Loading...
HomeMy WebLinkAbout20031063.tiff RESOLUTION RE: APPROVE NOTIFICATION OF FINANCIAL ASSISTANCE AWARD FOR LIFE SKILLS PROGRAM AND AUTHORIZE CHAIR TO SIGN - LORI KOCHEVAR, LLC WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with a Notification of Financial Assistance Award for the Life Skills Program, between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Social Services, and Lori Kochevar, LLC, commencing June 1, 2003, and ending May 31, 2004, with further terms and conditions being as stated in said award, and WHEREAS, after review, the Board deems it advisable to approve said award, a copy of which is attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, ex-officio Board of Social Services, that the Notification of Financial Assistance Award for the above listed program between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Social Services, and Lori Kochevar, LLC, be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said award. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 30th day of April, A.D., 2003. BOARD OF COUNTY COMMISSIONERS WEL OUNT , COLORADO a ATTEST: Lk/ 4f.' D vid E. Lon Chair Weld County Clerk to t e B' arctd o v Robert D. asden, Pro-Tem BY: • Deputy Clerk to the Board '---'-- J. Geile AP DA . OF• ' : �'L Y,G✓ William H. Jerke County Attorn y a v. IUTACr� Glenn Vaad s Date of signature: �"- \ 2003-1063 CO 1 a3 67 ) SS0030 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 03-CORE-LS 0004 Revision (RFP-PAC-03005) Contract Award Period Name and Address of Contractor Lori Kochevar LLC Beginning 06/01/2003 and Life Skills Program Ending 05/31/2004 810 12`s 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 them. services and conditions of award. Except where it is The program offers information, education, and in conflict with this NOFAA in which case the modeling of behaviors that promote bonding,to NOFAA governs,the RFP upon which this award is assist the parent in their relationship with the based is an integral part of the action. child. Service to a total of 56 families during the Special conditions 12-month period, 8-10 families served at any given time, 18 hours of one-on-one supervised 1) Reimbursement for the Unit of Services will be based visitation with the bonding specialist per family. on an hourly rate per child or per family. 2) The hourly rate will be paid for only direct face to face Cost Per Unit of Service contact with the child and/or family,as evidenced by client-signed verification form,and as specified in the Hourly Rate Per $ 65.00 unit of cost computation. Unit of Service Based on Approved Plan 3) Unit of service costs cannot exceed the hourly and Enclosures: yearly cost per child and/or family. X Signed RFP:Exhibit A 4) Payment will only be remitted on cases open with,and Supplemental Narrative to RFP: Exhibit B referrals made by the Weld County Department of Recommendation(s) Social Services. Conditions of Approval 5) Requests for payment must be an original submitted to the Weld County Department of Social Services by the end of the 25th calendar day following the end of the month of service. The provider must submit requests for payment on forms approved by Weld County Department of Social Services. Approvals: Program Official: By By David E. Long,Chair Jud6,{ta o,Dir ctor Board of Weld County Commissi ers Weounty Department 4 of Social Services 3.Date: 4- - U 3Q3 Date: 112 I/(/'3 „WO-ICLo3 EXHIBIT "A" RFP-FYC-03005 Attached A LIFE SKILLS PROGRAM BID PROPOSAL AND REQUEST FOR CONTINUATION OF AWARD UNDER FPP CORE SERVICES FUNDING FAMILY PRESERVATION PROGRAM 2002/2003 BID PROPOSAL APPLICATION PROGRAM FUNDS YEAR 2003-2004 OFF-SYSTEM BID 02-03 RFP-FYC-03005 NAME OF AGENCY: Ix ADDRESS: 4- �- /I that ,- ms Ix LLC PHONE: .970 3S a-9373 CONTACT PERSON: Urj1G(ar TITLE: any' 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. 2003 Start End May 31, 2004 End TITLE OF PROJECT: SO ggriet01 Pi/ /C4wn AMOUNT REQUESTTED��: • S__�&Airship��la¢tt✓� /1S Ut. 11C- 3/131 Q3 Namere of Person Preparing Document Date Judy A. Griego,Director Name and Signature Chief Administrative Officer Applicant Agency Date MANDATORY PROPOSAL REOUIREMENTS For both new bids and renewal bids,please initial to indicate that the following required sections are included in this Proposal for Bid. For renewal bids,please indicate which of the required sections have not changed from Program Fund Year 2002- 2003 to Program Fund year 2003-2004. Indicate No Change from FY 2002-2003 to 2003-2004 _AlProject Description Target/Eligibility Populations 3't Types of services Provided M Measurable Outcomes if Service Objectives f ____ Workload Standards _ Staff Qualifications Unit of Service Rate Computation _ Program Capacity per Month Certificate of Insurance Assurance Statement Page 26 of 32 • INVITATION TO BID OFF-SYSTEM BID 02-03 RFP-FYC 03005 DATE:February 19, 2003 BID NO: RFP-FYC-03005 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-03005) for:Colorado Family Preservation Act--Life Skills Program Emergency Assistance Program Deadline: March 14, 2003, Friday, 10:00 am. 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, 2003, through May 31, 2004, at specific rates for different types of service, the county will authorize approved vendors and rates for services only. The Life Skills Program must provide services that focus on teaching life skills which are designed to improve household management competency, parental competency, family conflict management and effectively accessing community resources. This program announcement consists of five parts,as follows: PART A...Administrative Information PART D...Bidder Response Format PART B...Background, Overview and Goals PART E...Bid Evaluation Process PART C...Statement of Work Delivery Date (After receipt of order) BID MUST BE SIGNED IN INK Loricuw" CT�ED OR PRINTED SIGNATURE ofVENDOR wet Ware MS IdC.LL�G c�� �� �Lj ihs ilk Lit (Name) Han tten Signature By Authorized SID {,,���. Officer or Agent of Vender SI ADDRESS D la* C5 hie TITLE &nt7A . C7 teed CD 10631 DATE 31/3 103 PHONE# 970 sS2-1 S 7 3 The above bid is subject to Terms and Conditions as attached hereto and incorporated. Page 1 of 32 RFP-FYC-03005 Attached A Date of Meeting(s)with Social Services Division Supervisor: .a-/ailG Comments by SSD Supervisor: ,4-trec fc .4 7 n /0-Dyc/(— — c-c r r-rl ct Ir, ell l�-‘7r-yr,�,� Name and Signature of SSD Supervisor Date Page 27 of 32 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. 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 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 be able to serve a total of 56 families during the twelve-month period. The bonding specialist will serve eight to ten families at one given time period. Each family will receive 18 hours of one-on-one supervised visitation with the bonding specialist. This would provide sixteen to twenty hours of intervention with families per week, sixty-four to 2 eighty hours per month. Total number of client hours provided per year would be 1008 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 280 clients. Focus will be on children whose ages are birth to three 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 56 families will be served during the year. D. Sub-total of individuals who will receive bilingual/ bicultural services: All services provided would be in a manner that is sensitive 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. Carmen Jimenez, a bicultural 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. Written program materials are available in Spanish. 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 referral 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 25 hours per week, which would make available 100 hours per month. G. The monthly average capacity: The monthly average capacity of this program is six to eight families. 3 H. Average stay in the program: The average stay in the program would be twelve weeks. 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. It is important that the family initially access services two hours per week, due to the urgency of healing the parent-child relationship. After the first six weeks, sessions will decrease to one hour per week for the remainder of the twelve weeks. 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 4 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 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 specialist is well informed about community resources due to her work in the Public Health field. 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. 5 B. Visitation: 1. Monitor parent-child interactions for physical and emotional safety: Supervised visitation by the bonding specialist will be made in the home 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. 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. 6 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 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 minor 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 • 7 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. MEASUREABLE 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 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. 8 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. • 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 9 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. 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 10 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. • 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. II • 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 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. 12 13 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. WORKLOAD STANDARDS A. Number hours per day, week or month:. The program has the capacity to serve up to 56 families. The bonding specialist would spend up to 20 hours a week providing services. Henceforth, 20 hours a week x 50 weeks, provides 1008 client hours a year. B. Staff: There are three bonding specialists. Lori Kochevar M.S., L.C.P., LLC will serve as the program supervisor for Becky McMahan R.N and Carmen Jimenez L.C.S.W. All providers have extensive experience in Family Services and Attachment and Bonding as documented in the attached resumes 13 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 4 hours a day, 20 hours a week, and 80 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 as an additional insured on this policy. Each individual provider also carries a 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. STAFF QUALIFICATIONS A. All the providers meet the minimum qualifications needed for both education and experience. Providers have a Masters Degree in Counseling or Registered Nurse License. In addition, specialists have between 6-21 years each in providing services for families. See resumes in Appendix C. 14 B. Staff available for this project consists of three experienced specialists who have a core value of clinical excellence. We believe in providing strength-based, family-focused services that empower the families we serve. Another strength of our staff is in our diverse areas of specialties. • Lori Kochevar, a licensed professional counselor, has extensive experience and training in providing services and supervision using the family preservation model. She has specialized training in substance abuse, trauma, grief, domestic violence, attachment and family systems. • Carmen Jimenez is a bilingual licensed clinical social worker with clinical expertise in medical social work. She is trained as a family preservation specialist and has extensive experience in providing bilingual services. • Becky McMahan has had extensive experience in the area of child health care. 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. As well as being skilled bonding specialists, due to our extensive background in the community, we are knowledgeable of the systems (i.e. biological families, social services, mental health services, legal services, etc.) that parents need to interface with in order to effectively meet the needs of their children. 15 APPENDIX A 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. The child will: • Indicate through his behavior, that he has increased sense of security with the parent. • Demonstrate increased emotional bond with the parent. • Behave appropriately in social interactions. • Begin to progress developmentally with expected achievement. The items checked above indicate areas of concern. A circled item indicates improvement. Parent: Bonding Specialist: Date: 2 FAMILY VISITATION EVALUATION FORM Name: Date: Location: Greetings: Good-byes: Activities: Planned Spontaneous Age Appropriate • Interactions: Initiated by: 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: ORIGINAL-TO CLIENT • YELLOW COPY-RN PINK COPY-CASE WORKER 10.02/I)I M:/wpfiles/bMcMahan/fami lyvisitationevaluationform • 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 TYPES OF ATTACHMENT TYPE DESCRIPTION BEHAVIORS -primary emotion is sadness Isolated (Avoidant) -passive aggressive -flat affect -thinking process-"no one will ever be there -appear depressed for me—"I can take care of myself' -avoid closeness -physical closeness or touch brings feelings of -talk under their breath-mutter of overwhelming sadness to the child -become enraged with forced -openly angry and defiant only when threatened closeness with closeness or need -not stranger friendly -priority is survival -almost never do what they are -place little value on other people asked to do -usually don't do school work -argue constantly Evasive (Anxious) -Fear is the predominate emotion -extremely superficially charming -fear of abandonment -seek physical closeness, don't usually don't resist -over friendly with strangers -thinking process-" no one will love me for -seek constant attention, often who I am" with incessant chatter and -extremely passive aggressive intrusion into adult space -act afraid to cover sadness and anger -never tell the truth-senseless -emotional responses unpredictable, based on lying what child thinks others want -manipulate friendship- seek closeness, but often inadvertently hurt person offering it -poor sense of own emotions -prefer superficial relationships Defiant (Ambivalent) -predominate emotion-anger/rage -charming to strangers -primary thinking error- " no one will give me -long lasting tantrums the "goodies", I won't ever get any, so I need -do not speak clearly, mumble to take -hostile -manipulate to get needs met -cruel to others and animals -place no value on other except to get needs met -act out anger openly -act out sexually -lack of conscience -openly defiant, oppositional -no empathy -allow touch as a way to manipulate -fascinated with blood, fire and gore Bizarre (Disorganized) -free floating anxiety, threatening to push -charming with strangers into psychotic thinking -intense tantrums -thinking pattern-multiple continuous bizarre -respond to touch briefly errors -lots of chatter, make up own -distorted sense of reality words -often had drug or alcohol exposure in utero -frequent mood changes -neurological damage common -primitive sense of conscience -remorse is soon forgotten -learning difficulties, lowered IQ levels on testing -will seek out closeness for brief periods -overwhelmed by own emotions Symptoms common to all types: -poor eye contact, need to be in control. impulsive, demanding, lack of cause and effect thinking, hoarding and sneaking food, stealing, poor conscience development, lying, persistent arguing, poor cause and effect thinking, refusal to take responsibility for actions, brief and few friendships- RESOURCE LIST BONDING PROGRAM . 810-12'"Street—Greeley,CO 80631 Phone(970-352-8879 HEALTH Monfort Children's Clinic 100 N. 11'" Avenue ( 970) 352-8898 Sunrise Community Health Center 1028 5th Avenue (970)353-9403 Urgent Care 1900 16th Street (970) 3531661 NCMC 1801 16th Street (970) 3524121 North Colorado Family Medicine 1600 23rd Avenue (970) 353-2424 Scheduling 346-2818 Quick Care 2928 W. 10th Avenue (970) 351-8181 Weld County Department of Public Health 1555 N. 17th Avenue (970) 304-6420 Family Connects 2985 W. 29'" ST. # A (970) 330-3842 North Range Behavioral Health 1306 11'"Avenue (970)346-1 166 353-3686 CLOTHING Church Women United 1030 11'"Avenue (970) 353-7144 Salvation Army 1119 6th Avenue (970) 353-1444 Adventist Community Services 612-23`d Ave (970) 356-3740 Budget Baby Shop 130111th 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. I l'"Avenue (970) 3528898 Sunrise 10285th Avenue (970) 353-9403 FOOD WIC 1028 5TH avenue (970) 353-9403 Weld Food Bank 104 11'"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 11'" Avenue (970) 352-1551 ext. 6541 Hudson Housing Authority 1151 Main/Hudson 1- 303- 536-4501 Ft. Lupton Housing Authority 400 2"d Street/Ft Lupton 1-303-857-4400 RENT/DEPOSITE ASSISTANCE Catholic Charities Northern 2500 Is' Avenue Bldg C-B (970)353-6433 Mi Casa Tu Casa 1311 3`d Street (970)352 -6417 Salvation Army 1119 6th Street (970) 353-1441 APPENDIX B Issue Date: 09/11/02 <<cN Th Reciprocal Reci rocal PROFESSIONAL LIABILITY OCCURRENCE ��Alliance INSURANCE POLICY FOR Risk Retention Group PROFESSIONAL COUNSELORS AND HUMAN DEVELOPMENT PRACTITIONERS ACA Insurance Trust,Inc. 5999 Stevenson Avenue ACA IKS$Aptz Policy Number: CL12509802 Administered by: Alexandria.VA 22364-3300 TRUST Toll Free 1.800-347.6647 x284 ...VV•..• ITEM DECLARATIONS RENEWAL CERTIFICATE NO. CL125098 INDIVIDUAL POLICY 1. NAMED INSURED: Lori Kochevar M.S . , L. P.C. LLC 2. ADDRESS: 810 12th Street Greeley, CO 80631 3. POLICY PERIOD: From: 09/17/02 To: 09/17/03 12:01 A.M.Standard Time at Location of Designated Premises 4. The insurance afforded is only with respect to such of the following types of insurance as indicated by specific premium charge or charges: COVERAGE PREMIUM A. PROFESSIONAL LIABILITY S 521 . 00 B. GENERAL LIABILITY S 117 . 00 TOTAL PREMIUM: S 638 . 00 5. LIMITS OF LIABILITY: $1 , 000, 000 each Incident or each Occurrence $3 , 000 , 000 in the Aggregate 6. THE NAMED INSURED IS: Sole Proprietor(incl.Individual) Partnership Corporation X Other(refer to Item 7 below) 7. BUSINESS OF THE NAMED INSURED: Part-Time < 20 hours Self-Employed (Rating Category) Bodywork Counselor 8. This policy is made and accepted subject to the printed conditions of this policy together with the provisions,stipulations and agreements contained in the following form(s)or endorsement(s): CPL-0004-0197 CPL-0006-0102 CPL-0015-0102 CPL-0007-0199- 0 NOTICE THIS POLICY IS ISSUED BY YOUR RISK RETENTION GROUP. YOUR RISK RETENTION GROUP MAY NOT BE SUBJECT TO ALL OF THE INSURANCE LAWS AND REGULATIONS OF YOUR STATE. STATE INSURANCE INSOLVENCY GUARANTY FUNDS ARE NOT AVAILABLE FOR YOUR RISK RETENTION GROUP. CPL-005R-1201-00 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 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 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 MEINECI E,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 Mbi ecke, LCSW/CAC III Colorado License# 991541 LORI KOCHEVAR, M.S., L.P.C. 2118 19th Avenue Greeley, CO 80631 (970) 353-6568 EDUCATION: University of Southern Mississippi, M.S. Counseling Psychology, Cumulative GPA 3.8 University of Northern Colorado, B.A. Pre-Professional Psychology, Cumulative GPA 3.5 • PROFESSIONAL EXPERIENCE: 5/95 - PRIVATE PRACTICE THERAPIST, STRETCHING OUR STRENGTHS Serve others through a creative process that stretches participants strengths and provides an environment for authentic healing. Facilitate opportunity for individuals, families, and groups to participate in body centered spiritually based psychotherapy. Interpersonal dynamic facilitation for community development, team building, stress reduction, anger management, parenting, and personal effectiveness are available. 5/95 - 9/96 • DIRECTOR, VALLEY COMMUNITY FUND Serve and manage Board of Directors to strengthen the internal structure of the agency to increase fundraising capabilities. Responsibilities include: accass state, government, and businesses to participate in payroll deduction, grant writing, marketing, coordination of special events and community trainings, and disbursement of funds. 5/92 - 5/95 FAMILY PRESERVATION SPECIALIST, SAN LUIS VALLEY MENTAL HEALTH CENTER Provide intensive home-based treatment for families that are at risk of having youth removed from the home. Intervention emphasizing strength-based approaches, including psychotherapy, skill budding (parenting, communication, anger control, problem-solving, etc.), educational support, and assistance in obtaining support for concrete needs. Management duties: public relations, supervise students, hire staff, and provide training for staff and community. 3/92 - 5/95 WILDERNESS THERAPIST, SAN LUIS VALLEY MENTAL HEALTH CENTER Provide intensive tent-based treatment for youth ages 8-17. Facilitate opportunities for young people to learn skills in leadership, team work, decision making, dealing with stress, facing fears, and building responsibility. Use outdoor challenge course experience such as rafting, backpacking, mountaineering, and rock climbing to provide skills based learning opportunities. 5/89 - 5/91 CONSULTANT, GRADUATE ASSISTANT, UNIVERSITY AFFLILIATED PROGRAM, UNIVERISTY OF SOUTHERN MISSISSIPPI Participating in an interdisciplinary team that provides assistance for community-based child care centers who serve children with disabilities and their families. Responsibilities include: Grant writing, development and presentation of awareness training, assessment of learning environment and handicapping conditions. Provide consultation for teachers and parents using a coaching model, skills- based training, and evaluation of improvement. 1/89 - 5/89 TEACHING ASSISTANT, UNIVERSITY OF NORTHERN COLORADO Teach skills for report writing and use of computer programs, PC Write and Labstat. Teach weekly labs and grade lab reports. 4/86 - 9/89 RECREATION SUPERVISION, BOYS AND GIRLS CLUB OF GREELEY Providing guidance and support for at-risk youth, fundraising, program planning, facilitate teenage drug and pregnancy prevention program, family and community involvement, organization and supervision of field trips, and participation in local and national staff development training. INVOLVEMENT: FOUNDER, BOARD MEMBER, BOYS AND GIRLS CLUB OF ALAMOSA Spearhead community organization to obtain Boys and Girls Club. Organize fundraising, board development, marketing, and regional and national networking. MEMBER, SAN LUIS VALLEY COALITION FOR YOUTH SERVICES . Member of steering committee and chairperson of the multicultural task force. • CONFERENCES: SPIRITUAL 2000 Hakomi Training 11/05/99 Marian Williamson - Enchanted Love 10/22-24/99 Shapeshifting: Shamanic Tranformation 1999 Women Who Run With the Wolves - Jungian 10/5-17/99 Phoenix Rising: Yoga Therapy Levels 1 and 2 09/24-26/99 Energy Medicine - Donna Eden 08/19/99 James Redfield -The Celestine Prophecy 08/14/99 Ruth and Naomi - Women's Partnerships 04/24/99 Substanability and Spirituality 04/23/'99 Time, Money and the Meaning of Life 03/19/99 Gandhi's Search for Meaning 10/23/98 Spirituality and Religion 06/06/98 Tying it all Together - Biblical Overview 03/28/99 Transformation -Job of the Old Testament 03/06/98 Matthew Fox - Spirituality of Compassion 11/6-9/97 Common Boundaries: Joy of Creation 07/10-13/97 Body and Soul Conference 04/26/97 Day of Prayer 04/19/97 Contemplative Living 1997 Catholic Biblical School 11/6-10/96 Common Boundaries: Intentional Living 1993-1995 Creative Process COMMUNITY DEVELOPMENT 1/7-8/00 Foster Parent Core Training 10/30/99 Matrix Leadership 10/21-22/96 Working as Partners with Managed Care 04/02-05/95 Leadership for Executive Directors 03/29/95 Fundsaving Workshop Fall 1995 Leading Edge/Business 02/09-13/95 Challenge by Choice: Ropes Course 05/20-22/94 Organizational Conflict Management: CSAP 05/06/94 CPR and First Aid Certification 02/01-/4/94 Multicultural Conference 11/30/93 Exploring Multiculturalism Within 10/13/93 Conflict Mediation Training 08/11-14/92 Multicultural Training: CSAP 05/12-26/89 Women as Leaders FAMILIES 06/4-6/99 Passionate Marriage 10/15-19/98 Marriage and Family Conference 05/16-17/98 Relationship Enhancement 12/08-9/97 Family Group Decision Making 10/06/97 Family Group Decision Making 05/2-3/97 Marriage and Family 9/15-16/94 Family Preservation - Supervision 07/20/94 Jim Fay Parenting • • 07/13/94 Family Sculpting 4/26-27/93 Family Sculpting Spring 1993 Redirecting Chidren's Behavior 02/06/93 Meaningful Family Comunication 07/070-8/92 Active Parenting 03/16-19/92 Family Preservation Training 09/20-21/90 Parents and Professionals United CHILDREN AND ADOLESCENTS 09/10/99 Testifying in Child Abuse Caes 07/12/99 Firestarting - Prevention and Intervention 01/29/99 Play Therapy 12/11/98 Attachment Disorders 10/18/97 Art Therapy for Children 04/04/97 Attachment Disorder 10/11-13/96 International Play Therapy Conference 07/8-9/94 Play Therapy 09/26/93 Traumatic Stress Reactins in Children 03/11-14/93 Child Adolescent Conference Spring 1993 Play Therapy Class 02/16-17/91 Strategic Therapy for Adolescence 10/11-13/90 C.H.A.D.D. Conference on ADHD 05/30-6/1/90 Early Intervention 12/05/89 Play Assessment TRAUMA AND GRIEF REACTIONS 12/03/99 Jurisprudence Workshop 06/25/99 Molecule of Emotions 04/09/99 Depression and Anxiety 05/19/97 Cultural Grief 09/14-16/95 Annual Hospice Conference 04/14/94 Empowering Resistive Client II 06/09/93 Empowering Resistive Clients 09/17-19/92 Annual Mental Health Conference SUBSTANCE ABUSE AND DOMESTIC VIOLENCE 10/14/98 Working with Aggression in group Therapy 09/23/97 Domestuc Violence 09/17/97 Substsance Abuse 05/16-17/94 FPS - Motivational Interviewing - Jill Kenney 05/3-14/94 Teen Baseline TOF - Drug Prevention 10/5-9/93 Baseline TOF - Drug Prevention 04/23-24/92 Domestic Violence Conference REFERENCES: Larry Mayer, M.A. Director of Family Preservation Program 26041 Woodland Avenue Esparte, CA 95627 (916) 787-4329 Sherri Malloy, Ph.D. Ackerman and Associates, P.C. 1750 25th Avenue, Suite 101 Greeley, CO 80634 (970) 353-3373 Carey Bryant, Executive Director Boys and Girls Club of Greeley 2400 W. Fourth Street P.O. Box 812 Greeley, CO 80632 (970) 353-1590 Sue Young, M.A., L.P.C. 2755 County Rd. 47/10 Alamosa, CO 81101 (719) 589-4531 Barb Jetley, M.A., L.P.C. P.O. Box 982 Pagosa Springs, CO 81147 (970) 264-2200 CARMEN M. JIMENEZ MSW, LCSW 3304 26TH St. Greeley, CO 80634 Hm # (970) 339-8345 Fax # (970) 346-8776 Objective: Psychotherapist/Medical Social Worker SUMMARY OF QUALIFICATIONS O Eight years experience in mental health O Five years experience in medical social work O State of Colorado License in Clinical Social Work O Master's Degree in Social Work with an emphasis in Generalist Social Work O Medicare provider O Bi-lingual and bi-cultural in Spanish O Specializing in work with victims of abuse and trauma O Trained in mediation, issues in the workplace, and substance abuse O Skilled in hospice work and life transition issues WORK EXPERIENCE /ACCOMPLISHMENTS 08/98 - COMPASION COUNSELING, Greeley, Colo. Pres. Carmen Jimenez, MSW, LCSW - Sole Proprietor Individual and group psychotherapy services to families, children, and adolescents. Contractual work with managed care and insurance com- panies. Provider on the Crime Victim Compensation Board of the 19th Judicial District of Weld County. Consultation and mental health counseling to residents in nursing facilities. Consultation with the Weld County Juvenile Diversion Program. Medicare and Colorado Access provider. 06/00-ASSOCIATED PROFESSIONAL HOME HEALTH CARE, INC. Pres. Medical Social Work(Part-time) Social work services to patients who are home-bound which include community resource planning, brief therapy, counseling for long-range planning, advocacy. 10/98 - LHS HOME AND COMMUNITY CARE, Greeley, Colo. 10/99 Medical Social Work Social work services to home-bound patients which included community resource planning, counseling for long-range planning and decision-making, financial resource management, short-term therapy. • Page 2 02/98 - MONFORT'S CHILDRENS CLINIC, Greeley, Colo. 03/99 Medical Social Worker(Part-time) Intensive family outreach program advocating for the needs of under-privileged families served by the Clinic. • Supervision of interns from Colorado universities • Development of psychosocial needs assessment • Psychosocial needs assessments& Family education of medical issues • Individual counseling of children and families,with emphasis on play therapy and systems models • Extensive interagency networking 07/96 -PREFERRED HOME HEALTH 11/98 Social Services Director Social work services to home-bound patients which included community resource ' planning, counseling for long-range planning and decision-making, financial resource management, short term therapy. • Instituted the Social Work Department; developed the Policies and Procedures Manual; systematized Medicare guidelines • Participation in Quality Improvement Standards • Extensive interagency networking 02/96 - ACKERMAN & ASSOCIATES, P.C., Greeley, Colo. 08/98 Contractual Position in Private Practice Individual psychotherapy services to families, children, adolescents. Mediation services for Dept. of Social Services. Interpretation services in Spanish for psychological evaluations and Social Security eligibility. Intensive home-based psychotherapy services to families referred to the Family Preservation Program. 11/95 - NORTH RANGE BEHAVIORAL HEALTH, Greeley, Colo. 07/96 Mental Health Therapist Individual psychotherapy services to children referred to the Children's Division. Many of these children were from under-privileged families, and had severe experiences of trauma and abuse. Facilitated groups for adolescent females of sexual abuse. 05/93 —CENTENNIAL MENTAL HEALTH, Fort Morgan, Colo. 11/95 Mental Health Therapist Individual psychotherapy services to families, children, and adolescents. Psychotherapist for the Obra Program in geriatric settings. Therapist for the Community Support Program, working with persons with chronic mental illness. • Assisted with the development of the Logan County and Morgan County Adult Protection Teams • Emergency psychological evaluations and initiation of 72 hour holds • Psychosocial group work and teaching of self-management skills to persons with chronic mental illness • Extensive out-patient psychotherapy and case management services with spanish-speaking clients • Page 3 09/91 -COLORADO STATE UNIVERSITY 05/93 GRADUATE PROGRAM, Ft. Collins, Cob. 06/81 - CITY OF FORT COLLINS, Fort Collins, Cob. 08/91 Community Development Block Grant Program Administrative Assistant Work with non-profit agencies under the U.S. Housing and Urban Development Program for community development and housing rehabilitation projects. Extensive work with low-income families and persons with disabilities. EDUCATION Master's Degree in Social Work, Summer 1993 Colorado State University,Fort Collins, Colorado Graduate School Research Positions: • Colorado Division of Mental Health, Rural Crisis Grant, Fort Logan, Denver, Cob. • Centennial Mental Health, Sterling, Cob. • Fostering Families Project, Fort Collins, Colo. Bachelor of Arts Degree, Social Work, Fall 1987 Colorado State University, Fort Collins, Cob. • REFERENCES Jalein Arnold, RN, BSN 1955 23rd Ave. Greeley, CO 80631 #(970) 356-6023 Leonor Willis, LPC 3417 W. 17th St. Greeley, CO 80631 #(970) 352-8045 Carmen Haynes, MSW Juvenile Diversion Program District Attorney's Office 915 Tenth St. Greeley, CO 80632 #(970) 356-4010 Pat Orleans, LCSW North Range Behavioral Health 1306 11th Ave. Greeley, CO 80631 #(970) 353-3686 APPENDIX C PROGRAM BUDGETS COMPUTERIZED BUDGET • • PROGRAM . . OUTSIDE SS FP CONSULT. IND FP CONSULT GRP BONDING A TOTAL HOURS OR DAYS OF DIRECT SERVICE PER CLIENT 6 12 18 B TOTAL CLIENTS TO BE SERVED 18 11 56 C TOTAL HOURS OR DAYS OF DIRECT SERVICE FOR YEAR(A X B) 108 132 1,008 D COST PER HOURS OR DAYS OF DIRECT SERVICES(E/C) $53.99 $200.01 $40.00 E TOTAL DIRECT SERVICE cos-rp FACE-TO-FACE $5,831 ' $26,401 $40,320 F ADMINISTRATION COSTS NON-FACE-TO-FACE ALLOCABLE TO PROGRAM $200 $1,964 $7,856 $20,093 G OVERHEAD COSTS ALLOCABLE TO PROGRAM $3,301 $660 $2,641 $4,401 H TOTAL DIRECT,ADMINISTRATION 8 OVERHEAD COSTS(E+F+G) $8,455 $36,898 $64,815 I ANTICIPATED PROFITS CONTRIBUTED BY THIS PROGRAM $185 $2,703 $707 J TOTAL COSTS AND PROFITS FROM THIS PROGRAM(H +I) $8,640 $39,601 $65,522 K TOTAL HOURS OR DAYS OF DIRECT SERVICE FOR THE YEAR(C) 108 132 1,008 L RATE PER HOURS OR DAYS OF DIRECT,FACE-TO-FACE SERVICE TO BE CHARGED TO WELD COUNTY SOCIAL SERVICES(J/K) $80.00 $300.00 $65.00 DIRECT SERVICE COSTS COMPUTERIZED BUDGET Minimum Budget Average Total % TIME SALARY % TIME SALARY % TIME SALARY % TIME SALARY % TIME SALARY % TIME SALARY Degree t01 Salary/Bene Salaries! 100% SPENT ON AND SPENT ON AND SPENT ON AND SPENT ON AND SPENT ON AND SPENT ON AND DESCRIPTION oreert PTEs @ 1.0 FTE Bene0ts/Other ALLOCATED PROGRAM OTHER COSTS PROGRAM OTHER COSTS PROGRAM OTHER COSTS PROGRAM OTHER COSTS PROGRAM OTHER COSTS PROGRAM OTHER COSTS PROGRAM OUTSIDE SS FP CONSULT INO FP CONSULT GRP BONDING A TOTAL CLIENT HOURS OR DAYS PER PROGRAM 6 12 16 B TOTAL CLIENTS TO BE SERVED PER PROGRAM 18 11 56 C TOTAL HOURS OR DAYS PER PROGRAM FOR YEAR 000 10800 13200 100800 000 000 DIRECT LABOR FACE-TO-FACE POSITION,TITLE OR JOB FUNCTION THERAPIST CONTRACT . MASTERS 1.00 $32,232 532.23200 YES $000 10.09% $583077 ' 81.91% $2640123 $000 $000 $000 BONDING SPECIALIST 2NRMSTERI 2.00 $20,160 $40.32000 YES $000 $000 S000 100.00% $40.32000 $000 $0 DO $000 NO S000 $000 $000 $0.00 $000 $0.00 • $000 NO $000 $000 $000 $000 $000 $000 $000 NO S000 $000 $0.00 $000 $0.00 $0.00 $000 NO $000 $000 $000 $000 $000 $000 $000 NO $000 $000 $0.00 $0.00 $0 O0 $000 $0 00 NO SO 00 $0 00 $0.00 $0.00 $0 00 50.00 ' $000 NO $000 $000 $000 $000 $000 $000 S0 00 NO $0 00 $0 00 $000 $0 CO S0 CO $0.00 $000 NO $000 $000 $000 $000 $000 $0.00 ' $000 NO $000 $000 $000 $000 $000 $000 $000 NO $000 $000 $000 $0.00 $000 $000 $000 NO $000 $000 $000 $000 $000 $000 TOTAL DIRECT LABOR PER PROGRAM $72,552 00 5000 $5399 $5.830 77 $200.01 $26.401 23 $4000 $4032000 $000 $000 OTHER DIRECT COSTS PER PROGRAM FACE-TO-ACE NO $000 $000 $000 $000 50.00 $000 NO $000 S000 $000 $000 $000 $000 NO 5000 $000 $000 5000 $0.00 $000 NO $000 $000 $000 $000 $000 $000 NO $000 $000 $000 $0.00 $000 $000 NO $000 S000 $000 $0.00 $000 $000 TOTAL OTHER DIRECT COSTS PER PROGRAM $0 00 $0 00 $0 00 $0 00 $0 00 $0 $0 00 E GRAND TOTAL DIRECT SERVICE COSTS $7255200 $000 $5399 $5,830 77 $20001 $26,401 23 $4000 540.320 00 4000 $000 ADMIN COST NON-FACE-TO-FACE COMPUTERIZED BUDGET Minimum Budget Avenge Total %OF TIME SALARY %OF TIME SALARY %OF TIME SALARY %OF TIME SALARY %OF TIME SALARY %OF TIME SALARY Degree It Of Salary/Bens Salaries/ 100% SPENT ON AND SPENT ON AND SPENT ON AND SPENT ON AND SPENT ON AND SPENT ON AND DESCRIPTION or Cert FTEs (g 1.0 FTE Benefits/Other ALLOCATED PROGRAM OTHER C05TS PROGRAM OTHER COSTS PROGRAM OTHER COSTS PROGRAM OTHER COSTS PROGRAM OTHER COSTS PROGRAM OTHER COSTS PROGRAM OUTSIDE 5$ FP CONSULT.IND FP CONSULT GRP BONDING A TOTAL CLIENT HOURS OR DAYS PER PROGRAM 6 12 18 B TOTAL CLIENTS TO BE SERVED PER PROGRAM 18 11 56 C TOTAL HOURS OR DAYS PER PROGRAM FOR YEAR 000 108.00 132 00 1008 00 0 00 0.00 DIRECT LABOR NOT FACE-TO-FACE BOOKEEPING BONDING .1.00 $7,047 $7,047.00 YES 0.00% $0.00 $0.00 $000 100.00% $7,04700 $000 $0.00 SUPERVISING 1.00 $20,800 $20,80000 YES 0.00% $0.00 8.00% $1684.00 32.00% $6,65600 80.00% $12,480.00 $000 $000 BOOKEEPING FP CONSULTATION .1.00 $1,000 $1,000.00 YES $000 20.00% $200.00 00,00% $80000 $0.00 $000 $0.00 $000 NO $0.00 $0.00 $000 $0 DO $000 $0.00 ' $0.00 NO $0.00 $000 $000 $000 5000 5000 $0.00 NO $0.00 $000 $000 $0.00 $000 $0.00 $000 NO $0.00 - $000 5000 $0.00 $000 $0.00 $0.00 NO $0.00 $000 $000 $0.00 $000 $000 5000 NO $000 $000 $000 $0.00 $000 $000 50.00 NO $0.00 $0.00 $000 $000 $000 5000 $0.00 NO $000 $000 $000 $000 5000 $0.00 50.00 NO $0.00 $000 $000 $0.00 $000 50.00 $0.00 NO $0.00 $0.00 $0.00 $0.00 $000 $0.00 SO 00 NO $0.00 $0.00 $0.00 $0.00 $0.00 $060 TOTAL DIRECT LABOR PER PROGRAM NOT FACE-TO-FACE $28,847 00 $0.00 $1726 $1864 00 $56.48 $7456.00 $19 37 $19,527 00 $0 00 $0.00 OTHERDIRECT COSTS PER PROGRAM NOT FACE-TO-FACE LEGAV' a%N Trine $600.00 YES $000 10.00% $6000 40.00% $24000 60.00% $300.00 $0.00 $000 INSURANCE 5%8.00 YES 30.00% $19980 8.00% $3996 24.00% $15904 40.00% $266.40 $0.00 $0.00 NO $000 $000 $000 $0.00 $0.00 , $0.00 NO $000 $000 $000 $000 $0.00 $000 NO $000 S000 $000 $0.00 $0.00 5000 - NO $000 $000 $000 $000 $000 5000 TOTAL OTHER DIRECT COSTS NOT FACE-TO-FACE PER PROGRAM $1,26600 ODIV/0! $19980 $093 $99.96 $3.03 $399.84 S056 $566.40 $000 50.00 F GRAND TOTAL DIRECT SERVICE COSTS NOT FACE-TO-FACE $30.113 00 ODIV/0! $19980 $18.18 $1,963 96 $59.51 $7,855 84 $1993 $20,093.40 50.00 $0.00 OVERHEAD COSTS AND PROFITS COMPUTERIZED BUDGET TOTAL ALLOCATED ALLOCATED ALLOCATED ALLOCATED I ALLOCATED I ALLOCATED 0 100% ALLOCATED OVERHEADCOSTS ALLOCATED OVERHEAD COSTS ALLOCATED OVERHEAD COSTS. ALLOCATED )VERHEAD COSTS %ALLOCATECDVERHEAD COSTS %ALLOCATEDOVERHEAD COSTS DESCRIPTION COSTS D TO PROGRAM TO PROGRAM TO PROGRAM TO PROGRAM TO PROGRAM TO PROGRAM TO PROGRAM TO PROGRAM TO PROGRAM TO PROGRAM 7O PROGRAM TO PROGRAM PROGRAM OUTSIDE 55 FP CONSULT.IND FP CONSULT GRP BONDING A TOTAL CLIENT HOURS OR DAYS PER PROGRAM 5600 $12 00 $18.00 B TOTAL CLIENTS TO BE SERVED PER PROGRAM $1B00 111.00 $66.00 C TOTAL HOURS OR DAYS PER PROGRAM FOR YEAR 0 00 10B 00 132.00 1008.00 0.00 0.00 OVERHEAD RENT $3,815.00 YES 30.00% $1,17450 6.00% $23490 24.00% $939.60 40.00% $1,566.00 $0.00 $0.00 PHONE $2,460.00 YES 30.00% $738.00 6.00% $14].60 24.00% $590.40 40.00% $98400 $0.00 $0.00 LICENSEA'ERMITS $146.00 YES 30.00% $43.60 6.00% $816 24.00% $35 40.00% $58.40 $0.00 $0.00 SUPPLIES $,482.00 YES 30.00% $1.344.60 6.00% $268.92 24.00% 51.07568 40.00% $179280 $0.00 $0.00 NO $0.00 $0.00 $0 00 $0.00 $0.00 $0 00 NO $0.00 $0 00 $0.00 $0.00 $0.00 $0.00 NO $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 NO $0.00 SO 00 $0.00 50.00 ! $0.00 $0 00 • NO $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 ' NO $0 00 $0.00 $0 00 $0.00 $0.00 $0 00 NO $0.00 $0.00 $0 00 , - $0 00 -� $0.00 $0.00 • NO $000 $0.00 $0.00 . $0.00 I $0.00 $0.00 NO $0.00 $0.00 $0.00 $000 ' $0.00 $0.00 . NO $0.00 $000 $000 $0.00 $0.00 $0.00 NO $000 SO00 SO00 SO00 $0.00 SO00 NO $000 $0.00 $0.00 50.00 I $0.00 $000 NO $000 $O.00 $0.00 $000 . $0.00 $0.00 NO $0 00 $0.00 $0 00 $0 00 $0.00 $0.00 G TOTAL OVERHEAD COSTS $11,003.00 $3,300.900 $660.18 $2640 72 $4.401 20 $0.00 5000 I TOTAL ANTICIPATED PROFITS $3,594.57 I YES $000 5% S1 B476 75% $2102.76 20% $707.05 $0.00 $000 TOTAL OVERHEAD AND ANTICIPATED PROFITS $14,597.57 $3,300 90 $84494 $5,343.48 $5,108.25 e $0.00 $0.00 a DEPARTMENT OF SOCIAL SERVICES P.O.BOX A GREELEY, CO. 80632 IDWebsite:www.co.weld.co.us Administration and Public Assistance(970)352-1551 Child Support(970)352-6933 O MEMORANDUM • COLORADO TO: David E. Long, Chair Date: April 28, 2003 Board of County Commissioners nn 0000 FR: Judy A. Griego,Director, Social Service a RE: Notification of Financial Assistance Awar s�AA) under Core Services Funds-Lori Kochevar, MS, LPC, LLC Enclosed for Board approval are Notification of Financial Assistance Awards (NOFAA) for Core Services Funds with Lori Kochevar,MS, LPC, LLC. The Families, Youth and Children Commission(FYC)has reviewed these proposals under a Request for Proposal process and is recommending approval of these bids. The major provisions of the NOFAA are as follows: 1. The period of each NOFAA is June 1,2003,through May 31, 2004. 2. The source of funding is Core Services,which is comprised of 80%Federal/State and 20%County resources and 100% State resources. The total budget for Core Services is projected to be $929,822. 3. Lori Kochevar agrees to provide services to those children and families who are in imminent risk of placement under child welfare. The services to be provided through Lori Kochevar are as follows: Under Lifeskills, this service offers supervised visitation for the family during the rime the bonding specialist is working with them. The program offers information, education, and modeling of behaviors that promote bonding, to assist the parent in their relationship with the child. The program capacity provides for service to a total of 56 families during the 12-month period, 8-10 families served at any given time, and 18 hours of one-on-one supervised visitation with the bonding specialist per family. The hourly rate is $65. If you have any questions,please telephone me at extension 6510. 2003-1063 Hello