to do after hours visitation. Ackerman and Associates maintains a twenty four hour a day 365 day a year on call system to handle emergencies. Our hours to see clients in the office begin at Nine AM and frequently end at Nine PM depending on the provider. As to home based visitation after hours,we would expect the following scenario. A call would come into the answering service and the provider on call would be contacted. That provider would evaluate if emergency contact was needed or if police response would be more appropriate. Then we would schedule the family to be seen at our offices on an emergency basis only if the conditions did not permit contact in regular hours and police intervention was not needed. We do not anticipate providing emergency visits in the client's home after hours. Scheduled after hours contact within the time window described(after five PM and before nine PM)would be at the discretion of the provider. Concerning Intensive Mediation,we agree to the condition related to consultative conflicts.. It is our understanding that any consultative conflicts specific to the case pending will lead to the withdrawal of the mediator with the perceived conflict as requested by any party. 1 • Page 2 Ackerman and Associates FYC Queries 2005-2006 Contact was made with John Kruse as requested concerning the unit of service rate consultations and all issues were resolved. John will be communicating his comments directly to Elaine. Basically, Ackerman and Associates has a 60% direct payment to providers and a 40%overhead rate. All social services programs submitted are justifiable within this framework as shown by the submitted budget worksheets. Please contact me to resolve any questions. We look forward to continued work with WCDSS. Sincerely p Joyce Sh hef ckker D. Ackerman and Associates P.C. 2 (stj ‘ta...H44 DEPARTMENT OF SOCIAL SERVICES P.O. BOX A GREELEY, CO. 80632 Website:www.co.weld.co.us Wilk. Administration and Public Assistance(970)352-1551 Child Support(970)352-6933 COLORADO April 18, 2005 Joyce Ackerman Ed. D. Ackerman&Associates,P.C. 1750 25th Avenue, Suite 101 Greeley, CO 80631 Re: RFP 05007-Sex Abuse Treatment RFP 05008-Mediation and Facilitation under the Intensive Family Therapy Program Area RFP 05010-Option B,Home Based Therapy RFP 05005-Lifeskills Dear Ms. Ackerman: The purpose of this letter is to outline the results of the Bid process for PY 2005-2006 and to request written information or confirmation from you by Wednesday, April 27, 2005. A. Results of the Bid Process for PY 2005-2006 • Through the 2005-2006 bid evaluation process, the Families, Youth and Children (FYC)Commission recommended approval of the bids listed below for inclusion on our vendor list. 1. RFP 05007-Sex Abuse Treatment 2. RFP 05010-Option B-Intensive Home Based Therapy • Through the 2005-2006 bid evaluation process,the Families,Youth and Children (FYC) Commission recommended approval of the bid listed below for inclusion on our vendor list,attaching the following condition for all Lifeskills program providers. 1. RFP 05005-Lifeskills Condition: All providers must define their capacity to do after-hours visitation. • Through the 2005-2006 bid evaluation process, the Families,Youth and Children (FYC) Commission recommended approval of the bid listed below for inclusion on our vendor list,attaching the following condition for all Intensive Mediation program providers. • Page 2 Ackerman&Associates,P.C./Results of Bid Process for PY 2005-2006 1. RFP 05008-Intensive Mediation under the Intensive Family Therapy Program Area Condition: If a consultation has occurred between a party to this action, and any party objects to the proposed mediator because of that consultation,the mediator shall remove himself/herself from performing the mediation. • Review of Unit of Service Rate Computations for All Submitted Bids: The Unit of Rate Computations on the submitted bids did not include a non face- to-face cost sheet. Further,the overhead does not calculate correctly on the Cover Cost Sheet. B. Required Response by FYC Bidders Concernine FYC Commission Conditions: 1. FYC Commission Conditions: All conditions will be incorporated as part of your RFP Bid and Notification of Financial Assistance Award(NOFAA). If you do not accept the condition(s),you will not be authorized as a vendor unless the FYC Commission and the Weld County Department of Social Services accept your mitigating circumstances. If you do not accept the condition,you must provide in writing reasons why. A meeting will be arranged to discuss your response. Your response to the above conditions will be incorporated in the RFP Bid and Notification of Financial Assistance Award. 2. Unit of Service Rate Computations: You are requested to contact John Kruse,Business Office Manager, extension 6530, to clarify the submitted Unit of Service Rate Computations. The Weld County Department of Social Services is requesting your written response to the FYC Commission's conditions. Please respond in writing to Gloria Romansik,Weld County Department of Social Services,P.O. Box A, Greeley, CO, 80632,by Wednesday,April 27, 2005, close of business. If you have questions concerning the above,please call Gloria Romansik, 970.352.1551, extension 6230. Sincerely, a_ y . 'ego, Di for cc: Juan Lopez, Chair,FYC Commission Gloria Romansik, Social Services Administrator Hello