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HomeMy WebLinkAbout20011406.tiff RESOLUTION RE: APPROVE NOTIFICATION OF FINANCIAL ASSISTANCE AWARD FOR OPTION B, HOME BASED INTENSIVE AND AUTHORIZE CHAIR TO SIGN - LUTHERAN FAMILY SERVICES WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with a Notification of Financial Assistance Award for Option B, Homes Based Intensive 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 Lutheran Family Services, 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 Option B, Home Based Intensive 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 Lutheran Family Services, be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said award. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 30th day of May, A.D., 2001. BOARD OF COUNTY COMMISSIONERS WELD CO COLORADO ATTEST: , „# 1 La 2 2 77 /& 77 sit Zilephair Weld County Clerk to th] P1f3: ' to ai iPt Glenn Va , o- em BY: Deputy Clerk to the Boat f! ' <7 Willi Jerk 2P-14 ED A ORM: e.11-V (C" /Dav d Long ounty ttorrley on Robert D. Masden 2001-1406 P (2 S SS0028 11 111 . 4 DEPARTMENT OF SOCIAL SERVICES PO BOX A GREELEY,CO 80632 WEBSITE:www.co.weld.co.us Administration and Public Assistance(970)352-1551 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 I Q Weld County Departme t of 4ial S is s RE: PY 2001-2002 Notification of Financial Assistance Awards (NOFAA) under Core Services Funds-Lutheran Family Services 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. Lutheran Family Services A. Option B, Home Based Services.A maximum number of 40 families with children 0-18 years, a maximum of ten families at any given time. Rate is$107/hour. B. Intensive Family Therapy: Family Group Decision Making: One or two clinicians will participate in the Family Group Decision Making depending on the needs of the family. Bicultural-bilingual services are available for a limited number of conferences. Direct service capacity is estimated at 100 hours per week. Staff availability is dependent on the combination of all cases in the Foster Care Services program. Rate per Family Group Conference is$1,800. MEMORANDUM TO M. J. GEILE,CHAIR WELD COUNTY BOARD OF COMMISSIONERS RE: CORE SERVICE NOFAA PY 2001-2002-Lutheran Family Services C. Foster Parent Consultation. Foster Parent Support groups, birth child support groups and training groups (parent and/or child). Program capacity is 40 families per year, or 160 clients, average length of service is 12 weeks. Direct service capacity is 100 hours per week There is no maximum capacity per month. Hourly rate is$107.00. 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 Type of Action Contract Award No X Initial Award 01-CORE-0001 Revision (RFP-FYC-01010) Contract Award Period Name and Address of Contractor Beginning 06/01/2001 and Lutheran Family Services Ending 05/31/2002 Option B, Home Based Intensive 3800 Automation Way, Suite 200 Fort Collins,CO 80525 Computation of Awards Description Unit of Service The issuance of the Notification of Financial Assistance Designed to promote the safety and well being Award is based upon your Request for Proposal (RFP). of children and their family members. Services The RFP specifies the scope of services and conditions will build on primary family connections and of award. Except where it is in conflict with this help parents improve parenting abilities, identify NOFAA in which case the NOFAA governs, the RFP parental strengths and support their efforts to upon which this award is based is an integral part of the care for their children. The program will action. expedite the return of children to their family Special conditions and assist in creating a stable and nurturing 1) Reimbursement for the Unit of Services will be based family environment. The program serves on an hourly rate per child or per family. families where children are ages 0-18. The 2) The hourly rate will be paid for only direct face to face number served is dependent on the number of contact with the child and/or family, as evidenced by direct contact hours per family. A clinician client-signed verification form, and as specified in the who serves a family 2 hours per week has the unit of cost computation. ability to serve 10 families at any given time, if 3) Unit of service costs cannot exceed the hourly and each family is served an estimated 3 months, yearly cost per child and/or family. LFS would serve 40 families each year. Group 4) Payment will only be remitted on cases open with,and Services: A minimum of two families and a referrals made by the Weld County Department of maximum of 10 participants per group that is Social Services. presented in 6 weekly 2 hour sessions. Requests for payment must be an original submitted to the Weld Cost Per Unit of Service County Department of Social Services by the end of the 25th Hourly Rate Per $ 107.00 calendar day following the end of the month of service. The Group rate per family per direct contact hour$ 51.50 provider must submit requests for payment on forms approved Unit of Service Based on Approved Plan by Weld County Department of Social Services. Enclosures: X Signed RFP:Exhibit A _X_Supplemental Narrative to RFP: Exhibit B Recommendation(s) Conditions of Approval App • Program Official: By By . . eile,Chair Judy .Grie ,Direc r Board of Weld County Commissioners Weld unn)y Department of Social Services Date: O5/.3O/aOO� - Date: 7/13/01 / 2001-1406 Signed RFP: Exhibit A Lutheran Family Services RFP: 01010-Option B-Home Based Services Ma,4-09--01 02 : 56x' "vut eran ' am y INVITATION TO BID DA-CE:April 18, 2001 BID NO: RFP-FYC-01010 RETURN BID TO: Pat Persichrno, Director of General Services 915 10th Street, P.O. Box 758, Greeley,CO 80632 SUMMARY Request for Proposal (RFP-FYC-01010) for:family Preservation Program--Home Base Intensivegamily Intervention Program Family Isje's Cash Fund of F Preservation Program Funds Deadline: May 11, 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. 20-5.3-101). 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 Home Based Intensive Family intervention Program is a family strength focused home-based services to families in crisis which are time limited,phased in intensity, and produce positive change which protects children,prevents or ends placement, and preserves families. This program announcement consists of five parts, as follows: PART A...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 —_ _- ,- ,/)MLtiati .761- 71a5. (After receipt of order) BID MUST BE SIGNED IN INK Sharon K. Thomas, LCSW TYPED OR PRINTED SIGNATURE 7 VENDOR James U. Barclay (Name) • dwritten Signature A orized Officer or Agent of Vender ADDRESS 363 S. Harlan #200 TITLE President/CEO Denver, CO 80226 DAB PHONE# (303)922-3433 The above bid is subject to Terms and Conditions as attached hereto and incorporated. Page 1 of 32 RFP-FYC-01010 Attached A HOME BASED INTENSIVE FAMILY INTERVENTION PROGRAM BID PROPOSAL AND REQUEST FOR CONTINUATION OF AWARD UNDER FPP CORE SERVICES FUNDING FAMILY PRESERVATION PROGRAM 2001-2002 BID PROPOSAL APPLICATION PROGRAM FUNDS YEAR 2001-2002 BID #RFP-FYC-01010 NAME OF AGENCY: Lutheran Family Services of Colorado ADDRESS: 3800 Automation Way, #200, Fort Collins, CO 80525 PHONE: ( 970) 266-1788 CONTACT PERSON: Sharon K. Thomas TITLE: Program Director DESCRIPTION OF FAMILY PRESERVATION PROGRAM CATEGORY: The Home Based Intensive Family Intervention Program is a family strength focused home-based services to families in crisis which are time limited,phased intensity, and produce positive change which protects children. prevents or ends_placement.and preserves families 12-Month approximate Project Dates: _ 12-month contract with actual time lines of: Start June 1. 2001 Start End May 31.2002 End TITLE OF PROJECT: Home Based Option B 4 Name and e of Person f'reparin ocument Date J // an Signature of Admini ative Officer Applicant Agency at 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 2000-2001 to 2001-2002 Project Description X Target/Eligibility Populations X Types of services Provided X Measurable Outcomes X Service Objectives X Workload Standards X Staff Qualifications X X Unit of Service Rate Computation Program Capacity per Month X X Certificate of Insurance Page 26 of 32 May 9, 2001 Core Services Proposal Home Based Intensive Family Intervention Lutheran Family Services of Colorado Home Based Option B I. PROJECT DESCRIPTION Lutheran Family Services of Colorado (LFS) is a community-based agency with an experienced staff that offers a wide range of services to children, families and adults. It is a non-profit agency, which has provided human services to Colorado since 1948. Although the agency was established as an affiliate of the Lutheran Church, it is an equal opportunity agency that provides services to all individuals without consideration of religious beliefs, race, ethnicity, sex or economic status. Lutheran Family Services' Home Based Option B is a component of the LFS Foster Care Program. LFS's Foster Care Program has been providing foster care placement services to this region since 1993 and specializes in establishing permanency for children experiencing significant emotional and behavioral impairments. The Option B program is designed to promote the safety and well being of children and their family members. Services will build upon primary family connections and help parents improve their parenting abilities, identify parental strengths and support their efforts to provide care for their children. The program will expedite the return of children to their family and assist in creating a stable and nurturing family environment in which children can grow and develop. When children are returning to their permanent home from out of home care they will be assisted in their reintegration in the family system and the family will be stabilized as quickly as possible. The program goal is to improve both individual and family functioning. Crisis intervention services will be provided throughout the duration of the families' involvement with the Option B program. The Option B program will utilize the Family Risk Scales to assess the families out of home placement risk areas; this will enable the program to individualize services for each family's specific needs. Additionally, we will be using the Achenbach Child Behavior Checklists. when appropriate, to assess problematic behaviors, if any, presented by the children in the family. We have the ability to administer the SASSI (substance abuse screening) when warranted. II. TARGET/ELIGIBILITY POPULATIONS: Families considered appropriate for these services are those in which family members are facing problems that have affected their well-being, safety, psychosocial growth and development, and family stability. Families mandated or referred by the courts will be considered for the Option B program contingent upon their willingness to participate in and ability to profit by participation in such services. Primary caregivers must demonstrate a desire to maintain family relationships and must possess the mental stability to utilize home-based services. Eligible families will be screened by the referring DSS worker to insure that they meet the eligibility criteria for Program Areas 4, 5 or 6 target groups. Children will be at imminent risk of out of home placement or have been removed from the home and imminent return is expected. Clients will not be eligible if they can be successfully treated with less intensive service programs and those services have not yet been tried. Families appropriate for this program should be able to benefit from services that are primarily therapeutic in nature (vs. concrete and collateral). The provision of services will have a reasonable possibility of diminishing or ameliorating the problematic behaviors/issues in the home. There must be a manageable level of risk of harm to the child or other family members. Lutheran Family Services Home Based Option B Caseloads are determined and cases assigned on a direct/indirect formula. The current ratio is 50% direct client time to 50% indirect time. Therefore answering this question is dependent on the number of direct contact hours needed for each family. If we assume that a full time Clinician has an average of 2 hours of direct contact per week per family, then the following numbers would apply. A full time LFS Clinician has the ability to serve 10 families at any given time. If each family is served for an estimated 3 months, we would be able to serve 40 families each year. (10 families x 4 quarters= 40). If family specific time extensions are needed and granted, the overall number of families served would be reduced. If we assume that half the families are two parent families and each family has 2.5 children, we would serve 160 clients. (20 families x 2.5 children and 1 adult= 70 plus 20 families x 2.5 children and 2 adults= 90 for a total of 160). These numbers are representative of the caseload of one Clinician. We currently have five full time Clinicians. All of our Clinicians are cross-trained so that they can carry foster care, intensive family therapy or foster family consultation cases. We have expanded, and continue to be willing to expand, our capacity if the county referrals demonstrate a sustained need for that expansion. During this past fiscal year we have not turned down referrals or placed families on a waiting list. The Option B program can serve children and their families where children are ages 0-18. We currently contract with a bilingual/bicultural therapist and can provide limited bi-lingual services. We currently service families in South Weld County. We are not planning on limiting services due to proximity. All clients will have access to 24-hour crisis intervention services. The expected maximum length of services is 6 months (a maximum total of 60 hours). The Option B program is specifically designed to be short term and time limited in nature, with a length of service of three months or less in order to focus on the priority issues which have placed the family at risk of dissolution. DSS may purchase services for another 1-3 month period of time or more if the need for services can be clinically justified. III. TYPES OF SERVICES TO BE PROVIDED Intake Assessment The Option B program staff will be responsible for screening referrals to the program. There will be an acknowledgment of the referral within 24 hours (one working day) with a tentative judgment as to the appropriateness of the family for services. If the initial information from the referring worker is adequate to make the assessment that the family is appropriate for services, then the family will be contacted within a maximum of 48 hours to identify any immediate needs and to set up an appointment for the Clinician to meet with the family team (which will include the family, the Option B Clinician, significant others in the family's life, the DSS caseworker, etc.). The intent of this initial meeting will be to tentatively evaluate risk factors (Family Risk Scales), to inform the family of the intervention strategies which the program will implement and to gain beginning agreement to proceed with the services offered. Home Based Therapy The clinical philosophy that drives our practice is that we will provide services in the families environment whenever possible and appropriate. We believe that this treatment approach reduces the stress on the family by reducing the need for the family to adjust to our environment. We believe that we can provide more appropriate treatment in the family's 'natural environment', their home, their church, their school, etc. The second primary philosophy that directs our practice is to build on the strengths of the family and utilize a strength-based model of treatment and intervention. A Program Clinician will provide in-home therapy. The Program Clinician will provide an average of 2 hours of direct service to the family per week. Weekly family therapy sessions will be designed to provide comprehensive, diagnostic and treatment planning with the family and other service providers. Therapeutic interventions will be flexible enough to bring in other Weld County 2 OPTION B RFP-FYC 01010 Lutheran Family Services Home Based Option B service providers, if needed. The preponderance of services provided in this program will fall into this category. Therapy will be designed to resolve conflicts and disagreements within the family and to enhance parenting skills and overall family functioning. Concrete Services Concentrated effort will be made to assist the family in the development and enhancement of parenting skills, stress reduction, problem solving, budget management, recreational activities, etc. Parenting classes will be offered to the families involved in our CORE services programs. Collateral Services The Program Clinician will assist the family and their support network in accessing and utilizing community resources to deal with particular risk areas identified (ex: access to health care, housing, employment). The family's effective use of community resources is an imperative goal within this program as accessing resources is generally a core issue for families who have achieved a level of stress intensive enough to warrant a referral for family preservation services. Crisis Intervention Services The Option B program staff will be available to open CORE Services cases on a 24-hour basis. All clinical staff carry pagers and can respond to a crisis (via telephone) within 1 hour. The Clinician and their supervisor will review cases at least on a monthly basis. A regular monthly meeting will be scheduled with the county caseworker, family and other involved parties to review progress and assess whether or not the family's needs can be met with alternative community services. Group Services LFS has the ability to provide group services (parenting education and/or issue specific groups addressing family functioning). The groups can be used at different junctures depending on the needs of the family. There will be a minimum of 2 families and a maximum of 10 participants per group. The fee structure for the group is one and a half times the hourly rate per direct contact hour. Since the rate is not figured on a per family basis, this is a particularly cost effective option for the County. For example, if there were 7 families represented in a group the rate would be $160.50 per direct contact hour instead of 1/2 our hourly rate per family ($51.50 per hour x 7 families = $360.50 per hour). This fee structure will enable this service to be used in conjunction with in-home therapy and still be within budget parameters. Follow-up on group homework and application in the home by the Clinician could increase the efficacy of the group intervention subsequently reducing the need for services more quickly than if the family failed to follow through with the concepts at home. The group also can be used by itself as part of the step down process. Referrals can be made for group only services as well. The LFS ABC Parenting Skills Group is presented in 6 weekly 2-hour sessions. Using the ABC model, participants will learn to pinpoint problems in behaviorally specific terms and to identify antecedent "triggers" and reinforcing consequences. They will also learn to define positive "teaching goals"—alternatives to problem behavior—as the core of an effective "teaching" program. Thinking and doing skills are emphasized. Step Down Services Program goals include diminishing direct service hours as soon as possible as treatment progresses. There will typically be 3 phases of treatment. The initial phase of treatment will be the most intensive. Activities will include addressing safety concerns and immediate needs, Weld County 3 OPTION B RFP-FYC 01010 Lutheran Family Services Home Based Option B completion of assessment instruments and gaining agreement on specific goals for development of a treatment plan. The treatment plan will be provided to WCDSS within 30 days of the date the referral is accepted. Four hours of direct service hours needed each week during this phase. The middle phase of treatment will be more of the practice stage of treatment. Ideally families will begin to obtain insight into their dynamics, gain better control of their maladaptive behaviors and begin to practice new skills in this time frame. Parents may be referred to the Lutheran Family Services ABC Parenting Skills Group or other resources during this stage. The number of weekly direct service hours needed in this phase of treatment will be two (not including involvement in groups or parent education). The ending or transition phase of treatment will be a time of moving the family in the direction of after care services as appropriate (e.g. ABC Parenting Skills Group, support groups, therapy with the Mental Health Center, grant funded services, etc). The One direct service hour will be needed each week in this phase of treatment. The number of weekly direct service hours in each phase will be as follows: Initial Phase—4 hours, Middle Phase—2 hours, and Ending Phase— 1 hour. The total direct service hours will not exceed 60 hours in 6 months. If an extension is needed beyond the end date of services identified by the County, LFS will submit a justification for extension of services at least 60 days prior to the end date. Every effort will be made to stay within the above parameters. Should a family present with extremely high needs at any given phase of treatment that require services above the stated amount of time per week to maintain the safety of the family members, the caseworker will be contacted and additional time negotiated. IV MEASURABLE OUTCOMES The Option B program will utilize the Family Risk Scales and the Achenbach Child Behavior Checklist in measuring the efficacy of the program. The Achenbach Child Behavior Checklist measures the caregiver's, teacher's and child's assessment of the child's problematic behaviors. The Family Risk Scales were designed as a standardized measure of a child's risk of entering foster care. The risk variables measured by the scales are those believed to contribute to or precipitate the need for out of home placement. Changes in a family's risk status may be determined by rating the scales two or more times (pre and post tests). Changes in the child's functioning may be determined by using the Achenbach two or more times (pre and post tests). The overall outcome objective of the program is to reduce the risk of the need for out of home placement. The measurement of the achievement of this objective will be obtained through completion of the Family Risk Scales. There are 26 risk factors included in the Family Risk Scales, the scales are: 1. Habitability of Family Residence 2. Suitability of Living Conditions 3. Financial Problems 4. Adult Relationships in Household 5. Family's Social Support 6. Parent's Physical Health 7. Parent's Mental Health 8. Knowledge of Child Care and Development 9. Parent's Substance Abuse 10. Parent's Motivation for Problem Solving 11. Parent's Attitude to Preventing Placement 12. Client's Cooperation with Agency 13. Preparation for Parenthood 14. Supervision of Child Under Age 10 15. Parenting of Child Age 10 and Over 16. Physical Punishment of Child 17. Verbal Discipline of Child 18. Emotional Care and Stimulation of Infant (Under 2 Years) Weld County 4 OPTION B RFP-FYC 01010 Lutheran Family Services Home Based Option B 19. Emotional Care and Stimulation of child Age 2 and Older 20. Physical Needs of Child 21. Sexual Abuse of Child 22. Child's Physical Health and Disabilities 23. Child's Mental Health 24. Child's School Adjustment 25. Child's Delinquent Behavior 26. Child's Home-Related Behavior. The Family Risk Scales and the Achenbach Checklists will be used with the family at the onset of treatment to pinpoint the family's specific intervention needs. The tools may be used throughout the course of treatment to measure the family's movement toward amelioration of the highest risk concerns. The Family Risk Scales and the Achenbach Checklists will be completed immediately prior to program completion in order to measure the expected improvement in the family and child's functioning. The child's living arrangements will be documented at the time the case is closed. (Is the child still in the home?). An aftercare plan for each family will be developed which includes referral to a less intensive family counseling program and/or the use of informal and community resources, such as family self help groups or support network. A system of follow-up contacts at 2 weeks and 5 weeks after case closing will be pursued. This system will check that recommended supports and services are in place. The program staff will follow up regarding the status of the family/child at 6 months and 12 months with WCDSS county caseworker. The program staff will complete a follow up contact sheet, which will include the objectives listed by the department, i.e. is the child still in the home? Has there been substantiated abuse/neglect in this family? V. SERVICE OBJECTIVES Family Conflict Management skills will be enhanced through individual, family and group therapy as well as the Family Group Decision Making process as needed. Improving Parental Competency will be achieved through individualized consultation regarding child specific behavior management and support issues. Additionally, the ABC Parenting Group will be available and can address most of these issues. Improved ability to access resources will be achieved through information and referral services. These services will be provided through individualized instruction. The three minimum service objectives that the department would like to have assessed are inherent in the Family Risk Scales. The Family Risk Scales provide more detailed assessment of the family's risk areas and will satisfy these criteria. The risk factors are listed in the section immediately prior to this one. Also the Child Behavior Checklist will be used to assess the children's level of functioning as it applies to these objectives. The assessments will be done pre and post service provision, as well as during the course of treatment when deemed necessary by the Clinician. Monthly Progress Reports and ongoing updating of the Treatment Plan will monitor the objectives. VI. WORKLOAD STANDARDS Please see the previous section "Target/Eligibility Populations" for a detailed explanation of our workload standards. Our supervision standard is one FTE supervisor for every seven full time professional staff members. The requested minimum standards for insurance have been met and documentation provided. VII. STAFF QUALIFICATIONS Direct service providers assigned to this program are qualified by one of the following: Weld County 5 OPTION B RFP-FYC 01010 Lutheran Family Services Home Based Option B • a master's degree in social work or a master's degree in another human service field and at least two years of pre- or post-master's experience in family and children's services; and/or • a bachelor's degree in social work or a bachelor's degree in another human service field and at least six years' post-degree experience in family and children's services. All staff has expertise in family therapy as demonstrated by specialized training and/or experience. All staff in this program will be required to secure a minimum of eight hours per year of continuing education training. All staff will receive weekly supervision from a supervisor experienced in Intensive Family Therapy. The clinical supervisor will be required to secure a minimum of ten hours per year of continuing education training. We currently have the following staff available to provide direct services in this program: Joe Madrid, LCSW Amy Hatcher, MSW Julie Box, MSW Shawna Boatman, MA Craig McFadden, LPC VIII. COMPUTATION OF DIRECT SERVICE RATE Total Hours of Direct Service Per Client 26 Hours (A) Total Clients to be Served 40 Clients (B) Total Hours of Direct Service for Year 1040 Hours (C) (Line [A] Multiplied by Line [B]) Cost Per hour of Direct Services $24 Per Hour(D) (salary, benefits, travel) Total Direct Service Costs $24,877 (E) (Line [C] Multiplied by Line [D]) Administrative Cost Allocable to Program $49,532 (F) Overhead Costs Allocable to Program $37,354 (G) Total Cost, Direct and Allocated, of Program $111,763 (H) Line [E] plus Line [F] plus Line [G] Anticipated Profits Contributed by this Program $0 (I) Total Costs and profits to be covered by this Program $111,763 (J) Line [H] plus Line [I] Total Hours of Direct Service for Year 1040 (K) Rate Per Hour of Direct, face-to-face Service to be Charged $107 (L) to Weld County Department of Social Services Weld County OPTION B 6 RFP-FYC 01010 Lutheran Family Services Home Based Option B IX. PROGRAM CAPACITY BY MONTH This program is a component of the Foster Care Program, which includes foster care, and family preservation services. As outlined in this proposal, our capacity is based on the number of staff we have and a direct/indirect service ratio. We currently have five FTE's and a direct service capacity of 100 hours per week. These FTE's are trained to provide services in any of the program components, so there is not a minimum client capacity necessary to support this program. Staff availability will be dependant on a combination of all cases in the foster care program. Additional staff can be hired if the county presents a sustained need for expansion of our program capacity. Weld County 7 OPTION B RFP-FYC 01010 Apr-20-01 09 : 28A Lutheran Family Services 9702661799 P . 03 REP-INC-01010 Attached A Date of Meeting(s) with Social Services Division Supervisor: 3 -GI Comme 4s by SSD Supervisor:,,,____ lilt ,CL ,LL4 ePte , use a-5 -01... Name and Signature of SSD Supervisor Date Page 27 of 32 �Wl3r�iPSp�j. ACORDN CERTIFICATE OF`�IABILIT NW C `'. 4 DATE(MM MY) PRODUCER ,rgn5J ^.>k 03/26/2001 MARSH ADVANTAGE AMERICA RTIFICATE IS ISSUED AS A MATTER OF INFORMATION HOLDER. Serial# A2757ONLY N THIS CERTIFICATE CONFERS VOTE DOES RIGHTS UPON NOT EXTEND THECERTIFICATE 160 SPEAR STREET I ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. SAN FRANCISCO, CA 94105 �_ COMPANIES AFFORDING COVERAGE `COMPANY —"- e 2 EBN UTUAL INSURANCE COMPANY INSURED COMPANY - - - -- _-' LUTHERAN FAMILY SERVICES OF COLORADO 'L .® _ 363 SOUTH HARLAN COMPANY ------------- ----' DENVER, CO 80226 C Imo .__ COMPANY I I D IO<V< 6 "` $ s Tt 1 ra,Jrw. . M ....rk' �#(�' u ,+.vied i .. ` "--,µ��r"i" " '+s +J"a34n - - N Lena. . .. .. ^ae_ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE 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 B Y THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. -r-._ CO TYPE OF INSURANCE ' POLICY EFFECTIVE POLICY EXPIRATION LTRPOLICY NUMBER DATE(MM/DDNY) DATE(MM/DDIYY) LIMITS GENERAL LIABILITY G NERAL AGGREGATE I 9618-911 7/1/00 7/1/01 3,000,000 A X (COMMERCIAL GENERAL LIABILITY CLAIMS MADE pci OCCUR I PRODUCTS-COMP/OP AGG $ 3,000,000 'PERSONALS ADV INJURY $ 1,000,000 OWNER'S B CONTRACTOR'S PROT _ X PROFESSIONAL EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Any one fife) $ 1,000,000 AUTOMOBILE LIABILITY AUMED EXP (Anyone person) $ 5,000 A X AUTOMOBILE O 1714-122-ARC 4/22/00 4/22/01 COMBINED SINGLE LIMIT I$ 1,000,000 ANYALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY $ X HIRED AUTOS (Per parson) X NON-OWNED AUTOS I BOrDlaLY oo IINeJUIRY $ PROPERTY DAMAGE $ GARAGE LIABILITY ANY AUTO AUTO ONLY-EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ EXCESS LIABILITY AGGREGATE $ UMBRELLA FORM EACH OCCURRENCE $ AGGREGATE $ OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION AND I TORYuwis I 0T EMPLOYERS'LIABIUTY THE PROPRIETow r EL EACH ACCIDENT $ PaarNERSEXEwTNE INCL EL DISEASE-POLICY LIMIT $ OFFICERS ARE: EXCL _ OTHER EL DISEASE-EA EMPLOYEE $ DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS WELD COUNTY, COLORADO, BY AND THROUGH THE BOARD OF COUNTY COMMISSIONERS OF WELD COUNTY, ITS EMPLOYEES AND AGENTS,ARE NAMED ADDITIONAL INSUREDS AS RESPECTS GENERAL LIABILITY ONLY. RE: FAMILY PRESERVATION CONTRACT. i. t fix, 'k. ' iy,7- p.F:'-_ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE WELD COUNTY SOCIAL SERVICES EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL ATTN:JUDY A GRIECO, DIRECTOR 30 DAYS WRITTEN NOTICE TO THEP.O. BOX A ' THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBUGAGON OR UABIUTY GREELEY, CO 80632 OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATWES. AU D REP ENTAGVE s_, MR7�- _2-- '- w F,iCf^, LO E=F-N r n r y =c 'J ._CUC -C - -_'lb] INTER:SRL REVENUE SERVICE DEPHRTi9ENT OF THE TREASURY Ciotrtot Cirectcr Ilea Commerce St. , Ca.claa, TX 75Z42 Person to Contact: EF/EO Correspondence Examiner T Lutheran Social Service of Telephone Number: C_I4)767-1E81 Colorado • 3$3 S. Harlan Refer Reply to: Denver, CO. 8eZ:&-3_=H2 EP/E' :MC:ASO) CAL Date: April 21 , 1593 EIN: S4-077SSE; Gear Sir or Madam: Our records show that Lutheran_ Social aery ce of Colorado is exempt from Federal. Income Tax under section SOI (c)(3) of the Internal Revenue Code. This exemption was granted February 1'9 .1 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 founda- tion within the meaning of section SOS(a) of the Internal Revenue Code because you are an organization described in section t70(b)( 1 )(A)( i) If we may 'be of further assistance, please contact the person whose name and telephane'number are shown above; Sincerely Yours , Mary A. Smith EP/EC Correspondence Examiner Hello