HomeMy WebLinkAbout20011043 RESOLUTION
RE: APPROVE 2001-2002 CORE SERVICES AND CHAFEE FOSTER CARE
INDEPENDENCE PROGRAM PLAN AND AUTHORIZE CHAIR TO SIGN
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 the 2001-2002 Core Services and
Chafee Foster Care Independence Program Plan from 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, to the Colorado Department of Human Services, Division of
Child Welfare Services, commencing June 1, 2001, and ending May 31, 2002, with further
terms and conditions being as stated in said plan, and
WHEREAS, after review, the Board deems it advisable to approve said plan, a copy of
which is attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of
Weld County, Colorado, ex-officio Board of Social Services, that the 2001-2002 Core Services
and Chafee Foster Care Independence Program Plan from 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, to the Colorado Department of Human Services, Division of
Child Welfare Services, be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said plan.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 18th day of April, A.D., 2001.
BOARD OF COUNTY COMMISSIONERS
WELD CO COLORADO
ATTEST: At,/Zeal e, EL %
J. Geile, Chair
Weld County Clerk to the ,
t*J — ; CUSED DATE OF SIGNING (AYE)
2 $lenn Vaad, Pro-Tem
Deputy Clerk to the Boar.'/ � � �, ✓. -e
r"� Williei\p�li. Jerke
�PPR-OV AST RM:
C vi . Long
unty Attorney
Robert . Masden
2001-1043
pc : SS0028
• 6 -
J , J DEPARTMENT OF SOCIAL SERVICES
PO BOX A
rm GREELEY,CO 80632
I
WEBSITE:www.co.weld.co.us
Administration and Public Assistance(970)352-1551.
D
C. Child
Support(970)352-6933
COLORADO MEMORANDUM
TO: M.J. Geile, Chair Date: April 13, 2001
Board of County Commissioners
FR: Judy A. Griego, Director, Social Services_ )0
RE: Core Services and Chafee Foster Care Independence Program Plan
for FY2001-2001
Enclosed for Board approval is Core Services and Chafee Foster Care Independence
Program Plan for FY2001-2001. The Weld County Families, Youth, and Children
Commission has reviewed the plan and approved the vendors listed in the plan as part of
the yearly bid process.
The major provisions of the Program Plan as follows:
1. The term of the Program Plan commences June I, 2001, and ends May 31, 2002.
2. The total budget under the Program Plan is $1,020,513.94 as follows:
A. Chafee Foster Care Independence Program $ 90,691.94
B. Home Based Intervention Services $164,603.33
C. Intensive Family Therapy $141,408.11
D. Lifeskills $141,538.86
E Day Treatment $199,781.16
F. Sex Abuse Treatment $ 52,548.54
G. Alcohol and Drug Contract $122,398.00
H. Mental Health Contract $ 97,544.00
L Special Economic Assistance $ 10,000.00
3. Of the $1,020,513.94 Budget, $90,691 is Chafee Foster Care Independence
Funds, $699,880 is 80%Federal/State 20% County Funds, and $229,942 is 100%
Federal/State Funds.
If you have any questions, please telephone me at extension 6510.
2001-1043
CORE SERVICES
&
CHAFEE FOSTER CARE INDEPENDENCE
PROGRAM PLAN
FY 2OO1-2OO2
FOR
WELD
COUNTY(IES)
REQUEST FOR STATE APPROVAL OF PLAN
® If this box is checked please complete all portions of the plan related to Chafee Foster Care Independence
Program(CFCIP),otherwise all statements throughout this document will be considered not applicable.
This Core Services Plan is hereby submitted for Weld [Indicate county name(s) and lead county if this is a
multi-county plan],for the period June 1,2001,through May 31,2002. The Plan includes the following:
4) Completed"Statement of Assurances";
ip Completed Statement of the eight(8)required Core services to be provided or
purchased and a list of county optional services, County Designed Program
Services,to be provided or purchased;
4) Completed program description of each proposed"County Designed Service";
4) Completed"Information on Fees"form;
4) Completed"Direct Service Delivery"form;
$ Completed"Purchase of Service Delivery"form;
$ Completed"Projected Outcomes"form;
$ Completed"Overhead Cost"form;
4, Completed"Final Budget Page"form;
4) Completed"State Board Summary";and,
0 Completed"100%Funding Summary"form
This CFCIP plan is hereby submitted for Weld [Indicate county name(s) and lead county if this is a multi-
county plan],for the period July 1,2001,through June 30,2002. The Plan includes the following:
0 Completed"Request for State Approval"form
0 Completed"State of Assurances"form
0 Completed"Chafee Foster Care Independence Program"format
$ Completed"Direct Service Delivery"and/or"Purchased Service Delivery"
form
$ Completed"Youth Direct"form
4) Completed"Final Budget page"
This Core Services and Chafee Foster Care Independence Program Plan has been developed in accordance with
State Department of Human Services rules and is hereby submitted to the Colorado Department of Human
Services, Division of Child Welfare Services for approval. If the enclosed proposed Core Services and/or
Chafee Foster Care Independence Program Plan is approved,the plan will be administered in conformity with
its provisions and the provisions of State Department rules.
The person who will act as primary contact person for the Core Services Plan is, David Aldridge and can be
reached at telephone number(970) 352.1551, extension 6290. The primary contact person for CFCIP is Joyce
Hause and can be reached at telephone number(970)352.1551,extension 6245.
If two or more counties propose this plan,the required signatures below are to be completed by each county,as
appropriate. Please attach an additional signature page as needed.
signatur , IRE R,CO DE ARTMENT OF SOCIAL SERVICES DA
Signature,CHAIR, CEMENT ALTERNATIVES COMMISSION DATE
// y iP-.2ro,
Signature, IR,BOXL OF COUNTY COMMISSIONERS DATE
2
CORE SERVICES
STATEMENT OF ASSURANCES
Weld County(ies)assures that,upon approval of the Core Services-Chafee Foster Care Independence Program
Plan the following will be adhered to in the implementation of the Plan:
Core Services Assurances:
• Operation will conform to the provisions of the Plan;
• Operation will conform to State rules;
• Core Services Program Services, provided or purchased, will be accessible to
children and their families who meet the eligibility criteria;
• Operation will not discriminate against any individual on the basis of race, sex,
national origin, religion, age or handicap who applies for or receives services
through the Core Services program;
• Services will recognize and support cultural and religious background and
customs of children and their families;
• Out-of-state travel will not be paid for with Core Services funds;
• All forms used in the completion of the Core Services plan will be State
prescribed or State approved forms;
• Core FTE/Personal Services costs authorized for reimbursement by the State
Department will be used only to provide Core Services authorized in the
county(ies)'approved Core Services Plan;
• The purchase of services will be in conformity with State purchase of service
rules including contract form,content,and monitoring requirements;and
• Information regarding services purchased or provided will be reported to the
State Department for program,statistical and financial purposes.
3
CHAFEE FOSTER CARE INDEPENDENCE PROGRAM PLAN
STATEMENT OF ASSURANCES
Weld County(ies)assures that,upon approval of the Core Services-Chafee Foster Care Independence Program
Plan the following will be adhered to in the implementation of the Plan:
Chafee Foster Care Independence Program statement of assurances:
• Funds shall be used exclusively for the purposes specified in the plan;
• Funds shall not be used to supplant,duplicate or replace existing child welfare funds and;
• Funds shall not be used for county budget shortfalls;
• Assistance and services will be provided to youth who have left foster care because they have attained
18 years of age,and have not attained 21years of age[Section 477(b)(3)(A)];
• Not more than 30 percent of the amounts allocated for CFCIP for a fiscal year
will be expended for room and board for youth who have left foster care because they have attained 18
years of age,and have not attained 21 years of age [Section 477(b)(3)(B)];
• None of the amounts paid to the County Department from its allocation will be expended for
room and board for any child who has not attained 18 years of age[Section 477(b)(3)(C)];
• The County Department will make every effort to coordinate the CFCIP program receiving
funds with other Federal and State programs for youth(especially transitional living youth projects
funded under part B of title III of the Juvenile Justice and Delinquency Prevention Act of 1974);
abstinence education programs,local housing programs,programs for disabled youth(especially
sheltered workshops),and school-to-work programs offered by high schools or local workforce
agencies [Section 477(b)(3)(F)]; •
• Adolescents participating in the program under this section will participate directly in designing their
own program activities that prepare them for independent living and the adolescents will be required to
accept personal responsibility for living up to their part of the program[Section 477(b)(3)(H)]; and
• The County Department agrees to enforce standards and procedures to prevent fraud and abuse in the
programs carried out under the plan.
4
CORE SERVICESTO BE PROVIDED/PURCHASED
Place an "X"to indicate which of the following Core Services Program Services will be provided/purchased in accordance with
State Department rules:
_X_ Home Based Intervention
Y� Intensive Family Therapy
X Sexual Abuse Treatment Services
`__ Day Treatment
_L Life Skills
X. Special Economic Assistance
X Mental Health Services
X Substance Abuse Treatment Services
List below"County Designed Service"that will be provided/purchased in accordance with State Department rules:
5
CORE SERVICE
COUNTY DESIGNED SERVICE
Service Name:None
Optional services approved as a part of the county's Core Services Plan are approved on an annual basis. For a County Designed
Service to be extended beyond one year,this portion of the plan must be submitted and approved annually by the State Department.
Given that County Designed programs are not standardized across counties, it is important to provide detailed information as
outlined below. This information can be use to justify continued finding of the program with the legislature. The information listed
below is to be completed for each County Designed Service to be included in the County(ies)'Core Services Program Plan.
1. Describe the service and components of the service,define the goals of the program.
2. Define the eligible population to be served.
3. Define the time frame of the service.
4. Define the workload standard for the program:
• number of cases per worker,
• number of workers for the program,and
• worker to supervisor ratio.
5. Define the staff qualifications for the service,e.g.,minimum caseworker III or equivalent,see 7.303.17 for guidelines.
• Define the performance indicators that will be achieved by the service,see 7.303.18.
• Identify the service provider.
• Define the rate of payment(e.g.,$250.00 per month).
6
INFORMATION ON CORE SERVICE FEES
Please check all that apply::
X Fees will not be assessed for Core Services Program Services. (STOP. Remainder of information does not need to be
completed.)
Fees will be assessed for the following services:Check those that apply:
Home Based Intervention
Intensive Family Therapy
Sexual Abuse Treatment
Day Treatment
Life Skills
Special Economic Assistance
Mental Health Services
Substance Abuse Treatment Services
County Designed Service(List Services Below)
Fee assessment formula is the same for all services. State the formula here(attach additional sheets as needed).
Fee assessment formula varies with service. State formula used for each service.
7
HOME BASED INTERVENTION SERVICES
DIRECT SERVICE DELIVERY- CORE SERVICES PROGRAM
CFMS—Function Code 1700,1800
Definition
7303.1 A Home Based Intervention: Services provided primarily in the home of the client and includes a variety of services which can include therapeutic services,
concrete services,collateral services and crisis intervention directed to meet the needs of the child and family.
Indicate information for each line service worker and his/her immediate supervisor for whom Core Services funding is proposed in whole or in part.Include only amounts that
are to be charged to Core Services. Staff positions to be included are employee Merit System/equivalent positions and employee contract positions.
1 2 3 4 5 6 7 8 9 10 11 12
Position Job Title Gross Monthly Monthly Monthly Percent of Percent of Percent Salary Total Monthly Number Total Direct
Number Monthly Fringe Travel Operate Salary Salary Funded by Direct Service of Service Cost
Salary Funded by Funded by Regular Cost Month
80/20 100% Admin (3+4+5+6) of Cost
None
TOTAL
8
INTENSIVE FAMILY THERAPY
DIRECT SERVICE DELIVERY-CORE SERVICES PROGRAM
CFMS--Function Codes 1710,1810
Definition
7.303.1 B Intensive Family Therapy:Therapeutic intervention typically with all family members to improve family communication,functioning,and relationships.
Indicate information for each line service worker and his/her immediate supervisor for whom Core Services funding is proposed in whole or in part. Include only amounts that
are to be charged to Core Services. Staff positions to be included are employee Merit System/equivalent positions and employee contract positions.
1 2 3 4 5 6 7 8 9 10 1 12
Position Job Title Gross Monthly Monthly Monthly Percent of Percent of Percent Salary Total Monthly Number Total Direct
Number Monthly Fringe Travel Operate Salary Salary Funded by Direct Service of Service Cost
Salary Funded by Funded by Regular Cost Month
80/20 100% Admin (3+4+5+6) of Cost
None
TOTAL
9
LIFE SKILLS
DIRECT SERVICE DELIVERY-CORE SERVICES PROGRAM
CFMS—Function Codes 1720,1820
Definition
7.303.1 C Life Skills:Services provided primarily in the home that teach household management,effectively accessing community resources,parenting techniques,
and family conflict management.
Indicate information for each line service worker and his/her immediate supervisor for whom Core Services funding is proposed in whole or in part.Include only amounts that
are to be charged to Core Services. Staff positions to be included are employee Merit System/equivalent positions and employee contract positions.
1 2 3 4 5 6 7 8 9 10 11 12
Position Job Title Gross Monthly Monthly Monthly Percent of Percent of Percent Salary Total Monthly Number Total Direct
Number Monthly Fringe Travel Operate Salary Salary Funded by Direct Service of Service Cost
Salary Funded by Funded by Regular Cost Month
80/20 100% Admin (3+4+5+6) of Cost
None
TOTAL
10
DAY TREATMENT
DIRECT SERVICE DELIVERY-CORE SERVICES PROGRAM
CFMS—Function Codes 1730,1830
Definition
7.303.1 D Day Treatment:Comprehensive,highly structured services that provide therapy and education for children.
Indicate information for each line service worker and his/her immediate supervisor for whom Core Services funding is proposed in whole or in part.Include only amounts that
are to be charged to Core Services. Staff positions to be included are employee Merit System/equivalent positions and employee contract positions.
1 2 3 4 5 6 7 8 9 10 11 12
Position Job Title Gross Monthly Monthly Monthly Percent of Percent of Percent Salary Total Monthly Number Total Direct
Number Monthly Fringe Travel Operate Salary Salary Funded by Direct Service of Service Cost
Salary Funded by Funded by Regular Cost Month
80/20 100% Admin (3+4+5+6) of Cost
None
TOTAL
11
SEXUAL ABUSE TREATMENT SERVICES
DIRECT SERVICE DELIVERY-CORE SERVICES PROGRAM
CFMS—Function Codes 1740, 1840
Definition
7.303.1 E Sexual Abuse Treatment:Therapeutic intervention designed to address issues and behaviors related to sexual abuse victimization sexual dysfunction, sexual
abuse perpetration,and to prevent further sexual abuse and victimization.
Indicate information for each line service worker and his/her immediate supervisor for whom Core Services funding is proposed in whole or in part.Include only amounts that
are to be charged to Core Services. Staff positions to be included are employee Merit System/equivalent positionsand employee contract positions.
1 2 3 4 5 6 7 8 9 10 11 12
Position Job Title Gross Monthly Monthly Monthly Percent of Percent of Percent Salary Total Monthly Number Total Direct
Number Monthly Fringe Travel Operate Salary Salary Funded by Direct Service of Service Cost
Salary Funded by Funded by Regular Cost Month
80/20 100% Admin (3+4+5+6) of Cost
None
TOTAL
12
COUNTY DESIGNED SERVICE
DIRECT SERVICE DELIVERY-CORE SERVICES PROGRAM
CFMS—Function Codes 17_,18_
Definition
7.303.1 J County Designed Services:innovative and/or otherwise unavailable service proposed by a county that meets the goals of the Core Services Program
Indicate information for each line service worker and his/her immediate supervisor for whom Core Services funding is proposed in whole or in part.Include only amounts that
are to be charged to Core Services. Staff positions to be included are employee Merit System/equivalent positions Md employee contract positions.
1 2 3 4 5 6 7 8 9 10 11 12
Position Job Title Gross Monthly Monthly Monthly Percent of Percent of Percent Salary Total Monthly Number Total Direct
Number Monthly Fringe Travel Operate Salary Salary Funded by Direct Service of Service Cost
Salary Funded by Funded by Regular Cost Month
80/20 100% Admin (3+4+5+6) of Cost
None
TOTAL
13
HOME BASED INTERVENTION SERVICE
PURCHASE OF SERVICE
CORE SERVICES PROGRAM
CFMS—Function Codes 1700, 1800
Indicate information for each CWEST provider from whom Core services are proposed to be purchased.
1 2 3 4 5 6 7 8
PROVIDER NAME CWEST Unit of Number of Units Payment Rate Cost Per Number of Total Cost
Provider Service* of Service/Month per Unit of Month Months of Per Provider
Number Service (4 x 5) Cost (6 x 7)
Ackerman&Associates 02916 Hour 60 $99.50
Island Grove Regional Treatment 02917 Hour 173.6 $100.00
Center
TOTAL $164,603.33
• -Identification of unit is: H=Hour,D=Day,W=Week,M=Month,E=Episode
14
INTENSIVE FAMILY THERAPY
PURCHASE OF SERVICE
CORE SERVICES PROGRAM
CFMS—Function Codes 1710,1810
Indicate information for each CWEST provider from whom Core services are proposed to be purchased.
1 2 3 4 5 6 7 8
PROVIDER NAME CWEST Unit of Number of Units Payment Rate Cost Per Number of Total Cost
Provider Service* of per Unit of Month Months of Per Provider
Number Service/Month Service (4 x 5) Cost (6 x 7)
Ackerman & Associates, Family 02916 Conference 2 $2,000.00 per
Group#1 conference
Ackerman&Associates, 02916 Hour 100 $99.50
Combined Mediated Family
Conflict Resolution-GAP#2
North Colorado PsychCarelYouth 63973 Hour 200 $82.00
Passages
Client Unit 1 client/mo; 2 $1,800/day
=4 families days
Island Grove Regional Treatment 02917 Hour 62 $90.00
Center
Alternative Homes for Youth- 92446 Hour 112 $110.67
MST
Mediation Communication 39595 Hour 12 $150.60
Training
TOTAL_$141,408.11
*-Identification of unit is: H=Hour,D=Day,W=Week,M=Month E=Episode
15
LIFE SKILLS
PURCHASE OF SERVICE
CORE SERVICES PROGRAM
CFMS—Function Codes 1720, 1820
Indicate information for each CWEST provider from whom Core services are proposed to be purchased.
1 2 3 4 5 6 7 8
PROVIDER NAME CWEST Unit of Number of Units Payment Rate Cost Per Number of Total Cost
Provider Service* of Service/Month per Unit of Month Months of Per Provider
Number Service (4 x 5) Cost (6 x 7)
Weld County Department of 45082 Hour 240 $11.00 (Plus
Social Services-Generic Lifeskills benefit rate of
$1.98/hr)
Weld County Department of 09755 Hour 92 $102.44
Public Health&Environment
Weld County Youth 17967 Hour 220 $16.50
Altematives/dba Weld County
Partners
Child Advocacy Resource& 62085 Hour 267 $45.84
Education,Inc.(Visitation)
Child Advocacy Resource& 62085 Hour 229 $54.98
Education,Inc.(Parent Advocate)
TOTAL 141.538.86
*-Identification of unit is: H=Hour,D=Day,W=Week,M=Month E=Episode
16
DAY TREATMENT
PURCHASE OF SERVICE
CORE SERVICES PROGRAM
CFMS—Function Codes 1730, 1830
Indicate information for each CWEST provider from whom Core services are proposed to be purchased.
1 2 3 4 5 6 7 8
PROVIDER NAME CWEST Unit of Number of Units Payment Rate Cost Per Number of Total Cost
Provider Service* of Service/Month per Unit of Month Months of Per Provider
Number Service (4 x 5) Cost (6 x 7)
North Colorado PsychCare/Youth 63973 Hour 5,120 $19.00/hr
Passages Month $2,090.00/mo
North Range Behavioral Health, 80103 Hour 1,260 $13.14/hr
Inc.
Month $1,550/mo
Alternative Homes for Youth 92446 Hour 545 $47.12/hr
Month $1,490.41/mo
TOTAL $199,781.16
* -Identification of unit is: H=Hour,D=Day,W=Week,M=Month E=Episode
17
SEXUAL ABUSE TREATMENT
PURCHASE OF SERVICE
CORE SERVICES PROGRAM
CFMS—Function Codes 1740,1840
Indicate information for each CWEST provider from whom Core services are proposed to be purchased.
1 2 3 4 5 6 7 8
PROVIDER NAME CWEST Unit of Number of Units Payment Rate Cost Per Number of Total Cost
Provider Service* of Service/Month per Unit of Month Months of Per Provider
Number Service (4 x 5) Cost (6 x 7)
Alternative Homes for Youth 92446 Hour 192 $43.28
Weld County Department of 45082 Hour 7-12 Families per To be
Social Services year-Flexible determined
Ackerman&Associates,P.C. 02916 Hour 135 $99.50
TOTAL $52,548.54
*-Identification of unit is: H=Hour,D=Day,W=Week,M=Month E=Episode
18
SPECIAL ECONOMIC ASSISTANCE
PURCHASE OF SERVICE
CORE SERVICES PROGRAM
CFMS—Function Codes 1855
Indicate information for each CWEST provider from whom Core services are proposed to be purchased.
1 2 3 4 5 6 7 8
PROVIDER NAME CWEST Unit of Number of Units Payment Rate Cost Per Number of Total Cost
Provider Service* of Service/Month per Unit of Month Months of Per Provider
Number Service (4 x 5) Cost (6 x 7)
Various Providers
TOTAL $10,000.00
19
MENTAL HEALTH SERVICES
PURCHASE OF SERVICE
CORE SERVICES PROGRAM
CFMS—Function Codes 1845
Indicate information for each CWEST provider from whom Core services are proposed to be purchased.
1 2 3 4 5 6 7 8
PROVIDER NAME CWEST Unit of Number of Payment Rate Cost Per Number of Total Cost
Provider Service* Units of per Unit of Month Months of Per Provider
Number Service/Month Service (4 x 5) Cost (6 x 7)
North Range Behavioral Health 80103 Hour 6 Assessments $78.00
*Ackerman&Associates 02916 Hour 62.5 $90.00
$45.00/Group
* Lori Kochevar New Hour 49.5 $75.00
$45.00/Group
*North Colorado 63973 Hour 133 $71.25
PsychCare/Youth Passages
20 $85.00/Group
*First Right of Refusal Waived for Foster Parent Consultation Program
TOTAL $97,544..00
*-Identification of unit is: H=Hour,D=Day,W=Week,M=Month E=Episode
20
SUBSTANCE ABUSE TREATMENT SERVICES
PURCHASE OF SERVICE
CORE SERVICES PROGRAM
CFMS—Function Codes 1840
Indicate information for each CWEST provider from whom Core services are proposed to be purchased.
1 2 3 4 5 6 7 8
PROVIDER NAME CWEST Unit of Number of Units Payment Rate Cost Per Number of Total Cost
Provider Service* of Service/Month per Unit of Month Months of Per Provider
Number Service (4 x 5) Cost (6 x 7)
Island Grove Regional Treatment 92017 Unit N/A See Menu of
Center Services
TOTAL $122,398.00
*-Identification of unit is: H=Hour,D=Day,W=Week,M=Month,E=Episode
21
COUNTY DESIGNED SERVICES
PURCHASE OF SERVICE
CORE SERVICES PROGRAM
CM-MS—Function Codes 17_,18_
Indicate information for each CWEST provider from whom Core services are proposed to be purchased.
1 2 3 4 5 6 7 8
PROVIDER NAME CWEST Unit of Number of Units Payment Rate Cost Per Number of Total Cost
Provider Service* of Service/Month per Unit of Month Months of Per Provider
Number Service (4 x 5) Cost (6 x 7)
None
TOTAL
*-Identification of unit is:H=Hour,D=Day,W=Week,M=Month E=Episode
22
PROJECTED CORE SERVICES OUTCOMES FOR
PERFORMANCE INDICATORS
FOR FY 2001-2002
+ `*7:1"'c A P'r",..,t.r s 'rv��p.d t `s, r ! ,5%(rY.a'u -: e
Home Base 10 15 20 45
Intensive Family Therapy 17 20 90 127
Life Skills 22 66 22 110
Day Treatment 28 7 11 46
Sexual Abuse Treatment 20 10 6 36
Mental Health Treatment 55 0 0 55
Substance Abuse Treatment 0 166 0 166
Special Economic Assistance 41 0 0 41
County Design(List) N/A
'-Client meets 86%or more of the treatment goals
2-Client meets between 85%-25%of the treatment goals
3-Client meets 24%or less of the treatment goals
23
CORE SERVICES PROGRAM
OVERHEAD COST
1. DIRECT SERVICE
A. Total Salary/Fringe/Travel/Operating Costs of Line
Service Workers and their Immediate Supervisors
B. Formula Percentage Allowed for Overhead Costs 15%
C. Provided Service Overhead Costs(A X B)
2. PURCHASED SERVICE
A. Purchased Service Dollar Amount _S_699.880..00
B. Formula Percentage Allowed for Overhead Costs 3.50
$0-50,000 =5% $50,001 -100,000=4.9%
For each$50,000(in total expenditure)increase the overhead
decreases by.1 %.
C. Allowed Amount for Overhead Costs(A X B) 24.495.80
D. Base Overhead Cost Allowed 500.00
E. Purchased Service Overhead Costs(C+D) 25.995.80
3. TOTAL OVERHEAD COSTS(1C+2E) 25.995.80
DISTRIBUTION OF OVERHEAD COSTS AMONG SERVICES*
SERVICE Provided Service Purchased Service Total Overhead
Overhead Costs Overhead Costs Costs
1.Home Based Intervention $5,761.12 $5,761.12
2. Intensive Family Therapy $4,949.28 $4,949.28
3. Sexual Abuse Treatment $1,839.20 $1,839.20
4.Day Treatment $6,992.34 $6,992.34
5. Life Skills $4,953.86 $4,953.86
6. County Designed Service None
COLUMN TOTALS $24,495.80 $24,495.80
*Formula to determine overhead cost by service:
Step 1: total provided service cost(by service)x 15%=provided service overhead cost
Step 2: total purchased service cost(by service)x%listed in 2B=Y
$500 divided by the number of purchased service=Z,then Y+Z=overhead cost
Step 3: Provided service overhead cost plus purchased service overhead cost equals total overhead cost.
24
GENERIC COST SUMMARY SHEET
1. Account Code
2. Total number of children to be served by provided services
3. Total number of children to be served by purchased services
4. Average number of children(total 2+3+12)to be served monthly
5. Total number of families to be served
6. Average number of families to be served monthly
7. Employee FTE number(should be the total staff listed on Direct Service
Delivery Page)
8. Provided cost
Overhead cost(From Overhead cost summary sheet)
Total provided cost
9. Monthly provided cost per child
[this is determined by dividing the total provided cost by the number
of children to be served from provided services and then dividing that
total by the number of months the service will be provided.]
10. Purchased cost
Overhead cost(From Overhead cost summary sheet)
Total purchased cost
11. Monthly purchased cost per child
[this is determined by dividing the total purchased cost by the number of
children to be served from purchased services and then dividing that
total by the number of months the service will be provided.]
12. TOTAL COST REQUESTED [Total provided cost
Total purchased cost]
13. Total 80/20 service cost requested
14. Total 100%service cost requested
25
FINAL BUDGET PAGE
FY 2001-2002
CORE SERVICES
CHAFEE FOSTER CARE INDEPENDENCE PROGRAM
CFMS Service Name Other DSS Other Chafee Foster Total Funds Total Funds TOTAL
Function Funds Source Care 80/20 100% FUNDS
Code Funds Independence
Funds
1905 CHAFEE Foster Care $90,691.94 $90,691.94
Independence Program
1783 Home Based Intervention 164,603.33 164,603.33
1784 Intensive Family Therapy 141,408.11 141,408.11
1785 Lifesldlls 141,538.86 141,538.86
1786 Day Treatment 199,781.16 199,781.16
1787 Sex Abuse Treatment 52,548.54 52,548.54
1889 ADAD Contract 122,398.00 122,398.00
1888 Mental Health Contract 97,544.00 97,544.00
1877 Special Economic Assistance 10,000.00 10,000.00
TOTALS $90,691.94 $699,880.00 $229,942.00 $1,020,513.94
CFMS Function Codes 17xx denotes 80/20 funded Core Service
CFMS Function Codes 18xx denotes 100%funded Core Service
CFMS Function Codes 2850 Chafee Foster Care Independence Program Purchased,Direct Services and Youth Direct
CFMS Function Codes 2810 Room&Board Reimbursement For Emancipated Youth
26
STATE BOARD SUMMARY
CORE SERVICES PROGRAM
FY 2001-2002-80/20 FUNDING
C0UNTY(IES) YVe1�
Services Provider or #of Families #Children Cost per Child Cost per Year
Number of FIE Age of Child Served Per Served Per Per Month
Month Month
Home Based Various 0-17 $164,603.33
Intervention
Intensive Family Various 0-17 $141,408.11
Therapy
Lifeskills Various 0-17 $141,538.86
Day Treatment Various 5-17 $199,781.16
Sex Abuse Various 0-17 $122,398.00
Treatment
County Design None None None None None None
TOTAL 80/20 CORE j669,$80.Q0
27
100 %FUNDING SUMMARY
CORE SERVICE PROGRAM
FY 2001-2002
COUNTY(IES) Weld
Services Provider or #of Families #Children Served Cost per Child Cost per Year
Number of FTE Age of Child Served Per Month Per Month per Month
ADAD Island Grove Regional NA N/A N/A N/A $122,398.00
Treatment Center
Mental Health North Range N/A N/A N/A N/A $97,544.00
Behavioral Health
Special Economic Various N/A N/A N/A N/A $10,000.00
Assistance
CHAFFEE Foster Various N/A N/A N/A N/A $90,691.94
Care Independence
TOTAL 100%CORE j320,633.94
28
CWEST CODING SUMMARY SHEET FY 2001-2002
(Applies only to counties still reporting on CWEST)
Contact Person Phone Number
David Aldridge 970-352.1551 x
6290
CWEST Provider Name CWEST Provider# Provider Name Unit of Rate of Payment Object Code Account Code
Service
Ackerman & 02916 Ackerman & Hour $99.50 1783
Associates, P.C. Associates, P.C.
CWEST Provider Name CWEST Provider# Provider Name Unit of Rate of Payment Object Code Account Code
Service
02917 Island Grove Hour $100.00 1783
Island Grove Regional Regional
Treatment Center Treatment Center
CWEST Provider Name CWEST Provider# Provider Name Unit of Rate of Payment Object Code Account Code
Service
02916 Ackerman & Per $2,000.00 1784
Ackerman & Associates, P.C., Conference
Associates, P.C Family Group
Decision Making
CWEST Provider Name CWEST Provider# Provider Name Unit of Rate of Payment Object Code Account Code
Service
Ackerman & 02916 Ackerman & Hour $99.50 1784
Associates Associates, P.C.,
Combined
Mediated Family
Conflict
Resolution-GAP
CWEST Provider Name CWEST Provider# Provider Name Unit of Rate of Payment Object Code Account Code
Service
North Colorado 63973 North Colorado Hour $82.00 1784
PsychCare/Youth PsychCare/
Passages Youth Passages
IFT
CWEST Provider Name CWEST Provider# Provider Name Unit of Rate of Payment Object Code Account Code
Service
Island Grove Regional 02917 Island Grove Hour $90.00 1784
Treatment Center Regional
Treatment Center
IFT
29
CWEST Provider Name CWEST Provider# Provider Name Unit of Rate of Payment Object Code Account Code
Service
Alternative Homes for 92446 Alternative Hour $110.67 1784
Youth Homes for Youth
Multisystemic
Treatment(MST)
CWEST Provider Name CWEST Provider# Provider Name Unit of Rate of Payment Object Code Account Code
Service
Mediation 39595 Mediation Hour $150.60 1784
Communication Communication
Training Training
CWEST Provider Name CWEST Provider# Provider Name Unit of Rate of Payment Object Code Account Code
Service
Weld County 45082 Weld County Hour $11.00(Plus 1785
Department of Social Department of benefit rate of
Services Social Services- $1.98/hr)
Generic Lifeskills
Program
CWEST Provider Name CWEST Provider# Provider Name Unit of Rate of Payment Object Code Account Code
Service
Weld County 09755 Weld County Hour $102.44 1785
Department of Public Department of
Health & Environment Public Health &
Environment,
Lifeskills
CWEST Provider Name CWEST Provider# Provider Name Unit of Rate of Payment Object Code Account Code
Service
Weld County Youth 17967 Weld County Hour $16.50 1785
Alternatives/dba Weld Youth
County Partners Alternatives/dba
Weld County
Partners,
Lifeskills
CWEST Provider Name CWEST Provider# Provider Name Unit of Rate of Payment Object Code Account Code
Service
Child Advocacy 62085 Child Advocacy Hour $45.84 1785
Resource& Education, Resource&
Inc. Education, Inc.,
Lifeskills,
Visitation
CWEST Provider Name CWEST Provider# Provider Name Unit of Rate of Payment Object Code Account Code
Service
30
Child Advocacy 62085 Child Advocacy Hour $54.98 1785
Resource & Education Resource&
Education, Inc.,
Lifeskills, Parent
Advocate
Program
CWEST Provider Name CWEST Provider# Provider Name Unit of Rate of Payment Object Code Account Code
Service
North Colorado 63973 North Colorado Hour $19.00/Hr 1786
PsychCare/Youth PsychCare/Youth Month $2,090.00/Mo
Passages Passages, Day
Treatment
CWEST Provider Name CWEST Provider# Provider Name Unit of Rate of Payment Object Code Account Code
_Service
North Range 80103 North Range Hour $13.14/hr 1786
Behavioral Health Behavioral Month $1,550.00/mo
Health/Littler
Center, Day
Treatment
CWEST Provider Name CWEST Provider# Provider Name Unit of Rate of Payment Object Code Account Code
Service
Alternative Homes for 92446 Alternative Hour $47.12/hr 1786
Youth Homes for Youth Month $1,490.41/mo
CWEST Provider Name CWEST Provider# Provider Name Unit of Rate of Payment Object Code Account Code
Service
Alternative Homes for 92446 Alternative Hour $43.28 1787
Youth Homes for Youth,
Sex Abuse
Treatment
CWEST Provider Name CWEST Provider# Provider Name Unit of Rate of Payment Object Code Account Code
Service
Weld County 45082 Weld County Hour Various 1787
Department of Social Department of
Services Social Services,
Sex Abuse
Treatment
CWEST Provider Name CWEST Provider# Provider Name Unit of Rate of Payment Object Code Account Code
Service
Ackerman & 02916 Ackerman & Hour $99.50 1787
Associates, P.C. Associates, Sex
Abuse Treatment
31
PURCHASE OF SERVICE CONTRACT
Core Services PROGRAM
1. THIS CONTRACT,made this day of , 1998 by and between the
County Department of Social Services at ,hereinafter called"County"
and (address)
(name) (address)
,hereinafter called"Contractor".
(Tax I.D. or Social Security Number)
2. This contract will be effective from until
3. County agrees to purchase and Contractor agrees to provide
(Core Service)
to at at other such
(population to be served) (location service is to be provided)
location as shall facilitate the provision of such services. This service is described in Staff Manual Volume 7, Section
7.303.1 , and,if appropriate,the State approved County Core Service Plan.
4. County agrees to purchase and contractor agrees to famish units of service at the cost of
per unit of service for a maximum amount of this contract of$
5. The parties agree that the Contractor's relationship to the county is that of an independent Contractor.
6. The parties agree that payment pursuant to this Contract is subject to and contingent upon the continuing availability
of fluids for the purpose thereof
7. County agrees:
a) To determine child eligibility and a s appropriate,to provide information regarding rights to fair hearings
b) To provide Contractor with written prior authorization on a child or family basis for services to be purchased.
c) To provide Contractor with referral information including name and address of family,social,medical, and
educational information as appropriate to the referral.
d) To monitor the provision of contracted service.
e) To pay Contractor after receipt of billing statements for services rendered satisfactorily and in accordance with this
Contract.
8. Contractor agrees:
a) Not to assign any provision of this Contract to a subcontractor.
b) Not to charge clients any fees related to services provided under this contract.
c) To hold the necessary license(s)which permits the performance of the service to be purchased,and/or to meet
applicable State Department of Human Services qualification requirements.
d) To comply with the requirements of the Civil Rights Act of 1964 and Section 504,Rehabilitation Act of 1973
concerning discrimination on the basis of race,color, sex, age,religion,political beliefs,national origin,or
handicap.
e) To provide the service described herein at cost not greater than that charged to other persons in the same
community.
f) To submit a billing statement in a timely manner,no later than 45 days after services. Failure to do so may result
in nonpayment.
g) To safe guard information and confidentiality of the child and the child's family in accordance with rules of the
Colorado Department of Human Services and the County Department of Social Services.
h) To provide County with reports on the provision of services as follows:
• Within weeks of enrollment/participation, submission of a treatment plan for the child/child's
family with specific objectives and target dates. The treatment plan is subject to county approval.
• At intervals of months,from the time of enrollment/participation, submit reports that include
progress and barriers in achieving provisions of the treatment plan.
32
a) To provide access for any duly authorized representative of the County or the Colorado Department of Human
Services until the expiration of five(5)years after the final payment under this Contract, involving transactions
related to this Contract.
b) Indemnify County,Colorado Department of Human Services from the action based upon or arising out of damage
or injury,including death,to persons or property caused or sustained in connection with the performance of this
contract or by conditions created thereby,or based upon any violation of any statue,regulation,and the defense of
any such claims or actions.
9. In addition to the foregoing,the County and Contractor also agree:
10. Termination: Either party may terminate this Contract by thirty(30)days prior notification in writing.
County Director's Signature Contractor's Signature
Date Contractor's Title
Date
Original to Contractor
Copy to the Case File
Copy to County Bookkeeping
Copy to State Accounting
33
WELD COUNTY'S
CHAFEE FOSTER CARE INDEPENDENCE PROGRAM SERVICE
NARRATIVE SUMMARY 2001-2002
1.This is not a regional plan.
2.Identify the populations to be served using the table on page 36 of this plan.
3.Describe the process for identification and outreach to eligible CFCIP participants.Be specific for each population
listed above.
For youth ages less than 16-21 in foster care,Division of Youth Corrections,or emancipated from foster care.
• Youth matching these criteria previously in care with Social Services can be identified through TRAILS.
• Information will be sent out to foster parents and shared through the Weld County Foster Parent Association.
• Flyers will be sent out to Social Services staff and Division of Youth Services staff.They will be asked to supply
the referral form to the Independent Living Workers.
• Youth who are presently residing out of Weld County,their names and information will be sent to the
Independent Living Worker of the county they are now residing.
4.Program Narrative-Weld County will deliver services to achieve the purposes of:
A. Helping youth make the transition to self-sufficiency.
Independent Living Education and Aftercare Support Groups are offered for the youth ages 16-21.These groups offer
skills training for self-sufficiency and support.Funding is designated for these groups to provide snacks and prizes to
promote participation.
Individualized training will be provided if needed.
Emancipation Economic Assistance allows youth emancipating from foster care to receive a stipend to assist with the
financial costs of moving such as deposits,acquiring furniture etc.The total amount allotted to each youth is based on
individual need but the maximum amount is$800.This will allow Weld to service 17+youth.This expenditure will
be approved by the Independent Living Worker and the Youth Services Supervisors.
Weld has been utilizing the CORE Services Special Economic Assistance for this,but that fund is frequently
overspent.With the approval of this money,we can increase the amount provided to each youth and decrease the
stress on the CORE Services Budget.
B. Helping youth receive the education.,training and services necessary to obtain employment.
The Independent Living Workers will refer youth to appropriate educational services offered in the community such
as pubic school,special education assessment,Transitional Education Program,tutoring through AIMS,UNC,
Rodarte Center or private programs,alternative schools,GED Programs offered in a variety of settings,Job Corps,
vocational training offered by AIMS,TANF Programs(if the youth is eligible),etc.
The Independent Living Workers will refer youth to appropriate employment services to assess for appropriate
employment interests,obtain skills and become employed.These may include services offered by Job Services,
Vocational Rehabilitation and AIMS.
C. Helping youth prepare for and enter post-secondary training and education institutions.
The Independent Living Workers will promote the necessity of post-secondary training and education by helping
youth research employment opportunities and the requirements for them.They may take youth to visit post-secondary
training and education alternatives,assist with completing forms and or financial aid.The workers may refer youth to
AIMS or the Educational Opportunity Center.
D. Providing personal and emotional support to youth through mentors and the promotion of interactions
with dedicated adults.
The Independent Living Workers will offer Independent Living Groups.These will provide the youth support,
ongoing training in self-sufficiency and an opportunity to meet different people or groups within the community.
Weld continues to attempt to start a mentoring program involving adult volunteers mentoring the youth living on their
own.
E. Providing financial,housing,counseling,employment,education,and other appropriate support and
services to former foster care recipients between 18 and 21 years of age.Room and Board payments can
only be used for youth,ages 18-21,who emancipated from foster care on or after their 18` birthday.
The Independent Living Workers will refer youth to appropriate community agencies for assistance in these areas.
Through the grant,for a total of$9,900.00, Social Services will offer temporary Emergency Economic Assistance
when all other resources have been exhausted or are unavailable.The goal of the use of these funds is to continue to
encourage the youth to be self-sufficient,provide a temporary safety net for unexpected needs and help youth avoid
homelessness.These funds cannot be used for purposes of room and board but for items such as new work boots,
employment license fee,assist temporarily with emergency medical co-pay fees,tuition for training or a class for
employment.The amount will not exceed$600.00 per year per youth and are only available,as the funds are
available.Payment will be made through a voucher.This expenditure will be approved by the Independent Living
Worker and the Youth Services Supervisors.
Through the grant,for a total of$7,443.60,Social Services will offer temporary Emergency Room and Board
Assistance when all other resources have been exhausted or are unavailable.The goal of the use of these funds is to
continue to encourage the youth to be self-sufficient,provide a temporary safety net for unexpected needs and help
youth avoid homelessness.These funds can be used for purposes of temporary housing,rental deposit,and food.The
amount will not exceed$600.00 per year per youth and are only available,as the funds are available.Payment will be
made through a voucher.This expenditure will be approved by the Independent Living Worker and the Youth
Services Supervisors.
F. Helping youth make life-long connections through relationships with caring adults that will be available
for them after they leave foster care.
Independent Living Workers will begin encouraging this at the time of initial contact at sixteen years of age.Group
topics will include maintaining relationships,techniques for reaching out to others and developing their own social
traditions.
During the period of initial involvement Independent Living Workers will begin speaking to and educating the foster
and adoptive parents,the placement staff and the caseworkers regarding the importance of their continuing
involvement after youth leave their home or placement and emancipate.
The Department in conjunction with the new ASFA regulations will encourage caseworkers to explore with the youth,
the family,the placement and research the case for these life-long connections and documenting these for the youth.
5. Describe your plans for networking and partnering with foster and adoptive parents,group home workers and
caseworkers regarding the needs of youth preparing for independent living.
During the period of initial involvement Independent Living Workers will begin speaking to and educating the foster and
adoptive parents,the placement staff and the caseworkers regarding the importance of their continuing,involvement after youth
leave their home or placement and emancipate.
Caseworkers will receive progress reports twice a year and a discharge report when the program has been completed or
terminated.
6. Describe your efforts at involving the public and private sectors in your CFCIP planning process as well as direct
care service provision.
Independent Living Workers will be referring youth to both public and private agencies as resources.By referring youth to
these programs already in the community and not directly providing the service,youth will learn how to seek out such services
in the future on their own.
These services may include:University of Northern Colorado,AIMS Community College,area school districts,Educational
Opportunity Center,the local Community Center Board-Centennial Developmental Services,Colorado Vocational
Rehabilitation Services,Weld Human Resources/Job Services,Job Corps,Department of Social Security,Weld Health
Department,Sunrise Community Health Center,Plan de Salude Clinics,Planned Parenthood,Colorado Child Health Plan,
Medicaid,North Range Behavioral Health,UNC Counseling Center,North Colorado Medical Center,North Colorado
Psychcare,I stand Grove Regional Treatment Center,Alcoholics Anonymous,Narcotics Anonymous,AL-ANON,Right to
Read,Local Military Recruiters,Youth Link, Greeley Recreation Center,Rodarte Center,Boy's and Girl's Club,Partners,
Support Groups,Women,Infants and Children Food Program,Weld Food Bank Child Advocacy Resource and Education,
First Steps,Bright Beginnings,Salvation Army,Transitional House,Guadelupe Center,A Woman's Place,etc.
Individuals and groups from both the public and private sector will be invited as speakers to the groups or may be visited by
the group.
7. Describe how youth are involved in the CFCIP planning process.
Weld's Independent Living Program:
The Independent Living Aftercare Program is a voluntary program offered to youth,ages 16-18 previously in foster care after
the age of sixteen through either Social Services or Division of Youth Services.Youth receive an assessment.Considering the
strengths and weaknesses identified in the assessment,the worker and the youth will develop a plan in which their needs may
be met.
Monthly contact with the Independent Living Worker or the case will be closed.This contact may include attendance in a
group,a scribbled note,a telephone call or message on phone mail.
Weld's Independent LivingAftercare Program;
The Independent Living Aftercare Program is a voluntary program offered to youth,ages 18-21 previously in foster care after
the age of sixteen through either Social Services or Division of Youth Services.Some financial programs are designated for
only those youth,ages 18-21,who emancipated from care on or after their 18th birthday.These youth may choose to stop
involvement and refer themselves again at a later date.
Youth that were not involved previously in Colorado's Independent Living Program after it is verified they have previously
been in foster care after the age of sixteen will receive an assessment.Youth previously open in an Independent Living
Program in another county,will authorize their information be forwarded to Weld County.
The youth will work with the Independent Living Worker in establishing a time-limited,goal oriented plan.A youth may
establish and complete several plans between 18-21 years of age.One criterion that will be required in all plans is the youth
will maintain monthly contact with the Independent Living Worker or the case will be closed.This contact may include
attendance in a group,a scribbled note, a telephone call or message on phone mail.
Total Budget for Weld Independent Living Program 2001-02
Name #Clients Monthly Clients Rate per Unit Cost per Month Total Cost
Of service per
Program
Independent Living Groups 80 34 $83.33 (W) $333.33 $4,000.00
Independence Support Groups (Aftercare) 30 7 $125.00 (W) $500.00 $6,000.00
Emergency Economic Assistance 12 1 $600.00 $600.00 $7,200.00
Mentoring Program 5 1 $83.33 (M) $83.33 $1,000.00
Emancipation Economic Assistance 15 1.25 $800.00 $1,000.00 $12,000.00
Room&Board Reimbursement 18 1.5 $503.33 $754.99 $9,059.94
P l'b Gross Monthly Monthly Monthly Monthly Total Monthly Number of Months Total FTE
Salary Fringe Travel Operate/Training Direct Service Cost Cost
.5 $1802.00 $324.00 $50.00 $20.00 $2196.00 12 $26,352.00
.5 $1712.00 $308.00 $50.00 $20.00 $2090.00 12 $25,080.00
Weld's Total: $90.691.94
DIRECT SERVICE DELIVERY FTE SERVICES
CHAFEE FOSTER CARE INDEPENCE PROGRAM
CFMS—Program Code E010,Function Code 2850
Definition
7305.4 The purpose of the Chafee Foster Care Independence Program is to provide Independent Living resources to youth in out-of-home care who are at least 16 years
of age. The services shall supplement existing Independent Living resources and programs.
Indicate information for each line service worker for whom CFCIP funding is proposed in whole or in part.Include only amounts that are to be charged to Independent Living.
1 2 3 4 5 6 7 8 9 10
Position Job Title Gross Monthly Monthly Monthly Percent of Total Monthly Number Total Direct
Number Monthly Fringe Travel Operate/ Salary Direct Service of Service Cost
Salary Training Funded by Cost Months (9x8x7)
2850 (3+4+5+6) of Cost
.5 Caseworker III $1,802.00 $324.00 $50.00 $20.00 100% $2,196.00 12 $26,352.00
.5 Caseworker III $1,712.00 $308.00 $50.00 $20.00 100% $2,090.00 12 $25,080.00
TOTAL $52.432.00
35
PURCHASE OF SERVICE
CHAFEE FOSTER CARE INDEPENDENCE PROGRAM
CFMS—Program Code E010,Function Code 2850
Indicate information for each provider CFCIP services are proposed to be purchased.
1 2 3 4 5 6 7 8
PROVIDER NAME CWEST** Unit of Number of Payment Rate Cost Per Number of Total Cost
Provider Service* Units of per Unit of Month Months of Per Provider
Number Service/Month Service (4 x 5) Cost (6 x 7)
TOTAL
*-Identification of unit is: H=Hour,D=Day,W=Week,M=Month,E=Episode
**-List only if applicable
36
YOUTH DIRECT SERVICE
CHAFEE FOSTER CARE INDEPENDENCE PROGRAM
CFMS--Program Code E010,Function Code 2850
Definition
7.416.1E Youth Direct Services shall be used according to federal guidelines as incentives for completing goals in the plan for transition to Independent Living and
other expenditures that will assist youth to emancipate and for which no other funding sources exist.
Indicate information for each provider from whom CFCIP services are proposed to be purchased.
2 3 4 5 7
PROVIDER NAME Clients to Number of Payment Rate Cost Per Month Total Cost
Be Served Clients Served per Unit of (4 x 5) Per Provider
per Service
Month
Independent Living 80 34 $83.33(w) $333.33 $4,000.00
Groups
Independent Living 30 7 $125.00(w) $500.00 $6,000.00
Support Groups
Emergency Economic 12 1 $600.00 $600.00 $7,200.00
Assistance
` Mentoring Program 5 1 $83.33(m) $83.33 $1,000.00
Emancipation 15 1.25 $800.00 $1,000.00 $12,000.00
Economic Assistance
TOTAL $30.200.00
37
CHAFEE FOSTER CARE INDEPENDENCE PROGRAM
POPULATION TO BE SERVED
COUNTY(ies)* _Weld
Number to be
served
Youth in out-of-home care,under the age of 16,who have a current permanency goal of other planned
20 permanent living arrangement/long term foster care.
Youth in out-of-home care, 4ge 16-21 with permanency goal of other planned permanent living
30 arrangement/emancipation.
Youth in out-of-home care, age 16-21 permanency goal of other planned permanent living
10 arrangement/long term foster care.
Young adults age 18- 21 who emancipated from foster care on or after their 18'birthday.
15
Youth (age 16-21)who meet community placement requirements for the Division of Youth
20 Corrections. •
95 TOTALS
*If you are part of a region please list all the counties for the region,the population serviced and number of eligible should be for all counties in the region.
38
ROOM AND BOARD REIMBURSEMENT FOR OVER 18 POPULATION
CHAFEE FOSTER CARE INDEPENDENCE PROGRAM
CFMS—Program Code E010,Function Code 2810
Definition:
Reimbursement for room and board is available to young adults,ages 18-21,that emancipated from foster care on or
after their 18th birthday. Indicate information for the number of young adults for whom reimbursement is to be provided.
1 2 3 4 5 7
PROVIDER Clients to Number of Payment Rate Cost Per Month Total Cost
NAME Be Served Clients Served per Unit of (4 x 5) Per Provider
per Service
Month
WCDSS 18 1.5 $503.33 $754.99 $9,059.94
TOTAL $9.05994
39
Hello