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Home My WebLink About20001547 RESOLUTION RE: APPROVE NOTIFICATION OF FINANCIAL ASSISTANCE AWARD FOR CORE SERVICES FUNDS AND AUTHORIZE CHAIR TO SIGN - NORTH COLORADO YOUTH ALTERNATIVES, DBA PARTNERS WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with a Notification of Financial Assistance Award for Core Services Funds between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Social Services, and North Colorado Youth Alternatives, dba Partners, commencing June 1, 2000, and ending May 31, 2001, with further terms and conditions being as stated in said award, and WHEREAS, after review, the Board deems it advisable to approve said award, a copy of which is attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, ex-officio Board of Social Services, that the Notification of Financial Assistance Award for Core Services Funds between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Social Services, and North Colorado Youth Alternatives, dba Partners 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 26th day of June, A.D., 2000, nunc pro tunc June 1, 2000. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO ATTEST: 4,, I � a ,'J\w',-/4Ay, \. ,,-LA i_L2y" 4 _ i ../ �� ` Barbara J. Kirkmeyer, Chair Weld County Clerk to th• ; r n ; �_I- EXCUSED M. J. G ile, Pro-Tem . BY: • . _� ' 1!. Deputy Clerk to the Boara��:_r.r: eo a E. Ba ter iAAI PF &VED AS TO • 5 Dale K. Hall 4tAttor)ey EXCUSED Glenn Vaad /� SS lC rouse/1 41A'r4 4 /yyes. 4rim°I'S 2000-1547 co: Weld County Department of Social Services Notification of Financial Assistance Award for Families,Youth and Children Commission (Core) Funds Twe of Action Contract Award No. X Initial Award FY00-CORE-0004 Revision (RFP-FYC-00005) Contract Award Period Name and Address of Contractor Beginning 06/01/2000 and North Colorado Youth Alternatives, Partners Ending 05/31/2001 Lifeskills 1212 8 Street Greeley, CO 80631 Computation of Awards Description Unit of Service The issuance of the Notification of Financial Assistance Award is based upon your Request for Proposal(RFP). Improve parental capacity to keep the children in The RFP specifies the scope of services and conditions the home, to reunite the children who are placed of award. Except where it is in conflict with this in foster care, and sustain the lowest level of care. NOFAA in which case the NOFAA governs, the RFP A maximum of 18 families in short-term upon which this award is based is an integral part of the intervention with children ages 8-18, average of action. 10 hours per week for 24 weeks. Special conditions Cost Per Unit of Service 1) Reimbursement for the Unit of Services will be based Hourly Rate Per $ 16.50 on an hourly rate per child or per family. Unit of Service Based on Approved Plan 2) The hourly rate will be paid for only direct face to face contact with the child and/or family, as evidenced by Enclosures: client-signed verification form, and as specified in the X Signed RFP:Exhibit A unit of cost computation. X Supplemental Narrative to RFP: Exhibit B 3) Unit of service costs cannot exceed the hourly and X Recommendation(s) yearly cost per child and/or family. Conditions of Approval 4) Payment will only be remitted on cases open with, and referrals made by the Weld County Department of Social Services. 5) Requests for payment must be an original submitted to the Weld County Depai lment of Social Services by the end of the 25`x' calendar day following the end of the month of service. The provider must submit requests for payment on forms approved by Weld County Department of Social Services. Approvals:/ Program Official: BYY (</igat J /46 6 ty,A J By arbara J. Kirkmeyer, Chair o Judy A Gr eg , Directo Board of Weld County Commissioners Wel ou9 �epartme t of Social Services Date: a _ah -Afro Date: (42 ,�1 © O(3 2000-1547 SIGNED RFP EXHIBIT A Par ¢rs Helping Youth Help Themselves March 20, 2000 Pat Persichino Director of General Services 915 10th Street P.O. Box 758 Greeley, CO 80632 Bid Number: RFP-FYC-00005 through 00011 Dear Proposal Review Committee: I have enclosed one original and 5 copies of Partners' Family Preservation Program Life Skills proposal. The Partners' Mentor-Advocate program has continued to be successful over the past year and we look forward to continuing to work with the Social Services case workers to provide needed advocate services to participating youth and their families. One change that should be noted from last years proposal is the unit cost which has been changed from $15.85 an hour to $16.50. This entails a raise for the mentor from $9.50 to $10.00 and a $.15 raise for administrative costs. The $.50 is to help compensate Mentor-Advocates for the money they spend on their Junior Partner for activities they participate in. This will also help to compensate mentors for the additional paperwork they will be asked to complete as part of this program. The $.15 raise for administrative costs will help to compensate Partners staff for additional time needed to administer the program based on the additional paperwork. Please let me know if there is any additional information that you may need to evaluate this application. Thank you again for your past support of Partners' Mentor-Advocate program. Sincerely, Michael Muskin Executive Director • 1212 8th Street•Greeley, Colorado 80631 • (970)351-0700• Fax (970)351-0562 Toll Free 1-877-351-0700• E-Mail: partners@info2000.net•www.info2000.net/-partners/ INVITATION TO BID RFP-FYC 00005 DATE:February 28, 2000 BID NO: RFP-FYC-00005 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-00005) for:Family Preservation Program--Life Skills Program Family Issues Cash Fund or Family Preservation Prom Funds Deadline: March 23, 2000, 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, 2000,through May 31, 2001, at specific rates for different types of service,the county will authorize approved vendors and rates for services only. The Life Skills Program must provide services that focus on teaching life skills which are designed to improve household management competency,parental 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 Michael Muskin TYPED OR PRINTED SIGNATURE Weld County Youth Alternatives V'VENDOR dba/Wald ("minty Part ners_ (Name) H written Sigma By Authorized Officer or Agent of Vender ADDRESS 1212 8th Street TITLE Executive Director Greeley, CO 80631 DATE 3/17/00 PHONE# 970-351 -0700 The above bid is subject to Terms and Conditions as attached hereto and incorporated. Page 1 of 33 RFP-FYC-00005 Attached A LIFE SKILLS PROGRAM BID PROPOSAL AND REQUEST FOR CONTINUATION OF AWARD UNDER FPP CORE SERVICES FUNDING FAMILY PRESERVATION PROGRAM 2000/2001 BID PROPOSAL APPLICATION PROGRAM FUNDS YEAR 2000-2001 BID #RFP-FYC-00005 NAME OF AGENCY: Weld County Youth Alternatives dba/Weld County Partners _ADDRESS: 1212 8th St. , Greeley 80631 PHONE: ( 970) -351 -0700 CONTACT PERSON: Mi rib aal Muskin fFIZE: Executive Director DESCRIPTION OF FAMILY PRESERVATION PROGRAM CATEGORY: The Life Skills 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 comnetencv.family conflict management and effectively accessing community resources. 12-Month approximate Project Dates: _ 12-month contract with actual rime lines of: Start June 1. 2000 Start June 1 , 2000 End May 31. 2001 • End May 31 . 9001 TITLE OF PROJECT:Mentor-Advocate Project (MAP 1 AMOUNT REQUESTED:_ , 1 6. 50 per hour Michael Muskin j6%% 3/17/00 Name and Signature of Person Preparing Document Date Michael Muskin /�i�G !�f!�(Z�/1 3/17/00 Name and Signature Chief Administrative&ficer 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 1999-2000 to Program Fund year 2000-2001. indicate No Change from FY 1999-2000 ▪ Project Description C4�2S� o/- r1.ep ,efac.f,t pot cf≤ Target/Eligibility Populations fl'C ✓ Types of services Provided ti G ✓ Measurable Outcomes L4e.—Sc /— AirkT • Service Objectives Arc. ✓ Workload Standards L(<,,5< / -54/ ` o—' Br""`S I. Staff Qualifications L4a-,Je Iq -nJc sh.-S • Unit of Service Rate Computation lG� Sic! I Program Capacity per Month A✓� Certificate ofInsurance Page 26 of 33 RFP-FYC-00005 Attached A Date of Meeting(s)with Social Services Division Supervisor: 3 , /0 — CO Comments by SSD Supervisor: a I -L —;C - o a d 55 S { F I -i-o c c _ wr )//C/6' 0 _Signature of SSD Supervisor Date Page 27 of 33 Program Category: Life Skills Program Bid Category - RFP-FYC 00005 Project Title: Mentor-Advocate Project (MAP) Vendor: Weld County Youth Alternatives dba/Weld County Partners I. PROJECT DESCRIPTION The Mentor-Advocate Project(MAP) is a community-based alternative for children or youth at imminent risk of out-of-home placement, which will: a] Provide short-term, intensive intervention with youth and parents, based on a relational advocate model, which combines the effects of mentoring with the intent of crisis management, advocacy, tracking and negotiation; b] Provide a paid mentor-advocate to work one-on-one with a child or youth; c] Conduct intake within 72 hours of referral, based on the availability of the youth and family, and provide match within 5 days of referral, OR notify program area supervisor of inability to match if mentor-advocate is not available at the time a referral is received; d] Provide direct, face-to-face skill building work and social, recreational and educational outlets for youth, with respite time for parents/guardians, 10 hours/week; e] Provide direct problem-solving and communication development by mentor-advocate with youth and parent or guardian, as part of 10 hours per week; f] Encourage change in youth focus and improvement in parent/child communication and problem/solving skills; g] Provide crisis Counseling and/or Family Mediation by staff as needed; h] Provide assistance as needed with implementation of case treatment plans; i] Provide services for a 6 month period with a step down process over the final 3 months. The mentor-advocate relationship differs from a regular mentoring relationship as provided by Partners in both intent and effect. The intent of MAP is to initiate relatively short-term intervention with youth and families, helping them negotiate a crisis or transitional period of time through provision of a "respite"or "release valve,"while also helping them develop lifeskills to avert crisis in the future. This intervention will be completed through a step down process which will include 10 hours a week for the first three to four months and then transitioning to 5 hours a week. This project utilizes the encouragement, concern and caring associated with mentoring, in conjunction with advocacy's focus on meeting immediate needs and providing regular, short-term skills practice. Partners will: 1] recruit and screen the mentor-advocates; 2] train the mentor-advocates in lifeskills development, and youth development curriculum such as "Character Counts," along with training in mentoring, advocacy, communication skills and problem solving facilitation. 3] provide staff assistance as necessary, in Counseling or Family Mediation. 4] provide regular group activities and Lifeskills Workshops for youth. 1 II. TARGET/ELIGIBILITY POPULATIONS The Mentor-Advocate Project(MAP) is designed to meet the needs of individual youth between the ages of 8 and 18 who are beyond the control of their parents or otherwise in a conflictual state with parents/guardians or are in need of transitional services pending and during family reunification. MAP will address the "criteria for out-of-home placement"primarily by: Criteria #1 - Responding in those cases when the child/youth is: 1] beyond the control of parents; 2] adjudicated delinquent; 3] child/youth returning home from out-of-home placement or moving to a less restrictive LOC. Criteria #2 - Responding primarily when: 1] it is necessary to assist the parent/relative/caretaker and/or child/youth in accessing and utilizing identified services to address the presenting conditions. Criteria #3 - Responding when: 1] placement out-of-home or in FPP is the best choice of available options/alternatives while continuing reasonable efforts to resolve the problems that led to imminent risk. MAP meets the definitions pertaining to the Family Preservation Program by: 1] directing its work toward families and family strengths, providing both respite/reprieve and skill building for youth and parents/guardians; 2] protecting children/youth and preventing placement through those same strategies, providing "away time" and active problem-solving "together" time; 3] being time limited, with an initial contract of 6 months of service, depending on the case circumstances and need; 4] using a "family friendly" model which encourages receptivity of services; 5] intervening at critical points, when out of home placement is imminent due to crisis, or when transitional support is needed by families pending reunification. MAP client capacity includes the following: A. Total number of clients to be served: 36 B. Total individual clients and children's ages: 36 (based on 18 parents/18 youth) Children/Youth ages: 8 - 18 C. Total family units: 18 D. Sub-total of individuals who will receive bicultural/bilingual services: 50% E. Sub-total of individuals who will receive services in South Weld County: 4 F. Monthly maximum program capacity: 6 families H. Monthly average capacity: 6 I. Average stay in the program (weeks): 24 J. Average hours week in the program: 10 • III. TYPE OF SERVICES TO BE PROVIDED Youth and parents/guardians will be provided support during critical junctures, with the understanding that t the relationship is key but only for the period of service provision, unless it is agreed to extend the youth's length of stay in the project. All youth in MAP are eligible for subsequent referral to Partners for the regular services of the agency's mentoring program. A. Teaching/modeling/demonstrating/coaching - interactive process with client 1: Mentor-advocate role. Combining the relational aspect of mentoring with advocacy, the mentor-advocate will be able to establish the trust of a friendship-based relationship with a child/youth, while at the same time purposefully working with that child/youth and the parent/guardian to teach new skills for communication and problem-solving. Mentor: As with Partners' other programming, MAP places the greatest emphasis on the child/youth. The mentoring concept recognizes that: 1) young people respond the most positively and effectively to significant caring adults who help them develop an internal locus of control; 2) youths' responses to external behavioral pressures without a caring relationship with an adult in place are most likely to be in favor of negative and risk-taking behaviors or against authority. First developing the relationship with the child or youth will make he or she more susceptible to the skill building process with the mentor-advocate. A similar response will hold true for the parent/guardian, though the relationship between the mentor-advocate and parent/guardian will be less intense. Advocate: The advocate role is much more focused on making change happen quickly and meeting immediate need. It is in this role that the mentor- advocate will be able to gain family confidence and participation in identifying problems. The goal will be to teach children/youth and their parents/guardians the skills necessary to repeatedly walk through the problem- solving and decision-making processes, and to gain awareness of the effects of various communication styles and learn new ones. The parent/guardian will be supported in learning to maintain the adult role, and the child/youth will be supported in getting his or her needs met. The mentor-advocate may also identify additional family needs and/or be of assistance in facilitating compliance with the case treatment plan. 2: Skill building. During 1-2 sessions per week, and more frequently if needed, the mentor-advocate will meet with the child/youth and parent/guardian together, in their home if distractions are minimal, at the Partners house if not, to identify problems and teach the skills to problem-solve step-by-step, to practice new communication techniques and to learn to engage in dispute without emotional eruption. Skills to be addressed will also be based on goals pertaining to the "Family Service Plan". 3: Counseling/family mediation. If crisis points emerge for which the mentor-advocate feels his or her skills are inadequate, professional staff with Partners will assist in resolution of issues. In such cases, either staff or the mentor-advocate will confer with the DDS caseworker regarding the next best course of action. Reports on outcomes of such sessions will be made to the caseworker. B. Training in household management 1: This service is not provided by MAP. 3 C. Teaching child rearing and discipline 1: Communication and problem-solving skill building. As stated in A.2., the mentor-advocate will meet with the child/youth and parent/guardian together to identify problems and household conflicts. The parenting skills addressed through this service will include those needed to implement problem-solving and communication techniques, to avoid escalation of anger and to produce working agreements between parent/guardian and child/youth (e.g., household rules, consequences for negative behavior). Again, these skills will be based on goals pertaining to the "Family Service Plan". D. Teaching development of community linkages/advocacy and use of services 1: Advocacy. While the mentor-advocate's role is primarily to focus on assisting youth and families in building communication and problem-solving skills, families will be assisted in meeting needs by accessing community resources (e.g., food, clothing, furniture, health care), especially where lack of such resources is a contributing factor in family conflict. 2: Skill modeling. Specific development of parent/guardian skills to access and use community resources is not a primary focus of MAP. To the extent that advocacy involves assisting with gaining access to resources, these specific skills will be modeled and demonstrated for the parent/guardian. E. Demonstrating nurturing/esteem role-modeling 1: Mentorinq. The practice of mentoring includes providing support and encouragement through challenges and difficulties, as well as communicating positive feedback as those being mentored utilize new skills. In the case of mentoring of youth, the process contributes to the development of their self- confidence and sense of self-worth. As the parent/guardian watches the mentor-advocate relationship develop with the child or youth, this process and its effects will be role-modeled for them. 2: Communication skill modeling. As the mentor-advocate meets with the parent/guardian and child/youth in weekly sessions, the mentor-advocate's interaction with both also will include role-modeling for the parent/guardian the communication of caring, pride, concern, love, etc. Parents/guardians will be taught the process of communicating positive feedback to youth as a technique for demonstrating caring and concern, as well as for developing increased self- esteem in the youth. These skills will be in conjunction with the goals based on the "Family Service Plan". F. Number to be served by above service types 1: Interactive process. At the maximum capacity of the project, 18 parents/guardians and 18 youth will be served through the interactive process described in A. above. 2: Advocacy for access to resources. All family members will learn the process as resources are located to meet family needs. The maximum capacity is as above. 3: Parenting skills. The communication, problem-solving and esteem building skills that will be worked on with both parents/guardians and youth will contribute to parenting skills for the maximum capacity of 18 parents/guardians. 4 G. Measures/Duplication. See Section IV for quantiative measures for service outcomes. No other community entitiy or program within Partners is providing the mentor-advocate service model for FPP eligible families. IV. MEASURABLE OUTCOMES Youth and parents/guardians will be provided support during critical junctures, and through this support, skill building, and advocacy the youth and their families will have additional tools to be able to better deal with the conflict related to this referral. Senior Partners will also would with the client's case worker to develop specific attainable goals based on the existing "Family Service Plan". All youth in MAP would be eligible for subsequent referral to Partners for the regular services of the mentoring program. MAP evaluation will be conducted in two phases, process evaluation and outcome evaluation. Process evaluation will mark the progress of the project in terms of numbers associated with project-specific processes. For MAP this will include tracking of the: 1) # of available screened and trained mentor-advocates 1) # of referrals and # of accepted clients; 2) total # of hours of service provided per client per week; 3) types of services provided per week per client by hours of service; 4) average weekly and monthly project caseload; 5) stipends paid to mentor-advocates. The Four outcomes on which MAP focuses are: 1) Prevention of imminent placement of children/youth, in those cases where the family can be effected by mentoring for youth, and building of communication and problem-solving skills; 2) reunification of children who are in out-of-home placement to residence with their parents/guardians, in those cases as described in #1; 3) completion of goals in conjunction with the "Family Service Plan"; 4) Youth will demonstrate a positive change in one or more of six "Mentoring Service Effectiveness Inventory" (MSEI) scales. The outcome objectives to be measured to assess the effectiveness of the program in achieving these outcomes are: Outcome Objective #1: Youth will demonstrate an increase in skills and perceptions associated with problem-solving, decision-making and effective communication, as well as a positive change in one or-more of the MSEI scales. Outcome Objective #2: Parents/guardians will demonstrate an increase in skills and perceptions associated with problem-solving, decision-making, effective communication and nurturing/esteem-building for their youth. Outcome Objective #3: Families will be successful in remaining unified at the time of termination of services, either because the child/youth is no longer at imminent risk of placement or because the child/youth is reunified and is not at imminent risk of placement. 5 Outcome evaluation marks progress in terms of behavioral and attitudinal change in a program's participants. For MAP this will require three dimensions of evaluation of the project's effectiveness: Finding #1: The % of youth participants who demonstrate increased knowledge and perceptions of positive problem-solving, decision making and communication processes. - Finding #2: The % of parents/guardians who demonstrate increased knowledge and perceptions of positive problem-solving, decision making, communication processes, and nurturing/esteem-building for their youth. Measurement for the first two findings, supporting Objective#1, will use the Social Services survey for parents as well as the MSEI for youth. We also will document the completion of specific goals related to the "Family Service Plan". Finding #3: The % of youth participants who demonstrate a positive change in one or more of the MSEI scales. Youth Participants will be given the pre and post MSEI to indicate positive changes in one or more of the following scales: self confidence/self esteem, future orientation, school bonding, individual/peer violence attitudes, individual delinquency, and ATOD use. This survey has been shown to be empirically reliable in conjunction with Partners year long mentorship program but has not been tested with a shorter duration. Finding #4: The % of all families in which the child/youth is successfully remaining in the home, either after being at imminent risk of placement, or after having been reunified with his/her family, as measured by mentor-advocates and confirmed by DSS caseworkers. Finding #5: The % of all goals developed based on the "Family Service Plan" that are successfully completed. The measurement for the finding number three and four, supporting Objective #2, will be achieved by simple documentation in case notes by the MAP counselor and the DSS caseworker. Specific measureable outcomes: A. Improvement of household management competency - Not provided by this project. B. Improvement of parental competency -Addressed in Outcome Objective #2 and Finding #2, to be measured evaluation instruments as described above. C. ,Parents working independently with other community sources - While the mentor-advocate's role is primarily to focus on assisting youth and families in building communication and problem-solving skills, families will be assisted in meeting needs by accessing community resources (e.g., food, clothing, furniture, health care), especially where lack of such resources is a contributing factor in family conflict. Though specific development of parent/guardian skills to access and use community resources is not a primary focus of MAP, evaluation of work in this regard with be measured through review of mentor-advocate log notes and the program's case files. D. Families remaining in tact six months after termination of services - Evaluation of successes in this regard will require review of DSS case files. E. Families/participants with improved competencies - Addressed in Outcome Objective #2 and Finding #2, to be measured by pre-and-post 6 evaluation instruments as described above and attached. Improved competencies will also be evaluated by the ability of the family to remain in tact, as in D above. F. Senior Partners and Families successfully completing the goals that were developed based on the "Family Service Plan". G. Participating youth will show improvement in one or more of the Mentoring Services Effectiveness Index scales -Addressed in Objective #1 and Finding #3, to be measured by pre-and post MSEI survey. V. SERVICE OBJECTIVES A. Improve Household Management Competencies 1: Not addressed by this project. B. Improve Parental Competency 1: Mentor-advocates. Partners will maintain a pool of screened and trained mentor-advocates to serve an average caseload of 6 families. These individuals will be recruited, screened, trained and placed as stipended volunteers with the program, and will be allowed to work with a maximum of two families simultaneously. The screening process will include the application, Central Registry check, Motor Vehicle records, CCIC-NCIC screen, 4 references, and an intensive interview. The assignment of a client to an mentor-advocate will be on the basis of availability, with secondary emphasis on compatibility, strengths and needs. Elements from materials developed for parent education and for youth development training will be included in the mentor-advocate training, including Partners' standard mentor training, Partners in Parenting - (CSU Cooperative Extension curriculum), Cara y Corazon - (Corporate Fund for Children, Austin, TX), Character Counts - (Josephson Institute of Ethics, So.Dak. State Univ.), PARTNERS' Communication Workshop, Real Justice/Teaching Peace, Partners' Problem Solving Workshop, and facilitation skills (UNC Office of Dispute Resolution) 2: Direct service. Partners will provide an average of 10 hours of direct service per week to each client family, to include 8-9 hours of one-to-one contact between the mentor/advocate and child/youth, and 1-2 hours of skill building contact between the mentor/advocate and both the child/youth and the parent/guardian together. During the one-on-one time the two will discuss concerns of the youth, role play problem solving and communication strategies, and participate in recreational activities, on their own or as provided - by Partners. For 1 to 2 hours per week, the mentor-advocate will meet at pre- scheduled times with the child/youth and his or her parent/guardian. During these sessions, the mentor-advocate will facilitate discussion of the status of the child/youth - parent/guardian relationship, including such things as conflictual incidents in the preceding week, encouraging, for example, description of the chain of events and participants' behavior, identification of different possible actions and outcomes, and role playing of the scenario with different behavior, communication styles, etc. MAP participants will have available to them all of the regular recreational, education, community service and mentor support services which 7 are provided for Partnerships in the core programs. These supports include the assigning of a Partners Counselor to the MAP case, access to community recreational discounts, Partners group activities and regularly scheduled Lifeskills Workshops. Staff support will include weekly contact by the Counselor with the mentor-advocate, and an expected average of 2 hours per month assisting the mentor-advocate with direct client services (e.g., counseling, family mediation). 3: Respite effect. The time that the mentor-advocate spends with the _ youth in 8-9 hours/week of one-to-one activity not only will provide the youth with new experiences, a change in focus, positive and successful behaviors and the "significant adult" relationship, but also will provide time apart for the child/youth and parent/guardian which will provid the opportunity for family members to "step back" and re-evaluate any problematic situations which must be negotiated. C. Improve ability to access resources 1: Advocacy. As described in Ill. D, while the mentor-advocate's role is primarily to focus on assisting youth and families in building communication and problem-solving skills, families will be assisted in meeting needs by accessing community resources (e.g., food, clothing, furniture, health care), especially where lack of such resources is a contributing factor in family conflict. To the extent that advocacy involves assisting with gaining access to resources, these specific skills will be modeled and demonstrated for the parent/guardian. VI. WORKLOAD STANDARDS Workload standards for MAP include the following: A. The number of hours of service per week will be: an average of 10 with a step down process in the final two to three months of an average of 5 . B. The number of individuals providing the services will be: 1 mentor-advocate 1 staff Counselor C. The maximum caseload per worker will be: 2 for mentor-advocate 8 for staff Counselor D. The modalities of treatment will be: Mentorinq Advocacy Skill building Counseling Family Mediation E. The total hours per week will be: Average of 10 per family Avg. of 60 for full caseload F. Total number of individuals providing services: 4 - 6 mentors at a 8 time, 1 staff G. The maximum caseload per supervisor: 8 H. Insurance: Commercial general liability - All American Agency Facilities do Van Gilder Insurance Corp. 700 Broadway, Ste 1000 Denver, CO 80203 (certificate attached) Mentor-advocates are asked to commit to a minimum of 10 hours/week with each youth they are matched with (can carry two cases at a time). VII. STAFF QUALIFICATIONS The project will administered by the Executive Director Michael Muskin, M.A. of the applicant agency, which previously provided services for the PAC for nearly 15 years. Mr. Muskin has been with the Partners program for one year and has previously worked closely with Social Services through his position with the District Attorney's Juvenile Diversion program and as Director of the Greeley Transitional House. The project will be supervised by Nomie Ketterling, MA, Lead Counselor, with 16 years experience in mentor screening, training and support. She is a trained Agency Counselor and Mediator. Clerical and admin. support will be provided by Dave Helmer, Office Manager, with 11 years financial and office management experience with the agency. It is the goal of the agency to maintain a pool of 4 - 8 mentor-advocates, who will be supervised by the Lead Counselor. These individuals will have a minimum of a BA in a human service-related field and will have completed the screening and training processes described earlier. VIII. UNIT OF SERVICE RATE COMPUTATION See next page, "Computation of Service Rate", Attached A. IX. PROGRAM CAPACITY BY MONTH The MAP program can support a monthly case load of 6 cases, dependent on the availabilty of mentors to work in the project. The case load has fluctuated between 2 and 6 on a monthly basis over the past year based on the number of referrals. 9 • RFP-FYC-00005 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) ( 10 hrs x 18wk + 5hr x 8wk) Total Hours of Direct Service per Client 220 Hours [Al Total Clients to be Served 18 Clients [B] 3960 Total Hours of Direct Service for Year Hours [C] (Line [A] Multiplied by Line [B] 10. 00 Cost per Hour of Direct Services $ Per Hour [D] Total Direct Service Costs $ 39, 600 [E] (Line [C] Multiplied by Line [D] ) Administration Costs Allocable to Program $ 16, 216 [F] Overhead Costs Allocable to Program $ 9, 524 [C] Total Cost, Direct and Allocated, of Program$ 65, 340 [H] Line (El Plus Line (F] Plus Line (0] ) Anticipated Profits Contributed by this Program $ -�- [I] Total Costs and Profits to be Covered 65, 340 by this Program(Line (H] Plus Line [I] ) $ [,I] Total Hours of Direct Service for Year 3, 960 [K] Page 31 of 33 d } RFP-FYC-00005 Attached A (Must Equal Line [C] ) Rate per Hour of Direct, Face-to-Face Service to be Charged to Weld County Department of Social Services $ 16. 50 [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. [B] This is an estimate of the number of clients who will be served during the period from June 1, 2000, through May 31, 2001. [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 Page 32 of 33 RFP-FYC-00005 Attached A for Proposal. [M1 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 [LI by Line [M] . Page 33 of 33 WELCCU ACORD. CERTIFICATE OF INSURANCE DATE(MM/DD"� 01/28/00 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION All American Agency Facilities ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE c/o Van Gilder Insurance HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Corp. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 700 Broadway, Suite 1000 COMPANIES AFFORDING COVERAGE Denver, CO 80203 COMPANY ACarolina Casualty INSURED COMPANY Weld County Youth Alternatives i Bunion Insurance Company Inc . Dba Weld County Partners 1212 8th Street COMPANY c Greeley, CO 80631 COMPANY D COVERAGES 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 BY 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. LTR TYPE OF INSURANCE POUCY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE(MWDD/YY) DATE(MOONY) A GENERAL LIABIUTY NP0763585 01/26/00 01/26/01 GENERAL AGGREGATE $1, 000, 000 X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG Si, 000, 000 CLAIMS MADE X. OCCUR PERSONAL&ADV INJURY $1, 000, 000 OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $1, 000, 000_ FIRE DAMAGE(Any one fire) $ 50 , 000 MED EXP(Any one person) $ 5 , 000 A AUTOMOBILE LIABILITY NP0763585 01/26/00 01/26/01 Si, 000, 000 X ANY AUTO COMBINED SINGLE LIMIT ALL OWNED AUTOS BODILY INJURY S SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS '.(Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY i AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY __ EACH ACCIDENT S _ AGGREGATE $ B EXCESSUABIUTY A4876520 01/26/00 01/26/01 EACH OCCURRENCE $3 , 000, 000 X UMBRELLA FORM AGGREGATE 0 , 000, 000 OTHER THAN UMBRELLA FORM ;S - WORKERS COMPENSATION AND STATUTORY LIMITS BI EMPLOYERS'UAUTY i; EACHI ACCIDENT S ,__- THE PROPRIETOR/ Ij INCL DISEASE-POLICY LIMIT $ PARTNERS/EXECUTIVE -- I OFFICERS ARE EXCL! DISEASE-EACH EMPLOYEE S A : OTHER - 1 NP0763585 _ ' 01/26/00 : 01/26/01 1, 000, 000 Each Claim Professional Liab'' 1, 000, 000 Aggregate I DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/$PECIAL ITEMS Certificate Holder is an additional insured on general liability policy regarding Restitution Program for youths to work to repay victims . CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE City Of Evans - EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 1100 37th Street '30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Evans, CO 80620 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBUGATION OR LIABILITY OF ANY KIND UPON THE, COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REP $ETJT a ,, � ."•'''.."•'''. ,/ III/// I .7" r ' I ACORD 25-(W93)1 of 1 #S88742/M88731 ar-.`-'"-) -WGK a ACORD.CORPORATION 1993 Mentoring Services Effectiveness Index Partners. Partners, Inc. An Association of Affiliated Youth Mentorship Programs 701 S. Logan Street, Suite 10 Denver, CO 80209 303-698-0808 MSEI: Individual Profile Information PRE-MATCH Copyright© 1998 by Partners, Inc. All right reserved. Affiliate : Case#: Edition 98-1 Date Given: Staff Name: This evaluation instrument was developed by Partners, Inc., ' P1. Ethnicity: a. Hispanic b. White c. Asian/PI d. Black an association of affiliated youth-mentoring organizations. It e. Native American f. Other P1 was designed specifically as a means for assessing the P2. Gender: Mate Female effectiveness of the Partners model of youth mentoring, which P2 all affiliates operate in accordance with Partners Association P3. Youth lives with: Standards of Accreditation. a. Both birth parents b. 1 Parent : M F Edition 98-1 is a pilot design. The scales included are c. 1 Parent& 1 Step-parent d. Legal guardian eavailable public domain evaluation tools. The specific f. 1 Extended Per& Sig. ay P3 f. family(grandparents/uncle/older sibling) scale sources are listed on page 20. g. Other: Although the scales that comprise it have themselves been P4. Youth is placed outside the home in: empirically tested and determined to be reliable, this a. Not Applicable b. RCCF instrument, and, therefore, the use of the included scales in c. Extended Family Home d. Foster Home the current arrangement, has not yet been evaluated. e. Dept. of Youth Corrections P4 Due to the pilot nature of this instrument, its specific design focus on the Partners mentoring model, Scale: Y=Yes N =No U = Unknown and the controlled data collection and analysis protocol established for its pilot testing, its use by other mentoring P5. Family lives at poverty level (I.e., family receives Y N U _ programs or services is both inappropriate and prohibited. AFDC; youth on Medicaid; family homeless)? P5 P6. Family is low-income (i.e., receives Food Stamps; Y N U For further information on this instrument, contact: housing assistance)? P6 Partners, Inc. P7. At least one parent is incarcerated? Y N U _ 701 S. Logan Street, Suite 10 P7 Denver, CO 80209 r P8. At least one parent has been incarcerated? Y N U 303-698-0808 P8 P9. At least one sibling is incarcerated? Y N U _ P9 1 P10. At least one sibling has been incarcerated? Y N U P10 P25. Youth has used ATOD in the past but not now? Y N U _ P25 P11. At least one parent abuses/has abused Y N U alcohol or drugs? P11 P26. Youth is involved with gangs? Y N U _ P26 P12. At least one other immediate family member Y N U abuses/has abused alcohol or drugs? P12 P27. Youth is sexually active? Y N U _ P27 P13. Youth experiences chronic school problems? Y N U P13 P28. Youth has been found guilty of a crime? Y N U _ P28 P14. Youth has dropped out of school? Y N U P14 P29. Youth has self-reported a crime? Y N U _ P29 P15. Youth has been expelled from school? Y N U P15 P30. Youth is or has been pregnant? Y N U P30 P16. Youth has been suspended from school? Y N U P16 P31. Youth has fathered a child? Y N U _ P31 P17. Youth is a victim of physical abuse/neglect? Y N U P17 P32. Youth has set fire to something he/she Y N U shouldn't have? P32 P18. Youth is a victim of sexual abuse? Y N U P18 P33. If P32 is yes, besides the above incident, how many other times has he/she played with fire P33 P19. Youth has run away from home? Y N U including matches or lighters or set something P19 on fire he/she shouldn't have? P20. Youth has been placed out of the home? Y N U P.34 Date of Birth P20 P.35 Primary source of funds for services to this youth. P21. Youth has attempted suicide? Y N U Select only one. P21 a. N/A b. DCJ P22. Youth uses alcohol? Y N U c. ADAD -- S.O. d. ADAD -- Safe Harbor P22 e. YCPI f. SB 94 g. Other P23. Youth uses tobacco? Y N N P43 P.36 Secondary source of funds for services to this youth. Select no more than two. P24. Youth uses other drugs? Y N U P24 a. N/A b. DCJ 2 c. ADAD -- S.O. d. ADAD -- Safe Harbor e. YCPI f. $6 94 g. Other 3 MSEI: PRE-MATCH ADMINISTRATION 2. How close or attached are you to school? a. A great deal (5) A. Self-confidence/Self-esteem SA A D SD b. Quite a it(4) (12) c. Some(3) d. Not too much (2) 1. I feel that I have many good qualities. 4 3 2 1 e. Very little/none(1) (1) 3. How much support and encouragement a. A great deal (5) 2. I feel that I am a failure. 1 2 3 4 have you received at school? b. Quite a bit(4) (13) (2) c. Some(3) d. Not too much (2) 3. I feel useless at times. 1 2 3 4 e. Very little/none(1) (3) 4. How much loyalty do you have for a. A great deal (5) 4. I take a positive attitude towards myself. 4 3 2 1 school? b. Quite a bit(4) (14) (4) I c. Some (3) d. Not too much(2) 5. On the whole, I am satisfied with myself. 4 3 2 1 e. Very little/none (1) (5) D. Individual/Peer Violence Attitudes 6. At times, I think I am no good at all. 1 2 3 4 (6) SA-Strongly Agree SD-Strongly Disagree A-Agree D -Disagree B. Future Orientation SA A D SD 1. I plan to graduate from high school. 4 3 2 1 _ (7) 1. It's all right to physically beat up people 1 2 3 4 2. I plan to go to college or trade school. 4 3 2 1 who call you names. (15) (8) 2. It's ok to steal something knowing that the 1 2 3 4 _ 3. I have a dream of a job I would like. 4 3 2 1 victim's insurance will pay for it. (16) (9) 3. If people do something to make you really 1 2 3 4 4. I think about what I will be doing 6 months 4 3 2 1 mad, they deserve to be beaten up. (17) from now. (10) 4. It's ok to rob someone for money in order 1 2 3 4 C. School Bonding to buy food. (18) 1. During the week, how much time do you a. A great deal (5) 5. You should never beat up another person. 4 3 2 1 generally spend at school or doing b. Quite a bit(4) (11) (19) homework? c. Some (3) d. Not too much (2) 6. Sometimes you have to commit crimes in 1 2 3 4 e. Very little/none (1) order to survive. (20) 4 I 5 E. Individual Delinquency 3- 1- During the past YEAR, how many times have you: ABOUT: ED EW EM 11 2 0 About About About 11. taken a vehicle (e.g., bicycle, 1 2 3 4 5 6 Every Every Every 3-11 1-2 0 car, motorcycle)for a ride without (31) Day Week Month Times Times Times the owner's permission? 3- 1- 12. broken into or tried to break into 1 2 3 4 5 6 _ ABOUT: ED EW EM 11 2 0 a building or vehicle to steal (32) something or just look around? 1. purposely damaged or destroyed 1 2 3 4 5 6 property? (21) 13 gone out at night when your 1 2 3 4 5 6 _ parents told you that you couldn't? (33) 2. stolen or tried to steal a motor 1 2 3 4 5 6 • vehicle such as a car or motorcycle? (22) 14. drawn graffiti, or written things, or 1 2 3 4 5 6 _ drawn pictures on buildings or other (34) 3. stolen something worth more than 1 2 3 4 5 6 _ property(without the owner's permission)? five dollars? (23) 15. sold illegal drugs? 1 2 3 4 5 6 4. carried a handgun? 1 2 3 4 5 6 (35) (24) 16. run away from home and stayed 1 2 4 5 6 _ 5. stolen something worth five dollars 1 2 3 4 5 6 away at least overnight? (36) or less? (25) 17. ridden in a car with a driver who 1 2 3 4 5 6 6. attacked someone with the idea of 1 2 3 4 5 6 has been drinking alcohol? (37) seriously hurting that person? (26) 18. driven a car while drunk? 1 2 3 4 5 6 7. used force to get money or things 1 2 3 4 5 6 _ (38) from people? (27) 19. gotten drunk or had 5 or more 1 2 3 4 5 6 8. been arrested by the police? 1 2 3 4 5 6 _ drinks at one sitting? (39) (28) F. ATOD USE 9. been in gang fights? 1 2 3 4 5 6 (29) 1. Have you ever iniected drugs? 1. YES 2. NO (40) 10. hit or threatened to hit someone? 1 2 3 4 5 6 During the past YEAR, how many times have you used: (30) 3- 1- ABOUT: ED EW EM 11 2 0 2. Tobacco (cigarettes/smokeless)? 1 2 3 4 5 6 (41) 6 7 3- 1- ABOUT: ED EW EM 11 2 0 3- 1- ABOUT: ED EW EM 11 2 0 3.Alcohol(beer/wine/liquor)? 1 2 3 4 5 6 I (42) 16. Hallucinogens/Psychedelics? 1 2 3 4 5 6 _ 4. Marijuana/hash? 1 2 3 4 5 6 (Mushrooms/LSD) (55) (43) 5. Inhalants (Glue/Paint)? 1 2 3 4 5 6 17. Cocaine(Coke/Crack)? 1 2 3 4 5 6 (44) (56) 6. Hallucinogens/Psychedelics? 1 2 3 4 5 6 18. Amphetamines (Speed)? 1 2 3 4 5 6 _ (Mushrooms/LSD) (45) (57) 7. Cocaine (Coke/Crack)? 1 2 3 4 5 6 19. Heroin? 1 2 3 4 5 6 (46) (58) 8. Amphetamines(Speed)? 1 2 3 4 5 6 20. Other Drugs? 1 2 3 4 5 6 _ (47) (59) 9. Heroin? 1 2 3 4 5 6 21. Prescription drugs to get high? 1 2 3 4 5 6 (48) (60) 10. Other drugs? 1 2 3 4 5 6 (49) 11. Prescription drugs to get high? 1 2 3 4 5 6 (50) During the past MONTH, how many times have you used: 3- 1- ABOUT: ED EW EM 11 2 0 12. Tobacco(cigarette/smokeless)? 1 2 3 4 5 6 (51) 13. Alcohol (beer/wine/liquor)? 1 2 3 4 5 6 (52) 14. Marijuana/hash? 1 2 3 4 5 6 (53) 15. Inhalants (Glue/Paint?) 1 2 3 4 5 6 (54) 8 9 MSEI: Individual Profile Information MATCH COMPLETION P10. At least one sibling has been incarcerated? Y N U P10 Affiliate : Case#: P11. At least one parent abuses/has abused Y N U Date Given: Staff Name: alcohol or drugs? P11 P12. P1. Ethnicity: a. Hispanic b. White c. Asian/PI d. Black At least one other immediate family member Y N U _ abuses/has abused alcohol or drugs? P12 e. Native American f. Other P1 P2. Gender: Male Female P13. Youth experiences chronic school problems? Y N U P13 P2 P3. Youth lives with: P14. Youth has dropped out of school? Y N U P14 a. Both birth parents b. 1 Parent : M F c. 1 Parent& 1 Step-parent d. Legal guardian P15. Youth has been expelled from school? Y N U _ e. 1 Parent& Sig. Other P3 P15 f. Extended family(grandparents/uncle/older sibling) g. Other: P16. Youth has been suspended from school? Y N U P16 P4. Youth is placed outside the home in: a. Not Applicable b. RCCF P17. Youth is a victim of physical abuse/neglect? Y N U _ P17 c. Extended Family Home d. Foster Home e. Dept. of Youth Corrections P4 P18. Youth is a victim of sexual abuse? Y N U _ Scale: Y=Yes N = No U = Unknown P18 P5. Family lives at poverty level (I.e., family receives Y N U P19. Youth has run away from home? Y N U AFDC; youth on Medicaid;family homeless)? P5 P19 P6. Family is low-income(i.e., receives Food Stamps; Y N U P20. Youth has been placed out of the home? Y N U housing assistance)? P8 P20 P7. At least one parent is incarcerated? Y N U P21. Youth has attempted suicide? Y N U P— 7 P21 P8. At least one parent has been incarcerated? Y N U P22. Youth uses alcohol? Y N U _ P8 P22 P9. At least one sibling is incarcerated? Y N U P23. Youth uses tobacco? Y N N P9 P23 P24. Youth uses other drugs? Y N U _ P24 10 11 MSEI: MATCH COMPLETION P25. Youth has used ATOD in the past but not now? Y N U SA-Strongly Agree A-Agree P25 D - Disagree SD-Strongly Disagree P26. Youth is involved with gangs? Y N U A. Self-confidence/Self-esteem SA A D SD P26 1. I feel I have many good qualities. 4 3 2 1 P27. Youth is sexually active? Y N U _ (1) P27 2. I feel that I am a failure. 1 2 3 4 P28. Youth has been found guilty of a crime? Y N U (2) P28 3. I feel useless at times. 1 2 3 4 P29. Youth has self-reported a crime? Y N U _ (3) P29 4. I take a positive attitude towards myself. 4 3 2 1 _ P30. Youth is or has been pregnant? Y N U (4) P30 5. On the whole, I am satisfied with myself. 4 3 2 1 P31. Youth has fathered a child? Y N U (5) P31 6. At times, I think 1 am no good at all. 1 2 3 4 (6) P32. Youth has set fire to something he/she Y N U B. Future Orientation shouldn't have? P32 besides the above incident, how 1. I plan to graduate from high school. 4 3 2 1 P33. If P32 is yes, (7) many other times has he/she played with fire P33 including matches or lighters or set something 2. I plan to go to college or trade school. 4 3 2 1 on fire he/she shouldn't have? (8) 3. I have a dream of a job I would like. 4 3 2 1 (9) 4. I think about what I will be doing 6 months 4 3 2 1 _ from now. (10) C. School Bonding 1. During the week, how much time do you a. A great deal (5) generally spend at school or doing b. Quite a bit(4) (11) homework? c. Some (3) d. Not too much (2) e. Very little/none(1) 13 12 E. Individual Delinquency 2. How close or attached are you to school? a. A great deal (5) During the past YEAR, how many times have you: b. Quite a bit (4) (12) c. Some (3) About About About d. Not too much (2) Every Every Every 3-11 1-2 0 e. Very little/none(1) Day Week Month Times Times Times 3. How much support and encouragement a. A great deal (5) 3- 1- have you received at school? b. Quite a bit (4) (13) ABOUT: ED EW EM 11 2 0 c. Some(3) d. Not too much (2) 1. purposely damaged or destroyed 1 2 3 4 5 6 _ e. Very little/none(1) property? (21) 4 How much loyalty do you have for a. A great deal (5) 2. stolen or tried to steal a motor 1 2 3 4 5 6 school? b. Quite a bit(4) (14) vehicle such as a car or motorcycle? (22) c. Some(3) d. Not too much (2) 3. stolen something worth more than 1 2 3 4 5 6 _ e. Very little/none(1) five dollars? (23) D. Individual/Peer Violence Attitudes 4. carried a handgun? 1 2 3 4 5 6 SA-Strongly Agree SD-Strongly Disagree (24) A-Agree D - Disagree 5. stolen something worth five 1 2 3 4 5 6 SA A D SD dollars or less? (25) 1. It's all right to physically beat up people 1 2 3 4 6. attacked someone with the idea of 1 2 3 4 5 6 _ who call you names. (15) seriously hurting that person? (26) 2 It's ok to steal something knowing that the 1 2 3 4 7. used force to get money or things 1 2 3 4 5 6 _ victim's insurance will pay for it. (16) from people? (27) 3. If people do something to make you really 1 2 3 4 8. been arrested by the police? 1 2 3 4 5 6 mad, they deserve to be beaten up. (17) (28) 4. It's ok to rob someone for money in order 1 2 3 4 9. been in gang fights? 1 2 3 4 5 6 to buy food. (18) (29) 5. You should never beat up another person. 4 3 2 1 10. hit or threatened to hit someone? 1 2 3 4 5 6 (19) (30) 6. Sometimes you have to commit crimes in 1 2 3 4 _ order to survive. (20) 15 14 3- 1- ABOUT: ED EW EM 11 2 0 3- 1- ABOUT: ED EW EM 11 2 0 3. Alcohol (beer/wine/liquor)? 1 2 3 4 5 6 (42) 11. taken a vehicle(e.g., bicycle, 1 2 3 4 5 6 car, motorcycle)for a ride without (31) 4. Marijuana/hash? 1 2 3 4 5 6 _ the owner's permission? (43) 12. broken into or tried to break into 1 2 3 4 5 6 5. Inhalants (Glue/Paint)? 1 2 3 4 5 6 a building or vehicle to steal (32) (44) something or just look around? 6. Hallucinogens/Psychedelics? 1 2 3 4 5 6 13 gone out at night when your 1 2 3 4 5 6 _ (Mushrooms/LSD) (45) parents told you that you couldn't? (33) 7. Cocaine (Coke/Crack)? 1 2 3 4 5 6 14. drawn graffiti, or written things, or 1 2 3 4 5 6 _ (45) drawn pictures on buildings or other (34) property (without the owner's permission)? 8. Amphetamines(Speed)? 1 2 3 4 5 6 _ (46) 15. sold illegal drugs? 1 2 3 4 5 6 (35) 9. Heroin? 1 2 3 4 5 6 _ (47) 16. run away from home and stayed 1 2 3 4 5 6 away at least overnight? (36) 10. Other drugs? 1 2 3 4 5 6 _ (48) 17. ridden in a car with a driver who 1 2 3 4 5 6 has been drinking alcohol? (37) 11. Prescription drugs to get high? 1 2 3 4 5 6 _ (49) 18. driven a car while drunk? 1 2 3 4 5 6 During the past MONTH how many times have you used: (38) 3- 1- 19. gotten drunk or had 5 or more 1 2 3 4 5 6 ABOUT: ED EW EM 11 2 0 drinks at one sitting? (39) F. ATOD USE 12. Tobacco(cigarette/smokeless)? 1 2 3 4 5 6 (50) 1. Have you ever injected drugs? 1. YES 2. NO 13. Alcohol (beer/wine/liquor)? 1 2 3 4 5 6 (40) (51) During the past YEAR, how many times have you used: 14. Marijuana/hash? 1 2 3 4 5 6 3- 1- (52) ABOUT: ED EW EM 11 2 0 15. Inhalants (Glue/Paint?) 1 2 3 4 5 6 2. Tobacco (cigarettes/smokeless)? 1 2 3 4 5 6 53 (41) 17 ( ) 16 DEFINITIONS 3- 1- Listed below are definitions for the words/terms/phrases that may be ABOUT: ED EW EM 11 2 0 unclear or unknown to younger kids. These terms are underlined in the instrument. In order to ensure as much consistency as possible in 16. Hallucinogens/Psychedelics? 1 2 3 4 5 6 _ administering the instrument, please use only these definitions when the (Mushrooms/LSD) (53) youth to whom you are giving the Index needs clarification for the term in question. 17. Cocaine (Coke/Crack)? 1 2 3 4 5 6 Item# Word/Term/Phrase Definition (54) A. 1 "good qualities" Things I like about myself. 18. Amphetamines (Speed)? 1 2 3 4 5 6 (55) 5 "satisfied with myself' Happy with who I am. • 19. Heroin? 1 2 3 4 5 6 B. 2 "trade school" A school where you learn how to do jobs (56) like electrician, mechanic, or plumber. 20. Other Drugs? 1 2 3 4 5 6 _ C. 4 "loyalty" A feeling of being close to and wanting to (57) be a part of. 21. Prescription drugs to get high? 1 2 3 4 5 6 D. 2 "victim" A person who is hurt or made to feel bad (58) by something that you do or did. "insurance" Something a person has that will pay for the loss of or damage to something they own. E. 14 "graffiti" Words, pictures, or designs someone paints on something public like a building, or wall, or sidewalk. 15 "illegal" Against the law. F. 1 "injected" Put into your body with a needle; like getting a shot at the doctors office. 19 18 Scale Sources Scale A: Self-confidence/Self-esteem Rosenberg Self-esteem Scale. Rosenberg, Morris (1979). Conceiving the Self. New York: Basic Books. Scale modified by James Moran, University of Denver. Scale B: Future Orientation Partners Evaluation Instrument (PEI). Partners, Inc. (1995) Scale C: School Bonding; Scale D: Individual/Peer Violence Attitudes; Scale E: Individual Delinquency; Scale F: ATOD Use Omni Survey. Omni Research & Training, Inc. (199?) SUPPLEMENTAL NARRATIVE TO RFP: EXHIBIT B RECOMMENDATION(S) Srtners. . F. v. Helping Youth Help Themselves May 18, 2000 Families, Youth and Children Commission Weld County Department of Social Services P.O. Box A Greeley, CO 80632 Dear Commission Members: Weld County Partners would like to thank the Families, Youth and Children (FYC) Commission for approving Partners to be listed on your vendor list. We look forward to working with Social Services to continue to provide our Mentor/Advocate services for your clients. In your recent letter you also listed the following recommendation and asked that we respond by May 24th in writing. The following is the recommendation along with our response: RFP 00005, Lifeskills: Recommendation: Partners would come closer to meeting the department's needs if professional staff is used as counselors in the client's home. Response: As part of our 2000-2001 contract we have added that Social Services will provide a treatment plan to Partners and we will develop a case management plan for each family and the MAP provider based on this plan. The goals, timelines and measurements for success could be discussed and contracted to at the time of match/introduction if all the necessary information is provided in advance. Through this process we will evaluate the needs of the clients and we can assess what services will be available. Our primary focus will continue to be the Mentor/Advocate working with the family. When problems arise that the Partners' counselors ate needed, they are available to provide these types of services. Please let me know if there is any additional information you may need. Thanks again for your support of the Mentor/Advocate program. Sincerely, Michael Muskin Executive Director 1212 8th Street• Greeley, Colorado 80631 • (970) 351-0700• Fax (970) 351-0562 Toll Free 1-877-351-0700 • E-Mail: partners@info2000.net•www.info2000.net/—partners/ g _ ;e t F9 DEPARTMENT OF SOCIAL SERVICES PO BOX A GREELEY,CO 80832 Administration and Public Assistance(970)352-1551 Child Support(970)352-6933 ig COLORADO May 10, 2000 Mr. Michael Muskin, Executive Director North Colorado Youth Alternatives dba Partners 1212 8th Street Greeley, CO 80631 Re: RFP 00005, Lifeskills Dear Mr. Muskin: The purpose of this letter is to outline the results of the.RFP Bid process for PY2000-2001 and to request written information or confirmation from you by Wednesday, May 24, 2000. A. Results of the RFP Bid Process for PY 2000-2001 On April 20, 2000, the Families, Youth and Children(FYC) Commission approved the RFP(s) listed above for inclusion on our vendor list. The FYC Commission attached the following recommendations and/or conditions regarding your RFP bid(s). RFP 00005. Lifeskills: Recommendation: Partners would come closer to meeting the department's needs if professional staff is used as counselors in the client's home. A. Required Response by REP Bidders Concerning FYC Commission Recommendations The Weld County Department of Social Services is requesting your written response to the FYC Commission's recommendations and conditions. Please respond in writing to Frank Aaron, Weld County Department of Social Services, P.O. Box A, Greeley, CO, 80632, by Wednesday, May 24, 2000, close of business as follows: You are requested to review the recommendations and to: • 1. accept the recommendation(s) as written by the FYC Commission; or 2. request alternatives to the FYC Commission's recommendation(s); or 3. not accept the recommendation(s) of the FYC Commission. Page 2 North Colorado Youth Alternatives, dba Partners Results of RFP Bid Process PY 2000-2001 Please provide in writing how you will incorporate recommendation(s) in your bid. If you do not accept the recommendation, please provide reasons why. All approved recommendations under the NOFAA will be monitored and evaluated by the FYC Commission. If you wish to arrange a meeting to discuss the above recommendation, please do so through Elaine Furister, 352.1551, extension 6295, and one will be arranged prior to Wednesday, May 24, 2000. Sincerely, A. .ego, 1 ID recto e i ty De ment of Social Services JG:ef cc: Esteban Salazar, Chair, FYC Commission Frank Aaron, Social Services Administrator Hello