HomeMy WebLinkAbout20052180.tiff RESOLUTION
RE: APPROVE SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT AND
AUTHORIZE CHAIR TO SIGN - SIGNAL BEHAVIORAL HEALTH NETWORK
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board has been presented with a Substance Abuse Treatment Service
Agreement 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 Signal
Behavioral Health Network, commencing July 1, 2005, and ending June 30, 2006, with further
terms and conditions being as stated in said agreement, and
WHEREAS,after review, the Board deems it advisable to approve said agreement, a copy
of which is attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County,Colorado,ex-officio Board of Social Services,that the Substance Abuse Treatment Service
Agreement 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 Signal
Behavioral Health Network be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to
sign said agreement.
The above and foregoing Resolution was, on motion duly made and seconded, adopted by
the following vote on the 3rd day of August, A.D., 2005, nunc pro tunc July 1, 2005.
BOARD OF COUNTY COMMISSIONERS
41 IE S WELD COUNTY, COLORADO
861 ra
di dal" William H. J e, Chair
'', Id "•u Clerk to the Bard
OR
N. 1\ / M. eile, Pro- em
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Deputy Clerk to the Board
Da ' E. Long
APP DASTOF
Robert D. Masde
ounty Attorney
allZIAL)L--
Glenn Vaad
Date of signature: g42.41-
2005-2180
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DEPARTMENT OF SOCIAL SERVICES
AI
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
wiik
COLORADO MEMORANDUM
TO: William H. Jerke, Chair Date: July 28, 2005 - -
Board of County Commissioners -
FR: Judy A. Griego, Director, Social Services /lA�4(4(4Cir
RE: Substance Abuse Treatment Service Agreement under AFS Service Funding
between Signal Behavioral Health Network and the Weld County Department of
Social Services
Enclosed for Board approval is a Substance Abuse Treatment Service Agreement under AFS
Service Funding between Signal Behavioral Health Network(Signal) and the Weld County
Depailnuent of Social Services (Department). This Agreement was reviewed at the Board's Work
Session held on May 31, 2005.
The major provisions of the Agreement are as follows:
1. The term of the Agreement is July 1, 2005 through June 30, 2006.
2. Signal will contribute $89,707.20 from designated ADAD Additional Family Service
(AFS) funds on behalf of families and adolescents receiving child welfare services
through the Department.
3. Signal will provide assessments, monitored sobriety services, and treatment according to
Signal's fee schedule and through their provider, Island Grove Regional Treatment
Center.
4. The Department will refer to Signal those families and adolescents involved in the child
welfare system and who are in need of substance abuse services.
If you have any questions,please telephone me at extension 6510.
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F;
2005-2180
Contract#AFS-05-06
SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF SOCIAL SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT
CHILD WELFARE CLIENTS-AFS SERVICE FUNDING
Fiscal Year July Is`2005 through June 30th 2006
This Agreement is between the Weld County Department of Social Services, hereinafter referred to as
"WCDSS" and Signal Behavioral Health Network,hereinafter referred to as "Signal".
WHEREAS,the Weld County Department of Social Services requires the services of a substance abuse
treatment provider to assist the County in delivering substance abuse treatment services to child welfare clients,and
Signal is willing and able to provide such services;and
WHEREAS, Signal is a Colorado non-profit corporation organized for the purpose of managing and
coordinating high quality, cost efficient, integrated chemical dependency and related behavioral health care services
in the State of Colorado.
NOW,THEREFORE,it is mutually agreed as follows:
SERVICES:
A. Responsibilities of Signal:
1. Signal agrees and desires to participate as the service coordinator for WCDSS qualified child
welfare clients under the definition set forth in the Child Welfare Lawsuit Settlement Agreement
(David Littman vs. State of Colorado).
2. Signal will maintain a high quality of clinical care to clients in a delivery system of limited
resources and public funding. The full continuum of care(Outpatient, Intensive Outpatient,
Transitional Residential,Intensive Residential,Therapeutic Community, or comparable
alternatives as mutually agreed upon)will be available to clients. The client's clinical needs will
determine the level of care Signal is to provide and Signal will meet those needs regardless of
"modality."
3. Signal encourages Agencies and clients/consumers/referral agencies to resolve any complaint or
grievance or appeal at the level closest to the situation. Should WCDSS and/or Signal and its
Provider fail to agree upon the level of care offered by Signal,they may appeal the case directly to
Bill Wendt, Signal Behavioral Health Network for resolution. Signal, its Provider(s) and WCDSS
will have an opportunity to provide Signal with consultation and documentation regarding the
appeal. Signal's Medical Director and Clinical Director may also be consulted. Appeals are to be
resolved within 72 working-day hours,unless good cause justifies an extension. In the interim of
the appeal, Signal is expected to continue providing services to the client.
4. Signal will assure that all eligible child welfare clients referred by WCDSS in need of treatment
will receive such in accordance with ASAM PPC-II R level of care, as reimbursed by the State of
Colorado,Alcohol and Drug Abuse Division.
5. Signal will serve child welfare clients(parents and children)on a priority basis who comply with
the following criteria as WCDSS refers:
• Case is active on TRAILS, and
• Case meets the State DHS program category criteria 4, 5,or 6,and
• Case meets the definition of"imminent risk for out-of-home placement/reunification"set forth
by the State of Colorado.
6. Signal will include the following provisions in all subcontracts with providers:
• The Provider shall submit a treatment plan for the client within 30 days
• The Provider shall submit monthly progress reports to the assigned caseworker via the Signal
website.
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Contract#AFS-05-06
• Signal, or their designee,agrees to provide Social Services monitoring results(UA,BA,
patch,tox trap)by faxing said results to Social Services at 970.346.7698 no later than 72
hours after the day of service.
• Signal agrees to send AFS Utilization Reports to Social Services each month by the 3rd
Wednesday of the month following the service. Additionally, Signal agrees to include in the
AFS Utilization Reports all AFS funded services for the month the services were provided.
• Signal agrees to cooperate with Social Services to resolve any duplicated fees and/or errors
identified by the WCDSS billing review process.
7. Signal will utilize AFS monies to pay for services in cooperation with designated WCDSS staff.
8. Signal will assure that the providers in its network give timely notice of cancelled appointments to
the clients and will reschedule such appointments as soon as practical.
9. Signal will provide monthly reports showing the amount of AFS and Core spent on treatment.
Signal will also provide access to monthly progress reports for each WCDSS client in treatment
via the Signal service management website.
10. Signal will provide training and technical support,as necessary, for WCDSS staff in accessing
data reports and on the use of the child welfare referral system.
11. Signal shall reconcile all treatment providers'claims to AFS funds within 180 days from the date of
service delivery.Claims submitted beyond 180 days will be denied.
B. Responsibilities of WCDSS:
1. WCDSS will work cooperatively with Signal and its Providers to deliver quality,efficient and
cost-effective substance abuse treatment services to WCDSS qualified clients.
2. WCDSS will make every effort to inform Signal and its Providers in a timely manner of system
issues,developments,and complications so that Signal and the Provider can make informed
choices in its role as the managed service organization and treatment agency respectively.
3. WCDSS will assure that all referrals under this contract meet the eligibility criteria expressed in
Section 1(A)(6)above.
4. WCDSS agrees to provide Signal with the name of a primary contact person who will be
responsible for interacting with Signal's data system.
5. WCDSS, or its authorized designee(s), will be responsible for electronically authorizing services
to various providers.
6. WCDSS will review monthly AFS Actual reports and determine any duplicate charges pursuant
to Core or other previously paid services.WCDSS will report monthly any discrepancies in
duplication and/or errors to Signal, and in cooperation with Signal,work with Signal to resolve
any conflicts of billed services or fees.
II. PERIOD OF PERFORMANCE
The Signal Additional Family Service period of performance under this Agreement shall be for the 12-
month period beginning July 1,2005 through June 30,2006,unless sooner terminated.
As a condition of continuing to render services under this Agreement, it is understood that Signal will
report any limitation or restriction of their license or insurance or the ability to perform the services covered
by this Agreement under any condition of impairment.
Either party may terminate this Agreement or any part herein at any time by giving not less than 45 days
advance written notice to the other party.
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Contract#AFS-05-06
In the absence of any formal agreement beyond the term of this agreement, Signal agrees to continue
providing treatment,under the terms of this agreement, for clients that are in treatment or referred by
WCDSS for treatment. This is with the further understanding that service delivery and payment are subject
to the termination terms mentioned above.
Signal reserves the right to suspend services to clients if funding is no longer available. WCDSS
acknowledges financial responsibility for all services authorized and performed before the effective date of
termination.
III. COMPENSATION
Signal agrees to contribute a maximum of eighty-nine thousand seven hundred seven dollars and twenty
cents($89,707.20)annually from designated ADAD Additional Family Service(AFS)funds to serve
eligible clients in accordance with the terms herein. Of this amount, Signal shall retain four thousand two
hundred seventy-one dollars and seventy-seven cents($4,271.77)or five percent of the service fees,
salaries, and other authorized costs that are actually incurred in the delivery of the treatment services
authorized in this Agreement.
IV. CLIENT FEES OR CO-PAYS
Neither Signal nor their network providers shall assess a client fee or co-pay to child welfare clients served
under this contract,unless the client is required to pay for any positive urine screen as a condition of their
treatment plan or through court order for monitored sobriety and/or treatment as a condition of their
treatment plan.
V. ATTACHMENTS
Signal and WCDSS agree to adopt herein the attached fee-for-service Exhibit A .
VI. INDEPENDENT CONTRACTOR
Signal and its providers shall be providing services hereunder as an independent contractor and the
relationship of employer and employee does not exist between WCDSS and Signal.
VII. NON-DISCRIMINATION
It is the policy of Signal to provide equal opportunity without discrimination based on race, color, sex,
religion, age, sexual orientation,national origin,veteran status,or individual handicap in any aspect of
employment, training or services offered. All Signal programs,activities,and services are administered on
a non-discriminatory basis subject to the provisions of:
Title VI and VII of the Civil Rights Act of 1964
Executive Order 11246, as amended
Title VII and VIII of the Public Health Services Act
Rehabilitation Act of 1973 (Section 503 and 504)
Equal Pay Act of 1963,as amended
Title IX of the Education Amendments of 1972
Vietnam Era Veteran's Readjustment Assistance Act of 1974
Age Discrimination in Employment Act of 1967
Age Discrimination Act of 1975
Non-Discrimination Laws of the State of Colorado.
VIII. ACCESS TO RECORDS
Signal and WCDSS agree to make available in a timely manner all books,documents,and records pertinent
to this contract for the purpose of billing for services, audit,and compliance with requirements and
regulations of federal and state agencies and commercial insurance carriers.
Signal acknowledges that in reviewing, storing,processing, or otherwise dealing with any client records
dealing with any client seen by a Signal provider or the on-site substance abuse counselor is bound by the
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Contract#AFS-05-06
confidentiality provisions of 42 CFR Part 2. If necessary, Signal shall resist in judicial proceedings any
efforts to obtain access to client records except as permitted by 42 CFR Part 2. WCDSS and Signal shall
sign a Qualified Service Organization Agreement in compliance with 42 CFR,Part 2.
IX. OBLIGATIONS
Obligations of WCDSS and Signal are contingent upon funds for that purpose being appropriated,budgeted
and otherwise made available.
X. PROVISIONS
This Agreement may be amended only by written agreement signed by each of the parties hereto. This
Agreement shall be binding upon, and shall inure to the benefit of the respective parties hereto and shall not
be assigned without the consent of all parties hereto.
XI. NOTICES:
Any notice required to be given pursuant to the terms and provisions hereof shall be in writing and shall be
sent by certified mail,return receipt requested;
To Signal at: To Weld County at:
Bill Wendt, Chief Executive Officer Judy A. Griego,Director
Signal Behavioral Health Network Weld County Department of Social Services
1391 Speer Blvd., Suite 300 P.O. Box A
Denver,CO 80204 Greeley,CO 80632
XII. DISPUTE RESOLUTION
It is the desire of all parties to resolve conflicts at the Signal/Provider/County level through cooperation.
Internally,the County Director(s)and the Signal Chief Executive Officer shall attempt to resolve all
conflicts and disputes. If the issue cannot be resolved,either party may request that the State intervene and
mediate the situation(by DHS Child Welfare and ADAD).
Any further unresolved issues may be submitted to George Kawamura,Office of Health and Rehabilitation
Services or his designee(s) for case presentation and review.
Should the above efforts fail, Signal,its Providers and WCDSS hereby agree to submit all unresolved
controversies,claims,and disputes arising out of this Agreement to mediation in Denver County,Colorado,
according to the commercial rules and practices of the American Arbitration Association then in force, or
pursuant to other rules or procedures as to which the parties may agree. Regardless of the outcome,each
party agrees to fund their own litigation expenses.
This Agreement shall be governed by and construed in accordance with the laws of the State of Colorado.
XIII. MISCELLANEOUS PROVISIONS
12.1 Headings. The headings of the sections and subsections of this Agreement are inserted solely for
ease of reference and shall not in any way affect the meaning or interpretation of this Agreement.
12.2 Non-Assignment. None of the parties shall have the right to assign the benefits or delegate the
obligations in this Agreement without prior written consent of the other parties. Subject to the
foregoing,this Agreement shall be binding upon and inure to the benefit of the parties and their
respective heirs, successors, legal or personal representatives and permitted assigns.
12.3 Waiver of Breach.The waiver of any party of a breach or violation of any provision of this
Agreement shall not operate as, or be construed to be, a waiver of any subsequent breach of the
same or any other provision thereof.
12.4 Gender and Number. Whenever the context of this Agreement requires,the gender of all words
shall include the masculine, feminine and neuter,and the number of all words shall include
singular and plural.
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Contract#AFS-05-06
12.5 Severability. If any provision of this Agreement is held to be unenforceable for any reason,the
unenforceability thereof shall not affect the remainder of this Agreement,which shall remain in
full force and effect and be enforceable in accordance with its terms.
12.6 Counterparts. This Agreement may be executed in duplicate originals, each of which shall be an
original instrument but both of which taken together shall constitute one and the same instrument.
12.7 Entire Agreement. This Agreement constitutes the entire understanding and agreement between
the parties with respect to its subject matter and supersedes all prior agreements or understandings,
whether written or unwritten,with respect to the same subject matter.
12.8 Hold Harmless. To the extent authorized by law each party shall indemnify, save and hold
harmless the other and the Colorado Department of Human Services,against any and all claims,
damages,liability and court awards including costs,expenses,and attorney fees incurred as a
result of any act or omission by the party's employees, agents, subcontractors,or assignees,or
arising out of any dispute between the WCDSS, Signal,Network Providers and the State
Department of Human Services in connection with the Agreement.
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Contract#AFS-05-06
SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF SOCIAL SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT
CHILD WELFARE CLIENTS-AFS SERVICE FUNDING
APPROVED BY:
SIGNAL :E�•VI I ALT. NETWORK
v2. -
O S
Scott Thoemke,Board P - Date
Signal's Federal tax ID'm i q' S.r�'1'•` '
•'1961 h. I
WELD COUNTY
COUNTY CLERK • HE BO
By: William H. Jere - '/ / r Date
Board of County Commissioners
D PUTY CLERK TO THE BOAR
WEL COU T EP MENT OF SOCIAL SERVICES
II OS"
By: u y A.Gri go,Dire o D to
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:a 0OS-o?/2L
Contract#AFS-05-06
EXHIBIT A
SCOPE OF SERVICES
A. Assessments
1) Alcohol and Drug Differential Assessment(3-Hours)
Assessment will evaluate alcohol/drug involvement as well as mental health status,history of mental
health issues,sexual history,legal history,and certain standard tests(ASAP,ASAM PPC-2,ASI,
SOCRATE,AODUI,Drinking History Questionnaire,Family Environment Scale)may be given.
Signal will provide two collateral contacts as part of the Assessment.
Baseline Urinalysis Testing(7-Panel)is included.Summary of assessment with recommendations sent
to referral agency. Tests determine what drugs are present in client.
The 7-Panel baseline urinalysis test for alcohol and drugs screens for the following:
THC Cutoff Level: 50 ng/ml
Amphetamines Cutoff Level: 1000 bg/ml
Cocaine Cutoff Level:300 ng/ml
Barbiturates Cutoff Level:200 ng/ml
Benzodiazepines Cutoff Level:200 ng/ml
Opiates Cutoff Level: 200 ng/ml
Creatinine >20 mgDL is normal
The 3-Panel baseline urinalysis test screens for: Amphetamines,THC,and Cocaine.
2) Co-Occurring Alcohol and Drug with Domestic Violence Assessment(3-Hours)
Summary of assessment with recommendations sent to referring agency. The following areas will be
assessed:
Criminal History Profile of Client's Violent
Behaviors
Potential for Violence Mental Health Status
Client's Medical History Substance Abuse History
Suicidal/Psychological/Cultural Millon Test,if needed
History
3) Substance Abuse Forensic Evaluation(3 hours,as staff expertise permits)
A forensic evaluation is specifically geared toward the substance-abusing offender. It involves
additional testing to determine the crimogenic aspect of the person to be taken into consideration
when developing treatment recommendations. Testing will be comprised of CVI,ASUS, SASSI,
Millon Clinical Multiaxial Inventory(MCMI-III),a clinical interview,and a behavioral profile. The
testing is cross-referenced with the clinical interview,and in relation to collateral data.
B. Treatment Options
1) Co-Occurring Alcohol and Drug with Domestic Violence Group Therapy(average length of
treatment,24 to 36 weeks): Groups for both men and women are offered. The group addresses
anger management,healthy relationships,male and female roles,and boundaries. As needed, a
Millon Test may be given, a standardized psychological test which measures functioning level in
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Contract#AFS-05-06
22 personality disorders and clinical syndromes for adults(8th grade reading level: > 18;available
in Spanish).
2) Family Therapy(average length of treatment,8 to 16 sessions): Involves two or more family
members and provides therapeutic intervention to improve family communications, functioning,
and relationships. Length of participation is dependent on client goals and progress toward
meeting goals.
3) Individual Counseling(average length of treatment,6 to 12 sessions): Primary client is seen
on an individual basis. Length of participation is dependent on client goals and progress toward
goals.
4) Substance Abuse Therapy(average length of treatment, 12 to 20 sessions): A group to
enhance positive coping skills by focusing on their lifestyle dealing with use and abuse of
chemicals.
5) Adult Intensive Outpatient(average length of treatment,4 to 12 weeks): An intensive
outpatient group therapy track that offers groups every evening,Monday through Friday, with a
family program component. This program will include medical aspects of addiction and adult
relapse education components focusing on understanding the relapse process as well as group
process(focuses on individual issues relating to their abuse of alcohol). The program length and
participation level will be individualized based on the presenting issues and other factors.
6) Women's Group(average length of treatment, 12-20 sessions): A gender-specific group
addressing issues affecting women and their relationships, such as family violence, co-
dependency,self-esteem and stress management.
7) Motivational Enhancement Therapy and Cognitive Behavioral Therapy for Adolescent
Cannabis Users(MET/CBT5 average length of treatment 5-8 weeks): The MET/CBT5 is a
brief treatment approach for cannabis abusing adolescents. Treatment consists of two individual
motivational enhancement therapy sessions(MET) Sessions, followed by participation in three
group cognitive behavioral therapy (CBT)sessions, The assessment includes a psychosocial
history and data from the Global Assessment of Individual Needs(CAIN),and a personalized
feedback report.
C. Special Program Option
1) Special Connections(through pregnancy and up to one year postpartum): A gender-specific
program that focuses on healthy babies,appropriate child care,prenatal care,birth control,
developmental stages of the baby,parenting skills,relationship issues, and other issues as
identified by the counselor. Services include group and individual therapy,case management and
family health education.
D. Miscellaneous Service Options
1) Fast Track Adolescent Program: The Fast Track Adolescent Program is an Intensive Outpatient
Program with supportive housing services if clinically necessary. The targeted population ranges
from 13 to 17 years of age who demonstrate substance abuse problems. The goal is to have these
adolescents discover positive alternatives to their current use behavior. The program consists of a
comprehensive differential assessment compiling personal and collateral information as well as
data obtained from the Addiction Severity Index(ASI), Substance Abuse Subtle Screening
Inventory(SASSI)and the Adolescent Self-Assessment Profile(ASAP)instruments. This data is
utilized to develop an individualized treatment plan. Clients receive a minimum of three
individual sessions with the focus on achieving their treatment goals and attend three groups per
week and three per day if in
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Contract#AFS-05-06
residential with the primary focus on education and motivational topics. Family therapy is
encouraged as a part of the client's treatment. A discharge planning session will be implemented
focusing on appropriate referrals addressing the needs and motivation of the adolescent and
family. To refer to the Fast Track Program, Social Services will contact Program Manager of
Youth Services at(970)356-6664, extension 16. If she/he is not on duty, inform the staff person
that Social Services is referring a Fast Track adolescent and give the youth's caseworker's name
so that the Fast Track staff can contact the caseworker when they return to duty.
2) Extended Detoxify Stay: This is an option when case management goals require that the person
be in a stable environment until they can be referred to the next level of care.
3) Enhanced Services: Enhanced services as approved services that are requested by Social
Services for specific cases,which fall outside of the defmitions, listed above in the description of
the ADAD menu of services. Enhanced services may be services not described on the menu,
services not included in the definition or due to lack of economy of scale, or rural location, or
result in additional costs to Signal. In order for Signal to provide enhanced service,the cost would
be outside of the approved rates. Any additional fees would be negotiated on a case-by-case basis.
Signal can arrange for services outside of the approved definitions,but Social Services will be
charged an additional fee that would be negotiated on a case-by-case basis by the designated
representative listed in the contract.
E. Measurable Outcomes and Objectives
Signal shall abide by Social Services outcome indicators of Safety,Permanency and Child and Family
Well-Being,which are provided under Adoption and Safe Families Act (ASFA), 1997;
Colorado Child and Family Services Plan 2000-2004; and ACF Reviews(Reference: Federal Register,
Volume 65,Number 16: 45 CRF Parts 1355, 1356, and 1357),March 25,2000.
1) Outcome Reports as Prescribed by Social Services
Quarterly Outcome reports will be provided to Social Services and will include the following:
a) Number of clients served;
b) Number of clients currently in each level of care;
c) Number of clients that have successfully completed their treatment. This will be broken
down into each level of care primary;
d) Number of clients that no showed,were unsuccessfully discharged or moved to a higher
level of care. This will be broken down by level of care primary;
e) Number of clients served whose primary addiction is to methamphetamine;
f) Number of clients served with a dual diagnosis, including the client's primary mental
health diagnosis;
g) Percentage of client progress delineated by each outcome objective as described under
Item 5, C of the Agreement.
2) Client Objectives
The Social Services caseworker will identify a maximum of three child welfare objectives to be
addressed within each client's treatment plan. Signal shall develop action steps to reach the
identified child welfare objectives. Signal shall report monthly on each client's progress in
meeting the three identified objectives. Each objective will be measured via a percentage Likert
Scale to determine progress.
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Contract#AFS-05-06
3) Overall Program Objectives
Signal and Social Services agree to monitor the ability of the substance abuse program offered by
Signal to achieve objectives as follows:
a) Demonstrate Abstinence with the use of UA/Patch Monitoring Only (Code#100).
b) Improve parental capabilities currently impaired by substance abuse(Code#101).
c) Develop the capacity to ask for help and assistance without resorting back to substance
abuse(Code#102).
d) Develop or increase the ability to recognize,prioritize and meet child(ren)'s needs(Code
#103).
e) Parent will identify how their substance use has affected their parenting(Code#104).
f) Parent will identify how their substance use got them involved with social services(Code
#105).
g) Parent will identify how their substance use helped them parent(Code#106).
h) Parent will identify relapse triggers and develop a safety plan for their children(Code
#107).
i) Parent will identify whom they consider to be a support in their recovery(Code#108).
j) Parent will identify who will care for their children should they relapse(Code#109).
k) Parent will identify what they enjoy about parenting sober(Code#110).
1) Improve parent-child functioning to lower the risk of out of home placement(Code
#201).
m) Parent will support their children in speaking about how living in a substance-effected
family has impacted them(Code#202).
n) Parents will demonstrate increased verbal skills, empathy and accountability with
child(ren) (Code#203).
o) Parent will identify their parenting strengths(Code#204).
p) Family members including significant other,children and extended family will increase
ability to communicate more effectively(Code#301).
q) Family members will identify how they can support the identified client in their recovery
(Code#302).
r) Family members will identify the positive parenting changes the substance-effected
person is making(Code#303).
s) Family members will identify who will care for the children in the event of a relapse
(Code#304).
t) Family members will identify relapse systems of the identified client(Code#305).
u) Family members will identify how they can reach out for help if a relapse occurs(Code
#306).
v) Increase level of functioning currently impaired by living in a substance affected family
(Code#401).
w) Identify how living in substance effected family has impacted their life(Code#402).
x) Improve level of functioning currently impaired by substance abuse issues(Code#403).
y) Decrease aggressive behaviors at home and/or school and in the community(Code#404).
z) Learn how to socialize without the use of substances(Code#405).
aa) Identify relapse triggers(Code#406).
bb) Create a sober support network(Code#407).
F. Staff Qualifications
Signal staff members who will provide services to Social Services clients will have credentials and/or
certifications as required by the Colorado Department of Human Services, Colorado Board of Education,
Alcohol and Drug Abuse Division,and the Colorado Board of Medical Examiners.
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•
Contract#AFS-05-06
EXHIBIT B
CORE SERVICES FEE SCHEDULE
1. General Core Services Fee Schedule
Description Service Weld County
Code
Trails Service Provide 5.0% AFS/Core Units
Description r Rate Rate
Alcohol(ethanol),breath 82075 Treatment $2.00 $0.10 $2.10 Each
Pkg-Low
Alcohol and/or drug 110003 Treatment $12.00 $0.60 $12.60 Each
screening;laboratory Pkg-Intensive
analysis of specimens for
presences of alcohol and/or
drugs(UA)
Alcohol and/or drug H0011 Detoxification $152.00 $7.60 $159.60 Day(s)
services; acute Services
detoxification(residential
addiction program inpatient)
(Detox)
Alcohol and/or drug H0005 Group $6.75 $0.34 $7.09 15
services;group counseling Therapy Minutes
by a clinician
Alcohol and or other drug H0048:HF Patch Reading/ $50.00 $2.50 $52.50 Each
testing,collection and Monitoring
handling only, specimens
other than blood: Substance
abuse program(Drug Patch
Monitoring)
Alcohol and/or substance T1006 Family $25.00 $1.25 $26.25 15
abuse services: family/couple Counseling Minutes
counseling
Behavioral health screening H0002 Intake Fee $140.00 $7.00 $147.00 Each
to determine eligibility for
admission to treatment
program(Evaluation)
Behavioral health screening H0002:tn Substance $200.00 $10.00 $210.00 Each
to determine eligibility for Abuse
admission to treatment Evaluation
program: Rural/out of
service area(Off-Site
Evaluation)
Behavioral health;long term 110019 Transitional $93.00 $4.65 $97.65 Day(s)
residential(non-medical, Residential
non-acute care in a Treatment
residential treatment
program where stay
is typically longer than 30
day(s), without room and
board,per diem(Transitional
Residential)
Drug confirmation, each 80102 GCMS UA $35.00 $1.75 $36.75 Each
procedure Confirmation
Individual behavioral health 110004 Individual $15.00 $0.75 $15.75 15
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• Contract#AFS-05-06
counseling and therapy Counseling Minutes
Medical testimony 99075 Court $18.75 $0.94 $19.69 15
Testimony Minutes
Office or other outpatient 99214 Antabuse $60.00 $3.00 $63.00 Each
visit for the evaluation and Physical
management of a new
patient,which requires these
three key components: a
detailed history; a detailed
examination; and medical
decision making of low
complexity. (Antabuse
Physical, new patient)
Office or other outpatient 99203 Antabuse $60.00 $3.00 $63.00 Each
visits for the evaluation and Physical
management of an
established patient, which
requires at least two of these
three key components: a
detailed history; a detailed
examination;medical •
decision making of
moderate complexity.
(Antabuse Physical,
established patient)
Oral medication H0033 Antabuse $2.00 $0.10 $2.10 Each
administration,direct
observation(Antabuse
Monitoring)
Vapor inhalations 94664 Other Services $40.00 $2.00 $42.00 Each
evaluation
Out of Region One
Services
Alcohol and/or drug H0020 Methadone $415.00 $20.75 $435.75 Month
services; methadone
administration and/or
services(provision of the
drug by a licensed program)
Behavioral health day H2012:HB Day Treatment $6.90 $0.35 $7.25 Hour(s)
treatment,per hour: Adult on behalf of
program non-geriatric(Day Child
Tx—Adult)
Behavioral health day H2012:HA Intensive $9.87 $0.49 $10.36 Hour(s)
treatment,per hour: Outpatient
Child/adolescent program Services
(Day Tx—Adolescent)
Behavioral health: long term H0019:HD New $175.00 $8.75 $183.75 Day(s)
residential(non-medical, Directions
non-acute care in a Treatment
residential treatment
program where stay is
typically longer than 30
days),without room and
board,per diem;
Page 2 of 3
Contract#AFS-05-06
Pregnant/parenting
women's program(New
Directions for Family)
Behavioral health; short- H0018:HB Treatment $170.00 $8.50 $178.50 Day(s)
term residential(non- Services only
hospital residential for
treatment program)without Residential-
room and board,per diem: Adult
Adult program, non-
geriatric(Intensive
Residential—Adult)
Behavioral health; short- H0018:HA Treatment $228.00 $11.40 $239.40 Day(s)
term residential(non- Services only
hospital residential for
treatment program) without Residential-
room and board,per diem: Adolescent
Child-adolescent program
(Intensive Residential—
Adolescent)
Therapeutic behavioral H2020:HB Therapeutic $59.00 $2.95 $61.95 Day(s)
services;per diem: Adult Community on
program, non-geriatric behalf of Child
(Therapeutic Community—
Adult w/out Infant)
Therapeutic behavioral H2020:HA Therapeutic $125.00 $6.25 $131.25 Day(s)
services,per diem: Staffing
Child/adolescent program
(Therapeutic Community—
Adolescent)
Therapeutic behavioral H2020:HD Women's $99.50 $4.98 $104.48 Day(s)
services,per diem: Therapeutic
Pregnant/parenting Community
women's program with Infant
(Therapeutic Community—
Adult w/Infant)
SWAB Treatment $15.00 $1.05 $15.75 Each
Pkg-Moderate
SWAB Treatment $45.00 $2.25 $47.25 Each
Pkg-High
2. Special Core Services Fee Schedule
All assessments shall include documentation of at least two collateral contacts
Assessments to confirm/refute client self-reported information
Residential Youth residential services may be billed to core, as negotiated on a case-by-
case basis.
Adult Treatment Adult treatment,case management and after care(45-60 days).
Services
Ongoing Treatment Ongoing treatment services will be assigned to funding streams according to
usage, as negotiated on a case-by-case basis.
Youth in Conflict(YIC)cases may be eligible for services through Core
Youth Services Service dollars, as negotiated on a case-by-case basis.
Page 3 of 3
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