HomeMy WebLinkAbout20031291.tiff RESOLUTION
RE: APPROVE NOTIFICATION OF FINANCIAL ASSISTANCE AWARD FOR FOSTER
PARENT CONSULTATION PROGRAM AND AUTHORIZE CHAIR TO SIGN - LORI
KOCHEVAR
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 Foster Parent Consultation 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, 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 Foster Parent Consultation 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 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 21st day of May, A.D., 2003.
BOARD OF COUNTY COMMISSIONERS
W COUN Y, OLO DO
ATTEST: gal/
D i . Long, Chair
Weld County Clerk to th(eB: „-.
BY: R bert D. Ma en, Pro-Tem
Deputy Clerk to the Boa 7�r n_;4,
M. J. eile
ED AST •
� �
William H. Jer e
Cotanty Att ey
Glenn Vaad-
eci/c(
Date of signature:
2003-1291
SS0030
��. SSra?‘A-4J
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 FY03-CORE-0007
Revision (PY 03-04 RFP-FYC-06-000)
Contract Award Period Name and Address of Contractor
Beginning 06/01/2003 and Lori Kochevar.
Ending 05/31/2004 Foster Parent Consultation
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
This program provides foster parent consultative Proposal(RFP). The RFP specifies the scope of
service in the areas of(1)consultation and foster services and conditions of award. Except where it
parent support, (2)mandated corrective action is in conflict with this NOFAA in which case the
consultation, and(3)mandated critical care NOFAA governs, the RFP upon which this award is
consultation. Foster parent consultations will be based is an integral part of the action.
provided through group consultation services for a
maximum of four groups per month, 8-10 participants Special conditions
per group. Individual consultation services will only
be provided when approved by the Resource Services 1) Reimbursement for the Unit of Services will be
Manager or Child Welfare Administrator of Social based on a per group rate.
Services.Bilingual-Bicultural services are available 2) Rates will only be remitted on cases open with, and
to all families. South County services are available. referrals made by the Weld County Department of
Social Services.
3) Requests for payment must be an original and
Cost Per Unit of Service
submitted to the Weld County Department of Social
Group Rate per 8-10 participants $300.00 Services by the end of the 25th calendar day
Maximum Allocation for Groups $14,400.00 following the end of the month of service. The
Hourly Rate per Individual Consultation $ 80.00
provider must submit requests for payment on
Maximum Allocation for forms approved by Weld County Department of
Individual Consultation $ 5,600.00 Social Services.
4) Requests for payment must include original client
Based on Approved Plan
verification signatures(blue or red ink preferred)
Enclosures:
X Signed RFP:Exhibit A and dates and hours of service.
_Supplemental Narrative to RFP: Exhibit B
Recommendation(s)
Conditions of Approval
Approval . Program Official:
By By
David E. Long,Chair Judy Gri g ,Directo
Board of Weld County Commi sioners Wel ounty epartment of Social Services
Date: d' 5`— 2( -O,3 Date: 6 !Y U
•
EXHIBIT A
SIGNED RFP
•
•
006-00 Attached A
FOSTER PARENT CONSULTATION PROGRAM BID PROPOSAL AND
REQUEST FOR CONTINUATION OF AWARD UNDER FPP CORE SERVICES FUNDING
COLORADO FAMILY PRESERVATION ACT
2003-2004 BID PROPOSAL APPLICATION
PROGRAM FUNDS YEAR 2003-2004
OFF SYSTEM BID 02-03 RFP-FYC 03-04#006-00
NAME OF AGENCY: (,� AS . LPC LIZ
ADDRESS: b /A+RSJ-
PHONE: MU ) 3C at '3973 l
CONTACT PERSON: Lori 1(athevece TITLE: Owner
DESCRIPTION OF FAMILY PRESERVATION PROGRAM CATEGORY: The Foster Parent Consultation
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 and effectively accessing community resources.
12-Month approximate Project Dates: _ 12-month contract with actual time lines of:
Start June 1, 2003 Start
End May 31, 2004 Aired
n- End
•
TITLE OF PROJECT: ter Airen C onStila e Piny yi
i
AMOUNT REQUESTED: 9 4111211 I ✓
4&!/zacra 07S C 1/C,, Sole,�/ 3 `1�Q3
N021
and gnature of Person Preparing Document Date
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 2002-2003 to Program Fund Year 2003-2004.
Indicate No Change from FY 2002-2003 to 2003-2004
4 Project Description
Target/EligibilitypesoacesProvlded SOndll — O
A. Types of services Provided
Measurable Outcomes t
1� Service Objectives S- _ Q,�.�/,,el
)P-' Workload Standards D[t�P�/ i'KK w��►
ems- Staff Qualifications
a Unit of Service Rate Computation
GL Program Capacity per Month
frog t . Certificate ofInsurance
)l" Assurance Statement
Page 23 of 29
INVITATION TO BID
OFF SYSTEM BID 02-03 RFP-FYC PY 03-04 006-00
DATE:February 19, 2003 BID NO: PY02-03 006-00
RETURN BID TO: Pat Persichino,Director of General Services
915 10th Street,P.O. Box 758, Greeley, CO 80632
• SUMMARY
Request for Proposal (006-00) for: Colorado Family Preservation Act—Foster Parent
Consultation, Emergency Assistance Program
Deadline: March 14, 2003,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 Act(C.R.S. 26-5.5-101)iand
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 Foster Parent Consultation Program must provide services
that focus on providing psychological consultations and parenting support to foster parents which are
designed to improve foster parent 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) MUST BE SIGNED IN INK
5061 Inanbm
Lwi Icochevar Ms lit L.LC,
TYPED OR PRINTED SIGNATURE
Csintban
VENDOR Ltd Vcche4a AISl-t UC- AS ix L-GG
(Name) and 'tten Signature By Authorized
Shad'
or Agent of Vender
ADDRESS 5D Itl"" a TITLE
CA 9063/ DATE 13)11/11—
PHONE# 97617;935111-n73
The above bid is subject to Terms and Conditions as attached hereto and incorporated.
Page 1 of 29
03/04/2003 13:57 FAX 9703535215 SOCIAL SERv10ES t®UU2vUUZ
76x - 79
011640 •
Attached A
Date of Mecting(s)with Social Services Division Supervisor: ', 7i/, .ZdD 3
Comments by SSD Supervisor. /� �7 7 �'I D
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Page 24 of 29
Foster Parent Consultation Program
Purpose: The purpose of the Foster Parent Consultation Program is to provide on-
going support and consultation to foster parents so that they are better able to
provide positive healing relationships for the children they serve.
Design: This program is designed on a strength based family preservation model of
service. This model is proactive as well as promptly responsive to the foster parents
in order to decrease placement disruption for foster children. This program provides
a variety of support group tailored to meet the individual needs of the foster parent.
In addition, when requested by the department, prompt individual consultation by
phone or appointment will be available to work with foster parents in accordance to
their needs. In our experience, during a crisis the need for intense consultation
decreases after the initial solution orientated planning sessions. This program can
provide training opportunities to help foster parents meet the state requirements for
on-going professional development. The information discussed during consultation
services is always confidential for voluntary participants.
Why Services are Important- Foster Parents have the difficult role of providing a
loving relationship and a structured home environment to children whom have most
often been severely abused and or neglected. These children often have a distorted
sense of self. Children in the Foster Care system often act out their feelings of
unworthiness by displaying behavior that is destructive to self and others. Foster
parents need to be able to access consultation services quickly to assist them in
better understanding what the child/children are going through and how to respond
to their behavior. As caretakers they also need awareness and skills to address their
own issues in order to not repeat maladaptive interactions behavior with the foster
children.
Consultation - Consultation will consist of short-term, solution orientated
planning that facilitate empowerment of the foster parents. Services will be able to
be accessed through a call to the specific provider and will be provided in an
expedient manner. It is common for caregivers to feel anxious, overwhelmed,
depressed and or resentment when working with children that are experiencing all of
these same feelings. Receiving a response from an objective consultant in a timely
manner can help the foster parents to regain their composure and confidence to act
instead of react to the challenging behavior exhibited by many foster children.
I
Target / Eligibility Population
A. Total number of clients to be served in the twelve month program has been
calculated as follows. We would be able to provide up to ten support groups a
month. We estimate that there would be an average of eight participants at each
support group. Henceforth, at ten support group a month , x twenty hours , x eight
participants, x 11 months this part of the program would provide 1600 hours of
service a year. We anticipate that on the individual component of this program that
we would spend two hours a week providing services for foster parents.
Henceforth, 2 hours a week x 52 weeks provides 108 client hours a year. We
anticipate that the average foster parent using our services would attend 11 hours of
support group a year, which would mean that we would serve 80 individual foster
parents a year. We anticipate that individual crisis consultation would be available
to 18 families for 6 hours of total individual service. Total number of client hours
provides over one year would be 1708 hours.
B. Distribution of clients. On average most foster parents provide services for
approximately four foster children a year. Each foster child is in placement an
average of 6 months. By providing support and consultation services for 40 foster
families these services improve that quality of care for approximately 320 children
in the placement system.
C. Families Served. We anticipate serving 40 foster families, 80 foster parents.
D. Sub total who will receive bicultural / bilingual services. All services
provided will be in a manner which is sensitive to the culture of origin of the family.
All of the therapist have extensive training in cultural competency issues. In
addition, Lori Kochevar was the chair of the multicultural task force that
successfully implemented multicultural training throughout the San Luis Valley.
Due to our experience in bicultural settings, all individuals in our program will
receive bicultural services. Carmen Jimenez, a bilingual bicultural provider, would
be available for any Spanish speaking families and written program materials will
also be available in Spanish.
E. Consultation services will be available in South Weld County. Currently 11 out
of 70 foster families reside in South Weld County. Given this ratio, we anticipate
that four of the families we serve will reside in South Weld County. Services will
be available where the foster parents live. Currently one support group is held in
South County.
2
F. The monthly maximum program capacity - If needed, we could expand the
number of hours we are available for individual consultation to 4 hours a week,
which would make available 16 hours of individual consultation and 20 hours of
support groups a month.
G. The monthly average capacity- The monthly average capacity of this program
is 16 hours of consultation services and 6 support groups.
H. Average stay in the program - The average stay in this program would be 10
months.
I. Average hours per week in the program would be one support group a month.
From experience, most foster families in crisis choose to use more hours when they
are initially dealing with an issue and then cut back after the first few solution
orientated planning sessions have occurred.
Services Provided
A. Consultation and Foster Parent Support will be provided around these and
other key issues that will assist foster parents: initial placement adjustment,
transition, separation and loss, effective discipline for children raised with
inconsistent parenting, behavioral management, child development, the effects of
visitation, legal risk and commitment issues, importance of documentation , work
with foster parents and caseworkers around interpretation and implementation of
treatment plans, solution oriented planning, and balancing your own /couples/
biological children's /birth families/ systems/foster children's needs. Both consumer
elicited and mandated consultation for critical care foster parents and corrective
action plans will be provided.
B. Mandated training's for foster parents under corrective action plans will be
provided as directed by the Department of Social Services
C. Training's - Training needs will be identified through an evaluation of foster
parents needs as well as in response to needs identified by the department. Before
training's are offered they will be approved and or requested by the department.
The budget for training will be determined on a per event basis. All foster parents in
Weld County will be invited to participate in each event. Evaluations of training's
provided will be conducted.
3
D. Therapeutic services for foster children will not be provided in a home where
consultation services are in place.
E. Team building staffing - At the foster parents request and if the caseworker is
willing, a team building meeting with the foster parent and the caseworker will be
held to address ongoing concerns and to develop a solution oriented plan. This will
be coordinated with the administration at DSS. This will help develop a unified plan
and address any miscommunication or differences in opinion before court. This will
increase the probability that the systems involved are able to work together for the
best interest of the foster children in their collective care. All assessments and
recommendations will be shared directly with the children's caseworker.
F. Agree to comply with 19-1-120 CRS., which requires that reports of child
abuse and any identifying information in those reports are strictly confidential.
All federal laws will be followed including the confidential reporting of suspected
child abuse.
In this program consultation funds will not be used to fund therapy or drug and
alcohol services for foster parents. If deemed appropriate a referral to a mental
health provider, or ADAD professional will be made.
Program Components:
1. Consultation - Both foster parent elicited and mandated consultation for critical
care foster parents and corrective action plans will be provided. Short term,
problem solving services will facilitate personal empowerment of the consumer. It is
imperative that foster parents have access to a variety of resources to support their
own psychological well being and to prevent burnout.
2. Support groups - We will organize and facilitate in depth exploration of issues
that effect certain sub-groups of foster parents i.e.., critical care, foster adopt, etc...
Foster parents will be encouraged to support each other. This creates a natural
ongoing support system. Underlying focus will include collaborative team work
with all parties working toward serving the best interest of the child in placement,
i.e. DSS, GAL, Therapist, etc.
3. Resource and Referrals - This program will facilitate the development of
internal and external resources to enhance the foster parents ability to meet the
demanding requirements of their role. Foster parents will be able to access written
4
information on specific diagnostic, behavioral, and developmental issues specific to
the foster children's special needs. See appendix A for a partial listing of topics
available. In addition, it is important to link foster parents to appropriate community
resources and with each other. We will facilitate knowledge of and encourage use
of available community resources , and make appropriate referrals. See Appendix
A for listing of current community resources available to foster parents.
4. Team building staffing - When requested by the foster parent and agreed upon
by the caseworker the consultant will facilitate a group meeting with the foster
parent and the case worker. This staffing will be coordinated with the
administration at DSS. The focus of the team building will always be on the foster
child's needs. We will address ongoing concerns and develop a solution oriented
plan. This will increase the probability that we are able to work together for the
best interest of the foster children in the systems care.
Measurable Outcomes
When clients are self-referred to this program they will choose training's, goals, and
objectives according to their perceived needs. In the case where the foster parent is
sent for disciplinary action or critical care, the consultant and the foster care
coordinators will help design specific outcome measures appropriate to the situation.
It is important to understand that as in any consultation process that these skills,
concepts, and techniques need to be understood and practiced before foster parents
will be able to consistently apply them with the children they serve.
A. After involvement in this program component foster parents will be able to
identify an improvement in their ability to deal competently with household
management issues, as measured by a pre and post assessment inventory - Volume 7
Compliance Checklist.
• Increase knowledge of and understanding of Volume 7 requirements for foster
parents.
• Increase understanding of importance of documentation and timelines concerning
medical, dental and, medication monitoring
• Increase awareness of state and federal requirements in Volume 7 regarding
higher standards of care required by foster homes.
• Increase awareness of and adherence to household cleaning, safety, and
maintenance requirements outlined in Volume 7.
• Increase awareness of resources available to assist with budgeting and
purchasing resources for foster children.
5
B. After involvement in this program component foster parents will be able to
identify an improvement in their parental competency as measured by a pre and post
assessment of skills needed to implement non-power based parenting effectively.
• Increase adherence to and understanding of state and federal requirements
regarding discipline policies.
• Increase understanding of characteristics of children raised with inconsistent
parenting.
• Increase ability to use and identify alternative discipline strategies.
• Increase ability to acknowledge and listen to the child's concerns with empathy.
• Increase recognition of communication barriers. -
• Increase ability to set effective limits using choices and enforceable statements.
• Increase ability to use empathy and consequences effectively.
• Increase ability to facilitate problem solving skills in foster children.
• Increase understanding of the importance of positive relationship message when
delivering negative content message.
• Increase ability to redirect mis-behavior.
• Increase understanding of foster children's need to learn about cause and effect
thinking in an emotionally neutral non blaming environment.
C. Foster parents will increase their ability to access resources independently so
that they are able to improve their ability to meet the specialized needs of each
individual foster child they serve. This will be measured by self report on
evaluations completed by foster parents after consultation and tracking the number
of referrals made by this program.
• This program will facilitate empowerment for foster parents by providing clear
user friendly information about the resources available in the community and
within the local, state, and federal government.
D. Foster parents will obtain higher skills and competency levels in fulfilling their
role in providing a healing relationship for children in out of home placement. This
will be measured and monitored through the development of individualized
consultation service objectives which will be evaluated at the exit interview by the
foster parent and the consultant.
• Increase ability to accept the child as s/he is
• Increase ability to deal with child's behavior in the context of a healing
relationship.
• Increase ability to support what the foster child is going through.
• Increase understanding of dynamics of child abuse and neglect.
• Increase understanding of developmentally appropriate expectations and the
effects of trauma on development.
6
• Increase understanding of the factors influencing the child's reaction to parent
separation and loss.
• Increase understanding of cultural competency issues that effect foster parenting.
• Increase understanding of roles and dynamics of children that grow up in homes
where parents have substance abuse issues.
• Increase ability to anticipate special emotional needs.
• Increase attunement to attachment and bonding issues.
• Increase understanding of the need for foster children to have empowering
corrective experiences.
• Increase understanding of regressive behavior and the need for reparative
bonding within the relationship.
• Increase understanding of the need for consistency and structure to establish
trust.
• Increase understanding of the effects severe boundary violations have on children
and how to facilitate the development of health boundaries in children.
E. Foster parents will positively meet their own and the needs of their biological
children's in adjusting to and dealing with the presence of foster children in the
home. This will be measured and monitored through the development of
individualized consultation service objectives which will be evaluated at the exit
interview by the foster parent and the consultant.
• Increase ability to set and maintain outside interests and relationships.
• Increase ability to communicate effectively with the multiple systems involved in
foster children lives.
• Increase ability to set and teach children how to set effective physical and
emotional boundaries.
• Increase awareness of symptoms of burnout.
• Increase understanding of the importance of knowing when to access support.
• Increase awareness of grief and loss issues for foster families when foster child
reunifies with family of origin.
• Increase awareness of inappropriate coping strategies (i.e , substance use,
denial, eating, fault-finding, passivity, revenge, withdrawal or excessive worry,
etc...).
• Increase ability to use appropriate coping strategies (i.e , diversions, balance,
conflict resolution, flexibility, networking, affirmations, assertiveness, contact,
enforceable limits, linking, organization, problem solving, re-labeling, providing
choices, time management, relaxation, self-care, exercise, commitment, prayer,
worship, surrender, etc...).
7
•
Service Objectives
We have the following service objectives:
A. Improvement of household management competencies. It is imperative that
foster parents are aware of and uphold regulations outlined in Volume 7 regarding
the need to maintain a safe household environment, that is adequately cleaned and
maintained. In addition, foster parents need to be able to budget their resources so
that they are able to provide for the children they serve. Specific aspects on this
service objective may include the following; consultation and referrals. This
component will be measured through the foster parents ability to reach specific
individualized consultation goals, a pre and post assessment tool and program
evaluations.
B. Improved parental competencies. Foster parents need to have the capacity to
maintain a solid relationship with each other, with their own biological children and
with the foster children they serve. In addition, foster parents need to provide
developmentally appropriate care, nutrition, hygiene, discipline, protection,
guidance and supervision. This service objective will be met through support
groups and consultation. This component will be measured through the foster
parents ability to reach specific individualized consultation goals, a pre and post
assessment tool and program evaluations.
C. Improve ability to access resources. Foster parents shall be empowered to
access resources in the community, as well as resources available thorough the
local, state and federal government. This program will encourage networking with
other foster parents. This service objective will be provided through support groups,
linking, consultation, and referrals. This component will be measured through foster
parent evaluations, ability to reach specific individualized consultation goals, and
record of number of referrals made.
Workload Standards
A. The program has the capacity to serve 80 foster parents. Consultants would
spend up to fourteen hours a month providing services. With an average of eight
foster parents per group, total number of client hours provides over one year would
be 1708 hours.
B. Staff- There are three Family Preservation Specialists. Lori Kochevar M.S.,
L.C.., LLC will serve as a provider and the program supervisor for Sherri Malloy
•
' 1
Ph.D.. and Carmen Jimenez L.C.S.W. All providers have extensive experience in
Family Services as documented in the attached resumes.
C. The caseload will be between 2-10 families per therapist. The caseload of each
therapist will depend on matching the specific needs of the referred family with the
therapist area of specialty.
D. The modality of treatment is support groups and individual crisis consultation.
Referral and linking services will be provided.
E. Hours- Total number of clinical time devoted to this program equals one hour a
day, six hours a week, and twenty-four hours a month.
F. Staff- The providers are supported by part time bookkeeping and clerical
services.
G. Supervisor- This contract would be supervised part time by Lori Kochevar
M.S. L.P.C. who would monitor the project for 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 general and group liability coverage's
are attached. All therapist 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 exceed the minimum qualifications needed for both
education and experience. All providers have their Master's Degree or Doctorate
in Counseling. In addition, the therapists have between 6-12 years a piece providing
services for families. See Resumes in Appendix C.
B. Staff available for this project consists of three experienced consultants that
have a similar core value of clinical excellence. We believe in providing
9
strength-based, family-focused 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 specialized training in substance abuse, trauma, grief, and
domestic violence. In the last ten 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 familles, school personnel, and service providers across the state.
• Sherri Malloy is a licensed clinical psychologist with clinical expertise in
attachment and adoption issues. She has extensive experience in identifying
developmental and relational issues for children dealing with trauma, and
attachment disorders. She is trained in EMDR.
• Carmen Jimenez is a bilingual bicultural 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.
Along with being skilled consultants, due to our extensive background as 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.
10
Appendix A
•
Lori Kochevar M.S. L.P.C. LLC
♦♦♦
Stretching ax Stayltrs•810 12th Street•Greeley CO 80631
Phone(970) 352-8873♦Fax(970)352-8879
Additional Resource
• Consultation Program - Call Dee or Barb for Info 352-1551 Ex 6293 or 9292
• Clothing Allowance - $200 per child per calendar year, see forms
• Foster Parent Library - Extensive collection of books and Videos, located at DSS
• Weld -Foster Parent Association- See brochure. Call Linda King 506-9754
• Food Bank- Medicaid side & Weld Foster Parent Association, 100 pounds a month.
• Round Table Lunches- Monthly at DSS with Dee and Barb
• State Foster Parent Association - Call Beverly Holtz at (303) 463-7989
• Training's- Look in Newsletters
• Rocky Mountain Children 's Law Center- (303) 871-6410
• Court Appointed Special Advocates- Contact Marsha at 353-3400
• Guardian ad Litem (GAL)- Appointed for your child by the court
• Monthly Newsletter- sent by Barb and Dee
• Child Find- See brochure and contact Brenda at 330-3842
• Children's Hospital Evaluation - (303) 861-6410
• North Range Behavioral Health - 346-1166
• Medicaid 1800 511- 5010(Access) 1-800221-3943 (Regular services)
• Sunrise Clinic - 353-9403
• North Colorado Family Medicine - Scheduling 346-2818 356-2424
• Monforts Clinic- 352-8898
• Dentistry for the Handicapped Orthodontics and other dentistry 1-800-466-8129
• Smile High Dentistry (303)825-2295
• HCP- orthodontics (303) 678-6064
• Statewide list Drs. & ODS - take Medicaid(303) 866-4562
• Donated Dental Services 298-1910
• Child Car Safety check- Greeley Fire Department-Mike Medhearst 350-9500
• Recreation Center- 350-9400 Voucher in summer&scholarships.
• Larimer- Foster Parent Association- (970) 669-3047
• Probation Department- 356-4000 ext 3870
• Boys and Girls Club- 353-5109
National Youth Sports Program- Summer camp ages 10-16 351-1996
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f Lori Kochevar M:S. L.P.C.-
4iF' r.t:sac..a_ ,.. r'. -. Su:a .t
-14"goci a�`80 �Gia3;GAO80637
Phone(970) 352-8673♦Fac(970) 352-9879
Additional Information Available
Specific Issues
• Fetal Alcohol Syndrome
• Eating Disorders
• Sexuality
• Guidelines for Substance Abused Infants
• Medication for Children with Behavior and Emotional Problems
•: Attachment - Healthy and Disorders
• Infant Stimulation Activities
• •Professional Burnout -
•: Discipline
• Communication difficulties with multiple systems
• Attention Deficit disorder
•: Y Trauma
G.•, • u..a"Se 'ilt ' n. `'#tK�l� '{c '"i:`{iaTyryJtTv'ai•-
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•- Anger Management -
• Delinquency y
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Individualized Consultation Plan
for
1. Foster parents will be able to identify an improvement in their parental
competency as measured by a pre and post assessment of skills needed to
implement non-power based parenting effectively.
• Increase adherence to and understanding of state and federal requirements
regarding discipline policies.
• Increase understanding of characteristics of children raised with inconsistent
parenting.
• Increase ability to use and identify alternative discipline strategies.
• Increase ability to acknowledge and listen to the child's concerns with ethpathy.
• Increase recognition of communication barriers.
• Increase ability to set effective limits using choices and enforceable statements
• Increase ability to use empathy and consequences effectively.
• Increase ability to facilitate problem solving skills in foster children.
• Increase understanding of the importance of positive relationship message when
delivering negative content message.
• Increase ability to redirect mis-behavior.
• Increased understanding of foster children's need to learn about cause and effect
thinking in an emotionally neutral non blaming environment.
2. Foster parents will increase their ability to access resources independently so
that they are able to improve their ability to meet the specialized needs of each
individual foster child they serve.
• Increase understanding of the importance of knowing when to access support.
• Increase awareness of resources available.
• Increase ability to access resources available in the community and within the
local, state, and federal government.
3. Foster parents will obtain higher skills and competency levels in fulfilling their
role in providing a healing relationship for children in out of home placement.
• Increase ability to accept the child as s/he is.
• Increase ability to deal with child's behavior in the context of a healing
relationship.
• Increase ability to support what the foster child is going through.
• Increase understanding of dynamics of child abuse and neglect.
• Increase understanding of developmentally appropriate expectations and the
effects of trauma on development.
• Increase understanding of the factors influencing the child's reaction to parent
separation and loss.
11
• Increase understanding of cultural competency issues that effect foster parenting.
• Increase understanding of roles and dynamics of children that grow up in homes
were parents have substance abuse issues.
• Increase ability to anticipate special emotional needs
• Increase attunement to attachment and bonding issues
• Increase understanding of the need for foster children to have empowering
corrective experiences.
• Increase understanding of regressive behavior and the need for reparative
bonding within the relationship.
• Increase understanding of the need for consistency and structure to establish
trust. -
• Increase understanding of the effects severe boundary violations have on children
and how to facilitate the development of health boundaries in children.
4. Foster parents will positively meet their own and the needs of their biological
children's in adjusting to and dealing with the presence of foster children in the
home.
• Increase ability to set and maintain outside interests and relationships.
• Increase ability to communicate effectively with the multiple systems involved in
foster children lives.
• Increase ability to set and teach children how to set effective physical and
emotional boundaries.
• Increase awareness of symptoms of burnout.
• Increase understanding of the importance of knowing when to access support
• Increase awareness of inappropriate coping strategies (i.e , substance use,
denial, eating, fault-finding, passivity, revenge, withdrawal or excessive worry.)
• Increase ability to use appropriate coping strategies (i.e , diversions, balance,
conflict resolution, flexibility, networking, affirmations, assertiveness, contact,
enforceable limits, linking, organization, problem solving, re-labeling, providing
choices, time management, relaxation, self-care, exercise, commitment, prayer,
worship, surrender, etc...)
5.
The areas checked above would assist me in serving the needs of foster children
and the areas circled are were improvement has occurred.
12
, v
Household Management Issues
1. Foster parents will identify an improvement in their ability to deal competently
with household management issues.
• Increase knowledge of and understanding of Volume 7 requirements for foster
parents.
• Increase understanding of importance of documentation and timelines concerning
medical, dental and, medication monitoring.
• Increase awareness of state and federal requirements in Volume 7 regarding
higher standards of care required by foster homes.
• Increase awareness of and adherence to household cleaning, safety, and
maintenance requirements outlined in Volume 7.
• Increase awareness of resources available to assist with budgeting and
purchasing resources for foster children.
13
• • •
RISK FACTOR CHECKLIST
INTAKE ASSESSMENT
ACCEPTABLE LOW MODERATE LICH
1,Severity of Abuse/Access of •Not Applicable •Minor injury/noninjury. •Mild/Multiple marks/bruises on •Severe injury.
Perpetrator .•Parent is protective&supportive torso,arms,and legs. •Old and new injuries.
of child. •Parent has history of ongoing or 'Ongoing history of harsh
•Parental disdptine maybe use of excessive discipline. physical discipline.
arbitrary and occasionally uses ' •Parent makes direct threats on a •Marks or bruises to child under 2
sare tactic. daily basis to child's sense of years.
•Alleged perpetrator of sexual security •Parent makes direct and dramatic
abuse has no unsupervised access •Perpetrator has some access. threats to child's emotional
to the child and is not in the home. security.
•Perpetrator in home.
2,Severity of Neglect •Not Applicable •Child has unkempt appearance. •Und spored trash. •Substantial safety and health
•House disorderly but not a hazard. •Parent reveals frequent inability to hazards in home.
•Meals irregular but adequate. are for or protect child. •Leaves child unsupervised for
•Child does not receive routine •Meals go unprovided and child is excessive periods of time and/or
medical/dental are but no ill chroniallyhungry. environment pose a threat
effect on the child. •Unattended medical/dental •Neglect results or could result in
•Parent u periodically unattuned to problems causing child severe injury or illness.
child's needs. discomfort. •Parent consistently withholds
•
•Some periods of unsupervised affection and reject child.
are and child has no access to or •Non-organic failure to thrive.
knowledge of resources. '•Significant developmental delays
•Parent avoids interaction with due to neglect.
child to meet emotional needs.
Lige/Handiapping •Child partake in appropriate •I2 years of age and over,displays •6.12 years. •Infancy to 5 years old or older
Conditions of Child activities outside of home. no handicapping conditions. •Requires some level of adult child who is severely disabled or
•Is visible to other. •Is able to obtain help. assistance to care for and protect handiapped.
•Child shows no symptoms of self,based upon age and •Unable to are for or protect self
developmental lags conditions. without extensive adult
assistance and supervision.
•
•Child not visible to others outside
of household.
le Paviout Reports of •No prior reports of abuse to •One unsubstantiated prior report. •More than one prior report. •Previous substantiated reports of
Abuse/Negied agency. •One previously substantiated severe abuse/neglect
abuse/neglect or several •Children in the past have been
unsubstantiated reports from placed due to abuse/neglect.
various sources. •Termination of parental rights on
. one or more children.
I
Appendix B
Issue Date: 09/11/02
Bi?ah1) 'OlPROFESSIONAL LIABILITY OCCURRENCE
<0 INSURANCE POLICY FOR
nce
Risk Retention Group PROFESSIONAL COUNSELORS AND HUMAN
DEVELOPMENT PRACTITIONERS •
ACA Insurance Trust.Inc.
5999 Stevenson Avenue au wend
Policy Number: CL12509802 Administered by: Alexandria,VA22304-3300 TRUST
Tel Free:1-806347-6647 x284
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 Tine 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 $ 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 c 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
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: access 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 building
(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, at-essment 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 Mariane Williamson - Enchanted Love
10/22-24/99 Shapeshi ting: 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 Corderence
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
San Luis Valley
0 Comprehensive Community
Mental Health Center
CUNIC OFFICE
ADMIN AND CLINIC OFFICE 1015 FOURTH STREET CLINIC OFFICE
522 ALAMOSA AVENUE ALAMOSA,CO 81101 402 FOURTH STREET
ALAMOSA,CO 81101 TDD 719-589-3671 MONTE VISTA.CO 81 144
719-589-3673 719-589-3671 719-852-5186
FAX 719-589-1521 FAX 719-589-9136 FAX 719-852-3043
August 6, 1996
26041 Woodland Ave.
Esparto, CA 95627
Dear Colleagues:
I have worked very closely with Lori in the Family Preservation program. Lori has
been a wonderful asset to this program and to all her colleagues at Mental Health.
More importantly, her dedicated and skillful service to our clients has greatly benefitted
many SLV families.
Lori's skills are numerous. She is well organized and very conscientious. She has
excellent speaking and writing skills. Her forte is her ability to work with all kinds of
people, and work through difficult interpersonal situations. Lori has consistently
impressed me with her resilience and problem solving skills in dealing with some of the
most chaotic and resistive families. In working with these families, Lori has also come to
know the needs of SLV families and has become an expert in resources that are
available throughout the Valley. She has worked in every county in the Valley.
Despite carrying a full caseload of challenging cases, Lori took "time off' for herself
by making solid contributions to other programs. I was amazed to see Lori doing good
work for such things as the Mental Health Center's Wilderness Program, the Boys and
Girls Club of Alamosa, the Multicultural Awareness Committee and the Drug and
Alcohol Baseline program. She attended trainings in all of these programs and then
consistently returned to share her expertise and take responsible roles in each, and
handling the mix of responsibilities effectively.
Lori has a strong philosophical commitment to the empowerment of the oppressed.
Lori will direct people toward healthy, fun relationships. Lori will earn the confidence of
the people with whom she works: staff, clients, and community leaders. I highly
recommend her.
Sincerely,
Offering Comprehensive Mental Health Core For The Entire Son Luis Valley
•
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 - COMFASION 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 19's
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 Arens 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, Cob.
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, Cob.
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
02196 -ACKERMAN & ASSOCIATES, P.C., Greeley, Cob:
•
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, Cob
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, Cob.
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
•
Sherri R.Malloy,Ph.D.
Licensed Clinical Psychologist
Office: Home:
Ackerman and Associates, P.C. 24 Alles Drive
1750 25th Avenue, Suite 101 Greeley, Colorado 80631
Greeley,CO 80634 (970)351-7218
(970)353-3373
Education
Ph.D. Double Major: Child Clinical Psychology; Clinical Psychology.
August 1993 University of Colorado, Boulder. Licensed as Psychologist 1-5-95
M.A. Department of Psychology, Clinical Program. University of
July 1989 Colorado, Boulder.
B.A. Major: Psychology; Minor: Spanish. Arizona State University.
May 1987 Summa Cum Laude.
Teaching Cert. Roston Montessori Teacher Training Institute.
August 1977 Orange, California. Montessori Elementary Education Certificate.
Clinical Experience
April 1998- Clinical Psychologist, Ackerman&Associates,Greeley, Colorado.
present Provide outpatient psychotherapy to children, adolescents, adults
& families. Family preservation home-based services. Assessment
&consultation. Consultation to foster and adoptive families.
August 1991- Child and Family Psychotherapist, Mental Health Center of Boulder
March 1997 County, Boulder, Colorado. Provided outpatient psychotherapy to
children and their families. Parent, teacher, and other agency
consultation. Consultation to foster and adoptive families.
September 1992- Psychology Intern; Denver General Hospital, Denver, Colorado.
August 1993 Outpatient assessment, consultation, and treatment
To children, adolescents, and adults; Inpatient treatment
to adolescents& their families. Consultation to multidisciplinary
hospital staff. Attended regular seminars and case conferences.
Completed an additional rotation in neuropsychology.
August 1990- Psychotherapist, University of Colorado, Farrand Residence Hall.
May 1992 Provided individual, conjoint, and group psychotherapy to Farrand
residents. Psychiatric consultation to faculty and staff. Presented
seminars and workshops to faculty, staff, and students.
2 Malloy
August 1988- Emergency Psychiatric Services Clinician, Mental Health Center •
August 1992 of Boulder County,Boulder, Colorado. Evaluation and
disposition planning for clients with psychiatric emergencies.
Composed a training manual for emergency psychiatric clinicians
January 1988- Psychotherapy Intern,Raimy Psychology Clinic,
May 1992 Department of Psychology,University of Colorado, Boulder.
Provided outpatient psychotherapy to adults, families, and
children.Parent and teacher consultation.
February 1986- Intake Clinician;Group Facilitator, Tri-City Behavioral Health
July 1987 Center,Mesa,Arizona. Conducted intakes for the adult team.
Facilitator for children's psychotherapy groups.
Administrative and Supervisory Experience -
April 1998- Private consultation and supervision provided to colleagues and to
Present unlicensed practitioners who are working toward licensure.
Jan 1996- Team Leader,Mental Health Center of Boulder County, Boulder,
May 1998 Colorado. Clinical and administrative supervision of a team of
psychologists and psychotherapists. Budgeting. Supervision of
support staff. Coordinate outpatient services/consultation to joint-
agency programs, including Head Start, Specialized Foster Care,
Fost-Adopt, 1178, School-Based Services, Boulder Day Nursery, and
People's Clinic.
August 1990- Adult Team Coordinator,Raimy Psychology Clinic, Department
August 1991 of Psychology,University of Colorado, Boulder. Chaired the adult
team meetings and case conferences. Assisted clinic director with
administrative tasks.
August 1990- Peer Counselor Supervisor, Farrand Residence Hall, University of
May 1991 Colorado,Boulder. Developed and implemented a peer counseling
training program. Provided ongoing training and supervision to
peer counselors.
January 1989- Supervisor in Training, Raimy Psychology Clinic,
August 1991 Department of Psychology,University of Colorado, Boulder.
Received training and supervision in supervisory techniques.
Supervised the psychotherapy of first-year clinical psychology
graduate students.
June 1989- Adult Team Intake Coordinator, Raimy Psychology Clinic,
August 1990 Department of Psychology,University of Colorado, Boulder. Intake
and disposition of psychotherapy clients.
3 Malloy
September 1989- Clinical Supervisor, Emergency Psychiatric Services Team,
August 1992 Mental Health Center of Boulder County, Boulder, Colorado.
Trained and supervised Masters level student interns in
emergency clinical assessment techniques, legal and procedural
practices, and psychological report writing.
February 1988- Volunteer Trainer, Maslin House for Chronically Mentally III,
May 1989 Mental Health Center of Boulder County,Boulder, Colorado.
Recruited and trained volunteer college students to work with
the chronically mentally ill population at this facility.
Publications
December 1994- Columnist:The Boulder County Parent, a monthly publication of the
April 1998 Parenting Place, Boulder, Colorado. Circulation: 8,000. Topics
include child development and parenting concerns.
•
Teaching Experience
January 2001- Instructor, University of Northern Colorado, Greeley, CO
May 2001 Graduate Level Play Therapy Practicum
August 1989- Psychology Instructor, Front Range Community College,
May 1992 Boulder Campus,Colorado.
Fall 1988 Head Teaching Assistant, Department of Psychology, University of
Colorado, Boulder. Trained and supervised graduate level Teaching
•
Assistants.
August 1987- Teaching Assistant, Department of Psychology, University of
May 1989 Colorado, Boulder.
August 1977- Montessori Elementary Teacher, Roston Montessori School,
May 1983 Orange,California; and subsequently,Tempe Montessori School,
Tempe,Arizona. Taught preschool through second grade classes.
Responsibilities included academic program planning and
implementation, supervising teacher assistants,conducting parent-
teacher conferences, academic record-keeping,and giving
educational presentations to parents.
August 1976- Student Teacher, Roston Montessori Teacher Training Institute,
August 1977 Anaheim, California. Taught in a Montessori classroom under the
supervision of a certified Montessori teacher. Duties were the same
as in the entry above.
Appendix C
15
2 Malloy
August 1988- Emergency Psychiatric Services Clinician, Mental Health Center •
August 1992 of Boulder County,Boulder, Colorado. Evaluation and
disposition planning for clients with psychiatric emergencies.
Composed a training manual for emergency psychiatric clinicians
January 1988- Psychotherapy Intern,Raimy Psychology Clinic,
May 1992 Department of Psychology,University of Colorado, Boulder.
Provided outpatient psychotherapy to adults, families,and
children. Parent and teacher consultation.
February 1986- Intake Clinician;Group Facilitator,Tri-City Behavioral Health
July 1987 Center,Mesa,Arizona. Conducted intakes for the adult team.
Facilitator for children's psychotherapy groups.
Administrative and Supervisory Experience -
April 1998- Private consultation and supervision provided to colleagues and to
Present unlicensed practitioners who are working toward licensure.
Jan 1996- Team Leader,Mental Health Center of Boulder County, Boulder,
May 1998 Colorado. Clinical and administrative supervision of a team of
psychologists and psychotherapists. Budgeting. Supervision of
support staff. Coordinate outpatient services/consultation to joint-
agency programs, including Head Start, Specialized Foster Care,
Fost-Adopt, 1178, School-Based Services, Boulder Day Nursery, and
People's Clinic.
August 1990- Adult Team Coordinator, Raimy Psychology Clinic,Department
August 1991 of Psychology,University of Colorado, Boulder. Chaired the adult
team meetings and dace conferences. Assisted clinic director with
administrative tasks.
August 1990- Peer Counselor Supervisor, Farrand Residence Hall, University of
May 1991 Colorado,Boulder.Developed and implemented a peer counseling
training program.Provided ongoing training and supervision to
peer couasekxs.
January 1989- Supervisor in Training,Raimy Psychology Clinic,
August 1991 Department of Psychology,University of Colorado, Boulder.
Received training and supervision in supervisory techniques.
Supervised the psychotherapy of first-year clinical psychology
graduate students.
June 1989- Adult Team Intake Coordinator, Rainy Psychology Clinic,
August 1990 Department of Psychology,University of Colorado, Boulder. Intake
and disposition of psychotherapy clients.
3 Malloy
September 1989- Clinical Supervisor, Emergency Psychiatric Services Team,
August 1992 Mental Health Center of Boulder County, Boulder,Colorado.
Trained and supervised Masters level student interns in
emergency clinical assessment techniques, legal and procedural
practices, and psychological report writing.
February 1988- Volunteer Trainer, Maslin House for Chronically Mentally Ill,
May 1989 Mental Health Center of Boulder County,Boulder, Colorado.
Recruited and trained volunteer college students to work with
the chronically mentally ill population at this facility.
Publications
December 1994- Columnist:The Boulder County Parent,a monthly publication of the
April 1998 Parenting Place, Boulder,Colorado. Circulation: 8,000. Topics
include child development and parenting concerns.
Teaching Experience
January 2001- Instructor, University of Northern Colorado,Greeley,CO
May 2001 Graduate Level Play Therapy Practicum
August 1989- Psychology Instructor, Front Range Community College,
May 1992 Boulder Campus, Colorado.
Fall 1988 Head Teaching Assistant,Department of Psychology, University of
Colorado, Boulder. Trained and supervised graduate level Teaching
•
Assistants.
•
August 1987- Teaching Assistant, Department of Psychology, University of
May 1989 Colorado, Boulder.
August 1977- Montessori Elementary Teacher, Roston Montessori School,
May 1983 Orange,California;and subsequently, Tempe Montessori School,
Tempe,Arizona. Taught preschool through second grade classes.
Responsibilities included academic program planning and
implementation, supervising teacher assistants,conducting parent-
teacher conferences, academic record-keeping, and giving
educational presentations to parents.
August 1976- Student Teacher, Roston Montessori Teacher Training Institute,
August 1977 Anaheim,California. Taught in a Montessori classroom under the
supervision of a certified Montessori teacher. Duties were the same
as in the entry above.
4 Malloy
•
Presentation Topics and Trainings Given
Legal and Emotional Aspects of Adoption
Reactive Attachment Disorder
Transitions for Children in Foster Care
Play Therapy
Engaging so-called"resistant"clients
Psychotherapy with adolescents and their families
Case Conferences
Parent-Toddler Attachment Patterns
Child Abuse
Child Psychopathology
Stress Management Workshop
Depression and Risk of Suicide in College Students
Research Projects
Adult Attachment Style and College Functioning(Doctoral Dissertation), 1992
Parent-Toddler Attachment Relationships(Masters Thesis), 1990
Post-Divorce Visitation Patterns and Parent-Toddler Attachment, 1988 •
Effects of Divorce on Children, 1987
Mental Health Center Client Satisfaction Study, 1986
Clinical Assessment
Trained in the use of the following assessment tools:
WISC-III
MMPI
Draw-a-Person
Kinetic Family Drawing
Thematic Apperception Test
Rorschach Inkblot Test
Sacks Sentence Completion Test
Strong-Campbell Interest Inventory
Professional Affiliations
1997- 1998 Member: Internal Review Board MHCBC
1996-1997 Member: Professional Advisory Board, Mental Health Center of
Boulder County
1991- 1992 Co-Chair: Multi-Ethnic Action Committee, Department of
Psychology, University of Colorado, Boulder.
5 Malloy
1991- 1993 Member:American Psychological Association, Division 12,
Clinical Child Psychology.
1989- 1991 Member:Multi-Ethnic Action Committee, Department of
Psychology, University of Colorado,Boulder.
1988- 1989 Student Representative: Department of Clinical Psychology,
University of Colorado, Boulder.
1987- 1989 Member:Developmental Psychology Research Group,
Department of Psychology, University of Colorado, Boulder.
1987-present Member:(Intermittent)American Psychological Association.
Honors and Awards
1988 Department of Clinical Psychology Scholarship; University of
Colorado, Boulder.
1987 Phi Beta Kappa
1987 Academic Scholarship, Arizona State University,Taupe, Arizona.
1986 Phi Kappa Phi Honor Society
1986 Golden Key National Honor Society
1979 West Valley College Track Team, West Valley,California;
State Champions.
1977 Fellowship Award; Roston Montessori School, Orange, California.
Other Experience
1996-1999 Vice President(elected), Suburban Ditch Company, Greeley,
Colorado.
1983- 1985 Small Business Owner/Operator: Graphicolor, Phoenix, Arizona.
Photography and advertising design. Commercial and portrait
photography,advertising design, sales, supervised salespeople,
performed administrative tasks.
1982- 1985 Dance Aerobics Instructor, International Fitness Center, Mesa,
Arizona. Choreographed dance routines,taught classes regularly,
made public presentations on behalf of the fitness club, and
participated in an ongoing certification/training program in
exercise physiology and dance choreography.
6 Malloy
Addendum
Graduate Coursework:
Child Development/Psychopathology
Developmental Psychology
Developmental Psychopathology
Child Psychotherapy
• Clinical Practicum(six semesters)
Theory and Issues in Developmental Psychology
Personality/Psychotherapy
Advanced Psychopathology
Advanced Personality Theory
Clinical Study of the Individual
Adult Psychotherapy
Family Research and Therapy
Research Methodology/Statistics
General Statistics(two semesters)
Research Practicum(four semesters)
Research Problems in Clinical Psychology
Assessment
Projective Testing
Objective Testing
Courses for Distributed Minor
Multicultural Psychology
`Community Mental Health
Marriage and Family Counseling
Behavioral Neuroscience:Clinical and Pathological Perspective
Updated 11-11-02
PROGRAM BUDGETS
. COMPUTERIZED BUDGET
PROGRAM OUTSIDE SS FP CONSULT.IND FP CONSULT GRP BONDING
1 TOTAL HOURS OR DAYS OF DIRECT SERVICE PER CLIENT 6 12 18
3 TOTAL CLIENTS TO BE SERVED 18 11 56
TOTAL HOURS OR DAYS OF DIRECT SERVICE FOR YEAR(A X B) 108 132 1,008
) COST PER HOURS OR DAYS OF DIRECT SERVICES(E/C) $5199 $200.01 $40.00
TOTAL DIRECT SERVICE COSTS FACE-TO-FACE $5,831 .$26,401 $40,320
ADMINISTRATION COSTS NON-FACE-TO-FACE ALLOCABLE TO PROGRAM $200 $1,964 $7,856 $20,093
3 OVERHEAD COSTS ALLOCABLE TO PROGRAM $3,301 $660 $2,641 $4,401
i TOTAL DIRECT,ADMINISTRATION 8 OVERHEAD COSTS(E+F+G) $8,455 $36,898 $64,815
ANTICIPATED PROFITS CONTRIBUTED BY THIS PROGRAM $185 $2,703 $707
I TOTAL COSTS AND PROFITS FROM THIS PROGRAM(H +I) $8,640 $39,601 $65,522
( TOTAL HOURS OR DAYS OF DIRECT SERVICE FOR THE YEAR(C) 108 132 1,008
. RATE PER HOURS OR DAYS OF DIRECT,FACE-TO-FACE SERVICE TO BE CHARGED
TO WELD COUNTY SOCIAL SERVICES(J 1 K) $80.00 $300.00 $65.00
DIRECT SERVICE COSTS• - e
- COMPUTERIZED BUDGET
MlMmum Budget Average Total %OF THE SALARY %OF THE SALARY %OF TIME SALARY %OF THE SALARY %OF THE SALARY %OF TIME SALARY
Degree BM S.WylBem Salaried 100% SPENT ON AND SPENT ON AND SPENT ON AND SPENT ON AND SPENT ON AND SPENT ON AND
DESCRIPTION Or CM FTEs 01.5 FTE BeneMSIOtMr ALLOCATED PROGRAM OTHER COSTS PROGRAM OTHER COSTS PROGRAM OTHER COSTS PROGRAM OTHER COSTS PROGRAM OTHER COSTS PROGRAM OTHER COSTS
PROGRAM OUTSIDE SS FP CONSULT MD FP CONSULT GRP BONDING e
1 TOTAL CLIENT HOURS OR DAYS PER PROGRAM 6 12 18
I TOTAL CLIENTS TO BE SERVED PER PROGRAM IS II 58 -
TOTAL HOURS OR DAYS PER PROGRAM FOR YEAR 000 108 00 132.00 1008.00 0.00 0.00 _
DIRECT LABOR FACE-TO-FACE POSITION TIRE OR JOB FUNCTION
THERAPIST CONTRACT - MASTERS 1.00 $32,732 $3223200 YES $000 18.09% $5.830.71 5191% 526.40123 $0.00 $0.00 $0.00
BOIOMG SPECIALIST i/YMASTERI 2.00 $20.180 $40.32000 YES SO 00 $000 $000 :100.00% 540,320.00 $0.00 - SO 00
SO OD NO $0.00 5000 5000 5000 50.00 - WW
. $000 NO 5000 1000 3000 SO03 $0.00 SO 00
$0.00 NO. $0.00 $000 $000 0000 $0.00 $0.00
. $0.00 NO 5000 SO.OO - $0.00 - 5090 $0.00
$0.00 NO $000 $0.00 $000 WW W00 $0.00
$0.00 NO SO 00 $000 - 5000 50.00 $0.00 - $0.00
$000 NO 5000 5000 $000 $000 $000 $000
50.00 NO $00D 30.00 $000 $0.00 $0.00 $000 -
• W.00 NO $000 $0.00 $000 50.00 $0.00 $0.00
WOO NO $0.00 $0.00 $000 WOO 50.00 $000
$0.00 NO $000 $0.00 $000 $000 $0.00 $0.00
I $000 NO $000 $0.00 SOW $000 $000 $000
TOTAL DIRECT LABOR PER PROGRAM $72.55200 $000 $5399 $5.8311.77 $200 01 $26401.23 54000 $40.320.00 $0.00 $000
OTHER DIRECT COSTS PER PROGRAM FACE-TOFACE
NO $000 $000 5000 $000 $000 $0.00
NO $000 W00 SO CO $000 $0.00 $000
, NO .3000 $000 30.00 $0.00 $0.00 W.00
NO SOW $0.00 $0.00 $0.00 $0.00 $0.00
NO SOW $0.00 $000 $0.00 $0.00 $0.00
". NO SOW SOW 500 W0 $000 - $000
TOTAL OTHER DIRECT COSTS PER PROGRAM W00 $000 $000 $0.00 $000 W00 W00
GRAND TOTAL DIRECT SERVICE COSTS $72.552.00 WOO S5399 55.83D77 $200.01 $26,40123 $40.00 $40.320.00 $000 $000
t
ADMIN COST NON-FACE-TO-FACE -
r , COMPIITERIZEDBUDGET
Minimum Budget Avenge Total %OF TIME SALARY %OF TIME SALARY %OF TIME SALARY %OF TIME SALARY %OF TIME SALARY %OF TIME SALARY
Degree SDI SMaryiaene Salaries/ 100% SPENT ON µD SPENT ON µD SPENT ON AND SPENT ON µD SPENT ON µD SPENT ON AND
DESCRIPTION or Cen FIE* 01.0 FTE BenetfelOther ALLOCATED PROGRAM OTHER COSTS PROGRAM OTHER COSTS PROGRAM OTHER COSTS\_PROGRAM OTHER COSTS PROGRAM OTHER COSTS PROGRAM OTHER COSTS
PROGRAM OUTSIDE 55 FP CONSULT.IND FP CONSULT GRP BONDING
1 TOTAL WENT HOURS OR DAYS PER PROGRAM 6 . 12 18
I TOTAL CLIENTS TO BE SERVED PER PROGRAM IS 11 56
TOTAL HOURS OR DAYS PER PROGRAM FOR YEAR 0.00 100.00 132.00 1008.00 0.00 0.00 —
DIRECT LABOR NOT FACE-TO-FACE
BOONEEP*IG BONDING 1.00 $7,047 $7.041.00 YES 000% $0.00 $0.00 woo 100.00% $7.04100 $0.00 $0.00
SUPERVISING • 1.00 $20.000 $20.80000 YES 0.00% $1.00 509% 51.66100 32.00% 56.656.00 '. 60.00% $12.40.08 - $OW $0.00
BOONEEPING FP CONSULTATION 1.00 $1.000 SI.00000 YES $0.00 20.00% $200.00 50.00% $80000 stoo $0.00 $0.00
$000 NO $0.00 $000 - sew $0.00 $000 sow
5000 NO sow $000 $000 _ $0.00 3000 $0.00
$000 NO $000 $0w $0.00 $000 - $000 $0.00
• f000 NO $000 $000 $0.00 $0.00 $ $0.00
- $0.00 NO $000 59.00 . $0.00 - $000 - $000 $000
$0.00 NO $000 $0.00 $0.00 $0.00 . $0.00 50.00
$000 NO $000 $000 $0.00 $0.00 $1.00 $0.00
$000 NO $000 $000 $000 $0.00 $000 $0.00
• $0.00 NO $000 $100 $000 $000 $000 $000
• 5000 NO 5000 $000 $000 $00) $000 $0.00
$000 NO $000 $000 $000 $0.00 $000 $000
•
TOTAL DIRECT LABOR PER PROGRAM NOT FACE-TO-FACE $28.84100 $0.00 St726 31.864.00 $56.48 $1456.00 $1937 $19.527.00 $0.00 $0.00
OTHER DIRECT COSTS PER PROGRAM NOT FACE-TO-FACE
LEGA✓ACCOUN ONE- $610.00 YES $000 10.00% $6000 40.00% $24000 60.00% $300.09 $0.00 - $0.00
INSURANCE . - 5668.00 YES 3000% $199 B0 6.00% 53996 24.00% $15984 40.00% $266.40 $0.00 $0.00
, NO $000 5000 $000 - 50.00 _ foto $0.00
• NO S000 $000 $000 $000 $0.00 sow
NO $000 $000 • $000 $0.00 $0.00 $0.00
NO $000 $000 . $000 - $000 $000 $000
TOTAL OTHER DIRECT COSTS NOT FACE-TO-FACE PER PROGRAM $1266.00 - WIN! $199.80 $093 $9996 $3.03 $399.84 $0.56 $566.40 $0.00 $0.00
GRAND TOTAL DIRECT SERVICE COSTS NOT FACE-TO-FACE $30,113.00 WIN! $19980 $18.18 $1.96396 $59.51 57.855.84 $19.93 $20.093.40 $0.00 $000
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DEPARTMENT OF SOCIAL SERVICES
P.O.BOX A
GREELEY,CO.80632
Webatte:www.eo.weld.co.us
VillAdministration and Public Assistance(970)352-1551
C. Child Support(970)352-6933
COLORADO MEMORANDUM
TO: David E. Long, Chair Date: May 14, 2003
Board of County Commissioners
FR: Judy A. Griego, Director, Social Services 1 ,.nl t\(,' l V.k017
RE: Notifications of Financial Assistance Awards(NOFAAs)with
Vendors—Foster Parent Consultation Program
Enclosed for Board approval are Notifications of Financial Assistance Awards
(NOFAAs)with vendors under the Foster Parent Consultation Program. The Foster
Parent Consultation Program is funded under Core Services. The Families,Youth, and
Children(FYC) Commission completed its Request for Proposal (RFP)process and
recommends that these vendors be funded. The NOFAAs,which were originally drafted
and presented as Agreements,were discussed and reviewed at the Board's Work Session
held on May 12, 2003. All provisions remain the same as discussed at the Work Session,
except funding of the project will be through Core Services,not Child Welfare Funding.
The major provisions of the NOFAAs are as follows:
1. The term of the NOFAAs are June 1,2003 through May 31, 2004.
2. The recommended vendors are: Lori Kochevar,Ackerman&Associates,and
Lutheran Family Services.
3. The vendors agree to provide psychological consultations and parenting support
to foster parents who are certified by the Department for the purposes of
maintaining positive placement of children in the Department's custody.
4. Each vendor will be reimbursed a maximum of$20,000 that includes $14,400 for
four groups per month at $300 per group, and$5,600 for individual consultation
with County Certified Foster parents at a rate of$80.00.
Ko 6.1 e Ja'- v-
If you have any questions,please telephone me at extension 6510. 2003-1291
Ad.ke r jv.,t,--'
2003-1292
GL.1- L...-.rp l
" /
2003-1293r
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