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Home My WebLink About20031067.tiff RESOLUTION RE: APPROVE THREE NOTIFICATION OF FINANCIAL ASSISTANCE AWARDS FOR VARIOUS PROGRAMS AND AUTHORIZE CHAIR TO SIGN -STILLWATER SERVICES, 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 three Notification of Financial Assistance Awards 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 Stillwater Services, LLC, commencing June 1, 2003, and ending May 31, 2004, with further terms and conditions being as stated in said awards for the following programs: 1) Option B Services 2) Mediation and Facilitation under the Intensive Family Therapy Program Area 3) Lifeskills - Smart Start, and WHEREAS, after review, the Board deems it advisable to approve said awards, copies of which are attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, ex-officio Board of Social Services, that the three Notification of Financial Assistance Awards for the above listed programs between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Social Services, and Stillwater Services, LLC, be, and hereby are, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said awards. 2003-1067 �� ( atit ad;) SS0030 THREE NOTIFICATION OF FINANCIAL ASSISTANCE AWARDS - STILLWATER SERVICES, LLC PAGE 2 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 OUNTY COLO O ATTEST: gtelik t Lam, vi E. Lon , Ch it Weld County Clerk tot ":o. Ai Ro ert D. asden, Pro-Tem BY: ' ' �2 Deputy Clerk to the Board • M. J. Geile R ED AS F • R6/11 /-271 Willi m H. Jerke ounty orne ) ,/J Glenn Vaad Date of signature: 2003-1067 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-IFT-0001 Revision (RFP-FYC-(03008) Contract Award Period Name and Address of Contractor Beginning 06/01/2003 and Stillwater Services Ending 05/31/2004 Mediation and Facilitation under the Intensive Family Therapy Program Area PO Box 336058 Greeley, CO 80634 Computation of Awards Description Unit of Service The issuance of the Notification of Financial Assistance Award is based upon your Request for The Mediation program will provide brief family Proposal(RFP). The RFP specifies the scope of therapy/mediation services including conflict resolution, services and conditions of award. Except where it problem-solving skills,parenting techniques, and is in conflict with this NOFAA in which case the communication enhancement. The program offers 24-hour, NOFAA governs, the RFP upon which this award is on-call service for all clients receiving therapeutic based is an integral part of the action. services, time-efficient, and cost-effective responses to clients in need of crisis intervention. Maximum length of a Special conditions family enrollment is 1 month, the average length of stay is 3 weeks. Clients will interface with therapists directly for 1) Reimbursement for the Unit of Service will be approximately 2 hours in each of 3 weeks of enrollment. based on an hourly rate per child or per family. Capacity to serve a total of 24 family units. All therapists 2) The hourly rate will be paid for only direct face to will receive cultural awareness and sensitivity training. A face contact with the child and/or family, as therapist who resides in South County will provide evidenced by client-signed verification form, and as services to that portion of the county. specified in the unit of cost computation. 3) Unit of service costs cannot exceed the hourly and yearly cost per child and/or family. Cost Per Unit of Service 4) Payment will only be remitted on cases open with, Hourly Rate Per $ 65.02 and referrals made by the Weld County Department of Social Services. Unit of Service Based on Approved Plan 5) Requests for payment must be an original and submitted to the Weld County Department of Social Enclosures: Services by the end of the 25th calendar day following the end of the month of service. The X Signed RFP:Exhibit A provider must submit requests for payment on X Supplemental Narrative to RFP: Exhibit B forms approved by Weld County Department of Social Services. X Recommendation(s) Conditions of Approval Approvals. Program Of icial: By By David E. Long, Chair Judy A. ego, D ector Board of Weld County Com • ioners Weld C Dep ent o Social Services Date: Li-36-.20(13 Date: �(2 ID\ 1 of 1 7 02003 -/O6 EXHIBIT "A" f Mi DIN JON PKOGKAM 5TII_1_WAT K 5i- KVICL 5, r• r" j�:i��{ ia� mediation penetrates waits of misperception and mistrust" r^ r- re- es- r- INVITATION TO BID OFF-SYSTEM BID 02-03 RFP-FYC 03008 DATE:February 19, 2003 BID NO: RFP-FYC-03008 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-03008) for:Colorado Family Preservation Act--Intensive Family Mediation and Facilitation under the Intensive Family Therapy Program Area 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 competing 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) 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 Intensive Family Mediation and Facilitation program under the Intensive Family Therapy Program area must provide for therapeutic intervention through one or more qualified family therapists, typically with all family members, to improve family communication, function, and relationships. 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 03-14 -03 ,{,hart- J(;yn n ynA� (After receipt of order) BID MUST BE SIGNED IN INK ,Shari S immonc , o/%an .1 OiaPet an TYPED OR PRINTED SIGNATURE VENDOR S+i II water ServiceS, l-t-C (Name) Handwritten Signature By Authorized Officer or Agent of Vender ADDRESS Po Box 336O.9 R TITLE meal,0,-f-inn. rccley , to '°b3µ DATE b3 - 14 -n3 • PHONE # ( 970 {-05-µ8o3, 4o5-4 o2 The above bid is subject to Terms and Conditions as attached hereto and incorporated. ^ Page 1 of 32 ,-• RFP-FYC-03008 Attached A INTENSIVE FAMILY THERAPY MEDIATION/FACILITATION PROGRAM BID PROPOSAL FAMILY PRESERVATION PROGRAM 2003-2004 BID PROPOSAL APPLICATION PROGRAM FUNDS YEAR 2003-2004 OFF-SYSTEM BID 02-03 RFP-FYC-03008 NAME OFAGENCY: S+iI1 wed-or Services ,,aDDREss: PO box 336058 Qree1 P y , Co 80634 ,-PHONE:f970) 405-4f-803, 1-o5-N-8o2 .CONTACT PERSON: Shari. (Simmons TITLE: thercr-pis* -)ESCRIPTION OF FAMILY PRESERVATION PROGRAM CATEGORY: The Mediation/Facilitation Program must ,.provide for solution-focused therapy through one or more qualified therapists, typically with all family members, to resolve .onflicts and disagreements within the family contributing to child maltreatment,running away, and to the behavior "onstituting status offenses. r .42-Month approximate Project Dates: _ 12-month contract with actual time lines of: Start June 1,2003 Start •Jlt.ne 1, 2003 End May 31,2004 End /nay ,3 i, 2 poi, ,:mfITLE OF PROJECT: (Y)ecl 0.+i n n .4MOUNTREQUESTED: $ b5, 02 Per hour ^cha-ri Simmons' . /1,244..(4.0n74nant. 03 - 14-03 )lame and Signature of Person Preparing Document Date flame and Signature Chief Administrative Officer Applicant Agency Date MANDATORY PROPOSAL REQUIREMENTS .or both new bids and renewal bids,please initial to indicate that the following required sections are included in this Proposal Bid. For renewal bids,please indicate which of the required sections have not changed from Program Fund Year 2002- )403 to Program Fund Year 2003-2004. Indicate No Change from FY 2002-2003 to 2003-2004 y Project Description Target/Eligibility Populations „I-cc Types of services Provided Lad Measurable Outcomes "...Id Service Objectives k(f Workload Standards 4 Staff Qualifications je Unit of Servrice Rate Computation 1'11 Program Capacity per Month J.(, Certificate ofinsurance AI- Assurance Statement Page 26 of 32 , , RFP-FYC-03008 Attached A 33 -3 ,-Date of Meeting(s)with Social Services Division Supervisor:2 — — omrgents by SSD �/ Supervisor: p {/..kft.r t/,., LP 4_14a 17(-e rc �'_� - ty >< �c � � Loi , .x�l r�mil' --e71({)-�_.k / i/ ,-. ,-. ,1 ,-. f.. A _ ame and Signature of SSD Supervisor Date ,-' ,-. ,. r. ,.. F-. r. A A A r A Page 27 of 32 ,- I. PROJECT DESCRIPTION Stillwater Services, LLC is an organization dedicated to helping Weld County youth and families. The MEDIATION program was designed to offer families the opportunity to seek reconciliation through brief family therapy/ mediation services. This service is offered to nuclear families, as well as, their extended families, and supporting systems. The program framework is designed to offer families an opportunity to resolve family conflicts and disagreements in a caring, supportive environment and work collaboratively with a therapist to create their own solutions. Although many families may be referred to this program for family problems contributing to child maltreatment, running away, and other status offenses, the emphasis is placed on respect for clients and their competence, strengths and resources. Our mediators will address family needs and concerns in accordance with Abraham Maslow's Hierarchy of Needs. Understanding that a family may need immediate responses such as food/clothing/housing provisions and safety, mediators will enlist community agencies to assist the family so that other issues requiring mediation can be addressed. Mediators utilize what Search Institute has identified as the 40 key developmental assets to ensuring success in today's families(Appendix A). Asset-building offers a set of benchmarks for positive child and adolescent development. The mission of the MEDIATION program is to address the physical, emotional, social, and spiritual needs of individuals and families and focus on building both external and internal assets. In the time frame allowed in this program, emphasis will be placed on helping families evaluate and locate area resources that will help them bolster the number of external assets that they possess. The External assets include: Support, Empowerment, Boundaries/Expectations, and Constructive Use of Time. While the focus of treatment will be helping families establish external assets, their knowledge of the internal assets will be vital to the long-term success of their family. The Internal assets include: Commitment to Learning, Positive Values, Social Competencies, and Positive Identity. Research on the "assets approach"indicates that assets are powerful influences on adolescent behavior because they protect young people from different problem behaviors and promote positive attitudes. As illustrated above, the more assets young people experience, the less likely they are to engage in a wide range of risky behaviors, and the more likely they are to engage in positive behaviors. In order to help families build external assets, the therapist will use his/her expertise to connect the family to community resources. As therapists who have lived and/or worked in Weld County for years, we have the benefit of knowing local resources and schools and having personal relationships with treatment providers, community leaders, and event coordinators. These community relationships and awareness of local opportunities will benefit youth and their families. Being based in Weld County and our close proximity to our clients allows our therapists to be available for on-call assistance and crisis intervention. Stillwater Services, LLC prides itself in utilizing therapists who possess a unique blend of professionalism while being personal enough to gain quick access into the daily workings of a family system. With the belief that it is a privilege to develop relationships with a youth and his or her existing support systems, the MEDIATION program is able to cast clients as"partners" and build upon family strengths, resources, and assets. 1 ■ HE ■ OWER OF The more asset.+-young people experience,the less likely they are to engage in a wide range of risky behaviors,and the more likely they are to engage in positive bdvvturs. DEVELOPMENTAL ASSETS Z4.1. 0-10 Assets MI 11-20 Assets I 21-30 Assets r" IN 31-40 Asses I IN Illicit Drug Use Violence Maintains Good S ds in Hoalth School Based on Starch Insitute's study of almost 100,000 youth in 312 towns and cities across the United States during the 1996-1997 school year IL TARGET /ELIGILIBILITY POPULATIONS In conducting brief family therapy, there are a multitude of people and issues that need to be dealt with in order for the family to experience success. For this reason, the program is designed to be flexible and information detailed below is based on an average caseload. The MEDIATION program will have the capacity to serve a total of 240 clients/ family units with clients ranging in age from 6-18 from June 1, 2003 to May 31, 2004. With our current therapists, it is projected that the program can service a total of 240 family units. Due to the richly diverse population of Weld County, Stillwater Services, LLC has estimated that 36 Spanish-speaking families will receive services by members of our bilingual _ and multi-cultural staff. It will be mandated that all therapists employed by Stillwater Services, LLC obtain cultural awareness and sensitivity training. It is estimated that 36 families will receive services in South Weld County. To provide better service to our clients in South Weld County, one of our therapists will live in this region. The MEDIATION program offers 24-hour, on-call service for all clients receiving therapeutic services. Locally based in Weld County, employees involved in this project will offer time- - efficient and cost-effective responses to clients in need of crisis intervention. We anticipate that 20 clients / family units can potentially be served in a month under the MEDIATION program. This program is designed to serve families quickly, efficiently and in a cost effective manner. The maximum length that a family will enroll in the program is one month. The average client will receive direct services for three weeks. These clients will interface directly with the assigned therapist for approximately two hours in each of the three weeks that they are enrolled in the program. 2 40. III. TYPE OF SERVICES TO BE PROVIDED A. Therapeutic Services The MEDIATION program will provide brief family therapy/ mediation services including conflict resolution, problem-solving skills, parenting techniques, and communication enhancement. This model focuses on solutions rather than problems. Part of the therapist's task is to discover whatever a person/family is already doing which might contribute to the resolution of the problem. Clients are encouraged to think about times when their problem did not exist, and how these times contributed to the absence of the problem, and how to recreate such circumstances in their present situations. Focus is on the clients' strengths and abilities rather than their weaknesses. Solutions are derived by clients themselves and therefore not only are they more involved in their success, but the solutions fit their unique lifestyles. Finally, because the clients find their own solutions that work, often self-esteem is increased. Clients can expect a therapist who is respectful and will take the time to 'listen' to the families' story. From our counseling experience, families often report that their relationship with their therapist is more important than any specific technique their therapist uses. The therapist will work from the assumption that clients are capable finding what they need to do to achieve what they want. Listening for and highlighting client strengths, resources, and past successes enhances client self-confidence, increases motivation and generally contributes to a strong therapeutic alliance. The therapist will show respect and support for the client's feelings and need to talk about pain, complaints or problems. Once the therapist has entered the client's experiential world, become familiar with it, and communicated understanding and respect for the client's frame of reference, they can then invite the client to entertain alternative and potentially more satisfying solutions. These solutions will be future focused and within the client's power to attain. These solutions will build upon on existing family strengths and offer a practical, hands-on approach to helping families develop parenting, coping, and communication skills. Often families need specific instruction on establishing boundaries and using a consistent method of rewards and consequences to shape behavior. We recognize that within each family there exist varying values and beliefs that can influence how interventions are implemented. For example, in Weld County, issues of acculturation versus assimilation are frequently relevant and deserve attention. We aim to explore issues affecting a family unit while teaching ways to live harmoniously. An emphasis on conflict resolution, stress reduction, and problem solving will be apparent throughout treatment. The therapists working in the MEDIATION program will be multifaceted and act as client advocates, liaisons to community agencies, therapists, transporters, and case managers. All therapists will submit required documents to the court to provide information about client accountability and progress. 3 B. Concrete Services Stillwater Services, LLC utilizes a strength-based, multi-systemic, and brief solution focused model of providing services. If the case warrants it, a staff meeting in which family members, the caseworker, probation officer, therapist, and any other relevant system in the client's life will be arranged. During these meetings, the problem will be defined; goals for reconciliation and asset building will be addressed. With the systemic approach to building relationships as the foremost focus of treatment, the development of positive assets will be the secondary emphasis throughout the therapeutic process. The Search Institute has developed a framework that builds positive experiences in the lives of youth. Teaching families about how to use the 40 developmental assets to gauge their health of their families is a useful tool not only to measure the success of the program but an ongoing guide for families as well. C. Collateral Services Stillwater Services, LLC seeks to identify existing services or create what is lacking to provide families with community links. Therapists providing service for the MEDIATION program have had experience with the youth and existing resources in Weld County for years. A knowledge base of local resources gives our providers the ability to connect clients to community agencies. With long-term success in mind, we aim to help the family foster relationships with local providers that will continue support once termination of the therapeutic relationship occurs. From assessment to termination, our therapists will work to teach families how to utilize existing services such as health care assistance, job training, substance abuse treatment, financial assistance, medication management, and educational services. D. Crisis Intervention Services As local providers, Stillwater Services, LLC has the ability to offer 24-hour emergency assistance. As standard operating procedure, our therapists will prepare the family for potential emergency situations by developing a detailed plan to implement in times of crisis. This plan will include de-escalation steps, resource numbers to call, and a detailed plan for communication among family members. If contacted with an emergency, we are prepared and willing to visit the family at their home in a timely manner to assist in guiding them through a prepared emergency plan. When confronted with an emergency situation, we will be working in cooperation with other professionals involved in efforts to avoid out-of-home placement. Relapse prevention plans will also be a required piece of the termination process so that clients and their families are left with a step-by-step guide to handling future conflict and crisis. r 4 IV. MEASURABLE OUTCOMES Stillwater Services, LLC is committed to providing quality services to youth and their families. The outcome of services provided offers pertinent information about the future direction of treatment. The MEDIATION program will provide its clients and referring agencies valid assessment tools to point out the strengths and weaknesses of the interventions used. Ultimately, our interventions target keeping the identified client in the home at the time the case is closed. This is accomplished by increasing the ability of parents to handle conflict with their children and manage their household in a positive and controlled manner. If parents are able to improve their parenting competency and manage their household in a positive, consistent manner, it is likely that the identified client will remain in the home 12 months after the case is closed. Since the parents are the focus of many interventions, youth who are out of the home initially can return home to receive reunification services with their families and expect similar results. Families who have had reported child abuse allegations can also expect to receive family therapy services aimed at providing them with realistic expectations and guidelines by which they can manage their household without violence. These services will improve their parenting competency to the level where they will not have any substantiated claims of child abuse in the 12 months following treatment. All family units that receive treatment services will show improvement on all measurements and risk assessments administered at the conclusion of treatment services. We will utilize pre- and post-treatment instruments to measure the success of our treatment services (See Appendix A& B). These pre- and post-treatment data sheets will give valid insight into the success of our clients. We are hoping to build positive assets and reduce the number of days away from school, out-of-home placements, severity of legal charges, and amounts of illegal substances used. The MEDIATION Program believes that by monitoring the acquisition of both internal and external assets it will give a clear picture of the ability of both the individual client and family to function effectively. Detailed below are some of the benchmarks of the 40 developmental assets and the objectives measured through the pre and post tests. External Assets The first 20 developmental assets focus on positive experiences that young people receive from the people and institutions in their lives. Four categories of external assets are included in the framework: Support-Young people need to experience support,care, and love from their families, neighbors, and many others. They need organizations and institutions that provide positive, supportive environments. Empowerment-Young people need to be valued by their community and have opportunities to contribute to others. For this to occur, they must be safe and feel secure. 5 Boundaries and expectations-Young people need to know what is expected of them and whether activities and behaviors are "in bounds" and "out of bounds." Constructive use of time-Young people need constructive, enriching opportunities for growth through creative activities, youth programs, congregational involvement, and quality time at home. Internal Assets A community's responsibility for its young does not end with the provision of external assets. There needs to be a similar commitment to nurturing the internal qualities that guide choices and create a sense of centeredness, purpose, and focus. Indeed, shaping internal dispositions that encourage wise, responsible, and compassionate judgments is particularly important in a society that prizes individualism. Four categories of internal assets are included in the framework: Commitment to learning-Young people need to develop a lifelong commitment to education and learning. Positive values-Youth need to develop strong values that guide their choices. Social competencies-Young people need skills and competencies that equip them to make positive choices, to build relationships, and to succeed in life. Positive identity-Young people need a strong sense of their own power, purpose, worth, and promise. By documenting a family's acquisition and use of the 40 developmental assets, we believe that we will have a practical measure of a family's ability to function effectively. Not only will this be useful information for professional and referral agencies, but this can serve as an ongoing guide to the family as well. The assessment detailed in(Appendix B) will serve as an indicator of the clients functioning in a number of different areas. This information will additionally be an indicator of family improvement. For example, as parental involvement and supervision increase, the number of socially unacceptable behaviors will likely decrease. The information on these data sheets will be collected at quarterly intervals for the year following treatment, providing factual information that will be the foundation for determining our success. 6 V. SERVICE OBJECTIVES Research suggests that low family emotional warmth, low monitoring, and high family conflict are contributing factors of delinquency. Therefore, improving family functioning and supervision will receive a concentrated effort. Research indicates that therapists encourage families to increase the amount of emotional warmth that they show to their children by role modeling positive behavior and educating parents on ways that they can show care and concern for their children. The MEDIATION program will stress the importance of appropriate supervision and monitoring as parents learn how to establish boundaries with their children. Pointing out barriers to effective communication and showing parents how they can communicate positively with their children will be an on-going therapeutic component. We are able to gauge our success in this area by utilizing the "40 Developmental Assets Checklist" as a pre- and post-treatment measure. In addition to improving the family's ability to manage conflict, it is important that we also teach effective parenting techniques. The MEDIATION program will help parents establish clearly defined expectations and enforce them consistently. When parents are able to have their expectations clearly defined and consistently enforced, children often rise up to meet those expectations. We are able to utilize the parents' strengths and their desire to become better parents to challenge them in a non-threatening way. Many parents are in need of learning basic parenting skills like how to set appropriate boundaries and curfews for their children. Gathering the specific information on the above data sheet will be a valid measurement tool in evaluating parental competency. As parenting competency increases, school attendance will increase; substance use and police contact will decrease. We also help parents establish age-appropriate household chores and responsibilities for their children in efforts to increase their ability to manage their household effectively. This includes instructing parents to educate their children how to clean their rooms and the common areas of the home. As the children increase in age, parents will increase the amount of responsibility that they require of their children. This would include education about cooking, shopping, outside employment, financial management, and home/auto maintenance. This increased responsibility — would enable their children to be semi-independent and successful in many other areas of their lives. In order to improve the likelihood that youth and their families will be successful upon termination from the program, we as therapists must be able to help the family foster necessary formal and informal relationships in the surrounding community. This would include encouraging the family to seek informal support from their extended family and utilize these resources to help monitor, mentor, educate, and transport their children. Ongoing support from the medical, school, and church communities are more formal forms of support that will be encouraged to help the youth and family remain successful after the therapeutic relationship is terminated. VI. WORKLOAD STANDARDS Stillwater Services, LLC will expect a maximum number of seven hours of involvement per case. This includes five hours of direct therapeutic / mediation service to the family, one hour of case management and one hour of supervision. During brief family therapy component there will be a minimum requirement of two hours of interaction per week. Including the founders of the MEDIATION program, Nathan Buxman and Shari Simmons, an additional bilingual therapist will provide therapeutic services. A maximum of eight clients per therapist will constitute a full caseload. These therapists will be matched with the families according to their varying backgrounds, specialties, and knowledge base. The MEDIATION program will maintain a brief-solution focused approach that is designed to utilize crisis interventions. These interventions target behavior patterns within multiple systems that contribute to the identified problem. Interventions are designed to require on-going, consistent effort from family members. Our interventions are designed to promote long-term therapeutic change by encouraging family members to empower one another and meet needs that span across multiple systems. The MEDIATION program holds to the premise that different people possess varied learning techniques, communication styles, and processes of internalization. Therapists will work on a family's case an average of seven hours during the month of service. This average is subject to change given the requests of the referral agency and client needs. One licensed therapist will supervise the two masters-level therapists. Weekly staff meetings, in which all therapists and supervisors meet to discuss the progress of each client, will be held. It is at this time that progress notes, weekly written summaries of contact, payroll, and any required court reports will be due. Discussion of cases is mandatory so that all members of the MEDIATION program have access to accurate, timely information regarding clients. We will require that all therapists be updated on cases so that any MEDIATION practitioner could effectively deal with a client in an emergency situation. The purpose of weekly team meetings will be to accrue a collaborative effort in formulating ideas, providing resources, and creating non-traditional forms of intervention that would promote positive change within a family. Additional one-on-one supervision will occur biweekly. Stillwater Services, LLC carries general liability, activity and worker's compensation insurance to cover both supervisors and all employees working on this project. Stillwater Services, LLC believes in the effectiveness of meeting clients "where they are at" both physically and emotionally. If the situation requires, these brief therapy/ mediation meetings can be held at a neutral site. Therefore, physical locations for the services provided will be as varied ry as meeting in a client's home, a local church, at school, or at a relative's/friend's home. Due to potential intensity of a crisis situation, clients are free to access their current therapist at any time for assistance. Pager and/or cell phone numbers of assigned therapists will be given to clients to utilize in case of an emergency. 8 VII. STAFF QUALIFICATIONS Therapists providing brief family therapy services to clients in the MEDIATION program will be required to possess a master's degree in a human services field (i.e. Social work, Psychology, Sociology, Child Development, or School Counseling) and be supervised by a licensed therapist. Proof of training and/or course work in crisis intervention, diagnostic measurement, child development, cultural sensitivity, and intervention implementation will also be required. My supervisor in the MEDIATION program will be required to hold a masters degree in one of the above mentioned human service fields. Stillwater Services, LLC also requires that all employees working with youth and/or their families undergo a CBI check, Central Registry Check, possess valid auto insurance, have proof of on-going liability insurance, and be able to provide transcripts. This information will be required documentation prior to the hiring of any staff within the Stillwater Services, LLC organization. It is projected that staff working within the MEDIATION program will consist of the two founders, who will serve as supervisors and service providers. The program will utilize an additional bilingual therapist. At least one therapist will exclusively serve the South Weld - County region. Stillwater Services, LLC holds a firm belief that it is important to obtain new, fresh ideas and knowledge about changing intervention strategies and programs. Stillwater Services, LLC requires all employees hired to work directly with youth to attend all mandated training by Social Services. Additional training on assets training, restorative justice, crisis intervention, and youth/family services will be encouraged and paid for by the company. Prior to employment, Stillwater Services, LLC must have proof that potential employees have knowledge of the Risk Factor Intake Assessment utilized by Social Services, as well as risk assessment guides provided by the company. Employees will be placed on a three-month probationary period in which they must demonstrate the capability of accurately assessing client and family needs. They must exhibit the ability to develop a rapport and a relationship that will lead to the implementation of creative interventions. Therapists must also show knowledge of community services and the ability to link clients to these resources. Therapists with areas of expertise in marital therapy, play therapy, or translation will be matched appropriately to client needs. In addition, Stillwater Services, LLC hires both male and female therapists. Stillwater Services, LLC has identified a need for culturally-based services to be provided to the youth and their families in this community. To address this need, the MEDIATION program provides bilingual and multicultural therapists. All therapists and are required to possess knowledge of cultural issues, sensitivity, and respect. It is the hope of Stillwater Services, LLC that by providing the above stated services, the youth and families of Weld County will have the opportunity to become successful members of the community. 9 VIII. COMPUTATION OF DIRECT SERVICE RATE-PHASE I -MEDIATION A. Total Hours of Direct Service per Client 5 Hours [A] Total Clients to be Served 240 Clients [B] Total Hours of Direct Service for Year 1,200 Hours [C] (Line [A] Multiplied by Line [B]) Cost per Hour of Direct Services $ 55.09 [D] Total Direct Service Costs $ 66,108 [E] (Line [C] Multiplied by Line [D]) Administration Costs Allocable to Program $ 5.131 [F] Overhead Costs Allocable to Program $ 3,789 [G] Total Cost, Direct and Allocated, of Program $ 75,028 [H] (Line [E] Plus line [F] Plus Line [G]) Anticipated Profits Contributed by this Program $ 3,000 [1] Total Costs and Profits to be Covered by this Program (Line [H] Plus Line [I]) $ 78,028 [J] Total Hours of Direct Service for Year 1,200 Hours [K] (Must Equal Line [C]) Rate per Hour of Direct, Face-to-Face Service to be Charged To Weld County Department of Social Services $ 65.02 [L] 10 Core Service Budget Computations A. Job Description, Minimum Certification & Hourly Rate In Home Therapist (MA) $35/hour Mediation Therapist (MA) $35/hour Life Skills Coach(Diploma&Experience) $17/hour Life Skills Instructor (MA) $35/hour B. Non-Direct Service Costs Supervision $35/hour Therapy Case Management $35/hour Life Skills Case Management $35/hour C. Administration Costs $ 20,525 Annually r Phone/Fax Office Supplies Mileage D. Overhead Costs $ 15,114 Annually Health Insurance Accountant Conferences Professional Insurance PO BOX Equipment E. Programs Involved & Percent Allocated In Home Therapy/Assets Program 25% Brief Therapy/ Mediation Program 25% Life Skills/ Smart-Start Program 25% Outside DSS 25% F. Total Administration Costs/Program $ 5,131 G. Total Overhead Costs/Program $ 3,779 Appendix A 40 Developmental Assets Asset Type Asset Name Definition Yes No 1. Family Support Family life provides high level of love and support 2. Positive family communication Parents and youth communicate positively;youth is willing to seek parents advice and counsel 3. Other adult relationships Youth receives support from three or more non- Support parent adults 4. Caring neighborhood Youth experiences caring neighbors _ _ 5. Caring school climate School provides a caring,encouraging environment 6. Parent involvement in schooling Parents are actively involved in helping youth succeed in school 7. Community values youth Youth perceives that community adults value youth tn 400 8. Youth given useful roles Youth are given useful roles in community life to on q 9. Community service Youth gives one hour or more per week to serving •- .. Empowerment in one's community 10. Safety Youth feels safe in home,school and neighborhood 11. Family boundaries Family has clear rules and consequences;and WDI monitors whereabouts 12. School boundaries School provides clears rules and consequences 13. Neighborhood boundaries Neighbors would report undesirable behavior to •-- Boundaries family and 14. Adult role models Parent(s)and other adults model prosocial behavior Expectations 15. Positive peer influence Youth's best friends model responsible behavior 16. High expectations Both parents and teachers press youth to achieve 17. Creative activities Involved three or more hours per week in lessons or practice in music,theater,or other arts • - 18. Youth Programs Involved three or more hours per week in sports, Time Use clubs,or school/community organizations 19. Religious community Involved one or more hours per week 20. Time at home Out with friends"with nothing special to do,"two or fewer nights per week 21. Achievement motivation Youth is motivated to do well in school 22. School engagement Youth is actively engaged in school _ T 23. Homework Youth reports one or more hours of homework per day — Educational 24. Bonding to school Youth cares about his/her school . _ Commitment 25. Reading for pleasure Youth reads for pleasure three or more hours per week 26. Caring Youth places high value on helping other people 27. Equality and social Justice Youth places high value on promoting equality and reducing hunger and poverty •- cm Values 28. Integrity Youth acts on convictions,stands up for his/her belie& 40 29. Honesty Youth"tells the truth even when its not easy" _ et "' Q 30. Responsibility Youth accepts and takes personal responsibility 3 I. Restraint Youth believes it is important not to be sexually active or to use alcohol or other drugs E 32. Planning and decision making Youth has skill to plan ahead and make choices "" �--� 33. Interpersonal competence Youth has empathy,sensitivity,and friendship skills 34. Cultural competence Youth has knowledge of and comfort with people of Social different racial backgrounds Competencies 35. Resistance skills Youth can resist negative peer pressure 36. Nonviolent conflict resolution Youth seeks to resolve conflict non-violently 37. Personal control Youth feels he/she has control over"things that happen to me" Positive 38. Self-esteem Youth reports high self-esteem Identity 39. Sense of purpose Youth reports,"my life has a purpose" 40. Positive view of personal future Youth is optimistic about his/her personal future Appendix B Educational Status Is Youth Attending School? Current Grade Level: Has Youth Graduated? Has Youth obtained a GED? Socially Accepted Behavior Last Month 3 months 6 months 1 year Number of days absent from school? Number of days spent in placement ? Number of times ticketed ? Number of misdemeanors? Number of felonies ? Number of convictions? Socially Accepted Behavior II Please use the following codes to indicate your substance use 01 Less than once a week 02 Once a week 03 Several times a week 04 Once Daily 05 2-3 times Daily 06 3 or more times daily 07 Continuous Use 08 Binge Use 09 No longer use 10 Have Never Used 11 Unknown 12 N/A Alcohol? Marijuana? Cocaine? Amphetamines? Hallucinogens? Opiates? Barbiturates? Tranquilizers ? Cigarettes? Inhalants? PCP ? Employment Is the youth working? Number of hours worked per week? How long at this job? OJ/ 1J/CUUJ 11 : 1 :4r American Prof Agency --> P.002/002 Account Number: CO STIL 3360 Date: 3/13/03 Initials: CV CERTIFICATE OF INSURANCE THE DOCTORS' COMPANY C/O: American Professional Agency, Inc. 95 Broadway, Amityville, NY 11701 This is to certify that the insurance policies specified below have been issued by the company indicated above to the insured named herein and that, subject to their provisions and conditions, such policies afford the coverages indicated insofar as such coverages apply to the occupation or business of the Named insured(s) as stated. THIS CERTIFICATE OF INSURANCE NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS, EXTENDS OR ALTERS THE COVERAGE(S) AFFORDED BY THE POLICY(IES) LISTED ON THIS CERTIFICATE. Name and Address of Insured: Additional Named Insureds: STILLWATER SERVICES, LLC SHARI SIMMONS P.O. BOX 336058 NATHAN BUXMAN GREELEY CO 80634 BRENT CLAY Type of Work Covered: Mental Health Counselor Location of Operations : N/A (If different than address listed above) - Claim History: Policy Effective Expiration Limits of Coverages Number Date Date Liability ^ PROFESSIONAL/ 1,000,000 LIABILITY MHL-5016498 8/01/02 8/01/03 3,000,000 - NOTICE OF CANCELLATION WILL ONLY BE GIVEN TO THE FIRST NAMED INSURED ON THIS �_ Dnrtr`v awn UT no sUr suarr arm nN oro'arr nr err rusrrornc wn r'i orsorT Tn r.TVTNf OR RECEIVING NOTICE OF CANCELLATION. —^ Comments; — This Certificate Issued to: - Name: STILLWATER SERVICES, LLC P.O. BOX 336058 Address: GREELEY CO 80634 — A horized Representative TravelersPropertyCasualty J WORKERS COMPENSATION A11 ..d maveler:Group AND EMPLOYERS LIABILITY POLICY CHANGE DOCUMENT WC 99 99 98 (00) ^ - POLICY NUMBER: (IOUB-5387W98-7-03) CHANGE EFFECTIVE DATE: 02-12-03 NCCI CO CODE: 15318 INSURER: THE CHARTER OAR FIRE INSURANCE COMPANY INSURED'S NAME: STILLWATER SERVICES,LW This change is issued by that member of The Travelers Insurance Companies which issued the policy and forms a part of the policy. It is agreed that the policy is amended as follows: An absence of an entry in the premium spaces below means that the premium adjustment, if any,will be made at time of audit. ADDITIONAL PREMIUM $ 46 RETURN PREMIUM $ NIL ADDITIONAL NON-PREMIUM $ NIL RETURN NON-PREMIUM $ NIL The Policy Minimum Premium is amended as follows: Minimum Premium: $ 292 The Policy Expense Constant is amended as follows: Expense Constant: $ 180 - . . .- Pending rates that apply to the policy have been approved by the proper regulatory authority. The new rates are shown below: STATE CODE NO RATE CO 8868 .90 The following endorsement is added: WC 89 04 15 (00) -001 DATE OF ISSUE: 12-26-02 RA CHANGE NO: 001 PAGE 001 OF LAST POL. EFF. DATE: 02-12-03 POL. EXP. DATE: 02-12-04 OFFICE: ELMIRAPAYROLLPATH 70A PRODUCER: PAYCHEX AGENCY INC SV998 COUNTERSIGNED AGENT TravelersPropertyCasualty' WORKERS COMPENSATION naeme.a Trav tersGroup AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 89 04 15 (00)- 001 POLICY NUMBER: (I00B-5387W98-7-03) POLICY INFORMATION PAGE ENDORSEMENT Item#4 is changed to the following: PREMIUM BASIS Total Estimated Rate Per Code Annual $100 of Estimated Classifications No. Remuneration Remuneration Annual Premium SEE CHANGE DOCUMENT OR INFORMATION PAGE SCHEDULE Total Estimated Annual Premium $ Minimum Premium $ Deposit Premium $ ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. - DATE OF ISSUE: 12-26-02 ST ASSIGN: NATIONWIDE LIFE INSURANCE COMPANY PO BOX 2399-COLUMBUS, OHIO 43216-2399 Nationwide Crossroads Insurance Agy Po Box 1010 Ault, CO 80610 RE: Specified Hazard Insurance Policy for 1 U U V/ h, Stillwater Services Uc APR 2 2 2002 1701 67th Ave Greeley, CO 80634 GY Policy No: 502-95.18018 Congratulations on selling this Specified Hazard Insurance Policy! Enclosed are: For your use: - A Priority Fax Order Form to order additional sales brochures and other supplies. - A machine copy of the application for your files. For the Plan Sponsor: - The policy delivery letter, the policy, and the claim forms (If applicable). Please sign the delivery letter and countersign the policy(at the bottom of page 6). The policy and supplies should be delivered to the plan sponsor named above. - Individual certificates (if required by the plan sponsor's state)will be mailed within 2 to 4 weeks. Thank you for thinking of Nationwide for your Special Risk Health insurance needs. Now may be a good time to consider these additional Special Risks Health prospects: CIVIC AND COMMUNITY ORGANIZATIONS such as auxiliary police, social clubs, swim clubs,volunteer fire companies, and volunteer service clubs. GROUP ACTIVITIES such as Bible schools, camps and conferences, child day care, picnics, preschools. recreation programs, religious day schools, trips and tours, and volunteer construction and/or repair work. AMATEUR SPORTS such as baseball, basketball, football, soccer, and softball teams, as well as sports camps. YOUTH GROUPS such as drill teams, 4-H Clubs, marching bands. Scouts,youth fellowships; and ...many others. If you need brochures or any assistance whatsoever, please call our Customer Service Center at 1-800.525-8669 (1-614-854-2196 for Columbus, Ohio area local calls), send us a Fax to 1-614-854-3753, send us a-mall to SpecRsks@Nationwide.com, view our website at www.GrouProtector.com, or write to us at: Special Risks Health Nationwide Insurance PO Box 2399 Columbus, OH 43216-2399 Sincerely, Special Risks Health Department Enclosures • which,.•pun aeeeprapcc and POLICY APPLICATION( I•a t grist err e) hamcaapproval by NATIONWIDE S�,�,,pj��, type) pan of SPECffIED HAZARD INSURANCE POIJCV NUMBER COMP 1 aR OGto e3216 will I. Name of hIHER 302.93 flan i .L (, twn paws u.r o,yl ceS LL (CtaapS Name) Permancal Mafl.g Address / 1) • 1 ti (('(Umber) (Sane 2. Policy (G�' (S e al,d farm: The policy tam starts at 12:01 a.m. a - :1,_. .t.'1 O, ) P) (Cowry) at12:01 La.nn on T - �_ _p�. which Is the/a tcrmitution date whichtais 3-month polity a date and nods $Crest removal date 12 moutG ondl poliq UM): J. Covered ACGvitks ( policytam). • ' 4. Maximum Benefit Amoaets—the word"None"means the benefit is not included - .. ACCith IDENTAL 000.0 DEATH AND SPECIFIC LOSS cell m,.; —for any Ymu .,' m Death.. _.................._................ x;''' /� DSsa ificth...LOU(Face Amount)......_........._.. S 1.500.00 S 2,500.00 S 5,000.00 J �.., 7,000.00 3,000.00 10.000.00 S 5.000.00 .:.'i ,:j /r.:'-.. MEDICAL EXPENSE .... IS,000.OQ/c?'/ i. . �.., Accident 4"‘:11,1.. -s��9 ,� - Oveail Maximum Deductible None None None '. 4 5,000.00 10,000.00 25,000.00 N000 �. 30.000.00N. 2GQ- �S��': our woe mar ,zee •�.� ///''''';",S. Premium Rate..b cis m of Ell Ibis Perm was asp ck Clan and Medical Ex.erase Plan desired `� -- I l ea ender egotistic day or portion co ..`\� Clap remium Rates Pc E, bk Perxoa. Migall D "" d« 'xpense P• . Plan All Darticipunu or all Participants and miff in she alternative community service program activities of the plan sponsor(check o Jy eng box): 1 CI Class I Bomefiss min.. 32• O Chu Baaefity nape S 0.13 S 0.09 �` Clap 3 Benefits psi 0.18 0.12 4 • Clay 3 Bebeatr two �^ NOT AVAILABLE 023 no .n car pals=per o 023 -- . $100.00 ire. P y term is S150.•c if . -Ica] expanse•bale . se ateeu .tan has • elected. Prase primary pines has • - ales«tl • 6.�. lTimt is policy li.e.oval au tUgibk pains which include: O eaniclpanu only nq or f�Earsicipaota and gaff w,. understood the eligible persons q. ` (a)the premium will be paid entirely by the plan sponsor with no coo made a�ar and the coat of the insurmcc;and(b)premium will be ggiann • 1sn dues .0 IA advance as*Gown on the Premium Report,or 0 k advance paid as m al estimated a aced+s shown on We Premium Report with an audit at the end of the policy band on Ike total eatlmated owe • e•,tkc minimum premlarr with ibis a du Y ram woo or for • ga,n.ip, GI "- application wits t6•rcmaloder due uanerl to arrean tears By PunifieWILC ,.:c:ic• 1 P Canoe Applicant) mat 4hnr; • (PI1° gnp4r�� byrl APPbotic) / • (Acmes Sips.and N bar) * r p GR-9034 p, �, (Adams cdAppllamt U UQo3c,1 NOSE' 11 ..�-'A•�hse den five CommWtry Service Ro Them plan,arc mailable la DC.P VI Eat.....LZcsz _ Fans ask*f to AL or PA;and m adult groups(IIe..ag 20 or over)I.NY. Clause It _ - LSSLB medkal pl.a as avWaWc:In NJ; W and 2 a1ly91 available is VS, 1b .a4'ptlba who . prison. Mac kloranstka la so application promoY Ulmor 9,'�atrrrk for payment of•loo or b•ocpt m cep• prised. and may be subject to fine'ad w IV b nfaeasmtb 901.n/or • 605GEN.1050 r- • PREMIUM REPORT*This report ust be completed when Individual DAILY premiums are used for Application to be accepted. Age Range of Participants(not start); ,.. t _ 10 t°—L.9—_years of age 'Not required If policy is renewable grid has"in arrears"billing. �. Daily Total Maximum Covered Date(e)o/ Premium Total Number Premium Per Number of Activity Activity Rate of Days Personle eeo Eligible Premium y Person Persona r La I i z X �2 S /I,, µ Due e hall �_ S (pea- yawn X u x �. _ 9 74 21 S EZetS „ $ X --� X — — " X S = h rein.} X _S�� S a an }, +i X s Total premium due(subject to policy minimum') �� X a if renewable•the estimated number of eligible persons per billing frequency is 3 'The annual minimum premium to 3150.00 for primary medical and$100.00 for excess. • I Certify that to the best of my knowledge and belief(1)the preceding information is correct and complete:(2) for the total number of eligible persons who are antkipa(ed to be insured;and(3)the premium la being the plan sponsor with no contribution made by the eligibly u ( )wemwm is being parsons toward the cost of the Insurance. paid entirely by _ X313 a � by • MATEI ( ) Oat ap3 (ANON-CANTS LTSSIGNITUREANOTmE) MAY TFIEPNONG NUWEAI — ( ) �.' _ - �•�•1 a 7 WAX MAIOErl) NOTE If additional s•.- : is ( AooNEss) required, use a separate sheet • RECEIVED c>Pt.aasipae„ • APR 12 2002 SPECIAL 1i13ES HEALTH a AUTOMOBILE INSURANCE IDENTIFICATION CARD AMERICAN FAMILY MUTUAL MSURANCE COMPANY "" THIS CARD MUST BE CARRIED IN THE INSURED MOTOR VEHICLE MADISON,WISCONSIN 53783-0001 SHELTER GENERAL INSURANCE COMPANY 1-800-SHELTER 1817 W. BROADWAY COLUMBIA, NO. 65218-0001 AGENT: ANDREW J GOLDFARB 303-444-2663 COLORADO INSURANCE-- POLICY NO. 05-1-C-3134638-6 EFFECTIVE DATE 01-29-2003 EXPIRATION DATE 04-29-2003 Policy No: 0763-2029-01-70-FPPA-CO 1996 CHEVY BLAZER 4WD 4DR VIN 1GNDT13W5T2125493 Eff Date: 10-15-2002 Exp Date: 4-15-2003 1999 CHEV SC1 VIN: 2GCEC19V6X1134835 NO FAULT-PPO WITH CORVEL CORPORATION Coverages: BIPD UM UIM COMP COLL PIP FOR PHYSICIANS, CALL 1-800-473-5293 IRO ARTC BUXMAN, NATHAN 337 53RD AVE GREELEY CO 80634-4223 SHARI SIMMONS 1701 67TH AVE Agent: DONNA FEIGIRIY-YANTIS GREELEY CO Agent Phone: (970) 351-6528 "� — ------ --' This card must be carried in the insured motor vehicle for production upon demand. Important message on reverse side. ACTIVE LC SW 9918.Y ky�'o �, '' PUe001 .. d'Y !03 • S R LYN TE-SIMMONS W. I 2 DEAN a I RCLE < yf OVELAN,t' CO 80537 BRUCE M. DOUGLAS DIRECTOR DIVISION OF REGISTRATIONS LICENSEES SIGNATURE r EXHIBIT B RECOM1vIENDATION(S) Stillwater Services, LLC PO Box 336058 Greeley, CO 80634 Phone: (970) 405-4802; (970) 405-4803 Fax: (970) 353-4422 Weld County Dept. of Social Services Clerical Unit APR 1 7 2003 April 15, 2003 Gloria Romansik Weld County Department ofSocial Services - - PO Box A, Greeley, CO 80632 In response to the RFP Bid process for PY 2003-2004, Stillwater Services, LLC accepts the following recommendations as written by the FYC Commission. Stillwater Services, LLC will make efforts to train our staff using a professional interpretation standard so that the use of our Mediation and Facilitation under the Intensive Family Therapy Program can be the most effective. Stillwater Services, LLC would like to accept the invitation for inclusion on your vendor list for the following: RFP 03005 —Lifeskills, RFP 030010 - Option B, and RFP 03008— Mediation. Sincerely, Nathan J. Buxman MA Shari Simmons, LCSW cttoa DEPARTMENT OF SOCIAL SERVICES P.O. BOX A GREELEY, CO. 80632 Website:www.co.weld.co.us II Administration and Public Assistance(970)352-1551 Child Support(970)352-6933 O • April 8, 2003 COLORADO Shan Simmons Nathan Buxman Stillwater, LLC P O Box 336058 Greeley, CO 80634 Re: RFP 03008: Mediation and Facilitation under the Intensive Family Therapy Program Area RFP 03010: Option B, Home Based RFP 03005: Lifeskills Dear Ms. Simmons and Mr. Buxman: The purposes of this letter are to outline the results of the Core Service Bid process for PY 2003-2004 and to request written information or confirmation from you by Wednesday, April 16, 2003. A. Results of the Bid Process for PY 2003-2004 The Families, Youth and Children(FYC) Commission has reviewed the bids according to the criteria established in the bids and provides recommendation(s) and/or condition(s) as follows: 1. RFP 03005—Lifeskills: The FYC Commission has no recommendations or conditions. 2. RFP 03005 -El Mundo de Esperanza(A World of Hope): The FYC Commission has no recommendations or conditions. 3. RFP 03010- Option B: The FYC Commission has no recommendations or conditions. 4. RFP 03008-Mediation and Facilitation under the Intensive Family Therapy Program area. The FYC Commission has a recommendation as follows. The provider shall make efforts to train staff in using a professional interpretation standard when interpreting during mediations. B. Required Response by FYC Bidders Concerning FYC Commission Recommendations and Conditions The Weld County Department of Social Services is requesting your written response to the FYC Commission's recommendation. Please respond in writing to Gloria Romansik, Weld County Department of Social Services, P.O. Box A, Greeley, CO, 80632,by Wednesday, April 16, 2003, close of business. Page 2 Stillwater, LLC/Results of Bid Process for PY 2003-2004 You are requested to review the FYC Commission recommendations and to: 1. accept the recommendation(s) as written by the FYC Commission; or 2. request alternatives to the FYC Commission's recommendation(s); or 3. not accept the recommendation(s) of the FYC Commission. Please provide in writing how you will incorporate the recommendation(s) into your bid. If you do not accept the recommendation,please provide written reasons why. Your responses that are accepted by the FYC Commission and the Weld County Department of Social Services will be incorporated as part of your bid and Notification of Financial Assistance Award(NOFAA.) If you wish to arrange a meeting to discuss the above recommendation,please do so through Elaine Furister, 352.1551, extension 6295, and one will be arranged prior to April 16, 2003. Sincerely, J Ju y A. Grego, 'rectt cc: Dick Palmisano, Chair, FYC Commission J !!!!!! Gloria Romansik, Social Services Administrator Weld County Department of Social Services Notification of Financial Assistance Award for Families,Youth and Children Commission (Core) Funds Type of Action Contract Award No. X Initial Award 03-CORE-Option B-0012 Revision (RFP-FYC-(03010) Contract Award Period Name and Address of Contractor Beginning 06/01/2003 and Stillwater Services Ending 05/31/2004 Option B Services PO Box 336058 Greeley, CO 80634 Computation of Awards Description Unit of Service The issuance of the Notification of Financial The ASSETS Program offers home-based intensive family Assistance Award is based upon your Request for interventions to youth ages 6-18, their nuclear families, Proposal (RFP). The RFP specifies the scope of extended families, and supporting systems. The program services and conditions of award. Except where it framework is designed to acknowledge and establish is in conflict with this NOFAA in which case the developmental assets that assist in overcoming present NOFAA governs, the RFP upon which this award is obstacles and challenges. Service to a total of 68 family based is an integral part of the action. units. 10 Spanish-speaking families will receive services Special conditions by members of Bilingual and multi-cultural staff. All 1) Reimbursement for the Unit of Service will be therapists will receive cultural awareness and sensitivity based on an hourly rate per child or per family. training. 10 families will receive services in South County 2) The hourly rate will be paid for only direct face to with therapists specifically assigned to the region. Service face contact with the child and/or family, as includes a 24-hour on call service for all clients receiving evidenced by client-signed verification form, and as therapeutic services. Program capacity is 12 client- specified in the unit of cost computation. families served per month,average length of the program 3) Unit of service costs cannot exceed the hourly and is 7 weeks. Clients will interface directly with assigned yearly cost per child and/or family. therapist approximately 3 hours in each of the seven weeks 4) Payment will only be remitted on cases open with, they are enrolled in the program. and referrals made by the Weld County Department of Social Services. Cost Per Unit of Service 5) Requests for payment must be an original and Hourly Rate Per $ 69.00 submitted to the Weld County Department of Social Unit of Service Based on Approved Plan Services by the end of the 25th calendar day Enclosures: following the end of the month of service. The X Signed RFP:Exhibit A provider must submit requests for payment on Supplemental Narrative to RFP: Exhibit B forms approved by Weld County Department of Recommendation(s) Social Services. Conditions of Approval Approv . Program Official: By By o\ Jp David E. Long, Chair Judy . Gri g ,Dire ctorj Board of Weld County Co issioners Wel ottnA/ epartment�of Social Services Date: �{-3)- 2OO3 Date: 9 Z1/t5 loft Wj ,o&7 EXHIBIT "A" f r, • A51/45r TS PKOGKAM n r'• STILLWATP SL KVICP 5, LLC "taken reintegrating lads, it is important to distinguish between cases wkere tioutk lad in tine communittj r and the communitij lads L)outk." �j agen, 2000) r r^ r r r r r INVITATION TO BID OFF-SYSTEM BID 02-03 RFP-FYC-03010 DATE:February 19, 2003 BID NO: RFP-FYC-03010 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-03010) for:Colorado Family Preservation Act--Home Based Intensive 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 competing 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) 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 Home Based Intensive Family Intervention ._ Program is a family strength focused home-based services to families in crisis which are time limited, phased in intensity, and produce positive change which protects children,prevents or ends placement, and preserves families. This program announcement consists of five parts, as follows: PART A...Adm_inistrativeInformation PART D...Bidder Response Format _ PART B...Background, Overview and Goals PART E...Bid Evaluation Process PART C...Statement of Work Delivery Date (23- 14-OA 1 fl1'tn J / ' � (After receipt of order) BID MUS BT E SIGNED IN)INK Shan. Si m1nS'1 A4144w I. Bwkman TYPED OR PRINTED SIGNATURE r. n VENDOR S-h 11w/deer- Serv;(e.S, LLC (Name) Handwritten Signature By Authorized Officer or Agent of Vender ADDRESS ()D PWX 33hn5R TITLE ASSETS Program (free ley , en Riya34- DATE 03-14-03 PHONE# '(9794.05-4-Sa31 4-05-4802 The above bid is subject to Terms and Conditions as attached hereto and incorporated. Page 1 of 32 RFP-FYC-03010 Attached A HOME BASED INTENSIVE FAMILY INTERVENTION PROGRAM BID PROPOSAL AND REQUEST FOR CONTINUATION OF AWARD UNDER FPP CORE SERVICES FUNDING FAMILY PRESERVATION PROGRAM 2003-2004 BID PROPOSAL APPLICATION PROGRAM FUNDS YEAR 2003-2004 OFF-SYSTEM Y( BID RFP-FYC-03010 NAME OF AGENCY: 3+t I u infer Jerv;c.c.s LLG ADDRESS: f 0 ,Rox WbLx58 Qrre,ley , Co 00b,34- .... PHONE(47n) -n,5-4 2/13 4/25-4 go o CONTACT PERSON: Sbar i Si rnrnonS TITLE: Therap/S9 DESCRIPTION OF FAMILY PRESERVATION PROGRAM CATEGORY: The Home Based Intensive Family Intervention ?rogram is a family strength focused home-based services to families in crisis which are time limited,phased intensity,and ' ,roduce positive change which protects children,prevents or ends placement, and preserves families. —12-Month approximate Project Dates: _ 12-month_contract^ with actual time lines of:' Start June 1,2003 Start dune 1, 2003 End May 31,2004 End ma v 31 t 200 a}- TITLE OF PROJECT:" ASS e.+S ?ro3r&rn "'"`� (Uri, 'flO Vri1/ C ) J Same and Signature of Person Preparing Document Date m Name and Signature Chief Administrative Officer Applicant Agency Date MANDATORY PROPOSAL REQUIREMENTS or 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 —12 Project Description Target/Eligibility Populations A A Types of services Provided Measurable Outcomes '"sak Service Objectives X4,2 Workload Standards Staff Qualifications S& Unit of Service Rate Computation -..-4,1k Program Capacity per Month itCertificate ofInsurance Assurance Statement _)ate of Meeting(s)with Social Services Division Supervisor: 03-03-n3 Page 26 of 32 RFP-FYC-03010 Attached A Co ents by SSD Supervisor? - / \Mil 1C, i , 5L-C.y ,(; `i- �-(. 4 -f,t ) i t iL t- "4.> Y-6 �J y � Lr; lei 'Le `e '1 .e it. -1k r10 Liu_n .l At eii et-L f' P,d • r rR _ 3-63 . ame and Signature of SSD S pervisor Date 4 —, r . Page 27 of 32 - I. PROJECT DESCRIPTION Stillwater Services, LLC is an organization dedicated to helping Weld County youth and families. The ASSETS program was designed to offer home-based intensive family interventions to youth ages 6-18, their nuclear families, extended families, and supporting systems. The program framework is designed to acknowledge and establish developmental assets that assist in overcoming present obstacles and challenges. Our therapists support what Search Institute has identified as the 40 key developmental assets to ensuring success in today's families(Appendix A). Asset-building offers a set of benchmarks for positive child and adolescent development. The mission of the ASSETS program is to address the physical, emotional, social, and spiritual needs of individuals and families and focus on building both external and internal assets. External assets include: Support, Empowerment, Boundaries/Expectations, and Constructive Use of Time. Internal assets include: Commitment to Learning, Positive Values, Social Competencies, and Positive Identity. The ASSETS program will focus and specialize in working with youth and families from culturally diverse backgrounds who are considered"at-risk" or highly involved in the legal system. Research on the "assets approach" indicates that assets are powerful influences on adolescent behavior because they protect young people from different problem behaviors and promote positive attitudes. As illustrated below, the more assets young people experience, the less likely they are to engage in a wide range of risky behaviors, and the more likely they are to engage in positive behaviors. Stillwater Services, LLC utilizes a strength-based, systemic approach to therapy with creative counseling techniques and teaching methods to help families develop stronger relationships and stable homes. With this focus, we are able to connect with -- youth and their families to form positive relationships that promote impacting and lasting change. Within the context of this proposal, "intensive family therapy" includes, but is not limited to, a range of services such as intensive individual, family, or marital therapy, play therapy, role-modeling, education, transportation, community liaison, advocacy, and case management. Therapists working in the ASSETS program recognize the varied needs of youth and their families and will provide services accordingly. THE POWER OF The mon assets young people experience,the less likely they art to engagein a wide now of risky behaviors,and die more likely they are to engage in positive behaviors. DEVELOPMENTAL ASSETS Ii:,",, ■ 0-10 Assets''%' '`"^ ■ I l-20 Assert 11 0 s ■ 31.40 Assets Illicit Dreg Use Vision Maintains Good Sottaods is Health Scheel Basal on SearthInstitute's study of almost 100,000 youth in 312 towns and sties aaoss the United Sates during t&1996-1997 school year - I - Stillwater Services, LLC is based in Weld County and our close proximity to our clients allows us the flexibility to icspond quickly and efficiently to clients' needs. Because the program is locally based, therapists can participate in spontaneous activities with clients and be available for on-call assistance and crisis intervention. In addition, as therapists actively involved in the community, we have the benefit of knowing local resources and schools and having personal relationships with treatment providers, community leaders, and event coordinators. Having resided and/or worked in Weld County for years, the providers of this program have a connection to the community and as a result, an awareness of local opportunities to benefit youth and their families. Our therapists have expertise in applying accurate assessments and implementing timely interventions. Stillwater Services, LLC prides itself in utilizing therapists who possess a unique blend of professionalism while being personal enough to participate in the daily workings of a family system. With the belief that it is a privilege to develop a relationship with a youth and his or her existing support systems, we are often participating in family rituals, assisting families in household chores, attending family events, enjoying a meal with the family, and - joining in family celebrations of success. By doing this, we seek to cast clients as"partners"and build upon family strengths, resources, and assets. H. TARGET/ELIGILIBILITY POPULATIONS In conducting intensive family therapy, there are a multitude of people and issues that need to be dealt with in order for the family to expciience success. For this reason, the program is designed to be flexible and information detailed below is based on an average caseload. The ASSETS program will have the capacity to serve a total of 68 clients ranging in age from 6-18 from June 1, 2003 to May 31, 2004. During the 2002-2003 fiscal year, the ASSETS program served families with children ranging in age from 2-18. With our current therapists, it is projected that the program can service a total of 68 family units. Due to the richly diverse population of Weld County, Stillwater Services, LLC has estimated that ten Spanish-speaking families will receive services by members of our bilingual and multi- cultural staff. It will be mandated that all therapists employed by Stillwater Services, LLC obtain cultural awareness and sensitivity training. It is estimated that ten families will receive services in South Weld County with therapists assigned specifically to the region. To provide better service to our clients in South Weld County, one of our therapists lives in the region. The ASSETS program offers 24-hour on-call service for all clients receiving therapeutic services. Locally based in Weld County, employees involved in this project will offer time- -- efficient and cost-effective responses to clients in need of crisis intervention. We anticipate that 12 clients / family units can potentially be served in a month under the ASSETS program. This program is designed to serve families quickly, efficiently and in a cost effective manner. The maximum length that a family will enroll in the program is two months. The average client will receive direct services for seven weeks. These clients will interface directly with the assigned therapist for approximately three hours in each of the seven weeks that they are enrolled in the program. 2 ILL TYPE OF SERVICES TO BE PROVIDED A. Therapeutic Services The focus of our in-home therapeutic services will rely on building relationships as the key to creating positive change. Our therapists will provide intensive family services including conflict resolution, problem-solving skills, parenting techniques, and communication enhancement. Our assessment tools(Appendix A&B) will provide the basis and direction for our interventions. We will empower families to help themselves by utilizing formal and informal support systems. We recognize the need for the inclusion of additional support systems to enhance the strengths of the nuclear family. Therefore, our therapists see the benefit in developing relationships with close friends, neighbors, grandparents, aunts, uncles, siblings etc. as a means of reaching our primary clients. Our therapists will provide concentrated individual and marital services when and if these issues inhibit effective family functioning. Play therapy for physically and/or emotionally young children will be offered if a need for such services is identified. The therapists working in the ASSETS program will be multifaceted and act as client advocates, liaisons to community agencies, therapists, transporters, and case managers. All therapists will submit required documents to the court to provide information about client accountability and progress. Stillwater Services, LLC has the ability to match the needs of the client to the expertise of our staff Therapists will assess client/family needs, provide direct services, and implement interventions designed to increase family functioning. The basic goal of the ASSETS program is to identify existing assets in client functioning and provide opportunities to acquire additional acsets- Through education and positive role-modeling, we hope to empower our clients to utilize community services that will promote positive, lasting change. B. Concrete Services Stillwater Services, LLC utilizes a strength-based multi-systemic model of providing services. Staff meetings in which family members,the caseworker,probation officer, therapist, and any other relevant system in the client's life will meet monthly. During these meetings, goals for treatment, progress in therapy, and asset building will be addressed. The ASSETS program will build upon on existing family strengths and offer a practical, hands-on approach to helping families develop parenting, coping, and communication skills. Often families need specific instruction on establishing boundaries and using a consistent method of rewards and consequences to shape behavior. We recognize that within each family there exist varying values and beliefs that can influence how interventions are implemented. For example, in Weld County, issues of acculturation versus assimilation are frequently relevant and deserve attention. We aim to explore issues affecting a family unit while teaching ways to live harmoniously. An emphasis on conflict resolution, stress reduction, and problem solving will be apparent throughout treatment. We have found this best occurs when a trusting, 3 safe relationship is developed between the therapist and client. We have leaned that lasting change does not frequently come from sitting in an office and expressing feelings. Rather, our therapists integrate themselves into the fabric of our clients' lives to provide services. It will be expected that therapists connect with families by fixing meals together, playing ball creating a budget,attending quinsineras, helping with household chores, taking a family member to a job interviews, and celebrating success. With the systemic approach to building relationships as the foremost focus of treatment, the development of positive assets will be the secondary emphasis throughout the therapeutic process. The Search Institute has developed a framework that builds positive experiences in the lives of youth Teaching families about how to use the 40 developmental assets to gauge the health of their family is a useful tool not only to measure the success of the program but an ongoing guide for families as well. C. Collateral Services Stillwater Services, LLC seeks to identify existing services or create what is lacking to provide families with community links. Therapists providing service for the ASSETS program have had experience with the youth and existing resources in Weld County for years. A knowledge base of local resources gives our providers the ability to connect clients to community agencies. With long-term success in mind, we aim to help the family foster relationships with local providers that will continue support once termination of the therapeutic relationship occurs. From assessment to termination, our therapists will work to teach families how to utilize existing services such as health care assistance, job training, substance abuse treatment, financial assistance, medication management, and educational services. D. Crisis Intervention Services As local providers, Stillwater Services, LLC has the ability to offer 24-hour emergency assistance. As standard operating procedure, our therapists will prepare the family for potential emergency situations by developing a detailed plan to implement in times of crisis. This plan will include de-escalation steps, resource numbers to call, and a detailed plan for communication among family members. If contacted with an emergency, we are prepared and willing to visit the family at their home in a timely manner to assist in guiding them through a prepared emergency plan. All clients will have access to an on- call therapist who will have background knowledge of the family through weekly meetings where their case and pertinent information is discussed. When confronted with an emergency situation, we will be working in cooperation with other professionals involved in efforts to avoid out-of-home placement. Relapse prevention plans will also be a required piece of the termination process so that clients and their families are left with a step-by-step guide to handling future conflict and crisis. 4 IV. MEASURABLE OUTCOMES Stillwater Services, LLC is committed to providing quality services to youth and their families. The outcome of services provided offers pertinent information about the future direction of treatment. The ASSETS program will provide its clients and referring agencies assessment tools to point out the strengths and weaknesses of the interventions used. Ultimately, our interventions target keeping the identified client in the home at the time the case is closed. This is accomplished by increasing the ability of parents to handle conflict with their children and manage their household in a positive and controlled manner. If the parents are able to improve their parenting competency and manage their household in a positive, consistent manner, it is likely that the identified client will remain in the home 12 months after the case is closed. Since the parents are the focus of many interventions, youth who are out of the home initially can return home to receive reunification services with their families and expect similar results. Families who have had reported child abuse allegations can also expect to receive family therapy services aimed at providing them with realistic expectations and guidelines by which they can manage their household without violence. These services will improve their parenting competency to the level where they will not have any substantiated claims of child abuse in the 12 months following treatment. All family units that receive treatment services will show improvement on all measurements and risk assessments administered at the conclusion of treatment services. We will utilize pre-and post-treatment instruments to measure the success of our treatment services (See Appendix A&B). These pre- and post-treatment data sheets will give valid insight into the success of our clients. We are hoping to build positive assets and reduce the number of days away from school,out-of-home placements, severity of legal charges, and amounts of illegal substances used. The ASSETS Program believes that by monitoring the acquisition of both internal and external assets it will give a clear picture of the ability of both the individual client and family to function effectively. Detailed below are some of the benchmarks of the 40 developmental assets and the correlating objectives measured in the pre-and post-tests. External Assets The first 20 developmental assets focus on positive experiences that young people receive from the people and institutions in their lives. Four categories of external assets are included in the framework: Support-Young people need to experience support,care,and love from their families, neighbors,and many others. They need organizations and institutions that provide positive, supportive environments. Empowerment-Young people need to be valued by their community and have opportunities to contribute to others. For this to occur, they must be safe and feel secure. 5 Boundaries and expectations-Young people need to know what is expected of them and whether activities and behaviors are "in bounds" and "out of bounds." Constructive use of time-Young people need constructive, enriching opportunities for growth through creative activities, youth programs, '" congregational involvement, and quality time at home. Internal Assets A community's responsibility for its young does not end with the provision of external assets. There needs to be a similar commitment to nurturing the internal qualities that guide choices and create a sense of centeredness,purpose,and focus. Indeed, shaping internal dispositions that encourage wise,responsible, and compassionate judgments is particularly important in a society that prizes individualism. Four categories of internal assets are included in the framework: Commitment to learning-Young people need to develop a lifelong commitment to education and learning. Positive values-Youth need to develop strong values that guide their choices. Social competencies-Young people need skills and competencies that equip them to make positive choices, to build relationships, and to succeed in life. Positive identity-Young people need a strong sense of their own power, purpose, worth, and promise. By documenting a family's acquisition and use of the 40 developmental assets, we believe that we will have a practical measure of a family's ability to function effectively. Not only will this be useful information for professional and referral agencies,but this can serve as an ongoing guide to the family as well. The assessment detailed in(Appendix B)will serve as an indicator of the clients functioning in a number of different areas. This information will additionally be an indicator of family improvement. For example, as parental involvement and supervision increase,the number of socially unacceptable behaviors will likely decrease. The information on these data sheets will be collected at quarterly intervals for the year following treatment,providing factual information that will be the foundation for determining our success. 6 V. SERVICE OBJECTIVES Research suggests that low family emotional warmth, low monitoring, and high family conflict are contributing factors of delinquency. Therefore, improving family functioning and supervision will receive a concentrated effort. Research indicates that therapists encourage families to increase the amount of emotional warmth that they show to their children by role modeling positive behavior and educating parents on ways that they can show care and concern for their children. The ASSETS program will stress the importance of appropriate supervision and monitoring as parents learn how to establish boundaries with their children Pointing out barriers to effective communication and showing parents how they can communicate positively with their children will be an on-going therapeutic component. We are able to gauge our success in this area by utilizing the "40 Developmental Assets Checklist" as a pre- and post-treatment • measure. In addition to improving the family's ability to manage conflict, it is important that we also teach effective parenting techniques. The ASSETS program will help parents establish clearly defined expectations and enforce them consistently. When parents are able to have their expectations clearly defined and consistently enforced, children often rise up to meet those expectations. We are able to utili7r the parents' strengths and their desire to become better parents to challenge them in a non-threatening way. Many parents are in need of learning basic parenting skills like how to set appropriate boundaries and curfews for their children. Gathering the specific information on the above data sheet will be a valid measurement tool in evaluating parental competency. As parenting competency increases, school attendance will increase; substance use and police contact will decrease. We also help parents establish age-appropriate household chores and responsibilities for their children in efforts to increase their ability to manage their household effectively. This includes instructing parents to educate their children how to clean their rooms and the common areas of the home. As the children increase in age, parents will increase the amount of responsibility that they require of their children. This would include education about cooking, shopping, outside employment, financial management, and home/auto maintenance. This increased responsibility would enable their children to be semi-independent and surrey ful in many other areas of their lives. In order to improve the likelihood that youth and their families will be successful upon termination from the program, we as therapists must be able to help the family foster necessary formal and informal relationships in the surrounding community. This would include encouraging the family to seek informal support from their extended family and utilize these - resources to help monitor, mentor, educate, and transport their children. Ongoing support from the medical, school, and church communities are more formal forms of support that will be encouraged to help the youth and family remain successful after the therapeutic relationship is terminated. vL WORKLOAD STANDARDS Stillwater Services, LLC will expect a maximum number of 28 hours of involvement per raw. This includes 20 hours of direct therapeutic service to the family, 4 hours of case management and 4 hours of supervision. During the intensive family therapy component there will be a minimum requirement of three hours of interaction per week. Including the founders of the ASSETS program, Nathan Buxman and Shari Simmons, an additional bilingual therapist will provide therapeutic services. A maximum of five clients per therapist will constitute a full caseload. These therapists will be matched with the families according to their varying backgrounds, specialties, and knowledge base. The ASSETS program will not be limited to one theoretical treatment modality. The program will maintain a multi-systemic approach that is designed to utilize present-focused, action- oriented interventions. These interventions target behavior patterns within multiple systems that contribute to the identified problem. Interventions are designed to require on-going, consistent effort from family members. Our interventions are designed to promote long-term therapeutic change by encouraging family members to empower one another and meet needs that span across multiple systems. The ASSETS program holds to the premise that different people possess varied learning techniques, communication styles, and processes of internalization. Therapists will work on a family's case an average of 14 hours per month, for two months. This average is subject to change given the requests of the referral agency and client needs. One licensed therapist will supervise the two masters-level therapists. Biweekly staff meetings, in which all therapists and supervisors meet to discuss the progress of each client, will be held. It is at this time that monthly progress notes, weekly written summaries of contact, payroll, and any required court reports will be due. Discussion of cases is mandatory so that all members of the ASSETS program have arress to accurate, timely information regarding clients. We will require that all therapists be updated on cases so that any ASSETS practitioner could effectively deal with a client in an emergency situation. The purpose of monthly team meetings will be to accrue a collaborative effort in formulating ideas, providing resources, and creating non-traditional forms of intervention that would promote positive change within a family. Additional one-on- one supervision will occur monthly. Stillwater Services, LLC carries general liability, activity and worker's compensation insurance to cover both supervisors and all employees working on this project. Stillwater Services, LLC believes in the effectiveness of meeting clients "where they are at" both physically and emotionally. We feel that integrating into the family environment includes spending time in clients' homes, with their friends and families, at school, in their churches, and at their local "hang-outs". Therefore, physical locations for the services provided will be as varied as meeting in a client's home, at a local restaurant, at the ball park, in a church, driving in a car to an appointment, at school, or at a relative's/friend's home. Due to the flexibility and development of a relationship that offering in-home services can afford, clients are free to access their current therapist at any time for assistance. Pager and/or cell phone numbers of assigned therapists will be given to clients to utilize in race of an emergency. 8 VII. STAFF QUALIFICATIONS Therapists providing intensive family therapy services to clients in the ASSETS program will be required to possess a master's degree in a human services field (i.e. Social work, Psychology, Sociology, Child Development, or School Counseling) and be supervised by a licensed therapist. Proof of training and/or course work in crisis intervention, diagnostic measurement, child development, cultural sensitivity, and intervention implementation will also be required. Any supervisor in the ASSETS program will be required to hold a masters degree in one of the above mentioned human service fields. Stillwater Services, LLC also requires that all employees working with youth and/or their families undergo a CBI check, Central Registry Check, possess valid auto insurance, have proof of on-going liability insurance, and be able to provide transcripts. This information will be required documentation prior to the hiring of any staff within the Stillwater Services, LLC organization. It is projected that staff working within the ASSETS program will consist of the two founders, who will serve as supervisors and service providers. The program will utilize an additional bilingual therapist. At least one therapist will exclusively serve the South Weld County region. _.. Stillwater Services, LLC holds a firm belief that it is important to obtain new, fresh ideas and knowledge about changing intervention strategies and programs. Stillwater Services, LLC requires all employees hired to work directly with youth to attend all mandated training by Social Services. Additional training on assets training, restorative justice, crisis intervention, and youth/family services will be encouraged and paid for by the company. Prior to employment, Stillwater Services, LLC must have proof that potential employees have knowledge of the Risk Factor Intake Assessment utilized by Social Services, as well as risk assessment guides provided by the company. Employees will be placed on a three-month probationary period in which they must demonstrate the capability of accurately assessing client and family needs. They must exhibit the ability to develop a rapport and a relationship that will lead to the implementation of creative interventions. Therapists must also show knowledge of community services and the ability to link clients to these resources. Therapists with areas of expertise in marital therapy, play therapy, or translation will be matched appropriately to client nerds. In addition, Stillwater Services, LLC hires both male and female therapists. Stillwater Services, LLC has identified a need for culturally-based services to be provided to the youth and their families in this community. To address this need, the ASSETS program provides bilingual and multicultural therapists. All therapists and are required to possess knowledge of cultural issues, sensitivity, and respect. It is the hope of Stillwater Services, LLC that by providing the above stated services, the youth and families of Weld County will have the opportunity to become successful members of the community. 9 VIII. COMPUTATION OF DIRECT SERVICE RATE-PHASE I-INTENSIVE A- Total Hours of Direct Service per Client 20 Hours [A] Total Clients to be Served 68 Clients [13] Total Hours of Direct Service for Year 1360 Hours [C] (Line [A] Multiplied by Line [B]) Cost per Hour of Direct Services $ 55.09 [D] Total Direct Service Costs $ 74,922 [E] (Line [C] Multiplied by Line [D]) Administration Costs Allocable to Program $ 5,131 [F] Overhead Costs Allocable to Program $ 3,789 [G] -- Total Cost, Direct and Allocated, of Program $ 83,842 [H] (Line [E] Plus line [F] Plus Line [G]) Anticipated Profits Contributed by this Program $ 10,000 [1] Total Costs and Profits to be Covered by this Program (Line [H] Plus Line [I]) $ 93,842 [J] Total Hours of Direct Service for Year 1360 Hours [K] (Must Equal Line [C]) Rate per Hour of Direct, Face-to-Face Service to be Charged — To Weld County Department of Social Services $ 69.00 [L] 10 Core Service Budget Computations A. Job Description, Minimum Certification & Hourly Rate In Home Therapist (MA) $35/hour Mediation Therapist (MA) $35/hour Life Skills Coach(Diploma&Experience) $17/hour Life Skills Instructor (MA) $35/hour B. Non-Direct Service Costs Supervision $35/hour Therapy Case Management $35/hour Life Skills Case Management $35/hour C. Administration Costs $ 20,525 Annually Phone/Fax Office Supplies Mileage D. Overhead Costs $ 15,114 Annually Health Insurance Accountant Conferences Professional Insurance PO BOX Equipment E. Programs Involved & Percent Allocated In Home Therapy/Assets Program 25% Brief Therapy/Mediation Program 25% Life Skills/ Smart-Start Program 25% Outside DSS 25% F. Total Administration Costs/Program $ 5,131 G. Total Overhead Costs/Program $ 3,779 Appendix A 40 Developmental Assets _ Asset Type Asset Name Definition Yes No I. Family Support Family life provides high level of love and support 2. Positive family communication Parents and youth communicate positively;youth is willing to seek parents advice and counsel _ 3. Other adult relationships Youth receives support from three or more non- , Support parent adults 4. Caring neighborhood Youth experiences caring neighbors 5. Caring school climate School provides a caring,encouraging environment _ 6. Parent involvement in schooling Parents are actively involved in helping youth succeed in school 7. Community values youth Youth perceives that community adults value youth . d 8. Youth given useful roles Youth are given useful roles in community life an m 9. Community service Youth gives one hour or more per week to serving Empowerment in one's community 10. Safety Youth feels safe in home,school and neighborhood 11. Family boundaries Family has clear rules and consequences;and W monitors whereabouts 12. School boundaries School provides clears rules and consequences 13. Neighborhood boundaries Neighbors would report undesirable behavior to Boundaries family and 14. Adult role models Parent(s)and other adults model prosocial behavior ..— Expectations 15. Positive peer influence Youth's best friends model responsible behavior I6. High expectations Both parents and teachers press youth to achieve -- 17. Creative activities Involved three or more hours per week in lessons or practice in music,theater,or other arts 18. Youth Programs Involved three or more hours per week in sports, Time Use clubs,or school/community organizations 19. Religious community Involved one or more hours per week 20. Time at home Out with friends"with nothing special to do,"two or fewer nights per week r 21. Achievement motivation Youth is motivated to do well in school 22. School engagement Youth is actively engaged in school 23. Homework Youth reports one or more hours of homework per dal Educational 24. Bonding to school Youth cares about his/her school _ _ -. Commitment 25. Reading for pleasure Youth reads for pleasure three or more hours per weel 26. Caring Youth places high value on helping other people 27. Equality and social Justice Youth places high value on promoting equality and reducing hunger and poverty +a.. Values 28. Integrity Youth acts on convictions,stands up for his/her beliefs to 29. Honesty Youth"tells the truth even when its not easy" m on 30. Responsibility , Youth accepts and takes personal responsibility "ot31. Restraint Youth believes it is important not to be sexually activt 4 or to use alcohol or other drugs M 32. Planning and decision making Youth has skill to plan ahead and make choices _ —.- 33. Interpersonal competence Youth has empathy,sensitivity,and friendship skills __ 34. Cultural competence Youth has knowledge of and comfort with people of Social different racial backgrounds Competencies 35. Resistance skills Youth can resist negative peer pressure 36. Nonviolent conflict resolution Youth seeks to resolve conflict non-violently „„- 37. Personal control Youth feels he/she has control over"things that happen to me" Positive 38. Self-esteem Youth reports high self-esteem Identity 39. Sense of purpose Youth reports,"my life has a purpose" 40. Positive view of personal future Youth is optimistic about his/her personal future Appendix B Educational Status Is Youth Attending School? Current Grade Level: Has Youth Graduated? Has Youth obtained a GED? Socially Accepted Behavior Last Month 3 months 6 months 1 year Number of days absent from school? Number of days spent in placement ? Number of times ticketed ? Number of misdemeanors? Number of felonies ? Number of convictions ? Socially Accepted Behavior II Please use the following codes to indicate your substance use 01 Less than once a week 02 Once a week 03 Several times a week 04 Once Daily 05 2-3 times Daily 06 3 or more times daily 07 Continuous Use 08 Binge Use 09 No longer use 10 Have Never Used 11 Unknown 12 N/A Alcohol? Marijuana? Cocaine ? Amphetamines ? Hallucinogens? Opiates? Barbiturates? Tranquilizers? Cigarettes ? Inhalants? PCP? Employment Is the youth working? Number of hours worked per week? How long at this job? U3/ 13/6UUJ 11 : 1 :4 American Prof Agency --> P.002/002 Account Number: CO STIL 3360 Date: 3/13/03 Initials: CV CERTIFICATE OF INSURANCE THE DOCTORS' COMPANY C/O: American Professional Agency, Inc. 95 Broadway, Amityville, NY 11701 This is to certify that the insurance policies specified below have been issued by the company indicated above to the insured nand herein and that, subject to their provisions and conditions, such policies afford the coverages indicated insofar as such coverages apply to the occupation or business of the named insured(s) as stated. THIS CERTIFICATE OF INSURANCE NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS, EXTENDS OR ALTERS THE CM/ERAGE(S) AFFORDED BY THE POLICY(IES) LISTED ON THIS CERTIFICATE. Name and Address of Insured: Additional Named Insureds : STILLWATER SERVICES, LLC SHARI SIMMONS P.O. BOX 336058 NATHAN BUXMAN GREELEY CO 80634 BRENT CLAY Type of Work Covered: Mental Health Counselor Location of Operations : N/A (If different than address listed above) Claim History: Policy Effective Expiration Limits of Coverages Number Date Date Liability PROFESSIONAL/ 1,000,000 LIABILITY MHL-5016498 8/01/02 8/01/03 3,000,000 NOTICE OF CANCELLATION WILL ONLY BE GIVEN TO THE FIRST NAMED INSURED ON THIS onrTry Ann UT no cur SROTT APT rim RTUhIr AY OTT rmcntrrnc WTTn vrcpTirm Tfl f:TUTNf: OR RECEIVING NOTICE OF CANCELLATION. -- Comments: This Certificate Issued to: Name: STILLWATER SERVICES, LLC P.O. BOX 336058 Address: GREELEY CO 80634 A horized Representative TravelersPropertyCasualty J WORKERS COMPENSATION mums 7YmelersGrouy AND EMPLOYERS LIABILITY POLICY CHANGE DOCUMENT WC 99 99 98(00) POLICY NUMBER: (IOUB-5387W98-7-03) CHANGE EFFECTIVE DATE: 02-12-03 NCCI CO CODE: 15318 INSURER: THE CHARTER OAK FIRE INSURANCE COMPANY INSURED'S NAME: STILLWATER SERVICES,LLC This change is issued by that member of The Travelers Insurance Companies which issued the policy and forms a part of the policy. It is agreed that the policy is amended as follows: An absence of an entry in the premium spaces below means that the premium adjustment, if any,will be made at time of audit. ADDITIONAL PREMIUM $ 46 RETURN PREMIUM $NIL ADDITIONAL NON-PREMIUM $ NIL RETURN NON-PREMIUM $ NIL The Policy Minimum Premium is amended as follows: Minimum Premium: $ 292 The Policy Expense Constant is amended as follows: Expense Constant: $ 180 -- Pending rates that apply to the policy have been approved by the proper regulatory authority. The new rates are shown below: STATE CODE NO RATE • CO 8868 .90 The following endorsement is added: WC 89 04 15 (00) -001 DATE OF ISSUE: 12-26-02 RA CHANGE NO: 001 PAGE 001 OF LAST POL. EFF. DATE: 02-12-03 POL. EXP. DATE: 02-12-04 OFFICE: ELMIRAPAYROLLPATH 70A PRODUCER: PAYCHEX AGENCY INC SV998 COUNTERSIGNED AGENT TravelersPropertyCasualty I WORKERS COMPENSATION ime..w 7hmekreGmwp Y AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 89 0415(00)- 001 POLICY NUMBER: (I0UB-5387W98-7-03) POLICY INFORMATION PAGE ENDORSEMENT Item#4 is changed to the following: PREMIUM BASIS Total Estimated Rate Per Code Annual $100 of Estimated Classifications No. Remuneration Remuneration Annual Premium SEE CHANGE DOCUMENT OR INFORMATION PAGE SCHEDULE Total Estimated Annual Premium $ Minimum Premium $ Deposit Premium $ ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. • DATE OF ISSUE: 12-26-02 ST ASSIGN: NATIONWIDE LIFE INSURANCE COMPANY PO BOX 2399-COLUMBUS, OHIO 43216.2399 Nationwide Crossroads Insurance Agy Po Box 1010 Ault, CO 80610 RE: Specified Hazard Insurance Policy for VIE427 TON I Stillwater Services Lie 1.1 APR 22 2002 1701 67th Ave Greeley. CO 80634 — $Y Policy No: 502.95-18018 Congratulations on selling this Specified Hazard Insurance Policy! Enclosed are: For your use: - A Priority Fax Order Form to order additional sales brochures and other supplies. - A machine copy of the application for your files. Fnr the Plan Sonnet{) : - The policy delivery letter, the policy, and the claim forms (if applicable). Please sign the delivery letter and countersign the policy (at the bottom of page 6).The policy and supplies should be delivered to the plan sponsor named above. - Individual certificates(if required by the plan sponsor's state) will be mailed within 2 to 4 weeks. Thank you for thinking of Nationwide for your Special Risk Health Insurance needs. Now may be a good time to consider these additional Special Risks Health prospects: CIVIC AND COMMUNITY ORGANIZATIONS such as auxllary police, social clubs, swim clubs, volunteer fire companies, and volunteer service clubs. GROUP ACTIVITIES such as Bible schools, camps and conferences, child day care, picnics, preschools, recreation programs, religious day schools,trips and tours, and volunteer construction and/or repair work. AMATEUR SPORTS such as baseball, basketball,football, soccer, and softball teams, as well as sports camps. YOUTH GROUPS such as drill teams, 4-H-Clubs, marching bands, Scouts, youth fellowships; and ...many others. If you need brochures or any assistance whatsoever, please call our Customer Service Center at 1.600-525.8669 (1-614-854-2196 for Columbus, Ohio area local calls), send us a Fax to 1-614-854-3753, send us e-mail to SpecRsks@Nationwide.com, view our website at www.GrouProtector.com, or write to us at: Special Risks Health Nationwide Insurance PO Box 2399 Columbus, OH 43216-2399 Sincerely, Special Risks Health Department Enclosures which,open acceptance sad POLICY APPLICAnoN latent tayslat or ttyy�,<t) .'..hich, ■put c SPECIFIED approval by NATIONWIDE A Lift DI CE COMP CE POLICY NUMBER 502.95 l •R Okla 932!6 will . i- Name of rwa on:n the Catty) Pew Sponsor /� I � wCl+ter •Set v;ces .LL C (Oroop'r Name) rantaacal MaU(ae Address / 1) • tth • 2 P• (Number) (Sue<t (C;ry, (Stlte - (2 ,) .3� P.(,� a�Tam: Tho policy alma starts at 12:01 a.m. a - "1/ 2.. . 7.0 2 ) (candy) 0(12:01 k.mw R - �7 -q� --�—__ which Is the which i mon pole a dais and pads tcrrttirtahaa dam(up to a 3-month polity tcnu); first renewal date(12.moath policy lent* -^ 3. Covered Activities 4. M•almuBaulkm Baulk Amou. • . .ts�}re ward"None"means the benefit is not included . ACCIDENTAL a l230.00000ENTA DEATH AND SPECIFIC LOSS amid= overall m••• —tor any one maxim an Specific Lou.........._.._.......... c: :: >"\.� — .............._........_. S 1300.00(Face Amount) 3,000.00 J 5.500.00 S 5,000.00 S 7,500.00 /:.. `I. -' " - ActidgttrAL(�E.'isE 000.00 10.000.00 12,000.09/C'i/ <I.O .:/ DeducUbk ":• -� Overall Idea mina None oo.00 10,000.00 25 000.00 50000.00 J��/pe ‘X.:::-,!..* tsar uroe raw sum -''� / S. Premium Hates b Class m of EU Ibis tern Soiic C!ae--e <h Class and Medial Er. nse Plan derived `� r I ca tst.0 COMIC dons portion -ea `\` Clw •Premium Rater Pa E b4 Persoa• . .._. ® Prima PPlan ❑ Y vile 'Tpene All participants EaRtr Plen or all ryico participants and muC in the alternative community' tunics program activities or the ' Plan apoasor(check only box): .-- 1 0 Class*BeatAes WU............-..._....._.._. 2 0 CJaaa T Sank t oar .......".__... $ 0.13 «'^ 3 S 0.07 C4uJDeuBtatwl_........... 0.18 0.12 4 • Class 3 Bearate tar _.-....•'....,....._. _. 0.24 NOT AVAL1A8LE 017 0.23 Pie .n um pvamd.m per Po ty term is 51St'' id- primary planhas ciee 5100,00 item gal . re owns.Ian his . .!cal expenseelected • «.., 6. Tie policy lam cover J(elglbkpumaspeas which include: O E'N aul clpatru y nth or Wparlicipao4 and'taffies 7. It is abderataod and agreed that: (a)the premium will be paid— • made by the eligible persons toward the coat of the. entirely by the plan sponsor with m email-button Isms' -0 la advance as show'on the Preatam Report,borpO In ad ancremium will be band n the soul as e,t premium alas r a►ewn on the Premium Report radvmtu bared oa the meal ma1mHr4 premium- the minimum premium with en audit at the end of the lie.� P m with ibis'moltutioa with the nmatader duce ,s._at la or arrears-nor' - new • / r/ By ma• 4hnri mm Inc /n �mbyr .• �lJO� (Printed ] Name.m rlar.rAppyanr) qq/y (Agent's Signature aMN hi 1 r U U 7 ,{/,[1]-«- CJ/ (Address ofAppllomtel/ ,/ &4 Say"""'' 7,'�?S...1/,� �.;�- it€dive Commedty ServicePcoVam— Y• "' o muu..ar'fq art available la DC.1'8.VI sad.1150 ski., X(T that Oblat coal*stilt group*Oa..ages 20 an over)4 NY. Ctesaess sad2 , !&Plea lad v W md2 ems nvl arallshk�la yfWa0k.4 NJ:1Y 11 •.4••Y perms weo prnyts Glee 10(y pates prisons•Ube er traudaltat pithy relg for and payment oh loss or kOIY primp. application for laminate b fuses and at Ww Y be subject to bath and t•rN•emart m 901.P2/rsr • . _ 405GFJ-1.1420 — PREMIUM REPORT*This report m.yg be completed when Individual DAILY premiums are used for Application to be accepted. Age Range of Participants(not staff):_j, v'_ [i_years of age 'Not required If policy is renewable and has"in arrears"billing. Covered Total Maximum Daily Dates)of Premium Total Number Premium Per Number of Coyer, Activity Rafe of Days Eligible Eligible ActivityDue t .ya I .. y Person Persons Premium c ti .o.11 S Crier Jro p as X i 1�9. 7k `___-. `S _Prix li r.. -" g x _�_- b-•c l, __ �___-S�_X -f ~� ~` s ��. S X a$ �� - aLL h relatc1�f{ X"_� -:�--.�� x �_ S Total premium due(subject to policy minimum').................................................... .X�� =$ If renewable,the estimated number of eligible ..r. l ling frequency s. 9 persons'The annual minimum premium is$150.00 for prima • a per billing frequency is . I certify that to The best of my knowledge and primary medical and$100.00 for excess. I cerid ror the total number bestof eligible g belief(1)the preceding information is correct and complete;(2)premium is being plan sponsor with no contribution tlonomawho by the eligible to be insured;and(3)the premium k beingInsurance. paid entirely by the q by(onT vintners(] 1 O a _La tners SIGNATURE 040 Tm.EJ «. MAY TNONe NU►IefiR) ( 1 (rA 1itodi Rj If additional s•- NOT'!; ce•µup ADDRESS) is required, use a separate sheet • RECEIVED — ern .nos t(1003) - APR 1 2 2002 SI'ECaL FiI3K5 HEALTH AMERICAN FAMILY MUTUAL INSURANCE COMPANY AUTOMOBILE INSURANCE IDENTIFICATION CARD MADLSON,WISCONSIN 57703.0001 THIS CARD MIST BE CARRIED IN THE INSURED MOTOR VEHICLE SHELTER GENERAL INSURANCE COMPANY 1-800-SHELTER 1817 W. BROADWAY COLUMBIA, MO. 65218-0001 AGENT: ANDREW J GOLDFARB 303-444-2663 COLORADO MOTOR VEHICLE POLICY NO. 05-1-C-3134638-6 PROOF OF INSURANCE CARO EFFECTIVE DATE 01-29-2003 EXPIRATION DATE 04-29-2003 Policy No: 0763-2029-01-70-FPPA-CO" 1996 CHEVY BLAZER 4WD 4DR VIN 1GNDT13W5T2125493 Eff Data: 10-15-2002 Exp Date: 4-15-2003 1999 CHEV SC1 VIN: 20CEC19V6%1134835 NO FAULT-PPO WITH CORVEL CORPORATION C : BIPD UN UIM COMP COLL PIP FOR PARTICIPATING PHYSICIANS, CALL 1-800-473-5293 BUXMAN,AN 23361 337 AN, AVNATHAN 53RE GREELEY CO 80634-4223 SHARI SIMMONS GREEL EY CO 7TH AVE Agent: DONNA FEIGHNY-YANTIS Agent Phone: (970) 351-6528 ---- - --- - -"- This card must be carried in the insured motor vehicle for production upon demand. Important message on reverse side. vACTIVE LCSW 9918.4 i"s a ,j 001 a'`,r a 103, issu`..,. j LIED & .:"- ittang,A'' LYN TD- SIMMONS' DEAN IRCLE-! W" � OV,ELAN rCo 80537 ',` _ - BRUCE 14:M DOUGLAS " x l DIRECTOR DIVISION OF REGISTRATIONS GQENSEE'S SI�GNA7uNE a a,%��„).3 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-LS 0003 Revision (RFP-FYC-03005) Contract Award Period Name and Address of Contractor Beginning 06/01/2003 and El Mundo de Esperanza(A World of Hope) Ending 05/31/2004 Lifeskills-Smart Start P O Box 336058 Greeley, CO 80034 Computation of Awards Description Unit of Service The issuance of the Notification of Financial Assistance Award is based upon your Request for Proposal(RFP). Smart Start focuses primarily on preparing youth The RFP specifies the scope of services and conditions for the workforce,however, family members will of award. Except where it is in conflict with this be called upon as active participants in NOFAA in which case the NOFAA governs, the RFP supporting and maintaining accountability. upon which this award is based is an integral part of the Youths are matched upon reaching the third action. phase of the program to an employer who has Special conditions agreed to offer a 60-day internship,up to 20 1) Reimbursement for the Unit of Services will be based on hours per week. A Job Coach will meet with an hourly rate per child or per family. each employer and the assigned youth on a 2) The hourly rate will be paid for only direct face to face monthly basis to complete the Individualized contact with the child and/or family as evidenced by Development Plan (IDP). The program serves client-signed verification form and as specified in the youth ages 16-18. Capacity to serve 120 clients unit of cost computation. through the funding year. Monthly average 3) Unit of service costs cannot exceed the hourly and yearly program capacity is 20. It is estimated that 40 of cost per child and/or family. the 120 clients would receive Bilingual-bicultural 4) Payment will only be remitted on cases open with, and services, and 40 of the 120 clients being served referrals made by the Weld County Department of Social will reside in South County. Services. 5) Requests for payment must be an original submitted to Cost Per Unit of Service the Weld County Department of Social Services by the end of the 25th calendar day following the end of the Hourly Rate Per $42.19 month. The provider must submit requests for payment Unit of Service Based on Approved Plan on forms approved by Weld County Department of Enclosures: Social Services. X Signed RFP:Exhibit A Supplemental Narrative to RFP: Exhibit B Recommendation(s) Conditions of Approval Approval . Program Official: By By David E. Long, Chair Jud . Grieg Directo Board of Weld County Co 'ssioners Wed ounty epartmen of Social Services Date: V-3v-cioa3 Date: `C� 2vo3 /CIO EXHIBIT "A" f 5MAKT- 5TAKT r I Mundo cle r Speranza CA Wore of hope) r r " I quipping the youth of Weld County with the r r value base, work, ethic, anc skills necessary to succeec in the community." 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 a.m. The Families, Youth and Children Commission, an advisory commission to the Weld County Department of • Social Services, announces that applications will be accepted for approved vendors pursuant to the Board of Weld County Commissioners' authority under the Colorado Family Preservation Program Act(C.R.S. 26-5.5- 101) and Emergency Assistance for Families with Children at Imminent Risk of Out-of-Home Placement Act (C.R.S. 26-5.3-101). The Families, Youth and Children Commission wishes to approve services targeted to run from June 1, 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 03-i N -03 rBh ; Vim.,at) (After receipt of order) BID MUST BE SIGNED IN INK Shari Sin-mnn.S I gill,,. J 6Nxm+h TYPED OR PRINTED SIGNATURE VENDOR El YihLLndo de ESperanzct, (Name) Handwritten Signature By Authorized Officer or Agent of Vender ry ADDRESS PD finx 33G,DS S TITLE Smart - Sf2rt _ Greeley, CO g0io3 DATE 03- 14-03 - PHONE# (97O) +05-4803, 40.5-49O2 The above bid is subject to Terms and Conditions as attached hereto and incorporated. Page 1 of 32 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: El jm. ncLo cM Esperanza. ADDRESS: Po 13ox 336O52 (ree l e y , Co 801034- ,- PHONE: (.9 70) 4-05-4-go3 > *US-42o2 CONTACT PERSON: Shari Simmons TITLE: Therapi Si` 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 June I, 2003 End May 31, 2004 End may 31, 2004- -- TITLE OF PROJECT: Sinn ar-J- - S-1-ar AMOUNT REQUESTED: 42 . 1 9 per h our Shari SI(tun OnS ,�l►afrl, ik neMan err)4_.) 03. 14-- 03 Name and Signature of Person Preparing Document Date — Judy A.Griego,Director Name and Signature Chief Administrative Officer Applicant Agency Date MANDATORY PROPOSAL REQUIREMENTS For both new bids and renewal bids,please initial to indicate that the following required sections are included in this Proposal for Bid.For renewal bids,please indicate which of the required sections have not changed from Program Fund Year 2002- -2003 to Program Fund year 2003-2004. Indicate No Change from FY 2002-2003 to 2003-2004 4,Ik Project Description Q Target/Eligibility Populations ,,.4.A, Types of services Provided Measurable Outcomes Service Objectives r4„6g Workload Standards A& Staff Qualifications 4k Unit of Service Rate Computation Program Capacity per Month U4, Certificate ofInsurance 44_ Assurance Statement Page 26 of 32 RFP-FYC-03005 Attached A Date of Meeting(s)with Social Services Division Supervisor �� 3 Comments by SSD Supervisor: /� o-n- f— �_ SEE �cG awl // Con G� /_ l�4 C.� c.4 1, e1 (/ "M Name and Signature of SSD Supervisor Date Page 27 of 32 The Smart-Start project is the first adolescent-driven program offered through El Mundo de Esperanza(A World of Hope). El Mundo de Esperanza is a nonprofit, Weld County organization dedicated to developing a"teen empowerment center" in Greeley for youth ages 14- 21. El Mundo de Esperanza will oversee the teen center that will eventually house several programs and opportunities for teens. The Smart-Start project will be the first program to eventually fold into the El Mundo de Esperanza teen center. The urgency in offering such a program at the present time evolved from interviews with local professionals and youth advocates about what was most needed given the recent budget crisis in the human services industry. Overwhelming response by area professionals indicated that programs which focused on training older adolescents in preparatory job skills and solidifying positive work ethic would be most beneficial at a time in which the luxury of spending money on costly residential and outpatient treatment is decreasing. PROGRAM DESCRIPTION The founders of Smart-Start believe that the single largest indicator of success in youth today is their ability to feel empowered, needed, and productive. The Smart-Start Program will provide the value base needed to establish positive work ethic, skill building, and on-going support to youth making the transition from adolescence into early adulthood and its coinciding job market. The Smart-Start project is a 16 week program designed to provide a comprehensive, multi- - modality curriculum to youth ages 16-18 who are seeking employment. Each youth referred will be matched with an experienced Job Coach and immediately undergo a life inventory and career assessment from the What Color Is Your Parachute Workbook by Richard Bolles. A condensed version of this career assessment is displayed in(Appendix A). If a client would rather undergo a computerized assessment, Smart-Start has access to several different programs and has additionally made an agreement to work closely with the Weld County Job Services to utilize some of their career testing. After completing the required Customer Service Module, youth will then select five of the following six Smart-Start Modules and upon completion, will receive a stipend to obtain clothes appropriate for interviewing. • Reliability on the Job: • Stress Management ^' • Living Clean and Sober a • Conflict Resolution • Anger Management a • Problem Solving • Customer Service (Required) Each class will be offered every six weeks and run for approximately 2 hours in duration. 1 TARGET ELIGIBILITY POPULATIONS The Smart-Start Project will employ four job coaches, each with the capacity to serve a caseload of 10 clients ranging in age from 16 to 18. Based on current demographics and need in Weld County, it is anticipated that the Smart Start program could provide services to 120 clients throughout the 2003 -2004 fiscal year. A total monthly maximum program capacity would be 40 clients with an anticipated average of 20 clients. It is estimated that 40 of the 120 potential clients would receive biculturaVbilingual services. To accommodate multicultural needs, the Smart-Start Program will employee two bilingual staff. It is also estimated that one-third of the estimated 120 clients could potentially be located in the South Weld County region. One Job Coach housed in this area will be adequate to carry such a caseload. Smart-Start focuses primarily on preparing youth for the workforce, however family members will be called upon as active participants in supporting and maintaining accountability. Parents, siblings, and other relatives will be welcome additions to the treatment team, as it is believed that youth who have solid systems of support have an increased likelihood for success. Once the initial assessment phase is complete, the youth has successfully participated in all required classes, and purchased his/her new attire appropriate for interviewing, the third phase of the program begins. In accordance with the youth's interests and career assessment indicators, youth are matched to a local employer who has agreed to offer a 60-day internship, up to 20 hours per week. The Job Coach will meet with each employer and the assigned youth on a monthly basis to complete the Individualized Development Plan- IDP (See appendix B). The focal point of these meetings will be to establish goals and objectives, assess work ethic, and track progress on the job. In the IDP, any strengths the youth possesses will be built upon and any areas of improvement will be detailed with accompanying strategies for improvement. Based on years of experience in working with youth in Weld County, it is anticipated that potential problem areas for teens in the workforce might be tardiness, lack of productive work ethic, conflict with co-workers and authority, and poor customer service skills. Each monthly assessment will serve as a tool for learning, skill building, and addressing these potential problem areas. If the youth has other service entities involved with them, such as Social Services, Probation, Department of Youth Corrections, Mental Health, or any Substance Abuse treatment providers, the Job Coach will initiate a staffing mid way through the internship to discuss the youth's IDP. It is at this staffing that future plans after internship completion will be explored. At the end of each internship, a youth will receive a letter of recommendation along with their newly acquired job skills or an offer for permanent employment. It will be the responsibility of the youth and Job Coach to find permanent employment elsewhere if a position has not been offered by the internship supervisor. - The final phase of the Smart-Start project will gear youth toward termination. This phase will include the Job Coach solidifying permanent employment and determining the budgeting and independent living skills of the youth. In preparation for the next phase of life, each youth will be asked to demonstrate their knowledge of how to live successfully within the community by budgeting correctly, locating community resources, obtaining housing, utilizing transportation, ^• 2 maintaining employment, and displaying healthy coping skills. If work is needed in one or more of these areas, the Job Coach will ensure that each youth has access to the education necessary to display the above-mentioned skills and function appropriately in society prior to discharge. It is estimated that youth will spend an average of 16 weeks in the Smart-Start Program. TYPE OF SERVICES TO BE PROVIDED The ultimate goal of the Smart-Start project is to equip youth with the value base, work ethic, and skills necessary to succeed in the work force. The Smart-Start team, consisting of therapists and mentors who have offered quality services in Weld County for years believe that while "traditional"treatment methods can be beneficial for older adolescents, many times funding can be better spent on preparing youth to succeed in the community through tangible means. Job Coaches employed in this program have witnessed first hand what working can do emotionally for a young person. Youth, not unlike adults, have a need to feel productive and useful in society. Older adolescents frequently glean a sense of empowerment and esteem when exhibiting a learned skill and in turn, receiving compensation for it. For youth to succeed in the work force, two components must co-exist: learned skills and the positive value base to draw from when exerting those skills. Frequently, well meaning treatment providers and employers attempt to teach youth the skills necessary to carry out a job but neglect to instill the components of a positive work ethic. Treatment providers have witnessed this before when a youth who has made his/her living for years by selling drugs is suddenly asked to work at a local fast food restaurant, making minimum wages. In a case such as this, the youth will often feel deflated and unmotivated to follow through with fast paced, energy draining work because no one has helped that youth readjust his/her value base about working and making money through legal means. r The Smart-Start project has developed training modules required for each youth that will address values that are consistent with productive employment. Through classes that offer a range of learning modalities from role-playing to video vignettes to homework assignments, youth are challenged to incorporate positive values and work ethic into their worldview. Employer expectations such as reliability on the job site and friendly customer service skills will be discussed and practiced. Specific tools for how to manage stress and conflict will be introduced and rehearsed. Because so many youth of today possess poor anger management skills and have a limited repertoire of coping skills, specific courses on effective ways to manage anger and how to develop relapse prevention plans will be offered. Youth must display a high level of participation and concept internalization prior to advancing to the next phase of the program. Once it has been determined by the Job Coach that a healthy value base and work ethic exists, youth are rewarded with a stipend that will be used for appropriate interviewing attire. (Examples of class curriculums and worksheets are displayed in Appendix C) From the on-set, Job Coaches will enlist the"buy-in"of the program from support systems the youth possesses i.e.: family members, neighbors, friends, church associations, and teachers. Coaches will fully explain the program to potential support systems and encourage their support. Additionally, they will assess family attitudes about employment and conduct a family meeting prior to the career assessment that the youth will undergo. At this family meeting,the Coach 3 will educate the family and other significant support systems about the level of commitment needed for the program. Together, the Job Coach, the youth, and systems of support will develop an Individualized Development Plan- IDP (Appendix B). This plan will detail the youth's goals and objectives in obtaining employment. It will additionally outline the youth's current value base, work ethic, and present skill base. This team will establish an appropriate timeline and accountability measures to ensure each youth's success. Upon employment, Job Coaches in the Smart-Start Program are given a job description, detailing expectations with their adolescent clients(See Appendix D). It will be the job of each coach to model and assist with integrating the skills that are learned in the classroom modules. Job coaches will be familiar with the curriculums and reinforce the concepts learned by their clients during the week. Following classroom learning, the youth will be placed in an internship. At this point,the Job • Coach will leap into action by meeting with the youth and intern supervisor to clarify the Individualized Development Plan started weeks prior with the youth's family and support systems. It is the Coach's job to assist the youth with incorporating classroom learning and establishing goals and values for the workplace. It is usually 4-6 weeks into a new job that a youth will begin to feel relaxed and confident enough to "test the waters". It is often at this juncture that youth will begin to show up late for work, allow the stress of working to affect their choices, and begin to question the authority of their supervisors. Job Coaches will be proactive in this regard and through weekly contact with both the youth and intern supervisor, assess the youth's functioning. Preventatively, the Job Coach will encourage youth to verbalize positive work ethic and values. It is believed that the more youth can verbalize new values,the more it will become an engrained piece of their identity and ethical composition. Job Coaches will assess workload, school obligations, and family life on a weekly basis and assist each youth in how to find emotional and spiritual balance. Most teenagers are still developmentally at a stage in which they are motivated by immediate gratification and often do not possess the coping strategies needed to handle a stressful work environment. Job Coaches will lend their expertise to educating parents on this developmental phase and create a prevention plan that will include the following skills: • Teaching each youth how to keep track of dates and appointments in a day timer • Developing stress management techniques • Establishing weekly goals and tracking progress on those goals • Identifying rewards when goals are accomplished • Saving and appropriately filing important documents in a filing system • Setting up a savings and/or checking account and balance an account • Learning how to budget money by adhering to an agreed upon cost inventory • Prioritize important events and role play how to request time off work for these events from a supervisor • Locating and beginning to utilize public transportation and other community connections and resources 4 Job Coaches will visit with each of their assigned clients once per week. Additionally, the coach will contact each intern supervisor by phone on a weekly basis. Job Coaches will meet personally with all youth and intern supervisors once a month to review the IDP. It will be a Job Coach requirement that each phone interaction and physical face-to-face contact be properly documented according to the DAP style (See Appendix E for sample documentation). DAPs will be faxed weekly to Smart-Start supervisors for review. The Smart-Start Program in sequential order will look in its simplest form like the following: Job Acquisition/ Living Skill Assessment (3 Weeks) Intemship/IDP Assessment (8 Weeks) Learning Modules ..� (3 Weeks) Career Assessment and Job Coach Match (2 Weeks) MEASURABLE OUTCOMES The ultimate goal of the Smart-Start Program is to educate, train, and employ Weld County youth in jobs where they can feel empowered and contribute to society. Due to the infancy of this project, pre and post testing will be a high priority for the Smart-Start program to flourish. Program supervisors are interested in what skills and values youth will enter the program with and what they will have incorporated upon program discharge. To evaluate youth's initial value base regarding work ethic, conflict resolution, reliability, honesty, stress management, etc. the Smart-Start Program will administer the 40 Developmental Assets pre-test (See Appendix F). Our staff support what Search Institute has identified as the 40 key developmental assets to ensuring success in youth today. Asset-building offers a set of benchmarks for positive adolescent development. External assets include: Support, Empowerment, Boundaries/Expectations, and Constructive Use of Time. Internal assets include: Commitment to Learning, Reliability, Social Competency, and Positive Identity. Youth will be asked to use the instrument again, serving as a post-test upon completion of their internship. One final test will be given as a follow-up six months after the youth has graduated from the program to assess if learned values have remained incorporated into the youth's moral code. Research on the "assets approach" indicates that assets are powerful influences on adolescent behavior because they protect young people from different problem behaviors and promote positive attitudes. The more assets young people experience, the less likely they are to engage in a wide range of risky behaviors, and the more likely they are to engage in positive behaviors. The desirable outcome would be that youth develop or in some cases"fine tune"the value base from which they operate through classroom activities, repetition of these values during meetings with their Job Coaches, and accountability documented in their IDP. Allowing a positive moral code to drive their work experience will allow youth to obtain employment that gives back to them as they are lending their skills to the community. To assess job skill performance upon entering the program, Job Coaches will administer the IDP and correlating Skills Assessment created by Richard Bolles and displayed in his book, What Color Is Your Parachute (See Appendix G). These instruments will be administered again upon internship completion and once again six months after discharge from the program. Both of these instruments were chosen for their simplicity and ability to captivate the attention of adolescents. In addition,they both address the two major areas that Smart-Start employees want to evaluate in youth: value base and job skills. It is anticipated that the measurement tools selected will give referral sources comprehensive information of the effectiveness of the program. Instruments will measure a youth's capacity for assets and values that parallel positive work ethic. Following concept introduction in the required modules,the repetition of concepts discussed in weekly meetings with the job coach, and the gratification that comes with excelling in the work force; it is anticipated that youth will possess the following at the end of their commitment to the program: • An improved capacity for qualities inherent in a model employee such as ethics, honesty, reliability,customer service, adaptability, copability, timeliness, cohesion among a team, motivation, and stress management. • An improved ability to locate and connect with community resources that will enable youth in the workforce such as: a transportation system, budgeting assistance, renters information, substance abuse prevention groups, affordable health care, banking needs, and prosocial activity list. • A reduced risk of non-compliance, defiance of authority, and conflict on the job. • An improved ability to glean job skills and advance in the workforce. • A higher likelihood of success in the community as a young adult due to the opportunity for ethics and job skill training. • Improvement in the management of life circumstances with the ability to utilize healthy coping strategies. In addition to these forms of measurement, Job Coaches will also evaluate youth through observation and verbal accounts of youth progress from support systems, their internship 6 A— supervisors, and through self-report. Proper evaluation of the youth's outcome promotes quality services. With that in mind,evaluation and the tools selected for measurement will be an important component to the Smart-Start Program. SERVICE OBJECTIVES As stated the in Smart-Start mission, it is anticipated that this program will equip the youth of Weld County with the value base, work ethic, and skills necessary to succeed in the community. The objectives required to accomplish that goal are that the youth entrusted to the program will have the opportunity to be challenged on their existing value basis and personal code of ethics. Research in vocational training for youth indicates that without this important component, youth enter the workforce without a strong basis for why they are there and what skills it will take for them to remain employable. Through classroom learning, youth will be presented with the 40 Developmental Assets, a highly acclaimed youth learning tool proven effective across the country. Youth beliefs about employment and management tools necessary to maintain employment will be tested, challenged, and in some cases, relearned. With adaptive strategies and a beginning basis for value building, youth will then receive hands- on training in a job that falls within their identified interest level. So often well-meaning professionals attempt to place youth in a job that either doesn't interest them or is not socially acceptable to their peers. For a youth attempting to enter adulthood with a fresh start, this can often be damaging and deflating. Job skills learned in an area of interest to the youth and the accountability a Job Coach brings will enable youth to begin their job search far more marketable. Built into the program are service objectives that will enable willing youth to receive education and practice how to manage their time effectively, learn of community resources, budget their earnings, and implement adaptive strategies that are repetitively discussed through the assistance of a Job Coach. Through the IDP, youth learn how to celebrate their successes and establish attainable goals for their improvement with attached incentives. The ages of 16-18 are developmentally a time in which youth are beginning to move away from ` their parents emotionally,therefore,the focus of this program is not on intense work with parents. Helping to improve child/parental interactions is better left to a family preservation modeL What the Smart-Start Program hopes to accomplish is a increase in the number of youth that can successfully work in the community and as a result, develop a sense of pride that will empower them to thrive without draining tax payers dollars by sitting in the juvenile or adult Social Service and Corrections systems. Smart-Start has conducted research in several communities that indicate a high level of success if youth are given both the positive value base and job skills to maintain employment. Opportunity mixed with the support of a Job Coach that will challenge a youth to meet the above stated objectives have proved effective in giving youth the push they often need from adolescence to adulthood and its coinciding work force. Objectives to the goals set forth for each youth will be evaluated weekly and based upon progress, incentives are built into the program to motivate and challenge youth. 7 WORKLOAD STANDARDS The Smart-Start Project is overseen by three project supervisors will employ both teachers and job coaches. The structure of the project is as follows: Project Supervisors: Shari Simmons Nathan Buxman Aimee Buxman Teachers: (Course instructors are yet to be solidified, however it is anticipated that the Smart-Start Project will employee four teachers. Aimee Buxman will teach the required Customer Service class. Shari Simmons will be the instructor for the Stress Management Module) Job Coaches: Jarrod Greene, Tammy Gonzales,Nathan Buxman, One Additional Job Coach The following is a graph of what each Smart-Start employee will be expected to work to fulfill program requirements: Employee Role #of Service hours Total Service Providers Maximum Caseload TX Modality Program The program Two supervisors will The program holds Each Supervisor will Supervision Supervisor supervisor will each supervise two two supervisors have a maximum of supervise Job Job Coaches and overseeing Job two Job Coaches and ^•^ Coaches 1 hour per approximately three Coaches and three Instructors every five hours of Instructors each with Instructors and one each. direct service. This a total of 5 hours of supervisor who will will equal supervision per monitor companies approximately one month. offering internships hour of supervision and employment. per month. Instructors will be supervised 1 hour&r each class they teach. .." Job Coach The Job Coach will Four Job Coaches Four Ten clients each. Job Coaches will provide an average of will total 16—20 Program capacity of utilize a"systems 1—2 hours per week hours per client per 40 clients per month. approach"and a of direct service to week of direct "strength-based" clients. This will service. Direct treatment modality total an average of 5- service hours for all for their clients. 10 hours per month. four Coaches per month will equal 256 hours. Classroom Instructors will Instructors will teach Seven total Eight students per Instructors will teach Instructor provide 2 hour a total of two hours instructors with a class curriculum that is classes to each per every six weeks. possible overlap if specific to the class student. Clients will one instructor wants title and pertinent to be expected to to teach more than issues in the complete 12 hours of one class. workforce. classroom time for this program. Instructors will have the opportunity to teach their classes eight times throughout the duration of the 2003- 2004 fiscal year. 8 Smart-Start is a four month program with the ability to expand beyond that if needed for class and internship completion. Job Coaches assigned to youth initially will manage the case through its termination. They will be expected to conduct the career assessment, life inventory, and IDP staffing within a two-week period. Hours spent on this initial program phase will consist of 2 - 3 hours per week. The Job Coach will spend one hour of face-to-face time with each youth on a weekly basis after they are placed in an internship and through completion of the program. Additionally, Coaches will meet monthly and have weekly phone contact with internship supervisors to assess progress. The Smart-Start Program carries Professional Liability Insurance through the American Professional Agency, activity insurance through CrossRoads Insurance Co., and Workers Compensation Insurance through Travelers Insurance Co. to cover supervisors, Job Coaches, and Instructors working on this project. STAFF QUALIFICATIONS Staff hired through El Mundo de Esperanza for the Smart-Start Project must be people of integrity. El Mundo de Esperanza in conjunction with Stillwater Services LLC have always taken pride in hiring individuals with a passion for working with youth. Potential employees must possess and exude the qualities (honesty, reliability, and respectfiilness)that would be modeled to the clients entrusted to them. Instructors and Job Coaches will display a high degree of cultural sensitivity and respect, however, two instructors and job coaches will possess bi- lingual skills and have the ability to take caseloads with Spanish speaking clients. - With that at the forefront of the hiring process, Smart-Start supervisors will additionally look hire teachers and job coaches with an Associates or Bachelors degree in a human service field (i.e. Social Work, Psychology, Sociology, Child Development, or School Counseling). Two years of experience with youth will be required and experience in the Weld County region is desirable. Additional training will only be required of the instructor teaching the Living Clean and Sober class. It is felt by Smart-Start supervisors that this individual must also have clear understanding of addictions and relapse prevention. Therefore, a CAC license or substantial hours toward a CAC will be required. The Smart-Start Project will employ three supervisors,two of which will supervise all instructors and job coaches. These supervisors(already in place),possess a Masters Degree in a human service related field and have a combined twenty years of experience working with youth in Weld County. The third supervisor will establish rapport, develop contracts with, and maintain an on-going relationship with intern and employment supervisors. It will be this supervisor's job to ensure that companies offering internships have a clear understanding of program expectations, adhere to the guidelines of the signed agreement, and treat Smart-Start clients with the respect and integrity they deserve. In return, this supervisor will ensure that the company feels comfortable with the program and the interns working for them. The role of this person is to ensure the satisfaction and future usage of each company agreeing to offer internships. How they, as employers will have the unique opportunity to give back to the community and assist the youth of today will be highlighted. This supervisor possesses a Bachelors degree in English with six years of experience as a business manager. 9 The project will hold 4-5 instructors, 4-5 Job Coaches, 3 supervisors, and 20-30 internships possibilities. The total number of Smart-Start staff available to this project is 13. One might ask why Social Service, Probation, DYC, or Senate Bill 94 monies should be spent on older adolescents that haven't responded to other, more traditional treatment methods when they are nearing the age of adulthood? The answer is quite simple; Money would be better spent in a preventative, proactive manner rather than later when rehabilitation is often too late or too costly. The facts are these: youth, like adults respond positively to feeling useful and productive. Youth who have been"institutionalized"or bombarded with treatment are often sensitized to become unmotivated and therefore, unsuccessful. If time and money are given to empower youth through an avenue they have identified as an interest, they have a higher likelihood of success. It is the responsibility of each adult thriving in the community to address what their younger generation needs and provide the proactive responses to assist them in becoming young adults with values and skills to contribute from society rather than take from it. 10 VIII. COMPUTATION OF DIRECT SERVICE RATE-PHASE I-LIFE SKILLS A. Total Hours of Direct Service per Client 38 Hours [A] Total Clients to be Served 120 Clients [B] Total Hours of Direct Service for Year 4,560 Hours [C] (Line [A] Multiplied by Line [B]) Cost per Hour of Direct Services $ 38.04 [D] Total Direct Service Costs $173,462 [E] (Line [C] Multiplied by Line [D]) Administration Costs Allocable to Program $ 5,131 [F] Overhead Costs Allocable to Program $ 3,789 [G] Total Cost, Direct and Allocated, of Program $ 182,382 [H] (Line [E] Plus line [F] Plus Line [G]) Anticipated Profits Contributed by this Program $ 10,000 [I] Total Costs and Profits to be Covered by this Program (Line [H] Plus Line [I]) $ 192,382 [J] Total Hours of Direct Service for Year 4,560 Hours [K] (Must Equal Line [C]) Rate per Hour of Direct, Face-to-Face Service to be Charged To Weld County Department of Social Services $ 42.19 [L] 11 Core Service Budget Computations A. Job Description, Minimum Certification & Hourly Rate In Home Therapist (MA) $35/hour Mediation Therapist (MA) $35/hour Life Skills Coach(Diploma&Experience) $17/hour Life Skills Instructor (MA) $35/hour B. Non-Direct Service Costs Supervision $35/hour Therapy Case Management $35/hour Life Skills Case Management $35/hour C. Administration Costs $ 20,525 Annually Phone/ Fax Office Supplies Mileage D. Overhead Costs $ 15,114 Annually Health Insurance Accountant Conferences Professional Insurance PO BOX Equipment E. Programs Involved & Percent Allocated In Home Therapy/Assets Program 25% Brief Therapy/Mediation Program 25% Life Skills/ Smart-Start Program 25% Outside DSS 25% F. Total Administration Costs/Program $ 5,131 G. Total Overhead Costs/Program $ 3,779 r r 40 The Keys to Cutting Down the Territory 3"r? ,�p, �k5R i�, h5-',`�"rt-n„ ✓,y,� ''' KINDS OF '` '� •:-' -",,w- KINDS r .,, THINGS I LIKE of INFORMATION .-. r TO USE MY SKILLS WITH 14' I LIKE TO USE MY SKILLS WITH -} 1 i"^ - _ FORM CONTENT w `.!a'dT 5 Do you prefer news- Which are your .-.. i"^ papers,magazines,books, favorite fields of '� 4 computer out output, knowledge? In what 'd r y 5 reports,or pictures?etc. order of priority? is 6 1 2 sari 7 9 , e- •-3` er F i. g 4 ck irr ti' -,-;t:''' .:J. ,r)',” 9 1r( i y # to y } ,;" r rA .,,,,,...,.?..,.7 ' PHYSICAL SETTING w 0 KINDS OF . r r ,..4.1:1:1.::51+ I LIKE TO WORK INSr.:"- 41;?.. PEOPLE I LIKE TO ,..,,�. �'' i 'ti GENERAL area SPECIFIC working v;i USE MY SKILLS WITH rvr 1, where I'd do my conditions where I d TASKS/SKILLS x most effective work: work most effectively: !� A:=•'-440- ..,r •�� r -E As Clients, j.t5 :'ill: e•'$ 1 1 s In need order be do my favorite Tasks/Skills, '..Customers, :";,:;Y., L+ r 9 I to using my favorite Functional 2 2 $ . / T��dther: 5f u$. 5 8 rr T}ansfeMlc Skills.These are: Other: ,.:=4, t , 4 4 ,u What!Like to Do With _ 'mot A .1, 5 5 y fit 4g S 6 e . THINGS OR PEOPLE OR IDEAS/INFORMATION .n' F' Three places which 7 ''3 1 ,7x.alvorkers: t@ n I"' - ° ratan: 8 1T 2 y t: 1 S 3 8 1� -.1 :c - ' S 10 ..a.:12”:: 5 rya z . itt�, 7 i 1f." '''''''2''''''''''''' OUTCOMES -C 8 " « a, e'^ IMMEDIATE fi 'u y 3"' REWARDS '� a { Do I want to produce a product or Of My Style C' t3 help offer some service to people,or to he‘,1/4„.....'t:.: of Doing Them: F'° SALARY AND LEVEL ==.'k it gather,manage or diueminate infornsatso t v^s' " r., ';i::„: people?What kind of product,service,or infoi' f,- s f I WANT/NEED /€ ^ f7p t 3� } Level Salary � And,what do I see as my central driving mob- , 'Cp r4 (? a `r Max. i vation,in whatever job or career I have? n s'r« ''a"Fa r''' ^ f d E t SPIRITUAL OR bitAir , r-. ,;:',:./;:2 LONG-RANGE '/ EMOTIONAL SETTING ": 3at. My long-range goals--the things I want t I LIKE TO WORK IN Min- Yj' -7 to do,or goals Pd like to accomplish - -'#' before I die,arc: MY PHILOSOPHY OF LIFE. What[believe about life in general,and my life Other rewards I would like this job to -{f�! in particular:(Key 7 ticulideas here): give me. e ,•-•^ t - trP.r .. x,:a Q. (`nJ v 1 In order to do bnt work,these are - the factors from my philosophy(above)that t are especially important to me to have ^, } at my work(or in my work): �:'-a ' ,7"41":4'; t 17Tf -r . t S 'L J n P i r - .l s r t �, e` 4:i /_ Smart - Start INDIVIDUAL JOB DEVELOPMENT PLAN NAME: AGE: D.O.B: START DATE: , JOB COACH: TODAYS DATE: CAREER ASSESSMENT COMPLETED ON: AREAS OF INTEREST: CLASSES COMPLETED: Customer Service Reliability on the Job Stress Management Living Clean and Sober Conflict Resolution Anger Management Problem Solving STIPEND USED TO BUY: CURRENT SKILLS: (Rate yourself in each category from 1 — no skill to 7 — very skilled. Check the "Your Style" page with those that fit your personality.) INTERNSHIP: SUPERVISOR: JOB DUTIES: GOAL #1: DESIRED OUTCOME: ACTION REQUIRED: r ASSISTANCE NEEDED: r PROGRESS MADE TOWARD GOAL: r. GOAL#2: DESIRED OUTCOME: ACTION REQUIRED: r• r` ASSISTANCE NEEDED: r` '� PROGRESS MADE TOWARD GOAL: r` GOAL #3: DESIRED OUTCOME: ACTION REQUIRED: ASSISTANCE NEEDED: PROGRESS MADE TOWARD GOAL: RECOGNITION OF COMPLETED GOALS: INTERN STRENGTHS: ADDITIONAL COMMENTS: DATE OF NEXT MEETING: INTERN: EMPLOYER: JOB COACH: , nv". rY ,�r}S i�,: -"� ,'A • ' s I.", r1 } *. "t�„ 3 -p. : y • p c . A' I F 1: I I• I I I I a° I I I' I I' A' Handout 4 RETHINK Skills for Teens Recognize when you are feeling angry.What makes you angry.What makes your parents, -^ Recognize teachers,friends,siblings angry.When anger is a cover-up for other emotions...fear, stress,shame,fatigue,embarrassment. Try to see things from the other person's point of view.What is that person feeling, thinking,experiencing?Can you remember having a similar feeling? • Practice stepping back during an anger attack.Then try to be empathic by"stepping into Empathize the other person's shoes."Just as you are trying to understand how others are feeling,help them understand how you are feeling.Learn to use"I"messages to express your feelings: "I feel angry when...I don't like it when...I am hurt that.." Often our anger comes from how we look at things.Some experts say that our thoughts actually create our angry feelings,that no one can make us angry.How we think about a situation,how we interpret what someone says,and how we handle our frustrations and disappointments are what stir up our anger. Link Can you find some humor in the situation?What can you tell yourself to change the way you feel?Think about why you are angry and see if you can change your outlook Often, you can reframe or look at the situation differently so that you can fmd a constructive solution. Hear what the other person is saying,where the other person is coming from.Check to see if you understand correctly:"I'm trying to understand what you are saying.You ear say.."Look into the other person's eyes to show that you are listening.This kind of active hearing works both when you are the angry person and when someone is angry with you. When people are hurt,they want to be heard.Give feedback that you are hearing them. Integrate respect and love with what you say about your anger."I was angry at what you said,but I still love you"or"I am angry with you,but I still want to be your friend." _ Sometimes a person needs to speak out angry feelings for a while,even if it seems ntegrate disrespectfuL Then the person can learn and practice more respectful and caring ways to express the anger.Words,after all,are safer than actions! Anger does not have to destroy friendship.Often when you clear the air,a better relationship can result. Notice your body's reaction as you get angry:increased heart rate,breathing harder and faster,headaches,stomach pains,tension in the neck,pains in the chest.Learn to bring yourself under control and notice how you calm yourself. Notice Do what works for you:long walks,jogging,thinking about other ways to look at the situation,meditating,listening to music,doing artwork,giving yourself instructions to calm down,counting to 10,telling yourself"I'm OK."What else works for you? Keep your attention on the present event and alternative solutions.Don't bring up old grudges and wounds. ee p Keep your focus on the behavior that is causing the difficulty. Keep personalities out of it. Know what makes you angry—what is your anger trigger? For a generic title: "Smart-Start Job Seminar" Objective: Facilitating proper etiquette for job inquiry and establishing concise responses and professional demeanor for interviewing skills. The student will be able to discuss the importance of appearance and personal presentation; possess a job skills and goal statement; and relate three personal strengths as well as how they plan to overcome their adversity. Time Goal: 4-4.5 hours total time: 3.5 hours training (including breaks); 30 minutes- , 1 hour for interviewing. *Perhaps the interviewing would be best as informal, giving the students a chance to practice and utilize their skills, without too much stress and pressure. If there is a need and enough students still without jobs, another option would be to establish a small area job fair. Media: Career Poker (card game); magazine articles; flip chart and markers; (depending on site: power point; overhead projector) Materials: white out tape; black pens; markers; highlighters; blank application forms; Handouts: fill in the blank lecture notes and personal worksheet. Motivators: small candy bars, etc; scratch lotto tickets; food or retail gift certificates Prizes Awarded For: neatest application; complete notes; positive insight and feedback Outline: Big Picture A. Jobs create a story; something useful can be learned from every job. 1. Important to choose good jobs and plan for the future. B. Game- Career Poker 1. Discussion questions a. Is life fair/unfair? b. Does$ =Happiness c. Is there power in choosing? 2. Choose own cards and further discussion a. Is this now fair? b. Why do you love your job? c. How did you get your job? (education, etc.) d. What are your work habits? r 1 C. A Process a ^ 1. Meeting expectations 2. The right education 3. Strong work ethic II. The Power of Appearance A. "The Quick Judge" 1. What do they do for a living? --power point or magazine 2. Discussion: The importance of personal presentation a. Presentable Attire b. Being prepared c. Charisma...and attitude III. Acquiring the Application A. Preparation 1. Black pen 2. White out 3. Address book 4. Knowing yourself skills;experience; availability B. Observation 1. Is there a uniform? 2. Team members or working alone? 3. Notice good customer interactions C. Talking! 1. Smile! Be friendly! Be positive! (good impressions with future team members and staff) 2. Ask questions of the staff a. Best/worst part of the job 3. Ask for the manager in charge or get a business card 4. Avoid talking salary! Money hungry is not good! IV. Filling out the Application A. Print Legibly in Black Ink I. Neatly white out any errors---no crossing out or scribbling B. Complete All Sections...Be thorough! C. Have Correct Dates of Employment and Schooling D. Only Honest Information V. Delivery of the Application A. Talking is Good! B. Ask for the manager in charge C. Get a business card or write down the name and number of who you need to contact. D. The "I turned in my application call!" Break-IS min es VI. Preparing for the Interview A. What are you good at? What do you love to do? 1. Developing and discussion of strengths and gifts B. Answers to the top 10 questions 1. Teamwork Experience ,.. a. Describe the problem b. Analyze your role c. What was the outcome 2. Worst/ Hardest Day ,. a. Describe the problem b. What was your thought process: your options c. What was the outcome? 3. What is your best friend like? a. What do you like best? b. Describe a situation where they helped you out 4. Tell me about yourself a. Your top three strengths b. What are your goals c. Why you are looking for this job 5. (If you've been in trouble) How are you going to change? a. What have you learned from your experience 6. How do you deal with difficult people? 7. What in your experience qualifies you for this job? 8. Describe what you think a typical day would be? 9. What makes you the best candidate? 10. What is one weakness? Break-10 min VII. The Big Day A. Dressing for the part B. Body Language C. Positive Responses- avoid complaining or blaming someone else D. Be Honest-What have you learned E. Smile—it's about your personality F. Give examples—esp. if you don't have job experience VIII. For fun: Top ten ways to flunk the interview -a. Career Poker Career Salary Living Situation CEO $100,000 1 bedroom apt Pro Athlete $350,000 2 bedroom condo School Teacher $40,000 ocean front condo Janitor $25,000 2 bedroom house Wait Staff $27,000 6 bedroom house Bus Boy $7/hr NY penthouse Shoe Salesman $10/hr farmhouse Writer $30,000 trailer Auto Mechanic $12/hr a car Banker $80,000 Grocery Clerk $9/hr married Gas Station Attendant $8/hr divorced Pilot $200,000 single US Senator $150,000 2 kids Teacher $36,000 4 kids Property Manager $29,000 6 kids Unemployed welfare checks 0 kids Chemical Engineer $90,000 living with mother How You React to Stress 7 Schedule of Recent Experience Part A instructions Think back on each possible life event listed below, and decide if it happened to you within the last year. If the event did happen, check the box next to it. Check Mean —. here if Value event (Use for happened scoring to 1. A lot more or a lot less trouble with the You later) boss. 2. A major change in sleeping habits(sleeping a lot more or a lot less, or change in part of day when asleep). 3. A major change in eating habits (a lot more or a lot less food intake, or very different meal hours or surroundings). 4. A revision of personal habits (dress, .- manners, associations, etc.). 5. A major change in your usual type and/or amount of recreation. 6. A major change in your social activities (clubs, dancing, movies, visiting, etc.). 7. A major change in church activities (a lot more or a lot less than usual). 8. A major change in number of family get- togethers (a lot more or a lot less than usual). 9. A major change in financial state(a lot worse off or a lot better off than usual). 10. In-law troubles. 11. A major change in the number of arguments with spouse(a lot more or a lot less than usual regarding child-rearing, personal habits, etc.). 12. Sexual difficulties. a How You Read to Stress 9 Number Mean _ Your of times X Value Score — 33. Wife beginning or ceasing work outside the home. 34. Taking on a mortgage greater than$10,000 (purchasing a home, business, etc.). 35. Taking on a mortgage or loan or less than $10,000(purchasing a car, TV, freezer, etc.). 36. Foreclosure on a mortgage or loan. 37. Vacation. 38. Changing to a new school. _ 39. Changing to a different line of work. 40. Beginning or ceasing formal schooling. 41. Marital reconciliation with mate. 42. Pregnancy. Your total score Scoring The "Mean Values" for each life event are listed below. Write in the mean values for those events that happened to you. For items in Part B, multiply the mean value .., by the number of times an event happened, and enter the result in "Your score." Add up the mean values in Part A and your scores in Part B to get your total score. Life Mean Event Value �. 1 23 2 16 .. 3 15 4 24 5 19 6 18 7 19 8 15 9 38 ., 10 29 11 35 12 39 Smart Start Job Coach Description and Duties The Smart-Start program is designed to provide a comprehensive, multi-modality job readiness, acquisition and implementation curriculum to youth ages 16-19. Below is a list of common requirements for the position of Job Coach. Due to the unique needs and individualism of each of our clients, this list should serve as only a guideline. El Mundo de Esperanza and Stillwater Services, LLC possess a strength-based focus and therefore, believe in the premise of"meeting the client where they are". With this in mind, understand that your duties as a Job Coach will focus on the client as an individual, and provide for his or her specific needs, whatever they may be. Community Resource Liaison Teacher—Stress Management, Reliability on the Job, Living Clean and Sober, Refusal Skills, Conflict Resolution, Anger Management, Problem Solving, Customer Service, Writing Skills, Reading Skills, Interviewing Skills, Communication, Cultural-Gender Education Mentor-Counselor Role-Model Employer-Employee Liaison Assessments Marketing and work-site acquisition ^ Life Skills Training Account Management and Budgeting Facilitator of monthly staffings in which the Individualized Development Plan is reviewed Youth advocate The following is a list of required documentation to be completed and submitted by all Job Coaches on a monthly basis: • DAP (Description/Assessment/Plan) notes are required on all Smart-Start clients to track progress. • Job Coaches much keep a documentation log of all case management work/contacts made on behalf of Smart-Start clients. • The IDP (Individualized Development Plan) SAMPLE DAP The DAP documentation format has been utilized by service professionals for years. It has proven to be an effective,concise means of communicating face-to-face interactions and phone conversations. Job Coaches will be required to follow the preceding form for all documentation. D—(Description: Content of the meeting,session,or phone conversation) This Job Coach met with Client A on March 03,2003 at 11:00am at Starbucks. Client A talked about his struggle with a particular co-worker at Company A,where he is interning. He described interactions in which his co-worker has"made fun of the way he dresses and acts". Client A stated that he often responds to the co-workers insults by calling him names and threatening him. This Job Coach explored other ways in which Client A could deal with the conflict and role-played these different scenarios. What Client A wants to obtain from his intern experience was reviewed. Client A developed a plan to tell the intern supervisor of the conflicting relationship and ask him/her to be present when he confronted the co- worker using the skills talked about in today's meeting. A—(Assessment: Evaluate the client's behavior,attitudes,emotions and Assess the meeting) Client A appeared somewhat anxious about the recent conflict with his co-worker. The fact that he immediately brought it to the attention of this Job Coach shows emotional growth. Client A wanted to initially be validated and then clearly wanted the assistance of this Coach in developing a plan of action. Client A displayed an eagerness to role-play various conflict resolution techniques. His affect appeared more relaxed after having a plan for how to effectively deal with the conflict. P—(Plan: Develop a follow-up plan for the next scheduled interaction) This Coach will call Client A following his upcoming encounter with his intern supervisor and co-worker. How he handled the situation will be assessed. If he follows through with his plan,verbal reinforcement will be given. If he struggled and needs further assistance,this Coach will set up a meeting with the intern supervisor to discuss future interventions. Job Coach Date a a ^ ^ r 40 Developmental Assets Asset Type Asset Name -.. Definition Yes No I. Family Support Family life provides high level of love and support 2. Positive family communication Parents and youth communicate positively;youth is willing to seek parents advice and counsel 3. Other adult relationships Youth receives support from three or more non- Support parent adults 4. Caring neighborhood Youth experiences caring neighbors .^ ,_ 5. Caring school climate School provides a caring,encouraging environment 6. Parent involvement in schooling Parents are actively involved in helping youth J succeed in school 7. Community values youth Youth perceives that community adults value youth 4q„ 8. Youth given useful roles Youth are given useful roles in community life um 9. Community service Youth gives one hour or more per week to serving Empowerment in one's community 10. Safety Youth feels safe in home,school and neighborhood 11 y 11. Family boundaries Family has clear rules and consequences;and _ monitors whereabouts W 12. School boundaries School provides clears rules and consequences _ , 13. Neighborhood boundaries Neighbors would report undesirable behavior to �. Boundaries family and 14. Adult role models Parent(s)and other adults model prosocial behavior ..-- Expectations 15. Positive peer influence Youth's best friends model responsible behavior 16. High expectations Both parents and teachers press youth to achieve 17. Creative activities Involved three or more hours per week in lessons or '" practice in music,theater,or other arts 18. Youth Programs Involved three or more hours per week in sports, Time Use clubs,or school/community organizations 19. Religious community Involved one or more hours per week 20. Time at home Out with friends"with nothing special to do,"two or �'^ fewer nights per week 21. Achievement motivation Youth is motivated to do well in school .— 22. School engagement Youth is actively enppged in school 23. Homework Youth reports one or more hours of homework per da' Educational 24. Bonding to school Youth cares about his/her school __ ..,_ Commitment 25. Reading for pleasure Youth reads for pleasure three or more hours per week .. "+ 26. Caring Youth places high value on helping other people .. 27. Equality and social Justice Youth places high value on promoting equality and reducing hunger and poverty ... an Values 28. Integrity Youth acts on convictions,stands up for his/her belie€ a 29. Honesty Youth"tells the truth even when its not easy" 30. Responsibility Youth accepts and takes personal responsibility 31. Restraint Youth believes it is important not to be sexually active 1 or to use alcohol or other drugs G 32. Planning and decision making Youth has skill to plan ahead and make choices .• s~ 33. Interpersonal competence Youth has empathy,sensitivity,and friendship skills 34. Cultural competence Youth has knowledge of and comfort with people of '+ Social different racial backgrounds Competencies 35. Resistance skills Youth can resist negative peer pressure 36. Nonviolent conflict resolution Youth seeks to resolve conflict non-violently 37. Personal control Youth feels he/she has control over"things that happen to me" .•. Positive 38. Self-esteem Youth reports high self-esteem Identity 39. Sense of purpose Youth reports,"my life has a purpose" �„ 40. Positive view of personal future Youth is optimistic about his/her personal future r A My transferable skills dealing with 33 THINGS A. A A A : am good at A. A7Al i N lf Skills With\A Skills With Skills With, %b Skills With Skills With Skills With Materials Objects Equipment, Growing 1 (clay, wood, (including Machine c Buildings 6 Things, The Body stone,jewels] instrumett tooltss) Or Vehicles Or Rooms Or Animals,Tti..1.. lir lir Ilir t Using My Hands Crafting, Washing, Having A 41 t Or Fingers it Sewing, Cleaning, Setting Up, Constructing Green Thumb (including Weaving, Or Or Or causing ,,, „., "signing,"or 4t, Hammering, Preparing Assembling Reconstructing 4 growing things massaging) etc. 1 to flourish -11 ,L .1111111111 6 1 02 3 4 5 6 7 1❑2 3 4 5 6 7 0 2 3 4 5 6 7 T2 3 :4 5 6 7 0 2 3 4 5 6 7 A Having Great Curtin • Operating, Having Skills , L Dexterity Carving, HanOr dling, Controlling,ii Modeling O ug Wt(rha Animals als (e.g.,with Expediting Remodeling y training,or Chiseling Driving , ,1. keyboards) treating, etc) ❑©©RIRIE 1❑2 3 4 5 6 7 0❑2 3 4 5 6 7 l❑2 3 4 '5 6 7 1❑2 3 .4 5 6 7 0❑2 3 4 5 6 7 A / A Fashioning, Using My Molding Making, Tending, , A Eyes& Hands r Sha to Producing, Minding, In Opr g' Manufacturing Feeding, Or A Coordination 0,, Sculpting (Or Cooking) Emptying 4JJJjJ6 i 1❑2 3 4 5 6 7 1❑2 3 4 5 6 7 l❑2 3 4 5 6 7 A./ m Motor/ Finishing, , Maintaining, Maintaining, Physical Painting, Preserving, Cleaning, - A Coordination Refinishing, O Or With My Or Repairing Repairing .‘j. Whole Body Restoring ;. w ❑©©j© 6 I 92 3 4 '5 6 7 1❑2 3 4 5 6 7 1 2 3 4 5 6 7 J. A Having Precision Precision Breaking Agility, Working Working Down Seed, '? with Disassembling Strength, •' with my " tools or Or hands Or Stamina `__ instruments Salvaging ., ,. , r--, r— rn" J J. .L 34 My transferable skills dealing with A PEOPLE ,.. - y aol good at, A- With With Groups, 4 ...-L. Individuals Organizations, r one at a time N'' or the masses f) x it .i.. Playing Games or r, Managing, s Taking t . Dia Treating, Communicating - Supervising, t g, n } a particular game, p g, t a d Effectively Or Running Instructions, _ to a group or Leading Others g Or in recreation (a business, Or Helping ►A Healing ' , a multitude o- or exercise 3. fund drive,etc.) '.s te ;? A x [12 3 4 5 6 7 n 2 3 4 5 6 7 I�l2 3 4 5 6 7 n 2 3 4 5 6 7 n2 3 4 5 6 1 .1.... 11 I I I I ' 1 I ' i''. By Teaching '^ Following Communicating Referring Training Through, Well in i People, Using Words g Ex ressivel or designing Getting Things conversation, - or helping P Y �~ in person,or - two people in speaking educational 4i Done, ii or writing events Producing ;.,� on the phone �'°- to link up 4 gg s I IJ 3 4 5 6 7 112 3 4 5 6 7 (12 3 4 5 6 7 n2 3 4 5 6 7 [l2 3 4 5 6 J� I I ' I I I 1 t I I A. Communicating Assessing, Bye Guiding Leading, L Well in Evaluating, Making A Group 4 Taking Presentations Discussion The Lead, writing Screening, Presentations ;tiL (e.g., excellent Or Selecting in person,or conveying >a- Being A ' on TV or film warmth Pioneer letters) Individuals 1 4 11 s4 4 $ .l [ 12 3 4 5 6 7 n 2 3 4 5 6 7 n2 3 4 5 6 7 n 2 3 4 5 6 7 [12 3 4 5 6 .+1 I ' I I 1 I t I I 4, Instructing, Persuading, ` By Persuading Initiating, Teaching, Motivatin Performing, A Group �.r Tutoring, Recruiting, Entertaining, Debating, Founding,Or "" Or Training t Or Selling Amusing, vii Motivating Establishing 1 Individuals To Individuals or Inspiring Or Selling `. S n2 3 4 5 6 7 n2 3 4 5 6 7 n2 3 4 '5 6 7 n2 3 4 5 6 7 I I 112 3 4 5 6 ,� I ' I I 1 f '"" Advising, ' Representing V, "Signing," Consulting m Negotiating iv Others, Miming, Acting g Giving Advice between two Coaching, Sin n Or to groups parties,or Counseling, I Interpreting Singing,g� Mentoring, Others Ideas 7 Playing an in your area V, Resolving Empowering ',--g- or Language i Instrument *v. of expertise _ Conflicts 11-1 2 a a S fi 7 1112 3 4 5 6 7 n2 3 4 5 6 7 n2 3 4 5 6 7 n2 3 4 5 6 /g1 A "t' My transferable skills dealing with 35 .t. INFORMATION, DATA, AND IDEAS l am good at t Gathering Managing ;. Storin ='"Storing, Putting It Or Retrieving It Creating It Itaza To Use a :::: J, STEP BY STEP HOLISTICALLY Compiling, Adapting, P g Copying Translating mcl x Keeping Records With �, and/or v g( ) (incl. recording, -- People Searching, � Comparing Computer ( g' P t. Or Programming) z filming, , similarities 4 or entering ix See People Researching �'"" Developing, ip on a computer) -.' Skills or differences i" 10 Or Improving "Si 3 _,[12 3 4 5 6 7 n 2 3 4 5 6 1 r] 2 3 4 5 6 7 Ill2 3 4 5 6 7 i I ' I I I I L. Gathering k Computing, Visualizing, ,N� Storing Or Filing ;��= With , Information By ; Working with Drawing,Painting, (in file cabinets, Things 4, .3�. Interviewing Numbers, g' microfiche, 4. Dramatizing, See Skills Or Observing Doing video,audio, „_ J� Creating Videos, or computer) with Things x People Accounting Or Software 44 jn2 3 4 5 6 7 n2 3 4 5 67 n 3 4 5 6 7 n2 3 456 7 i ' 1 I I Gathering Analyzing, j Synthesizing, Retrieving ,h Information By ,�. breaking combining a Information, Studying '3 down .I-. y g parts w into le Ideas, Dta Or Observing into its a whole Data Things parts : ; t�.,: . .,L,I112 3 4 5 6 7 n2 3 4 5 6 7 n2 3 4 5 6 7 n2 3 45 6 7 I ' I ' I ' I Having An Acute ® Organizing, Problem . Enabling '' Sense Of Classifying, Solving '. Other People ,! Hearing, Systematizing, or seeing To Find Or Smell,Taste, and/or patterns among Retrieve .i-. Or Sight Prioritizing a mass of data Information -`` i S 1 1 2 3 4 5 6 7 V n 2 3 4 5 6 7 ri 2 3 4 5 6 7 3 (1 2 3 4 5 6 7 A-. Imagining, f I Planning, I I Deciding, �` I I Having A '„ ,h Inventing, $ laying out Evaluating, 4 Superior Creating,Or <4 a step-by-step a Appraising, 4.),„ Memory Designing z4 process for 4 Or Making 414 keeping track 3' new ideas 41 achieving a goal Recommendations ii4 of details 334,- 4 l.. 34 44 1,1712 3 4 5 6 7 n2 3 4 5 6 7 n2 3 4 5 6 7 n2 3 4 5 6 7 UJ/ 13/GUUJ 11 : 15:42 American Prof Agency --> P.002/002 Account Number: CO STIL 3360 Date: 3/13/03 Initials: CV CERTIFICATE OF INSURANCE THE DOCTORS' COMPANY 0/0: American Professional Agency, Inc. 95 Broadway, Amityville, NY 11701 This is to certify that the insurance policies specified below have been issued by the company indicated above to the insured named herein and that, subject to their provisions and conditions, such policies afford the coverages indicated insofar as such coverages apply to the occupation or business of the flamed insured(s) as stated. THIS CERTIFICATE OF INSURANCE NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS, EXTENDS OR ALTERS THE COVERAGE(S) AFFORDED BY THE POLICY(IES) LISTED ON THIS CERTIFICATE. Name and Address of Insured: Additional Named Insureds : STILLWATER SERVICES, LLC SHARI SIMMONS P.O. BOX 336058 NATHAN BUXMAN GREELEY CO 80634 BRENT CLAY r r' Type of Work Covered: Mental Health Counselor --. Location of Operations: N/A (If different than address listed above) Claim History: Policy Effective Expiration Limits of Coverages Number Date Date Liability PROFESSIONAL/ 1,000,000 LIABILITY MHL-5016498 8/01/02 8/01/03 3,000,000 NOTICE OF CANCELLATION WILL ONLY BE GIVEN TO THE FIRST NAMED INSURED ON THIS Pnrrry INn WV nu cur CUATT ar-T nN crvars nw ATT TNCTTPRnC NTTU PrCPvrmT Tn r•.TVTIM OR RECEIVING NOTICE OF CANCELLATION. ^ Comments: -- This Certificate Issued to: Name: STILLWATER SERVICES, LLC P.O. BOX 336058 Address: GREELEY CO 80634 A horized Representative TravelersPropertyCasualty � WORKERS COMPENSATION Aura huvder:Group AND EMPLOYERS LIABILITY POLICY CHANGE DOCUMENT WC 99 99 98 (00) POLICY NUMBER: (I0IIB-5387W98-7-03) CHANGE EFFECTIVE DATE: 02-12-03 NCCI CO CODE: 15318 INSURER: THE CHARTER OAK FIRE INSURANCE COMPANY INSURED'S NAME: STILLWATER SERVICES,LLC This change is issued by that member of The Travelers Insurance Companies which issued the policy and forms a part of the policy. It is agreed that the policy is amended as follows: An absence of an entry in the premium spaces below means that the premium adjustment, if any, will be made at time of audit. - ADDITIONAL PREMIUM $ 46 RETURN PREMIUM $NIL ADDITIONAL NON-PREMIUM $NIL RETURN NON-PREMIUM $NIL The Policy Minimum Premium is amended as follows: Minimum Premium: $ 292 The Policy Expense Constant is amended as follows: Expense Constant: $ 180 Pending rates that apply to the policy have been approved by the proper regulatory authority. The new rates are shown below: STATE • CODE NO RATE CO 8868 .90 The following endorsement is added: WC 89 04 15 (00)-001 Ask DATE OF ISSUE: 12-26-02 RA CHANGE NO: 001 PAGE 001 OF LAST POL. EFF. DATE: 02-12-03 POL. EXP. DATE: 02-12-04 OFFICE: ELMIRAPAYROLLPATH 70A ^ PRODUCER: PAYCHEX AGENCY INC SV998 COUNTERSIGNED AGENT a. TravelersProperty�Cy�a��sua/.�lty��'� WORKERS COMPENSATION „- A tS.rSThJWk/ZV/Wp J AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 89 04 15(00)- 001 POLICY NUMBER: (I0UB-5387W98-7-03) POLICY INFORMATION PAGE ENDORSEMENT a Item#4 is changed to the following: PREMIUM BASIS Total Estimated Rate Per Code Annual $100 of Estimated Classifications No. Remuneration Remuneration Annual Premium SEE CHANGE DOCUMENT OR INFORMATION PAGE SCHEDULE Total Estimated Annual Premium $ Minimum Premium $ Deposit Premium $ ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. a a DATE OF ISSUE: 12-26-02 ST ASSIGN: NATIONWIDE LIFE INSURANCE COMPANY PO BOX 2399-COLUMBUS, OHIO 43216-2399 a Nationwide Po Box 1010 Ault, Agy Ault, CO 80610 e 11 RE: Specified Hazard Insurance Policy for l97 !$ u Stillwater Services Uc APR 2 D 1701 67th Ave Hu 2 2002 Greeley, CO 80634 By Policy No: 502.95-18018 Congratulations on selling this Specified Hazard Insurance Policy! Enclosed are: For your use: - A Priority Fax Order Form to order additional sales brochures and other supplies. - A machine copy of the application for your files. For the Plan Sponsor: - The policy delivery letter, the policy, and the claim forms(if applicable). Please sign the delivery letter and countersign the policy (at the bottom of page 6). The policy and supplies should be delivered to the plan sponsor named above. - Individual certificates (if required by the plan sponsor's state)will be malted within 2 to 4 weeks. Thank you for thinking of Nationwide for your Special Risk Health Insurance needs. Now may be a good time to consider these additional Special Risks Health prospects: CIVIC AND COMMUNITY ORGANIZATIONS such as auxiliary police, social clubs, swim clubs, volunteer fire companies, and volunteer service clubs. GROUP ACTIVITIES such as Bible schools, camps and conferences, child day care, picnics, preschools, recreation programs, religious day schools, trips and tours, and volunteer construction and/or repair work. AMATEUR SPORTS such as baseball, basketball,football, soccer, and softball teams, as well as sports camps. YOUTH GROUPS such as drill teams, 4-H Clubs, marching bands, Scouts, youth fellowships; and ...many others. If you need brochures or any assistance whatsoever, please call our Customer Service Center at 1-800.525.8669 (1-614-854-2196 for Columbus, Ohio area local calls), send us a Fax to 1-614-854-3753, send us a-mall to SpecRsks@Natlonwlde.com, view our webslte at www.GrouProtector.com, or write to us at: Special Risks Health Nationwide-Insurance PC) Box 2399 Columbus, OH 43216-2399 Sincerely, Special Risks Health Department a Enclosures a White.'Ton acceptance and a POLICE APPLICATION(please prim or ryo „'conic a pan c SPECIFIED approval by NATIOP15YmE LIFE RI CE COMPe)HAZARD INSURANCE POLICY h71MBER 502,95 1 us,OAIo 43216s.will "' 1. Name of 1 Heaton:e the 0,071 ...... Plea Sp.nor �1Jar@✓' ✓ . . 1CeS LL • (Oroap'a N • ame) .+ Permanent Medlin Address / 0 th �lyr �l v (Number) (Sou (city a 2. Policy Tenn: Ibo policy tam s(ezu a 12:01 a.m.„a_,7 . ?7.O (S e) (zip) (county) A(12:01 Lm.on R . 3 -p which Is the which is the effective dart and cods rumination date(up to■3-mondt policy. first r nog date(12-month policy tam). 3. Covered Activities 4. sommunimminimMaalmam 8tae0t Amauats—she word"Menem . s Nc benefit is net included M ACCIDENTAL DEATH AND SPECIFIC(ASS `gIntla lIMMES with a 5250,000,00 overall maximum for any ant accident 1 ,•• Death S 1.300.00 S 2,50000 •,J'.42:'' , i;�•. ... Specific Lou(Face Amount).._..........__._...... ].000.00 5,000.00 S 5,000.00 S 7,500.00 ; q i r--. MEDICAL EXPENSE 10.000.00 15,000.0Q�(i/ ,<J� " ,9N>.,. Accident - Ovemli Sdsxsmum.... S one 10000.00 �� ;: e 000.00 None None ". ` . 25.000.00 30,000.00 • �• OD- (!nG. \ �.. ,• . !snit fide Mu 4220e lout[ /4/S. Premium Rate b Clam es of Ell Ible Pere -u—e ck Class and Medial Ea. rise Plan desired ` `.� I I u fader exppgyT day or portion -c. \. Premium Rates Par E' • •ktersoa Class • . . ... ' die 'x(+aue • • F.aawu P(an A l alternative l pparticip utc or all participants and stag In the n ntimity saris.program activilirs of the — plan sponsor(check only ant box): 1 O Clba I R.u.11bueu......_......_.........._............. ... S 0.13 S 0.09 '� 3 ill.: Clau 3 Deaelra asst .......__....-_........., 0.ba 4 • Clam 311eaeRta teal 0.12 NOT AVAILABLE 023 ilia .rt.•um easant=p c 5100,00 ease ' y Ian has • f15el g ' cal expense primary plan bas - elected cal e Scse access • elected. • ..-. 6. The policy la to cover S4 pumas pcas which include: CI taNcipara PAY tats or (eS2Vrlicipaois and W rm% 7. It is understood and agreed that (a)the premium will be paid entirely by the plan sponsor with no conptbutjon made by the eligible persona inward the coat.f the immaace;and(b)premium will be paid as feVowa:tar short ISI 1,sgurare.O In advises as shown on the Premium Report,or D la advises bawd on the total atlmstad rpremium due as share en the Premium Ripen with an audit at the end of the policy tam tan%or for rmewaht. the minimum prcaWw wilt this application wide th.remalader due saner, in arrears urns • r:t,.;.,,,i:`;1 t�hmu Amato) mat Shari �;mm n c //)t)rim • (Prlobd Nemc T • aw lde scAppik,a) r "' (Azalea Sipmwe andN ) X70) 107 IP (i rpJn rU fjUO3'/ GR-9050 ///��.� p.] ��,,.�y�,� (Addmas of Apollo's; Y" arciL_,Qi1.. �,,..- -mss, „6,..th �l l vc Community Service Program._.. NOTE:Thaw plan arc available la DC,Pit VI and s1(Sd sato,EXA:irr that yam®metier plump_is avWabk:In NJ;J! '- elute nki AL or PA;lad to adWl groups(1:„ages 30 er over)la NY, Classes I sad 2 y,(avalahe(a y(, ymatI^ Is Louglaoa,may pares wile lmewmvy oraaata a fobs or badmen!claim far .-, rata islet laf.rmiuea le as application far Insurance Ispayment of•loss or based[or Yao.laab prime. t�V of.crime sad may Oe subject to fines sad soallaaawnt la 901,P2/wr • 605GF7d.1030 A. ^ PREMIUM REPORT*This report ust be completed when — Individual DAILY premiums are used for Application to be accepted. Age Range of Participants(not staff): /O y'1�years of age -- "Not required If policy is renewable and has in arrears"billing. Total Maximum Daily Covered LUIS of Premium Total Number Premium Per Number of Activity of Days Eligible Eligible Premium Activity Rate Person jpar-rY Person Persons ^ 2 2 I S 29 X .$ $ Due Las bail 'IS x..._ (Pce ycwn ` x --�--`i $ x a' X i --��asx $ uric:.. ok+ �` 5 X --- � x _ i ,,, oLL h reln.tcoC } �$ X ' $ _ Total premium due(subject to policy minimum•)..X�— s S�— X ----` $ if renewable,the estimated number of eligibleli frequency i...' persons per billing frequency is .................... ......i — "The annual minimum premium la 313040 for primary medical and$100.00 for excess. I certify that to the best of my knowledge and belief:(1)the preceding information is correct and co e (2)Premium is being paid for the total number of eligible persons who are anticipated to be insured;end(3)the premium is being paid entirely by the plan sponsor with no contribution made by the eligible persona toward the cost of the Insurance.• — _ (ate by ( (] ) 3 o d _ p tAPPLICA ers SIGNATURE ANIS Ma ..- ld1Y TP.(J:YNONi alWEa) •--L-rO Mau Z _ I auoL m.. r. NOTE If additional 9.: (RAWL DRESS) : is required, use a separate sheet RECEIVED x(10,99) - APR 1 2 2001 .-. St'ECI.'',I,F13XS HEALTH AMERICAN FAMILY MUTUAL INSURANCE COMPANY AUTOMOBILE INSURANCE IDENTIFICATION CARD MADISON,WISCONSIN 53703-0001 THIS CARD MUST BE CARRIED IN THE INSURED MOTOR VEHICLE • SHELTER GENERAL INSURANCE COMPANY 1-800-SHELTER 1817 N. BROADWAY COLUMBIA: MO. 65218-0001 COLORADO MOTOR VEHICLE AGENT: ANDREW J GOLDFARB 303-444-2663 PROOF OF INSURANCE CARD • POLICY NO. 05-1-0-3134638-6 • EFFECTIVE DATE 01-29-2003 EXPIRATION DATE 04-29-2003 Policy No: 0763-2029-01-70-FPPA-CO' 1996 CHEVY BLAZER 4WD 4DR VIN 1GNOT13W5T2125493 , Elf Data: 10-15-2002 Exp Date: 4-15-2003 1999 CHEV SC1 VIN: 2GCEC19V6X1134835 NOOFAULTTIPO WITHGCORVEL CORPORATION FOR Coverage.: BIPD IM U7)I COW' COLL PIP BUIMAN NATHAN NAICR 23361 337 5340 AVE GREELEY CO 80634-4223 ,.- 1701I 6 SIMMONS Agent: DONNA FEIGIRIY-MANTIS .•., GREELEY CO Age. Phone: (970) 351-6528 -------- -- This card must be carried in the insured motor vehicle for production upon demand. Important message on reverse side. r-- A. r 4-4 LCSW . 9918 4' 001::•;.„ 03 • [JED ; .- LYN T SIMMONS' W 2 'DEAN T RCLE ,s�,+ OVELAN CO : 80537 „,: k4,e{ 4 A,. BRUCE M DOUGLAS ... 'DIRECTOR DIVISION Of PEGISTRATIONS ."c f?o N$EESIGNATV E ' ) a a a-. a.� ate. r-, a� a. a a^' n a a rs DEPARTMENT OF SOCIAL SERVICES P.O. BOX A GREELEY, CO. 80632 White www.co.weld.co.us Administration and Public Assistance(970)352-1551 Child Support(970)352-6933 O C COLORADO MEMORANDUM TO: David E. Long, Chair Date: April 28,2003 Board of County Commissioners FR: Judy Griego, Director, Social Services tiC44, (* A/W ri RE: Notification of Financial Assistance Aw s(N4AA)u er Core Services Funds- Stillwater Services, LLC Enclosed for Board approval are Notification of Financial Assistance Awards (NOFAA) for Core Services Funds with Stillwater Services, 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 NOFAAs 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. Stillwater Services, LLC, agrees to provide services to those children and families who are in imminent risk of placement under child welfare and as referred by the Department. The services to be provided through Stillwater Services, LLC, are as follows: A. Under Option B—ASSETS Program the program offers home-based intensive family interventions to youth ages 6-18, their nuclear families, extended families, and supporting systems. The program has the capacity to serve 68 family units during the program year. Ten Spanish-speaking families will receive services by members of Bilingual and multi-cultural staff. All therapists will receive cultural awareness and sensitivity training. Ten families will receive services in South County with therapists specifically assigned to this region. Services include a 24- hour on-call service for all clients receiving therapeutic services. The program capacity is 12 client-families served per month; the average length of the program is seven weeks. Clients will interface directly with the assigned therapist approximately three hours in each of the seven weeks they are enrolled in the program. The hourly rate is $69.00. 2003-1067 MEMORANDUM Page 2 David E. Long, Chair, Board of County Commissioners NOFAAs— Stillwater Services, LLC B. Under Mediation and Facilitation under the Intensive Family Therapy Program Area the Mediation program will provide brief family therapy/mediation services including conflict resolution,problem-solving skills,parenting techniques, and communication enhancement. The program offers 24-hour, on- call services for all clients receiving therapeutic services, time-efficient, and cost- effective responses to clients in need of crisis intervention. The maximum length of a family enrollment is one month; the average length of stay is three weeks. Clients will interface with therapists directly for approximately two hours in each of three weeks of enrollment. The program year capacity is 24 family units. All therapists will receive cultural awareness and sensitivity training. A therapist who resides in South County will provide services to that portion of the county. The hourly rate is $65.02. C. Under Lifeskills -El Mundo de Esperanza(A World of Hope) the program focuses primarily on preparing youth for the workforce; however, family members will be called upon as active participants in supporting and maintaining accountability. Youths are matched upon reaching the third phase of the program to an employer who has agreed to offer a 60-day internship, up to 20 hours per week. A job coach will meet with each employer and the assigned youth on a monthly basis to complete the Individualized Development Plan (IDP). The program serves youth ages 16-18. The program has a capacity to serve 120 clients through the funding year. The monthly average program capacity is 20. It is estimated that 40 of the 120 clients would receive Bilingual-bicultural services, and 40 of the 120 clients being served will reside in South County. The hourly rate is $42.19. If you have any questions,please telephone me at extension 6510. Hello