HomeMy WebLinkAbout20011396.tiff RESOLUTION
RE: APPROVE NOTIFICATION OF FINANCIAL ASSISTANCE AWARD FOR SEX ABUSE
TREATMENT AND AUTHORIZE CHAIR TO SIGN -ACKERMAN AND ASSOCIATES,
P.C.
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 Sex Abuse Treatment 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 Ackerman and Associates, P.C., commencing June 1, 2001, 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 Sex Abuse Treatment 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 Ackerman and Associates, P.C., be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said award.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 30th day of May, A.D., 2001.
BOARD OF COUNTY COMMISSIONERS
WELD CO TY, COLORADO
ATTEST: LI/I i'�/.f.. J . La� 77, nix/� M. J. eile, Ch it
Weld County Clerk to the o. .
1861 4iä)
lenn Vaae4r—
BY: /
Deputy Clerk to the B�j O N I�/ '� 4z—
% 8\1 Willi Jerke
AP A O M: f4 f *I/
vi E. Long
unty A or ey Ili
Robert D. Masden
2001-1396
yOG •'SS SS0028
DEPARTMENT OF SOCIAL SERVICES
PO BOX A
GREELEY,CO 80632
WEBSITE:www.co.weld.co.us
Administration and Public Assistance(970)352-1551
II I
O Child Support(970)352-6933
COLORADO
MEMORANDUM
TO: M. J. Geile, Chair Date: May 23, 2001
Board of County Commissioners
FR: Judy Griego, Director £1
Weld County Departme of cial rvir es
RE: PY 2001-2002 Notification of Financial Assistance Awards (NOFAA) under Core
Services Funds-Ackerman& Associates, P.C.
Enclosed for Board approval are the PY 2001-2002 Notifications of Financial Assistance
Awards (NOFAA) for Families, Youth, and Children Commission(FYC) Core Services
Funds, which are for the period of June 1, 2001,through May 31, 2002. ,
The Families, Youth and Children Commission(FYC) reviewed proposals under a
Request for Proposal process and are recommending approval of these bids.
Ackerman and Associates. P.C.
A. Option B, Home Based Intensive: A maximum of 84 families for an average of
three hours per week of in-home services for a 20-week period. The average
length of stay will be 60 hours. Rate is$99.50/hour per unit of service.
B. Intensive Family Therapy:
1. Mediated Family Conflict Resolution and Short-term Intensive Family
Therapy-Goal Achievement Program(GAP): A maximum of 14 families
per month. Average capacity is five families per month (60 per year).
Maximum stay is 20 hours over a five-month period. The program has a
capacity of providing Bicultural-bilingual services to 15,families per year.
Rate is$99.50/hour.
Page 1 of 2
MEMORANDUM TO M.J. GEILE, CHAIR
WELD COUNTY BOARD OF COMMISSIONERS
RE: CORE SERVICE NOFAA PY 2001-2002
2. Family Group Decision Making: A maximum of four families per month
(48 per year) involving the nuclear family,professionals involved in the
case, and individual members of the extended family. Rate is$2,000 per
family group conference.
C. Sex Abuse Treatment: Projected maximum total per year is estimated at 36
families, the average monthly capacity is three families, the maximum stay is 46
sessions over a 12-month period. Group treatment is provided at an equivalent of
five individual hour-long sessions. Rate is$99.50/hour.
D. Foster Parent Consultation: Group training for a maximum of 12 participants with
an average of four participants per group. Average stay is 12.5 hours. Telephone
consultations for crisis management are available for a maximum of one-half
hour per call. This program anticipates serving 60 family units. Rate is $90 an
hour. Group rate per client is$45/hour.
If you have any questions, please telephone me at extension 6510.
of
Page 2 of 2
Weld County Department of Social Services
Notification of Financial Assistance Award
for Families,Youth and Children Commission(Core)Funds
ype of Action Contract Award No
X Initial Award FY01-CORE-01007
Revision (RFP-FYC-01007)
Contract Award Period Name and Address of Contractor
Beginning 06/01/2001 and Ackerman and Associates P.C.
Ending 05/31/2002 Sex Abuse Treatment
1750 25th Avenue, Suite 101
Greeley, CO 80634
Computation of Awards Description
Unit of Service The issuance of the Notification of Financial Assistance
This program proposes to provide a time-limited, Award is based upon your Request for Proposal(RFP).
outcome focused therapy model for treatment of The RFP specifies the scope of services and conditions
the non-offending parent,the victim and siblings of award. Except where it is in conflict with this
of the victim in sexual abuse cases.The program NOFAA in which case the NOFAA governs, the RFP
is proposed in four parts: (each of these parts may upon which this award is based is an integral part of the
be used as part of an integrated program, may action.
stand alone,or be used in combination with other
treatment regimens.) The projected maximum Special conditions
total per year is estimated at 36 families, 3
families per month. The average monthly 1) Reimbursement for the Unit of Services will be based
capacity is 3 families. The maximum stay is 46 on an hourly rate per child or per family.
sessions over a 12—month period. Group 2) The hourly rate will be paid for only direct face-to-face
treatment is provided at one-half the hourly rate. contact with the child and/or family as evidenced by
client-signed verification form, and as specified in the
unit of cost computation.
Cost Per Unit of Service 3) Unit of service costs cannot exceed the hourly and
Hourly Rate Per $99.50 yearly cost per child and/or family.
Group rate per family $49.75 4) Rates will only be remitted on cases open with, and
referrals made by the Weld County Department of
Unit of Service Based on Approved Plan Social Services.
Enclosures: 5) Requests for payment must be an original and submitted
X Signed RFP:Exhibit A to the Weld County Department of Social Services by
X Supplemental Narrative to RFP: Exhibit B the end of the 25th calendar day following the end of
X Recommendation(s) the month of service. The provider must submit
requests for payment on forms approved by Weld
Conditions of Approval
County Department of Social Services.
Approvals: Program Official:
By By ,__174
r�
M.J. eil ,Chair Judy A. rie o Direc r
Board of Weld County Commissioners Weld County Department of Social Services
Date: 0S,&-i --20o/ Date: 5,Z3/O
aJp/- /396
Signed RFP: Exhibit A
Ackerman & Associates
RFP: 01007-Sex Abuse Treatment
INVITATION TO BID
RFP-FYC 01007 S'aci2 _ , Pry,
' DATE:February 28, 2001 BID NO: RFP-FYC-01007
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-01007) for:Family Preservation Program--Sexual Abuse Treatment Program
Fami y Issue's Cash Fund or Family Preservation
Program Funds
Deadline: March 23, 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 June 1, 2001, through May 31, 2002, at specific rates for different types of service, the
County will authorize approved vendors and rates for services only. The Sexual Abuse Treatment Program
must provide for therapeutic intervention through one or more modalities to prevent further sexual abuse
perpetration or victimization. This program announcement consists of five parts, as follows:
PART A...Administrative Information PART D...Bidder Response Format
PART B...Background, Overview and Goals PART E...Bid Evaluation Process
PART C...Statement of Work
Delivery Date March 19, 2001 '�QSk
(After receipt of order) IWSIUST BE SIGNED IN INK
Joyce Shohet Ackerman, Ed.D.
TYPED OR PRINTED SIGNATURE
VENDOR Ackerman and Associates P.C.
(Name) dwri ten Signature By Authorized
O cer or Agent of Vendor
ADDRESS 1750 25th Avenue, Suite 101 TITLE President, Licensed Psychologist
Greeley, Colorado 30634 DATE March 19, 2001
PHONE# 970-353-3373 -
The above bid is subject to Terms and Conditions as attached hereto and incorporated.
Page 1 of 31
RFP-FYC-01007 Attached A
SEXUAL ABUSE TREATMENT 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-01005
NAME OF AGENCY: ACKERMAN AND ASSOCIATES P.C.
ADDRESS: 175tH ^venue suite 101 Greer'e� , Co {(OG3i
PH)NE: (970 ) 353-3373 ( fax 970-353-3374)
CONTACT PERSON: Joyce Shohet Ackerman Ed.D TITLE: President, Licensed Psychologist
DESCRIPTION OF FAMILY PRESERVATION PROGRAM CATEGORY: The Sexual Abuse Treatment Program must
provide for therapeutic intervention through one or more modalities to prevent further sexual abuse perpetration or
victimization.
12-Month approximate Project Dates: _ I2-month contract with actual time lines of:
Start June 1.2001 Start
End May 31.2002 End
TITLE OF PROJECT: The Sexual Abuse and Family Education Treatment Program ( SAFE - T PROGRAM)
AMOUNT REQUESTED: Budget maximun $173,130 W
Joyce Shoh Ac erman, Ed.D. 'March 19. 2001
Name and Signature of Person Preparing Document Date
Joyce Shohet Ackerman, Ed.D. �\ \__`�
wa O �7b •• \R \ March 19_, 20n1
Name . S atuk Chief Administrative Officer Applicant Agtncy J 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.
Indicate No Change from FY 2000-2002 to 2001-2002
Project Description minor changes
f— Target/Eligibility Populations no c iangc
Types of services Provided no change
Measurable Outcomes minor changes
Y. Service Objectives no changes
Y, Workload Standards minor changes
- Staff Qualifications minor chnages
- Unit of Service Rate Computation —"no c1an.0e
•
X Program Capacity per Month
Cemficate of Insurance minor change
Page 25 of 31
RFP-FYC-01007 Attached A
Date of Meeting(s)with Social Services Division Supervisor: 3(7/to (
Comments by SSD Supervisor: 1-7, v- +--vi
o
i1c^.vv,!
-n �a ( /�TCc K Gs r,;,ita
3(7/70/
Name and Signature of SSD Supervisor Date
Page 26 of 31
RFP-FYC-01007 Attached A
Program Category Sexual Abuse Treatment Program Bid Category
Project Title Sexual Ahuaa and Family Education and Treatment Program (The SAFE -T Program)
Vendor Ackerman and Associates P.C.
PROJECT DESCRIPTION
Provide a one page brief description of the project.
II. TARGET/ELIGIBILITY POPULATIONS
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 to be served. Please describe if your clients are:
1. Victims under age 18.
2. Perpetrators under age 18.
3. Adult incest perpetrators.
4. Non-abusing spouse
5. Relatives (under 18) in the household of incest victims and/or incest perpetrators.
C. Total family units.
D. Sub-total of individuals who will receive bicultural/bilingual services.
E. Sub-total of individuals who will receive services in South Weld County.
F. Subtotal of individuals who will provide 24-hour access to services.
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.
III. TYPE OF SERVICES TO BE PROVIDED
Please provide a two page description of the types of services to be provided. Please address if your
project will provide the service minimums as follows:
A. Comprehensive, diagnostic and treatment planning with the family and other service
providers.
B. Therapeutic intervention with flexibility to bring in other services if needed.
C. Therapeutic services through a variety of modalities including: individual, family, group,
marital, data, etc.
D. Therapy designed to address issues and behaviors related to sexual abuse victimization, sexual
dysfunction, sexual abuse perpetration, and to prevent further sexual abuse.
E. Specialized intake/investigation function for families with sexual abuse allegations.
Also,provide your quantitative measures as they directly relate to each service. At a minimum,
include a number to be served in each service component. Describe your internal process to assure
that FYC resources will not supplant existing and available services in the community; e.g. mental
health capitation services, ADAD and professional services otherwise funded.
Page 27 of 31
RFP-FYC-01007 Attached A
IV. MEASURABLE OUTCOMES
Please provide a two page description of your expected measurable outcomes of the project. Please
address the following measurable outcomes:
A. Reduced rate of recidivism of sexual abuse perpetration within a stated time frame.
B. Decrease in re-victimization.
C. Prevent victim perpetration.
D. A percentage of child abuse incest victims receiving services do not go into placement.
E. Improvement in parental competency as measured by pre and post placement functional test.
F. More rapid reunification of children with families.
Describe your quantitative measures: Also, describe the methods you will use to measure, evaluate,
and monitor each quantitative measure.
V. SERVICE OBJECTIVES
Please provide a one page description of your expected service objectives and quantitative measures.
Please address, at a minimum, the following ways the project will:
A. Improve Parental Competency-Capacity of parents to maintain sound relationships and
appropriate physical and emotional boundaries with their children, and to empower non-
abusing parents and victims.
B. Improve Family Conflict Management-Mediation and counseling designed to resolve
conflicts and disagreements within the family contributing to child maltreatment and sexual
abuse.
C. Improve Personal and Individual Competencies-Primarily in terms of self-esteem, victim
awareness, awareness and management of one's own personal history of victimization, sex
education,peer relationships enhancement, establishing appropriate physical and emotional
boundaries, assertive in lieu of aggressive behaviors, and assuming responsibility for one's
own behavior.
D. Improve Ability to Access Resources- Services shall assist parent in learning to obtain help
from other sources in the community and within local, state, and federal governments.
Describe the methods you will use to measure, evaluate, and monitor each service objective.
VI. WORKLOAD STANDARDS
Please provide a one page description of the project's work load standards and quantitative measures.
Please address, at a minimum, the following areas:
A. Number of hours per day, week or month.
B. Number of individuals providing the services.
Page 28 of 31
RFP-FYC-01007 Attached A
C. Maximum caseload per worker in the intake function and in the Sexual Abuse Treatment.
D. Modality of treatment
E. Total number of hours per day/week/month.
F. Total number of individuals providing these services.
G. The maximum caseload per supervisor.
H. The modality of treatment.
I. Insurance.
VII. STAFF QUALIFICATIONS
Please provide a one-page description of staff qualifications and address, at a minimum, the
following:
A. Will your staff, including supervisors,who are providing direct services have the minimum
qualifications in education and experience as defined in Staff Manual Volume VII, Section
7.303.17, and Section 7.000.6,Q, Colorado Department of Human Services. Describe.
B. Total number of staff, including supervisors, available for the project.
C. Is your agency approved by the Sexual Offender Management Board? Explain your
compliance with any mandatory regulating agency.
Page 29 of 31
RFP-FYC-01007 Attached A
VIII. COMPUTATION OF DIRECT SERVICE RATE
This form is to be used to provide detailed explanation of the hourly rate your
organization will charge the Core Services Program for the services offered in
this Request for Proposal. This rate may only be used to bill the Weld County
Department of Social Services for direct, face-to-face services provided to
clients referred for these services by the Department. Requests for payment based
on units of service such as telephone calls, no shows, travel time, mileage
reimbursement, preparation, documentation, and other costs not involving direct
face-to-face services will not be honored. Likewise, billings must be for hours
of direct service to the client, regardless of the number of staff involved in
providing those services. Therefore, it is imperative that this rate be
sufficient to cover all costs associated with this client, regardless of the
number of staff involved in providing these services.r
(Explanations for these Lines are Provided on the Following Page) Parr 0
Pµrtc Are rC
Total Hours of Direct Service per Client I-/S— Louts Hours [A] to h04/...1
o
Total Clients to be Served 3 6 H0,--0/6 Clients [B] - F"odiU
Total Hours of Direct Service for Year & p- O Hours [C] / h tf
(Line (Al Multiplied by Line [B]Cost per Hour of Direct Services $ 5-1 q 1 70 Per Hour [D] C4 20
Total Direct Service Costs $ / 6 7 y [E] 7/0-/
(Line [C] Multiplied by Line [D] )
Administration Costs Allocable to Program $ 3 P- -36?
Overhead Costs Allocable to Program $ 3P- a-38 [G] A3gr
Total Cost, Direct and Allocated, of Program$ / (n / / c/ 0 [H] II 9t
Line [E] Plus Line [F] Plus Line [G] )
Anticipated Profits Contributed by this Program $ O [I] O
Total Costs and Profits to be Covered ` ' / O �[ y0
by this Program(Line [H] Plus Line [I] ) $ [J]
Total Hours of Direct Service for Year ! L 9-0 (K] /;__LP
(Must Equal Line [C] )
Rate per Hour of Direct, Face-to-Face Service
to be Charged to Weld County Department of
Page 30 of 31
RFP-FYC-01007 p� is 4 r B r G /ur rO
pp Attached A
Social Services $ / / , 5-0 [L] Sv
Day Treatment Programs Only:
Direct Service House Per Client Per Month [M]
Monthly Direct Service Rate $ [N]
[A] This is an estimate of the total hours of direct, face-to-face service each
client will receive from the time he or she enters the program until completing
the program.
[B] This is an estimate of the number of clients who will be served during the period
from June 1, 2001, through May 31, 2002.
[D] This represents the average hourly salary and benefits that your organization
pays its direct service providers plus any costs which are directly attributable
to the face-to-face session with the client.
[F] This represents the salary and benefits of direct service, supervisory, and
clerical personnel which are not incurred in providing direct, face-to-face
service to the client, but can be allocated to this program for time spent on the
program for activities such as travel, phone conversations, "no-shows,"
discussions with involved parties, meeting preparation, and report completion.
[G] This represents the Agency Overhead costs, such as Rent, Utilities, Supplies,
Postage, Travel Reimbursement, Telephone Charges, Equipment, and Data Processing
which are not incurred in providing direct, face-to-face service to the client,
but can be allocated to this program for time spent on the program for activities
such as travel, phone conversations, "no-shows," discussions with involved
parties, meeting preparation, and report completion.
[H] This represents the Grand Total Costs directly attributable or allocable to this
program. It should be a reasonable assumption that if you decided to discontinue
this program, your agency would realize a reduction in costs approximately equal
to this amount.
[I] This represents the total amount of profit your firm expects to realize as a
result of operating this program. Any difference between Lines [H] and [J] must
be substantiated by an amount indicated on this line.
[L] This is the actual direct, face-to-face hourly service rate at which you will be
requesting payment for the services provided under the conditions of this Request
for Proposal.
[M] To be completed by prospective providers of the Day Treatment Program only, this
line represents the estimated number of hours per month your organization will
provide direct, face-to-face services per client.
[N] To be completed by prospective providers of the Day Treatment Program services
only, this line represents the actual direct, face-to-face monthly service rate
at which you will be requesting payment for the services provided under the
conditions of this Request for Proposal. Calculated by multiplying Line [L] by
Line [M] .
Page 31 of 31
Project Description 2001-2002
Sexual Abuse Family Education and Treatment Program
The SAFE-T Program
Project Description:Ackerman and Associates P.C. proposes to continue to provide
in 2001-2002 the time limited, outcome focused therapy model for treatment of the
non- offending parent, the victim and siblings of the victim in sexual abuse cases. The
only changes that have been made to the protocol originally submitted in 2000 - 2001
are to expand part A maximum from 12 to 15 sessions with an average completion of
part A in ten sessions rather than the six projected in the year 2000 and to require that
in part C each child receiving treatment as a victim of sexual abuse needs to have
their own authorization. These changes are to better adjust the treatment protocol
created for the 2000 budget cycle, based on our experience in that initial period.
The program is proposed in four parts: ( each of these parts may be used as part of
an integrated program, may stand alone or be used in combination with other
treatment regimens.)
A. The development of the prescriptive safety education and treatment plan of the
family unit. This will take place over no more than fifteen hours and should average
ten hours;
B The implementation of the plan with the non-offending parent to increase safety
and avoid repetition of sexual abuse in the family unit. This will take place over no
more than 15 sessions. Up to ten of these sessions would be for individual treatment.
Up to an additional five of these individual session times could be converted to ten
hours of group work. (Throughout the proposal, whenever we discuss group work
note that it will be billed as one hour of individual treatment for each two hours of
group treatment .)
C. Short term treatment for the child who was abused and for the siblings over a
maximum of fifteen sessions to develop skills for future safety and to reestablish trust,
including family issues that need to be addressed with the children. Each child in
treatment whether the victim or the sibling, should have their own authorization for
treatment.
D A protocol of therapy to taper down the frequency of support needed to provide
maintenance of skills developed. This will take place over no more than ten sessions
designed to be delivered twice a month basis over a maximum of five months. This
provides an additional support program for those families in need of the service.
Based on the past year's experience Parts A, B and C have been used by WCDSS
1
and D has not been used. Nevertheless, we submit it here as an appropriate
program for potential future use. Note that part D is presented as a separate budget
page.
For any family who is not appropriate to continue in the treatment model due to
severity they will be transferred.
Program Review point #1: A report of recommendations for treatment will be
completed at the end of part A . It will specify 1. the goals to be achieved in part B and
part C, which can then proceed over the next two or three months 2. which other types
of treatment or intervention is appropriate and 3. if no other intervention is
recommended.
Program Review point# 2: A report of the summary of treatment at the completion of
the treatment plan in part B and part C. The purpose of this report is to answer these
questions.
1. How much progress has been made to date in relation to the treatment
plan?
2. Is it probable the family will complete the treatment in part B or Part C
within the session limits specified and if not what other services might
be needed.
This will also be the point that a determination will be made as to if there is a need for
an extension of sessions in phase B and C and if so why this is needed. An
extension, if needed, will be limited to twelve sessions. Such an extension can occur
only through a second authorization.
The criteria for making judgments as to the family's progress will be based upon their
completion of the prescriptive treatment plan and the adequacy of that treatment plan
to protect the child and family from repeat offenses in relation to sexual abuse.
Families not making progress will be discussed with the caseworker and as needed
referred to other programs.
Please note: the end point of treatment is not necessarily intended to be the full and
complete resolution of all psychodynamic issues precipitated by the sexual abuse
event. Such issues will likely continue to emerge as the child enters different stages
of development into adulthood. If further funds are needed for full and complete
restoration of mental health (beyond that required for family safety) these funds
should be obtained from the perpetrator and or through victim's assistance and other
funds. The purpose of this program is to recommend to WCDSS if the incident of the
actual abuse has been resolved sufficiently to provide for the ongoing physical and
mental health and safety of the non offending parent, the child victim and siblings at
the time of discharge from the program.
2
The purpose of this highly structured system is to assist family members to achieve
careful implementation of safety and child protection plans. Through role modeling,
psychoeducational group and individual work with adults and through child therapy in
individual and on a group basis, families will progress along a structured treatment
course. Treatment will move from recognition of the factors that lead to the sexual
abuse in their particular case to developing an effective plan to eliminate the
resurfacing of these factors and repetition of these kind of events in the future.
Of the four phases of the program , Part A would be limited to 15 session delivered
over no longer than three months. Part B and C would be limited to fifteen sessions
each delivered either separately or concurrently over four months. The step down
phase of the program Part D would be limited to no more than 10 sessions over four
to six months. Reviews for the need to continue in the program would occur in month
one , month three and month five.
Families will need the sexual abuse family education and treatment program ( the
SAFE-Treatment Program) because the sexual abuse and its implications have either
1. immanently placed the children at risk of outplacement from the non offending
parent or parents, 2. created a need to be reunified or 3. the family is facing
imminent reunification failure or 4. have failed to implement the behaviors required of
them. Our model does not treat the adult offender. Where that offender is the parent
(usually the father or step father) and reunification is the agreed upon course of action
desired, we would only assist the parties in developing a formal reunification plan
after the offender has completed treatment in another program and then only in those
cases we accept based upon our clinical judgment.
Our model is expected to work best with younger children and younger teens. It is
expected to be especially useful where the non offending parent is herself a victim of
sexual or physical abuse in her home of origin, or who has a highly disrupted home of
origin from other causes. The program will provide continuity for the non offending
parent and the children through each family having a coordinator within Ackerman and
Associates. That coordinator will also coordinate the case and be the contact for the
case worker and lead the clinical team on the family. The coordinator will also track
the goals of treatment and organize the aspects of treatment within our clinical team
approach. Clinical teams will discuss each case as necessary.
Purpose: The purpose of the time limited, outcome (safety) focused (as opposed to
psychodynamically focused) therapy is to implement the changes needed to insure
future safety from further sexual abuse. The model assumes a clinical team oriented
family systems approach of education and treatment and seeks clearly defined
behaviors and outcomes that will insure safety. The role of the non offending parent in
the sexual abuse will be explored, looking for points where protection can be
strengthened in the future. The life experiences of abuse or neglect of the non
offending parent in the home of origin will be part of the psychoeducational work that
3
will be needed by many of the families.
In order to develop a treatment plan for addressing the sexual abuse which has
brought the family into social services, the first part of the model will be the
development of the psychological scope of work that will need to be completed. What
are the goals needed to insure future safety? This will be developed through a review
of the case, psychological testing if indicated, assessment of the victim and of the
victim's siblings. From there, clearly defined, achievable, structured behavioral
changes that are needed to insure future safety of the child will be developed into a
written plan. Once signed by the therapist and non offending parent, this plan will
become the treatment goals for the family in relation to the safety of the child.
Time lines and work to be achieved by phase are listed below:
Part A. The development of the prescriptive treatment plan of the family unit over no
more than fifteen sessions with a goal of the program for prescriptive assessment to
average ten sessions. The prescriptive treatment plan typically involves interviews
with the non offending parent (up to five hours) three hours of case review, three hours
of assessment and interpretation and up to four hours of assessment of other family
members.
Part B: The implementation of the plan with the non offending parent to assure safety
and avoidance of repetition of sexual abuse in the family unit over no more than 15
sessions. It is anticipated that ten hours of these 15 sessions can be through group
work (at a cost equivalent of five individual hour long sessions) For the non offending
parent a mentoring of psychoeducational process of identifying factors that
contributed to the abuse and dealing with these factors will be explored. This will be
particularly important if negligence or home of origin issues are present. We postulate
that a large percentage of the non offending parents will either have been themselves
sexual abuse victims or have come from significantly dysfunctional backgrounds.
Such a psychological history would be amenable to this mentoring approach.
Part C For the child victim or sibling, the restoration of trust and safety assurance after
the abuse incident itself would be the goal of child treatment. If appropriate and if the
offending parent has successfully completed treatment and if the victim and non
offending parent are appropriate for reunification, steps toward reunification may
progress in selected cases.
Part D A step down protocol of therapy no more than ten sessions designed to be
delivered on no more than a twice a month basis for supportive transition from the
support program, for those families in need of this extended service.
Other Considerations:
There is no risk of the program running up costs above those budgeted for any one
4
family because we propose a treatment cap for social services funds for any family at
a maximum of sessions, 15 for part A, 15 for part B, 15 per child for part C. In the last
year most patients had either part A or Part B and some had both programs. Some
also had part C. None were treated in part D. This protocol sets a maximum figure
per family of 45 hours if one child is in treatment in part C. We have set our maximum
at 36 families for treatment under this contract. We anticipate twenty four families will
more likely be treated. For our four therapists/case managers this provides a
caseload of six to nine families for each to coordinate over the contract. Additional
services would be supported either through victims assistance or through insurance.
The program does not seek renewals above the cap of sessions unless this is the
lowest cost option appropriate for achieving success as determined by the WCDSS
case worker and supervisor. Even within the renewal request, we would limit a
renewal to twelve additional sessions per approval. If significant resolution cannot be
achieved by a family within 45 sessions of competent psychological treatment, other
options should also be examined. In our opinion, it should be extremely rare for a
case to go on this long and then fail. The majority of cases responding poorly to
psychological intervention should have been ended at one of the review points in
treatment. We propose that no family should continue in our treatment program if two
successive review points indicate that progress is inadequate.
Target/Eligibility Populations
A Total number of clients to be served in this twelve month program has been
calculated as follows. Three families per month times twelve months equals thirty-six
families per year. If we assume a family size of four, one adults and three children,
then the total client pool to be served is 144 individuals. That number includes at
least 36 individuals who are victims and 36 non offending parents with the remaining
72 being siblings and other household members. Our projected maximum total for
2001 -2002 is 36 families. We expect to treat between 18 and 24 families. We
calculated the budget based on one child in treatment in part C on average.
B. Distribution of clients. Maximum number of clients we will serve is approximately
144 as calculated above. We would expect approximately 36 of these would be adult
members of the family (non offender) and approximately 108 would be minors. We
estimate that they would be distributed across the age range from 1 to 17. There
would be 36 index children victims and 72 siblings. We do not accept adult
perpetrators into this treatment program We only accept them for work on
reunification or ongoing issues of family contact short of reunification on a case by
case basis..
C. Families Served. We anticipate serving 18 - 24 family units with no more than 36
being served under this contract
D. Sub total who will receive bicultural/bilingual services. We anticipate we can
5
serve 50% or more of the total referred in a bilingual manner. All of the staff have
extensive cross cultural experience so 100% can be served in a biculturally
appropriate manner.
E. We can provide services in South County if Social Services can provide a site to do
such work. We anticipate the majority of the sexual abuse treatment work will be done
at our Greeley Offices.
F. Accessibility. On weekdays, all providers of Ackerman and Associates are
accessible through our office secretary and through cell phones and pagers. After
hours we maintain a 24 hour answering service and pager system. On weekends,
this 24 hour access reaches the provider on call who is always a licensed Mental
Health provider.
G. Maximum per month. The program maximum is three new families per month
with the ability to carry eight cases per month maximum.
H. The monthly average capacity is two new families per month with the ability to
carry five such cases per month
I. The average stay in the program is expected to be 40 sessions over a six month
period. The maximum stay is 45 sessions over a 12 month period assuming one
child in part C with parts A, B and C being used. Use of part D adds ten hours to this
total. Group treatment would be provided at a rate of one half of the proposed
session rate of this bid so each session of group treatment would be two hours of
time billed as equivalent to one hour of individual treatment. A number of scenarios
may be used to reduce the cost of this program, For example, assessment might be
mostly complete through activities of others and this would reduce costs in Part A.
The child may need less treatment, or the treatment of the non offending parent be
easier than expected reducing the costs of parts B and the same for the child in Part
C. The need for ongoing support may be in less than the one in three we estimate of
those who complete treatment, reducing the cost of D and this was indeed the case in
the year 2000-2001. However, we have tried to make the best estimates for the
average length of stay as reflected in the figures proposed in this bid.
Types of Services Provided
We propose to provide up to a maximum of 55 sessions of outcome focused
treatment over four program subtypes (A, B, C or D) and anticipate completion of
treatment for at least half the non offending parent, the child victim and siblings in 40
sessions or less over a six month period. We would use a model which would
address the family's safety needs and maximize the cost effectiveness of the
treatment. These are described under the project description and purpose described
above.
6
Our program will meet the services minimums through the following activities.
We will provide comprehensive diagnostic and treatment planning for the family
through part A described above. This includes a prescriptive treatment plan for the
non offending parent and a specialized intake procedure for the child victim as
required in item IIIE of this bid RFP.
We do not intend to serve as a replacement for investigative services related to
criminal prosecution as there are other programs better suited to this task.
Nevertheless, the intake format we use is designed to address the psychosocial
needs of the non offending parent to enable her to recognize how the abuse is often a
partially a consequence of a family dynamic which resulted in failure to protect the
child and not only as a result of the isolated and secret actions of the perpetrator.
Our services use a variety of modalities including play therapy, group therapy for the
child and for the non offending adult, individual therapy and family therapy (without the
offending parent being in treatment with our program).
The primary goal of treatment is to address the prevention of further sexual abuse, to
use psychoeducational techniques to work with the non offending parent to avoid
repetition of behavioral patterns that have failed to fully protect the children and to help
the non offending parent and child victim recover from sexual abuse victimization. Our
program does not treat the offending parent.
Our program has been designed so each portion is able to stand alone. If it is likely to
be more effective, for any reason, to have treatment done in a modular fashion by
different agencies, our program design makes this a relatively simple option to
implement.
The numbers to be treated in each service component are a maximum of 36 non
offending adults a maximum of 36 child victims and 72 siblings. the ratio of victims to
siblings may be altered depending on the number of cases of multiple victims in the
same family.
To insure the FYC resources do not duplicate existing services in the community we
will coordinate with he social services caseworker to limit our costs, as appropriate, if
other programs can provide the specified services in each case. This will take place
at each review point.
Measurable outcomes:
A. To achieve a reduced rate of recidivism of sexual perpetration does not apply as
we do not accept perpetrators into this treatment program.
7
B. Decrease in revictimization should be substantial and persistent. The program is
set up to empower the non offending parent to identify situations where victimization is
likely and to reduce these occurrences. We set a goal of 90% of families who
complete treatment will not be revictimized in the next two years. This number
assumes that after treatment is completed the non offending parent not reenter a
marital relationship to the offending parent. We set a goal of 40% at two years post
treatment to avoid revictimization if marital reunification occurs with the offending
parent in the next year.
C. Prevention of victim perpetration. For those victims who complete treatment and
because of the likely age of the victims ages three to thirteen , victim perpetration will
be rare as we set a goal at 90% will not become perpetrators within a two year period.
D. We project that 80% of the non offending parents will complete treatment. For
these non offending parents we project that 90% will keep their children for at least
two years after the treatment regimen is completed.
E. Improvement of parental competency will be measured using either the Parenting
Stress Index (PSI) or the Parent Child Relationship Index (PCRI) by pre and post
testing or by other tests as selected for the case by the clinical staff. We expect 80%
of non offending parents to complete the phase B training.
F. While we do not expect more rapid reunification with biological family nor with the
offending parent, we do expect the acquisition of life skills in anger management and
increase in psychoeducational knowledge and subsequent risk reduction for return to
an abusive environment.
Quantitative measures for determining these goals can be made by file review at two
years post treatment and determination of if a new case has opened in the county in
that time. Individuals no longer in the county ( who had moved or could not be
reached) would be lost to follow up. The data would have to be tabulated by the case
worker at the end of the two year timeframe as we are not budgeted for such long term
evaluation.
Service objectives:
This proposal meets all the service objective for the non offending parent and the
victim. The areas for improvement are documented in the quantitative measures that
will be rated for the non offending parent at the two review points and at the
completion of therapy as listed under the measurable objectives section. These
areas include the required components of improving parental competency, improving
family conflict management, improving personal and individual competent. and
improving ability to access resources for the non offending parent.
Work load standards.
8
Number of hours per month based is based on 36 families per year in treatment .
This is three families per month on averages. (This is the same as six families
having 18 hours each or 12 families having nine hours each per month). A total of
108 per month is the monthly average = @ $10,746 service projection per month or
$128,956 per year as the most likely projection. The Maximum projection is for based
on all families needing 45 sessions and 12 families needing part D as well for a
yearly total capacity we could provide of $173,130.
Number of providers . We have eight providers described below.
Joyce Shohet Ackerman, Ed.D. ,licensed psychologist, has spent twenty years in
practice in Weld County. She has extensive child and family related experience. She
will serve as administrative coordinator of this program.
Karen Bender, M.A., L.P.C. is our lead in treatment of adult non offenders. Her
personal life experiences have included recovery from childhood sexual abuse and
she bring unique skills to this process along with her formal training. She will conduct
the adult groups for non offending parents and provide individual therapy for the non
offending parent. She has extensive training in treating adult victims of sexual abuse
and domestic violence. She will also serve as a case coordinator , primarily where the
non offending parent is a sexual abuse or physical abuse victim.
Susan Bromley, Psy..D. is both trained and experienced a social worker and a
practicing licensed psychologist with extensive experience . She will serve in this
program in an on call capacity on weekends on a rotating basis with other providers.
Emily Jaramillo M.A., L.P.C. is a licensed professional counselor fluent in Spanish.
She has specific training in solution focused therapy and specializes in working with
children, teenagers and families. She will provide our bilingual services, She has
experience in criminal justice, and in drug abuse treatment as well as in Family Group
Conferencing, Home based treatment and Foster parent support consultation. She
will also serve as a case coordinator.
Larry Kerrigan Ph.D., licensed psychologist, has more than twenty five years
experience as a therapist in Greeley working through the Weld Mental Health Center
and Ackerman and Associates. He has extensive child protection experience. He will
rotate call and be available for individual sessions with teens, particularly with male
siblings who may need a male therapist or who potentially have experienced sexual
abuse from the offending parent.
Sherri Malloy, Ph.D. Licensed Clinical Psychologist who has bicultural experience at
the Boulder Mental Health Center as director of the Children's Team can use a brief
play therapy session to assist the child and document the impact of the sexual abuse
on the younger children and siblings. She will be one of the principle case
9
coordinators as well.
Nicole Wamygora, M.A., L.P.C. has experience with latency age children in psychiatric
settings and has been providing services for Ackerman and Associates P.C. since
1998 in both home based and foster parent support. She is a doctoral student in
school psychology and will conduct the psychological, personality and projective
testing in this program. She will also coordinated group treatment of children. She will
also serve as a clinical case coordinator. She also has clinical experience with
bicultural families.
Cassie Yackley, M.S., L.P.C. is experienced with children and families and especially
with adolescents. She is completing her doctoral work in counseling psychology at
UNC. She will serve as a case coordinator and also has clinical experience in Home
based and bicultural treatment models.
Maximum caseload is seven families at a time over a six month period per therapist.
Modality of treatment :
Part A: assessment
Part B: psychoeducational group and individual therapy
Part C: individual and play therapy, group therapy - children's safety group
Part D: family , child or individual therapy as required.
Hours per month: We expect to average 108 hours per month and will set a
maximum of 216 hours per month.
Eight individuals provide or assist with these services.
Maximum case load per case supervisor is 15 in 12 months for this program
Maximum families accepted for treatment in one year is 36 families.
Insurance of one million three million professional malpractice is carried by all
providers and by Ackerman and Associates P.C. for the corporation. General liability is
carried through Farmers insurance in excess of the required minimum. Car insurance
is carried by each provider.
Staff qualifications are stated above and resumes are available if requested.
Bid is calculated as follows Therapy time for individual treatment or assessment is at
$99.50 per contact hour. Therapy in group time is at that rate for two hours of contact
time. The maximum for this contract for thirty six families if all required 45 sessions of
individual treatment would be 1620 sessions for a maximum of $161,190. The
expected cost of the proposal based on an average of two families per month would
be $95,520 if 40 sessions was the average. Our experience in the 2000-2001 bid year
was significantly lower than this set of theoretical maximums.
10
DECLARATIONS O TRUCK INSURANCE EXCHANGE ® FARMERS INSURANCE EXCHANGE O FIRE INSURANCE EXCHANGE
SPECIAL
SENTINEL SCUM RS
MEMBERS of FARMERS INSURANCE GROUP OF COMPANIES "'u"".rl�
PACKAGE HOME OFFICE:4680 WILSHIRE BLVD.,LOS ANGELES,CALIFORNIA 90010 cxa \
SUPER
1. Named . DR JOYCE SHOHET ACKERMAN PC Prod.
Count
Insured Prematic Acc't No.
Mailing 1750 25TH AVE SUITE 101
Address . 07-04-362 04576-38-07
GREELEY CO 80631 Agent Policy Number
Type of
The named Insured is an individual unless otherwise stated: ❑ partnersa ® Corp. Business OFFICE
❑ Joint Venture LJ Organization(Other than Partnership or Joint Venture)
2. Policy Period from 07/01/00 (not prior to time applied for)
to 07/01/01 12:01 a.m.Standard Time.
If this policy replaces other coverages that end at noon standard time on the same day this policy begins, this policy will not take effect until the other
coverage ends. This policy will continue for successive policy periods as follows: If we elect to continue this insurance,we will renew this policy if
you pay the required renewal premium for each successive policy period subject to our premiums,rules and forms then in effect.
3. Insured location same as mailing address unless otherwise stated: 1750 25TH AVE SUITE 101
GREELEY CO 80631
4. Mortgage Holders
Loan# Loan#
5. Premium$ 507.00 ❑ "X"if Mortgage Holder Pays
6. Policy Forms and Endorsements attached at inception: 25-2880 E4103-ED2 565310-ED2 S0700-ED3
E6036-ED1 E4168-ED1 E4004-ED1 E4216-ED1 E3026-ED1
7. We provide insurance only for those coverages Indicated by a specific limit or by an
COVERAGES LIMITS OF INSURANCE DEDUCTIBLE
A-Building $ $250 applies unless other
SECTION 1 B-Business Personal Property $ 52,000 o tlon indicated b an®
�stoo❑ssoo �$_
C-Loss of Income(Not exceeding 12 consecutive months) ACTUAL LOSS SUSTAINED NONE
Property OPTIONAL COVERAGES
and Swimming Pool/Fences and Walkways $ Above deduc-3
Loss of IC Building Glass(Blanket) REPLACEMENT COST lible applies 3 100
Income 7 Outdoor Sign Coverage $ 100 unless other 3
Valuable Papers(In addition to$1000 included.) $ option Inch- $
cater!.
❑ Earthquake Damage See Coverages
A,B,8 C of the applicable ins. limit.
SECTION II 0-Business Liability•Including Products and Completed LIMITS OF LIABILITY
Operations. (Annual aggregate applies for all occurrences (Annual Aggregate)
during the policy period.) $ 1 ,0 00,000
Liability E-Fire Legal Liability$75,000 Included unless other option indicated by an X
and 0$100,000 0$150,000 each occurrence(Subject to the annual aggreagate shown for Cov.D)
Medicals F-Medical Payments to Others(Subject to the annual aggregate $5,000 each person
shown for Coverage D.)
Limit of Liability
(Annual Aggregate)
❑Professional Liability(see attached endorsement) $
I-V COVERED DEDUCTIBLE
SECTION III Agreement I-Employee Dishonesty $5,000 NONE
Agreement II-Broad Form Money and Securities-Inside $1,0 00 $250
Agreement III-Broad Form Money and Securities-Outside $1,000 $250
Crime Agreement IV-Medical Payments $500 each person NONE
Agreement V-Forgery or Alterations / $2,500 NONE
56.5300 2-92 2ND EDITION Countersigned r N, a_ /
Authorized Represents ive
Attach to.your policy with the same number shown on3hirendorsement• n
b z-
2nd Edition`
Named Insured• DR JOYCE SHOUT ACKERMAN PC Agent Policy Number
Address. 1750 25TH AVE SUITE 101
• GREELEY CO 80631 07-04-362 04576-38-07
of the Company
designated in the
Insured Declarations -
Location
(Same as above unless otherwise stated here) •
Effective Date 07/31/96 Limit of Liability $ 1,000,000 each occurrence
$ 1,000,000 Annual Aggregate
ADDITIONAL INSURED ENDORSEMENT
(SPECIAL SENTINEL)
In consideration of the premium we agree with you to the following:
1. The insurance provided by this policy for bodily injury liability and property damage liability under Coverage .
D—Business Liability insurance will also apply to the additional insured named below, but only with respect
to an occurrence arising out of the ownership, maintenance or use of that part of the insured location
occupied by you.
2. This insurance does not apply to:
(a) Any occurrence which takes place after you cease to occupy the insured location.
(b) Any structural alterations, new construction or demolition operations performed by or for any additional
insured named below.
3. The additional insured will not be construed or deemed to be a subscriber to the Company issuing this policy.
4. The additional insured will not be or become liable for any premium payments due upon this policy.
5. If this policy is terminated for any reason we will give 30 (THIRTY) days notice
in writing to the additional insured named below.
This endorsement is part of your policy. It supersedes and controls anything to the contrary. It is otherwise
subject to all other terms of the policy.
Additional STATE OF COLORADO
nsured • C/O WELD COUNTY SOCIAL SERVICES DEPT
IATTN: JUDY GRIEGO
PO BOX A
• GREELEY CO 80632 Countersigned
Authorized Representative •
PYM(9f
f- �iXtuPP.1 I
� 4N0JP �
9,4,03 2ND EDITION 6.95 1501 K-95 1501
MEMORANDUM OF INSURANCE Date Issued
05/24/2000
Insured This memorandum is issued as a
ACKERMAN AND ASSOCIATES PC matter of information only and confers
1750 25TH AVENUE no rights upon the holder. This
GREELEY CO 80631 memorandum does not amend, extend
or alter the coverages afforded by the
Certificate listed below.
Company Affording Coverage
Producer
Chicago Insurance Company
Kirke Van Orsdel
1776 West Lakes Parkway
West Des Moines, Iowa 50398 Covered Person (Status) Owner
x
Employee
JOYCE SHOHET ACKERMAN
This is to certify that the Certificate listed below has been issued to the insured named herein for the policy
period indicated, notwithstanding any requirement, term or condition of any contract or other document
with respect to which this memorandum may be issued or may pertain, the insurance afforded by the
Certificate described herein is subject to all the terms, exclusions and conditions of such Certificate. The
limits shown may have been reduced by paid claims.
Certificate
Type of Insurance Number Effective Date Expiration Date Limits
Professional Liability each incident $1,000,000
Claims-Made 45P-2032570 05/01/2000 05/01/2001 annual aggregate $3,000,000
Covered Person's Retroactive Date: 05/01/1992
Should the above described Certificate be canceled Memorandum Holder
before the expiration date thereof, the issuing
company will endeavor to mail written notice to the
named Memorandum Holder, but failure to mail such GADR IAN
notice shall impose no obligation or liabilty of any PO BOX 172687
kind upon the company, its agents or representatives. DENVER CO 80217
Authorized Representative:
Ja a" e Air via
6LR
Issue Date: 12/01/0 0
<6neipocPROFESSIONAL LIABILITY OCCURRENCE
Alliance INSURANCE POLICY FOR
Risk Retention Group PROFESSIONAL COUNSELORS AND HUMAN
DEVELOPMENT PRACTITIONERS
ACA Insurance Trust,Inc.
5999 Stevenson Avenue ACA IMIWr1
Policy Number: CL10073401 Administered by: Alexandria,VA 22304-3300 TRUST
Toll Free:1100-347-6647 x284 1.. "'
ITEM DECLARATIONS INDIVIDUAL POLICY
1. NAMED INSURED: Norma Karen Bender
2- ADDRESS:
1104 Twin Peaks Circle
Longmont , CO 80503-2170
3. POLICY PERIOD: From: 02/04/01 To: 02/04/02
12:01 A.M.Standard Time at Location of Designated Premises
4. The insurance afforded is only with respect to such of the following types of insurance as indicated by specific premium charge or charges:
COVERAGE PREMIUM
A. PROFESSIONAL LIABILITY $ 370 . 00
B. GENERAL LIABILITY S 0 . 00
TOTAL PREMIUM: S 370 . 00
C. LIMITS OF LIABILITY: $1 , 000 , 000 each Incident or each Occurrence $3 , 000 , 000 in the Aggregate
6. THE NAMED INSURED IS: Sole Proprietor(incl.Individual) Partnership
Corporation X Other(refer to Item 7 below)
7. BUSINESS OF THE NAMED INSURED: Self-Employed
(Rating Category) Counselor/Human Development Professional
8. This policy is made and accepted subject to the printed conditions of this policy together with the provisions,stipulations end
agreements contained in the following formis) or endorsement(s): CPL•0004•0199 CPL-0005-0199 CPL-0005.0199
NOTICE
THIS POLICY IS ISSUED BY YOUR RISK RETENTION GROUP. YOUR RISK RETENTION GROUP MAY NOT BE SUBJECT TO ALL OF THE
INSURANCE LAWS AND REGULATIONS OF YOUR STATE. STATE INSURANCE INSOLVENCY GUARANTY FUNDS ARE NOT AVAILABLE
FOR YOUR RISK RETENTION GROUP.
CPL 0005 0199.00
Branch B/A Producer# Issue Date Renewal/Replacement No.
32 A 0002360 03/08/2001 RENEWAL
PSYCHOLOGISTS PROFESSIONAL LIABILITY
CLAIMS-MADE INSURANCE POLICY
PURCHASING GROUP POLICY NUMBER: 452-0002000
NOTICE: THIS IS A CLAIMS-MADE POLICY, PLEASE READ THE POLICY CAREFULLY.
i cnt DECLARATIONS CERTIFICATE NUMBER: 45P- 2050203
NAMED INSURED: SUSAN FLOCK BROMLEY PSYD
ADDRESS 1621 13TH AVENUE
(Number (Sf Street, Town, GREELEY CO 80631
County. State & Zip No.)
POLICY PERIOD: From 04/01/2001 To 04/01/2002
(12:01 A.M. Standard Time At Location Of Designated Premises)
COVERAGE: LIMITS OF LIABILITY PREMIUM
Professional Liability $1 , 000,000 $3,000,000 $802 .0':
each Incident Aggregate
BUSINESS OF THE INSURED: Psychology
THE NAMED INSURED IS:
-----------
( X ) Sole Proprietor (including Independent Contractors) ( ) Partnership ( ) Corporauon
) OTHER:
---------- ----
n his policy shall only apply to incidents which happen on or after: a) the policy effective
cate shown on the Declarations; or b) the effective date of the earliest claims-made policy
issued by the Company to which this policy is a renewal; or c) the date specified in any
endorsement hereto. 04/05/1996
This policy is made and accepted subject to the printed conditions of this policy together ssiui
the provisions, stipulations and agreements contained in the following form(s) or endorscr,te:.t,
P- , - 2008 ( 10/94 ) POE -8004 ( 5/88 ) PLE -2167 ( 07/001 PLE - 208 '
Pot) -2003 PLE -8035 ( 09/97 )
CHICAGO INSURANCE COMPANY
55 E. MONROE STREET, CHICAGO, ILLINOIS 60603
REPRESENTATIVE: Agent or Broker: Kirke Van Orsdel
Office Address: 1776 West Lakes Parkway
Town and State: West Des Moines, IA. 50398
Toll-free Number: 1-800-852-9987
. ' tn• IATL
k \NCt
PLP-21312 (06'93) (Elec.)
PRIOR ACTS EXTENSION ENDORSEMENT
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
in consideration of the premium charged for this policy, sub-paragraph B of Section I,
COVERAGE, is deleted in its entirety and replaced by:
B. At any time prior to the policy effective date shown on the Declarations if
(1) Such act or omission happens on or subsequent to the "prior acts
date" listed below; and
(2) No Insured knew or could have reasonably foreseen that such act or
omission might be expected to be the basis of a Claim or suit on the
effective date of this policy or the first claims-made policy issued by
the Company to which this policy is a renewal, whichever is earlier
Prior Acts Date: 04/05/ 1996
ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED.
Crern,urn 101 this endorsement is included in the premium shown on Additional Premium $
= cec'arauons unless a specific amount is shown here. Return Premium $
E^.:ORSEMENT NO.: Effective: 04/01 /2001
aaacnec and forms part of your evidence of insurance no.: 45P-2050203
Issued by: the Company named in the Declarations
Executive Offices: 55 E. Monroe Street
Chicago, Illinois 60603
SUSAN PLOCK BROMLEY PSYD
=-e iSs_ec Authorized Representative:
b 2 0 0 1 e
--_ _--- L_5 LEC '10:93) Dec)i •
MEMORANDUM OF INSURANCE Date Issued
11/07/2000
Memorandum Holder This memorandum is issued as a matter
of information only and confers no
ACKERMAN & ASSOCIATES ATTN DONNA rights upon the holder . This
SUITE 101 memorandum does not amend, extend
1750 25 AVENUE or alter the coverages afforded by the
GREELEY CO 80634 Certificate listed below.
Producer Company Affording Coverage
Chicago Insurance Company
Seabury & Smith
1776 West Lakes Parkway Covered Person (Status) Owner
West Des Moines, Iowa 50398 EMILY L JARAMILLO-BANSBERG MA x
Employee
This is to certify that the Certificate listed below has been issued to the insured named herein for the policy
period indicated, notwithstanding any requirement, term or condition of any contract or other document with
respect to which this memorandum may be issued or may pertain, the insurance afforded by the Certificate
described herein is subject to all the terms, exclusions and conditions of such Certificate. The limits shown
may have been reduced by paid claims.
Certificate
Type of Insurance Number Effective Date Expiration Date Limits
Professional Liability each incident 1 ,000,000
or occurrence
Occurrence 80M-4003488 11/01/2000 11/01/2001 3,000,000
in the aggregate
General Liability each incident
or occurrence
Occurrence
in the aggregate
Should the above described Certificate be canceled Insured
before the expiration date thereof, the issuing
company will endeavor to mail written notice to the
named Memorandum Holder, but failure to mail such EMILY L JARAMILLO-BANSBERG MA
notice shall impose no obligation or liabilty of any 183 50 AVENUE PLACE
kind upon the company, its agents or representatives. GREELEY CO 80634
Authorized Representative:
t • e 4;, ,e,
:1/14/00 - A PSYCHOLOGISTS PROFESSIONAL LIABILITY POLICY
• THIS IS A CLAIMS MADE POLICY-PLEASE READ CAREFULLY •
*** RENEWAL ***
NOTICE. A LOWER LIMIT OF LIABILITY APPLIES TO JUDGEMENTS OR SETTLEMENTS WHEN THERE ARE ALLEGATIONS
OF SEXUAL. MISCONDUCT(SEE THE SPECIAL PROVISION "SEXUAL MISCONDUCT" IN THE POLICY). •
DECLARATIONS
. .POLICYNO 801-0005006 ACCOUNT NO: CO-KERL175-0 0099745=
ITEM I. (al NAME AND ADDRESS OF INSURED: ITEM I. (b)ADDITIONAL NAMED INSUREDS:
LAURENCE P . KERRIGAN, •
PH . D .
•
1750 25TH AVE .
• SUITE #101
GREELEY, CO 80631
TYPE OFORG: INDIVIDUAL
ITEM - ADDITIONAL INSUREDS: . ----
•
!TEM3 POLICY PERIOD: FROM: 12/01/00 TO: 12/01/01 •
12:01A.M. STANDARD TIME AT THE ADDRESS OF THE INSURED AS STATED H=b.'_:".
ITEM 4 LIMITS OF LIABILITY: (a)$ 1 , 000 , 000 EACH WRONGFUL ACT OR SERIES OFCONTIN(1O1 :. H!:T '.
OR INTERRELATED WRONGFUL ACTS OR ° C( I;i.l
(b)$ 5 , 000 DEFENSE REIMBURSEMENT
(c)$ 3 , 000, 000 AGGREGATE
ITEM 5 PREMIUM SCHEDULE: - - - --
CLASSIFICATION NUMBER RATE ANNEAL PRE\IT \I
1ST PSYCHOLOGIST 1 1254 . 00 1 , 254 . 0
DEFENSE LIMIT
SURPLUS LINES TAX 1 37 . , 1
INSPECTION FEE 1 2 . 51 •
•
•
ITEM 6 RETROACTIVE DATE: 12/01/91 TOTAL PREMIUM: 1 , 294 . 1_ 3
ITEM 7 EXTENDED REPORTING PERIOD -- _-ADDITIONAL PREMIUM(ifexercised):$ 2 , 265 . 24
ITEM S. POLICY FORMS AND ENDORSEMENTS ATTACHED TO THIS POLICY
922138 (7/95 ED . ) B22137
THIS IS NOT A BILL. PREMIUM HAS BEEN PAID. AL'T RIZED COMPANY REPRP NLN I
4PA?_'(1095) i
Americ Pro lismnal Agcnc� ")i Ifi,�,iJvr. .�
Branch B/A Producer# Issue Date Renewal/Replacement No.
• 32 A 0002360 02/29/2000 RENEWAL
PSYCHOLOGISTS PROFESSIONAL LIABILITY
CLAIMS-MADE INSURANCE POLICY
PURCHASING GROUP POLICY NUMBER: 452-0002000 •
NOTICE: THIS IS A CLAIMS-MADE POLICY, PLEASE READ THE POLICY CAREFULLY.
Item DECLARATIONS CERTIFICATE NUMBER: 45P- 2055185
1. NAMED INSURED: SHERRI MALLOY PHD
ADDRESS 24 ALLES DRIVE
0
(Number & Street, Town, GREELEY CO 80631
County, State & Zip No.)
2. POLICY PERIOD: From 04/01/2000 To 04/01/2001
(12:01 A.M. Standard Time At Location Of Designated Premises)
3. COVERAGE: LIMITS OF LIABILITY PREMIUM
Professional Liability $1,000,000 $3,000,000 $598.00
each Incident Aggregate
4. BUSINESS OF THE INSURED Psychology
5. THE NAMED INSURED IS:
(X ) Sole Proprietor (including Independent Contractors) ( ) Partnership ( ) Corporation
( ) OTHER:
6. This policy shall only apply to incidents which happen on or after: a) the policy effective
date shown on the Declarations; or b) the effective date of the earliest claims-made policy
issued by the Company to which this policy is a renewal; or c) the date specified in any
endorsement hereto. 04/01/1998
7. This policy is made and accepted subject to the printed conditions of this policy together with
the provisions, stipulations and agreements contained in the following form(s) or endorsement(s):
PLJ-2008 ( 10/94) POE-8004 PLE-2167 PLE-2081
PON-2003 PLE-8035 109/97 )
CHICAGO INSURANCE COMPANY
55 E. MONROE STREET, CHICAGO, ILLINOIS 60603
REPRESENTATIVE: Agent or Broker: Kirke Van Orsdel
Office Address: 1776 West Lakes Parkway
Town and State: West Des Moines, IA. 50398
Toll-free Number: 1-800-852-9987
INTERSTATE
INSURANCE
GROUP
PLP-2012 (06/93) (Elec.)
;j".PLR8003(7/94)(Ed. LASER)
EVEREST NATIONAL INSURANCE COMPANY
MENTAL HEALTH PRACTITIONER'S
PROFESSIONAL LIABILITY POLICY
DECLARATIONS
Renewal of No. 2200009922.991
NOTICE: A SUB-LIMIT OF LIABILITY APPLIES TO "CLAIMS" ARISING OUT OF
"SEXUAL MISCONDUCT".
POLICY NO. 2200009922-001
ITEM 1: NAME AND ADDRESS OF INSURED: SEND ALL INQUIRIES TO:
Nicole R Warnygora ROCKPORT INSURANCE ASSOCIATES
1800 Angelo Court PROGRAM ADMINISTRATOR
Fort Collins, CO 80528 R 0 BOX 1809
ROCKPORT, TX 78381.1809
1-800.423.5344
ITEM 2: ADDITIONAL INSUREDS: NONE
ITEM 3: DESCRIPTION OF BUSINESS: MENTAL HEALTH PRACTITIONEP(SI
• ITEM 4: POLICY PERIOD: FROM 05/20/2000 TO 05/2012001
12:0' am STANDARD TIME AT THE ADDRESS OR [HE INSURED A5 STATED HEREIN• ITEM 5: LIMITS OF LIABILITY: $ 1,000,000 EACH WRONGFUL ACT OR EACH OCCURRENCE SUBJEC 1 -0 A
•
525,300 SUB-LIM:T OF LIABILTY FOR ALL "WRONG%Vl a.CTE-
INVOLVING "SEXUAL MISCONDUCT..
$ 3,000.000 AGGREGATE
ITEM 6: PREMIUM SCHEDULE:
p1A8$IFICATION NUM MI RAIL ANNUAL PRFMIUM
CATEGORY M2 1 263.00 S 263.00
TOTAL PREMIUM S 263.00
ITEM 7. POLICY FORMS AND ENDORSEMENTS ATTACHED TO THIS POLICY:
190.00 0195, 189.00 0195, EEO 25 501 12 98, 193.00 0195
April 28, 2000 /9, ,J�fl ,/ 'J''/� ,� �
lOCL W vvr l,>S�'
AUTHORIZED COMPANY REPRFSENTATT/E
189.00 0195 m Everest National Insurance Company, 1995
Issue Date: 09/08/00
<C� The Reciprocal PROFESSIONAL LIABILITY OCCURRENCE
sA Alliance INSURANCE POLICY FOR
Risk Retention Group PROFESSIONAL COUNSELORS AND HUMAN
DEVELOPMENT PRACTITIONERS
ACA Insurance Trust,Inc.
5999 Stevenson Avenue kC"`Si2'u
Policy Number: CL12494600 Administered by: Alexandria,VA 223043700 TRUST
Toil Free: 6800347.6647 x284
ITEM DECLARATIONS INDIVIDUAL POLICY
NAMED INSURED: Cathleen Yackley
2 ADDRESS:
1020 Wabash Street #6 -203
Fort Collins , CO 80526 -0000
POLICY PERIOD: From: 09/05/00 To: 09/05/01
12:01 A.M. Standard Time at Location of Designated Premises
4 The insurance afforded is only with respect to such of the following types of insurance as indicated by specific premium charge or charges:
COVERAGE PREMIUM
A. PROFESSIONAL LIABILITY S 395 . 00
B. GENERAL LIABILITY S 0 . 00
TOTAL PREMIUM: $ 395 . 00
5 LIMITS OF LIABILITY: $1 , 000 , 000 each Incident or each Occurrence $3 , 000 , 000 in the Aggregate
6. THE NAMED INSURED IS: Sole Proprietor(incl. Individual) Partnership
Corporation X Other (refer to Item 7 below)
7. BUSINESS OF THE NAMED INSURED: Self-Employed
(Rating Category) Counselor/Human Development Professional
_. This policy is made and accepted subject to the printed conditions of this policy together with the provisions,stipulations and
agreements contained in the following form(s) or endorsement(s): CPL•0004 0199 CPL0005.0199 CPL 0006 0199
NOTICE
THIS POLICY IS ISSUED BY YOUR RISK RETENTION GROUP. YOUR RISK RETENTION GROUP MAY NOT BE SUBJECT TO ALL OF THE
INSURANCE LAWS AND REGULATIONS OF YOUR STATE. STATE INSURANCE INSOLVENCY GUARANTY FUNDS ARE NOT AVAILABLE
FOR YOUR RISK RETENTION GROUP.
CPL-0005 0199.00
AMERICAN FAMILY MUTUAL INSURANCE COMPANY
MADISON,OR WISCONSIN 5E3H783.0001
PROOFAor INSURANCEIPARD
Policy No: 0869-0235-01-84-FPPA-CO
Eff Data: 11-3-2000 Exp Data: 5-3-2001
1999 PONT GAS VIN: 1G2NE52E3XM811960
C II PO UM UIM COMP COLL PIP ERS
JARAMILLO, EMILY
183 50TH AVENUE PL
GREELEY CO 80634-4718
Agent: CHRISTINA GALINDO
ASent Phone: (970) 346-9356
COLORADO
INSURANCE CARD
INSURED KERRIGAN,LARRY P MUTL
VOL
POLICY NUMBER 200 0862-D28-068 EFFECTIVE
YR 1988 MAKE HONDA
MODEL OCT 2820009JC ITOT APR 282001
ACCORD
VIN JHMCA532JC133q
AGENT RICK WALLACE
PHONE (970)356.8237 1679-625
A BODILY INJURY/PROPERTY DAMAGE LIABILITY
P1 NO-FAULT
D COMPREHENSIVE
G 100 DEDUCT COLLISION
H,U
SEE REVERSE SIDE FOR ADDITIONAL COVERAGE INFORMATION
COLORADO
l INSURANCE CARD
INSURED BROMLEY,JOHN MUTL
VOL
POLICY NUMBER 653 7520•F07.08C EFFECTIVE
YR 1984 MAKE VOLVO DEC 072000 TO JUN 072001
MODEL 240 VIN YV1AX8855E1583112
AGENT MARK LARSON
PHONE (170)356.1700
THE COVERAGE PROVIDED BY THE POLICY MEETS THE
MINIMUM LIABILITY LIMITS PRESCRIBED BY LAW.
A BODILY INJURY/PROPERTY DAMAGE LIABILITY
P3 NO FAULT•PPO(SLOAN'S LAKE)
D 50 DEDUCT COMPREHENSIVE
G 100 DEDUCT COLLISION
H,R1,U
SEE REVERSE SIDE FOR ADDITIONAL COVERAGE INFORMATION
USAA CASUALTY INSURANCE COMPANY •
\ IA Stock Insurance Company) Stale 06 D7 Idea POLICY NUMBER
•
SAA® 9800 Fredericksburg Road San Antonio, Texas 78288
SAA® D29P29 err 00211 02 59C 7103 5
COLORADO AUTO POLICY POLICY PERIOD: (12:01 A.M. standard time)
RENEWAL DECLARATIONS EFFECTIVE OCT 17 1999 TO APR 17 2000
( ATTACH TO PREVIOUS POLICY ) OPERATORS
famed Insured and Address 01 SHERRI R MALLOY-GONZALEZ
07 DAVID M GONZALEZ
SHERRI R MALLOY-GONZALEZ
24 ALLES DR
GREELEY CO 80631 -6829
lescription of Vehicles) EH USE • MWoes;sCHOOL
19 YEAR TRADE NAME MODEL BODY TYPE ANNUAL IDENTIFICATION NUMBER SYM One Per
Way
)6 94 HONDA CIVIC LX SED 4D 10000 1HGEG8666RL030869 11 W 02 3
)7 99 TOYOTA SIENA LE/XLE WAG 4X2 5D 10000 4T3ZF13C9XU091812 15 P
•
PNOGREEDTh(E'
Insurance Identification Card- COLORADO
G California Casualty Name of Insurer: •
PROGRESSIVE SPECIALTY INSURANCE COMPANY
CA'-i FBOX3 CASUALTY INDE ITT EXCHANGE
P.O. BOX 39700 P.O. BOX 31557
:gPAS SPRINGS CO 80999-9700 TAMPA, FL 33631-3557
w Ev:OEN Name of Insured:
EV:JENCE OF MOTUP VEHICLE LIA2ILITT INSURANCE ALAN H ACKERMAN Effective Date:
01/08/01
INSURED 1600 AORA TOI1D & NICOLE
1800 ANGEIN cT Listed Drivers:
FORT COLLINS Co 80528 JOYCE S ACKERMAN O1/O8/O2 ate:
EFFECTIVE DATE EXPIRATION DATE POLICY NUMBER . RACHEL ACKERMAN
08/09/00 08/09/01 1022312594 •
YEAR MAKE/MODEL VIN Policy Number AA 70109900-0
99 TOYOTA TACOMA XCH 4TAWN72N9XZ569122
CLAIMS 8oc-800-Salo SERVICE. 800-800-9410 Year Make/Model Vehicle Identification Number
M„ .99, 1992 HONDA 1HGCB7877NA788218
COLORADO • �_E � NEW HAMPSHIRE
IN •
SIIRANCI: CARD INSURED YADKLINSURANCE CARD
INSURED BENDER,BRICE J&N KAREN BONNEMA,DOUG MUTL
MUTL POLICY NUMBER 8011•F11.29A VOL
POLICY NUMBER C054252-D14.08C VOL YR 1996 MAKE HONDA EFFECTIVE
YR 2000 MAKE TOYOTA EFFECTIVE MODEL CIVIC DEC 112000 TO JUN 1';2001
MODEL AVALpN OCT 142000 TO APR 142001 VIN iMGEJB1sOTL022250
VIN 4T1BF28B8YU048578 AGENT RICH YACYSITYN
AGENT JEFF PFEIFFER PHONE (603)224-5298 2018.876
PHONE (303)651.0111
THE COVERAGE PROVIDED BY THE POLICY MEET S THE MINIMUM LIABILITY LIMITS PRESCRIBED BY LAW, AB BODILY INJURY/PROPERTY DAMAGE UA SILfTY
A BODILY INJURY/PROPERTY DAMAGE LIABILITY C MEDICAL PAYMENTS
P1 NO•FAULT ABILITY 0 50 DEDUCT COMPREHENSIVE
D 500 DEDUCT COMPREHENSIVE 0 250 DEDUCT COLLISION
G 500 DEDUCT COLLISION - H,91,U
91,U SEE REVERSE SIDE FOR ADDITIONAL COVERAGE INFORMATION
SEE REVERSE SIDE FOR ADDITIONAL COVERAGE INFORMATION
.
Supplemental Narrative to RFP:
Exhibit B
Recommendation(s)
RFP: 01007-Sex Abuse Treatment
Ackerman & Associates
Ackerman and Associates, P.C.
1750 25th Avenue, Suite 101
Greeley, Colorado 80634
(970)353-3373
fax(970)353-3374
May 21, 2001
Frank Aaron
Weld County Department of Social Services
315 N. 11th Avenue
Greeley, Colorado 80631
Dear Frank:
This letter is our written response as required by your letter dated May 11, 2001.
FYC Recommendations:
1. RFP 01-060 Foster Parents Consultation
Acceptable
2. RFP 00008 # 1 FGDM
Most of these recommendations are not recommendations to us that we can act on; rather
they are WCDSS policy statements.
1. Concerning not ordering FGDM for every EPP case. It is our understanding the
FGDM was intended to help meet ASFA guidelines. We would like to know
what other mechanism is being used to involve the extended family in these
decisions.
2. No referrals will be made to Family Group Decision Making when a family
member has been identified. Again, this is a new policy statement by WCDSS.
The spirit of ASFA, as we have experienced it across the country, is to increase
extended family input and responsibility in the process of selecting the"best"
family member or non-family member for placement. How does the
identification of a family member by the department meet this criteria?
3. The focus of this service must be on tenable solutions for the children. A tenable
and permanent plan will be developed to assure success for the children.
The purpose of FGDM is to have the family develop and propose a tenable solution.
It is the responsibility of the caseworker to define tenable prior to the meeting. It has
been the caseworker's responsibility to inform the contractor, what parameters are or
are not acceptable prior to the actual meeting. All caseworkers have done so. One
caseworker has revised her statement of what is acceptable after the meeting took
place. This created confusion and is not representative of the process. We do not
accept the implication that this statement reflects a common problem with the
process. We do accept this as a principle and it has always been our principle in how
we do FGDM with WCDSS.
4. Concerning bilingual availability. Agreed. We have already made arrangements
for a translator to be available, as needed. The historical context of why this
statement appears to have arisen relates to a single complicated case (already
referenced above) and is not representative of the activities of Ackerman and
Associates.
5, RFP 01008 GAP
Agreed. This is not different that what we proposed.
5. RFP 01010, Option B
A. Recommendation: this is consistent with our proposal intent.
B. Condition: The first three sentences assume we are working with
a 60-hour model. The fourth sentence contradicts this. We
request a meeting to clarify these conditions. It is difficult to
plan family therapy in these complex families without knowing
how much time will be available on a program basis. The
proposal requires an effective change in the family environment,
not treatment of symptoms.
C. Comment: We cannot assure additional staff availability, unless
we have consistent, ongoing relationships that provide stability
for such expansion and planning. We will attempt to obtain
additional bilingual services for the benefit of WCDSS and the
county.
6. RFP 00007, Sex Abuse Treatment.
We agree to utilize less than 15 hours in the assessment. Most cases have taken and
will continue to take less than 12 hours for this portion. As needed, for complicated
cases, (of which we had several), we need enough clinical time to appropriately
assess the case. We would like a mechanism to receive supervisor approval if an
extra hour or two is needed for complicated cases.
SUMMARY: Ackerman and Associates very much appreciates and enjoys the
opportunity to be a vendor for WCDSS and provide much needed quality services to
your clients. However, we wish to express our concern that the tone of this letter is
inappropriately negative. It is not, and has never been our intent to provide any
amount of service beyond the amount approved and/or the amount clinically
necessary. We are dealing with some severely dysfunctional families with high risks
of suicide, homicide, and sexual and physical abuse. Vendors, DSS and the county
need to support and work together to protect these children, families and the county.
The department, in order to have appropriate cost containment, has adopted an"HMO
type model" of oversight of the therapy process. While we agree with the need for
cost containment(i.e. we have asked for no increase in this year's budget over last
years), the county must have a mechanism to insure that the termination of the
therapeutic process and/or the regulation of the therapeutic process to achieve cost
containment does not put children or families at increased risk.
Respectfully,
Joyce Shohet Ackerman, Ed.D.
Hello