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Home My WebLink About20051673.tiff Weld County Department of Social Services Notification of Financial Assistance Award for Families,Youth and Children Commission(Core)Funds Type of Action Contract Award No. X Initial Award FY05 05-CORE-0038 Revision (RFP-FYC-05005 Contract Award Period Name and Address of Contractor Beginning 06/01/2005 and Transitions Psychology Group, LLC Ending 05/31/2006 Lifeskills 804 11 Avenue Greeley, CO 80031 Computation of Awards Description Unit of Service Program offers two areas of service (1) The issuance of the Notification of Financial Lifeskills Coaching, which is a structured Assistance Award is based upon your Request for mentoring (coaching)program,beginning with Proposal (RFP). The RFP specifies the scope of an assessment; and(2)Parent-Child Interaction services and conditions of award. Except where it is Therapy(PCIT)that utilizes learning theory and in conflict with this NOFAA in which case the play therapy concepts to facilitate warm and safe NOFAA governs, the RFP upon which this award is relationships.The yearly capacity 180 clients, based is an integral part of the action. which includes 120 children, ages 0-18, monthly capacity is 30 family units,average stay in Special conditions program is 12 weeks, 3 hours per week. Follow- ups at 3 months and 6 months to ensure 1) Reimbursement for the Unit of Services will be based improvements are being maintained.Bilingual on a monthly rate per child or per family. and South County Services. 2) The monthly rate will be paid for only direct face-to- face contact with the child and/or family or as Cost Per Unit of Service specified in the unit of cost computation. Hourly Rate Per $92.34 3) Unit of service costs cannot exceed the hourly and Treatment Package-Intensive yearly cost per child and/or family. Treatment Package-Moderate 4) Payments will only be remitted on cases open with, Aftercare-Low and referrals made by the Weld County Department Court Testimony $150.00 of Social Services. 5) Requests for payment must be an original submitted to the Weld County Department of Social Services by the Enclosures: end of the 25th calendar day following the end of the X Signed RFP: Exhibit A month of service. The provider must submit requests X Supplemental Narrative to RFP: Exhibit B for payment on forms approved by Weld County Recommendation(s) Department of Social Services. X Conditions of Approval 6) The Contractor will notify the Department of any changes in staff at the rime of the change. Approvals: Program Official: By XX1,\',17/ 4/�.-� By ` C William H. Jerke, Chair Judy A. 'ego, irector Board of Weld County Commissioners Weld Co my Department of Social Services Date: JUN 0 6 2005 Date: fi� 2005-1673 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 �' '° or S. C (After receipt of order) BID MUST BE SIGNED IN INK E O RINTED SIGNATURE VENDOR Trans',14oas R14•4•11•b GroutIWA- (Name) Handwritten Signature By Authorized 2014 l Pw„"„R Officer or Agent of Vender ADDRESS Grt4t- co roc, 3 / TITLE GO DATE 3/to/OS PHONE# (9 ioY334-/17-3 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: T1"9.44;%-N«.S 9S14"11.%1 &rev P I L1_C_ ADDRESS: 13.09 t1ft"Avevn&e , G ked-Pa I CO $0631 PHONE: (q 7.0)33im-i/22._3 CONTACT PERSON: Toad` Wlos4kar4-r,,,u&. TITLE: Ce^0We2'r- 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: Lice. SIC.ti 5 Coack;noe ord. Iliars re Air': .V i g;4r.A-,,3 AMOUNT REQUESTED: Progrsvr 3II04gtt /hoAr1 9 l412.3 SAMi Moe-R4rt vn4vl/ Mk) LPGill r _ S/t0/05 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 arget/Eligibility Populations _ ypes of services Provided _ Measurable Outcomes Service Objectives Workload Standards _ taff Qualifications Unit of Service Rate Computation _ 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 _Z‘6 Comments by SSD Supervisor: I1 /�1 ;rl (_ 'r'1/\,'ly/k'c j i --- ,L,/ f i c f�t,i 1_.t7Y `≥D r N (J r, —X111:' O- --t,- C-2(4-1. . 0 detCh1/41-NI '51-1, 4-( Name and Signature of SSD Supervisor Date Page 27 of 33 Life Skills 2005-2006 Transitions 1 - spore • • w $ Life Skills Program Bid Proposal • • $ • Coaching and Therapeutic Visitation • •� ; : Transitions Psychology Group, LLC • * i' 2005-2006 Transitions PSYCHOLOGY GROUP, LLC I. PROJECT DESCRIPTION Transitions Psychology Group, LLC is a private counseling agency with a multidisciplinary team of human service professionals, including Licensed Psychologist and School Psychologist, Licensed Professional Counselors, Licensed Clinical Social Worker and other degreed paraprofessionals. Transitions provides superior counseling, assessment and consultation services to children and families in Northern Colorado. The purpose of the Life Skills program is to teach skills that will improve household management competencies, parental competencies, family conflict management and utilization of community resources in order to prevent imminent placement of children and/or reunify children in placement with their families. Transitions' Life Skills Coaching is a structured training program with specific objectives that begins with a Life Skills Assessment (LSA). The LSA elicits family strengths and needs by evaluating content areas in the family through the use of participant self-anchored scales. The LSA provides a baseline score in each content area being evaluated. The life skills coach will work with the participating family members to identify priority areas on which to focus and target goals. These goals become part of the action plan developed together between the coach and the family, with input from the referring caseworker. The life skills coach will help the family to tap into strengths in order to find solutions to the current problems, teach skills related to the priority areas, provide opportunities for the participants to practice newly learned skills, and coach participants, consistently offering feedback and encouragement. Transitions' Therapeutic Visitation program utilizes a Parent Child Interaction Therapy (PCIT) model that integrates learning theory and play therapy concepts to facilitate warm and safe relationships. The visitation is structured with strong teaching and practice components. Structured observations are used to record and evaluate changes in parent/child interactions. Life Skills 2005-2006 Transitions 2 II. TARGET/ELIGIBILITY POPULATIONS Transitions estimates that the Life Skills program will serve 180 clients. Of the total number of clients, approximately 120 of these clients would be children ages 0-18 years old. The probable number of family units accepted into the program would be 60. One-fourth of the total number of clients (45) would be eligible for bicultural/bilingual services. All Transitions coaches and therapists have multi- cultural experience; two therapists are bilingual. Up to 20 families could receive services in South Weld County. The monthly maximum program capacity is 30 family units, with a monthly average of 20 active family units. The average stay in the program will be 12 weeks, with each family participating an average of three hours per week. Services will be more intensive at the outset of the coaching program, tapering off gradually throughout the course of the intervention. Follow-ups will be provided at the end of three months and again at six months when possible to help ensure that improvements have been maintained. III. TYPES OF SERVICES PROVIDED A. Life Skills Coaching: Through in-home, office and community interventions, the Life Skills Coaching program will address the following: 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 access to community resources 6. Encourage goal setting and pro-social values Transitions utilizes a Life Skills Assessment (LSA), conducts pre and post intervention for each referred family and including scaled ratings in various content areas. Transitions will utilize the assessment to identify strengths and needs in the content areas under household management competencies, parental competencies, family conflict management and utilization of community resources. The data from the LSA will be used to develop goals and objectives for the action plans. B. Visitation: The Visitation program will provide the following services through a Parent Child Interaction Therapy (PCIT) model. 1. Monitor parent/child interactions for physical and emotional safety: A trained therapist will be present during the contact between the parent and child. Life Skills 2005-2006 Transitions 3 2. Document clinical observations: The therapist will monitor parent/child interactions and collect specific data, such as quality and type of play, number of positive interactions and the child's compliance with the parent's requests. 3. Strategize for teaching and modeling parenting skills: The therapist acts as a coach during the sessions, directly teaching discipline techniques and re-teaching parenting errors. 4. Teach relational skills: The therapist teaches the parent play therapy concepts and models interaction skills as a way to bond with the child. 5. Encourage goal setting and pro-social values: Reduction of parental stress through the use of PCIT often decreases the propensity that a parent will commit violent or neglectful acts towards the child. Developing a better relationship with the parent has been shown to improve the child's compliance with rules and requests. III. MEASURABLE OUTCOMES A. Improvement of household management competencies will be measured using a pre and post intervention screening, the Life Skills Assessment. The assessment will include self-anchored scales related to household management competencies. B. Improvement of parental competencies will also be measured using the LSA and documented observations of parenting skills. C. Parents can independently work with other sources in the community and within the local, state and federal governments as measured through the use ecological maps. Ecological maps document the participants' support network pre and post participation. Changes in the network can be measured over time. D. Transitions will conduct participant follow-up with Life Skills Coaching participants three months and six months after discharge. The participant families will remain intact at the time of the six-month follow-up. E. Participants who complete the Life Skills services will have improved competency levels or reduced risk on a standardized assessment. Transitions will utilize the Parental Stress Index (PSI), the risk assessment tool or the FACES (Family Adaptability and Cohesion Evaluation Scales) IV. Life Skills 2005-2006 Transitions 4 V. SERVICE OBJECTIVES A. Life Skills Coaching 1. Improve household management competencies, the capacity of parents to provide a safe household environment for their children through competent household cleaning and maintenance, budgeting, purchasing and leisure activities. This will be measured through the use of self-anchored scales and pre and post measures on the Life Skills Assessment (LSA). 2. Improve parental competencies, the capacity of parents to use adaptive strategies, maintain sound relationships with their children and provide care, nutrition, hygiene, discipline, protection, instruction and supervision. Progress will be measured via pre and post measures on the LSA. 6. Improve ability to access community connections and resources, services that assist parents to work with other sources of help in the community and the local, state and federal governments. This will be measured by comparisons between pre and post ecological maps. 7. Improve goal setting and pro-social values. Families will establish and work on specific goals throughout the program. Their progress towards their goals will be documented, along with their cooperation with the program. B. Visitation 1. Improve parenting skills, parent child/parent child interactions and relational skills and monitor for physical and emotional safety through structured activities and documentation of visitations to achieve the objectives of the treatment plan. Monitoring, teaching and documentation will me accomplished through the use of trained Master's level therapists and the PCIT model. 2. Improve goal setting and pro-social values through helping the parent experience feelings of success in parenting. Parenting stress will be measured through the use of the Parental Stress Index pre- and post intervention. VI. WORKLOAD STANDARDS The Life Skills program will provide services for approximately 20 hours each week, divided between six service providers. The maximum caseload per worker would be six family units. The primary modality of service for the Coaching program will be home visits. However, depending on the specific goals, in-person office meetings and community-based interventions would also be appropriate. Visits Life Skills 2005-2006 Transitions 5 will typically include the entire family and be held in the office, although in-home visits are also available and other community venues are sometimes utilized (e.g. parks). The total number of hours per day would not exceed 18 the total number of service hours per week would not exceed; the hours per month would not exceed. Program supervisors, therapists and life skills coaches carry professional liability insurance with coverage of at least $1,000,000 per occurrence and $3,000,000 aggregate. VII. STAFF QUALIFICATIONS A. Transitions staff members, including supervisors, who are providing direct services meet or exceed 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. Transitions staff members providing services under the Life Skills program area possess a minimum of a bachelor's degree in human service or human development field and six months of relevant experience. Staff members providing therapeutic visitation hold at least a master's degree in a human service field and at least two years of relevant experience. Program supervisors hold master's degrees and are licensed as professional counselors. B. Transitions has four contracted staff members available for the Life Skills program. Additionally, Transitions has two supervisors in the program area who also provide direct services, for a total of six available staff members for the Life Skills program area. VIII. 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LL 2 O O1 gyp • 0 0 w 0 a S N 0 ,:41- .• 2 J J O QQ • W H W 0 < < -41 cl.,ti:' 'i,:'' '''';:-,:,iL:',.:„V.,1'. :;:-:!:::'71:::1:1;%:,";:- :l: -1 -1 -1 a o 0 0 o o O o m v 0 - • CNA Healthcare Providers Service Organization Purchasing Group El—IPSO FHA Plaza, J 'Chicago.11 60685 trfifcafr of �Jnn ranr.e Producer Branch Prefix Policy Number Policy Period 018098 970 from: 12:01 AM Standard Time on: 07/04/04 HPG 270170686-8 to: 12:01 AN Standard Time on: 07/04/05 Named Insured and Address Program Administrator GREGORY S CREED Healthcare Providers Service Organization 804 ORYH AVE 159 East County Line Road Hatboro, PA 19040-1218 GREELEY CO 80631-3246 Medical Specialty: Code: Insurance Provided by Clinical Counselor 72990 American Casualty Co. of Reading, PA ; CNA Plaza 26S Chicago, IL 60685 COVERAGE PARTS LIMITS OF LIABILITY A. PROFESSIONAL LIABILITY Professional Liability $1,000,000.00 each claim $6,000,000.00 aggregate Good Samaritan Liability Included above Personal Injury Liability Included above Malplacement Liability Included above B. Coverage Extensions License Protection $5,000.00 per proceeding $12,500.00 aggregate Defendant Expense Benefit $5,000.00 a Deposition Representation gggegate $1,250.00 per deposition $2,500.00 aggregate Assault $5,000.00 per incident $12,500.00 agareaate Medical Payments $1,000.00 per person $50,000.00 aggregate First Aid $1,250.00 aggregate Damage to Property of Others , $250.00 per incident 55,000.00 aggregate C. WORKPLACE LIABILITY Coverage part C. does not apply if Coverage part D. is made part of this polio-, Workplace Liability Included in A. Professional Liability Limit shown above Fire and Water Legal Liability Included above subject to $150,000 sub-limit Personal Liability I $500,000.00 aggregate D. GENERAL LIABILITY Coverage part D. does not apply if Coverage part C. is made part of this policy. Workplace Liability None Hired Auto & Non Owned Auto None I None Fire & Water Legal Liability None None Personal Liability I None Total Premium $125.00 Policy forms and endorsements attached at inception QUESTIONS? CALL: 1-800-982-9491 G-144872-A G-144959-A G-121500C G-121EO1C G-123846C-05 G-121503C Healthcare Providers Service Organization is a division of Affinity Insurance Services.lac..in NY and NH.AIS Affinity Insurance Agency,in MN and(NC,AIS Affinity Insurance Agency.Inc.;and to CA.AIS Affinity Insurance Agency.Inc.dba Aon Direct Insurance Administrators License#079St65 Master Policy: 188711433 Keep this document in a safe place. This and 1�n. your cancelled check act as proof of. coverage. Chairman of the Board Secretary 925 XX 000024A-R ni.n69C ocuunn ,,,,... _. .__ NA Healthcare Providers Service Organization Purchasing Group �H�S� LN�A Plaza,60685 hi ago. II. H,a1tF..rc PfonJen$.erne Ory,ry�,q�- Terttficate of 1xtsurarme Producer Branch Prefix Policy Number Policy Period from: 12:01 AM Standard Time on: 07/04/04 018098 970 HPG 270170798-8 to: 12:Q1 AM Standard Time on: 1)7/04/05 Named Insured and Address Program Administrator Healthcare Providers Service Organization JAMI MOE HARTMAN 159 East County Line Road 804 11TH AVE Hatboro, PA 19040-1218 GREELEY CO 80631-3246 Medical Specialty: Code: Insurance Provided by Clinical Counselor 72990 American Casualty Co. of Reading, PA CNA Plaza 26S Chicago, IL 60685 COVERAGE PARTS LIMITS OF LIABILITY A. PROFESSIONAL, LIABILITY Professional Liability $1,000,000.00 each claim $6.000 ,000.00 aggregate Good Samaritan Liability Included above Personal Injury Liability Included above Malplacement Liability Included above B. Coverage Extensions License Protection $5,000.00 per proceedina $12.500.00 aggregate Defendant Expense Benefit $5,000.00 aggregate Deposition Representation a p p $1,250.00 per deposition $2,500.00 aggregate Assault $5,000.00 per incident $12.500.00 aggregate Medical Payments $1,000.00 per person $50,000.00 aggregate First Aid $1,250.00 aggregate Damage to Property of Others $250.00 per incident $5,000.00 aggregate C. WORKPLACE LIABILITY Coverage part C. does not apply if Coverage part D. is made part of this policy. Workplace Liability Included in A. Professional Liability Limit shown above Fire and Water Legal Liability Included above subject to $150,000 sub-limit Personal Liability I $500,000.00 agaregate D. GENERAL LIABILITY Coverage part D. does not apply if Coverage part C. is made part of this policy. Workplace Liability None 1 None Hired Auto & Non Owned Auto None Fire & Water Legal Liability None None Personal Liability 1 None Total Premium $125.00 Policy forms and endorsements attached at inception QUESTIONS? CALL: 1-800-982-9491 G-144872-A G-144959-A G-121500C G-121501C G-123846C-05 G-121503C Healthcare Providers Service Organization is a division or Affinity Insurance Services.hie.:in NY and NH.AIS Affinity Insurance Agency.in MN and OK,AIS Affinity Insurance Agency.Inc.:and in CA.MS Affuuty Insurance Agency.Inc.dba Ann Direct Insurance Adnunistrators License»0"95965 Master Policy: 188711433 2 X Keep this document in a safe place. This and your cancelled check act as proof of coverage. Cf)'Y4- 1"4-04-- ill Chairman of the Board Secretary 925 XX 0000246-R 040426 RENHCP 2/04 R177Ht1 04117 SUPPLEMENTAL NARRATIVE TO RFP: EXHIBIT B CONDITIONS 04/26/2005, 11:52 3510182 PAGE 01• w w 804 11''Avenue FAX '4.0 m se • so. ,y a Greeley,CO 80631 e a w0 -+ s Phone (970)336-1123 'w6 M. . FAX(970)351-0182 • er®m `� , Transitions PV, GV .LLC TO: Elaine Furister, CPS/CAP FAX 970-346-7698 FROM: Gregory S. Creed, MA, LPC DATE: 4/26/05 RE: Confirmation Letter to Judy Griego PAGES: 3 COMMENTS: Please accept this letter of confirmation for the 2005-2006 Bid process. Thanks for going over the conditions with me, Elaine. You are always such a big help. Please confirm that you have received this FAX by calling me at 590-1424. Then I can rest assured. CONFIDENTIAL The information contained in this facsimile message is privileged and confidential information intended for the use of the individual or entity named above. If the reader of this message is not the intended recipient or the employee or agent responsible to delver it to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this fax in error, please immediately notify us by telephone and return the original message to us at the above address via the U.S. Postal Service. Thank you. 04/26/2005 11:52 3510182 PAGE 02 • ,, _s. . • +�� . 80411"'Avenue • ea y f, r Greeley, CO 80631 e rA 0 lid w t Phone; (970) 336-1123 • • 0 * a FAX: (970)351-0182 Do 4v � Cell: (970)590-1424 Transitions /lYCHOIOCY Om JP 4K Judy Griego, Director Weld County Department of Social Services PO Box A Greeley, Colorado 80632 April 26, 2005 Re: RFP 04005: Lifeskills RFP 006-00A: Foster Parent Consultation RFP 006-DOB: Home Study, Relinquishment Counseling RFP 006-00: Mental Health Services Dear Ms. Griego, Transitions Psychology Group, LLC, is pleased to confirm our acceptance of the bids for PY 2005-2006 with the attached conditions as follows: • RFP 006-00A: Foster Parent Consultation. CONFIRMED. • RFP 006-00B: Home Study, Relinquishment Counseling. CONFIRMED with conditions: 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 Condition #2: It has been mutually decided that the turnaround time for receipt of the completed home study by the Department is set at six weeks form the date of receipt of the referral. • RFP 04005: Lifeskills: CONFIRMED with the condition: Condition: Transitions has the following capacity to provide after-hours visitation: Monday-Friday evenings times from 5:00-8:00PM with the maximum of two simultaneous sessions in any given time slot. Saturdays 8:00AM-12:00Noon with only one therapist available for 04/26/2005, 11:52 3510182 PAGE 03 services. • RFP 006-00: Mental Health Services: CONFIRMED with the condition: Condition; Reports will be provided to the Department 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. We look forward to another successful year of serving Weld County residents and Social Services agencies. Please feel free to call me on my cell phone, 590- 1424, or at the office, 336-1123, with any questions. Thank you. Sincerely, Gregory S. Creed, MA, LPC Cc: Jami Moe-Hartman, Co-director, Transitions Psychology Group, LLC C P e��- � ' 804 11th Avenue • " • Greeley, CO 80631 t e . lit ' * Phone: (970) 336-1123 e 0* y i FAX: (970) 351-0182 0. Cell: (970) 590-1424 RECEIVED APR 27 2005 Transitions PJYCHOIOGY GROUP,Ut Weld County Dept. of Judy Griego, Director Social Services g Clerical Unit Weld County Department of Social Services PO Box A APR 2 7 2.005 Greeley, Colorado 80632 April 26, 2005 Re: RFP 04005: Lifeskills RFP 006-00A: Foster Parent Consultation RFP 006-00B: Home Study, Relinquishment Counseling RFP 006-00: Mental Health Services Dear Ms. Griego, Transitions Psychology Group, LLC, is pleased to confirm our acceptance of the bids for PY 2005-2006 with the attached conditions as follows: • RFP 006-00k Foster Parent Consultation. CONFIRMED. • RFP 006-00B: Home Study, Relinquishment Counseling. CONFIRMED with conditions: 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 Condition #2: It has been mutually decided that the turnaround time for receipt of the completed home study by the Department is set at six weeks form the date of receipt of the referral. • RFP 04005: Lifeskills: CONFIRMED with the condition: Condition: Transitions has the following capacity to provide after-hours visitation: Monday-Friday evenings times from 5:00-8:OOPM with the maximum of two simultaneous sessions in any given time slot. Saturdays 8:00AM-12:00Noon with only one therapist available for services. • RFP 006-00: Mental Health Services: CONFIRMED with the condition: Condition: Reports will be provided to the Department 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. We look forward to another successful year of serving Weld County residents and Social Services agencies. Please feel free to call me on my cell phone, 590- 1424, or at the office, 336-1123, with any questions. Thank you. Sincerely, Gregory S. Creed, MA, LPC Cc: Jami Moe-Hartman, Co-director, Transitions Psychology Group, LLC : * 804 11t Avenue FAX : s e w .' Greeley, CO 80631 • S e .� . s Phone (970)336-1123 • -e�° M < < FAX (970)351-0182 00 Transitions PSYCHOLOGY GROUP ac TO: Elaine Furister, CPS/CAP FAX 970-346-7698 FROM: Gregory S. Creed, MA, LPC DATE: 4/26/05 RE: Confirmation Letter to Judy Griego PAGES: 3 COMMENTS: Please accept this letter of confirmation for the 2005-2006 Bid process. Thanks for going over the conditions with me, Elaine. You are always such a big help. Please confirm that you have received this FAX by calling me at 590-1424. Then I can rest assured. CONFIDENTIAL The information contained in this facsimile message is privileged and confidential information intended for the use of the individual or entity named above. If the reader of this message is not the intended recipient or the employee or agent responsible to delver it to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this fax in error, please immediately notify us by telephone and return the original message to us at the above address via the U.S. Postal Service. Thank you. ra;;;Iist DEPARTMENT OF SOCIAL SERVICES P.O. BOX A GREELEY, CO. 80632 Website:www.co.weld.co.us I Administration and Public Assistance(970)352-1551 Child Support(970)352-6933 O � April 18, 2005 COLORADO Greg Creed,Co-owner Transitions Psychology Group,LLC 804 11 Avenue Greeley,CO 80631 Re: RFP 04005: Lifeskills RFP 006-00A:Foster Parent Consultation RFP 006-00B: Home Study,Relinquishment Counseling RFP 006-00 Mental Health Services Dear Mr. Creed: 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 RPF 006- 00A,Foster Parent Consultation for inclusion on our vendor list. • The Families,Youth and Children(FYC) Commission recommended approval of Bid#006- 00,Home Studies and Relinquishment Counseling for inclusion on our vendor list,attaching the following conditions for all Home Study 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. Condition#2: It has been mutually decided that the turnaround time for receipt of the completed home study by the Department is set at six weeks from the date of receipt of the referral. • 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. Page 2 Transitions Psychology Group/Results of RFP Process for 2005-2006 • The Families,Youth and Children(FYC)Commission recommended approval Bid#006-00 Mental Health Services for inclusion on our vendor list, attaching the following condition for all Mental Health Services providers. Condition: 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. 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 at 352.1551, extension 6230. Sincerely, ego, ' for 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 0004 Revision (RFP-PAC-05005) Contract Award Period Name and Address of Contractor The Jubilee Retreat Center-Lori Kochevar LLC Beginning 06/01/2005 and Life Skills Program Ending 05/31/2006 810 12 Street Greeley,CO 80631 Computation of Awards Description Unit of Service The issuance of the Notification of Financial Assistance Award is based upon your Request for Supervised visitation for the family during the Proposal (RFP). The RFP specifies the scope of time the bonding specialist is working with services and conditions of award. Except where it is them. The program offers information, in conflict with this NOFAA in which case the education, and modeling of behaviors that NOFAA governs,the RFP upon which this award is promote bonding,to assist the parent in their based is an integral part of the action. relationship with the child. The program serves Special conditions children ages 0-12. Service to a total of 60 families during the 12-month period, 8-10 1) Reimbursement for the Unit of Services will be based families served at any given time, 24 hours of on an hourly rate per child or per family. one-on-one supervised visitation with the 2) The hourly rate will be paid for only direct face-to- bonding specialist per family.Bilingual and face contact with the child and/or family, as monolingual services. 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 yearly cost per child and/or family. Hourly Rate Per 4) Payment will only be remitted on cases open with, Treatment Package $ 86.00 and referrals made by the Weld County Department Court Testimony $ 86.00 of Social Services. 5) Requests for payment must be an original submitted 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: Exhibit B 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 11/, a By ,JC 7W.,13'n7 William H. Jerke, Chair Judy . 'eg irector Board of Weld County Commissioners Weld ounty Department of Social Services Date: JUN 0 6 9005 Date: (421t%- /1‘a 7-3 SIGNED RFP: EXHIBIT A • 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) nn DQ NAME OF AGENCY: ��' /��)J&t22cc, �8 f �Z 47ij4 ADDRESS: 49/O I0 ill �f PHONE: (9 o ) 3c a -$ 7 3 CONTACT PERSON: L T V i?Li /) I I'1 LE: at m Dt DESCRIPTION OF FAMILY PRESERVATION PROGRAM CATEGORY: The Life Skills Program Category mustprovide 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: sihfi (li-Idtr5. p/Jc pc AMOUNT REQUESTED:'A 12 j)$59j o 31fl/as N e and ignature of 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 bit Project Description e �1C Oro� +CjN �n d 5e4VICL, Target/Eligibility Populations ii fit- Types of services Provided O Measurable Outcomes 44 Service Objectives (_ Workload Standards Staff Qualifications Chu,, fie y Unit of Service Rate Computation At Program Capacity per Month 4E— Certificateat of Insurance NC—Assurance Statement Page 26 of 33 Bid 002-05 (RFP-FYC-05005) Attached A Date of Meeting(s)with Social Services Division Supervisor: 2-2s'LC-- Comments by SSD Supervisor: ( - (Ai ff Name and Signature of SSD Supervisor Date Page 27 of 33 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 k_Delivery Date (After receipt of order) BID MUST BE SIGNED IN INK Lag.f�J D n At //�� D TYPED OR{ PRINTED- SIGNATURE VENDOR 02"124 ,f 01 lZGritte4 ridi GG t Y LPC> ame) U Handwritten Signature By Authorized Officer or Agent of Vender n ADDRESS �3ID=a.ar TITLE -1t,QA DATE PHONE # t7 V 392- S73 The above bid is subject to Terms and Conditions as attached hereto and incorporated. Page 1 of 33 THE BONDING PROGRAM Purpose: The purpose of the Bonding Program is to provide support and information in order to assist parents in building a stronger emotional relationship with their children. The focus of this program is to teach parents how to create an emotionally safe and secure environment for their children in the home. The goal of this program is to keep children with their biological parents. Design: This program will provide supervised visitation for the family during the time the bonding specialist is working with them. Starting this year, we have the expertise on staff to serve children up to age twelve. It has become clear over the last ten years of this program that bonding and attachment work for older children is greatly needed. When parents are unaware of how to set significant structure and firm boundaries with children that have attachment issues they are more likely to fail in their attempts to reunify with their children. It is paramount that these parents be given direct training, modeling and coaching on how to address the specific needs of the older child in need of bonding work. In addition, due to an increase in staff availability we will be able to provide services for more bi and mono-lingual families. While in the past we have used interpreters and had limited clinical time from a bilingual therapist, we now have the capacity to serve this need. Providing services in the most comfortable language for the clients greatly increases its effectiveness. All other aspects of the program will remain the same using the design and assessment tools that have evolved over the last ten years of providing this service. STAFF QUALIFICATIONS A. All the providers exceed the minimum qualifications needed for both education and experience. All providers have their Master's Degree in Counseling or Registered Nursing Degree. In addition, the therapists have between 8-20 years a piece providing services for families. See Resumes in Appendix B. B. Staff available for this project consists of five experienced bonding specialists that have a similar core value of clinical excellence. We believe in providing strength-based, services that empower the families we serve. Another strength of our staff is our diverse areas of specialties. • Lori Kochevar a licensed professional counselor has extensive experience and training in providing services and supervision using the family preservation model. She has been working in the field for over twenty years and has been in child welfare for the last ten of those. She has specialized training in substance abuse, attachment and bonding, trauma, grief, and domestic violence. In the last fifteen years Lori has developed and facilitated multiple training's that emphasize experiential learning opportunities. Many of these training's were developed specifically for foster parents, while others were created for families, school personnel, and service providers across the state. • Heidi Friese has a master's degree that includes specialization in public child welfare, as part of government efforts to improve the foster care system, and trauma counseling. She has over ten years of experience in child welfare, as well as over fifteen years experience working with children. As a caseworker in Milwaukee County's child welfare system, Heidi worked in the foster care (carrying foster child and birth parent cases), family reunification (intensive service provision to foster children and birth parents to reunify birth families), and adoption units. In recent years, she has been the Child Placement Supervisor for the Institute for Attachment and Child Development, specializes in the treatment of foster children with attachment issues using Love and Logic. Heidi has also provided outpatient and intensive therapy, as well as in-home therapy, including Wraparound. • Bill George has a master's degree in counseling from the University of Northern Colorado. He has over twenty years of experience in the field 16 and is certified in many areas of practice. He has specialized training in individual and group services as a member of a psychiatric crisis team, drug and alcohol counselor, medical social worker, and vocational rehabilitation specialist. He is a Certified Alcohol and Drug Counselor in the State of Colorado, level III and an Expert Witness. Most recently he became certified as a Disability Management Specialist and has provided evaluations, vocational testing and assessments for the Department of Veteran Affairs. He is currently taking additional training on therapeutic attachment and bonding issues. • Ellenor Dominguez has a master's degree in counseling and is bilingual in Spanish. She has eight years of experience with Weld County Social Services, and is well respected by her colleagues. Last year, she received the prestigious title of caseworker of the year. She received her Master's degree from the University of Northern Colorado. Over the last ten years Ellenor, has worked as a caseworker III, Case aid, Supervisor, and lead Counselor at a Women's Place, and Migrant Outreach Coordinator. She has extensive experience with mono-lingual families in the community and community resources. She is currently taking additional training on therapeutic attachment and bonding issues. • Lisa Downs is a licensed professional counselor and a registered play therapist. She received her Master's degree from the University of Northern Colorado. She has experience working with children and families in both the mental health and school setting. Her expertises are working with families that have been affected by drug or alcohol addiction, play therapy, and women's issues. • Becky McMahan has had extensive experience in the area of child health care. She received her R.N. from the Mennonite Hospital School of Nursing - Bloomington, Illinois. She worked as pediatric nurse for fourteen years. The past 7 1/2 yrs she was a public health nurse where she was in charge of the bonding program and other pediatric related programs. Along with being skilled trainers, due to our extensive background as caseworkers and therapists we are knowledgeable of the systems (i.e. biological families, social services, mental health services, legal services, etc...) that foster parents need to interface with as advocates for the children that are placed with them. 17 APPENDIX A • RESUME Rebecca McMahan 3720 Boulder Street Evans, CO 80620 Home Phone: 339-5522 Experience: 1995-2003- Weld County Department of Public Health and Environment Greeley, Co. • Staff nurse on Child Health Team. Responsibilities included charge nurse of the well-child clinic, home visitation for post-partum cases, follow up with referrals from other agencies to respond to a concern regarding an infant or child. • Development and implementation of the Bonding Program in 1995. Continued to develop and serve as bonding nurse until 12/31/03 when the program was terminated due to funding. • Instrumental in starting and coordinating a parent support group for parents of children with attachment issues, 1996-1998. 1981-1995- North Colorado Medical Center Greeley, CO • Staff Nurse on Pediatrics Unit- Provided nursing care for infants, children and young adults with acute and chronic illnesses • Provided support and education for parents of those children 1974-1975- School Nurse with Weld County School District 6 1970-1974- NCMC (Weld County Hospital at that time) • Pediatric staff nurse 1968 and 1969- Summer Migrant Health nurse in southern eastern Colorado for Colorado State Health Department • Program included home visitation • Directing clients to local and state resources • Arranging for evening clinics at local physician offices 1966-1968- Lutheran Hospital — Denver, Co. • Staff nurse — emergency room 1964-1966-Pioneer Memorial Hospital - Rocky Ford, CO. • Staff Nurse Education: 1975-1976-Pediatric Nurse Practitioner Program- University Hospital 1970- Bachelor of Science Degree in Nursing University of Northern Colorado, Greeley, CO 1961-1964- Mennonite Hospital School of Nursing - Bloomington, Illinois Diploma- RN-three year program Continuing Education and Inservices 1995-1996 — Training at The Attachment Center at Evergreen, CO. Focused on attachment and bonding and the parenting of children with attachment concerns. -Training with therapeutic foster parent in her home —8 hours • -This foster mom came to Greeley 8 hours x5, to offer guidance when bonding program began and to assist with the Parent support group 1996,1997,1999-Attendence at ATTACh Conference-a three day conference which offers current information for parents and professions in the field of attachment and bonding. Presenters are therapists, psychologists, therapeutic foster parents, adoptive parents and biological parents. !997,1998,1999,2000- Annual summer conference at the Attachment Center at Evergreen- Annual one day seminar updating new resources and research in the field of bonding. !999- FIRST (Family-Infant Relationship Training) NCAST ( Nursing Child Assessment Satellite Training Program) Assessment of Parent-Child Interaction-Interdisciplinary Training 1997-Training for the Prevention and Treatment of Maltreatment of Children with Disabilities- Loveland, CO- hour training 1997-Fetal Alcohol Syndrome-Greeley, CO —7 hour training 1999- Play Therapy in Therapeutic Care of Children in Foster Care- Presented by Ken Swartzenberger — Greeley, CO —8 hour 2001- Operation Kids Child Passenger Safety Class — presented by Union Colony Fire/ Rescue- 8 hour class- Greeley. CO 2001- Emotional Disorders in Children- presented by Patricia Kerwin, PhD.- Cheyene, WY. 8 hour 2001-"Early Life Experience and Brain Development: How we can Help Our Children Reach Their Potential"- Bruce Perry 2002- "Breastfeeding:A Gold Medal Beginning"- presented by Marianne Neifert, MD. 4 hours MARGARET E. MEINECKE, LCSW, CAC III Individual, Couples and Family Therapies Licensed Clinical Social Worker Certified Addictions Counselor, Level III 5911 S. Middlefield Road. Suite 103 Littleton. CO 80123 (303) 973-1064 August 11, 2002 Weld County Health Department 1555 North 17th Avenue Greeley, CO 80631 Re: Becky McMahan To Whom It May Concern: On May 8, 2002 I met with Ms. McMahan for three hours to discuss clinical issues related to her work with the Weld County Health Department. Specifically reviewing cases of at-risk infants and parent-child bonding and attachment. Becky and her colleague, Trish McClain,noted challenges in reaching some parents with dysfunctional attitudes and discipline practices. We also talked about some parents' poor interpersonal skills that would likely result in weak and/or insecure family bonds. An integral part of Ms McMahan's work involves helping parents develop healthy relationships with their children by providing clear limits with kindness and consistency. By teaching the importance of physical safety, intellectual stimulation and emotional support, she helps parents provide for the overall health and well-being of their children. Ms. McMahan has a professional attitude and models respect and integrity in all her clinical relationships with parents and children. She is known for her calm and kind approach that helps her effectively deliver strong messages about the importance of child safety and health. She is a valuable advocate for at-risk children and a strong proponent of healthy parenting skills that provide safe, secure and loving homes for children. It is truly a privilege to confer with Ms. McMahan. Respectfully submitted, Margaret i ecke, LCSW/CAC III Colorado License #991541 Lisa R. Downs 4925.WCR 83 Roggen, CO 80653 Home (303) 514-6129 Work(970) 867-3770 SUMMARY OF OUALIFICATIONS Insightful, creative, dedicated counselor who quickly establishes rapport with children and adults of all ages. Able to facilitate change and outcomes by consistently communicating respect and holding a belief that children, adults and families have the ability to heal. Special skills include but are not limited to: *Trained child/play therapist *Child and Adult Trauma *Children's Groups *Supervision skilled *Crisis Management *Severe Mental Illness EDUCATION May 1996-December 2000 M.A. Community Counseling University of Northern Colorado, Greeley, CO August 1986-December 1990 B.A. Psychology, Minor in Music University of North Dakota, Grand Forks,ND August 1985-Mav 1986 General Education, Music& Sports Scholarships Tabor College, Hillsboro, KS Numerous professional courses and workshops attended to specialise in: child development, divorce, play therapy, social skills training and crisis counseling. CERTIFICATION/LICENSURE L.P.C. -#3374 N.C.C. National Certified Counselor-#67252 A.C.A. American Counseling Association Member- # 06115160 R.P.T. Registered Play Therapist Certification - T-862 Heidi S. Friese, LCSW Experience Kinder Kounseling September 2003 to present Therapist,Owner Providing therapy to children, adolescents, adults, couples, and families. Specializing in work with adoption, trauma, and Attachment Disorder. Institute for Attachment and Child Development August 2002 to present Therapist, Training Coordinator Child Placement Supervisor, Clinical Services Manager Providing outpatient and intensive therapy to children and families. Coordinate workshops, conferences, and Therapist Training Program both on site as well as throughout the country. Recruitment, initial licensure, training, and maintenance of licensure for agency therapeutic foster homes. Responding to initial and ongoing queries from potential clients and referral sources, assessment of potential clients, as well as coordination of intake process. Executive administrative responsibility when Clinical and Executive Directors absent. Specializing in work with Attachment Disorder. Child and Family Therapeutic Systems November 1997 to August 2002 Child and Family Therapist Provide outpatient and in-home therapy to individuals, couples, families, and groups. Specializing in work with children, teenagers, trauma, and attachment problems. Children's Service Society of Wisconsin April 2000 to October 2000 Second team member Provide in-home therapy for children, teenagers, and their families. Client referrals primarily received form public child welfare system. Milwaukee County Department of Human Services, Youth Services Division March 1995 to April 2000 Human Service Worker, Child Welfare Experienced in Adoption, Foster Care, and Family Reunification. Assess and supervise family situations to protect the best interest of children. References available upon request Heidi S. Friese, LCSW (nee Wilmanns) 901 Granite Court, Longmont, Colorado 80501 home 303-684-6847; cell 303-921-2173 Objective To obtain a position as a therapist, utilizing my skills and knowledge to promote personal growth of others. Professional Qualifications Clinical Social Worker license granted by the State of Colorado, Department of Regulatory Agencies, on May 30, 2003. Clinical Social Worker license granted by the State of Wisconsin, Department of Regulation and Licensing, on February 27, 2003. Advanced Practice Social Worker certification granted by the State of Wisconsin, Department of Regulation and Licensing, on December 17, 1999. Masters of Social Work conferred on August 9, 1997, by the University of Wisconsin—Milwaukee. Completed the Trauma Counseling Program, Child Welfare Training Program, Marriage and Family Therapy curriculum, field experience in public child welfare. Initiation into Upsilon Chapter of Alpha Delta Mu National Social Work Honor Society on December 8, 1996. Bachelor of Arts in Psychology conferred in May of 1991 by the University of Wisconsin—Milwaukee. Maintain a Strengths Perspective Approach with colleagues and clients. Communicate eloquently with professionals and clients, including those resistant to intervention. Proficient in handling the complexities of case management, including multifaceted ongoing assessments, problem resolution, crisis intervention, court appearances, knowledge of state statutes, case documentation, visitation scheduling, and referrals and coordination of services. Strong background in childcare, complete with lapsed state certification. Consistently maintain a professional demeanor. Member of the National Association of Social Workers. References Beverly Baker White, M.A., LPC Clinical Supervisor and colleague through the Institute for Attachment and Child Development 8094 South Trinchera Peak Littleton, Colorado 80127 303-9-4-3012 Forrest Lien, LCSW Clinical Director and colleague at the Institute for Attachment and Child Development 5911 South Middlefield Road, #102 Littleton, Colorado 80123 303-904-0038 Jennifer Lant, MSW Coworker with the Milwaukee County Department of Human Services, Child Welfare Division 10267 Glassboro Court Las Vegas, Nevada 89123 702-205-9538 Lawrence Gross, MSW Coworker with the Milwaukee County Department of Human Services, Child Welfare Division 18685 Centennial Street Hesperia, California 92345 760-617-7831 Paul Krepel, CICSW, MFT Clinical Supervisor and Owner of Child and Family Therapeutic Systems 4848 South 76 Street Milwaukee, Wisconsin 53220 414-325-7741 William (Bill)E.George 4909 30th St Greeley, CO 80634 Home Ph. (970) 339-9328 Cell Ph. (970)371-2220 E-mail bgeorge16@comcast.net Objective To work as a health care professional where I can utilize my skills in counseling, case management, and health care coordination. Relevant Skills Clinical Knowledge&Practice: • Unique ability to communicate with people in stressful situations, establish trust, and facilitate positive change. • Have counseled adults in both outpatient and inpatient settings. Over six years of experience in group and individual therapy. Experience in mental health and substance abuse assessments with adults and adolescents. Identification of appropriate diagnoses using ICD-9 and DSM IV-TR. • Over ten years of case management experience coordinating patient focused outcomes. Excellent problem resolution skills through face to face intervention or telephone. The ability to gather and synthesize sensitive information from people with varied backgrounds. • Experience in home visits to clients for vocational/medial disability evaluations. • Expertise in medical and psychiatric utilization review. A unique blend of clinical background including mental health, substance abuse,vocational rehabilitation counseling or consultation and disability management Administrative&Organizational Strengths: • In a director-level position, made policy decisions, delegated work, handled problems, oversaw budget,and represented interests for a non-profit organization. • Proven skills in classifying and organizing information, allowing for quick access to needed facts and resources. • Implemented new treatment curriculum for a nonprofit agency. • Possess broad computer background in database administration, Microsoft Word and Internet Background in Employee Relations&Training: • Completed graduate-level training in counseling/interpersonal communications. • • For more than five years, have provided employee relations counseling and support to team members. • Skilled in creating a confidential environment, sharing company-policy information, coaching employees on options, and operating within established guidelines. • Provided ongoing training and support to team members regarding procedures, policies, and computer tools. • Have completed extensive course work addressing personality and learning styles, and the development of effective training methods and curricula. Skills in Management&Supervision: • Supervised seven highly-skilled case management professionals, providing guidance, monitoring work quality and deadlines, and overseeing reporting and administrative activities. • Supervised three counselors and provided clinical supervision of two hundred clients for an outpatient alcohol/drug treatment program. • Have consistently received positive feedback for managerial and administrative work performed. Comment from previous supervisor. "He is not afraid to face a challenge, and works as a team player. He had a good grasp on the business end, and follows up every step of the way." • Excellent oral/written communication abilities, especially for status reports, business correspondence, etc. Comments from a provider.'He was kind, direct,thorough and respectful.' Benefits Knowledge: • Knowledge of COBRA, HIPAA,Workers' Compensation, labor acts, and discrimination policies. • Extensive background in benefits claims handling, including serving as a liaison between the plan participant, the insurance provider, and other related parties. • Highly accomplished at managing enormous amounts of data: Was responsible for knowing the details for more than 30 different benefit insurance plans, as well as monitoring eligibility status for thousands of plan participants. • Accomplished negotiator. Coordinated treatment with various providers, insurance companies. Arranged costs and pricing with a range of service providers, including home health care, skilled nursing facilities, rehabilitation centers, and hospitals. Work Hlstorv: 2003- Present Vocational/Medical Genex-Denver, CO Case Manager 2001 -2002 Medical Case Manager Sedgwick CMS-Denver, CO 2000-2001 Clinical Director Mile High Council on Alcoholism and Drug Abuse- 1994-2001 On-call Therapist Longmont United Hospital-Longmont, CO 1994-2000 Health Management Zenith Administrators-Westminster, CO Coordinator 1987-1993 Supervisor Intracorp-Denver, CO (Also held positions as Psychiatric Case Coordinator and Rehabilitation Specialist at Intracorp) 1983- 1987 Therapist Island Grove Regional Treatment Center- Greeley, CO 1980-1983 Psychiatric Team Assistant North Colorado Medical Center-Greeley, CO Education: University of Northern Colorado, MA, Psychology, Counseling&Guidance with emphasis in Agency Counseling, 1984 University of Northem Colorado, BA, Psychology, 1980 Certifications: Certified Case Manager, Certified Disability Management Specialist Alcohol and Drug Counselor,Level III • PROFESSIONAL AND PERSONAL REFERENCES William E. George 4909 30th St. Greeley, Colorado 80634 Home(970)339-9328 Work(970)339-3427 Professional References: Ellen Goren,Vocational Rehabilitation Counselor 16739 E. Arkansas Dr. Aurora, CO 80017 (303)369-8884 Mary Anderson,Previous Supervisor 19053 E. Low Dr. Aurora, CO 80015 (303)287-3748 Joan Lee, Previous Supervisor 915 W. 44th Loveland,CO 80538 (970)635-9679 Cathleen Cundell, Previous Supervisor Longmont United Hospital-ATS 1331 Linden St. Longmont, Colorado 80501 (303)651-5388 DiAnn ICalvels,Previous Supervisor 1090 Birch St. Broomfield, CO 80020 (303) 469-9917 Anne Hazelton,MD, MSPH 11453 E. Orchard Place Englewood, CO 80111 (303) 587-7879 Personal References: Jackie Moore-Davis 4464 Pioneer Dr. Greeley, Colorado 80634 (970) 381-3559 ELLENOR DOMINGUEZ 720 26 Avenue,Greeley,Colorado 80634(970)392-2653 OBJECTIVE Seeking a challenging and rewarding position performing Home Studies and utilizing my bi-lingual educational background to assist clients in the bonding process with the children. OVERVIEW OF CAPABILITIES Offering a Masters degree and more than nine years of experience on positions requiring the following abilities: Interpersonal Relationships Crisis Intervention Individual and Group Counseling Report Preparation Advocacy Assessment • Understand and work closely with community referral agencies Establish and maintain productive rapport with people of all Backgrounds and socioeconomic levels Communicate clearly and concisely, speak fluent Spanish Possess sound judgment and excellent decision-making skills Work efficiently and under pressure; good coping skills EDUCATION UNIVERSITY OF NORTHERN COLORADO, Greeley, CO Master of Arts Degree in Rehabilitation Counseling(1995) • Bachelor of Arts Degree in Psychology(1990) EMPLOYMENT SOCIAL SERVICES, Greeley, CO 1/98-1/05 Caseworker III Create client treatment plans and monitor client progress Visit clients monthly to ensure safety and well being of children Work closely with attorneys and the legal community Document client progress and distribute reports to appropriate Individuals Utilize the TRAILS computer system to document case information accurately SOCIAL SERVICES,Greeley, CO 1/98- 7/99 Case Service Aide Supervise child/parent visitations to ensure appropriate and safe Environment for children Document and report findings to case workers; testify in court Regarding home visit observations Work closely with foster parents to coordinate visits and transportation ELLENOR DOMINGIJEZ Page 2 EMPLOYMENT front) A WOMAN'S PLACE, Greeley,CO 10/95-1-98 Lead Counselor/Supervisor Evaluate, provide individual and crisis counseling, and serve as advocate for women and children victims of domestic violence Establish and maintain effective working relationships with community referral agencies resulting in a more effective assistance program Successfully initiated new counseling program for Spanish speaking sector Facilitate Spanish-speaking support groups Oversee daily operations, scheduling, and safe-house coverage Developed record-keeping forms used for reporting to Social Services CATHALIC CHARITIES,Greeley, CO 5/93-10/95 Migrant Outreach Coordinator Visited homes and labor camps throughout Weld County, providing supportive services COLORADO EASTER SEALS,Denver,CO 4/94-11-94 Migrant Coordinator Participated in highly successful pilot program developed to work with migrant workers with disabilities Assessed needs, provided referrals to community agencies and served as advocate for migrant farm workers with disabilities Served as agency representative throughout Colorado • • Print Date: 01/18/05 HEALTHCARE PROVIDERS " CD' • SERVICE ORGANIZATION PURCHASING GROUP CERTIFICATE OF INSURANCE asa..,,,' >s.Y�..: _ z.�.-.::. 0 .., �. 018098 970 HPG 0273177648 from 12:01 AM Standard Time on:02/26/05 to: 12:01 AM Standard Time on: , 2. 06 Lori Kochevar MS LPC LLC Healthcare Providers Service Organization 810 12th Street 159 East County Line Road Greeley, CO 80631-4022 Hatboro, PA 19040-1218 Medical Soedalty Code: Clinical Counselor Firm 72990 American Casualty Co. of Reading, PA CNA Plaza 28S Chicago, IL 60685 ss ,c;<•F A. PROFESSIONAL LIABILITY Professional Liability(PL) $ 1,000,000 each claim $ 6,000,000 aggregate Good Samaritan Liability included above _ Personal Injury Liability included above �__.. ,.• r., —.,:. Malplacement Liability included above .II x t t; t t_ , B. COVERAGE EXTENSIONS: License Protection $ 10,000 rproceedin• $ 25,000 aggregate Defendant Expense Benefit $ 10,000 aggregate �. — �r'z_wa+._ Me_ , Deposition Representation _ »4w• .a v $ 10,000 aggregate Assault $ 10,000 per incident $ 25,000 aggregate Medical Payments $ 2 000 .-r • -rson $ 100,000 aggregate First Aid $ 2.500 aggregate Damage to Property of Others $ 2,500 per incident $ 10,000 aggregate C. WORKPLACE LIABILITY Coverage part C.Workplace Liability does not apply If Coverage pad D.General LiabMy is made pan of this pony. Workplace Liability none Fire &Water Legal Liability none Personal Liability j = 31 }3 none D. GENERAL LIABILITY Coverage part D.General Liability does not apply if Coverage pan C.Workplace Liability IS made part or this policy. General Liability(GL) $1,000,000 each occurrence $1,000,000 aggregate Hired Auto&Non Owned Auto included in UL limit above _' - :gv : k Fire &Water Legal Liability included in GL limit above subject to $250,000 sub-limit Personal Liability r,xv ;fie µr r f - none Total Premium: $ 673 .00 QUESTIONS?CALL: 1-888-288-3534 5 Y d G-121500-C G-12150 1-C G-145184-A G-147292-A G-144872-A G-123846-005 G-121504-C G-123827-B G-14123 9--A Master Policy#188711433 Keep this document in a safe place. It and proof of payment are evidence of your insurance coverage- if)n ‘t /-6( SaA-4,ill 7A,44--v Chairman of the Board Secretary ® HEALTHCAREPROVIDERS GENERAL LIABILITY COVERAGE PART ENDORSEMENT Additional Insured General Liability In consideration of the premium paid,and subject to the General Liability limit of liability shown on the certificate of insurance,it is agreed that the GENERAL LIABNLITY COVERAGE PART is amended as follows: The person or entity named below(the*additional insured,is an insured under this Coverage Pan but • only as respects its liability arising out of named insuced's operations, or premises owned byor rented • by the named insured and solely to the extent that: • 1. a general liability claim is made against the named insured and the additional insured;and 2. in any ensuing litigation arising out of such claim,the named insured and the additional insured remain as codefendants, • In no event le there any coverage provided under this policy for an occurrence that is the direct liability of the additional insured. Additional Insured: State of Colorado do Weld County Social Svs. PO Box A Greeley,CO 80634 This endorsement is a part of your policy and takes effect on the effective date of your policy,unless another effective date is shown below. All other provisions of the policy remain unchanged. Must Be Completed Complete Only When This Endorsement Is Not Prepared with the Policy ENDT.NO. POLICY NO. ISSUED TO $is Not to be Effective with the Policy j ENDORSEMENT EFFECTIVE DATE 01 j 0273177648 Lori Kochevar MS LPC LLC 2126/2005 G-123327-B(07/2001) Paget of 1 TOTAL P.03 m ( \ , CO ' ® ® k co CO - 0) 0 ] ` I i i. ■ a ■ 2 k r f , ) \ } $ \ \ \ \ \ 8 ■ # , F- ›.. - , , 2 # # a } - 4,'"; ~ § 0 I 2 S j k CI if \ i ■ 2 s I \ I \ to COCCi _ 2 !cow Si § 8 Ce2 49 49 - 0 o § rc 8 E § \ / a. + ' f \ a § 0 _ . 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W22221.999999229999 o 727 888888 8 8 o" »"ia» 2 8 d z E p< & LL 2 K 6 O W LL LLy 8 O O LL 6 G W> K t 6 OK Q m w p = 1 i $ 2 W .Fj -JJO leg;• i F W . a U p = m i l >O 6 0 l$ E LL 2 2 2 rc ff 8 LE1 p.0 0 O THE BONDING PROGRAM Purpose: The purpose of the Bonding Program is to provide support and information in order to assist parents in building a stronger emotional relationship with their children. The focus of this program is to teach parents how to create an emotionally safe and secure environment for their children in the home. The goal of this program is to keep children with their biological parents. Design: This program will provide supervised visitation for the family during the time the bonding specialist is working with them. Starting this year, we have the expertise on staff to serve children up to age twelve. It has become clear over the last ten years of this program that bonding and attachment work for older children is greatly needed. When parents are unaware of how to set significant structure and firm boundaries with children that have attachment issues they are more likely to fail in their attempts to reunify with their children. It is paramount that these parents be given direct training, modeling and coaching on how to address the specific needs of the older child in need of bonding work. In addition, due to an increase in staff availability we will be able to provide services for more bi and mono-lingual families. While in the past we have used interpreters and had limited clinical time from a bilingual therapist, we now have the capacity to serve this need. Providing services in the most comfortable language for the clients greatly increases its effectiveness. All other aspects of the program will remain the same using the design and assessment tools that have evolved over the last ten years of providing this service. The program provides modeling of how to build nurturing relationships with the family during visitation in the home or at the Department of Social Services. The program is designed to assess the response of the parent to the child and the child's response to the parent. Assessment will include the parent's commitment and ability to make changes in parenting which will enhance the emotional relationship. From this assessment, a Case Management Plan for intervention will be developed which addresses the strengths and deficiencies of the relationship. This program is based on a strength-based family preservation model of service. This program offers information, education and modeling of behaviors that promote bonding, to assist the parent in strengthening the relationship with their children. Other topics regarding parenting and children (including discipline, growth and development, health and safety) will be addressed during the sessions. Establishing a strong emotional parent-child relationship will be the underlying foundation for teaching other child related issues. Why Services are Important: Bonding is a deep and lasting relationship which develops between the caregiver and the child during the first two years of life. The strength of this bond has a profound affect on every aspect of the child's nature. The child, who develops a strong sense of nurturing from his mother, will develop: a sense of trust, a good self-esteem, positive reciprocal interaction with others and an ability to function as a healthy adult. In addition, an adult who had a positive bonding experience with his mother will be able to establish an emotionally healthy foundation for his own children. A child who does not experience the development of a strong bond with the parent will be prone to difficulties with relationships, antisocial behavior and learning difficulties. When these children grow up, they are often unable to regulate their emotions or their behavior. Any event that separates the child from the mother either physically or emotionally during the first three years of life, places the child at risk for inadequate bonding. Lack of bonding in a parent-child relationship can occur for several reasons. Children who experience frequent moves within a foster care system become resistive to bonding. When the mother experiences a high level of stress during pregnancy, suffers from depression 2 or is involved in substance abuse, she may not be emotionally available to nurture the child. Domestic violence may cause a child to develop fear and distrust of the parent making bonding difficult. Children who experience abuse/neglect are at high risk for bonding difficulties. Children who are not well bonded do not learn to trust. They have a difficult time building strong meaningful relationships throughout life. This may be reflected in early childhood through angry, defiant and controlling behavior. The child may also have difficulty dealing with authority figures throughout his life. The lack of a strong parent-child bond may also interfere with the child's learning ability. These children may have difficulty focusing in the classroom. They are often emotionally and developmentally delayed. Due to the impact inadequate bonding may have on the future of the child and our society, it is imperative that intervention begin as early as possible in the child's life. TARGET / ELIGIBILITY POPULATION A. Total Number of clients to be served: The program will serve a total of 60 families during the twelve-month period. Each bonding specialist will serve eight to ten families at one given time period. Each family will receive 24 hours of one-on-one supervised visitation with the bonding specialist. This would provide 27 hours of intervention with families per week, 120 hours per month. Total number of client hours provided per year would be 1440 hours. B. Total number of clients and ages: Based on the approximation that the average family is made up of four children and one parent, the total number of clients for the year could be 240 clients. Focus will be on children whose ages are birth to twelve years of age. When the family includes older children, they will be included in the family intervention C. Total number of families served: A total of 60 families will be served during the year. C. Sub-total of individuals who will receive bilingual/ bicultural services: All services provided would be in a manner that is sensitive 3 to the family's culture of origin. The program manager and specialists have extensive training in cultural competency issues. Lori Kochevar chaired the multicultural task force that successfully implemented multicultural training throughout the San Luis Valley. Becky McMahan has worked with families from various cultural roots. She has a sense of respect for the family's cultural beliefs and practices. Ellenor Dominguez a bicultural bilingual provider will be available for any Spanish speaking families. Due to our experience in bicultural settings, all individuals in our program will receive bicultural services. E. Sub-total of individuals who will receive services in South County: The program could serve three to four families in South County during a given time period. Based on referrals in past years, this would be an adequate estimate. Services will be provided for families where they reside as determined by Social Services. F. The monthly maximum program capacity: If needed, we could expand the number of hours we are available for services to 35 hours per week, which would make available 140 hours per month. G. The monthly average capacity: The monthly average capacity of this program is six to eight families. H. Average stay in the program: The average stay in the program would be six months. It is felt that clients have adequate opportunity to make positive changes in parenting styles in that period of time. I. Average hours per week in program: Initially, each family would receive services two hours per week, unless a different number of hours is requested by the caseworker for clinical reasons. After the first twelve weeks, sessions will decrease as recommended by the treatment team. Number of hours of service and length of service vary according to the individual family situation. 4 SERVICES TO BE PROVIDED A. Through mentoring, the program will address the following areas: 1. Teach, model and coach adaptive strategies: The bonding specialist will teach through use of visual aides, demonstration and verbal interaction with the parent and child. She will use demonstration of bonding behaviors. She will guide the parent and child through activities that utilize bonding skills and encourage a positive emotional interaction between the parent and child. She will support the parent with encouragement and recognition of positive changes. 2. Model and influence parenting practices: During the visits with the parent and child, the bonding specialist will influence and direct parenting practices through education of the parent. The parent will be given opportunity to gain increased awareness of the child's developmental level and have a better understanding of expectations which are appropriate to the child's age. The bonding specialist will have opportunity to model for and guide the parent during the visitation. 3. Teach relational skills: The parent will receive information and guidance regarding nurturing behaviors which, when put into practice, will enhance relationships. The bonding specialist will guide and support the parent as she makes efforts to utilize new skills. Just as the mother has difficulty in her attempts to make changes in her parenting and bonding behaviors, the poorly bonded child struggles to respond to those changes. This can be discouraging to the parent who will be offered support and encouragement. 4. Teach household management, including prioritizing, finances, cleaning, and leisure activities: The program will address everyday living concerns faced by the family through observation and initial assessment. The bonding specialist will address issues such as the safety and health of the family as related to hygiene and care of the living quarters. The bonding specialist will increase the parent's awareness of the importance 5 of structure and consistency in the home routine for the children and the parent. This will be a process of education presented through verbal and written materials. 5. Actively help to establish community connections and resources: the bonding specialists are well informed about community resources. She will be able to direct the client to resources as needed and to assist with accessing those resources. This would include offering the information to the client, setting up an initial appointment, and possibly meeting the parent at a designated appointment as a support person. This could also include guiding the parent to Play Groups or other activities that would offer opportunities for social interaction for the child and parent. A Resource Guide will be used in the intervention with the family. (Appendix A) 6. Encourage goal setting and pro-social values: When working with the family in the above areas, the bonding specialist will assist the parent in developing goals that the parent recognizes as important to the welfare of the child and the family. Goals will be developed with the parent and put into writing, to be reviewed periodically together. Through this experience, it is hoped that the client would develop a greater awareness of how to function successfully in society. B. Visitation: 1. Monitor parent-child interactions for physical and emotional safety: Supervised visitation by the bonding specialist will be made in the home of the client, our home setting for visitation, or in a location designated by the Department of Social Services. During the visitation, the bonding specialist will be attentive to the interactions between the child and parent. She will guide, direct and model behavior with the parent and child as a means of increasing parent awareness regarding ways to provide an emotionally and physically safe environment. 6 2. Document clinical observations: The bonding specialist will utilize The Family Visitation Evaluation Form (Appendix A), developed specifically for the program, to document clinical observations made during the visitation. The form will be filled out at the time of the visit or prior to the following visit. The client receives a copy and is asked to review it with the bonding specialist at the end of the visit or at the beginning of the visit. The parent is the asked to sign the form. This allows the client written feedback from each visit. The parent and caseworker receive a copy and the bonding specialist keeps one copy for her records. The bonding specialist keeps her own notes in addition for each visit and from these submits a monthly report to the caseworker, the supervisor of Life Skills Programs and a billing person. 3. Strategize for teaching and modeling parenting skills: Demonstration is most often the most effective strategy for increasing parent awareness and teaching new skills. As events unfold during a visit, it is effective to be able to point out emotional or physical safety concerns as the issues arise. It is also effective to offer support and positive feedback to the parent and the child as positive events occur during the visit. It is through this process of redirecting and recognition of a parent's efforts that the she begins to understand her own sense of success. 4. Teach relational skills: Parents will be educated through visual aides and verbal information about bonding and ways the parent can enhance the relationship with the child. During visitation, the bonding specialist will point out behaviors of the child which relate to an insecure bond and direct the parent to tools she can use to offer the child more emotional support. The bonding specialist will also use demonstration and modeling to assist the parent's understanding of her child's needs and healthy responses to those needs. 5. Encourage goal setting and pro-social values: During the visitation, much of the focus will be on the emotional interactions between parent and child. As the parent comes to a better understanding of her child's needs and how her own 7 behaviors affect the child, she will be better able to focus on her own goals. The bonding specialist will work with the parent to develop goals that are within the parent's understanding. Those goals will be reviewed with the client periodically and enhanced or changed as the parent progresses. Through the increased awareness of her responsibility as a parent and her self- discipline in changing parenting patterns, she may develop a greater awareness of social values that allow her to function more successfully in society. 6. Plan structured activities in visitation to help achieve the objectives of the treatment plan: The bonding specialist will plan and implement activities that will enhance the interactions between parent and child. The focus of these activities is to encourage the basic modes of emotional connection; holding, touching, rocking, eye contact, talking, pleasant facial expression and feeding. This would include demonstration of various activities that encourage those behaviors. Activities such as peek-a-boo, looking in the mirror and rolling the ball back and forth (which encourage eye contact) will be demonstrated. Parents will also be encouraged to read books to the child to encourage closeness. Emphasis will be placed on assisting parent's response to the child's behavior through modeling and guiding at the time of the behavior. Through these interactions, the bonding specialist will be able to offer education and demonstration to increase the parent's awareness of appropriate expectation of the child at his current developmental stage. Other activities would be to practice making physical contact and face-to-face posturing. Activities will be practiced according to the age of the child and the parent/child relationship at a particular point in the intervention. MEASURABLE OUTCOMES At the time the family is accepted into the bonding program, bonding will be assessed through observation and through use of a Bonding Assessment Tool, which is based on input from the parent and parent-child interaction (Appendix A). This will include assessment of the level of bonding the child has experienced and identify behaviors that indicate areas of concern. The bonding specialist will discuss concerns with the parent and develop a 8 Case Management Plan. This will be an outcomes-based plan that will be shared and reviewed periodically with the parent. A. After involvement in this program the parent will be able to provide a safe secure home for the children. This includes health, safety, and provision for every day needs. The parent will have: • Resources to provide for the child's basic needs, such as adequate housing and resources for providing food and clothing on a consistent reliable basis. • Increased awareness of daily planning for the child's needs and providing a stable environment by establishing routines around mealtime, after school activities, bath time and bedtime. • Increased understanding of the nutritional needs of the family and a means of providing for those needs. • Increased awareness of the exposure of the children to health and safety risks when the home is not well maintained. • The ability to focus spending on the basic needs of the family as a priority over other expenditures. B. After involvement in this program parents will be able to realize increased competency in their parenting. Parent will demonstrate through her behaviors: • Increased awareness of the emotional needs of the child and demonstrate nurturing behaviors meant to enhance their bonding. • Increased demonstration of nurturing behaviors in parent-child interactions. • Increased awareness of the emotional and physical developmental age of the child and responses that are fitting for that child. • Increased knowledge and understanding of child's behavior as related to bonding issues. 9 • Increased use of discipline measures that are effective (not damaging to the relationship) and is consistent in the use of those measures. After involvement in this program, the child will: • Indicate through his behavior that he has an increased sense of security and trust in the parent. • Demonstrate an increased emotional bond with the parent. • Behave appropriately in social situations. • Begin top progress developmentally with expected achievement. C. After involvement in the program the parent will have increased ability to access resources in the community independently in order to better meet the needs of the child and family. • This program will empower the parent to access community resources by providing information and initial support and guidance. The parent will have an increased knowledge of resources available and show confidence in seeking out resources independently, making appointments, keeping appointments and following up with services. D. Parents who complete the program will obtain higher skill and competency levels in order to provide the child with a safe, secure home. The Parent will provide the nurturing needed to enhance the child's sense of security. Parents will be able to identify factors that have a positive affect on family unity and security. In order to keep the family together after six months from discharge, the parent will: • Be able to prioritize the needs of the children over the parent's own needs. • Will recognize and have ways of meeting their own needs. • Maintain awareness of enhanced family relationships and continue to utilize skills gained during the program. • Have in place identified and used sources of support in the community. • Be aware of the need for continued focus on and attention to the emotional needs of the child. 10 E. Families who participate in the program will develop skills and awareness that will increase their competency as parents. Increased competency will be measured through documentation occurring at each visit through use of an outcomes-based Case Management Plan developed at the time of entry into the program. Risk factors will be identified at the time the initial plan is written. This will be reviewed with the parent and updated as goals are met and as changes occur in the parent-child relationship. SERVICE OBJECTIVES The program has the following service objectives: MENTORING: A. Improvement of household management competencies: It is imperative that parents understand and show competence in the practice of keeping a clean, well-maintained home for the health and safety of the children. It is expected that parents will manage the household finances in a manner that allows for the children to be nutritionally healthy, clean, and adequately dressed. It is expected that the parents will consider the child's health and emotional safety when planning leisure activities for themselves and the children as they develop increased awareness of health and safety issues. Included in household management is the parent's ability to maintain structure and consistency in the child's life in the home. This objective will be measured through the parent's ability to reach specific goals as defined in the Case Management Plan relating to household concerns. B. Improve parental competency: • Parents will have the capacity to provide a safe environment for the children, both physically and emotionally. Parents will show competency in being able to protect and keep the child safe. Parents must be aware of the need for structure in the home in order to enhance the child's security. 11 • Parents will indicate through their behavior, their understanding of bonding and nurturing behavior that serves to enhance the child's sense of security. It is crucial to the well being of the child that the parent be able to continue to utilize strategies to maintain and enhance the relationship. • The child will show in his responses to the parent that he feels safe and secure. • Parents will demonstrate their understanding and their ability to utilize parenting techniques that are effective and emotionally healthy for the child. This includes use of adaptive strategies for discipline and behavior management, offering age- appropriate activities, and conveying expectations that are age- appropriate. • Parents will recognize the importance of being a dependable caretaker for the child. It is necessary to the well-being and emotional growth of the child that the parent be both emotionally and physically available to the child in a consistent manner. The parent must understand that this is the foundation for building and maintaining trust. • Parents will acknowledge their responsibility for providing a healthy diet for the children. They must offer the child healthy and adequate food. • It is important that the parent take responsibility for attending to the child's hygiene. The parent must guide the child in hygiene issues and model good practices. This includes basic everyday hygiene, such as bathing, hand washing, changing clothes and care of teeth. The parent must make every effort to provide the necessary tools for practicing good hygiene. This service objective will be measured through use of the Case Management Plan objectives (the use of a pre and post assessment tool) and the Family visitation evaluation form. C. Improve ability to access community connections and resources: • After being in this program, parents will have information regarding resources in the community and an understanding of how to access them. Parents will be empowered to make the necessary steps to resolve their concerns. This objective will 12 be measured with use of Case Management Plan objectives and the parent's demonstration of utilizing resources independently, making and keeping appointments. (Resource List, Appendix A) D. Improve goal setting and pro-social values: • Parents will experience a sense of success, as they are able to utilize new skills and achieve goals set early in the program. With that sense of success, the parent will realize the value of goal setting and be able to apply it to other areas of life. This objective will be measured through use of Case Management Plan anticipated outcomes and observation which indicate the parent's use of goal setting. VISITATION: A. Improve parenting skills, parent/child interactions and relational skills for physical and emotional safety throughout structured activities in, and documentation of, visitations to achieve the objectives of the treatment plan: • The parent will show increased ability to put into practice the skills that are demonstrated during the visitation and will use the skills independently, without the continued guidance of the bonding specialist. • The parent will have an understanding of ways to make an emotional connection with the child. It is crucial for the emotional health of the child that the parent be committed to that emotional connection. • The child will show positive response to the parent's efforts to make emotional connection. • The parent will demonstrate her capacity to protect the child from physical harm. She will take the initiative to set limits and follow through in order to protect the child. These objectives will be measured and progress documented in face-to-face visitation with the family. 13 WORKLOAD STANDARDS A. Number hours per day,week or month: The program has the capacity to serve up to 60 families. The bonding specialists would spend up to 27 hours a week providing services. Henceforth, 27 hours a week x 52 weeks, provides 1440 client hours a year. B. Staff: There are three bonding specialists and a program supervisor. Lori Kochevar M.S., L.C.P., LLC will serve as the program supervisor for Becky McMahan R.N, Bill George M.A, Heidi Friese L.C.S.W., Ellenor Dominguez M.A., and Lisa Downs M.A., L.P.C. All providers have extensive experience in Family Services and Attachment and Bonding as documented in the attached resumes C. Caseload: The caseload will be between 2-10 families per bonding specialist. The caseload of each specialist will depend on matching specific needs of the referred family with the area of specialty of the bonding specialist. D. Modality of treatment will be supervised visitation that provides a psycho-education regarding of attachment and bonding. Referral and linking services will be provided. E. Hours: Total number of clinical hours devoted to this program equals 6 hours a day, 27 hours a week, and 108 hours a month. F. Staff: The providers are supported by part time bookkeeping and clerical staff. G. Supervisor: This contract would be supervised part time by Lori Kochevar M.S., L.P.C., who will monitor the program compliance and clinical excellence. H. Insurance: Lori Kochevar M.S., L.P.C., LLC carries one million three million-liability on the company and each one of the independent contractors connected to this bid. In addition, Lori Kochevar M.S., L.P.C., LLC carries a general liability policy related to accident or injury on the premises. The State of Colorado is named 14 as an additional insured on this policy. Each individual provider also carries one million three million-liability insurance. Both the general and group liability coverage's are attached. All specialists providing services are self-employed and choose to be exempt from workman's compensation and Employer's liability insurance. 15 Appendix C VISITATION FORMAT Visit 1: - Intake form - Family concerns indicator--parent take home and return at next visit - ROI - Explain to parent the purpose of the Bonding Program - Introduce the basic elements of bonding—needs of the child - Parent responses that encourage or enhance closeness Visit 2: - Review parent concern indicator with the parent - Parent Questionnaire—age appropriate Individual visit - Bonding assessment with parent - Pre and post parent assessment - Discuss G&D per age of child Visit 3: - Share strengths and concerns with parent - Develop interventions with parent input - Limit setting and structure - Need vs.want The following visits will focus on addressing concerns from above assessment and observation. Format for these visits will be developed to meet the individual needs,level of understanding and progress of each family. Written materials will be provided related to various issues after discussion and at a level of understanding of the parent. Observation: Attachment Interaction Mastery Social support 5/20/03 • . • ., FAMILY VISITATION EVALUATION FORM Name: Date: Location: • • Greetings: Good-byes: Activities: Planned_ Spontaneous Age Appropriate Interactions: Initiated bv: Parent Child Touch Holding Eye contact Voice Smile Description of Interactions: Limit Setting, Discipline: Food Offered: Strengths: • Suggestions: Did interactions or activities reflect feedback given last visit? : • Parent: Bonding Nurse: ORJOINAI.-TO CLIENT YELLOW COPY-RN • PINK COPY-CASE WORKER lu U2.0I M:/wp fi l essb Mc M a haW(a mi l yv is i to t ioneva l ua a on form RESOURCE LIST BONDING PROGRAM 810-l2'"Street—Greeley,CO 80631 Phone(970-3524879 HEALTH Monfort Children's Clinic 100 N. 11'"Avenue (970)352-8898 Sunrise Community Health Center 1028 5'h Avenue (970)353-9403 Urgent Care 1900 16'" Street (970)3531661 NCMC 1801 16th Street (970)3524121 North Colorado Family Medicine 1600 23t"Avenue (970)353-2424 Scheduling 346-2818 Quick Care 2928 W. 10'h Avenue (970)351-8181 Weld County Department of Public Health 1555 N. 17'"Avenue (970)304-6420 Family Connects 2985 W. 29th ST. #A (970)330-3842 North Range Behavioral Health 1306 11th Avenue (970)346-1166 353-3686 CLOTHING Church Women United 1030 11th Avenue (970)353-7144 Salvation Army 1119 6'"Avenue (970)353-1444 Adventist Community Services 612-23r'Ave (970)356-3740 Budget Baby Shop 130111'"Avenue (970)351-8427 Life and Light Community Church 110 N.25th Avenue (970)353-3451 Baby Stuff and More 2126 9th Street (970) 353-2229 DENTAL CARE Monfort Children's Clinic 100 N. 11t Avenue (970)3528898 Sunrise 10285°Avenue (970)353-9403 FOOD WIC 1028 5TH avenue (970)353-9403 Weld Food Bank 104 11th Avenue (970)356-2199 Share Colorado 1311- 11th Avenue (970)353-6433 Salvation Soup Kitchen 1119 6th Street (970)353-1441 Supplemental Foods 104 11th Avenue (970)356-2199 PARENTING CLASSES CARE 3700 Golden Street,Evans (970)3566751 HOUSING Greeley Housing Authority 315 N 11th Avenue (970)352-1551 ext.6541 Hudson Housing Authority 1151 Main/Hudson 1-303-536-4501 Ft. Lupton Housing Authority 400 2""Street/Ft Lupton 1-303-857-4400 RENT/DEPOSITE ASSISTANCE Catholic Charities Northern 2500 i"Avenue Bldg C-B (970)353-6433 Mi Casa Tu Casa 13113s Street (970)352-6417 Salvation Army 1119 6"'Street (970)353-1441 BEET TERS Greeley Transitional House 1202 6i°Street (970)352-3215 Guadalupe Center 1516 n 25'"Avenue (970)353-372 A Women's Place 1327 rd Avenue (970)356-4 A Room At the Inn 1213 5TH Avenue (970)378-0100 MEDICAID/CHP+APPLICATION Weld County Department of Public Health 1555 N. 17t°Ave. (970)304-6420 Department of Social Services 315 N. 11th Avenue (970) 352-1551 PRE AND POST BONDING ASSESSMENT Child Parent Date: Date: Check: / Avoids eye contact Resists being- held-stiffens body, _/ Pulls away from touch Does not respond to mothers voice-avoids, ignores _/ Resists feeding when mother holds bottle-prefers propped bottle Somber, sad expression, withdrawn /_ Lack of responsive smile Prefers to play away from mom, does not check in with mom periodically Decreased stranger awareness, prefers others to mom Eating problems, gorging, refusal, FT Destructive of own or others property, frequently breaks own toys /_ High pain tolerance, self-abusing behaviors /_ Clingy, whiney, fussy baby, hard to console / Defiant, resistive behavior Manipulative Senseless lying _/_ Hyperactive behavior, unable to be still or to focus, _/ Sullen, quiet and withdrawn Frequent tantrums, often lasting for unusually long time _/ Developmental delays, learning, speech, motor _/_ Speech delays or speech is difficult to understand _/ Hurtful to others or animals PRE AND POST ASSESSMENT Bonding Program Name: Date: Date: 1. Parents will be able to show improved competency in parenting practices. • Increased awareness of the emotional needs of the children. • Increased understanding of bonding and how poor bonding affects the child • Increased positive responses to the child • Increased ability to interact with the child in a manner which enhances bonding • Increased awareness of the developmental age of the child and practice age appropriate expectations. • Child will show increased response to the parent. • Child will show increased respect for the parent • Increased understanding of punishment vs. discipline • Increased ability to utilize discipline measures which are not emotionally detrimental to the children 2. Parents will develop a greater understanding of the components that are necessary to insure a lasting family relationship. • Increased ability to place the children a position of high priority in the home. • Increased ability to continue to utilize the parental and relationship skills learned in the program. • Increased ability to recognize and meet own needs. • Increased ability to maintain sources of support in the community for self and children. • Increased awareness of the ongoing emotional needs of the children. 3. Parents will be able to improve household management competency as measured by a pre and post assessment of skills needed to maintain a safe and secure home. • Increased resources to provide for the family needs • Improved ability to maintain a clean, healthy environment • Increased ability to provide structure and consistency in the home structure the home • Increased awareness of the nutritional needs of the children • Increased awareness of health and safety risks in the home • Increased ability to keep the child safe 4. Increased ability to utilize resources available in the community. • Increased knowledge of community resources. • Increased understanding of how to access services. • Increased confidence in seeking services. • 5. 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C CO C CN E — ••• — c - U y a L cN L +r 4r C L G J U a SUPPLEMENTAL NARRATIVE TO RFP: EXHIBIT B CONDITIONS Lori Kochevar, MS LPC 810 12`h Street Greeley Co 80631 Weld County Det. or Socia' Services Clerical Unit Weld County DSS PO Box A APR 2 5 2005 Greeley Co 80631 Re: RFP 04005; Lifeskills Re: RFP 006-00c: Foster Parent Consultation Re: RFP 006-00a: Foster Parent Training Re: RFP 006-00: Home Study Dear Ms. Griego, This letter serves as written confirmation that I received the results of the Bid process for the 2005-2006. I am in agreement with the Commission's conditions with the following clarifications. The following is the response requested by the conditions for the RFP 05005, Lifeskills. Condition 1: Definition of our capacity to do after-hour visits. We will have the capacity to see clients after 4 and on Saturdays as deemed appropriate by caseworker and or client request. Appropriateness will be measured by safety concerns for the children. The following is the response requested by the conditions for the RFP 006-00 Home Studies. Condition 1: The threshold for hours for an incomplete home study will be set at 3.5 hours at our hourly rate of$85. Additional adults in the home were a home study is being completed will be billed at $250. Thank you for this opportunity to again serve the families of Weld County. Please let me know if you are in need of any further clarification. Sincerely, Lori Kochevar M.S. LPC a DEPARTMENT OF SOCIAL SERVICES A P.O. BOX A �1 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 Lori Kochevar MS LPC The Jubilee Center for Families 810 12th Street Greeley,CO 80631 Re: RFP 05005: Lifesldlls RFP 006-00C: Foster Parent Consultation RFP 006-00A: Foster Parent Training RFP 006-00: Home Study,Relinquishment Counseling Dear Ms.Kochevar: 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 bids below for inclusion on our vendor list. 1. 006-00A Foster Parent Training 2. 006-00C Foster Parent Consultation • The Families, Youth and Children(FYC)Commission recommended approval of the bid, RFP 05005 Lifeskills,for inclusion on our vendor list,attaching the following condition for all Lifeskills providers. Condition: All providers must define their capacity to do after-hours visitation. • The Families,Youth and Children(FYC)Commission recommended approval of the bid, RFP 006-00 Home Studies,Updates, and Relinquishment Counseling, for inclusion on our vendor list, attaching the following conditions for all Home Study 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. Condition#2: It has been mutually decided that the turnaround time for receipt of the completed home study by the Department is set at six weeks from the date of receipt of the referral. • - Page 2 Lori Kochevar,LLC,Results of Bid Process 2005/2006 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 at 352.1551,extension 6230. Sincerely, et- J A. go,D. tor cc: Juan Lopez,Chair,FYC Commission Gloria Romansik, Social Services Administrator Hello