HomeMy WebLinkAbout20011413.tiff RESOLUTION
RE: APPROVE NOTIFICATION OF FINANCIAL ASSISTANCE AWARD FOR FOSTER
PARENT CONSULTATION AND AUTHORIZE CHAIR TO SIGN - NORTH COLORADO
MEDICAL CENTER -YOUTH PASSAGES
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 Foster Parent Consultation 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 North Colorado Medical Center- Youth Passages, 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 Foster Parent Consultation 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 North Colorado Medical Center- Youth Passages, 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: )04 , za`` / 2rLtJ
.,��." e fle
Weld County Clerk to the is . %�y t♦�
dcaiL
I'� \t
r ' .., Glenn Vaad, •ro- em
BY:
Lie
Deputy Clerk to the Board
Willis Jerke
�APPROV D AS F M:
Davi E. Lo
unty orn 1\•e 6
Robert D. Masden
2001-1413
fie a3 SS0028
11(:C II
" DEPARTMENT OF SOCIAL SERVICES
PO BOX A
GREELEY,CO 80632
' WEBSITE:www.co.weld.co.us
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 Departme of S ial Se ices
RE: PY 2001-2002 Notification of Financial Assistance Awards (NOFAA)under Core
Services Funds-North Colorado Medical Center, PsychCare, Youth Passages
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.
North Colorado Medical Center, PsychCare, Youth Passages
A. Option B-Home Based Intensive: Program serves children and adolescents under
the age of 18 and their families, new clients in the YP system, as well as being
used as a step-down service for partial hospitalization program clients. Yearly
capacity is 72 families, two to four hours of direct service per week per family,
with an average length of treatment of 8-10 weeks. Services provided by a
Bilingual therapist who is experienced in the treatment of families with chemical
dependency and domestic violence issues. Rate is$82/hour. Home visits include
30 minutes commute time at $11.12 and 10 miles at$3.25.
B. Intensive Family Therapy. A maximum of 72 clients under the age of 18 for two to
four hours of brief solution-based therapy per week per family at an average of 8
to 10 weeks. Home visits will be considered on a case-by-case basis. Rate is
$82.00/hour; $1,800 Multiple Contact rate; $1,800 Network Intervention Rate.
MEMORANDUM TOM.J. GEILE, CHAIR
WELD COUNTY BOARD OF COMMISSIONERS
RE: CORE SERVICE NOFAA PY 2001-2002-NCMC,PSYCHCARE, YOUTH PASSAGES
C. Day Treatment Sixty adolescents (10-18 years) and/or (range of 5 years to 18
years)per year, 12 monthly average capacity, 40 hours weekly for 6-10 weeks.
Average hours in intensive outpatient program is 12. Rate is$19/hour;
$2,090/month.
D. Foster Parent Consultation: Two hours of direct service per week for a period of
six weeks for foster parents under corrective action. Timelines for other types o foster parent consultation cases will be within the parameters set by WCDSS. f
Bilingual services are available. Families completing service are invited to attend
PsychCare's Family Continuing Care Group, a free service offered weekly at the
PsychCare/Family Recovery Center Building Total number of families estimated
to be served per year is 60, monthly maximum program capacity is seven,
monthly average capacity is five, average stay in the program is six weeks,
average hours per week is two. Rate is$71.25 per hour. Group rate is$85 per
hour per group.
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 FY01-CORE-0009
Revision (FP-FYC-01006)
Contract Award Period Name and Address of Contractor
Beginning 06/01/2001 and North Colorado Medical Center-Youth Passages
Ending 05/31/2002 Foster Parent Consultation
1801 16 Street
Greeley,CO 80031
Computation of Awards Description
Unit of Service The issuance of the Notification of Financial Assistance
This program provides 2 hours of direct service Award is based upon your Request for Proposal (RFP).
per week for a period of 6 weeks for foster The RFP specifies the scope of services and conditions
parents under corrective action. Timelines for of award. Except where it is in conflict with this
other types of foster parent consultation cases NOFAA in which case the NOFAA governs, the RFP
will be within the parameters set by WCDSS. upon which this award is based is an integral part of the
Bilingual services available. Families action.
completing the Foster Family Consultation Special conditions
Program are invited to participate in 1) Reimbursement for the Unit of Services will be based
PsychCare's Family Continuing Care Group. on a monthly rate per child or per family.
This is a free service offered on Thursdays from 2) The monthly rate will be paid for only direct face to
6-8 p.m. at PsychCare's Family Recovery face contact with the child and/or family or as specified
Center Building. Total number of families in the unit of cost computation.
estimated to be served during the year is 60, 7 3) Unit of service costs cannot exceed the hourly and
monthly maximum program capacity, 5 monthly yearly cost per child and/or family.
average capacity, average stay in the program is 4) Payments will only be remitted on cases open with,and
6 weeks, average hours per week is 2. referrals made by the Weld County Department of
Cost Per Unit of Service Social Services.
Hourly Rate Per $ 71.25 5) Requests for payment must be an original submitted to
Hourly Rate Per Group $85.00 the Weld County Department of Social Services by the
end of the 25`s calendar day following the end of the
Unit of Service Based on Approved Plan month of service. The provider must submit requests
for payment on forms approved by Weld County
Enclosures: Department of Social Services.
X Signed RFP:Exhibit A
Supplemental Narrative to RFP: Exhibit B
Recommendation(s)
Conditions of Approval
Appr v Is: Program Official:
By 41.O By J (A
M. J. eile, Chair Judy f.. Gri go,Di ctor
Board of Weld County Commissioners Wel Coun Department of Social Services
Date: O5-,D e2Lo1 Date: 613/01
2001-1413
Signed RFP: Exhibit A
North Colorado Medical Center/Youth Passages
RFP: 01-060-Foster Parent Consultation
INVITATION TO BID
016-00
DATE:February 28, 2001 BID NO: 016-00
RETURN BID TO: Pat Persichino,Director of General Services
915 10th Street, P.O. Box 758, Greeley, CO 80632
SUMMARY
Request for Proposal (016-00) for: Family Preservation Program—Foster Parent
Consultation
Family Issue's Cash Fund or Family Preservation
Program Funds
Deadline: March 23, 2001, Tuesday, 10:00 a.m.
The Families, Youth and Children Commission, an advisory commission to the Weld County Department of
Social Services, announces that 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 Foster Parent Consultation Program must
provide services that focus on providing psychological consultations and parenting support to foster parents
which are designed to improve foster parent competency, family conflict management, and effectively
accessing community resources. 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
Jon Sewell
TYPED OR PRINTED SIGNATURE
VENDOR North Colorado Medical Center _J,.._Thrc ._
(Name) Handwritten Signature By Authorized
Officer or Agent of Vender
ADDRESS 1801 16th Street TITLE Administrator
Greeley, CO 80631 DATE
PHONE# ( 970) 352 - 1 056
The above bid is subject to Terms and Conditions as attached hereto and incorporated.
Page 1 of 30
016-00 Attached A
FOSTER PARENT CONSULTATION 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#016-00
NAME OF AGENCY: NorhColorado
Me Cedicacal
Center
ADDRESS: 1 1Col Street,
PHONE: (970 ) 352-1056
CONTACT PERSON: Pam Johnson TITLE:Regional Dir.Behavioral
Health
DESCRIPTION OF FAMILY PRESERVATION PROGRAM CATEGORY: The Foster Parent Consultation
Program Category must provide services that focus on teaching life skills designed to facilitate implementation of
the case plan by improving household management competency.parental competency. family conflict
management and effectively accessing community resources
12-Month approximate Project Dates: x 12-month contract with actual time lines of:
Start June 1. 2001 Start June 1 , 2001
End May 31. 2002 End May 31 , 2002
TITLE OF PROJECT: Youth Passages
AMOUNT REQUESTED: Open to discretion of WCDSS
Pam Johnson 1 ,.rm- 3/14//Jf
Name and Signature of Person Preparing L ocument Date
Jon Sewell Je - et
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 Funyear 2001-2002.
Indicate No Change from FY 2000-2001 to 2001-2002
Project Description
Target Eligibility Populations
Types of services Provided
Measurable Outcomes
Service Objectives
Workload Standards
Staff Qualifications
Unit of Service Rate Computation
Program Capacity per Month
Certificate of Insurance
Page 24 of 30
016-00 Attached A
Date of Meeting(s)with Social Services Division Supervisor:
Comments by SSD Supervisor: _
(704/, 7 —12-icy
Name and Signature of SSD pe sor Date
Page 25 of 30
016-00 Attached A
Program Category Foster Parent Consultation
Project Title Youth Passages
Vendor North Colorado Medical Center
PROJECT DESCRIPTION
Provide a brief one-page description of the project.
H. 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 and the children's ages.
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. The monthly maximum program capacity.
G. The monthly average capacity.
H. Average stay in the program (weeks).
I. Average hours per week in the program.
III. TYPE OF SERVICES TO BE PROVIDED
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. Consultation and Foster Parent Support around placement issues,behavioral management,
foster home issues involving biological children in the home,transition and loss issues,work
with foster parents and caseworkers around interpretation and implementation of treatment
plans, discipline in the home, group training for foster parents-access to training materials,
work with foster adopt parents on legal risk and commitment issues,visitation issues, and
solution oriented planning.
B. Mandated training for foster parents under corrective action plans and follow-up services as
needed.
C. Mandated consultation services for identified critical care foster parents.
D. Assure the foster parent consultation will not be provided by a professional staff member who
is providing therapeutic services to foster children in the same home.
E. Assure that all assessments, clinical recommendations, and other opinions derived by the
contractor in the performance of this contract will be shared directly with the assigned
caseworker of the children involved. If there is disagreement over the implementation of the
treatment plan with the caseworker, a meeting shall be held with the contractor, assigned
caseworker, foster parents, and the caseworker's supervisor. The objective will be to
determine a unified departmental response for the court. The contractor will not use the legal
system to oppose the department's recommendations.
Page 26 of 30
Attached A
016-00
F. Agrees to comply with 19-1-120 C.R.S., which requires that reports of child abuse and any
identifying information in those reports are strictly confidential.
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.
IV. MEASURABLE OUTCOMES
Provide a two-page description of your expected measurable outcomes of the project. Address the
following measurable outcomes:
A. Improvement of household management competency as measured by pre and post assessment
instruments.
B. Improvement of parental competency as measured by pre and post assessment instruments.
C. Foster parents can independently work with other sources in the community and within the
local, state, and federal governments.
D. Foster parents have demonstrated higher skill and competency levels in fulfilling their
designated function for children in out-of-home placement.
E. Foster parents have positively met the needs of their biological children in adjusting to and
coping with the presence of foster children in the home.
Describe your quantitative measures: Also, describe the methods you will use to measure, evaluate,
and monitor each quantitative measure.
V. SERVICE OBJECTIVES
Provide a one-page description of your expected service objectives and quantitative measures.
Address, at a minimum,the following ways the project will:
A. Improve Household Management Competency - capacity of parents to provide safe
household environment for their children through competent household cleaning and
maintenance,budgeting and purchasing.
B. Improve Parental Competency- capacity of parents to maintain sound relationships with their
children and foster children and provide care, nutrition,hygiene, discipline,protection,
instructions, and supervision.
C. Improve Ability to Access Resources - services shall assist parents to work with other sources
in the community and ahead the local, state, and federal governments.
Describe the methods you will use to measure, evaluate, and monitor each service objective.
VI. WORKLOAD STANDARDS
Provide a one-page description of the project's workload standards and quantitative measures.
Address, at a minimum,the following areas:
A. Number of hours per day,week or month.
Page 27 of 30
016-00 Attached A
B. Number of individuals providing the services.
C. Maximum caseload per worker.
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. Insurance.
VII. STAFF QUALIFICATIONS
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.
Page 28 of 30
FYC PROPOSAL
I. PROJECT DESCRIPTION
Youth Passages has been an FYC provider for eight years. Throughout that time we have
provided high quality intensive treatment to youths experiencing significant emotional,
behavioral,psychiatric, educational, interpersonal, familial and chemical dependency
problems. We have always focused on providing support, education and training to the
families of our youth. Because many of our children receive treatment from us while they
are in placement we have proven experience providing these types of services to foster
parents.
Throughout our history we have proven our ability to safely and productively manage a
complex and difficult milieu. This skill set is an asset that sets us apart from other
providers of this service. The goal of our service delivery in this area will be to teach
foster parents the"why and how to" for developing a safe, caring and prosocial
environment. The parameters for service provision include providing 2 hours of direct
service per week for a period of 6 weeks for foster parents under corrective action.
Timelines for other types of foster parent consultation cases will be within the parameters
set by WCDSS. The therapist who will be providing this direct service is bilingual and is
experienced in working with children and families with behavioral,psychiatric, chemical
dependency and domestic violence issues. The Clinical Coordinator of Youth Behavioral
Health Services for North Colorado Medical Center will provide supervision for this
program.
The method we will use to accomplish this goal is: 1) meeting the foster parent(s) and
establishing a working relationship; 2) completing a thorough assessment of the foster
home including speaking with WCDSS to collect background information; 3) formulating
a written action plan to address areas of need; 4) communicating action plan to all
involved parties including WCDSS; 5)providing support, education and training to foster
parent(s); 6) completing follow-up to assess efficacy of intervention; and 7) modifying
action and retraining, if necessary.
Youth Passages has always shared a collegial relationship with Weld County Department
of Social Services. We work hard to communicate openly and directly with the
caseworkers and will maintain this standard while providing foster parent consultation.
Our minimum standards of communication with WCDSS for this program include
biweekly phone reports to caseworkers, the completion of monthly summaries updating
treatment and a final discharge report summarizing the intervention.
Families who successfully complete the Foster Family Consultation Program are invited
to participate in North Colorado PsychCare's Family Continuing Care Group. This free
of charge service is offered on Thursdays from 6:00 pm to 8:00 pm at the
PsychCare/Family Recovery Center building.
1
X 12 Mo Program
Name of Project: Youth Passages Vendor: North Colorado PsychCare
Yes/No (Be Specific)
Explain How This Item Will Be Met
2. TARGET ELIGIBILITY POPULATIONS
QUANTITATIVE MEASURES
A. 60 Total number of clients to be served in the 12month 5 kids/month for 12 months
program.
B. 60 Total individual clients who are children under age 18 With younger children(under age 4)the foster parents may be the primary client
C. 60 Total family units
D. 30 Sub-total of individuals who will receive bicultural/ Youth Passages will employ one full time bilingual therapist to provide services for this
bilingual services program.
E. 20 Sub-total of individuals who will receive services in We will accept a limited percentage of cases for which we will provide services to in the
South Weld County client's home in South Weld County.
F. 7 The monthly maximum program capacity
G. 5 The monthly average capacity
H. 6 Average stay in the program(weeks) for Foster Parent
Consultation
I. 2 Average hours per week in the program
2
III. TYPES OF SERVICES TO BE PROVIDED
A. Youth Passages will provide consultation and foster parent support around
placement issues,behavioral management, foster home issues involving
biological children in the home, transition and loss issues. We will also
work with foster parents and caseworkers around interpretation and
implementation of treatment plans, discipline in the home, visitation issues
and solution oriented planning. Youth Passages will research training
materials and provide these when indicated. We will also offer group
training to foster parents when it is requested.
B. Youth Passages will provide mandated training for foster parents under
corrective action plans and follow-up services as needed.
C. Youth Passages will provide mandated consultation services for identified
critical care foster parents.
D. Youth Passages will not provide foster parent consultation by a
professional staff member who is providing therapeutic services to foster
children in the same home.
E. Youth Passages will share all assessments, clinical recommendations, and
other opinions derived in the performance of this contract with the
assigned WCDSS caseworker of the children involved. If there is a
disagreement over the implementation of the treatment plan with the
caseworker, a meeting shall be held with the Youth Passages staff
member, assigned caseworker, foster parents, and the caseworker's
supervisor. Our objective will be to determine a unified departmental
response for the court. Youth Passages will not use the legal system to
oppose the department's recommendations.
F. Youth Passages agrees to comply with 19-1-120 C.R.S.,which requires
that reports of child abuse and any identifying information in those reports
remain strictly confidential.
Quantitative Measures
A. 100% of the 30 referred foster parents will receive consultation and the
delivery of supportive services.
B. 100% of the 12 foster parents under corrective action plans will receive
mandated training and follow-up services as needed.
C. 100% of 18 referred critical care foster parents will receive mandated
consultation services.
3
D. 100% of referred foster parent consultation cases will be handled by a
Youth Passages professional staff member who is not providing
therapeutic services to foster children in the same home.
E. In 100% of cases Youth Passages will share all assessments, clinical
recommendations, and other opinions derived in the performance of this
contract with the assigned WCDSS caseworker of the children involved. If
there is a disagreement over the implementation of the treatment plan with
the caseworker, a meeting shall be held with the Youth Passages staff
member, assigned caseworker, foster parents, and the caseworker's
supervisor. Our objective will be to determine a unified departmental
response for the court. Youth Passages will not use the legal system to
oppose the department's recommendations.
F. In 100% of referred cases Youth Passages will comply with 19-1-120
C.R.S., which requires that reports of child abuse and any identifying
information in those reports remain strictly confidential.
Youth Passages and PsychCare/Family Recovery Center have always
enjoyed collaborative relationships with service providers in our region
(e.g. North Range Behavioral Health and Island Grove Regional
Treatment Center). We will utilize our brief intervention model and refer
clients to lesser levels of care/consultation as soon as it is appropriate.
Youth Passages will utilize written treatment plans, including timelines,
and host case conferences to ensure that the relevant service providers are
involved in the treatment at the appropriate time. Additionally,
PsychCare/FRC and Youth Passages deal daily with a huge breadth of
public and private payer sources. This experience will help us to channel
clients into appropriate funding streams.
IV. MEASURABLE OUTCOMES
A. 80% of clients will demonstrate improved household management
competency as measured by an approved pre and post assessment
instrument.
B. 80% of clients will demonstrate improved parental competency as
measured by an approved pre and post assessment instrument.
C. 100% of foster parents can independently work with other sources in the
community and within the local, state and federal governments.
D. 80% of foster parents will demonstrate higher skill and competency levels
in fulfilling their designated function for children in out of home
placement. This will be measured by an approved pre and post assessment
instrument.
4
E. 80% of foster parents will positively meet the needs of their biological
children in adjusting to and coping with the presence of foster children in
the home. This will be measured by an approved pre and post assessment
instrument.
V. SERVICE OBJECTIVES
A. 90% of foster parents will demonstrate improved household management
competency including the capacity to provide a safe household
environment for their children through competent household cleaning and
maintenance,budgeting and purchasing. This will be measured by an
approved pre and post assessment instrument.
B. 80%of foster parents will demonstrate improved parental competency
including the capacity to maintain sound relationships with their children
and foster children and provide care, nutrition, hygiene, discipline,
protection, instructions and supervision. This will be measured by an
approved pre and post parenting skills assessment instrument.
C. 100% of foster parents will demonstrate an improved ability to access
resources. This will be measured via an approved pre and post assessment
instrument.
VI. WORKLOAD STANDARDS
A. The therapist providing this service for Youth Passages is a fulltime
bilingual therapist who will not work more than 40 hours per week, 173
(on average)per month, and 2080 per year. One per diem Master's Level
therapist will be available to assist in high census periods.
B. There is one full time Master's Level bilingual therapist and one per diem
Master's Level therapist who will provide services for this program.
C. Maximum caseload per therapist—4
D. The treatment modality is a brief consultation model which utilizes
assessment and education to effect change. Anticipated duration is 2 hours
of direct service per week over 6 weeks for foster parents under corrective
action. Length of treatment for other consultation services will be open to
the discretion and recommendation of WCDSS.
We will offer group training sessions for foster parents if requested to do
so by WCDSS
5
E. Total Number of Hours of Service-
Foster Parents Under Corrective Action
2 hours per week
8 hours per month
F. Total number of individuals providing these services—
1 fulltime bilingual Master's Level therapist
1 per diem Master's Level therapist
G. Maximum caseload per supervisor— 10
H. Insurance—see attached certificate
VII. STAFF QUALIFICATIONS
A. The therapist providing services will have a minimum of a Master's
Degree in psychology, counseling, social work or a related field and direct
service experience treating children, adolescents and families. Youth
Passages will meet or exceed requirements for 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.
B. Total number of staff, including supervisors, available for this project - 3
6
Computation of Direct Service Rate Foster Parent Consultation
Total hours of Direct Service/Client 40 Hours A
Total Clients to be served 40 Clients B
Total Hours of Direct Service
For year line A X B _ 1600 Hours C
Cost/hour of Direct Service $ 49.95 Per Hour D
Total Direct Service Costs
C X D , $ 79,920.00 E
Administrative Costs $ 4,320.00 F
'Overhead Costs [ $ 23,760.00 G
Total Costs direct/allocated
E+ F +G $ 108,000.00 H
Anticipated Profits $ 6,000.00 I
Total Costs/Profits
H + I L $ 114,000.00 J
Total Hours of Direct Service for Year
must equal C 1600 K
Rate per Hour of direct face to face
service $ 71.25 L
Computation of Direct Service Rate Foster Parent Consultation
Computation of Direct Service Rate Foster Parent Group Training
Total hours of Direct Service/Client 8 Hours A
Total Clients to be served _ 30 Clients B
Total Hours of Direct Service
For year line A X B 240 Hours C
Cost/hour of Direct Service $ 59.7.6 Per Hour D
Total Direct Service Costs
CXD I I 514,341.20 E
Administrative Costs $ 775.20 F
Overhead Costs 1 - $ 4,263.60 G
Total Costs direct/allocated
E + F + G I $19,380.00 H
Anticipated Profits $ 1,020.00 rl _
Total Costs/Profits _
H + I 1 $20,400.00 J
Total Hours of Direct Service for Year
must equal C I
240 K
Rate per Hour of direct face to face service S 85.00 L
Note: 1] Training groups are limited to 6 participants.
21 Family groups are limited to 12 participants.
33 Anticipate 30 family units _
4]Anticipate 2 sessions of 4 hours/family unit
tat
YtFP ��-01 � Attached A
Dayt'Treatment Programs Only:
Direct Service House Per Client Per Month (M]
Monthly Direct Service Rate $ [N]
[A]b . 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;" .`discu"ssions with involved
parties, meeting preparation, and report completion.
[H] Ibla represents the Grand Total Costs directly attributable or allocable to this
program. It should be a reasonable assumption that if you decided to discontinue
ithis-program,._your agency would real-ize=a eduction—i-n—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 32 of 32
ANa
North Colorado Medical Center
Banner Health Colorado
March 14, 2001
TO WHOM IT MAY CONCERN:
RE: BANNER HEALTH SYSTEM
This is to advise that Banner Health System, along with its subsidiary operations, are self-insured
through the BHS Self-Insured Liability Trust. The coverage is continuous. This coverage
extends to all corporate entities as well as any employee working within the scope of their
employment. The limits provided by the BHS Self-Insured Liability Trust are at least $2,000,000
per occurrence/$15,000,000 in the aggregate.
Excess liability limits of$25,000,000 are provided through the American Healthcare System
Risk Retention Group.
If additional information is necessary, please contact Philip Holt, Insurance Manager at Banner
Health System,Post Office Box 6200, Fargo, North Dakota 58106-6200 (701/277-7577) (FAX
701/277-7636).
Sincerely,
Philip B. Holt
Insurance Manager
1801 16th St. • Greeley,CO 80631 • 970-352-4121 • Fax 970-350-6644 • ncmcgreeley.com
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