HomeMy WebLinkAbout20013307.tiff RESOLUTION
RE: APPROVE NOTIFICATION OF FINANCIAL ASSISTANCE AWARD FOR CORE
SERVICES FUNDS AND AUTHORIZE CHAIR TO SIGN - STILLWATER SERVICES
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board has been presented with a Notification of Financial Assistance
Award for Core Services Funds 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, commencing January 1, 2002, and ending May 31, 2002, with
further terms and conditions being as stated in said award, and
WHEREAS, after review, the Board deems it advisable to approve said award, a copy of
which is attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of
Weld County, Colorado, ex-officio Board of Social Services, that the Notification of Financial
Assistance Award for Core Services Funds 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 be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said award.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 5th day of December, A.D., 2001.
BOARD OF OUNTY COMMISSIONERS
WELD C NTY, COLORADO
ATTEST: geihed��a�`
M. J. eile, C it
Weld County Clerk to the r
H O .ece( debA
lenn Vaad,-P o-Tem
BY.
Deputy Clerk to the Boa !I T\"
Willia Jerke
APPROVED AS TO F0R�VI: I cc\ ' r)\4^
D vi E. Long ),1
fc unty terne� n
/ obert D. Masden
Date of signature: /6/
2001-3307
e 'SC SS0028
At
,,
`t' DEPARTMENT OF SOCIAL SERVICES
PO BOX A
GREELEY,CO 80632
liv
WEBSITE:www.co.weld.�.us
Administration and Public Assistance(970)352-1551•O Child Support(970)352-6933
COLORADO MEMORANDUM
TO: M.J. Geile, Chair Date: December 3, 2001
Board of County Commissioners
FR: Judy A. Griego, Director, Social Services.it,u3LL C� \,UL ;
O`
RE: Notification of Financial Assistance Award/for Core Services
Funds with Stillwater Services
Enclosed for Board approval is a Notification of Financial Assistance Award (NOFFA)
for Core Services Funds with Stillwater Services. The Families, Youth and Children
(FYC) Commission have reviewed and are recommending Board approval of the bid.
The major provisions of the NOFFA as follows:
1. The term begins on January 1, 2002 through May 31, 2002.
2. Stillwater Services agrees to provide alternative programs to Residential
Treatment Center Placements as follows:
A. Intensive Services Phase will include 43.3 maximum hours per family per
month for a three-month period.
B. Step-Down Services will include 12.99 hours per family per month for a
one-month period.
3. Social Services agrees to reimburse Stillwater Services as follows:
A. Intensive Services Phase of$98.20 per hour at a maximum monthly rate of
$4,252.06.
B. Step-Down Services Phase of$98.20 per hour at a maximum monthly rate
of$1,275.62.
4. The source of funds is Core Services which are Federal, State, and Local funding
out of the total Child Welfare Block at the State Level.
If you have any questions, please telephone me at extension 6510.
2001-3307
F
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 01-CORE-0012
Revision (RFP-FYC-(01010)
Contract Award Period Name and Address of Contractor
Beginning 01/01/2002 and Stillwater Services
Ending 05/31/2002 Alternative Programs to RTC Placements under FPP Option
B Home Based Services
PO Box 336058
Greeley, CO 80634
Computation of Awards Description
Unit of Service The issuance of the Notification of Financial
The A.S.A.P. Project offers mentoring services to youth, Assistance Award is based upon your Request for
their nuclear families,extended families,and supporting Proposal(RFP). The RFP specifies the scope of
systems as an alternative to residential placement.The services and conditions of award. Except where it
mission of the project addresses the physical,emotional, is in conflict with this NOFAA in which case the
social, and spiritual needs of individuals and their families. NOFAA governs,the RFP upon which this award is
Monthly capacity of 65 clients per month; a monthly based is an integral part of the action.
average of 55 clients to be served through either mentoring Special conditions
and/or the education component. 1) The program will consist of two phases.The two
phases will be the intensive phase and the step
Cost Per Unit of Service down phase.
Hourly Rate Per $ 98.20 2) The intensive phase will include an average of 43.3
Step Down Rate $ 98.20 hours per family per month. Step down services
Unit of Service Based on Approved Plan will include an average of 12.99 hours per family
per month. Social Services agrees to reimburse
Stillwater Services at an hourly rate of$98.20 per
family per direct service hour with a maximum
reimbursement of(1)$4,252.06 per month for the
intensive phase for a maximum duration of 3
months and, (2) $1,275.62 per month for step down
services for a maximum duration of 1 month. The
intensive phase or the step down phase will not last
Enclosures: longer than the cost and duration granted by the
Signed RFP:Exhibit A expressed written permission of the Social Services
Supplemental Narrative to RFP: Exhibit B administrator.
_ Recommendation(s) 3) Reimbursement for the Unit of Services will be
Conditions of Approval based on an hourly rate per child or per family.
4) The hourly rate will be paid for only direct face-to-
face contact with the child and/or family,as
evidenced by client-signed verification form,and as
specified in the unit of cost computation.
I of 2
Special Conditions continued from Page 1:
5) Unit of service costs cannot exceed the hourly,and
yearly cost per child and/or family.
6) Rates will only be remitted on cases open with, and
referrals made by the Weld County Department of
Social Services.
7) Requests for payment must be an original and
submitted to the Weld County Department of Social
Services by the end of the 25th calendar day
following the end of the month of service.The
provider must submit requests for payment on
forms approved by Weld County Department of
Social Services.
Approvals: Program Official:
By By
M. J. Geil , Chair Judy . Grie ,Director
Board of Weld County Commissioners Wel ounty epartment of Social Services
Date: /,i/O51, o/ Date: ;13 /0
2 of 2
EXHIBIT A: SIGNED RFP
INVITATION TO BID
DATE:September 26, 2001 BID NO: RFP-FYC-01010
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-01010) for: Alternative Programs to Residential Treatment Center
Placements under Family Preservation Program--Home
Based Intensive Family Intervention Program Family
Issue's Cash Fund or Family Preservation Program
Funds
Deadline: October 19, 2001, 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 Statewide Family Preservation Program(C.R.S.
26-5.5-101) and Emergency Assistance for Families with Children at Imminent Risk of Out-of-Home
Placement (C.R.S. 26-5.3-101). The Families, Youth and Children Commission wishes to approve services
targeted to run from the date of approval by the Board of Weld County Commissioners, through May 31,
2002, 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. Under the Home Based Intensive
Family Intervention program, the Families Youth and Children Commission is targeting alternative programs
to prevent and/or transition from the placement of children, and/or youth in residential treatment centers. 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 .
51-44-<-4: c71-ni n z-.
Delivery Date gt:
(After receipt of order) BID MUST BE SIGNED IN INK
Shari ..S�ifmmons
AAli/QM , 'fL%m a n
TYPED OR PRINTED SIGNATURE
VENDOR _ jf%//a/ei Setv,ce ac
(Name) Handwritten Signature By Authorized
Officer or Agent of Vender
ADDRESS f'O Os 33eon TITLE
l*,n/sy, Co awn DATE
PHONE # (970) - drYs-
(g7j .jo. - a034,
The above bid is subject to Terms and Conditions as attached hereto and incorporated.
RFP-FYC-01010
Attached A
HOME BASED INTENSIVE FAMILY INTERVENTION PROGRAM BID PROPOSAL AND
REQUEST FOR CONTINUATION OF AWARD UNDER FPP CORE SERVICES FUNDING
FAMILY PRESERVATION PROGRAM
2001-2002 BID PROPOSAL APPLICATION
PROGRAM FUNDS YEAR 2001-2002
BID#RFP-FYC-01010
NAME OF AGENCY: S-tillIAJP-ter Sr•rviGCS /
ADDRESS: Pa. £px 201.'058
PHONE: (q10 302- 81*6 i /970) 302-203
CONTACT PERSON: ;..10-4*-4.71. 8uurn ant TITLE: rMLentor
DESCRIPTION OF FAMILY PRESERVATION PROGRAM CATEGORY: The Home Based Intensive Family
Intervention Program is a family strength focused home-based services to families in crisis which are time limited,phased
intensity, and produce positive change which protects children,prevents or ends placement, and preserves families. Under
the Home Based Intensive Family Intervention program,the Families, Youth, and Children Commission is targeting
alternative programs to prevent and/or transition from the placement of children, and/or youth in residential treatment
centers.
Approximate Project Dates: Contract with actual time lines of:
Start November 7, 2001 (or Date of Approval by Start Date of Approval by Board of Weld County of Weld Board
of Weld County Commissioners) Commissioners
End May 31, 2002 End May 31,2002
TITLE OF PROJECT: ,4,S.A-, P. /Prnj P e.-/-
7/...61•,1 nut Q.c.C.\A/,m✓m.,071CJ /o'/5 - ai
Name and Signa'lire of Person Preparing Doc ment Date
Name and Signature Chief Administrative Officer Applicant Agency Date
MANDATORY PROPOSAL REQUIREMENTS
For both new bids and renewal bids,please initial to indicate that the following required sections are included in this
Proposal for Bid. For renewal bids,please indicate which of the required sections have not changed from Program Fund
Year 2000-2001 to Program Fund year 2001-2002.
_ Project Description
_ Target/Eligibility Populations
_ Types of services Provided
Measurable Outcomes
Service Objectives
Workload Standards
Staff Qualifications
_ Unit of Service Rate Computation
Program Capacity per Month
Certificate of Insurance
RtFP-FYC-01010 Attached A
Date of Meeting(s)with Social Services Division Supervisor: I0 -10- 01
Comments by SSe pervisor; a � �� ,' 5 s '1
t �_ t r , fA ' <L i ,i-L f t.' �.
cep a, a � l�F i_ ,Y Q r_ Jd7 )fie it 1 Lt t [J
rr . •
•
( &LLi 1, LLL 3 p?
"Name and Signature of SS�D Supervisor Date
Program Category: Home Based Intensive Family Intervention Program Bid Category-Alternative
Programs to prevent and/or transition from Residential Treatment Center Placements
Project Title:
Vendor:
PROJECT DESCRIPTION
Provide a brief one-page description of the project. Include a description of your organization's
area(s) of specialty or expertise.
II. TARGET/ELIGIBILITY POPULATIONS (Eligibility for this program will be determined solely by
the Weld County Department of Social Services' Placement Review Team in response to caseworker
presentation or requests from the Court.)
Provide a one page brief description of the proposed target/eligibility populations. At a minimum
your description must address:
A. Total number of clients to be served.
B. Total individual clients and the children's ages.
C. Total family units.
D. Sub-total of individuals who will receive bicultural/bilingual services. Only include those
individuals who will be directly provided ethnically and culturally appropriate services, not
services provided through a translator.
E. Sub-total of individuals who will receive services in South Weld County.
F. Sub-total of Individuals who will have access to 24 hour service.
G. The monthly maximum program capacity.
H. The monthly average capacity.
I. Average stay in the program(weeks).
J. Average hours per week in the program.
The Bidder will explain more in detail the services' anticipated length if it exceeds 6 months to 12
Stillwater Services, LLC
PO Box 336058 Greeley, CO 80634
Phone: (970) 302-8145; (970) 302-2036
Fax: (970) 353-4422
Stillwater Services,LLC
Alternative Services for Adolescents and Parents
(The A.S.A.P. Project)
"When reintegrating fails it is important to distinguish between cases where
youth fail in the community and the community fails youth."
(Fagen, 2000)
•
L PROJECT DESCRIPTION
Stillwater Services, LLC is an organization dedicated to helping the youth ages 6 to 18 and their
families of Weld County. The A.S.A.P. project was designed to offer mentoring services to
youth, their nuclear families, extended families, and supporting systems as an alternative to
residential placement. Stillwater Services, LLC believes that personal relationships with others
can bring lasting change. In our experience, we have found that meeting youth and their families
in their living environments is much more effective than traditional "office therapy". We have
found that building relationships through meeting friends, sharing meals, and participating in a
client's every day life paves the way to reaching both at-risk youth, as well as youth who are
already entrenched within the system.
The mission of the A.S.A.P. project is to address the physical,emotional, social, and spiritual
needs of individuals and families. This program will focus and specialize on working with youth
and families from culturally diverse backgrounds who are considered "at-risk" or highly
involved in the social and legal system. Stillwater Services,LLC utilizes a strength-based
approach 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. The
words"mentoring services"within this proposal refer to a range of services that include
intensive individual, family, or marital therapy, play therapy, partnering, role-modeling,
education,transportation, community liaison, advocacy, and case management. Mentors
working in the A.S.A.P. project recognize the varied needs of youth and their families and will,
therefore,provide services accordingly.
The Stillwater Services,LLC A.S.A.P. project is based in Weld County. Our close proximity
allows us the flexibility to respond quickly and efficiently to our clients' needs. The locale of
this project provides the ability to participate in spontaneous activities with our client base and
make ourselves available for on-call assistance. In addition, as mentors actively involved in the
community, we have the benefit of knowing and having personal relationships with local
resources, including schools, treatment providers, community leaders, and event coordinators.
Having resided and/or worked in Weld County for years, the providers of this project have a
connection to the community and as a result, an awareness of local opportunities to benefit youth
and their families.
Stillwater Services,LLC specializes in assessing the needs of youth and their families. Having
the experience of both providing therapeutic services to youth in a residential setting and through
home-based services, has given these providers the expertise in accurate assessment and timely
intervention implementation. Stillwater Services,LW prides itself in hiring mentors 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.
2
Our home-based services allow for variations in intensity, frequency, and duration of services
provided. This allows for mentors to be involved intensely during the initial stage of treatment
and gradually decrease treatment services as we near termination. Our hope is that a lasting
connection has been made so that when our mentors terminate a case, they are still viewed as a
resource for the future. This mentoring relationship will work to prevent outside placement,
while keeping the family unit intact. Our unique position between the "system" and the family
allows us as mentors to align ourselves with our clients and provide services needed in a non-
threatening manner. We provide therapeutic treatment, job training, educational tutoring, role
modeling, financial advisement,transportation, and education regarding healthy coping skills.
In addition to our intensive to low intervention mentoring services, Stillwater Services, LLC has
been able to identify the strengths and deficiencies within the community and has moved to fill
the gaps with our group education programming. Recognizing that some mentoring clients may
internalize interventions better or become more accountable within a group setting, we have
created additional support with our education program. This program currently offers Spanish-
and/or English-speaking Parenting Adolescents classes, Life Skills classes for emancipating
youth, an Anger Management class for adolescents, and after school groups offered to adolescent
boys and girls. Classes will be offered once weekly for a 1 '/s hour time span. Boys and girls
groups are offered two days per week. This program may serve both court-ordered and volunteer
clients. Stillwater Services, LLC is currently in the development phase of its Gang Intervention
group to address the on-going concern of gang violence in Weld County.
IL TARGET/ELIGILIBILITY POPULATIONS
The A.SAP. project will serve a total of 170 clients from November 7, 2001 to May 31, 2002 in
both its mentoring (50 youth) and education components (120 participants). Therefore, it is
projected that the program will service a total of 130 family units. Due to the rich, culturally
mixed population of Weld County, Stillwater Services, LLC has estimated that at least 30 clients
will receive bilingual services. The A.S.A.P. project addresses this concern by offering Spanish-
speaking parenting classes and hiring bilingual mentors. It will be mandated that all mentors
under Stillwater Services, LLC, obtain cultural awareness and sensitivity training.
It is estimated that at least 16 youth and their families will receive services in South Weld
County with mentors assigned specifically to that region. It is crucial that mentors assigned to
various regions possess knowledge of the existing resources offered in that area, have
recognition of deficiencies, and an awareness of gang territories. The A.S.A.P. project of brs 24-
hour on-call service for all of mentoring clients. 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 65 clients can potentially be served in a month under the A.S.A.P. project (25
mentoring clients and 40 clients through the education program) The A.S.A.P. projects estimates
3
a monthly average of 55 clients to be served through either mentoring and/or the education
component.
Research indicates that effective interventions are those in which there is a continuum of care,
flexibility to meet needs, parental education, reconstructing of family and neighborhood ties,
role-modeling, problem solving, and community advocacy. The A.S.A.P. project seeks to
implement these interventions within a time frame that allows for relationship building so that
the internalization of newly learned interventions is solidified. Therefore, our mentoring services
will be offered a minimum of three hours and a maximum of ten hours per week. The
assessment and intervention portion of our mentoring services will run an estimated average of
12 weeks. Step-down services that include a decrease in visitation, linkage to community
resources, and accountability check-ins will be offered for approximately one to three hours per
week and last approximately 4 weeks in duration. It may be deemed appropriate by team
members working with a client to encourage enrollment in the Stillwater Services, LLC
education program. Attendance will be expected if not mandated by the court. Educational
classes are as follows:
*Parenting Adolescents Class taught by Dr. Alex Trujillo— Six week course on
Thursdays from 6:00-7:30 pm
Life Skills Class taught by Marsha Jones—Twelve week course on Wednesdays from
4:00-5:30 pm
Anger Management Class taught by Rob and Areena Webb—Ten week course on
Tuesdays from 4:00-5:30pm
Boys and Girls Groups led by mentors of the A.S.A.P. project—On-going groups every
Wednesday and Friday from 4:00-5:30pm
*Denotes"day care availability"
Classes are offered to mentoring clients, as well as volunteer,and court ordered clients. Classes
are $20.00 per client,per hour.
III. TYPE OF SERVICES TO BE PROVIDED
Research on home-based services has indicated a 47 - 64% reduction of out-of-home
placements for youth when effective services and interventions are placed within the home
environment. The A.S.A.P. project is based on the same premise that utilizing family strengths
and casting practitioners as partners rather than authorities can facilitate the change process.
With that as a basis for intervention,the A.S.A.P. project will address the following areas:
A. Youth and Family Services
4
The focus of our mentoring services will rely on building relationships as the key to
creating positive change. We will provide conflict resolution, problem-solving skills,
education on child development, parenting techniques that offer children both nurturing
and structure, and communication enhancement. We will empower our clients to help
themselves by utilizing formal and informal support systems. We recognize the need for
the inclusion of extended family members to enhance the strengths of the nuclear family.
Therefore, our mentors see the benefit in developing relationships with close friends,
neighbors, grandparents, aunts, uncles, siblings etc. as a means of reaching our primary
clients. Concentrated individual and marital services will be provided by our mentors
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.
If specific issues are so overwhelming that they take the focus off of the established client
goals, referrals for specialized and/or ongoing services within the community will be
made.
Mentors working on the A.S.A.P. project will be multifaceted and act as client advocates,
liaisons to community agencies,therapists, transporters, and case managers. All mentors
will submit required documents to the court to provide information about client
accountability and progress. Mentors with experience in play therapy, marital therapy,
and translation will be matched according to client needs.
Mentors will assess client/family needs,provide direct services, and implement follow-up
services once intensive work is complete. The basic goal of A.S.A.P. mentors is to
identify deficiencies in client functioning, provide education and positive role-modeling,
and empower clients to utilize community services that will promote positive, lasting
change. If additional services are needed to further solidify change, Stillwater Services,
LLC offers its education program as an additional component of mentoring. This
program is also offered to clients who are not in need of mentoring services or are
attempting to fulfill court ordered sentences. The education program consists of English-
or Spanish-speaking Parenting Adolescents Class, Life Skills Class, Anger Management
Class, and Boys/Girls groups.
B. Concrete Services
Stillwater Services, LLC utilizes a strength-based model of providing services. We
locate and build upon on existing family strengths but offer concentrated assistance in the
enhancement of coping methods and skill building. We recognize that within each
family there often exist varying values and beliefs. 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.
We focus on the utilization of appropriate parenting skills, conflict resolution, stress
reduction, refinement of prosocial coping skills, financial management, and healthy
communication. We have found this best occurs when a trusting, safe relationship is built
between mentor and client. Much time and attention is given to building and solidifying
this rapport. We have learned that lasting change does not frequently come from sitting
5
in an office and expressing feelings. Rather, our mentors integrate themselves into the
fabric of our clients' lives to provide services. Fixing meals together, playing ball,
creating a budget, attending a quinsinera, helping with household chores,taking a family
member to a job interview, providing a box of donated food,giving a client a manicure,
and encouraging role-plays in which families practice new ways of communicating are
examples of how mentors in the A.S.A.P. project develop skills in non-conventional
ways.
C. Collateral Services
Stillwater Services, LLC, seeks to identify existing services or create what is lacking to
provide families with community links. Mentors providing service for the A.S.A.P.
project have had experience with the youth and existing resources in Weld County for
years. A knowledge base of what is available has given these 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 mentoring relationship occurs. From assessment to termination, our
mentors will work to teach families how to utilize existing services such as health care
assistance, job training, substance abuse treatment, financial assistance, medication
management, educational services, and spiritual guidance.
D. Crisis Intervention Services
As local providers, Stillwater Services, LLC, has the ability to offer 24-hour emergency
assistance. We will offer to assist the family by whatever means necessary in their time
of need. As standard operating procedure, our mentors 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 our prepared emergency plan. All of our mentoring clients will
have access to an on-call counselor 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 ow-of-home placement if possible. 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.
IV. MEASURABLE OUTCOMES
Stillwater Services, LLC is committed to providing quality services not only to the youth and
their families, but also to those agencies utilizing our services. We can best serve ourselves,
clients, and referring agencies by utilizing valid assessment tools to point out the strengths and
weaknesses of our service. The goal of Stillwater Services, LLC, is to provide services to the
family that will allow them to be successful. We will utilize several pre- and post-treatment
6
measures to determine the success of our treatment services. Our pre-treatment measures will
include the data sheet on the following page.
The following pre- and post-treatment data sheet will give valid insight into whether or not the
youth was successful. We are hoping that our mentoring and education educational classes will
be able to successfully reduce the number of days away from school, out-of-home placement,
severity of legal charges, and amount of illegal substances used. This information will also be an
indicator of family improvement: as parental involvement and supervision is increased, the
number of socially unacceptable behaviors will decrease. The information on this data sheet will
be collected at quarterly intervals for the year following treatment, providing us with factual
information that will be the foundation for determining our success.
Other measurements that will aid in evaluating our services will be the use of the Prevention Plus
III and the State of Colorado Family Risk Assessment Continuum. These instruments given pre-
and post-treatment will allow us to assess the effectiveness of our treatment services as we try to
increase the family's ability to function effectively. We realize that these assessments will have
to be given at quarterly intervals throughout the year following treatment to obtain stability
measures. While it is our goal to have the child remain at home throughout treatment as well as
at termination, success will only be realized if the child is in the home several months after
treatment.
7
Stillwater Services, LLC
Pre and Post Treatment Data Sheet
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 ?
8
V. SERVICE OBJECTIVES
Stillwater Services, LLC is committed to reducing recidivism and enhancing family strengths. In
order to do this; we must effectively improve the family's ability to manage conflict. Research
suggests that low family warmth, low monitoring and high family conflict are contributing
factors of delinquency. Knowing this, improving family functioning and supervision will receive
a concentrated effort. We will 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. We will also stress the importance
of appropriate supervision and monitoring if parents are assisting their children in being
successful. Pointing out barriers to effective communication and showing parents how they can
communicate more positively with their children will also help the family avoid some of the high
conflict at home that causes their children to become involved with delinquent peers. We are
able to gauge our success in this area by utilizing the "Family Issues 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
the parents how to become more competent parents. In many situations, parents feel that they
just do not know what to do anymore. Many of these parents are doing everything that they
know how to do; they simply possess low level parenting skills. Stillwater Services LLC helps
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 able to manage their own household
when emancipation becomes an issue.
In order to improve the likelihood that youth and their families will be successful upon
termination from the program, we must be able to help the family foster necessary formal and
informal relationships in the surrounding community. These 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 mentoring relationship is terminated.
9
YL WORKLOAD STANDARDS
Stillwater Services LLC will expect a minimum of three hours and a maximum of ten hours of
mentoring service to be provided to each family per week. Including founders of the A.S.A.P.
project, Nathan Buxman and Shari Simmons, an anticipated three additional mentors with
varying caseloads will be hired to provide mentoring services to youth and their families. A
maximum of eight clients will constitute a full caseload.
Stillwater Services LLC does not limit itself to one theoretical treatment, however the modality
of treatment offered to the clients produced in this project will be mentoring. Mentoring is
defined by Stillwater Services LLC as services that include but are not limited to therapy, case
management, transportation, community liaison, advocate, resource provider, educator, and
positive role model. It is expected that mentors will work with families an average of 30 minutes
per day, 4 hours per week, and 16 hours per month. This average is subject to change given the
requests of the referral agency and client needs.
It is estimated that two to five mentors will provide mentoring services to clients in the A.S.A.P.
project. Four educators have agreed through a contractual process to provide classes within the
educational component of this project. Upon request for the start up of Boys and Girls after
school groups, an estimated two to six facilitators will be utilized to provide after school
supervision, career counseling, sex education, recreational activities, and issue specific groups.
Two supervisors will carry a caseload consisting of two mentors. Monthly staff meetings in
which all mentors 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 are due. Discussion of the cases is mandatory so that all members of the
team will have accurate, timely information regarding clients. We will require that all mentors
are updated on cases so that any mentor 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 liability insurance to cover both supervisors on this project.
When it becomes appropriate to hire additional mentors, these contractual employees will be
required to provide appropriate liability insurance or be added to the existing Stillwater Services
LLC policy. No mentor will offer services to youth and their families if not properly insured
under the state of Colorado guidelines.
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 a client's home, with their friends and family, at school, in their church, and at
their local "hang-out". 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 relatives/friend's home. Due to the flexibility and
development of a relationship that offering in-home services can afford, clients are free to access
10
mentors at any time for assistance. Pager and/or cell phone numbers of assigned mentors will be
given to clients to utilize in case of an emergency.
VII. STAFF QUALIFICATIONS
Mentors providing direct services to clients in the A.S.A.P. project will be required to possess a
bachelor's degree in a human services field (i.e. Social work, Psychology, Sociology, Child
Development, or School Counseling). Proof of training and/or course work in crisis intervention,
diagnostic measurement, child development, cultural sensitivity, and intervention
implementation will be required.
Supervisors of mentors and facilitators in the education 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 A.S.A.P. project will consist of the two founders,
who will serve as supervisors and service providers and approximately two additional mentors
(one of which will be bilingual). At least one mentor 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 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 developing a rapport and a relationship that
will lead to the implementation of creative interventions. Mentors must also show knowledge of
community services and the ability to link clients to these resources. Mentors with areas of
expertise in marital therapy, play therapy, or translation will be matched appropriately to client
needs. Stillwater Services LLC hires both male and female mentors to accommodate youth
needs.
Stillwater Services, LLC has identified a need for cultural-based services to be provided to the
youth and their families in this community. To address this need,the A.S.A.P. project provides a
Spanish-speaking Parenting Adolescents class. Mentors and educators will be of mixed
ethnicity. This project seeks a bilingual mentor who is able to perform translations when needed.
All mentors are required to possess knowledge of cultural issues, sensitivity, and respect.
11
Stillwater Services, LLC does not limit itself to the implementation of one theoretical
orientation. It is our belief that people are unique and often times unpredictable, which calls for
varied approaches. We utilize a strength-based systems approach to addressing the needs of our
youth and families. This encompasses the idea that community professionals are team members
and partners rather than experts. It is essential that youth and their families are the experts of
determining their assessment, treatment planning, and implementation. A value is placed on
relationships over authoritative systems.
12
VIII. COMPUTATION OF DIRECT SERVICE RATE-PHASE I-INTENSIVE
A.
Total Hours of Direct Service per Client 36 Hours [A]
Total Clients to be Served 50 Clients [B]
Total Hours of Direct Service for Year 1800 Hours [C]
(Line [A] Multiplied by Line[BJ)
Cost per Hour of Direct Services $ 31.60 [D]
Total Direct Service Costs $ 56.880 [E]
(Line[C]Multiplied by Line [D])
Administration Costs Allocable to Program $2.730 [F]
Overhead Costs Allocable to Program $ 13.650 [G]
Total Cost,Direct and Allocated, of Program $ 73.260 [H]
(Line [E] Plus line[F] Plus Line[G])
Anticipated Profits Contributed by this Program $43.750 [I]
Total Costs and Profits to be Covered by this Program
(Line[H] Plus Line[I]) $ 117.010 [J]
Total Hours of Direct Service for Year 1890 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 [L]
13
IX. COMPUTATION OF DIRECT SERVICE RATE-PHASE II—STEP-DOWN
B.
Total Hours of Direct Service per Client 6 Hours [A]
Total Clients to be Served 50 Clients [B]
Total Hours of Direct Service for Year 300 Hours [C]
(Line [A]Multiplied by Line[B])
Cost per Hour of Direct Services $31.60 [D]
Total Direct Service Costs $9.480 [E]
(Line [C] Multiplied by Line[D])
Administration Costs Allocable to Program $ 819 [F]
Overhead Costs Allocable to Program $ 1.910 [G]
Total Cost,Direct and Allocated,of Program $ 12.209 [H]
(Line [E]Plus line [F] Plus Line [G])
Anticipated Profits Contributed by this Program $ 7.291 [I]
Total Costs and Profits to be Covered by this Program M.
(Line [H]Plus Line[I]) $ 19,500 [3]
Total Hours of Direct Service for Year 300 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 [L]
14
PLEASE TIE �REMOVE THESE CARDS BY CUTTING ON DOTTED LINES
THIS CARD T11RE1�IN F11NRFD MOTOR VEHICLE THIS CARD OUST DE CARRIED AFRIUURTJEp MOt VEHICLE
1�lime DISURANCE COMPANY SHELTER GENERAL INSURANCE COMPANY
N. YaDFARB IA, MD. 65218-SOS -2663 AAWIT AIOI D I4 COLDER IA. MD. 6521G-5.3-4M .2663 POLICY NO. 0S-1-C-51346.48-6 POLICY NO. 44-1-0-3134634-6
EFFECTIVE DATE 89-42-2401 EXPIRATION DATE 83-82-2682 EFFECTIVE DATE 49-42-2841 EXPIRATION DATE 43-42-2882
1996 CIEVY BLAZER-4WD:4DR ..� VIM 1WOTLT16 CHEW BLAZER 1996 CHE BLAZER 4150 4DR VIN 1pW 9IDT1 ST2I25493
NFORR PARTIICC°IPATDUN ►R E�ICZANS. -4SR4--158-2147 FOR PAARTIfFPOSPATILHERSPHYS6IC . CALL 1-4048-454-2147
gI1 1p�SIIf10Nt. SHARI SIMMONS
LLOOVELA 0 CO 86537-6526 CIR OVELAAND DEAN CO 84537-6628
KEEP ONE CARD IN YOUR MOTOR VEHICLE AND CARRY THE OTHER CARD WITH YOU
PROOF OF INSURANCE-PLACE IN YOUR VEHICLE
AMERICAN FAMILY MUTUAL INSURANCE COMPANY
MADISON,
p �A
WISCONSIN 6370c344001
PROXCfCARD
Policy Net 0763-2029-02-73-FPPA-CD
Elf Dates 10-15-2001 Exp Date: 4-15-2102
1994 CHEW CSA YIN: 101LD55N3RY262909
Coverages: SI-PD WI UIN COMP COLT PIP
337 53RD NATAN HAN & LISA
GREELEY CO 80634-4223
Agent: DONNA FEIOIRIY-YANTIS
Agent Phones (970) 351-6520
This card must be carried in the insured motor vehicle
for production upon demand.
Important message on reverse side.
AMERICAN FAMILY MUTUAL INSURANCE COMPANY •
MADISON,� WISCONSIN 037034001
;WPM INSURANCE CARD
Polley Ns: 0763-2029-01-70-FPPA-CO
Eff Dotes 10-15-2101 Exp Date: 4-15-2002
1999 CHEW SC1 YIN: 20CEC19V6X1134635
Coverages: SI-PD UN UIN COMP COLL PIP
6UXNAN, NATHAN
337 53RD AVE
GREELEY CO 80634-4223
Agent: DONNA FEIOHNY-YANTIS
Agent Phan: (970) 351-6528
This card must be carried in the insured motor vehicle
for production upon demand.
Important message on reverse side.
Account Number: CO STIL 3360 Date : 7/26/01 Initials : LL
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
Type of Work Covered: Mental Health Counselor
Location of Operations :
(If different than address listed above)
Claim History:
Policy Effective Expiration Limits of
Coverages Number Date Date Liability
PROFESSIONAL/ 1 ,000,000
LIABILITY MHL-0000000 8/01/01 8/01/02 3, 000,000
NOTICE OF CANCELLATION WILL ONLY BE GIVEN TO THE FIRST NAMED INSURED ON THIS
POLICY AND HE OR SHE SHALL ACT ON BEHALF OF ALL INSUREDS WITH RESPECT TO GIVING
OR RECEIVING NOTICE OF CANCELLATION.
Comments:
This Certificate Issued to:
Name: STILLWATER SERVICES, LLC �-
P.O. BOX 336058
Address:
GREELEY CO 80634
Au orized Representative
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