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HomeMy WebLinkAbout20011400.tiff RESOLUTION RE: APPROVE NOTIFICATION OF FINANCIAL ASSISTANCE AWARD FOR SEX ABUSE TREATMENT AND AUTHORIZE CHAIR TO SIGN -ALTERNATIVE HOMES FOR YOUTH 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 Alternative Homes for Youth, 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 Alternative Homes for Youth, 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 C NTY COMMISSIONERS WELD CO , COLORADO ATTEST: g/ "`✓ Eccji`� Bpi .• M. J. eile, Chair � � p 4vpSZP (/ Weld County Clerk to the • .: .� _.�_ BY: cQ.drfi�,r. ►d:�. - J Deputy Clerk to the Boat 61- ��, Willie goL J Jerke V D AS RM: vi E. L ng q ounty ttot ey � � Robert D. Masden 2001-1400 SS0028 ,pe - 35 `•_"' DEPARTMENT OF SOCIAL SERVICES PO BOX A GREELEY,CO 80632 WEBSITE:www.co.weld.co.us VI ID C Administration and Public Assistance(970)352-1551 Child Support(970)352-6933 COLORADO MEMORANDUM TO: M. J. Geile, Chair Date: May 23, 2001 Board of County Commissioners FR: Judy Griego, Director Weld County Departmen f S ial S rvic RE: PY 2001-2002 Notification of Financial Assistance Awards (NOFAA) under Core Services Funds-Alternative Homes for Youth 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. Alternative Homes for Youth A. Intensive Family Therapy. Multisystemic Therapy (MST): A maximum of 24 clients, an average monthly program capacity of 14,for an average of 20 weeks, with an average of three hours per week of family preservation services. The program will serve both males and females from the ages of 12 to 18, which have a primary caretaker. Appropriate youth will have one or more issues involving delinquency, drug and alcohol,family conflict, school issues, or mental health concerns. Rate is$110.67/hour. B. Day Treatment: A maximum monthly capacity of 14 youth (12-18 years of age) per year,five-eight hours of site-based services per day, 40 hours per week,for 24 weeks. Rate is$47.12/hour or$1,490.41/month. Page 1 of 2 MEMORANDUM TO M. J. GEILE,CHAIR WELD COUNTY BOARD OF COMMISSIONERS RE: CORE SERVICE NOFAA PY 2001-2002-ALTERNATIVE HOMES FOR YOUTH C. Sex Abuse Treatment: A maximum of two hours per day,four hours per week, 16 hours per month. Monthly maximum capacity is limited to 12 youth and their families, monthly average capacity is 10, average length of stay is 32 weeks, average hours per week is,four hours per week. Bilingual services provided,for Spanish-speaking families. Rate is$43.28 per hour. If you have any questions, please telephone me at extension 6510. e£ Page 2 of 2 Weld County Department of Social Services Notification of Financial Assistance Award for Families,Youth and Children Commission (Core)Funds Type of Action Contract Aw.r N X Initial Award FY01-CORE-0006 Revision (RFP-FYC-(01007) Contract Award Period Name and Address of Contractor Beginning 06/01/2001 and Alternative Homes for Youth Ending 05/31/2002 Sex Abuse Treatment 9201 W. 44t Avenue Wheatridge, CO 80033 Computation of Awards Description Unit of Service The issuance of the Notification of Financial Assistance Program utilizes a non-medical, cognitive Award is based upon your Request for Proposal(RFP). behavioral model,focusing primarily on treatment The RFP specifies the scope of services and conditions of juveniles with sexually reactive behavior. The of award. Except where it is in conflict with this program is geared toward providing specialized NOFAA in which case the NOFAA governs, the RFP outpatient services meeting the needs of male upon which this award is based is an integral part of the youth between the ages of 12 and 18 years. action. Program provides education, treatment, and Special conditions support to ensure a safe & successful integration I) Reimbursement for the Unit of Services will be based with the family&community.Bilingual services on an hourly rate per child or per family. provided for Spanish speaking families. 2) The hourly rate will be paid for only direct face-to-face Maximum 2 hours per day,4 hours per week, 16 contact with the child and/or family, as evidenced by hours per month. Monthly maximum capacity is client-signed verification form,and as specified in the limited to 12 youth and their families, monthly unit of cost computation. average capacity is 10, average length of stay is 3) Unit of service costs cannot exceed the hourly, and 32 weeks, average hours per week is 4 hours per yearly cost per child and/or family. week. 4) Rates will only be remitted on cases open with, and referrals made by the Weld County Department of Cost Per Unit of Service Social Services. Hourly Rate Per $43.28 6) Requests for payment must be an original and submitted to the Weld County Department of Social Services by Unit of Service Based on Approved Plan the end of the 25th calendar day following the end of the month of service. The provider must submit requests Enclosures: for payment on forms approved by Weld County X Signed RFP:Exhibit A Department of Social Services. Supplemental Narrative to RFP: Exhibit B Recommendation(s) Conditions of Approval Approvals: Program Official: By ti461. ,tl M. J. ile, Chair Judy A. Gr' o, Dir ctor Board of Weld County Commissioners Wel County Department of Social Services Date: .O49O/o2Uol Date: Jr` 2 O( 2001-1400 Signed RFP: Exhibit A Alternative Homes for Youth RFP: 01007-Sex Abuse Treatment Lai d` u t INVITATION TO BID RFP-FYC 01007 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 Family 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 (After receipt of order) BID MUST BE SIGNED IN INK LoRbM,a J . t cc " TYPED OR PRINTED SIGNATURE VENDOR ALiETR4JRIivE flit-500m �z c / (Name) Handwritten Signatifre By Authorized Officer or Agent of Vendor ADDRESS 920/ (AJE5T L9T?I AEiL'Le TITLE Omie12 I,no er;, Il1It1E�7 Tie ioc,c 0,O 60(933 DATE .o / PHONE# ( 303) q.4o- 5-Syo - 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: R i-TEgn-'AT s k4 t—AWIES /NJ 110014 ADDRESS: 'laO1 WEST 111/714111/714 /'n/EN(../ej akeilr/C+ ec (n/�EIDe4A0 qOo 3_5 PHONE: (305 )94/0-5-S /U T CONTACT PERSON: OJ UL JE Alt SCNi MA, CPC TITLE: IHERAP IST 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: _ 12-month contract with actual time lines of: Start June 1. 2001 Start to-)E I ,ZCo End May 31.2002 End /Y)A .W 3i, Zn o 2 TITLE OF PROJECT: f41-4tk.NFl T NV'N1YnEs t=oe. t UM OtinVnaur T06 0) Foe. /gpoik-Seacir AMOUNT REQUESTED: �Yq`1t 7/`l Gc SUAL A&ISL� 1 .cLLSj l 4212d , MA, CPC � .; �l Nam Signature of Person Preparing Document Date Name and Signature Chief Administrative Officer Applicant Agency Date MANDATORY PROPOSAL REQUIREMENTS For both new bids and renewal bids,please initial to indicate that the following required sections are included in this Proposal for Bid. For renewal bids,please indicate which of the required sections have not changed from Program Fund Year 2000-2001 to Program Fund year 2001-2002. Indicate No Change from FY 2000-2002 to 2001-2002 c--*_ 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 Page 25 of 31 RFP-FYC-01007 Attached A Date of Meeting(s)with Social Services Division Supervisor: -s 7/ t/ro i • Comments by SSD Supervisor: 4o- ^e'�� /r env u�r c� 1-0-, /LC: 31 'U0/ Name and Signature of SSD Supervisor Date Page 26 of 31 RFP-FYC-01007 Sexual Abuse Treatment Program Bid Category Greeley Outpatient Program for Adolescent Sexual Abusers Alternative Homes for Youth I. PROJECT DESCRIPTION Alternative Homes for Youth will utilize a non-medical, cognitive behavioral model, focusing primarily on the treatment of juveniles with sexually reactive behavior. This program will be geared toward providing specialized outpatient services that meet the needs of male youth between ages 12 and 18 years old. This program will provide education, treatment, and support to ensure a safe and successful integration with the family and community. The mission of the Greeley outpatient program for sexual abusers is to reduce recidivism rates of adolescent sexual abusers by: • Providing a structured environment for the safety of the client, family, and community. • Increasing awareness and empathy for the victim and the impact of the offense on the victims and family members. • Fostering a family environment to effect positive change. • Developing the use of appropriate social/sexual skills and expressions through recognition of situations and stimuli that trigger sexually reactive behavior. • Assisting family members to develop the skills necessary to recognize and understand the sexual behavior of their child for the purpose of providing support while the child progresses through treatment. The Greeley outpatient program for sexual abusers will treat: • Male youth 12 to 18 years of age • Youth with current sexual offense adjudications, youth who have admitted guilt, or youth who have witnesses that this behavior occurred. • Youth with adequate intelligence and social functioning (IQ of at least 80) • Youth with sexual or incestual crimes against other children. Program Services for target youth include: • Psychosexual testing and evaluation (prior to admission) • Polygraph administration (prior to admission and discharge) • Offense-specific group therapy(2 hours/week) • Individual and/or family therapy(1 hour/week) • Family education/support groups (3 hours/month) • Relationship and interpersonal social skills • Sex education • Interdisciplinary team meetings (monthly or as needed) • Victim empathy and awareness • Anger management/impulse control skills • Cognitive/behavioral modification • Self-esteem building • Values clarification and examination • Relapse prevention plan • After care services Page 1 of 7 II. TARGET/ELIGIBILITY POPULATIONS Guidelines for conducting offense-specific groups indicate that the ideal number of clients should be approximately nine youth, with a maximum group of 12. As mentioned previously, clients for the offense-specific groups will include youth between the ages of 12 to 18. Eighteen year olds will be accepted into the program if they began the program at age 17. Total family units will coincide with number of youth in the offense-specific program. Bilingual services will be provided for Spanish-speaking families. Offense-specific services, including individual, group and family therapy, will be provided at the Alternative Homes for Youth facility at Greeley. All eligible Weld County families will have to arrange transportation to the facility. As this is a day program, 24-hour services will not be available through this program. However, emergencies will be anticipated, and resources identified for after-hours situations. Monthly maximum capacity will be limited to 12 youth and their families, with monthly average capacity expected at 10. Due to the intensity of the program, youth are expected to complete the program in an average of 32 weeks. Average hours per week in the program are expected at approximately 4 hours per week. III. TYPE OF SERVICES TO BE PROVIDED A. Before a youth can be accepted into the outpatient program, a psychosexual assessment is necessary to determine whether this program will be appropriate for the youth. Assessment will look at five areas: • The youth's potential to reoffend • Amenability for treatment • Recommended treatment setting • Type of treatment needed • Risk factors/monitoring/potential new victims • Psychiatric/substance abuse/individual/family needs Assessment will include: • A structured clinical interview with parents and youth • Collateral information from school, caseworkers, probation officers, therapists, doctors, or other relevant sources Other assessments may include (depending on the age of the youth and circumstances of the case): • Shipley (measures IQ) • Jesness Inventory-JI (measures criminal thinking) • Milan Adolescent Clinical Inventory— MACI (measures personality traits) • Multiphasic Sexual Inventory for Adolescents—MSI-A(measures sexual knowledge, behaviors, attitudes, and beliefs) • Penile Plethysmograph (measures deviant arousal) An integral part of assessment will include a polygraph prior to acceptance to the program, as well as shortly before discharge from the program. The purpose of the polygraph includes: • Encouragement of more disclosure of additional victims or other deviant sexual behavior. Page 2 of 7 • Monitoring for honesty of client to assess progress in treatment regarding safety plans, covert sensitization, and relapse prevention plan. Assessment may reveal the need for specialized treatment such as medication evaluation and monitoring or substance abuse treatment. Referrals will be made to the appropriate agencies to address these treatment needs. Results of the initial assessment will indicate what treatment goals will need to be addressed. Measurable treatment goals will be developed and monitored on a monthly basis. Group therapy for adolescent sexual abusers will focus on the"abuse is abuse" model. This model focuses on the various types of abuse that youth have committed, including physical, sexual, emotional, verbal and psychological. Understanding of when sexual behavior is abusive will be taught by helping youth understand the concept of consent versus coercion. However, treatment will center on the universal goals that address problems common in all sexually reactive youth—communication, empathy, and accountability. Youth will also be introduced to the sexual abuse cycle. The cycle will be used throughout group therapy to help youth understand their personal abuse cycle, and develop ways they can make their behavior patterns more functional. Part of the abuse cycle will include how defense mechanisms and cognitive distortions contribute to the continuation of the cycle. Youth will learn about their thoughts and feelings at each point in the cycle to assist in understanding their behavior, as well as changing faulty behavior patterns. An important part of group therapy will be addressing victim empathy. Youth will learn to read cues from others, interpret them accurately, and validate what they have heard from others. The goal is for youth to identify an empathy experience or interaction, and eventually develop empathic foresight on how their behavior affects others. An essential part of developing empathy includes addressing youth's own victimization and how it affected their own choices. Parent groups will provide two essential elements: • Improve parental understanding of the pattern of sexual abuse. • Develop a support group with other parents to gain acknowledgment from others about their experiences as parents of abusive kids. Family therapy will focus on the situations at home that may have contributed to past abuse, and what needs to occur in order to make the home safe for all members. This may include sorting out feelings for each family member about the abuse, reunifying family members, and assessing how family members can contribute to improving safety in the home. Family members will also learn how to support the abuser while he completes the therapy process. Parenting education and conflict resolution for family members will also be addressed. Individual therapy will primarily focus on non-abuse issues. These would include: • Anger management/impulse control • Social skills • Self—esteem • Sex education Once the youth can demonstrate understanding and implementation of these concepts, individual therapy will no longer be required, and the youth will be successfully discharged from individual therapy. Page 3 of 7 Youth that are not considered to be safe in the school setting, or who have been suspended or expelled from school may attend Alternative Homes day school program. This program offers six hours of educational services in a school approved by the Colorado Department of Education. Sex education will be offered as a component of day treatment. Aftercare will also be provided for youth who have successfully completed the program. Youth will meet individually with a therapist weekly, then bi-weekly, and finally monthly, with the plan of releasing the youth from aftercare treatment within two to six months. More intensive aftercare can be provided for families that need additional support, such as Multi Systemic Therapy (MST). IV. MEASURABLE OUTCOMES Upon completion of the program (six to nine months), youth should be able to demonstrate the following behaviors: (Ryan, Metzner, Yager) • Consistently defines all abuse(self, others, property) • Acknowledges risk (foresight and safety planning) • Consistently recognizes/interrupts cycle (no later than the first thought of an abusive solution) • Demonstrates new coping skills (when stressed) • Demonstrates empathy (sees cues of others and responds) • Displays accurate attributions of responsibility(Takes responsibility for own behavior, does not try to control behavior of others) • Able to manage frustration and unfavorable events (anger management and self protection) • Rejects abusive thoughts as dissonant(incongruent with self image) • Demonstrates pro-social relationship skills (closeness, trust, and trustworthiness) • Projects positive self image • Youth and family members have the ability to resolve conflicts and make decisions (assertive, tolerant, forgiving, cooperative, able to negotiate and compromise) • Celebrates good and experiences pleasure (able to relax and play) • Works/struggles to achieve delayed gratification (persistent pursuit of goals, submission to reasonable authority) • Able to think and communicate effectively (rational cognitive processing, adequate verbal skills, able to concentrate) • Able to make pro-social peers • Family and/or community support system • Adaptive sense of purpose and future Tracking progress through the program will take place in the following manner: • Youth will receive feedback form weekly from therapist(s) to monitor progress on treatment goals. Evaluation will indicate whether youth has completed, partially completed or has not had the opportunity or inclination to address each goal objective. Staff will discuss progress and indicate whether youth is on track. A compilation of these reports will be issued to the interdisciplinary team on a monthly basis. • Group notes will be compiled by youth after each group. The therapist will evaluate whether the client is learning during groups. Feedback will be provided to help the youth obtain maximum benefit from groups. • Parent will be questioned weekly during family therapy on their child's progress at home. Parents will be evaluated monthly regarding their progress in treatment Page 4 of 7 by verbally testing to see if they understand the concepts being taught and can demonstrate their use in therapy and at home. • Schools will also be contacted on a monthly basis to monitor behavior there. • A polygraph will be conducted two months prior to discharge to determine whether a youth is being truthful regarding changes in deviant arousal. An MSI-A may also be administered to assess changes in sexual attitudes. In some cases, a penile plethysmograph may be indicated to see if deviant arousal can be controlled. • The interdisciplinary team will meet monthly to discuss youth's progress in the program. Any major concerns that arise prior to the monthly meeting will be discussed with the caseworker and probation officer within 48 hours. V. SERVICE OBJECTIVES The primary objective of the Greeley outpatient program for adolescent sexual offenders will be to provide safety for the abuser, victim, family members, and the community. Successful completion of this objective requires addressing issues in the following areas: • Parental competency—Parents will initially be assessed to determine their level of parenting skills. Parents will be offered parenting education to increase their skill level. In addition, parents will be monitored weekly in family therapy to check on behaviors occurring at home, and help parents understand "red flags" that indicate potential problem areas regarding safety in the home. Parent groups will offer educational information on the "nuts and bolts"of sexual abuse (e.g., polygraphs, the legal process of adjudication, plethysmographs, etc.) Parents will also be encouraged to talk about their experiences and share support and information with each other. Progress will be measured by verbal demonstration of understanding of concepts, successful completion of homework assignments and participation in group discussion. • Improve family conflict management—Families will learn to talk about the underlying feelings resulting in anger and conflict at home. Family culture will be explored, and family members will learn to develop a peace plan, implement constructive discipline, improve communication, and develop problem-solving skills. Progress will be measured by successful completion of homework assignments. • Improve Personal and Individual Competencies— Upon acceptance into the program, youth will be assessed to determine deficiency areas. Problems that are not specifically limited to sexual abusers, such as self-esteem, sex education, anger/impulse management, and social skills will be addressed in individual therapy. Progress will be measured by successful completion of assignments and demonstration of the ability to apply these concepts in therapy, at home, and in the community. Sexually abusive issues will be discussed in group therapy. Youth will learn to describe the sexual abuse cycle in detail, and identify each step of the cycle as it pertains to their own abuse. Youth will also be able to explain defense mechanisms and cognitive distortions in relation to the sexual abuse cycle. Empathy training will include teaching youth to accurately read cues from others, interpret cues from others, and check for understanding by validating cues. Youth will learn to experience empathic interactions from others and will develop the ability to understand in advance how their actions affect others. To assist youth in controlling deviant fantasies, abusive youth will be instructed on the use of covert sensitization, which will assist them in changing their sexual thoughts to become positive and caring. Finally, youth will address Page 5 of 7 their own abuse, and learn how their abuse led to their choice to abuse others. Progress will be measured by successful completion of assignments, increasingly appropriate contributions in groups, completion of non-deceptive polygraphs as scheduled, reports from family members, school, therapist(s), and the interdisciplinary team, and audio tapes from youth indicating successful completion of covert sensitization. • Improve ability to access resources—Part of family therapy will include assessing what resources family members need to have a successful transition home. Therapists involved in the program will assess what resources are needed and will assist family members in locating these resources as they are identified. Progress will be measured by successful follow through by parents or caseworkers (if the youth does not have family members involved in his life). VI. WORKLOAD STANDARDS A. Number of hours per day/week/month. Day—maximum of two hours per day Week— maximum of four hours per week Month— 16 hours per month B. Number of individuals providing treatment. 1 - Group therapist 1 — Individual/Family Therapist C. Maximum caseload per worker = 12 D. Modality of treatment will be cognitive/behavioral format, including group, individual and family therapy. E. See A above. F. Total number of individuals providing services = 2 G. Maximum caseload per supervisor = 12 H. See D above. See enclosed insurance agreement. VII. STAFF QUALIFICATIONS The Greeley outpatient program for adolescent sexual offenders will meet or exceed the minimum qualifications in education and experience. A. Therapist(s)will have a minimum of a Master's degree in Social Work, Psychology or a related field. Therapists without a license will be supervised by therapists or supervisors with a Colorado license. B. Total number of staff available for the project =4 Page 6 of 7 C. As of March 11, 2001, all new programs for juvenile sexual offenders must be reviewed by the Colorado Sexual Offense Management Board. This program is in the process of scheduling a review by the board. Consultation will be provided by an SOMB board-approved, licensed therapist. Page 7 of 7 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. (Explanations for these Lines are Provided on the Following Page) Total Hours of Direct Service per Client /2C/ Hours [A] Total Clients to be Served lA Clients [B] Total Hours of Direct Service for Year Hours [C] (Line [A] Multiplied by Line [B]Cost per Hour of Direct Services $ 21)4)7 Per Hour [D] Total Direct Service Costs $ 46/ 2.670 [E] (Line [C] Multiplied by Line [D] ) Administration Costs Allocable to Program $ gas 44/00 [F] Overhead Costs Allocable to Program $ o'+�0l4Y0 [G] Total Cost, Direct and Allocated, of Program$ 96, o/0 [H] Line [E] Plus Line [F] Plus Line [G] ) Anticipated Profits Contributed by this Program $ A 997`' [I] Total Costs and Profits to be Covered pq rliii by this Program(Line [H] Plus Line [I] ) $ ! I 6 [J] Total Hours of Direct Service for Year 2/ 3 [K] (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 �/��j Lt Attached A Social Services $ "T.7,2CJ [L] 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. [El 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 [MI . Page 31 of 31 i h ; ; a' • I - 2 3 i 21 : 3.4 M`NS 2 5—S a<,sssrxss, srk)MN:O vi#9'tc k't�tk+�'+k k?rrna�i s*I N o 15 9 91 F • ti I £ { ♦..r.}:. r' ...,. :..vi r . . ,x:'?r ,. ..S . ..., /1 .. I4.;Y C4:AM PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER. OF Riedman Corporation INFORMATION ONLY AND CONFERS NO RIGHTS UPON 1650 Pennsylvania St THE CERTIFICATE HOLDER. THIS CERTIFICATE Denver, CO 80203-1390 DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE (303) 831-1717 AFFORDED BY THE POLICIES BELOW. INSURED +u''rs's'il'`;.a I COMPANIES AFFORDING COVERAGE ' R ALTERNATIVE HOMES FOR YOUTH COMPANY A: GENERAL SECURITY INS. GROUP ATTN: DENISE DOZEMAN COMPANY B: PINNACOL 9201 WEST 44TH AVENUE COMPANY C: WHEAT RIDGE, ` CO 80033 COMPANY D: I 'k'RO 3�#t#• �.y,.: .,'k, ' .`'�i„K? M Xk}}"��3�ynr) i "tali y. en .roe n»r . .i•.:.,v�,vr.•.vr.i.,: i,�.s;..a. ?:'�;r3:.v5 a`��t�>:u�ee"'k+.c:"R?ta�;,�,:::<I COVERAGES Pr'f�'` 3l ��+;�g��?�t'.�.`�•M��.k,�'S�'�f ' :'�`G''f � � �.'� ��,',3' 3,i;; I a,..... a,•� rr:, e::p €y er�� •.: :,;The is to certify that poi else of insurance listed below have been issued to tie insured named above for the policy period indicated, notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, exclusions and conditions of such policies. Limits shown may have been reduced X b aid claims, I CO I; f INSURANCE I ,€,l POLICY NUMBER & DATES I S g°,'„g£ ,44, ,fg'.,I LIMITS I;, ,'°,'F e,�fY€a'',$ eo €im A GENERAL LIABILITY 21x330009 $ 3, 000, 000 General Agg [X] Comm Gen Liab Eff 09/20/00 Exp 07/01/01 $ 3, 000,000 Pro/Co Ops Agg I ] CM [X] Occur $ 1, 00O, 0OO Pers/Adv Inj [ ] OCP Eff / / Exp / / $ 1, 000,000 Ea Occurrence [ $ 50, 000 Fire Damage ] Eff / / Exp / / $ 5, 000 Medical Exp A AUTO LIABILITY 21A330009 [ ]Any [ ]All Own Eff 09/20/00 Exp 07/01/01 $ 1, 000, 000 CSL [X] Schd [X] Hired $ BI (person) `X)Non-Owned Eff / / Exp / / $ BI (accident) $ Property Dam GARAGE LIABILITY $ Auto-Each Acc Any Auto Eff / / Exp / / $ Other-Ea ACC [ ] $ -Aggregate EXCESS LIABILITY $ Occurrence [ ] Umbrella Form Eft / / Exp / / $ Aggregate [ ]Other Than Umb [X]WC Stet Lmts [ ] Other— B WCf2MP LIABILITY 1453282 $ 100,000 EL Each Acc [ ] Inc1 [ ]Excl Eff 07/01/00 Exp 07/01/01 $ 500, 000 EL Dis-Po1 Lmt Prop/Part/Execs $ 100,000 EL Dis-Ea Emp Eff / / Exp / / Description of operations/locations/vehicles/special items REF: 1110 °MW STREET; GREELEY, COLORADO f CANCELLATION f < e .,s≥gI CERTIFICATE HOLDER lalSea Should any of the above described. policies be cancelled before the expiration date thereof, the issuing company will endeavor WELD COUNTY DEPT OF SOCIAL SRVCS to mail 30 days written notice to the ATPN:TONY GROEGER certificate holder named to the left, but p.O. BOX A failure to mail such notice shall pose no GREELEY CO 80632 obligation or liability of any kind upon thclil any, its agents or reps . ` 6 CrAiNrized Representative I Departmental the Treasury — No . i 59 P . 4 Mternal Revenue Service ! 600 17th St . M/S 6674 DEN In reply refer to : 8450029352 Denver C0 80202-2490 Mar . 06 , 2000 LTR 1721C 84-0712493 199906 67 000 02960 ALTERNATIVE HOMES FOR YOUTH 9201 W 44TH AVE WHEAT RIDGE CO 80033-3006016 Taxpayer Identification Number : 84-0712493 Tax Period(s) : June 30 , 1999 Form ; 990 Dear Taxpayer : Thank you for your inquiry of Feb . 29 , 2000 . . This is to confirm that ALTERNATIVE HOMES FOR YOUTH federal identification number 84-0712493 now has the following address of records 9201 W 44TH AVE WHEAT RIDGE , CO 80033 . If you have any questions, please call us toll free at 1-800-829-1040 . If you prefer, you may write to us at the address shown at the top of the first page of this letter . E , O HY' REVENUE SERVICE~ DEPARTMENT OF TEN° . h93:AS.P • 3e District Director 1100 Commerce et# , Dalldz; TX 75242 :arson to Contact; Alternative Homes for Youth Mary Smith 3000 Youngfield at 157 Telephone Number: Lakewood, CO 80215 (214) 767-6023 Refer Reply to; Mail Code 4940 DAL Date: June 13, 1995 Employer Identification Number: 84-Q712493 Dear Sir or Madam: Our records show that Alternative Homes for Youth Is exempt from Federal Income Tax under section 501(c) (3) of the Internal Revenue Code. This exemption was granted March 1976 and remains in full force and effect. Contributions to your organization are deductible in the manner and to the extent provided by section 170 of the Code. We have classified your organization as one that is not a private foundation within the meaning of section 509(a) of the Internal Revenue Code because you are an organization described in section 509(a) (2) . • If we may be of further assistance, please contact the person whose name and telephone number are shown above. Sincerely Yours, Mary A. Smith EP/EC Correspondence Examiner $R1- Hello